Patient Note — 251066

4/23/26, 6:45 AM Print Preview [PATIENT_NAME] DOB: [DOB] (48 yo F) Acc No. [ACCOUNT_ID] DOS: 04/21/2026 TV-F/U Patient: [PATIENT_NAME] Provider: [PATIENT_NAME], MD Account: [ACCOUNT_ID]: [ACCOUNT_ID] DOB: [DOB] Age: 48 Y Sex: Female Date: 04/21/2026 Phone: [PHONE] Address: [ADDRESS] Pcp: [PATIENT_NAME] Subjective: Chief Complaints: 1. 2 MONTH FU REV LABS. HPI: Kidney Stone: 48yF w/ hx of right flank pain and kidney stones, s/p R ureteral stent placement 05/02/2025; subsequant R CVAC [06/04/2025], presents here today for 2-month followup. Pt was seen via doximity. Pt continues to c/o intermittant sharp R flank pain. No f/c/v, GH. She went to ER earlier and was dx with kidney infection. She says she was rx Keflex and Hydrocodone but pain remains bothersome. ----------------------------------------- Nephrolithiasis Exp occasional sharp pain on the R flank side, x1-5 times a day. Her pain is random in nature. Exp occasional nausea. S/p R URS/LL (01/08/2026). RBUS (02/02/2026): Mild L hydronephrosis. No hydronephrosis on R. No discrete solid mass within either kidney. Patient reports experiencing right-sided flank pain, which is sharp and intermittent. Hx of right PCNL (2009), right URS/LL (2015) ***************************************** The patient's previous work-up history is listed below: Litholink 24 Hr Urine (03/2026): Urine Volume (Preserved)-2320; Citrate, Urine-293; Sodium, Urine- 231; Ammonium, Urine-14; Chloride, Urine-266; Sulfate, Urine- 24 RBUS: Mild BL hydro. Unchanged BL renal stones, measuring 8mm RLP and up to 4 mm LLP. Mild increased echogenicity of the kidneys with focal areas of parenchymal scarring. Normal bladder mucosa (Aug '25) CT A/P: Residual stones in the right kidney, non-obstructive, up to 6mm. Also mild left-sided hydronephrosis without any intra-ureteral stones.(07/17/2025). CT Abd/Pelvis (June 2025): 1. Bilateral intrarenal stones measuring up to 0.7cm at the inferior pole on the right. No ureteral stone. 2. Extensive right renal cortical scarring, stable relative to the prior CT of 5/20/2022. 3. Bilateral ureteral urothelial thickening, nonspecific but request correlation with urinalysis and urine culture to exclude acute urinary tract infection. Lasix renal scan: No evidence of obstruction (May 2025) Stone Analysis (June 2025): Calcium Oxalate Monohydrate [65%], Calcium Oxalate Dihydrate [30%], Calcium Phosphate [5%]. Provider: [PATIENT_NAME], MD Date: 04/21/2026 1/3 4/23/26, 6:45 AM Print Preview [PATIENT_NAME] DOB: [DOB] (48 yo F) Acc No. [ACCOUNT_ID] DOS: 04/21/2026 CT ap iv: BL renal nonobstructing calculi, largest measuring up to 13 mm in LP right kidney. Significant scarring and volume loss, similar to previous exam (Mar'25) CR 0.60, Ca10.0, eGFR 111 (Mar'25). ROS: 12 system Review of Systems completed in the chart and all pertinent positives and negatives reviewed with the patient . Medical History: type II diabetes, High blood pressure, High cholesterol, Kidney stone. Surgical History: parathyroidectomy , la