REVIEW OF SYSTEMS: General: Has gained about 10 lb in the past 4 yr, no fatigue Skin: No rashes or other changes Head: See present illness. Eyes: Reading glasses for 5 yr, last checked 1 yr ago. No double or blurry vision Ears: Hearing good. No tinnitus, vertigo, infections Nose, Sinuses: occasional mild cold. No hay fever, sinus trouble Mouth and Throat: Last to dentist 2 yr ago. Occasional canker sore Neck: No lumps, goiter, pain Breasts: No lumps, pain, discharge. Habits: Patient claims to have quit smoking about two years ago. FAMILY HISTORY - Mother died, 67, stroke; had varicose veins, headaches, hypertension - Father died, 43, train accident