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A 57 year-old black male patient presenting to the office for a scheduled appointment. Vitals are as follows: BP 131/55; heart rate 155; temperature 98.0 F; O2 Sat 94%. Patient states, “I Feel fine”. Denies shortness of breath, chest pain, nausea, and vomiting, or recent diarrhea. Past medical history is multiple Myeloma, HTN, Anemia, and ESRD with dialysis MWF. Patient admits to smoking 5 minutes prior to vitals being checked.