Physician To The President, The White House, January 16, 2018 Memorandum For: Sarah Sanders, Assistant To The President and White House Press Secretary From: Ronny L. Jackson, MD; Physician To The President; Rear Admiral, U.S. Navy Subject: The President's Periodic Physical Exam President Donald J. Trump has completed his first periodic physical examination as President of the United States. I performed and supervised the examination with appropriate specialty consultations and diagnostic testing. The exam was conducted January 12, 2018 at the Walter Reed National Military Medical Center. The purpose of this exam was to provide the public with an update of the President's current health status and to ensure the President continues to enjoy all the benefits of good health. This examination focused on evidence-based health screening and disease prevention. With President Trump's consent, I release the following health information: Vital Statistics Age: 71 years, 7 months Height: 75 inches Weight: 239 pounds Resting heart rate: 68 bpm Blood pressure: 122/74 mm Hg Pulse-oximetry: 99% room air Temperature: 98.4 degrees F Physical Examination by System (to include studies) Eyes: Uncorrected visual acuity was 20/30 bilaterally, with corrected visual acuity of 20/20 bilaterally. Visual fields were normal. Fundoscopic exam was normal bilaterally. Intraocular pressures were normal bilaterally. No ocular pathology was discovered. Head/Ears/Nose/Throat: Normal exam of the head, ears, nose, mouth, and throat. Dental: Healthy teeth and gums. Neck: Normal thyroid exam. No noted lymphadenopathy. Auscultation of the carotid arteries normal Pulmonary: Lungs clear to auscultation. A screening Low Dose CT of the chest demonstrated no pulmonary pathology. Cardiac: Heart exam normal. Regular rhythm. No murmurs or other abnormal heart sounds noted. ECG with normal sinus rhythm, rate of 71, normal axis, and no other significant findings. Transthoracic Echocardiogram demonstrated normal LV systolic function, EF 60-65%, normal LV chamber size and wall thickness, no wall motion abnormalities. RV normal, atria grossly normal, all valves normal. Exercise Stress Echocardiogram demonstrated above average exercise capacity based on age and sex, and normal heart rate, blood pressure, and cardiac output response to exercise. No evidence of ischemia noted and wall motion was normal in all images. Gastrointestinal: Normal exam. No masses, hepatomegaly or splenomegaly noted. Normal optical colonoscopy with no polyps or abnormal findings completed June 2013. Repeat colonoscopy not indicated and was deferred until next periodic physical exam. Genitourinary: Normal exam. Extremities/Musculoskeletal: Normal throughout. Full range of motion in all joints. Strong distal pulses and good capillary refill in all extremities. No swelling or edema noted. Neurological: Examination of cranial nerves, cerebellar function, deep tendon reflexes, motor function, and sensory system all normal. Cognitive Screening Exam using the Montreal Cognitive Assessment was normal with a score of 30/30. Dermatologic: Normal exam. No evidence of melanoma, basal cell carcinoma, squamous cell carcinoma, or any other significant dermatologic disease. Laboratory Results - Lipid Panel: Total cholesterol: 223 (mg/dL); Triglycerides: 129 (mg/dL); HDL cholesterol: 67 (mg/dL); LDL cholesterol: 143 (mg/dL); Cholesterol to HDL ratio 3.3; Laboratory Results - Complete Blood Count: WBC: 5.5 (KJUL); HGB: 16.1 (g/dL); HCT: 48.7 (%); PLT: 241 (KJUL); Laboratory Results - Extended Metabolic Panel: Fasting Blood Glucose: 89 (mg/dL); BUN: 19.0 (mg/dL); CREAT: 0.98 (mg/dL); ALT: 27 (U/L); AST: 19 (U/L); Hemoglobin AlC: 5.0 (%); Vitamin D: 20.0 (ng/ml); PSA: 0.12 (ng/ml); TSH: 1.76 (uIU/m1); Urinalysis:; Appearance: Clear; Protein: Negative; Ketones: Negative; Glucose: Negative; Blood: Negative; Past Medical History: Hypercholesterolemia, Rosacea Past Surgical History: Appendectomy (age 11) Social History: No past or present use of alcohol. No past or present use of tobacco. Medications: Rosuvastatin (Crestor). 10 mg daily to lower cholesterol; Acetylsalicylic Acid (Aspirin). 81mg daily for cardiac health; Finasteride (Propecia). 1 mg daily for prevention of male pattern hair loss; Ivermectin Cream (Soolantra). As needed for treatment of Rosacea; Multi-vitamin (Centrum Silver). Daily for overall health maintenance. Immunizations: Prevnar 13 (to prevent pneumococcal pneumonia) and Twinrix (to prevent hepatitis A/B) given. Routine vaccinations, to include seasonal influenza, all up to date. All indicated travel vaccinations up to date. Summary: The President's overall health is excellent. His cardiac performance during his physical exam was very good. He continues to enjoy the significant long term cardiac and overall health benefits that come from a lifetime of abstinence from tobacco and alcohol. We discussed diet, exercise and weight loss. He would benefit from a diet that is lower in fat and carbohydrates and from a routine exercise regimen. He has a history of elevated cholesterol and is currently on a low dose of Rosuvastatin. In order to further reduce his cholesterol level and further decrease his cardiac risk, we will increase the dose of this particular medication. The President is currently up to date on all recommended preventive medicine screening tests and exams. All clinical data indicates that the President is currently very healthy and that he will remain so for the duration of his Presidency.