Mayo Foundation is developing synonym rich entry points for the recording of patient problems by clinicians, which will map to the KP-Mayo Convergent Medical Terminology. We describe the empirical sources for these terminology components, and how the number and complexity of the terms could be substantially reduced by the introduction of a Qualifier axis. The expressive power of these entry points is dramatically enhanced by this axis. This work is being integrated into terminology navigation modules being jointly developed with Lexical Technology, which leverages UMLS content. It will from the basis for structured problem entry into Mayo's Computer-based Electronic Record.