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{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5900 }
Medical Text: Admission Date: [**2148-12-26**] Discharge Date: [**2148-12-30**] Date of Birth: [**2148-12-26**] Sex: M Service: NEONATOLOGY HISTORY OF PRESENT ILLNESS: This is a 2800 gram, 36 and [**5-6**] week gestation male born to a 31 year old, gravida I, para 0, now I, woman. PRENATAL SCREENS: A positive, antibody negative, RPR nonreactive, rubella immune, hepatitis B surface antigen negative, GBS unknown. Pregnancy complicated by hyperemesis and hypertension. New secondary to pregnancy induced hypertension. Rupture of membranes approximately ten hours prior to delivery. Intrapartum antibiotics started twelve hours prior to delivery. No maternal fever or fetal tachycardia. Infant delivered by cesarean section due to failure to progress. Apgar eight at one minute and eight at five minutes. Nurse practitioner called to evaluate the infant due to grunting. Infant with grunting and retractions. Infant brought to the Neonatal Intensive Care Unit for evaluation of respiratory distress. PHYSICAL EXAMINATION: On admission, birth weight 2800 grams, length 18.5 inches, head circumference 34 centimeters. Anterior fontanelle soft, flat, nondysmorphic, intact palate. Tachypneic with shallow respirations, fair aeration, grunting when disturbed, mild retractions, pink with needle cannula in place. Grade II/VI murmur left sternal border, normal pulses. The abdomen is soft, three vessel cord, no hepatosplenomegaly. Normal male genitalia, both testes descended into scrotum. No hip click. No sacral dimple. Normal tone. HOSPITAL COURSE: 1. Respiratory - The infant was admitted to the Neonatal Intensive Care Unit for respiratory distress shortly after delivery and was placed on nasal cannula and had increased respiratory distress and required nasal CPAP 6.0 centimeters of water, 25% FIO2. Arterial blood gas was pH 7.31, pCO2 46, paO2 71, pCO2 24, base excess -3. The infant was also tachypneic with respiratory rate 80 to 100. Infant transitioned to room air from CPAP by day of life two. The infant remains in room air with respiratory rate 50s to 60s, no apnea or bradycardia this hospitalization. 2. Cardiovascular - The infant has remained hemodynamically stable this hospitalization, no murmur, heart rate 120 to 140 with mean blood pressure 48 to 54. 3. Fluid, electrolytes and nutrition - Initially the infant was NPO receiving 50cc/kg/day of D10W. Enteral feeds were started on day of life two. The infant was advanced to full volume feedings by day of life three. The infant is currently taking a minimum of 60cc/kg/day of breast milk 20 or Enfamil 20 p.o. Glucose has remained stable and has been 69 to 114. The infant tolerated feeding advancement without difficulty. Serum electrolytes were drawn on day of life one which showed a sodium of 138, chloride 103, potassium 4.0, bicarbonate 24. The most recent weight is 2640 grams. 4. Gastrointestinal - The infant had a bilirubin level drawn on day of life three which showed a total bilirubin of 11.1 and a direct of 0.4. The infant is currently not under phototherapy at this time and a repeat bilirubin level is being checked on [**2149-1-10**]. 5. Hematology - The infant has not received any blood transfusions this hospitalization. The hematocrit on admission was 42.0%. 6. Infectious disease - The infant received 48 hours of Ampicillin and Gentamicin for respiratory distress. Blood cultures remained negative to date. The complete blood count on admission showed a white blood cell count of 16.7, hematocrit 42.0%, platelet count 349,000, 68 neutrophils, 4 bands. 7. Sensory hearing screening was performed with automated auditory brain stem responses. The infant passed both ears. 8. Psychosocial - Parents involved. CONDITION ON DISCHARGE: Stable in room air. DISCHARGE DISPOSITION: To Newborn Nursery. PRIMARY PEDIATRICIAN: Dr. [**First Name8 (NamePattern2) 449**] [**Last Name (NamePattern1) **], telephone [**Telephone/Fax (1) 54092**]. FEEDINGS AT DISCHARGE: Breast milk 20 calories per ounce or Enfamil 20 calories per ounce p.o. ad lib, minimum 60cc/kg/day, breast feeding ad lib. MEDICATIONS: None. CAR SEAT POSITION SCREEN: Recommended prior to discharge. STATE NEWBORN SCREEN: Sent on day of life three, results are pending. IMMUNIZATIONS: The infant has not received immunizations this hospitalization. Hepatitis B vaccine is recommended prior to discharge. FOLLOW-UP APPOINTMENTS: Primary pediatrician is scheduled for Friday, [**2149-1-3**]. DISCHARGE DIAGNOSES: 1. Prematurity, 36 and [**5-6**] week gestation male. 2. Status post respiratory distress. 3. Status post rule out sepsis, ruled out. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 35940**], M.D. [**MD Number(1) 35941**] Dictated By:[**Last Name (NamePattern1) 43219**] MEDQUIST36 D: [**2148-12-30**] 16:23 T: [**2148-12-30**] 16:58 JOB#: [**Job Number 54093**] ICD9 Codes: V053
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5901 }
Medical Text: Admission Date: [**2125-5-15**] Discharge Date: [**2125-6-1**] Date of Birth: [**2125-5-15**] Sex: M Service: DISCHARGE DIAGNOSIS: Premature male infant 34 weeks gestation. HISTORY OF PRESENT ILLNESS: [**Known lastname **] is the former 2.040 kilogram male infant born at 34 weeks gestation to a 38 history notable only for a TAB at six weeks gestation. Prenatal screens revealed mother is A negative, group B strep unknown, remaining screens were noncontributory. Rhogam was administered at 28 weeks. Pregnancy was otherwise uncomplicated until hypertension developed one week prior to delivery. Mother was placed on bed rest and admitted to [**Doctor First Name **] worsening hypertension. She was started on magnesium sulfate and one dose of antibiotics prophylaxis was administered one hour prior to delivery. She was induced for progression of pregnancy induced hypertension with subsequent fetal bradycardia to 40 beats per minute leading to stat cesarean section under general anesthesia. The infant emerged with Apgars of 7 and 8. He was admitted to the [**Hospital3 **] Special Care Nursery. On admission he weighted 2.040 kilograms. His head circumference was 32 cm and his length 47.5 cm all appropriate for gestational age. PROBLEMS DURING HOSPITAL STAY: 1. Respiratory: The infant remained in room air throughout the hospital course. He had a rare episode of apnea and bradycardia. He was free of these episodes for five days prior to discharge. 2. Cardiovascular: There were no cardiovascular issues. 3. Infectious disease: An initial CBC was obtained, which had a white count of 8.4 with 17 polys, 2 bands and 79 lymphocytes with a hematocrit of 54.8 and a platelet count of 151,000. There were no risk factors for sepsis and antibiotics were not initiated. Blood culture obtained at the time of CBC was negative at 48 hours. 4. Feeding and nutrition: At the time of discharge the infant weighed 2.325 kilograms. He was feeding ad lib demand of Enfamil 24 with iron ad lib demand and was taken upward of 145 cc per kilogram per day. 5. Hearing screening performed on [**5-26**] and was normal. 6. Circumcision performed on [**5-28**]. 7. Hepatitis B immune vaccine given on [**5-26**]. 8. Hematologic: Mother was A negative, baby A positive, [**Name (NI) 36243**] negative. Peak bilirubin was 12.4 for which he underwent 24 hours of phototherapy. Rebound bili was 6.6. The patient is being discharged home with family. He will have a follow up visit within five days of discharge at [**Hospital1 **] [**Hospital1 8**] Center Dr. [**Last Name (STitle) 41658**]. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], M.D. [**MD Number(1) 38370**] Dictated By:[**Last Name (NamePattern1) 38304**] MEDQUIST36 D: [**2125-5-30**] 09:12 T: [**2125-5-30**] 09:23 JOB#: [**Job Number 41659**] ICD9 Codes: 7742, V053, V290
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5902 }
Medical Text: Admission Date: [**2134-10-14**] Discharge Date: [**2134-11-8**] Date of Birth: [**2066-11-25**] Sex: M Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 3913**] Chief Complaint: fever and hypotension Major Surgical or Invasive Procedure: diagnositic and therapeutic paracentesis PICC line placement Skin biopsy Bronchoscopy Bone Marrow Biopsy Wound Care History of Present Illness: 67 yo male w/ MDS with recent admission from [**Date range (1) 73061**] to surgical service for R. hemicolectomy with end ileostomoy and mucous fistula admitted on [**2134-10-14**] with SIRS/early sepsis with unknown source of infection. . Admission [**Date range (1) 73061**] was for evaluation for bilateral erythema/blisters on arms after injections/ treatment with IM vidaza for his MDS on [**9-20**]. His hospital course was complicated by necrotic bowel and an exp lap was performed with hemicolectomy and end ileostomy and mucous fistula ([**2134-9-28**]). He required intubation for respiratory distress and cardioversion for atrial fibrillation. Also developed VRE (sensitive to daptomycin) in peritoneal fluid, discharged on daptomycin. . ER visits [**10-12**] and [**10-13**]: Presented with concern of infected wound dehisence, evalutated by surgery, discharged with bactrim and keflex for presumed wound infection and concomittant UTI. Represented the following day with hypotension, fever, Hct of 21 and INR of 8. Received total 6 Units PRBC, 1 unit FFP and IVF, vitK. Rt IJ placed, started on Dapto/Zosyn. . SICU admission [**10-14**]: Presentation notable for skin lesion, fever, hypotension, HCT drop, and elevated INR. He was continued on daptomycin and pip-tazo. The patient has had volume responsive hypotension with no current pressor requirement. He underwent U/S-guided paracentesis w/ removal of 2700cc. He was found to have erythema surrounding his abd incision with an additional erythematous nodule on the R thigh. The etiology of the patient's presentation has been unclear, however possible infectious sources include a secondary wound infection vs. hematogenous spread of an alternate underlying infection. The patient's skin findings are felt to be more consistent with inflammatory etiology (as opposed to infectious etiology). Prelim biopsy for hip and peri-incisional biopsies read as neutrophilic dermatosis (pyoderma gangrenosum), though cannout rule out infectious process. . Upon admission to [**Hospital Unit Name 153**] patient reports intermittent abdominal pain mid-abdomen fluctuating in intensity [**2134-4-24**], no radiation. Occasional nausea, no vomitting. Ostomy output loose and brown. Review of systems: (+) Per HPI (-) Denies fever, chills, night sweats, recent weight loss or gain. Denies headache. Denies cough, shortness of breath, or wheezing. Denies chest pain, chest pressure, palpitations. He feels generalized weakness. Denies dysuria, frequency, or urgency. Denies arthralgias or myalgias. Past Medical History: Myelodysplastic syndrome, Carpal tunnel syndrome, COPD. Past Surgical History: L knee surgery, back surgery. Social History: Retired, used to work for a chemical company. History of asbestos and other chemical exposure. He has a history of significant alcohol use, which he stopped approximately seven years ago. 60 pack year history of tobacco use. Has a daughter. Lives alone. Was going to the gym every other day and walking 4 miles before his necrotic bowel surgery. Family History: Per med record: Sister - died of scleroderma; Another sister - died of unclear etiology; Brother - died of EtOH abuse; Daughter with Marfan's; Two brothers are alive and well; Mother - died of lung cancer; Father - died in an MVC. Physical Exam: GEN: no acute distress, lying in bed HEENT: Dry mucous membranes with white plaque on tongue. No LAD. Lungs: coarse breath sounds, expiratory wheezing on right, rhonchi anteriorly, with bibasilar crackles bilaterally CV: tachycardic, regular rhythm, normal S1 S2, no M/G/R. R IJ site c/d/i BACK: no focal tenderness, no CVAT GI: abdomen with large midline open incision extended from pubic symphisis to subxiphoid with serosanguinous drainage. Ostomy with dark necrotic appearing mucosa. GU: foley in place draining yellow urine. MSK: no joint swelling or erythema EXT: trace pitting edema bilaterally SKIN: mucocutaneous fistula site with necrotic center. 2cm nodular lesion on lateral aspect of R thigh with surrounding erythema, warm, and tender to touch. NEURO: CN2-12 grossly intact, UE 5/5 strength, LE RLE [**1-22**] strength and LLE able to lift against gravity. Pertinent Results: Labs upon admission: [**2134-10-13**] 06:35PM BLOOD WBC-8.0 RBC-2.38* Hgb-7.7* Hct-21.9* MCV-92 MCH-32.2* MCHC-34.9 RDW-18.4* Plt Ct-70* [**2134-10-13**] 06:35PM BLOOD Neuts-79.2* Bands-0 Lymphs-13.0* Monos-3.9 Eos-3.6 Baso-0.2 [**2134-10-16**] 05:37AM BLOOD Hypochr-NORMAL Anisocy-1+ Poiklo-1+ Macrocy-1+ Microcy-NORMAL Polychr-NORMAL Ovalocy-1+ Schisto-OCCASIONAL [**2134-10-13**] 06:35PM BLOOD PT-51.0* PTT-45.9* INR(PT)-5.6* [**2134-10-14**] 04:51AM BLOOD Fibrino-625* [**2134-10-18**] 03:33AM BLOOD Gran Ct-1794* [**2134-10-14**] 04:51AM BLOOD Ret Aut-3.1 [**2134-10-18**] 03:33AM BLOOD ACA IgG-PND ACA IgM-PND [**2134-10-13**] 06:35PM BLOOD Glucose-108* UreaN-19 Creat-1.1 Na-129* K-4.0 Cl-96 HCO3-26 AnGap-11 [**2134-10-14**] 04:51AM BLOOD ALT-24 AST-29 LD(LDH)-132 AlkPhos-78 TotBili-2.0* [**2134-10-13**] 06:35PM BLOOD proBNP-1421* [**2134-10-14**] 04:51AM BLOOD Albumin-2.4* Calcium-7.2* Phos-4.2 Mg-1.7 [**2134-10-14**] 04:51AM BLOOD Hapto-268* [**2134-10-17**] 10:40PM BLOOD Ferritn-3219* [**2134-10-17**] 10:40PM BLOOD Triglyc-79 [**2134-10-17**] 04:02AM BLOOD Osmolal-283 [**2134-10-17**] 04:02AM BLOOD TSH-2.4 [**2134-10-17**] 04:02AM BLOOD Cortsol-33.7* [**2134-10-18**] 03:33AM BLOOD ANCA-NEGATIVE B [**2134-10-18**] 03:33AM BLOOD [**Doctor First Name **]-NEGATIVE [**2134-10-14**] 04:44AM BLOOD Type-CENTRAL VE pO2-85 pCO2-38 pH-7.46* calTCO2-28 Base XS-2 Comment-GREEN TOP [**2134-10-13**] 06:46PM BLOOD Glucose-107* Lactate-1.3 Na-130* K-4.1 Cl-94* calHCO3-27 [**2134-10-13**] 06:46PM BLOOD Hgb-8.1* calcHCT-24 [**2134-10-14**] 04:44AM BLOOD freeCa-1.00* Labs upon discharge: WBC RBC Hgb Hct MCV MCH MCHC RDW Plt Ct [**2134-11-8**] 00:10 1.8* 2.80* 8.1* 24.3* 87 28.9 33.4 13.8 26* Platelets post transfusion: 54* Glucose UreaN Creat Na K Cl HCO3 AnGap [**2134-11-8**] 00:10 103*1 35* 0.6 136 4.3 98 33* 9 ENZYMES & BILIRUBIN ALT AST LD(LDH) CK(CPK) AlkPhos Amylase TotBili DirBili IndBili [**2134-11-8**] 00:10 30 15 161 60 0.5 CHEMISTRY TotProt Albumin Globuln Calcium Phos Mg UricAcd Iron [**2134-11-8**] 00:10 3.5 8.7 3.0 2.1 AUTOANTIBODIES ANCA [**2134-10-18**] 03:33 NEGATIVE B1 OLD S# [**Serial Number **]C NEGATIVE BY INDIRECT IMMUNOFLUORESCENCE IMMUNOLOGY [**Doctor First Name **] [**2134-10-18**] 03:33 NEGATIVE B-Glucan, Galactomannan: negative . CXR [**2134-10-13**]: Small bilateral pleural effusions. Equivocal signs for mild pulmonary vascular congestion. Otherwise, unremarkable. . CT Abdomen [**2134-10-13**]: 1. Large volume ascites with mild peritoneal enhancement in the right paracolic gutter. Overall appearance appears simple though given history of recent surgery, peritonitis cannot be excluded. Consider paracentesis with culture. 2. Post operative changes rel;ated to recent bowel resection without evidence of bower obstruction or perforation. 3. Small bilateral pleural effusions with bilateral lower lobe compressive atelectasis. . Right hip skin biopsy [**2134-10-14**]: The findings in both specimens are similar, with intense neutrophilic infiltration of the dermis. The overlying epidermis exhibits neutrophilic spongiosis with foci of spongiform pustulation; in specimen 2, frank cleavage is noted through the spinous layer. No micro-organisms are identified within the inflamed tissue in PAS, GMS, and Gram stained sections . Paracentesis: Technically successful diagnostic and therapeutic paracentesis yielding 2.7 liters of amber clear ascitic fluid, which was sent for microbiology and cell count. . Liver/RUQ Ultrasound [**2134-10-18**]: Ascites. Sludge within the gallbladder. No gallstones. No dilated bile ducts. No focal lesions seen in the liver. Assessment was limited to the liver, gallbladder and related structures. . CXR [**2134-10-19**]: In comparison with the study of [**10-17**], there are continued low lung volumes. Persistent enlargement of the cardiac silhouette with some indistinctness of pulmonary vessels consistent with some elevation of pulmonary venous pressure. Probable mild bilateral effusions with compressive atelectasis. Silhouetting of the left hemidiaphragm is consistent with substantial volume loss in the left lower lobe. . Pertinent Imaging after ICU: . Paracentesis: IMPRESSION: Successful uncomplicated therapeutic and diagnostic ultrasound-guided paracentesis of 1.2 liters of clear ascites. Fluid was sent for Gram stain, culture, cell count, protein, LDH and albumin. . CT Torso: 1. Multifocal ground-glass pulmonary opacities, most compatible with multifocal infectious process. New left lower lobe collapse. 2. Small-to-moderate bilateral pleural effusions, left greater than right, appear simple. 3. Unchanged moderate volume ascites, with mild peritoneal enhancement again seen in the right paracolic gutter. This may again be post-surgical, though clinical correlation is advised to exclude peritonitis. 4. Unremarkable appearance of the large and small bowel, status post right hemicolectomy, with end ileostomy and mucous fistula in the right abdomen. No evidence of abscess formation. 5. Splenomegaly 6. Anasarca. . CT Chest: 1. Markedly improved multifocal lung opacities. The largest area that remains is in the left upper lobe. 2. Mild increase in size in moderate left pleural effusion. Resolved left lower lobe collapse. 3. Splenomegaly . MRI Pelvis: 1. No interval change in the free fluid within the abdomen and pelvis but no abscess seen. 2. Bilateral AVN, more significant on the right side. 3. Extensive subcutaneous edema. . Pathology: R buttock skin biopsy: Superficial and deep perivascular, periappendageal and interstitial dermatitis with prominent neutrophils and overlying papillary dermal edema, epidermal hyperplasia, and spongiosis. See note. Note: The depth of the infiltrate is suggestive of an infection such as bacterial cellulitis. The histologic pattern is not typical of those observed with deep fungal or atypical mycobacterial infections (unless inflammation is more prominent deep to the tissue sampled in this biopsy). The depth of the infiltrate and lack of a more florid neutrophilic infiltrate are unusual for Sweet's syndrome, however, a variety of neutrophilic inflammatory patterns may be observed in patients with myelodysplastic syndrome (MDS) and in association with G-CSF (if clinically applicable). The inflammation is peri-eccrine in areas and focally there are neutrophils involving eccrine units. This finding raises consideration of a neutrophilic eccrine hidradenitis (NEH) in the differential diagnosis. NEH may be observed in association with chemotherapeutic agents and G-CSF. It was recently reported to occur with decitabine, a derivative of azacytidine (Vidaza). . Special stains (Gram, [**Last Name (un) 18566**], PAS, and GMS) are negative for organisms. Culture may be a more sensitive method to detect organisms than histologic special stains. In summary, if infection is excluded, the differential diagnosis includes a neutrophilic infiltrate associated with MDS or a drug associated NEH. Preliminary results of this case were discussed with Dr. [**Last Name (STitle) 73062**] on [**2134-10-28**]. . Microbiology Cultures: Peritoneal: [**2134-10-14**] 2:14 pm PERITONEAL FLUID GRAM STAIN (Final [**2134-10-14**]): NO POLYMORPHONUCLEAR LEUKOCYTES SEEN. NO MICROORGANISMS SEEN. FLUID CULTURE (Final [**2134-10-17**]): NO GROWTH. ANAEROBIC CULTURE (Final [**2134-10-20**]): NO GROWTH. FUNGAL CULTURE (Final [**2134-10-29**]): NO FUNGUS ISOLATED. ACID FAST SMEAR (Final [**2134-10-15**]): NO ACID FAST BACILLI SEEN ON DIRECT SMEAR. ACID FAST CULTURE (Preliminary): NO MYCOBACTERIA ISOLATED. . Time Taken Not Noted Log-In Date/Time: [**2134-10-22**] 3:58 pm PERITONEAL FLUID SOURCE IS PERITONEAL FLUID. **FINAL REPORT [**2134-10-28**]** GRAM STAIN (Final [**2134-10-22**]): NO POLYMORPHONUCLEAR LEUKOCYTES SEEN. NO MICROORGANISMS SEEN. FLUID CULTURE (Final [**2134-10-25**]): NO GROWTH. ANAEROBIC CULTURE (Final [**2134-10-28**]): NO GROWTH. . Tissue Cultures: Time Taken Not Noted Log-In Date/Time: [**2134-10-27**] 4:01 pm TISSUE Source: Skin biopsy. GRAM STAIN (Final [**2134-10-27**]): NO POLYMORPHONUCLEAR LEUKOCYTES SEEN. NO MICROORGANISMS SEEN. TISSUE (Final [**2134-10-30**]): NO GROWTH. ANAEROBIC CULTURE (Final [**2134-11-4**]): NO GROWTH. POTASSIUM HYDROXIDE PREPARATION (Final [**2134-10-28**]): NO FUNGAL ELEMENTS SEEN. FUNGAL CULTURE (Preliminary): NO FUNGUS ISOLATED. ACID FAST SMEAR (Final [**2134-10-28**]): NO ACID FAST BACILLI SEEN ON DIRECT SMEAR. ACID FAST CULTURE (Preliminary): NO MYCOBACTERIA ISOLATED. . Time Taken Not Noted Log-In Date/Time: [**2134-10-27**] 4:01 pm TISSUE Source: Skin biopsy. GRAM STAIN (Final [**2134-10-27**]): NO POLYMORPHONUCLEAR LEUKOCYTES SEEN. NO MICROORGANISMS SEEN. TISSUE (Final [**2134-10-30**]): NO GROWTH. ANAEROBIC CULTURE (Final [**2134-11-4**]): NO GROWTH. POTASSIUM HYDROXIDE PREPARATION (Final [**2134-10-28**]): NO FUNGAL ELEMENTS SEEN. FUNGAL CULTURE (Preliminary): NO FUNGUS ISOLATED. ACID FAST SMEAR (Final [**2134-10-28**]): NO ACID FAST BACILLI SEEN ON DIRECT SMEAR. ACID FAST CULTURE (Preliminary): NO MYCOBACTERIA ISOLATED. . [**2134-10-26**] 12:10 pm Rapid Respiratory Viral Screen & Culture **FINAL REPORT [**2134-10-29**]** Respiratory Viral Culture (Final [**2134-10-29**]): No respiratory viruses isolated. Culture screened for Adenovirus, Influenza A & B, Parainfluenza type 1,2 & 3, and Respiratory Syncytial Virus.. Detection of viruses other than those listed above will only be performed on specific request. Please call Virology at [**Telephone/Fax (1) 6182**] within 1 week if additional testing is needed. Respiratory Viral Antigen Screen (Final [**2134-10-27**]): Respiratory viral antigen test is uninterpretable due to the lack of cells. Refer to respiratory viral culture for further information. REPORTED BY PHONE TO DR [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] 11:05AM [**2134-10-27**]. . [**2134-10-26**] 12:10 pm BRONCHOALVEOLAR LAVAGE GRAM STAIN (Final [**2134-10-26**]): NO POLYMORPHONUCLEAR LEUKOCYTES SEEN. NO MICROORGANISMS SEEN. RESPIRATORY CULTURE (Final [**2134-10-28**]): RARE GROWTH Commensal Respiratory Flora. POTASSIUM HYDROXIDE PREPARATION (Final [**2134-10-28**]): KOH REQUESTED PER DR. [**Last Name (STitle) 6401**] PG #[**Numeric Identifier 73063**]. NO FUNGAL ELEMENTS SEEN. This is a low yield procedure based on our in-house studies. . Immunoflourescent test for Pneumocystis jirovecii (carinii) (Final [**2134-10-27**]): NEGATIVE for Pneumocystis jirovecii (carinii).. FUNGAL CULTURE (Preliminary): YEAST. ACID FAST SMEAR (Final [**2134-10-27**]): NO ACID FAST BACILLI SEEN ON CONCENTRATED SMEAR. ACID FAST CULTURE (Preliminary): NO MYCOBACTERIA ISOLATED. . Please see OMR for BC/UC results. All negative with UC < 100,000 CFU. . Bone Marrow Biopsy: Completed Follow up. Brief Hospital Course: 67 y/o male with MDS s/p R. hemicolectomy with end ileostomy/mucous fistula on [**2134-9-28**], who presented with fluid responsive hypotension and fever. . SIRS/Sepsis/Fever: Upon admission he was intermittently febrile, and his hyoptension was fluid responsive. He did not require vasoactive medication. Possible etiologies included uperinfection of right thigh lesion with neutrophilic dermatosis, post-operative wound infection with wound dehiscence. CT torso was completed without evidence of intraabdominal abscess. He was started on daptomycin and zosyn, later stopped zosyn due to low platelets, switched to ciprofloxacin and flagyl, then finally broadened to meropenum. Discharged from MICU on daptomycin (6 total days given in MICU) and meropenum (2 days given in MICU). He was also empricially covered with meropenem. An infectious cuase for the hypotension was never identified by culture or by serology. ID followed the patient throughout his hospital course, and eventually recommended d/c his antibiotics after his new diagnosis of Sweet's syndrome. Additionally, A workup was also completed including [**Doctor First Name **], ANCA, and anti-cardiolipin out of concern for underlying autoimmune process that could explain the etiology of his fevers. Rheumatology was also consulted, and did not did not recommend any additional work up for his fevers. The most likely etiology for the hypotension was secondary to a wound infection and sepsis. . #MDS/Pancytopenia: Upon admission to the hospital his counts steadily dropped throughout his stay in the MICU. There was initial concern for leukemia in his bone marrow. Hemolysis labs were negative. Reticulocyte count was low. HIT antibody was negative. The differential diagnosis included worsening MDS, AML progression, or other hematopeoieic malignancy. Hemolysis and Smear analysis did not suggest DIC. His counts remained low throughout the hospital course and his WBC count continued to flucuated. He was supported with pRBC's and platelets. He had a BM biopsy prior to discharge and his last ANC was 790. - Please transfuse pRBC's for HCT < 25. - Please transfuse platelets for count < 10 or active signs of bleeding when < 30. - He will need Bactrim, and Acyclovir for PPX due to his low WBC. . #Sweet's Syndrome/Neutrophilic dermatosis: He was found to have an erythematous nodule on his right leg and pain. A skin biopsy was sent which was consistent with neutrophilic dermatosis. Based upon the biopsy in addition to his clinical findings, a diagnosis of Sweet's syndrome was proposed to explain his high grade fevers in addition to his skin lesions. Corticosteroid treatment was not initiated until multiple imaging studies confirmed that there was no infectious process or abscess in his abdomen after his recent surgery. Multiple cultures, both urine and blood, were negative. A bronchoscopy was also preformed after a CT revealed multiple opacities. Subsequently, the BAL was only positive for yeast which was thought to be a non-pathological. The Pulmonology Consult team felt that the infiltrates and skin findings were consistent with Sweet's syndrome. He also developed another sight of pain adjacent to his R sacrum that also had a neutrophilic infiltrate, but not to the degree of the R thigh skin biopsy. The differential diagnosis was neutrophilic dermatosis vs. neutrophilic eccrine hidradenitis. Based upon his clinical symptomology, he was treated empirically for Sweet's syndrome with methylprednisone 1 mg/kg with a slow week taper to 0.5 mg/kg. He was then started on oral prednisone 50 mg/day. He was also started on GI prophylaxis with famotidine, Vit D, and calcium. A non-contrast CT of the lungs demonstrated improvement of his multi-focal opacities, his skin lesions continue to heal, and he has been afebrile since the initiation of steroids. - Please continue prednisone 50 mg/day. Do not taper dose. His steroid course will be determined by Dr. [**Last Name (STitle) **] as an outpatient. - Please continue Ca/Vit D and Famotidine for steroid prophylaxis - Please continue PO dilaudid for Pain, may wean as patient tolerates . # End ileostomy/mucous fistula s/p hemicolectomy: He presented with wound dehisence. His intial presentation may have been secondary to infection of his wound. He was initially started on broad spectrum antibiotics with minimal improvement in his wound healing. After the initiation of corticosteroids for Sweet's syndrome the erythema along the margins of his wound improved. He subsequently developed granulation tissue, and his wound continues to demonstrate healing. - Please continue daily wound care as outlined in attached notes - Scheduled for follow up as outlined above . Hyponatremia: The patient had persistent hypnatremia that was secondary to Hypervolemia due to fluid resuscitation, and Sweet's syndrome with SIADH due to infilatrates in the lung. Urine osms were consistenly elevated relative to [**Name2 (NI) **] osms. His [**Name2 (NI) **] sodium remained > 128 while on the floor. He was placed on fluid restriction and subsequently allowed to autodiuresis. His sodium level stabilized and he was no longer fluid restricted. - No fluid restriction . # Hyperglycemia: His sugars have been monitor QID, and he has been placed on an ISS with lantus to help regulate his blood glucose levels. His sugars have flucuated between 150's -200's. - Please keep blood glucose less than 180's. . # Decreased hearing: Patient had large cerumen plug in left ear. Patient received ear drops which were ineffective. His ear canals were clear by examination, and ENT was consulted for hearing loss. It was believed to be sensorineural, and an audiology test confirmed the hearing loss in his R ear. He will be followed up by ENT for a hearing aide. . # Ascites: He had a paracentesis on [**2134-10-14**] with removal of 2.7L of fluid which did not demonstrate any infection. He had an additional paracentesis which did not reveal SBP. He continues to have ascites without any evidence of infection. although the volume decreased throughout his hospital stay. It was thought that his ascites may have been secondary to his poor nutritional status upon presentation when his albumen was < 3.0. . # Stage II decubitus ulcer: Currently has a stage II decubitus ulcer. - Continue wound managment . # Incidential AVN (bilateral based upon MRI). He had an MRI of the pelvis and legs which demonstrated AVN. - Will need follow up as an outpatient . # History of AFIB w/RVR: Patient had atrial fibrillation during his last hospital admission. He was in sinus rhythm during this admission, and prior to discharge. His amiodarone was discontinued. . # COPD: Hed did not have any evidence of an acute exacerbation of COPD - Continue albuterol inhalers PRN Medications on Admission: 1. miconazole nitrate 2 % Powder Sig: One (1) Appl Topical QID (4 times a day) as needed for to groin. 2. silver sulfadiazine 1 % Cream Sig: One (1) Appl Topical WITH EACH DRESSING CHANGE (). 3. heparin (porcine) 5,000 unit/mL Solution Sig: 5000 (5000) units Injection TID (3 times a day). 4. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) neb Inhalation Q6H (every 6 hours) as needed for Wheeze. 5. oxycodone-acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. 6. amiodarone 200 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). . Medications (on transfer to MICU): Ondansetron 4 mg IV Q8H:PRN nausea Micafungin 100 mg IV Q24H Ciprofloxacin 400 mg IV Q12H Fentanyl Citrate 25-100 mcg IV Q2H:PRN pain Acetaminophen 1000 mg PO/NG Q6H:PRN fever Albuterol Inhaler 2 PUFF IH Q4H Famotidine 20 mg IV Q12H Insulin SC (per Insulin Flowsheet) Daptomycin 600 mg IV Q24H Piperacillin-Tazobactam 4.5 g IV Q8H Discharge Medications: 1. glucagon (human recombinant) 1 mg Recon Soln Sig: One (1) Recon Soln Injection Q15MIN () as needed for hypoglycemia protocol. 2. guaifenesin 100 mg/5 mL Syrup Sig: 5-10 MLs PO Q6H (every 6 hours) as needed for cough/sputum. 3. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) Inhalation Q4H (every 4 hours) as needed for sob/wheeze. 4. miconazole nitrate 2 % Powder Sig: One (1) Appl Topical [**Hospital1 **] (2 times a day). 5. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed for fever, pain. 6. trazodone 50 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) as needed for insomnia. 7. famotidine 20 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours). 8. sulfamethoxazole-trimethoprim 400-80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. acyclovir 400 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours). 10. ergocalciferol (vitamin D2) 50,000 unit Capsule Sig: One (1) Capsule PO 1X/WEEK (WE). 11. calcium carbonate 200 mg (500 mg) Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 12. insulin glargine 100 unit/mL Solution Sig: One (1) 23 units Subcutaneous at bedtime. 13. Humalog 100 unit/mL Solution Sig: One (1) variable Subcutaneous four times a day: ISS, Please see attached. 14. prednisone 50 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 15. hydromorphone 4 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4 hours) as needed for pain. 16. sodium chloride 0.9 % 0.9 % Syringe Sig: Three (3) ML Injection Q8H (every 8 hours) as needed for line flush. 17. Dextrose 50% 12.5 gm IV PRN hypoglycemia protocol 18. Ondansetron 4 mg IV Q8H:PRN nausea 19. heparin, porcine (PF) 10 unit/mL Syringe Sig: Two (2) ML Intravenous PRN (as needed) as needed for line flush. 20. sodium chloride 0.9 % 0.9 % Syringe Sig: Ten (10) ML Injection PRN (as needed) as needed for line flush. 21. polyvinyl alcohol-povidone 1.4-0.6 % Dropperette Sig: [**12-19**] Drops Ophthalmic PRN (as needed) as needed for dryness. Discharge Disposition: Extended Care Facility: [**Hospital3 7665**] Discharge Diagnosis: Primary Diagnosis MDS Secondary Diagnosis Sweet's Syndrome Ascities Hyponatremia AVN bilaterally Hyperglycemia Poor wound healing Discharge Condition: Mental Status: Clear and coherent. Activity Status: Ambulatory - Independent. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: Dear [**Known firstname **], Thank you for receiving your care at [**Hospital3 **] Hospital. You were admitted for low blood pressure neccessitating and ICU stay and a new diagnosis of Sweet's syndrome. You were initially given antimicrobial therapy for high fevers, however, no infectious source was cultured. You also had numerous imaging studies which did not reveal an infectious collection of fluid. Several lesions on your skin were biopsied which showed an inflammatory infiltrate. After the biopsy results returned, you were started on steroids. You will need a slow taper of steroids. You will need to go to a rehab facility to help improve your physical strength. . The following medications were ADDED to your regiment: Lantus Humalog Prednisone Hydromorphone Vitamin D (weekly) Calcium Carbonate Acyclovir Bactrim Famotidine Trazadone Guaifenesin Zofran Artificial Tears . The following medications were STOPPED: Amiodarone Oxycodone-Tylenol heparin silver sulfadiazine . The following medications were CHANGED: None Followup Instructions: Please come to the [**Hospital 18**] medical complex for the following Appointments: [**2134-11-26**] 10:30a [**Doctor Last Name **],[**Last Name (un) 6410**] T LM [**Hospital Unit Name **], [**Location (un) **] OTOLARYNGOLOGY/AUDIOLOGY (NHB) [**2134-11-25**] 02:00p ACUTE [**Hospital 23692**] LM [**Hospital Ward Name **] BLDG ([**Doctor First Name **]), [**Location (un) **] SURGICAL ASSOC LMOB-3A (SB) [**2134-11-19**] 01:45p [**Doctor Last Name **],TEACHING SC [**Hospital Ward Name **] CLINICAL CTR, [**Location (un) **] [**Hospital **] CLINIC-CC2 (SB) [**2134-11-15**] 12:30p [**Last Name (LF) **],[**First Name3 (LF) **] E. SC [**Hospital Ward Name **] CLINICAL CTR, [**Location (un) **] HEMATOLOGY/ONCOLOGY-SC [**2134-11-15**] 12:30p [**Last Name (LF) **],[**First Name3 (LF) **] H. SC [**Hospital Ward Name **] CLINICAL CTR, [**Location (un) **] HEMATOLOGY/ONCOLOGY-SC Completed by:[**2134-12-26**] ICD9 Codes: 0389, 2761, 5990, 496
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Medical Text: Admission Date: [**2127-7-1**] Discharge Date: [**2127-7-9**] Date of Birth: [**2070-8-20**] Sex: M Service: CARDIOTHORACIC Allergies: Tape / Percocet / Zyvox Attending:[**First Name3 (LF) 5790**] Chief Complaint: Trachaelbronchialmalcia Major Surgical or Invasive Procedure: [**2127-7-2**]: Right thoracotomy and tracheoplasty with mesh, right mainstem bronchus/bronchus intermedius bronchoplasty with mesh, left mainstem bronchus bronchoplasty with mesh, and flexible bronchoscopy with aspiration. [**2127-7-1**]: Dynamic flexible bronchoscopy. History of Present Illness: Mr. [**Known lastname **] is a 56-year-old gentleman with a history of COPD who was found to have severe tracheobronchomalacia. He [**Known lastname 1834**] a placement of a tracheobronchial silicone Y stent on [**2127-5-20**]. Following this his dyspnea on exertion markedly improved. Unfortunately, he did suffer a stent-related infection and this needed to be removed. We spoke at length at the utility of moving on to a surgical correction of his malacia with posterior splinting with Marlex mesh. We talked about the risks of this procedure including injury to the recurrent laryngeal nerve, tracheal injury, esophageal injury, vessel, heart, or diaphragmatic injury. We talked about the risks of pneumonia or other infection as a result of this, as well as the possibility of postoperative pain from the thoracotomy. We also talked about the possibility that the cervical trachea may develop or may present with symptomatic malacia which would not be corrected by this intrathoracic procedure. Finally, we discussed the possibility of improvement of the malacia without betterment of his symptoms despite the stent trial findings, if his underlying lung disease were to take precedence. Mr. [**Known lastname **] and his partner had a chance to ask all pertinent questions following this discussion and they wished to proceed. Past Medical History: # HTN # tracheobronchomalacia (90-95% collapse of mid-distal trachea, b/l mainstem bronchi collapse 95%) s/p Y stent placement - COPD x 4 yrs, RAD x 15 yrs (trigger floor wax) - recent esophageal candidiasis while on steroids [**3-7**] - GERD w/ laryngitis - thalassemia minor - hypogonadism - osteopenia - L arm neuropathy anxiety - infrarenal AAA 3.2cm, stable CT [**5-6**] - hx cdiff (clinical dx, flagyl x 7 days) # Sleep apnea # GERD with laryngitis s/p Bravo procedure ([**2127-3-26**]. [**Doctor First Name 18348**], [**Location (un) 9095**] CT), and Nissen fundoplication [**2125**] # Thalassemia minor # Hypogonadism with decreased testosterone, reliance on patch # hx HSV/shingles tx valacyclovir # Osteopenia # L arm neuropathy # h/o MRSA # Anxiety # s/p tracheostomy (closed [**4-2**]) # s/p uvulopalatoplasty, rhinoplasty, adenoidectomy, septoplasty, tonsillectomy # s/p B knee surgery # s/p B saphenous vein stripping # s/p pilonidal cyst excision Social History: # Professional: RN at [**Hospital1 1012**]-affiliated VA # Tobacco: Smoked from age 16 - mid 40s, maximum 2 ppd Family History: Noncontributory Physical Exam: VS: Temp 98.9, HR 104, BP 122/60, RR 18, 90% on RA General: 56 year-old male no apparent distress HEENT: normocephalic, mucus membranes moist Neck: supple, no lymphadenopathy Card: RRR Resp; scattered crackles throughout R>L GI: benign Extr: warm no edema Incision: Right thoracotomy site clean, dry, intact Neuro: non-focal Pertinent Results: [**2127-7-6**] WBC-4.5 RBC-4.81 Hgb-9.7* Hct-31.2* Plt Ct-209 [**2127-7-1**] WBC-5.5 RBC-6.43* Hgb-12.3* Hct-42.4 Plt Ct-219 [**2127-7-6**] Glucose-92 UreaN-10 Creat-0.9 Na-144 K-3.9 Cl-106 HCO3-31 [**2127-7-1**] Glucose-115* UreaN-14 Creat-1.3* Na-144 K-4.3 Cl-105 HCO3-29 CHEST (PA & LAT) [**2127-7-6**] The heart size is normal. Mediastinal position, contour and width are unremarkable. The appearance of the lungs is stable including right mid lung scarring, left lower lobe linear opacities consistent with atelectasis and there is no change in small amount of right pleural effusion and right pleural thickening. There is a small amount of right subcutaneous emphysema. The known severe emphysema is unchanged. SPECIMEN SUBMITTED: LEVEL 7 LYMPH NODES. Procedure date Tissue received Report Date Diagnosed by [**2127-7-2**] [**2127-7-2**] [**2127-7-7**] DR. [**Last Name (STitle) **] [**Last Name (NamePattern4) **]/mb???????????? Lymph node, level 7: One unremarkable lymph node, no malignancy identified. Pathology Report Tissue: SKIN BX (PENIS)...1 JAR. Study Date of [**2127-7-7**] Report not finalized at time of discharge Brief Hospital Course: 56M former smoker with TBM and COPD who presented to [**Hospital1 18**] on [**2127-7-1**] s/p Y-stent removal for follow-up bronchoscopy and Tracheoplasty. On [**2127-7-2**] Mr.[**Known lastname **] [**Last Name (Titles) 1834**] Right thoracotomy and tracheoplasty with mesh. He tolerated the procedure well and a right chest tube was left in place. Pt was extubated transferred to the surgical ICU from the operating room. Post-operative pain was controlled with an epidural catheter as well as a PCA (split bupivacaine/Dilaudid) managed by the acute pain service. Pt received scheduled nebulizer treatments. On POD#2 PCA and epidural were increased, and clonidine was started for improved pain control. The patients blood pressure was low via arterial line with systolic pressures in the 70's and 80's. The pts urine output was also decreased during this time for which he was bolused with crystalloid and transfused with Hespan. Diltiazem was held and narcotics were reduced with good effect of SBP in the 120's and return of appropriate urine output by the morning of POD#3. On POD#3 the chest tube was removed and the patient was transferred from the ICU to the surgical floor. Pt continued to improve with scheduled nebulizer treatments, and was ambulating and tolerating a regular diet. O2 was weaned as tolerated but still required to maintain saturations >90%. Pts home medications were restarted including his home dose of diltiazem which he tolerated well. On POD#5 dermatology was consulted for a lesion on the patients penis which was not improving with antifungal cream. A biopsy of the lesion was taken by dermatology, of which the pathology was pending at the time of discharge. On POD#6 pt was weaned off of oxygen and maintained saturations above 90% with ambulation. Pt was discharged home on POD#7 off of supplemental oxygen, tolerating a regular diet, and ambulating without assistance. Medications on Admission: Duloxetine 40mg daily, fluticasone-Salmeterol 500-50 mcg/disk [**Hospital1 **], montelukast 10mg daily, clonazepam 0.5mg [**Hospital1 **], gabapentin 100mg tid, pantoprazole 40mg daily, guaifenesin 1200mg [**Hospital1 **], albuterol sulfate 2.5mg/3ml q4hprn, acetylcysteine 20% tid, ipratropium bromide 0.02% q4h, MVI, testim 1% TP daily, cymalta 40mg daily, Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 2. Fluticasone-Salmeterol 250-50 mcg/Dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). 3. Montelukast 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Trazodone 50 mg Tablet Sig: Three (3) Tablet PO HS (at bedtime). 5. Clonazepam 0.5 mg Tablet Sig: 1-2 Tablets PO BID (2 times a day). 6. Ibuprofen 600 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 7. Gabapentin 300 mg Capsule Sig: One (1) Capsule PO Q8H (every 8 hours). Disp:*90 Capsule(s)* Refills:*1* 8. Hydromorphone 4 mg Tablet Sig: 1 or 1 [**1-29**] Tablet PO Q3H (every 3 hours) as needed. Disp:*100 Tablet(s)* Refills:*0* 9. Guaifenesin 600 mg Tablet Sustained Release Sig: One (1) Tablet Sustained Release PO bid (). 10. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 11. Albuterol Sulfate 2.5 mg/3 mL Solution for Nebulization Sig: Three (3) ML Inhalation Q4H (every 4 hours). 12. Acetylcysteine 20 % (200 mg/mL) Solution Sig: Three (3) ML Miscellaneous Q4H (every 4 hours). 13. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed. 14. Diltiazem HCl 180 mg Capsule, Sustained Release Sig: Two (2) Capsule, Sustained Release PO DAILY (Daily). 15. Valacyclovir 500 mg Tablet Sig: One (1) Tablet PO daily (). 16. Duloxetine 30 mg Capsule, Delayed Release(E.C.) Sig: Two (2) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 17. Calcium Carbonate 500 mg (1,250 mg) Tablet Sig: Two (2) Tablet PO BID (2 times a day). 18. Clotrimazole 10 mg Troche Sig: One (1) Troche Mucous membrane QID (4 times a day). Disp:*120 Troche(s)* Refills:*1* 19. Testim 50 mg/5 gram (1 %) Gel Sig: One (1) Transdermal daily (). 20. Nystatin 100,000 unit/mL Suspension Sig: Five (5) ML PO QID (4 times a day). Disp:*300 ML(s)* Refills:*1* 21. Tiotropium Bromide 18 mcg Capsule, w/Inhalation Device Sig: One (1) Cap Inhalation DAILY (Daily). Discharge Disposition: Home With Service Facility: VNA Services, INC Discharge Diagnosis: TBM, COPD, RAD x 15 yrs, GERD w/ laryngitis, thalassemia minor, hypogonadism, osteopenia, L arm neuropathy, MRSA, anxiety, infrarenal AAA 3.2cm stable CT [**5-6**], OSA Discharge Condition: Good Discharge Instructions: Call Dr.[**Name (NI) 2347**] office [**Telephone/Fax (1) 170**] if experience: -Fever > 101 or chills -Increased shortness of breath, or cough -Difficulty swallowing, nausea, vomiting -Incision develops drainage or increased redness You may shower: No tub bathing or swimming for 6 weeks No driving while taking narcotics: Take stool softners with narcotics. wear your oxygen 2 liters continuously Followup Instructions: Follow-up with Dr. [**Last Name (STitle) **] on [**2127-7-22**] 10:00am in the chest disease center [**Hospital Ward Name **] building [**Hospital1 **] one. Please arrive 45 minutes prior to you appointment and report to the [**Location (un) 470**] radiology for a chest XRAY. ICD9 Codes: 496, 4019
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Medical Text: Admission Date: [**2166-1-16**] Discharge Date: [**2166-1-20**] Date of Birth: [**2141-4-18**] Sex: M Service: MEDICINE Allergies: IV Dye, Iodine Containing Attending:[**First Name3 (LF) 30**] Chief Complaint: drug overdose Major Surgical or Invasive Procedure: None History of Present Illness: Mr. [**Known lastname **] is a 24 year old man with history of prior drug overdose who was transferred from OSH with altered mental status. Per report, he initially presented with complaints of abdominal pain and nausea to [**Hospital3 22765**], then became non-responsive ("catatonic state") but continued to protect his airway. He had a metabolic workup, including chem10 (revealing only mildly elevated BUN at 21), CBC, and tox screen (which was negative for amphetamines and positive for opiates). He also had a head CT and chest x-ray, which were unremarkable. Per OSH report, tox screen was positive for opiates. He was given lorazepam 1mg x 1 and transferred to [**Hospital1 18**] for further workup. . In the ED, his vitals were T98.9F, BP 117/100, HR 148, RR 20, Sat 100%. He was initially given 5mg haloperidol for agitation, but a subsequent EKG demonstrated prolonged QT interval. He continued to be agitated, with visual hallucinations and was unable to maintain his own safety without physical restraints. A blood culture was drawn. Urine tox at [**Hospital1 18**] was positive for both opiates and amphetamines. He received a total of 10mg IV ativan in the ED prior to transfer to the MICU for further workup and evaluation. Past Medical History: h/o drug overdose requiring dialysis ORIF, rightleg fracture, Required fasciotomy [**2164**]. s/p recent surgery for tendon lenghtening [**2165-12-6**]. Social History: Denies any alochol or illicit drug use. He does smoke 1ppd for 6-7 years. Per father has had a problem with percocet abuse in the past. He has often requested more pain medications and has made excuses for having percocets stolen. Family History: nc Physical Exam: VITALS: T98.7F, BP 150/83, HR 140's, RR 18, Sat 99%2L GENERAL: Agitated, slurring speech, occasional yelling out; visual hallucinations HEENT: PERRL, EOMI, mucus membranes dry CARD: Tachycardic no m/r/g RESP: CTA bilaterally anteriorly ABD: Soft, non-distended, non-tender, no HSM, normal active bowel sounds RECTAL: Deferred BACK: Deferred EXT: RLE in cast, LLE warm, well-perfused, with 2+ DP pulse NEURO: A&O x 1 PSYCH: Visual hallucinations Pertinent Results: Lactate:3.0 . Na 139 K 3.4 Cl 105 HCO3 23 BUN 18 Creat 1.0 Gluc 99 Ca: 8.7 Mg: 1.9 P: 3.9 . ALT: 22 AST: 17 AP: 96 LDH: 132 Tbili: 0.2 Alb: 4.3 [**Doctor First Name **]: 29 Lip: 13 Serum Tox: ASA, EtOH, Acetmnphn, Benzo, Barb, Tricyc Pending Acetone: Negative . Urine Tox: positive for opiates and amphetamine, o/w negative . WBC 16.5 N:85.4 L:11.1 M:3.0 E:0.1 Bas:0.4 Hgb 14.4 Hct 41.4 Plt 281 MCV 74 . PT: 14.2 PTT: 28.0 INR: 1.2 . U/A: Yellow, Clear, SpecGr 1.027, pH 5.0, Tr prot, Tr ketones, few bact, otherwise negative . STUDIES: EKG [**2166-1-16**]: Tachycardic at 139bpm, QTc 444ms. No ST elevations or depressions. . CT [**2166-1-16**] (from OSH, reviewed at [**Hospital1 18**] with radiology): ? slightly enlarged ventricles for age, otherwise unremarkable. . CXR [**2166-1-16**] (from OSH): Normal chest x-ray. Brief Hospital Course: MICU COURSE: The patient was admitted to the medical ICU for managment of altered mental status. His urine studies were posative for amphetamines and given his clinical picture of agitation, hallucinations, and irritability he was treated for presumed aphetamine toxicity along with possible wellbutrin overdose. He was given IV fluids and IV lorazepam. He required leather restraints overnight, and despite these suffered a minor fall. His clinical condition improved over 24 hours and he no longer required restraints or benzodiazepines for management of agitation. He was transfered to the floor. QT interval was initilly prolonged, but resolved. The psychiatry team evaluated him and found that he had a history of depression, oppositional defiant disorder, drug abuse, stealing, and suicide attempt. They recommended in-patient psychiatric stabilization, and the patient is therefore being transferred to deaconness 4. Old records and communication with [**Hospital6 **] showed that his cast on his right foot was from an achilles release procedure and required the cast for 6 weeks. This is to be followed up as an outpatient. He has a history in [**2164**] of compartment syndrome in his right lower extremity, rhabdomyolysis and renal failure. He had a CK elevation on admission attributed to being found down. It elevated to 6000 and this was thought secondary to his fall; it trended down to [**2157**] on the day of transfer. The orthopedics team evaluated him and removed a cast. He has persistantly asked for escalating doses of narcotics. We fell that [**1-1**] percocets Q 4 hours is an adequate dose. . #) Microcytosis. normal iron studies. ?thalasemia trait. hct stable. . #) Communication. [**Name (NI) **] father, [**Name (NI) 122**] [**Name (NI) **], [**Telephone/Fax (1) 76829**] (unable to contact). Medications on Admission: percocet prn Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day) as needed. 2. Phenazopyridine 100 mg Tablet Sig: One (1) Tablet PO TID (3 times a day) for 3 days. 3. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed. 4. Thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Hexavitamin Tablet Sig: One (1) Cap PO DAILY (Daily). 6. Lorazepam 1 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed. Discharge Disposition: Extended Care Facility: [**Hospital1 69**] - [**Location (un) 86**] Discharge Diagnosis: Drug overdose Depression Rhabdomyolysis Discharge Condition: Good Discharge Instructions: You were admitted to the hospital after a drug overdose and were monitored in the intensive care unit initially. You were also seen by psychiatry who recommended inpatient psychiatry unit for further treatement. You also had some muscle injury from a fall and received IV fluids. You were also seen by orthopedics who recommended outpatient follow up with your surgeon. Please return to the hospital if you fevers, chills, nausea, vomiting Followup Instructions: Please follow up with your PCP [**Name9 (PRE) **],[**Name9 (PRE) **] [**Telephone/Fax (1) 73578**] in 2 weeks after discharge from psych facility. You should also follow up with your orthopedic surgeon as scheduled next week. Completed by:[**2166-1-21**] ICD9 Codes: 311
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Medical Text: Admission Date: [**2135-4-17**] Discharge Date: [**2135-4-18**] Date of Birth: [**2064-1-17**] Sex: M Service: MEDICINE Allergies: Penicillins / Shellfish Attending:[**First Name3 (LF) 2160**] Chief Complaint: [**Last Name (un) 15557**] Major Surgical or Invasive Procedure: EGD History of Present Illness: 1 yo endocrinologist here at [**Hospital1 18**], h/o GIB (unknown source), p/w black stools. Here with guaiac + brown stool with black specks. SBP 116, HR 75.Warfarin recently stopped due to anemia on routine blood work. Past Medical History: 1. Seizure disorder 30 yrs ago, no recurrence ever on meds 2. h/o sigmoid volvulus [**2124**], Rx colectomy and ileoanal anastemosis. 3. VF defect in [**2128**], after stopping his coumadin after a fall. Adm to [**Hospital1 **] showed no acute stroke on MRI, but suggestion of PFO on bubble echo, and Rx with resumption of anticoagulants 4. Cataracts s/p bilateral surgery 5. Hypertension 6. After sz got a foot drop, c/b DVT x 3/PE x 1 7. Recent renal consult felt c/w nephrosclerosis 8. [**2-8**] with SBO and summer [**2133**] with SBO, EGD showed celiac on bx, + ab, and pt Rx with diet after surgery for lysis of adhesions Social History: [**Hospital1 18**] Endocrinologist; married with 4 children, lives in [**Location (un) 55**]. Does not smoke. Social drinker Family History: Mother - 70's with encephalitis; father - esophageal cancer at 84 y.o.; paternal grandfather - 75 y.o. colon cancer; maternal grandfather with DM. Physical Exam: Pertinent exam: Pale. CV, RS - normal Abd - soft, nontender. Good bowel sounds. No distended. Extremeties no edema. Pertinent Results: [**2135-4-18**] 01:05PM BLOOD Hct-38.2* [**2135-4-17**] 12:50AM BLOOD WBC-8.1 RBC-3.35* Hgb-9.5* Hct-28.2* MCV-84 MCH-28.4 MCHC-33.8 RDW-13.5 Plt Ct-261 [**2135-4-17**] 12:50AM BLOOD Neuts-55.4 Lymphs-27.3 Monos-5.6 Eos-11.4* Baso-0.2 [**2135-4-18**] 06:15AM BLOOD PT-13.9* PTT-26.0 INR(PT)-1.2* [**2135-4-18**] 06:15AM BLOOD Fibrino-227# [**2135-4-18**] 06:15AM BLOOD Glucose-82 UreaN-35* Creat-2.2* Na-139 K-4.4 Cl-107 HCO3-25 AnGap-11 [**2135-4-17**] 12:50AM BLOOD ALT-22 AST-19 AlkPhos-94 TotBili-0.2 [**2135-4-17**] 12:50AM BLOOD Lipase-35 [**2135-4-18**] 06:15AM BLOOD Calcium-9.2 Phos-3.2 Mg-2.1 [**2135-4-17**] 12:50AM BLOOD Albumin-3.8 Calcium-9.8 Phos-4.6* Mg-2.0 Cardiology Report ECG Study Date of [**2135-4-17**] 12:40:12 AM Sinus rhythm with borderline A-V conduction prolongation. Early R wave transition. Non-specific ST-T wave changes. Compared to the previous tracing of [**2133-4-2**] there is no significant change other than the borderline prolonged P-R interval. EGD: Brief Hospital Course: Gastrointestinal bleeding Acute blood loss anemia - initially in ICU, transfused 3 units of PRBC. Hct stabilized and pt sent to floor. EGD done and results as above. Capsule endoscopy was initiated prior to discharge. Pt to follow up with primary gastroenterologist for results of capsule endoscopy. PPI continued. Warfarin not initiated. Hypertension - discharged only on valsartan. Doxazosin and diltiazem held and to be restarted in clinic depending on BP. History of deep vein thrombosis, pulmonary embolism, Chronic kidney disease, osteoporosis, hypothyroidism - no acute issues. Medications on Admission: valsartan 80 mg daily alprazolam 0.25 mg qhs:prn calcitriol 0.25 mcg [**Hospital1 **] diltiazem 240 mg daily doxazosin 8 mg daily Boniva q6months levothyroxine 50 mcg daily phenytoin ER 400 mg daily citracal +D ASA 81 mg daily Discharge Medications: 1. Alprazolam 0.25 mg Tablet Sig: One (1) Tablet PO QHS (once a day (at bedtime)) as needed for insomnia. 2. Calcitriol 0.25 mcg Capsule Sig: One (1) Capsule PO BID (2 times a day). 3. Levothyroxine 50 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 5. Phenytoin Sodium Extended 100 mg Capsule Sig: Four (4) Capsule PO once a day. 6. Valsartan 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. Citracal + D Oral 8. Ibandronate (boniva) as directed q 6 months 9. Aspirin 81 mg Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Home Discharge Diagnosis: Gastrointestinal bleeding Acute blood loss anemia Hypertension History of deep vein thrombosis, pulmonary embolism, Chronic kidney disease, osteoporosis, hypothyroidism Discharge Condition: stable. Hct stable. Discharge Instructions: As you are aware, you were admitted for possible bleeding and transfused with 3 unit of blood. Your hematocrit has responded well. The endoscopy you had did not show signs of bleeding. Capsule study results should be available in [**4-9**] days. Please contact Dr [**Name (NI) 96799**] regarding the results. Do not take doxazosin and diltiazem till your follow up blood pressure check with your primary care doctor. Discuss with him regarding the timing of your medications. Followup Instructions: Follow up with Dr [**Last Name (STitle) 2539**] in [**1-5**] days for follow up hematocrit and blood pressure check. Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 9052**], MD Phone:[**Telephone/Fax (1) 49151**] Date/Time:[**2135-6-13**] 1:30 Provider: [**Name10 (NameIs) **] DENSITY TESTING Phone:[**Telephone/Fax (1) 4586**] Date/Time:[**2136-4-6**] 9:00 Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 10545**], M.D. Phone:[**Telephone/Fax (1) 4586**] Date/Time:[**2136-4-6**] 10:00 ICD9 Codes: 5789, 2851, 5859, 2449
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Medical Text: Admission Date: [**2160-9-29**] Discharge Date: [**2160-10-14**] Date of Birth: [**2160-9-29**] Sex: F Service: NB HISTORY: This is a 34-2/7-week gestation infant admitted to the NICU for prematurity. She was born by cesarean section to a 32-year-old gravida 1, para 0-2 mother with the following prenatal screens: Blood type A positive, DAT negative, hepatitis B surface antigen negative, RPR nonreactive, rubella immune, group B Strep unknown. Estimated date of delivery was [**2160-11-8**] for an estimated gestational age of 34-2/7 weeks at time of delivery. This was a spontaneous twin pregnancy, which was complicated by preterm labor, refractory to tocolysis. The betamethasone course was completed four days prior to delivery. Spontaneous rupture of membranes occurred 10 hours prior to delivery yielding clear amniotic fluid. Mother experienced intrapartum fever to 100.7 degrees. Intrapartum antibiotic therapy administered five hours prior to delivery. Infant was delivered by a cesarean section. This baby was vigorous. She required bulb suctioning and free-flow oxygen and had Apgars of 8 at 1 minute and 8 at 5 minutes. PHYSICAL EXAMINATION UPON ADMISSION: A well-appearing infant in no distress. Birth 2325 grams, 50th percentile. Head circumference 32.5 cm, 75th percentile, and length 45 cm, 50th percentile. Temperature 100.5. Heart rate 160. Respiratory rate 40. O2 saturation 96 percent. Blood pressure 52/37 with a mean of 41. HEENT: Anterior fontanel is soft and flat, nondysmorphic. Palate intact. Neck and mouth normal. No nasal flaring. Normocephalic. Red reflex present bilaterally. Chest: No retractions. Good bilateral breath sounds, no crackles. Cardiovascular: Well perfused, regular rate and rhythm. Femoral pulses normal. S1, S2 present. No murmur. Abdomen: Soft, nondistended, no organomegaly, no masses. Bowel sounds active. Anus patent. GU: Normal female genitalia. CNS: Active, responsive to stimulus. Tone appropriate for gestational age and symmetric. Moves all extremities equally and symmetrically. Suck, root, and gag intact. Grasp and morrow symmetric. Skin is intact. Musculoskeletal: Normal spine, limbs, hips, and clavicles. SUMMARY OF HOSPITAL COURSE BY SYSTEMS: Cardiovascular: This baby required normal saline boluses x2 for decreased perfusion. She remained cardiovascularly stable throughout the hospitalization. Daily examination revealed heart rates 120-150 with blood pressure mean 39-48. Baby was noted to have an ejection click on day of life four. She had an EKG, which was normal. She had a chest x-ray, which was also interpreted as normal. Four extremity blood pressures were all within normal limits. Hyperoxia test was passed with a transcutaneous O2 saturation of greater than 300. Cardiology was consulted to evaluate the baby's click, and echocardiogram was performed on [**10-7**], which revealed normal cardiac structures with a patent foramen ovale and baby has remained cardiovascularly stable and no murmur or significant click appreciated at the time of discharge. Respiratory: Baby demonstrated mature pulmonary function and has been in room air throughout her hospitalization. She has not experienced any periodic breathing patterns. Fluid, electrolytes, and nutrition: Baby initially was placed NPO and peripheral IV fluids with D10W were initiated. Feeds were initiated in the first 24 hours of life with breast milk. She was fed a combination of by mouth and gavage feedings for the first 10 days of life. Since that time, she has been all by mouth feeds for the last 48 hours. She is taking a combination of breast and Similac 24 adlib with an average intake of 140 cc/kg on demand. She has had normal urine and stool output. GI: This baby was treated with phototherapy for physiologic jaundice with a peak bilirubin of 12.4/0.4 on day of life three. She continued under phototherapy until day of life six at which time it was shut off. A rebound bilirubin was obtained on day of life seven, which was 5.5. Baby was started on Vi-Daylin multivitamins on [**10-13**], and was increased at that time to 24 calories/ounce as a supplement to breast feeding. Weight at time of discharge is 2420 grams. Heme/ID: A CBC and blood culture obtained upon admission. CBC revealed a white count of 15 with 15 polys, 0 bands, and 73 lymphocytes. Hematocrit 58.6 percent. Her platelets were 253. Baby received 48 hours of ampicillin and gentamicin, which were discontinued in face of negative cultures and improved clinical course. Baby required [**Name2 (NI) **] for neutral thermal environment for the first week of life and transitioned to a crib. She has been with her twin in an open crib. Neurologic: Infant is appropriate for gestational age. Sensory: Hearing screening was performed with automated auditory brain stem responses. The baby passed the hearing screening. Ophthalmology examination was not indicated at this gestational age. CONDITION ON DISCHARGE: Good. DISCHARGE DISPOSITION: To home. NAME OF PRIMARY PEDIATRICIAN: Dr. [**Last Name (STitle) 45938**] of [**Hospital1 6687**]. FEEDS AT DISCHARGE: Breast milk with Similac powder for 24 calories/ounce. MEDICATIONS: Vi-Daylin 1 cc by mouth each day. IMMUNIZATIONS RECEIVED: Hepatitis B vaccine given on [**10-10**]. IMMUNIZATIONS RECOMMENDED: i. Synagis RSV prophylaxis should be considered from [**Month (only) **] through [**Month (only) 958**] for infants who meet any of the following three criteria: 1) born at <32 wks; 2) born between 32 and 35 wks with 2 of the following: daycare during RSV season, a smoker in the household, neuromuscular disease, airway abnormalities, or school age siblings; or 3) with chronic lung disease. ii. Influenza immunization is recommended annually in the fall for all infants once they reach 6 months of age. Before this age (and for the first 24 months of the child??????s life), immunization against influenza is recommended for household contacts and out-of-home caregivers. STATE NEWBORN SCREENING: Performed at recommended intervals and results are pending at the time of discharge. FOLLOW-UP APPOINTMENTS: Follow-up appointment with Dr. [**Last Name (STitle) 45938**] is recommended upon return to [**Hospital1 6687**]. DISCHARGE DIAGNOSES: 1. Prematurity at 34-2/7 weeks twin number one. 2. Sepsis suspect, ruled out. 3. Physiologic jaundice. 4. Ejection click with normal cardiac findings. [**Name6 (MD) **] [**Last Name (NamePattern4) **], [**MD Number(1) 55472**] Dictated By:[**Last Name (NamePattern1) **] MEDQUIST36 D: [**2160-10-14**] 01:50:21 T: [**2160-10-14**] 04:17:09 Job#: [**Job Number 56641**] ICD9 Codes: 7742, V290, V053
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Medical Text: Admission Date: [**2188-11-19**] Discharge Date: Service: THIS IS AN INCOMPLETE DISCHARGE SUMMARY. PLEASE SEE DISCHARGE ADDENDUM FOR COMPLETION OF THE [**Hospital **] HOSPITAL COURSE, DISCHARGE DIAGNOSES AND DISCHARGE MEDICATIONS. HISTORY OF PRESENT ILLNESS: The patient is a 79 year old male with hypertension, portal vein thrombosis secondary to pancreatitis leading to portal hypertension. No history of coronary artery disease. He presented to the Emergency Room on [**2188-11-19**], after having black, maroonish stools since [**2188-11-15**]. The patient says he took approximately six aspirin (325 mg strength) the week prior for an upper respiratory tract infection. The patient denies any abdominal pain, nausea, vomiting or gastroesophageal reflux disease type symptoms. The patient was very weak, dizzy, and lightheaded. He denies any chest pain but did have shortness of breath. In the Emergency Room, the patient was noted to have a blood pressure of 120/50 with a heart rate of 80 and a hematocrit of 15.3, with a baseline hematocrit of 30 to 36. An nasogastric lavage was performed which was clear 300 cc. The patient was subsequently admitted to the Medical Intensive Care Unit. PAST MEDICAL HISTORY: 1. Hypertension. 2. B12 deficiency, pernicious anemia. 3. Status post cholecystectomy. 4. Gastritis. 5. Empyema in [**2178**]. 6. Choledocholithiasis. 7. Pancreatitis in [**2184**]. 8. Right portal vein thrombosis. 9. Portal hypertension. 10. Ascites. 11. Colonic polyps on colonoscope in [**2188-8-26**]. ALLERGIES: No known drug allergies. MEDICATIONS AT HOME: 1. Norvasc 10 mg p.o. q. day. 2. Tylenol 650 mg p.o. q. day. 3. B12 injections q. month. SOCIAL HISTORY: The patient lives at [**Location (un) 5481**]. He is a retired engineer and is widowed. Drinks one alcoholic drink per week. The patient quit tobacco 30 years ago. He normally swims approximately three times a week and walks a mile and a half per day without difficulties. FAMILY HISTORY: Noncontributory. PHYSICAL EXAMINATION: In general, a pale appearing elderly male in no acute distress. Temperature 97.8 F.; blood pressure 125/53; heart rate 80; respiratory rate 18; oxygen saturation 100% on room air. HEENT: Mucous membranes were moist. Conjunctivae pale. No oral lesions detected. Neck: Jugular venous pressure at 4 centimeters without lymphadenopathy. Chest with diffuse expiratory wheezes without crackles. Cardiovascular: III/VI systolic ejection murmur at the left lower sternal border. Regular rate and rhythm. Abdomen with positive bowel sounds, distended, no hepatosplenomegaly, nontender. Plus/minus fluid wave. Rectal examination revealed occult blood positive maroon stool. Extremities with three plus pitting edema bilaterally. Neurological: Alert and oriented times three, moves all four extremities. LABORATORY: White blood cell count 14.9, hematocrit 15.3, platelets 227, differential is 73 polys, 19 lymphocytes, 6.6 monocytes. Sodium 141, potassium 4.6, chloride 106, bicarbonate 21, BUN 49, creatinine 1.5, glucose 108. ALT 27, AST 35, alkaline phosphatase 194, bilirubin 0.3. INR 1.1, PT 12.8, PTT 26.6, CK 163, MB 12, CK MB index 7.4, troponin 3. EKG with sinus rhythm at 80 beats per minute with PR intervals of 168, QTC of 410; [**Street Address(2) 2914**] depressions noted in II, III, AVF, V4 through V6, with T wave inversions in V6 and I. Chest x-ray with questionable pulmonary edema. No focal consolidations. HOSPITAL COURSE: 1. Upper gastrointestinal bleed: The patient was transfused a total of 6 units of blood for a hematocrit of 30 which was stable. The patient underwent an esophagogastroduodenoscopy on [**2188-11-20**], which revealed Grade 3 varices which were nonbleeding with a nonbleeding pedunculated polyp that was benign appearing in the stomach. The patient was started on Octreotide for a 72 hour course as well as Propranolol. The patient will undergo a repeat esophagogastroduodenoscopy prior to discharge in order to pursue variceal banding as well as to re-evaluate the gastric polyp. 2. Ischemia: Upon admission, the patient was noted to have inferior lateral ischemia changes on EKG as well as an elevated troponin and MB fraction. The patient's cardiac enzymes were cycled and peaked at a troponin of 10.8 and a CK of 189 with a CK MB of 17. It was thought that this troponin leak was secondary to demand ischemia from his anemia. The patient will likely need an outpatient stress test in the future. The patient remained completely chest pain free during his hospital stay. 3. Congestive heart failure: The patient was noted to have an intermittent oxygen requirement on [**2188-11-20**], with his oxygenation saturation changing from 98% on room air to 90% on room air. The patient was noted to have crackled on examination and was thought to be volume overloaded secondary to his numerous blood transfusions. The patient responded well to Lasix 20 mg intravenously. An echocardiogram was performed on [**2188-11-21**], which revealed an ejection fraction of greater than 60% with mild left ventricular hypertrophy and two plus aortic regurgitation which was worse than prior examination, two plus mitral regurgitation, two plus tricuspid regurgitation, moderate pulmonary artery systolic hypertension, and mild aortic stenosis which was new since his prior examination. The patient was continued on Spironolactone during his hospital stay. 4. Ascites: The patient had portal hypertension secondary to a portal vein thrombosis which was chronic and seemed to have occurred during an episode of pancreatitis. The patient had an abdominal ultrasound on [**2188-11-20**], which showed moderate ascites with chronic occlusion of the right portal vein with cavernous transformation and a heterogeneous echogenic liver consistent with cirrhosis. The patient underwent a diagnostic peritoneal tap on [**2188-11-20**], which revealed culture negative, just ascites. The patient was started on initially Ciprofloxacin and then switched over to Ceftriaxone 2 grams q. 24 hours for treatment. Throat culture negative; will check ascites for a four or five day total course. The patient likely has cirrhosis and will need to be followed up with Dr. [**Last Name (STitle) **] in order to arrange for a liver biopsy to confirm this diagnosis. In addition, the patient was started on Propranolol and Spironolactone. This is an incomplete discharge summary. Please refer to following discharge addendum for completion of the [**Hospital 228**] hospital course, discharge diagnoses and discharge medications. [**Name6 (MD) 251**] [**Name8 (MD) **], M.D. [**MD Number(1) 1197**] Dictated By:[**Last Name (NamePattern1) 1336**] MEDQUIST36 D: [**2188-11-22**] 15:37 T: [**2188-11-22**] 16:52 JOB#: [**Job Number 11659**] ICD9 Codes: 5715
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Medical Text: Admission Date: [**2115-9-19**] Discharge Date: [**2115-9-20**] Date of Birth: [**2052-12-23**] Sex: M Service: MEDICINE Allergies: Ciprofloxacin Attending:[**First Name3 (LF) 594**] Chief Complaint: Sent in by cardiologist for hypotension Major Surgical or Invasive Procedure: None History of Present Illness: 62 yo male with advanced esophageal ca s/p palliative chemo/XRT, recurrent pl effusions s/p L pleurex, CAD s/p POBA/PCI [**2101**] who presents from cardiology clinic with tachypnea and hypotension. The patient had 450cc drained from his pleurx yesterday ([**9-19**]) as usual. This morning he awoke with a [**Month/Year (2) **] and states he developed some chest pain after a coughing spell "like a pulled muscle, not cardiac" after coughing. He also notes feeling short of breath, but not much more than he has in the past. Pt attributes SOB to pain during inspiration. He went for a routine clinic visit today to follow-up for his known pericardial effusion. He was reportedly hypotensive to the 80's, tachypnic, and complaining of pain. An echocardiogram performed earlier today showed a moderate effusion without evidence of tamponade. In clinic, his pulsus paradoxus was reportedly normal. Pt he felt dizzy earlier in the week but currently denies any dizziness or lightheadedness. In the ED, initial VS were: 98.3 128 97/56 26 89%. Cardiology was consulted and believed pt's symptoms were not secondary tamponade physiology based on pt's echo and pulsus <3. Pt was given 1L NS with improvement in sbp to 105. An ECG sinus tachycardia, old inf TW flattening. CXR was notable for stable L pleural effusion with pleurx in place and R pleural effusion, unchanged from [**9-18**]. The patient was given iv dilaudid and tachypnea improved. On arrival to the MICU, the patient in laying comfortably, saturating 97% on room air with HR 106, BP 110/69. Past Medical History: ONCOLOGIC HISTORY: Mr. [**Known lastname 26973**] presented with a sensation of food getting stuck in his chest in the fall of [**2112**]. Barium swallow demonstrated a stricture in the distal esophagus. ECG demonstrated circumferential narrowing and thickening at the GE junction (40 cm), and extended proximally to 35 cm. Biopsies were performed and pathology demonstrated adenocarcinoma, mucin-producing with few signet ring cells, moderately differentiated. He underwent PET/CT scan [**2113-12-31**], which showed FDG uptake in the GE junction but no evidence of regional or distant metastases. He was referred for EUS staging, performed on [**2114-1-5**], which demonstrated a mass at the distal esophagus/GEJ consistent with known adenocarcinoma, maximum depth 1 cm, with extension beyond the muscularis propria. There were no concerning lymph nodes identified. By EUS, the tumor was staged as T3N0Mx, Stage IIB esophageal adenocarcinoma. . He began concurrent chemoradiation with cisplatin/5-FU on [**2114-1-23**]. He had a J-tube placed prior to treatment. His last radiation treatment was on [**2114-3-1**], total dose 5040 cGy. His last cycle of chemotherapy (C2D1) was [**2114-2-19**]. He underwent [**Month/Day/Year 12351**]-[**Doctor Last Name **] esophagectomy [**2114-4-25**] which demonstrated residual disease, including a positive proximal margin. Surveillance endoscopy demonstrated friable and nodular distal esophagus and biopsy demonstrated adenocarcinoma. . [**2114-9-3**] C1D1 Epirubicin, Oxaliplatin, 5-fluorouracil (5-FU given by continuous infusion pump Mon-Fri x96 hours given his difficulty swallowing pills) [**2114-9-24**] C2D1 Epirubicin, Oxaliplatin, 5-fluorouracil . PAST MEDICAL HISTORY: -Myocardial infarction in [**2101**] treated with plain old balloon angioplasty to one vessel and a stent in another vessel. -Choleocystectomy -Kidney stones -Osteoarthritis: mainly neck and right knee -Low back injury -GERD Social History: Married to his wife of 40 years. two children, & two grandchildren. He works in software and customer teaching for an electronic access device maker. Smoked half a pack to pack a day for approximately 30 years, but quit in [**2101**] with his heart attack. He does not drink alcohol regularly. Family History: Parents both died of heart attack. He has a sister who has had breast cancer twice and a brother with diabetes. Family members with emphysema Physical Exam: Admission: General: Alert, oriented, no acute distress HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, PERRL Neck: supple, JVP not elevated, no LAD CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops Lungs: Clear to auscultation bilaterally, no wheezes, rales, ronchi Abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly GU: no foley Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Neuro: CNII-XII intact, 5/5 strength upper/lower extremities, grossly normal sensation, 2+ reflexes bilaterally, gait deferred, finger-to-nose intact Discharge: General: Alert, oriented, no acute distress HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, PERRL Neck: supple, JVP not elevated, no LAD CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops Lungs: Clear to auscultation bilaterally, no wheezes, rales, ronchi Abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly GU: no foley Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Neuro: CNII-XII intact, 5/5 strength upper/lower extremities, grossly normal sensation, 2+ reflexes bilaterally, gait deferred, finger-to-nose intact Pertinent Results: Labs [**2115-9-20**] 04:16AM BLOOD WBC-8.4 RBC-4.07* Hgb-11.5* Hct-35.6* MCV-88 MCH- 28.2 MCHC-32.2 RDW-16.6* Plt Ct-255 [**2115-9-20**] 04:16AM BLOOD Glucose-94 UreaN-14 Creat-0.5 Na-137 K-4.1 Cl-108 HCO3-23 AnGap-10 ECHO [**9-19**] The left atrium is normal in size. Overall left ventricular systolic function cannot be reliably assessed due to the technically suboptimal nature of this study. However, the inferior and posterior walls appear dyskinetic, and the overall left ventricular ejection fraction is depressed (? 35%). Other segmental wall motion abnormalities cannot be excluded with certainty. The right ventricular free wall thickness is normal. The right ventricular cavity is dilated with borderline normal free wall function. The aortic root is mildly dilated at the sinus level. The ascending aorta is mildly dilated. The aortic valve is not well seen. There is no aortic valve stenosis. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Trivial mitral regurgitation is seen. There is a moderate sized pericardial effusion. The effusion appears circumferential. The effusion is echo dense, consistent with blood, inflammation or other cellular elements. No right atrial or right ventricular diastolic collapse is seen. Compared with the findings of the prior study (images reviewed) of [**2115-7-18**], the overall left ventricular ejection fraction appears lower secondary to increased dyskinesis of the inferior and posterior walls CXR: IMPRESSION: Stable appearance of esophageal stent, bilateral pleural effusions, right greater than left, and bibasilar opacities, possibly reflecting atelectasis MICRO: None Brief Hospital Course: 62 yo male with advanced esophageal ca s/p palliative chemo/XRT, recurrent pl effusions s/p L pleurex, CAD s/p POBA/PCI [**2101**] who was sent in from cardiology clinic for hypotension and tachypnea. #Respiratory distress: Pt found to be tachypnic in ED and was started on nasal canula. Most likely secondary to poor tidal volumes in setting of chest wall strain from coughing yesterday. Pt notes acute onset of pain after coughing last night and physical exam notable for reproducable pain. ECG unchanged from baseline and echo unremarkable for new wall abnormalities this morning. While pleural effusion may be contributing to dyspnea, CXR is largley unchanged from yesterday with stable R effusion and drained L effusion with pleurex in place. No signs of pneumothorax on CXR. His tachypnea improved with dilaudid and he had no need for supplemental oxygen following admission. He was discharged with a prescription of dilaudid for breakthrough pain. His pleurx catheter was also drained prior to discharge. #Hypotension: Most likely secondary to poor po intake. No signs of tamponade or MI on cardio workup. No signs of pneumothorax on CXR. Pt does promote poor po intake over recent weeks with 25lbs weight loss. He has need admission previously for IV hydration. Pt's hypotension has resolved thus far with hydration. -Continued with hydration with bolus target sbp >105, UOP>50cc/hr -Continued to monitor for signs of PP #Pericardial effusion: Chronic and followed by cards as an outpt. Echo this am does not show tamponade physiology and pt has no PP on exam. Furthermore, hypotension resolved with fluids and no appreciable JVP on PE. -Considered elective pericardial drainage -Montitored for PP #Esophageal Ca: Advanced now focusing on palliative chemo and radiation. Followed by Dr. [**Last Name (STitle) 26981**] as an out pt. -Continued with home megace -Sent email to Dr. [**Last Name (STitle) 26981**] Medications on Admission: The Preadmission Medication list is accurate and complete. 1. Ascorbic Acid 250 mg PO BID 2. Aspirin 325 mg PO DAILY 3. Fentanyl Patch 25 mcg/h TP Q72H 4. Lansoprazole Oral Disintegrating Tab 30 mg PO BID 5. Lorazepam 0.5 mg PO 4-6H:PRN nausea/insomnia 6. Megestrol Acetate 400 mg PO DAILY 7. Multivitamins 1 TAB PO DAILY 8. Ondansetron 8 mg PO Q12:PRN nausea/vomitting 9. OxycoDONE (Immediate Release) 5 mg PO Q4H:PRN Pain Please monitor and hold for sedation, RR<12 or AMS 10. Senna 1 TAB PO BID:PRN constipation 11. Docusate Sodium 100 mg PO BID:PRN constipation 12. Vitamin D 800 UNIT PO DAILY Discharge Medications: 1. Ondansetron 8 mg PO Q12:PRN nausea/vomitting 2. Ascorbic Acid 250 mg PO BID 3. Aspirin 325 mg PO DAILY 4. Docusate Sodium 100 mg PO BID:PRN constipation 5. Fentanyl Patch 25 mcg/h TP Q72H 6. Lansoprazole Oral Disintegrating Tab 30 mg PO BID 7. Lorazepam 0.5 mg PO 4-6H:PRN nausea/insomnia 8. Megestrol Acetate 400 mg PO DAILY 9. Vitamin D 800 UNIT PO DAILY 10. Senna 1 TAB PO BID:PRN constipation 11. OxycoDONE (Immediate Release) 5 mg PO Q4H:PRN Pain Please monitor and hold for sedation, RR<12 or AMS 12. Multivitamins 1 TAB PO DAILY 13. HYDROmorphone (Dilaudid) 2 mg PO Q6H:PRN pain take 1-2 tablets as needed for pain not controlled by oxycodone. Do not take if drowsy or driving. Call your oncologist if requiring more than 2 tablets in 24 hours RX *hydromorphone [Dilaudid] 2 mg [**12-3**] tablet(s) by mouth up to once every 6 hours Disp #*30 Tablet Refills:*0 Discharge Disposition: Home With Service Facility: [**Hospital3 **] VNA Discharge Diagnosis: Primary: hypotension, chest pain Secondary: Pleural effusion, pericardial effusion, esophageal cancer Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Mr. [**Last Name (Titles) 26982**], It was a pleasure taking care of you at the [**Hospital1 771**]. You were admitted with shortness of breath and low blood pressure. We gave you fluids and treated your pain, which helped you feel more comfortable and improved your breathing. We also drained your pleurx catheter. Please followup with your oncologist, see below. Please call your cardiologist to schedule a followup appointment to check the status of the [**Hospital1 **] collection around your heart in the next week. Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight goes up more than 3 lbs. We made the following changes to your medications: -STARTED Dilaudid for pain control. Please continue taking your other medications as usual. Followup Instructions: Department: HEMATOLOGY/ONCOLOGY When: TUESDAY [**2115-10-1**] at 9:00 AM With: [**First Name8 (NamePattern2) 251**] [**Name8 (MD) **], MD [**0-0-**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 24**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: HEMATOLOGY/ONCOLOGY When: TUESDAY [**2115-10-1**] at 9:30 AM With: [**First Name8 (NamePattern2) 4617**] [**Last Name (NamePattern1) 26978**], RN [**Telephone/Fax (1) 9644**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 24**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Please call your cardiologist Dr. [**Last Name (STitle) **] to schedule a followup appointment to check the status of the [**Last Name (STitle) **] collection around your heart in the next week. ICD9 Codes: 4589, 5119, 412
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Medical Text: Admission Date: [**2153-9-14**] Discharge Date: [**2153-9-15**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2297**] Chief Complaint: transfer from OSH for subdural hematoma and unresponsiveness Major Surgical or Invasive Procedure: None History of Present Illness: [**Age over 90 **] y/o transferred from Mt. [**Hospital 69293**] Hospital after being found at home, unresponsive, by his wife at 2:30 pm. He was "not waking up" per her report. She called EMS who found him responsive only to painful stimuluoi. He was tranported to [**Last Name (un) 1724**] where he was found to have a large, Lt. - sided SDH with midline shift, GCS of 4. He was also found to have an INR of 4.1 - he is on coumadin for atrial fibrillation as an outpatient. Transferred here for neurosurgery after being given FFP and Vitamin K. On arrival here, pupils were dilated to 5 mm without response to light. Neurosurgery was consulted, and they feel that there would be no meaningful recovery from this injury and no therefore no indication for intervention. A discussion was started with the family about the withdrawal of care, and they have decided to make him DNR, but would like other measures undertaken short of compressions and shocks at the time of my evaluation. Past Medical History: AFib on coumadin CVA with residual lt. hemiparesis HTN Hyponatremia Hypothyroidism Social History: Lives in [**Location **] with his wife. Family History: NC Physical Exam: Intubated, non-responsive, not on sedation Cervical collar in place [**Last Name (un) **] [**Last Name (un) **] rhythm CTAB Soft, ND, BS+ No edema Pertinent Results: [**2153-9-14**] 06:20PM GLUCOSE-154* UREA N-17 CREAT-1.0 SODIUM-136 POTASSIUM-4.5 CHLORIDE-100 TOTAL CO2-23 ANION GAP-18 [**2153-9-14**] 06:20PM CK(CPK)-223* [**2153-9-14**] 06:20PM cTropnT-<0.01 [**2153-9-14**] 06:20PM CK-MB-5 [**2153-9-14**] 06:20PM WBC-7.0 RBC-3.75* HGB-11.3* HCT-31.9* MCV-85 MCH-30.1 MCHC-35.4* RDW-13.1 [**2153-9-14**] 06:20PM NEUTS-91.3* BANDS-0 LYMPHS-5.9* MONOS-2.4 EOS-0.2 BASOS-0.2 [**2153-9-14**] 06:20PM URINE RBC-0-2 WBC-0 BACTERIA-NONE YEAST-NONE EPI-0 [**2153-9-14**] 06:20PM URINE BLOOD-TR NITRITE-NEG PROTEIN-TR GLUCOSE-NEG KETONE-TR BILIRUBIN-NEG UROBILNGN-NEG PH-6.5 LEUK-NEG Brief Hospital Course: Pt was transferred from [**Hospital6 1597**] with a subdural hematoma with midline shift as confirmed on CT scan. Shortly after admission, patient was made comfort measures only by the family and was extubated without complication. All medications and treatments were stopped and patient was made comfortable with morphine. Patient died without any complications and with family present at the bedside. Medications on Admission: Digoxin Coumadin Lisinopril Levothyroxine Discharge Medications: None Discharge Disposition: Expired Discharge Diagnosis: Subdural Hematoma in the setting of elevated INR Discharge Condition: Expired Discharge Instructions: Pt. expired. Followup Instructions: None ICD9 Codes: 2449, 4019
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Medical Text: Admission Date: [**2184-11-1**] Discharge Date: [**2184-11-13**] Date of Birth: [**2184-11-1**] Sex: F Service: NB HISTORY: Baby Girl [**Known lastname 37193**] [**Known lastname 74476**] was referred for evaluation by the primary pediatrician for evaluation of dusky episodes noted by the parents after a feeding. [**Known lastname 37193**] is the 2930-gm product of a 36-6/7-week gestation pregnancy, born to a 32-year-old G1, P0-now-1 mother by cesarean section for failure to progress and non-reassuring fetal heart rate tracing. Prenatal labs were blood type A positive, antibody negative, HBSAG negative, RPR nonreactive, rubella immune, GBS negative. This was an uncomplicated pregnancy but there was a slight uncertainty about the dating as the mother moved here from [**Country 6962**] at approximately 28 weeks gestation and her records from prior to the move were uncertain. There was no maternal fever. Rupture of membranes was at 14 hours prior to delivery with clear fluid. The infant emerged vigorous and required only warming, drying, and stimulation, bulb suction for resuscitation. Apgars were 8 at one minute and 9 at five minutes. She was admitted to the newborn nursery on the day of admission. On day of life three she was noted by the parents to have 4 episodes of color change, all associated with feeding. They describe her breast feeding without difficulty, then being burped, then while being held in semi-upright position developing noisy breathing and appearing to choke, associated with color change in dark red or purple. She appeared to resolve these episodes over several minutes with patting on her back. She has not been vomiting prior to this. She never had these episodes during feed or during sleep. She was admitted to the NICU for further evaluation of these cyanotic episodes. PHYSICAL EXAMINATION: Physical exam at birth had a weight of 2930 gm, 75th percentile; length of 47 cm which is 50th percentile; and a head circumference of 33.5 cm which is greater than 90th percentile. On admission the infant was alert and active on an open warmer. The appearance was consistent with gestational age of 36 weeks. HEENT showed anterior fontanelle soft and flat, red reflex deferred, nares patent, no macroglossia, mucous membranes moist, palate intact. Neck - no mass. CV - normal rate, rhythm, no murmur, 2+ radial and femoral pulses, capillary refill brisk. Chest - clear and equal, no increased work of breathing. Abdomen - soft, nontender, nondistended, bowel sounds present, no mass, no hepatosplenomegaly. GU - normal female external genitalia, patent anus. Back - no cleft, tuft, or dimple. Extremities - warm, well perfused; hips stable. Skin - pink, no lesions. Neuro - alert, normal tone, moves all extremities well, good suck, good grasp. SUMMARY OF HOSPITAL COURSE BY SYSTEMS: Respiratory - the infant has remained on room air while in the NICU although she did have episodes of apnea, bradycardia, and desaturation at rest requiring blow-by oxygen on days of life 5 and 6 so the infant has been monitored closely for these apneic episodes with further studies being done. The most recent apneic episode was a desaturation with a feeding on [**2184-11-9**]. The infant will be 3 days spell free prior to discharge from the hospital. Between spells there is no increased work of breathing. Sats have remained stable with normal respiratory rates in between. The infant has not been on any methylxanthine therapy. Cardiovascular - the infant has not had a murmur, has normal heart rates and blood pressures but due to the dusky episodes with some bradycardia, a 4-extremity blood pressure was done which was normal. EKG was done and read as normal. Pre-and- post ductal sats were within normal range. Cardiology was consulted and came and evaluated the infant and felt that no further cardiovascular workup was needed and that the spells were not related to a cardiovascular issue. Fluids, electrolytes, nutrition - the infant has been ad lib p.o. feeding by breast and feeding well, is voiding and stooling normally. Electrolytes were measured on admission to the NICU [**2184-11-4**] - sodium 149, potassium 4.4, chloride 110, CO2 of 23, BUN 16, creatinine 0.7, calcium 9.3, glucose 74. No further electrolytes have been measured. Gastrointestinal - peak bilirubin level was 12.4/0.4 on day of life seven. The bilirubin has come down to 10.5/0.3 on day of life nine which is [**2184-11-10**]. No further bilirubins have been measured. The infant has not required any phototherapy. Hematology - no blood typing has been done on this infant. A crit on admission, day of life three, was 46 with a platelet count of 358,000. No further crits or platelets have been measured. Infectious disease - a CBC and blood culture were screened on admission to the NICU to rule out sepsis causing cyanosis. The CBC was benign. The infant was not given any antibiotics. The blood culture remains negative. The infant developed yellow eye drainage in the left eye on [**2184-11-12**], and although conjunctivae were not reddened, at the parents' request erythromycin ointment was started. No eye culture has been done. Neurology - the infant has maintained a normal neurologic exam. No neurologic evaluations have been done. Sensory/audiology - a hearing screen was performed with automated auditory brainstem response and the result is pending. CONDITION AT DISCHARGE: Good. DISCHARGE DISPOSITION: Home with the parents. NAME OF PRIMARY PEDIATRICIAN: Dr. [**Last Name (STitle) 28812**], telephone #[**Telephone/Fax (1) 74477**]. CARE RECOMMENDATIONS: Ad lib p.o. feeding by breast with supplementation as needed. Medication - iron ferrous sulfate 0.3 mL p.o. daily; Tri-Vi- [**Male First Name (un) **] multivitamins 1 mL p.o. daily; erythromycin ophthalmic ointment both eyes q.8h. Iron and vitamin D supplementation - 1) iron supplementation is recommended for pre-term and low-birth-weight infants until 12 months corrected age, 2) all infants fed predominantly breast milk should receive vitamin D supplementation at 200 international units which may be provided as multivitamin preparation daily until 12 months corrected age. Car seat position screening - the infant had passed the car seat position test for 90 minutes in an upright position in the car seat. State newborn screen was sent on day of life three; results are pending. Immunizations received - the infant received the hepatitis B vaccine on [**2184-11-4**]. Immunizations recommended - 1) Synagis RSV prophylaxis should be considered from [**Month (only) **] through [**Month (only) 958**] for infants who meet any of the following 4 criteria - a) born less than 32 weeks gestation, b) born between 32 and 35 weeks with two of the following either day care during RSV season, a smoker in the household, neuromuscular disease, airway abnormalities, or school age siblings, c) chronic lung disease, or d) hemodynamically significant congenital heart defect; 2) influenza immunization is recommended annually in the fall for all infants once they reach 6 months of age. Before this age and for the first 24 months of the child's life, immunization against influenza is recommended for household contacts and out-of-home caregivers; 3) this infant has not received the rotavirus vaccine. The American Academy of Pediatrics recommends initial vaccination of pre-term infants at or following discharge from the hospital if they are clinically stable and at least 6 weeks or fewer than 12 weeks of age. Follow-up appointment is recommended with the pediatrician after discharge from the hospital. VNA referral has been made with VNA Care Group, telephone #[**Telephone/Fax (1) 14297**]. DISCHARGE DIAGNOSES: 1. Near-term infant. 2. Dusky episodes resolved. 3. Mild hyperbilirubinemia, resolving on own. 4. Sepsis ruled out. 5. Conjunctivitis, being treated. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 48738**], MD [**MD Number(2) **] Dictated By:[**Doctor Last Name 74478**] MEDQUIST36 D: [**2184-11-12**] 23:32:01 T: [**2184-11-15**] 00:30:48 Job#: [**Job Number 74479**] ICD9 Codes: V290, V053
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Medical Text: Admission Date: [**2113-4-10**] Discharge Date: [**2113-4-22**] Service: MEDICINE Allergies: Zocor / Lipitor Attending:[**First Name3 (LF) 1515**] Chief Complaint: Worsening shortness of breath for 5-6 months. Critical AS. Major Surgical or Invasive Procedure: Core Valve placement Endotracheal intubation Cardioversion History of Present Illness: Mr. [**Known lastname 6330**] is a a very articulate [**Age over 90 **] year old [**Location 7972**] man who has been in good health until the past two years when his activity level has diminished. Over the past three months, he had increasing dyspnea with exertion. He does not have chest pain or syncope-presyncope but is limited to a few stairs or walking across the room. His dyspnea resolves rapidly with rest. He has not had PND, orthopnea, or other cardiovascular symptoms. As part of assessment for percutaneous aortic valve therapy he was found to have iliofemoral peripheral vascular disease. He underwent stenting (x2 Bare Metal Stents) of his right iliac artery on [**2113-3-2**], with excellent result. He was discharged home on [**2113-3-3**] with VNA and has been doing well since. He did complain of back pain to the VNA who sent a U/A via his PCP. [**Name10 (NameIs) **] was positive for a UTI (unknown bacteria) and pt is on day [**3-25**] of Cephalexin. Able to ambulate only 20 steps before has DOE causing him to rest. Also has incontinance at baseline, uses pads at home. On review of systems, he denies any prior history of deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. He denies recent fevers, chills or rigors. He denies exertional buttock or calf pain. All of the other review of systems were negative. . Cardiac review of systems is notable for absence of chest pain, paroxysmal nocturnal dyspnea, orthopnea, palpitations, syncope or presyncope. He does have DOE after 20 ft. He has had TIA s/p stenting of left cartotid artery [**2105**]. Past Medical History: 1. Hypercholesterolemia 2. Recurrent UTIs ([**12-21**] Foley catheters), urinary incontinence 3. Left carotid stenting in [**2105**] due to a TIA with mild left eye droop 4. Bilat Total hip replacement [**2106**] 5. Stage III chronic kidney disease 6. Essential Thrombocytopenia 7. Stage 3 CKD 8. Aortic valve stenosis with valve area 0.5 cm2 9. Hypertension 10. NYHA class III CHF Social History: He lives with his wife in [**Name (NI) 89789**] MA. He has much support at home including daily nursing and home health aide from VNA of [**Hospital3 **]. One son lives next door and is frequently over to see him several times a day; another son is also in to visit several times a day. He uses a cane and has not had any falls. He does not have lifeline in the home but son states there is almost someone there during the day but not at night. He will be accompanied by his son [**Name (NI) **] [**Name (NI) 6330**] (cell) [**Telephone/Fax (1) 89790**]. Uses a walker at home. No history of falls. -Tobacco history: None -ETOH: None -Illicit drugs: None Average Daily Living: Live independently Yes [X] No [ ] Bathing [X] Independent [ ] Dependent Dressing [X] Independent [ ] Dependent Toileting [X] Independent [ ] Dependent Transferring [X] Independent [ ] Dependent Continence [X] Independent [ ] Dependent Feeding [X] Independent [ ] Dependent Family History: There is no history of hypertension, diabetes,stroke and premature coronary artery disease. His mother and father both died at age 85 of natural causes. Physical Exam: ON ADMISSION: Pulse: 50-57 SR B/P: Right 136/73 Left 131/63 Resp: 18 O2 Sat: 99% RA Temp: 98.4 Height: 68 inches Weight: 76.8 kg General: Alert, comfortable, sitting in bed. Skin: no open areas, warm, dry HEENT: supple, JVD 1/2 up bilat. PERLA, EOM's intact. MM moist. Sclera non-icteric. Chest: CTAB posteriorly Heart: regular, 3/6 systolic murmur across precordium, no radiation to carotids. Abdomen: soft, NT, ND Extremities: trace peripheral edema, bilat at ankles and feet. No bruits. Neuro: A/O HOH, appropriate. . ON ADMISSION TO CCU: BP 130/74 (on .5 neo), HR 70, RR 18, O2 sat 100% on 500/16, 60%, PEEP 5, T 34.9 General: initially intubated, sedated, paralyzed. Later, still intubated but awake and following commands HEENT: intubated, JVD difficult to visualized, moist mucosa Chest: clear anteriorly Heart: regular with frequent premature beats, very faint systolic murmur Abdomen: soft, nontender, nondistended Groin: bilateral bandages in place, no evidence of swelling or tenderness (R hip firm, which seems to be his baseline [**12-21**] THR). No bruit. Extremities: trace peripheral edema bilaterally, pulses dopplerable faintly at PT (obtained by one examiner and not another), warm but slightly mottled feet bilaterally Neuro: after withdrawal of sedation, patient able to squeeze hands, blink eyes to command. PERRL . On discharge: Gen: alert, oriented x2 HEENT: supple, CV: RRR, no M/R/G RESP: [**Month (only) **] at bases, no crackles or wheezes ABD: soft, NT, pos BS, had BM EXTR: left groin with large resolving hematoma, no bruit noted. right groin wtih pos bruit. No tenderness NEURO: alert, conversant, less confused. Oriented x 2 Extremeties: no edema Pulses: Right: DP 1+ PT 1+ Left: DP 2+ PT 1+ Skin: intact Pertinent Results: ADMISSION LABS: [**2113-4-10**] 12:40PM WBC-6.7 RBC-3.56* HGB-11.7* HCT-33.8* MCV-95 MCH-33.0* MCHC-34.7 RDW-15.3 [**2113-4-10**] 12:40PM PLT COUNT-191 [**2113-4-10**] 12:40PM NEUTS-66.0 LYMPHS-20.0 MONOS-6.4 EOS-6.4* BASOS-1.1 [**2113-4-10**] 12:40PM PT-14.5* PTT-32.5 INR(PT)-1.2* [**2113-4-10**] 12:40PM GLUCOSE-99 UREA N-32* CREAT-2.2* SODIUM-139 POTASSIUM-4.7 CHLORIDE-106 TOTAL CO2-23 ANION GAP-15 [**2113-4-10**] 12:40PM ALBUMIN-4.1 CALCIUM-9.8 PHOSPHATE-3.6 MAGNESIUM-2.3 [**2113-4-10**] 12:40PM ALT(SGPT)-17 AST(SGOT)-28 LD(LDH)-252* CK(CPK)-56 ALK PHOS-133* TOT BILI-0.4 [**2113-4-10**] 12:40PM CK-MB-4 . DISCHARGE LABS: [**2113-4-22**] 06:50AM BLOOD WBC-9.8 RBC-2.93* Hgb-9.4* Hct-29.0* MCV-99* MCH-32.2* MCHC-32.6 RDW-19.0* Plt Ct-217 [**2113-4-22**] 06:50AM BLOOD PT-44.0* INR(PT)-4.6* [**2113-4-22**] 06:50AM BLOOD Glucose-91 UreaN-51* Creat-2.7* Na-138 K-4.6 Cl-106 HCO3-19* AnGap-18 [**2113-4-12**] 03:25PM BLOOD LD(LDH)-362* CK(CPK)-185 TotBili-1.5 . ECHO ([**4-11**]): The left ventricular cavity size is normal. Overall left ventricular systolic function is normal (LVEF>55%). with mild global free wall hypokinesis. The aortic valve leaflets are severely thickened/deformed. Mild (1+) aortic regurgitation is seen.There is severe aortic stenosis. Moderate (2+) mitral regurgitation is seen, with a restricted posterior leaflet.There is also a mitraal valve cleft bettween P1 and P2. Moderate [2+] tricuspid regurgitation is seen. There is no pericardial effusion. Post TAVI There is 2+ aortic regurgitation.The regurgitation is parvalvular, 2+ mitral regurgitation similar to preprocedure No pericardial effusion is seen LV function is preserved . ECHO ([**4-18**]): The left atrium is mildly dilated. The right atrium is moderately dilated. There is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (LVEF>55%). The right ventricular cavity is dilated with mild global free wall hypokinesis. The aortic root is mildly dilated at the sinus level. An aortic CoreValve prosthesis is present. The prosthetic aortic valve leaflets appear normal. The transaortic gradient is normal for this prosthesis. There are two small paravalvular aortic regurgitation jets, together constituting no more than mild (1+) aortic regurgitation is seen. Moderate (2+) mitral regurgitation is seen. Moderate [2+] tricuspid regurgitation is seen. There is severe pulmonary artery systolic hypertension. There is no pericardial effusion. IMPRESSION: Normally-functioning CoreValve aortic prosthesis. Symmetric LVH with normal global and regional systolic function. Severe pulmonary hypertension with dilated right ventricle and mild global systolic dysfunction and moderate to severe functional tricuspid regurgitation. . EKG ([**4-19**]): Sinus bradycardia with first degree atrio-ventricular conduction delay. Low QRS voltage in limb leads. Inferior wall myocardial infarction of indeterminate age. Lateral myocardial infarction of indeterminate age. Compared to the previous tracing of [**2113-4-18**] multiple abnormalities persist without major change. . Brief Hospital Course: [**Age over 90 **]yoM with NYHA Class 3 CHF and severe AS, now s/p COREvalve with post-procedure course complicated by hemodynamic instability and new onset AF with RVR. . # Aortic stenosis: Corevalve procedure was without complications. He was extubated immediately post-op. Subsequent TTEs showed appropriate positioning and functioning of the valve. Aspirin and Plavix were continued. . # Hypotension: In the immediate post-procedure period, he was recurrently hypotensive, and did several hours after the procedure, lose his pulse briefly. He regained blood pressure and consciousness after 1 round of CPR. However, over the next 48 hours he had 3 more episodes of sudden, profound hypotension to the 40s systolic with loss of consciousness. Each time he regained consciousness within seconds without intervention. This was all thought to be due to profound systemic dilatation in the setting of the sudden relief of his outflow tract obstruction He required intermittent neosynephrine in the first 48 hours post-procedure. Echo showed a collapsed LV and outflow tract obstruction, prompting fluid resuscitation. His blood pressures improved, but subsequently decreased due to atrial fibrillation. His blood pressures again stabilized with rate, and eventually rhythm control. . # Atrial Fibrillation. New diagnosis of Afib. On [**4-14**] amio loaded and anticoagulation started with hep ggt. He was cardioverted on [**4-18**] and continued on amiodarone and coumadin. He remained in sinus bradycardia with stable blood pressures. The decision was made to discontinue coumadin on [**2113-4-22**] given bleeding risk and interaction with amio. Amiodarone was changed to 200 mg daily. . # Thrombocytopenia. Patient with 191 -> 83 drop in platelets in the several days post-procedure. D-dimer and FDP were elevated but fibrinogen was not low and no evidence of hemolysis. RBC morphology did not demonstrated schistocyes. HIT was thought to be unlikely. Platelets returned to baseline over the next week. . # Anemia: HCT stable after 2u of pRBC on [**4-13**]. CT showed Left pelvic hematoma with layering blood in the pelvis and a small amount of peri-hepatic hemoperitoneum. No retroperitoneal hematoma. Repeat b/l LE duplex - Normal appearance to right CFA, and CFV Pseudoaneurysm no longer seen. Hct stabilized and no further transfusions were required. . # Acute on chronic Diastolic CHF: After core-valve procedure patient was hypotensive and very pre-load dependent with bedside echo demonstrating low filling. Was treated with IVF boluses. BP??????s subsequently stabilized and patient was LOS balance positive upto 5L. Subsequently appeared clinically fluid overloaded with crackles and wheezing on lung auscultation and congested appearance of chest x ray, this prompted diuresis with boluses of 10mg IV lasix. He was approximately euvolemic upon discharge. . # Delirium. Patient developed confusion and disorientation during hospitalization, which was likely secondary to prolonged ICU course. He had no signs of active infection. He was given seroquel prn and daily ECG was followed to monitor for QTc prolongation. Seroquel was discontinued on discharge due to sedation. . # CORONARIES: No history of CAD. ASA and pravastatin were continued. . # Peripheral Vascular disase: S/P BMS to right iliac artery. Pulse exam was stable - PT pulses dopplerable, DP very faint on doppler . # CKD, Stage 3: Creatinine increased to 2.7 from baseline 2.2. Believed to be pre-renal given FeUrea <25%. He was given 1 liter NS bolus on the day of discharge. He will require daily Cr checks. . # Dyslipidemia: Pravastatin was continued . CODE: Full . COMM: [**Name (NI) **]: [**Name (NI) **] [**Name (NI) 6330**], [**First Name3 (LF) **]. [**Telephone/Fax (1) 89791**]. Pt is illiterate. . Transitions of Care: - Daily Cr checks Medications on Admission: confirmed with son and list 1. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 2. pravastatin 10 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 3. multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 5. clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Lumigan 0.01 % Drops Sig: Two (2) drops Ophthalmic at bedtime. 7. Cephalexin 500 mg po QID, day #5 of 7 for UTI 8. Tylenol 500 mg PO BID for back pain Discharge Medications: 1. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 2. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. pravastatin 10 mg Tablet Sig: One (1) Tablet PO once a day. 4. multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. latanoprost 0.005 % Drops Sig: One (1) Drop Ophthalmic HS (at bedtime). 7. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 8. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 9. senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 10. polyethylene glycol 3350 17 gram/dose Powder Sig: One (1) packet PO DAILY (Daily) as needed for constipation. 11. Outpatient Lab Work please check daily Cr, until begins trending down to baseline 2.2. 12. amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Discharge Disposition: Extended Care Facility: Cape Regency, A [**Hospital 671**] HealthCare Center - [**Location 41366**] Discharge Diagnosis: Severe Arotic Stenosis s/p CoreValve placement Delerium Atrial fibrillation Acute on Chronic kidney disease Chronic thrombocytopenia and anemia Acute on chronic diastolic congestive heart failure Discharge Condition: Mental Status: Confused - always. Level of Consciousness: Alert and interactive. Activity Status: Out of Bed with assistance to chair or wheelchair. Discharge Instructions: You had a naortic CoreValve placed that has fixed your severe aortic stenosis. The procedure went well but you had some complications that include bleeding at the right and left groin site, delerium and atrial fibrillation. Your groin sites have been stable with no evidence of bleeding at present. The atrial fibrillation was converted to a normal rhythm via a cardioversion procedure and you were started on a medicine called amiodarone to keep you in a normal rhythm. You will need to have your thyroid, liver and lung function followed regularly while you are on this medicine. You thyroid and liver function tests were OK here in the hospital. You were also started on coumadin to prevent a blood clot from the atrial fibrillation. Your coumadin level is high now, probably from the interaction with the amiodarone. This level will be followed closely from now on. You were confused from being in the hospital and this is clearing slowly. Weigh yourself every morning, call Dr. [**Last Name (STitle) **] if weight goes up more than 3 lbs in 1 day or 5 pounds in 3 days. . We made the following changes to your medicines: 1. START amiodarone to keep you in a normal rhythm 2. START senna, colace and miralax to treat your constipation Followup Instructions: Department: CARDIAC SERVICES When: FRIDAY [**2113-5-12**] at 12:20 PM With: [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern1) **], MD [**Telephone/Fax (1) 62**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: CARDIAC SERVICES When: FRIDAY [**2113-5-12**] at 11:00 AM With: ECHOCARDIOGRAM [**Telephone/Fax (1) 62**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage ICD9 Codes: 4241, 2930, 5990, 2762, 9971, 2875, 4280, 2720, 4168
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Medical Text: Admission Date: [**2187-2-12**] Discharge Date: [**2187-2-15**] Date of Birth: [**2109-8-5**] Sex: M Service: GU ADMISSION DIAGNOSIS: Benign prostatic hypertrophy. POSTOPERATIVE DIAGNOSES: Benign prostatic hypertrophy, postoperative anemia. ADMISSION HISTORY AND PHYSICAL: Patient is a 77-year-old male with a history of BPH and no other medical history who presented for surgical resection after complaining of weak stream. PAST MEDICAL HISTORY: Includes BPH and mild exercise intolerance. PAST SURGICAL HISTORY: Of renal cyst aspiration, hernia repair, cataract surgery, and colonoscopy and biopsy. MEDICATIONS: Include aspirin 81 mg every day. ALLERGIES: No known drug allergies. SOCIAL HISTORY: Includes no tobacco use and [**2-16**] alcoholic drinks a day with no drug use. REVIEW OF SYMPTOMS: Otherwise noncontributory. PHYSICAL EXAM: Revealed a 71 inch, 157 pound male with a pulse of 68, blood pressure of 147/92 in no apparent distress with clear lungs with a [**2-19**] murmur in left sternal border with abdomen that is soft and nontender. No extremity edema. HOSPITAL COURSE: Patient presented as above and underwent a transurethral resection of the prostate for BPH on [**2187-2-12**]. This was a large resection, and postoperatively was noted to have a great deal of hematuria requiring brisk CBI immediately postoperatively. Because of the brisk CBI and requiring bag changes approximately every 30 minutes, patient was monitored overnight for 1-to-1 nursing care in the ICU. Medically, however, patient remained stable throughout the hospital course, and patient's hematocrit postoperatively was in the 30s (stable at 30 at discharge). Patient did not require any transfusions. The patient's Foley was removed on postoperative day #2 after urine was noted to be fruit punch color off of CBI. Patient was then observed for another day of hospitalization, and reported urinating well. But initially urinated several clots. The urine color then became much lighter in color after urination of clots. Patient reported sensation of complete emptying upon discharge, and also reported a very strong stream and good satisfaction of his urination. Therefore, upon discharge on postoperative day #3, patient was ambulating, voiding, without significant pain, and tolerating POs without difficulty. DISCHARGE CONDITION: Good. DISCHARGE DIET: Regular. DISCHARGE MEDICATIONS: Tylenol 650 mg p.o. q.4h. p.r.n. pain, Colace 100 mg p.o. b.i.d. No antibiotics were given upon discharge because 3 days of ciprofloxacin had been given in the hospital. FOLLOWUP: Will be with Dr. [**Last Name (STitle) 365**] in [**1-15**] weeks. DISCHARGE ACTIVITIES: No restrictions. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], [**MD Number(1) 27469**] Dictated By:[**Name8 (MD) 20918**] MEDQUIST36 D: [**2187-2-15**] 07:27:56 T: [**2187-2-15**] 08:49:15 Job#: [**Job Number 27470**] ICD9 Codes: 2851
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Medical Text: Admission Date: [**2196-1-25**] Discharge Date: [**2196-2-8**] Date of Birth: [**2149-10-8**] Sex: M Service: SURGERY Allergies: Cefepime Attending:[**First Name3 (LF) 371**] Chief Complaint: Biliary colic Major Surgical or Invasive Procedure: [**2196-1-25**] ERCP w/ sphincterotomy open cholecystectomy History of Present Illness: 46M with history of biliary colic, morbid obesity, HTN, lower extremity edema , who presents directly from ERCP where he underwent ERCP and sphincterotomy. Pt tolerated the procedure well. Prior to the ERCP pt was admitted to [**Hospital **] hospital [**1-22**] for severe recurrent epigastric pain after eating, lasting hours, in the setting of elevated transaminases (AST:ALT 370:447 AP 166, TB 4, lipase 22 ). Pt does have history of similar pain just a few days prior as well as approx one year ago which resolved on its own. On [**1-18**] and again on [**1-22**] pt underwent RUQ U/S which showed cholelithiasis but no evidence of cholecystitis. Pt denies fever at any point, but does admit to recent nausea and vomiting. Past Medical History: obesity, depression, hypothyroidism, lower extremity edema, biliary colic Social History: Lives alone in [**Location (un) 932**], unemployed. Denies cigs or drugs, +etoh (1-2 drinks a night) Family History: Noncontributory Physical Exam: Upon presentation: VS: 97.6, 128/85, 68, 18, 93% RA GEN: A&O, NAD HEENT: No scleral icterus, mucus membranes dry CV: RRR, No M/G/R PULM: Clear to auscultation b/l, ABD: Soft, obese, nontender, no rebound or guarding, normoactive bowel sounds, no palpable masses Ext: Severe LE edema. Psych: flat affect. Pertinent Results: RENAL & GLUCOSE Glucose 78 Urea Nitrogen 9 6 - 20 mg/dL Creatinine 0.6 0.5 - 1.2 mg/dL Sodium 136 133 - 145 mEq/L Potassium 3.8 3.3 - 5.1 mEq/L Chloride 100 96 - 108 mEq/L Bicarbonate 27 22 - 32 mEq/L ENZYMES & BILIRUBIN Alanine Aminotransferase (ALT) 206* 0 - 40 IU/L Asparate Aminotransferase (AST) 98* 0 - 40 IU/L Alkaline Phosphatase 121 40 - 130 IU/L Bilirubin, Total 0.6 0 - 1.5 mg/dL OTHER ENZYMES & BILIRUBINS Lipase 24 0 - 60 IU/L CHEMISTRY Calcium, Total 8.4 Phosphate 3.3 Magnesium 2.0 IMAGING: [**2196-1-25**] ERCP: A sphincterotomy was performed in the 12 o'clock position using a sphincterotome over an existing guidewire.CBD was sweeped with balloon catheter and sludge was extracted. Impression: Normal major papilla Cannulation of the biliary duct was successful and deep with a sphincterotome using a free-hand technique. Contrast medium was injected resulting in complete opacification. CBD and intrahepatic biliary tree was normal in calibre. There was a filling defect that appeared like sludge in the distal CBD. A sphincterotomy was performed in the 12 o'clock position using a sphincterotome over an existing guidewire. CBD was sweeped with balloon catheter and sludge was extracted. [**2196-1-30**] BLE Duplex U/S: No evidence of DVT in bilateral lower extremities. [**2196-1-30**] CT TORSO (non-con): IMPRESSION: 1. Bilateral heterogeneous opacification in the lungs, worst in the left lower [**Last Name (LF) 3630**], [**First Name3 (LF) **] represent atelectasis; however, underlying infectious process such as pneumonia or aspiration cannot be completely excluded and should be considered in the correct clinical setting. 2. Status post cholecystectomy with percutaneous biliary drain. 3. Fat-containing ventral periumbilical hernia and a fluid filled right inguinal hernia. [**2196-1-31**] CT TORSO (w/ con): IMPRESSION: 1. Nondiagnostic examination in the evaluation of pulmonary embolism secondary to respiratory motion artifact. 2. No evidence of venous clot in the iliac veins or veins of the pelvis. 3. Increasing size and number of lymph nodes both in the mediastinum and right inguinal area. Clinical correlation recommended to exclude low grade hematologic malignancy. 4. Areas of consolidation in bilateral lung bases and in the right upper [**Month/Day/Year 3630**] may be on the basis of atelectasis, although superimposed infection or central obstructing lesion cannot be excluded based on this examination. [**2196-2-1**] ECHO: Technically suboptimal study despite the use of Definity. No clinically useful information was derived. If clinically indicated, a radionuclide ventriculogram may be better able to assess biventricular systolic function. Brief Hospital Course: He was admitted to the Acute Care Surgery Service as a direct admission following ERCP. He was given IV hydration and made NPO. His LFT's and bilirubin were followed closely and slowly trended downward. Early discussions took place with patient for operative management with cholecystectomy for which patient wanted to discuss further with team and his family before definitively consenting for this. On [**1-26**] the he underwent a laparoscopic converted to an open cholecystectomy. POD #1 his urinary output dropped and he received fluid along with 1 unit pRBC with adequate urinary response. On POD #2 he was advanced to a regular diet. He continued to do well. However, overnight he began to drop his O2 sats and became tachycardic. In addition, his Cr rose to 1.6 from 0.9 the day before. A CXR was performed which showed mild pulmonary vascular congestion. He was given a dose of Lasix with no response. An ABG revealed hypoxemia with pO2 of 65. Given the concern for PE and his ongoing hypoxia, he was transferred to the ICU for close monitoring. A CTA chest with PE protocol was unable to be performed because the patient's Cr had bumped to 1.9. Therefore, a CT torso without contrast was performed which showed a bilateral lower [**Month/Day (4) 3630**] opacification (L>R) but was otherwise unremarkable. BLE duplex U/S was negative for DVT. While in the unit, he became hypotensive with systolic blood pressures ranging between 70s-80s. He was empirically started on vanc/zosyn. The next day ([**2196-2-1**]), his antibiotics were changed to vanc/Cipro/cefepime to cover hospital acquired pneumonia. An NGT was placed with immediate return of 500 cc of coffee ground fluid; his HCT was found to be 22.8. He was transfused 2 units of pRBC's. GI team was consulted regarding a potential upper endoscopy. However, they felt EGD would require elective intubation and therefore the procedure was deferred. The patient was aggressively fluid resuscitated and his urine output remained adequate. The following day his Cr dropped to 1.3 and he was sent for a CTA with PE protocol which was indeterminate for PE due to motion artifact but did not show thrombus in the aortoiliac or pelvic veins. Serial HCT were trended and remained stable. An echo was attempted [**2-1**] but the quality was suboptimal secondary to the patient's large body habitus. He still had a significant supplemental oxygen requirement. Over the next few days in the ICU his respiratory status remained tenuous. He was started on intermittent Lasix boluses [**2196-2-1**] which resulted in large diuresis and he was able to be weaned to nasal cannula. On [**2196-2-2**], he was started on 20mg PO Lasix daily and was given 40mg IV Lasix as well as a dose of Diamox. He again responded with a brisk diuresis but then became hypotensive overnight requiring 2.5L of fluid boluses. His HCT in the AM was 21 and he was transfused one unit pRBC's. The patient also developed an urticarial rash on [**2196-2-2**] and this was attributed to having switched his Cipro from IV to PO. The Cipro was therefore discontinued and he was started on Levofloxacin. His rash has virtually resolved at time of this dictation. He remained on the Vancomycin and Levofloxacin for the pneumonia for a total of 7 day course, stop date [**2196-2-10**]. He is also receiving Flagyl for a presumed C. difficile colitis given his stool volume. It should be noted that he has had 2 negative stool for C. Diff cultures. His treatment with Flagyl will continue for a total of 7 day course. A Flexi seal system was placed rectally for stool containment and protection of patient's skin given his large body habitus. Cholestyramine was started as well. He was also seen by Psychiatry for his anxiety and depression and it was recommended to increase his Celexa to 40 mg daily from 30 mg and to avoid benzodiazepines as this would put him at risk for delirium. He was evaluated by Physical therapy and is being recommended for rehab after his acute hospital stay. Medications on Admission: Lisinopril 10mg PO daily Levothyroxine 137 mcg PO daily Lasix 20 mg PO daily Celexa 30 mg PO daily Discharge Medications: 1. lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. levothyroxine 137 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. furosemide 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. citalopram 20 mg Tablet Sig: 1.5 Tablets PO DAILY (Daily). 5. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) Neb Inhalation Q4H (every 4 hours) as needed for shortness of breath or wheezing. 6. ipratropium bromide 0.02 % Solution Sig: One (1) Neb Inhalation every six (6) hours. 7. pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). 8. heparin (porcine) 5,000 unit/mL Solution Sig: One (1) ML Injection TID (3 times a day). 9. levothyroxine 75 mcg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 10. diphenhydramine HCl 25 mg Capsule Sig: One (1) Capsule PO Q6H (every 6 hours) as needed for pruritis. 11. furosemide 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 12. trazodone 50 mg Tablet Sig: 0.5 Tablet PO HS (at bedtime) as needed for insomnia. 13. citalopram 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 14. miconazole nitrate 2 % Powder Sig: One (1) Appl Topical three times a day: apply to skin folds. 15. hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. 16. cholestyramine-sucrose 4 gram Packet Sig: Two (2) Packet PO BID (2 times a day). 17. Vancomycin 1500 mg IV Q 12H Start: [**2196-2-3**] stop date [**2196-2-10**] 18. levofloxacin in D5W 750 mg/150 mL Piggyback Sig: Seven [**Age over 90 1230**]y (750) MG Intravenous Q24H (every 24 hours): stop date [**2196-2-10**]. 19. metronidazole in NaCl (iso-os) 500 mg/100 mL Piggyback Sig: Five Hundred (500) MG Intravenous Q8H (every 8 hours): stop date [**2196-2-11**]. 20. insulin regular human 100 unit/mL Solution Sig: One (1) Dose Injection four times a day as needed for per sliding scale. Discharge Disposition: Extended Care Facility: [**Hospital3 1107**] [**Hospital **] Hospital - [**Location (un) 38**] Discharge Diagnosis: Choledocholithiasis Upper Gastrointestinal Bleed Acute Blood Loss Anemia Pneumonia Anxiety Depression Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: You were admitted to the hopsital with gallstones and underwent a procedure called an ERCP which looks inside of your biliary system. You then had your galbladder removed. You did well in the post operative period and your diet was advanced. You should avoid fried and/or greasey foods; food choices should include those that are low in fat. You may resume your home medications as prescribed. If you have been prescribed an anitibiotic please continue the course as directed. Return to the emergency room if your symptoms come back. Followup Instructions: Follow up in [**12-31**] weeks in Acute Care Surgery Clinic. Please call [**Telephone/Fax (1) 600**] for an appointment. Follow up with your primary care providers as directed. Completed by:[**2196-2-9**] ICD9 Codes: 486, 5789, 2851, 5180
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Medical Text: Admission Date: [**2112-1-14**] Discharge Date: [**2112-1-21**] Date of Birth: [**2059-9-23**] Sex: F Service: UROLOGY ADMITTING DIAGNOSIS: Pheochromocytoma. HISTORY OF PRESENT ILLNESS: The patient is a 52-year-old white female who was initially referred for evaluation of microscopic hematuria and right adrenal mass. The patient underwent a cystoscopy, which was normal. Review of outside films did not demonstrate any ureteral or renal abnormality. However, a magnetic resonance scan was performed which demonstrated a 3.6 x 4.4 irregularly shaped right adrenal mass with T2 hyperintensities. On further questioning, the patient was found to have proximal palpitations, chest pain and headaches all precipitated by exertion several times per day for the last half year or so. The blood pressure was checked by her school nurse during one of these episodes, and her blood pressure was elevated to 190/120. The patient had also developed night sweats starting [**9-/2111**], and reported a [**11-30**] pound weight loss between [**7-/2111**] and 12/[**2110**]. The patient had been treated with p.o. phenoxybenzamine and nifedipine with partial resolution of her palpitations and headaches. A 24-hour catecholamine study revealed elevated normetaepinephrine of 493 and elevated combined metanephrine and normetanephrine of 633. Vanillylmandelic acid or VMA was normal at 5.3. The patient also had normal levels of urinary 17-ketosteroids, cortisol, chromogranin-A, aldosterone, and plasma renin. The patient denied any flank pain, fevers, chills. PAST MEDICAL HISTORY: 1. Glaucoma. 2. Hypothyroidism. PAST SURGICAL HISTORY: Glaucoma surgery. MEDICATIONS ON ADMISSION: 1. Levothyroxine 50 mcg q day. 2. Phenoxybenzamine 10 mg b.i.d. 3. Nifedipine 30 mg q day. ALLERGIES: No known drug allergies. SOCIAL HISTORY: The patient is a teacher at a local school. The patient smokes about one and a half packs of cigarettes per day for thirty years. The patient also drinks [**12-18**] alcoholic beverages per day. PHYSICAL EXAMINATION: VITAL SIGNS: Pulse 95, blood pressure 137/77, respiratory rate 16. HEAD AND NECK: Within normal limits. CHEST: Clear to auscultation bilaterally. HEART: Regular rate and rhythm. GASTROINTESTINAL: Soft, nondistended, nontender, no CVA tenderness, no palpable mass. LABORATORY DATA: Please see History of Present Illness. HOSPITAL COURSE: The patient was admitted on [**2112-1-14**] and underwent a laparoscopic right-sided adrenalectomy. The patient tolerated the procedure well and there were no immediate postoperative complications. The patient's pain was well controlled with intravenous morphine. The patient was continued on intravenous fluids for hydration, and the patient's hematocrit and creatinine were stable and normal. On postoperative day one, the patient was continued on NPO status, and the patient's diltiazem was continued, but her alpha adrenergic blockers were discontinued. The patient's blood pressure remained stable. On postoperative day two, the patient had decreased breath sounds on the left chest, and the patient's O2 saturations began to decline. The patient denied any shortness of breath, but an arterial gas revealed a pH of 7.38, PCO2 of 49 and a PO2 of 45. The patient was transferred to the Intensive Care Unit and was intubated for better oxygenation. A chest x-ray revealed opacification of her left chest. The patient was started on levofloxacin and Flagyl for possible pneumonia. The patient's poor oxygenation was felt to be due to a combination of her underlying chronic obstructive pulmonary disease and possible atelectasis/pneumonia. By postoperative day three, the patient had improved O2 saturations overnight, and her blood pressures were well controlled on nifedipine. The patient was continued on levofloxacin and Flagyl, and a follow-up chest x-ray also showed only slight improvement on the left side. A bronchoscopy performed on [**2112-1-17**] revealed some secretions on the right lower lobe, but the left side was indeed clear. On postoperative day four, the patient's respiratory status slightly improved from the previous day. A chest x-ray also showed some improvement and Pulmonary consult recommended starting on systemic steroids, as well as inhaled steroids. By postoperative day five, the patient's chest x-ray was dramatically improved, and her O2 saturations remained stable. The patient was extubated successfully. As the patient appeared comfortable and in no respiratory distress, it was felt that the patient would be transferred to the floor on postoperative day five. The patient was continued on Solu-Medrol 60 mg q eight which was eventually tapered. On postoperative day six, the patient was weaned off her O2, and her O2 saturations remained above 90%. Chest x-ray showed marked clearing of the left side. The Foley was discontinued and the patient was encouraged to ambulate t.i.d. By postoperative day seven, the patient was in no further respiratory distress. It was felt that the patient would be ready for discharge home. FOLLOW-UP INSTRUCTIONS: The patient was to follow-up with Dr. [**Last Name (STitle) 4229**] within 2-4 weeks. DISCHARGE STATUS: Home. DISCHARGE CONDITION: Good. DISCHARGE MEDICATIONS: 1. Colace 100 mg p.o. b.i.d. 2. Inhaler four puffs inhalation b.i.d. 3. Percocet 5/325 mg tablets, 1-2 tablets p.o. q 4-6 hours p.r.n. for pain. 4. Levofloxacin 500 mg p.o. q day. 5. Flagyl 500 mg p.o. t.i.d. 6. Prednisone 20 mg q day. 7. Prednisone 10 mg q day after finishing 20 mg dose. 8. Nicotine patch q 24 hours. 9. Synthroid 50 mcg q day. 10. Albuterol and Atrovent inhalers. DISCHARGE DIAGNOSIS: Pheochromocytoma, status post laparoscopic right adrenalectomy. [**Doctor First Name **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **], M.D. [**MD Number(1) 8916**] Dictated By:[**Name8 (MD) 3430**] MEDQUIST36 D: [**2112-1-21**] 08:20 T: [**2112-1-21**] 10:52 JOB#: [**Job Number 98581**] ICD9 Codes: 486, 496, 5180, 2851, 2449, 3051
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Medical Text: Admission Date: [**2178-5-8**] Discharge Date: [**2178-6-13**] Service: ICU CHIEF COMPLAINT: Decreased hematocrit, increased INR. HISTORY OF THE PRESENT ILLNESS: The patient is an 84-year-old male who presented for outpatient ERCP and was found to have a newly diminished hematocrit to 17 and newly increased INR to 3.0. The patient had recently been diagnosed with diabetes mellitus three months ago and started on insulin. Approximately 3 1/2 weeks ago, the patient developed dark urine and went to his primary care physician who noted jaundice and had the patient go for a CT of the abdomen where a mass in the head of the pancreas was seen. The patient was scheduled for outpatient ERCP on the day of presentation. Upon presentation, he noted melenic dark black stools mixed with some [**Male First Name (un) 1658**]-colored stools, fatigue, back pain, early satiety and some decreased appetite. The patient was admitted to the General Medical Service and Gastroenterology was consulted for ERCP. The patient was evaluated and concern for pancreatic carcinoma led to scheduling for an ERCP. There was also concern for a possible biliary obstruction given the elevated alkaline phosphatase of 1,818 and total bilirubin of 12.4 and so the procedure was also for the purpose of decompression. On the day after admission, the patient had received 2 units of packed red blood cells and had a CT of the abdomen which revealed a 3.2 cm mass in the head of the pancreas with clear fat planes between the mass and all surrounding abdominal organs with vascular structures intact with the exception of the mass which abutted and possibly invaded the duodenum. The SMV, portal vein, SMA, gastroduodenal artery and stomach were all free from involvement. There was massive intra and extrahepatic biliary ductal dilatation and pancreatic ductal dilatation upstream to the pancreatic head mass. Incidental finding of a small left renal cyst versus angiomyolipoma was noted. The patient had episodic desaturations to the low 70s to 80s which improved to 90s with supplemental oxygen. Chest x-ray done at one of the episodes revealed diffuse interstitial opacities, raising a question of pulmonary edema versus lymphangitic spread versus atelectasis with collapse versus pneumonia. The patient received a trial of IV Lasix and concern for ongoing clinical deterioration led to the consideration for ICU level care. On [**2178-5-10**], the patient was found to be very short of breath, saturating mid 90s on a 100% nonrebreather. The patient's white blood cell count was noted to continue to rise into the mid 20s and his renal function was found to decline with a creatinine of 2.2 concerning for ATN. There was concern for evolving sepsis in the setting of biliary obstruction and possible cholangitis. The patient had been started on ceftriaxone and Flagyl for antibiotic coverage. The patient was electively transferred to the ICU and evaluated for emergent biliary decompression. Infectious Disease was consulted and recommended that the patient undergo treatment with Zosyn 2.25 grams IV q. eight hours. The patient was admitted to the ICU. The patient's hematocrit was noted to continue to be low and he was given 3 units of packed red blood cells along with vitamin K 10 mg subcutaneously for an elevated INR. The patient's hypoxia was thought to be secondary to multilobar pneumonia versus evolving ARDS. There was concern about the need to intubate preprocedure in order to enable the patient to undergo ERCP. The patient's acute renal failure was thought secondary to possible prerenal state in the setting of sepsis. Renal was consulted for further evaluation of the patient's acute renal failure and it was felt that the patient's acute renal failure was secondary to acute interstitial nephritis in the setting of treatment with Zosyn. The Zosyn was discontinued and the patient underwent supportive care with avoidance of nephrotoxins and discontinuation of the patient's angiotensin receptor blocker. At 7:35 p.m. on [**2178-5-10**], the patient was intubated for progressive hypoxemia. The patient underwent emergent ERCP which showed a giant ulcer in the posterior vault, evidence of previous cholecystectomy, biliary stricture compatible with known tumor in the head of the pancreas. The patient was continued on broad spectrum antibiotics. There was inability to place this biliary stent on the first attempt. The patient returned to the ERCP Suite on [**2178-5-11**] and sphincterotomy was performed with a coated walled stent placed in the distal common bile duct. There was concern for malignant ulcer in the posterior duodenal bulb, distal common bile duct stricture consistent with the known tumor in the head of the pancreas. Surgery was consulted for a possible Whipple procedure; however, given the patient's current clinical status at this time, no surgical intervention was needed at the time. The patient was followed by Renal who recommended the use of diuretics for volume control. Cortisol levels revealed that the patient did not have any evidence of adrenal insufficiency. He transiently required pressors consisting of Levophed but this was eventually able to be weaned off. The patient was bronchoscoped for evaluation of pneumonia versus ARDS. The patient's pancreatic and liver function tests diminished after ERCP. The option of dialysis was presented and the family elected not to partake of this. The patient's volume was able to be controlled with intravenous diuretics. The patient was ventilated with low tidal volumes and increased respiratory rate per the ARDS net protocol. An esophageal balloon was used to guide the patient's PEEP requirement and this suggested ARDS as the patient had increased chest wall and abdominal pressures. The patient's ICU course was also complicated by hyponatremia which warranted increased free water boluses. The patient required an insulin drip for glycemic control which was worse in the setting of infection. The patient underwent diuresis to try to decrease the amount of FI02 that he was requiring. By [**2178-5-23**], the patient showed improvement in his ventilatory requirements as well as ability to come off pressor agents. His acute renal failure continued to improve. The Renal Service recommended a short steroid course of prednisone to treat the patient's acute interstitial nephritis. This was initiated with steady improvement in the patient's creatinine which had reached a high of 8.5. The patient developed some neutropenia which was also felt to be due to a reaction of Zosyn. This resolved spontaneously with discontinuation of the medication. Also, in support of a reaction to Zosyn, the patient developed a maculopapular rash. All of these improved with the discontinuation of the drug. The patient had been afebrile for a significant amount of his ICU stay and around [**2178-5-21**], developed low-grade temperature elevation and cultures were drawn. The patient eventually grew MRSA from sputum, likely related to ventilator-associated pneumonia. He was started on vancomycin for treatment of this. Given the possible presence of a drug reaction and some decreased urine output and difficulty controlling the patient's volume, the patient was diuresed with ethacrynic acid with good response. The patient developed hematuria for which Urology consult was obtained and this was thought to be secondary to ethacrynic acid which is associated with gross hematuria and the patient was diuresed further with Lasix in place of ethacrynic acid. The patient developed a contraction alkalosis for which he received Diamox with a good improvement. The patient's ARDS was shown to resolve on serial chest x-rays. The patient underwent weaning from the ventilator and his sedation was changed from Ativan to propofol in the hope of achieving sustained extubation. On [**2178-6-4**], a family meeting was held with the plan to discuss the need for reintubation after an extubation attempt. The family elected to reintubate in the event of an extubation failure. The patient was extubated successfully on [**2178-6-4**]. He remained with a relatively high oxygen requirement post extubation. He continued treatment for MRSA pneumonia with vancomycin for a total course of ten days. His acute renal failure resolved to a baseline creatinine of 1.4. As the patient was off sedation, his mental status improved. He developed oral lesions shortly after extubation which were thought to be secondary to HSV. The patient remained with tenuous respiratory status over the next four days after extubation but did show slow but steady improvement in his oxygen requirement. PAST MEDICAL HISTORY: 1. Type 2 diabetes mellitus times 22 years. 2. Hypertension. 3. Hypercholesterolemia. MEDICATIONS: 1. Humalog/Humulin sliding scale 17 units in the a.m., 8 units at h.s. 2. Lopressor 50 mg p.o. b.i.d. 3. Glyburide 5 mg p.o. b.i.d. 4. Cozaar 100 mg p.o. q.d. 5. Percocet p.r.n. ALLERGIES: The patient has no known drug allergies. SOCIAL HISTORY: The patient is married and did not smoke or drink. He use to work as a truck manager for Ford Motors. FAMILY HISTORY: The patient has a sister with diabetes and chronic renal insufficiency. There is no history of pancreatic malignancy in his family. LABORATORY/RADIOLOGIC DATA: The patient had a white blood cell count of 14.3 on admission with a hematocrit of 16.4 and platelets of 341,000. His INR was 3.9. His ALT was 167, AST 221, total bilirubin 17.2, alkaline phosphatase 2,024, amylase 28, total bilirubin 17.2 with a lipase of 233. CT of the abdomen revealed a 3.2 cm mass in the head of the pancreas, clear fat planes between the mass and all surrounding abdominal organs and vascular structures with the exception of the duodenum. SMV, portal vein, SMA, gastroduodenal artery, and stomach were all free from involvement. Massive intra and extrahepatic biliary ductal dilatation was noted, pancreatic ductal dilatation upstream of the pancreatic mass was noted. Small left renal cyst versus angiomyolipoma was noted. Chest x-ray revealed biapical pleural thickening, small bilateral pleural effusion. HOSPITAL COURSE: The patient was an 84-year-old male with a pancreatic mass status post ERCP and stenting for biliary obstruction with a complicated ICU course significant for respiratory failure and acute renal failure. 1. PULMONARY: The patient underwent extubation on [**2178-6-4**] and had ongoing difficulties with secretions and aspiration. The patient oxygenated with steady improvement over the course of several days postextubation. He was initially able to be weaned to 4 liters of nasal cannula. His ARDS continued to resolve on serial chest x-rays. He underwent several bedside swallow evaluations which initially showed severe aspiration but with time he was able to pass a bedside swallow examination. ENT evaluated his vocal cords for vocal cord dysfunction and he appeared to be able to protect his airway. He completed a ten day course of vancomycin for MRSA pneumonia. He continued to have aggressive pulmonary toilet and continued to do well from a respiratory standpoint. 2. RENAL: The patient's acute renal failure resolved completely to be better than baseline, creatinine of 1.4. The patient's acute interstitial nephritis was thought to be secondary to Zosyn. He completed a short course of steroids which were tapered and continued to make adequate urine output over the course of his admission. 3. NEUROLOGIC: The patient initially had depressed mental status which was thought secondary to the heavy sedation while intubated. As the sedation wore off, his mental status cleared and he was able to participate in discussions of level of care and was quite lucid and cooperative. 4. CARDIOVASCULAR: The patient did undergo an echocardiogram which revealed LV ejection fraction of 70%, mild diastolic dysfunction, no regional wall motion abnormalities, normal right ventricular systolic function, mild 1+ mitral regurgitation, moderate pulmonary hypertension, moderate 2+ tricuspid regurgitation, and no evidence of pericardial effusion. The patient had some hypertension after extubation and was initially started on Lopressor. His Lopressor dose was limited by bradycardia while asleep at night and thus his Losartan was reinitiated after his renal function improved. He was titrated up on his Losartan to the maximal dose. The patient did have one run of nonsustained ventricular tachycardia while in the ICU limited to three beats. Given his normal ejection fraction and no evidence of coronary artery disease on echocardiogram, this was observed with telemetry. The use of beta blocker will be helpful in limiting ventricular ectopy. 5. ENDOCRINE: The patient was maintained on a regular insulin sliding scale and fingerstick blood sugar monitoring for his diabetes mellitus. After extubation, he did not require an insulin drip and was able to be maintained with subcutaneous insulin. 6. GASTROINTESTINAL: The patient was with a pancreatic mass concerning for pancreatic adenocarcinoma. Surgery was reconsulted after the patient was extubated but continued to feel that the patient was too deconditioned to undergo such a significant abdominal surgery. Discussion was held with the patient and his family including his son, [**Name (NI) **], and wife and he elected not to consider surgery for his pancreatic malignancy. It was stressed that based on the CT abdominal findings of his recent examination that the tumor may be resectable and Surgery confirmed this. Despite this knowledge, the patient continued to wish to defer on surgery. He was given the option to reconsider should he change his mind. Gastroenterology was consulted because of the patient's intolerance of tube feeds after extubation. They felt that it was possible that the patient had gastric outlet obstruction secondary to a malignant ulcer versus extrinsic compression from a pancreatic mass. The patient was gradually able to tolerate p.o. alimentation and underwent a video swallow examination which showed that he could tolerate thin liquids with a chin tuck and ground solids. If he is able to take adequate p.o. nutrition through this way, no further workup was warranted. If the patient is not able to nourish himself orally, a permanent enteric feeding tube would need to be considered versus chronic total parenteral nutrition. If PEG or PEG J tube were to be considered, the patient may need to undergo upper GI series and esophagram to evaluate the anatomy for possible placement of one of these tubes. Multiple attempts were made to pass a NG tube in the postpyloric position and were met with difficulty suggesting the possibility of the pancreatic mass limiting the ability to achieve a postpyloric tube even through interventional radiology. The patient's LFTs improved steadily throughout his hospitalization. 7. FLUIDS, ELECTROLYTES, AND NUTRITION: The patient initially received tube feeds while intubated and then after extubation was not able to tolerate even 10 cc an hour. He was eventually able to pass a Speech and Swallow evaluation and video swallow examination and Nutrition and Speech Pathology aided in management of oral feeding. At the time of this dictation, the patient was attempting to take in an oral diet and if he fails this, consideration of an alternative need for nutrition will need to be considered. The patient also had his course complicated by hypernatremia which was treated with free water boluses initially and then IV D5W. It is hoped that the patient's hypernatremia will improve as he begins to take more free water through oral means. 8. PROPHYLAXIS: The patient was maintained on subcutaneous heparin, Venodyne boots, and a proton pump inhibitor. 9. ACCESS: The patient has a left PICC line in place. 10. CODE STATUS: The patient was DNR, but okay to intubate throughout most of his admission. 11. COMMUNICATION: Communication was maintained between the patient's family including himself, his wife, and his son, [**Name (NI) **]. 12. HEMATOLOGIC: The patient had a stable crit in the low 30s throughout the ultimate dates of his ICU admission. CONDITION AT TRANSFER: Stable. DISCHARGE STATUS: The patient was discharged to rehabilitation placement. The patient should be discharged on 4 liters of supplemental oxygen nasal cannula. MEDICATIONS AT DISCHARGE: 1. Losartan potassium 100 mg p.o. q.d. 2. Metoprolol 50 mg p.o. t.i.d. 3. Vancomycin 1 gram IV q. 24 hours to be continued for two more days. 4. Protonix 40 mg p.o. q.d. 5. Heparin subcutaneously 5,000 units q. 12 hours. 6. Sarna lotion one application b.i.d. p.r.n. 7. Miconazole powder 2% one application b.i.d. p.r.n. 8. Desitin one application q.d. p.r.n. 9. Albuterol, Atrovent, MDI two puffs inhaled q. four hours. 10. Lacrilube ointment one application to each eye t.i.d. p.r.n. 11. Acetaminophen 650 mg p.o. q. four to six hours p.r.n. 12. Clorhexadine gluconate 15 milliliters p.o. t.i.d. p.r.n. 13. Potassium chloride 60 mEq p.o. q.d. given in three separate doses as 20 mEq p.o. t.i.d. DIET: Thin liquids with chin tuck and ground solids. If the patient is found aspirating on thin liquids, he should be switched to nectar consistency liquids. His diet should be [**First Name8 (NamePattern2) **] [**Doctor First Name **] diet. DIAGNOSIS: 1. Pancreatic mass concerning for pancreatic adenocarcinoma. 2. Biliary obstruction secondary to pancreatic mass. 3. Adult Respiratory Distress Syndrome. 4. Aspiration. 5. Acute renal failure secondary to acute interstitial nephritis from Zosyn. 6. Hypertension. 7. Diabetes mellitus type 2. 8. Hypernatremia. 9. Methicillin-resistant Staphylococcus aureus pneumonia. 10. Neutropenia and drug rash to Zosyn. 11. Coagulopathy. 12. Contraction alkalosis. 13. Toxic metabolic encephalopathy now resolved. 14. Giant ulcer in the posterior bulb of the duodenum. DR.[**First Name (STitle) **],[**First Name3 (LF) **] 12-981 Dictated By:[**Last Name (NamePattern1) 5246**] MEDQUIST36 D: [**2178-6-12**] 02:59 T: [**2178-6-12**] 19:12 JOB#: [**Job Number 15042**] cc:[**Name8 (MD) 15043**] ICD9 Codes: 5849, 5185, 2761, 5070
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Medical Text: Unit No: [**Numeric Identifier 61305**] Admission Date: [**2144-4-18**] Discharge Date: [**2144-4-18**] Date of Birth: Sex: Service: [**Last Name (un) **] HISTORY OF PRESENT ILLNESS: This is an 82-year-old gentleman with multiple comorbidities who presents with abdominal pain, fever, and shock. There was a question of a history of Crohn disease in the past, but in retrospect the patient probably had intestinal ischemia. At rehabilitation center with a fever to 101.8 and hypotension. He was transferred to [**Hospital3 11531**] where he required vasopressors, intubated, and transferred. PAST MEDICAL HISTORY: Notable for multiple comorbidities including coronary artery disease, peripheral vascular disease, chronic renal insufficiency. He has had multiple bypasses and coronary artery bypass as well as above-the-knee amputations and below-the-knee amputations. PHYSICAL EXAMINATION: The patient was intubated and sedated and in extremist, with a blood pressure of 80/40 which was raised to 115/50 with vasopressors. The abdomen was distended without masses. The extremities were cool status post the above-mentioned amputations. LABORATORY DATA: Evaluation included a white blood cell count of 3500 with a left shift. INR was 1.7. Bicarbonate was 16. CPK was 449 with a MB fraction of 9. Creatinine was 1.8. Blood gasses revealed a significant base deficit. STUDIES: A CT scan was performed which showed pneumatosis of the left colon. HOSPITAL COURSE: The patient was admitted with a diagnosis of colonic ischemia and infarction. This was thought to be most likely an unsurvivable injury in this elderly man. A long discussion was held with the family who wished aggressive treatment on the basis of past wishes expressed by the patient himself and understood the very low likelihood of survival even with operation. The patient was then to the operating room where there was an extensive infarction throughout the majority of the intestinal tract. This was not a survivable injury. The patient was closed. He was sent back to the intensive care unit. After family members were able to be assembled the patient had withdrawal of support. The patient then expired shortly thereafter. FINAL DIAGNOSES: 1. Intestinal infarction. 2. Coronary artery disease. 3. Chronic renal insufficiency. 4. Peripheral vascular disease. 5. Diabetes mellitus. 6. Status post multiple amputations. SURGICAL PROCEDURE: Exploratory laparotomy. DISPOSITION: Post was declined by the family. [**First Name11 (Name Pattern1) 333**] [**Last Name (NamePattern4) 366**], [**MD Number(1) 367**] Dictated By:[**Last Name (NamePattern4) 24987**] MEDQUIST36 D: [**2144-7-10**] 14:14:44 T: [**2144-7-11**] 14:12:16 Job#: [**Job Number **] ICD9 Codes: 0389, 2762
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Medical Text: Admission Date: [**2146-5-29**] Discharge Date: [**2146-6-2**] Service: SURGERY Allergies: Iodine / Shellfish Attending:[**First Name3 (LF) 2534**] Chief Complaint: Neck pain, right sided hip and leg pain Major Surgical or Invasive Procedure: none History of Present Illness: Mrs. [**Known lastname **] is a [**Age over 90 **] yr old female who arrived by ambulance to [**Hospital1 **] [**First Name (Titles) **] [**Last Name (Titles) **] after falling down stairs. She was pulled by her dog on a leash as she was leaving her house. She landed on the right side of her hip and leg. She began to have neck pain immediately after the fall. She did not loose consciousness after the fall. Past Medical History: Hypertension, Hyperlipidimia, Osteoporosis Physical Exam: Neuro: GCS 15, Alert and oriented X3, [**4-8**] motor strength equal and bilateral CV: RRR Resp: CTA B/L ABD: soft, non-tender, non-distended, +BS EXT: right leg abrasion Pertinent Results: CT C-SPINE W/O CONTRAST [**2146-5-29**] 2:23 PM: Acute sagittal fracture of the anterior arch of C1. Mild prominence of prevertebral soft tissue anterior to the level of fracture. Brief Hospital Course: Patient was initially taken to an outside hospital where she was found to have a C1 anterior arch fracture. She was transferred to [**Hospital1 18**] as a trauma patient for further evaluation on [**2146-5-29**] @17:11. Initial assesment by the trauma team found her to be stable and she was taken to CAT scan suite for additional studies. Her C-spine CAT scan showed acute sagittal fracture of the anterior arch of C1. Studies of her head, chest, abdomen, pelvis, and T&L-spine showed no acute injuries, hemorrhage, or fractures. Dr. [**Last Name (STitle) 548**] from neurosurgery was consulted on hospital day #1 and patient was found to be neurologically intact. Patient was transferred to T-SICU under the care of [**First Name4 (NamePattern1) 449**] [**Last Name (NamePattern1) **], M.D. Patient remained stable overnight in the T-SICU. Patient was transferred to acute trauma/surgery floor on Clinical Center-6 on hospital day #2. Patient was evaluated by PT/OT on hospital day #3 and recommended the patient to be discharged to a rehabilitation facility. Patient continued to remain stable through out hospital day #3. On HD#4 she had a hypertensive episode to 210/50, which returned to 150/60 with IV hydralazine. Pt was restarted on home medications Norvasc and HCTZ. Her BP remained stable. On HD#5 Pt. reported some urinary urgency and pain with a temp of 101.1. Repeat temp was 99.7 but due to symptoms, Pt. was given Levofloxacin for presumed UTI to take at rehab. Medications on Admission: Famotidine 20 mg IV every 2 to 4 hours Metoprolol 5 mg IV every 6 hours Acetaminophen 650 mg PO every 4 to 6 hrs as needed Morphine Sulfate 2 mg IV every 2 hours as needed Insulin Sliding Scale Magnesium Sulfate 2 gm / 100 ml D5W IV as needed Potassium Chloride 40 mEq / 500 ml D5W IV as needed Calcium Gluconate 2 gm / 100 ml D5W IV as needed Potassium Phosphate 15 mmol / 500 ml NS IV as needed Heparin 5000 UNIT sub-cutaneous three times per day Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*0* 2. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed. Disp:*30 Tablet(s)* Refills:*0* 3. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day): Hold for BP <100, HR<60. Disp:*60 Tablet(s)* Refills:*0* 4. Amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 5. Hydrochlorothiazide 25 mg Tablet Sig: 12.5 Tablets PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 6. Potassium Chloride 10 mEq Capsule, Sustained Release Sig: One (1) Capsule, Sustained Release PO EVERY OTHER DAY (Every Other Day). Disp:*30 Capsule, Sustained Release(s)* Refills:*0* 7. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 8. Potassium & Sodium Phosphates [**Telephone/Fax (3) 4228**] mg Packet Sig: One (1) Packet PO BID (2 times a day). Disp:*60 Packet(s)* Refills:*2* 9. Levofloxacin 250 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours) for 4 days. Disp:*4 Tablet(s)* Refills:*0* Discharge Disposition: Extended Care Facility: [**Doctor Last Name **] [**Doctor Last Name **] hospital Discharge Diagnosis: C1 Fracture Discharge Condition: Good Discharge Instructions: Return to Emergency Room for: Fever>101.5 Numbness or tingling in extremities Paralysis of extremities Nausea/Vomiting Incontinence of Bowel or Bladder Followup Instructions: Follow up in Trauma Clinic in 2 weeks. Please call ([**Telephone/Fax (1) 29931**] to schedule an appointment Follow up with your PCP [**Last Name (NamePattern4) **]. [**Last Name (STitle) 27267**] in one week. Completed by:[**2146-6-2**] ICD9 Codes: 5990, 2724, 4019
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Medical Text: Admission Date: [**2181-2-28**] Discharge Date: [**2181-3-13**] Service: MEDICINE Allergies: Nsaids / Sulfa (Sulfonamide Antibiotics) Attending:[**First Name3 (LF) 2387**] Chief Complaint: Hypotension in Clinic Major Surgical or Invasive Procedure: Dialysis History of Present Illness: Mr [**Name13 (STitle) 21658**] is an 85 year old man, recently discharged from the intensive care unit, with history of prior DVT (now s/p IVC filter), HTN, CKD on HD, right lower extremity dry gangrene, presenting from his PCP/cardiologist's office where the pt had a chief complaint of worsening SOB and cough. Per ED notes (patient is poor historian) the pt has "not looked great" for the past few days. The pt is currently living at [**Hospital1 **], denies nausea, vomiting. Has been regularly attending dialysis. Mr [**Name13 (STitle) 21658**] has been residing at nursing home since his discharge, and has been feeling more weak and short of breath than usual in the last few days. Hemodyalisis has been limited secondary to hypotension. In the emergency department the pt's vital signs were: 98.5, P90, NP 70/48, RR22 and O2sat 96% on 3L. In the ED the pt received 2 or 3 liters IVF (although only 1L documented in ED papers), and had a chest x-ray that showed a new left-sided PNA and he got Vanc and Zosyn with improvement in SBP's to in low 100's. Past Medical History: HTN thoracic and abdominal aortic aneurysm h/o transitional cell bladder cancer CKD h/o lumbar laminectomy tertiary hyperparathyroidism BPH DVT in the past, s/p IVC filter placement bilateral cataracts s/p removal glaucoma s/p L TKR ?[**Name (NI) **] unclear per records PVD ? Fem/[**Doctor Last Name **] bipass Social History: Formerly worked in family business, now retired. Was living independently until [**12/2180**] hospitalization. More recently lived in [**Hospital1 **]. Family History: Non-contributory. Physical Exam: GENERAL: Elderly man, decorticate posturing, but moving upper extremities HEENT: Normocephalic, atraumatic. No conjunctival pallor. No scleral icterus. PERRLA/EOMI. MMM. OP clear. Neck Supple, No LAD, No Neck: supple, JVP not elevated, no LAD Lungs: Clear to auscultation bilaterally, no wheezes, rales, ronchi CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly Ext: cool feet bilaterally w/ right foot gangrene, LLE swelling w/ +2 edema, not able to palpate pedal pulses; doplerable LLE dp/pt and R dp. Pertinent Results: Admission labs: [**2181-2-28**] 01:00PM BLOOD WBC-14.7*# RBC-2.79* Hgb-8.5* Hct-25.8* MCV-92 MCH-30.3 MCHC-32.8 RDW-17.6* Plt Ct-303 [**2181-2-28**] 01:00PM BLOOD Neuts-66.8 Lymphs-13.5* Monos-5.4 Eos-14.1* Baso-0.2 [**2181-2-28**] 01:00PM BLOOD Glucose-103 UreaN-77* Creat-3.4* Na-130* K-4.7 Cl-92* HCO3-27 AnGap-16 [**2181-2-28**] 01:10PM BLOOD Lactate-1.5 [**2181-2-28**] 01:00PM BLOOD CK-MB-3 cTropnT-0.24* [**2181-3-1**] 12:57AM BLOOD CK-MB-4 cTropnT-0.24* [**2181-2-28**] 01:00PM BLOOD CK(CPK)-48 [**2181-3-1**] 12:57AM BLOOD CK(CPK)-65 Micro: Blood cx: 3 neg, 4 NGTD Blood cx ([**2-28**]): STAPHYLOCOCCUS, COAGULASE NEGATIVE, FROM ONE SET ONLY. Stool O+P: neg x2 Urine cx ([**3-9**]): ENTEROCOCCUS SP. >100,000 ORGANISMS/ML. C diff: pending Imaging: CXR [**2181-2-28**]: Indistinctness of the left heart border which may be related to overlying soft tissue, but infection is not excluded. CXR [**2181-3-4**]: Portable chest radiograph demonstrates a large-bore catheter on the right extending into the cavoatrial junction. The left IJ catheter has been removed. The left costophrenic angle has been omitted from the study. There is a probable small left pleural effusion. There is patchy atelectasis at the left lung base. There is also mild patchy airspace opacity in both lungs which could represent a combination of atelectasis or aspiration, possibly infiltrate. There is mild congestive failure. Heart is top normal in size. LUE U/S [**2181-3-6**]: No evidence of deep vein thrombosis in the left arm. CXR [**2181-3-9**]: Since [**2181-3-6**], lung volumes are lower, increasing bibasilar dependant atelectasis. Note that the right costophrenic angle was excluded. Small left pleural effusion is likely unchanged. Mild volume overload persists. A right PICC, a right central venous line, and a gastrostomy tube are still in place. There is no other change. . [**2181-3-9**] 11:13 am URINE Source: Catheter. **FINAL REPORT [**2181-3-11**]** URINE CULTURE (Final [**2181-3-11**]): ENTEROCOCCUS SP.. >100,000 ORGANISMS/ML.. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ ENTEROCOCCUS SP. | AMPICILLIN------------ =>32 R LINEZOLID------------- 2 S NITROFURANTOIN-------- 256 R TETRACYCLINE---------- =>16 R VANCOMYCIN------------ =>32 R Brief Hospital Course: 1. Hypotension: The cause of the patient's hypotension was unclear, since although he had a leukocytosis on admission, there was no convincing infiltrate on chest x-ray, and the pt's HD line appeared non-erythematous. The pt does have extensive right lower extremity gangrene with ulceration of the right ankle, which may be a potential nidus of infection. Microbiology failed to grow out organisms other than Coagulase Negative Staph, which may have been a contaminant. Given the pt's tenuous status on admission the pt was treated initially with broad spectrum antibiotics (Vanc and Zosyn) which were then tapered to just Vanc to treat a presumed line infection for a 14-day course. During the first few days of this admission the pt's blood pressure was supported with peripheral vasopressin, which was stopped successfully on [**3-3**] and [**3-5**], but on both days was added back on during dialysis sessions during which the pt's blood pressure would fall to the 70s systolic. On transfer to the CCU the pt was no longer requiring vasopressin, although did have SBP 60s with HD once, treated with 500cc IV fluid. Other sessions of HD were associated with asymptomatic hypotension to SBPs 80s, which improved without intervention with SBPs typically in 90s. He remained afebrile, although cultures were sent [**3-9**] for an elevated temp of 100.0. Urine cultures were positive for VRE and patient was started on linezolid as described below. 2. Tachycardia: During the pt's HD session on [**3-5**] the pt developed a rapid heart rate in the 160s. Carotid massage was attempted several times with no alteration in the rhythm. Then adenosine 6mg was administered with no effect. Then adenosine 12mg was administered with a temporary drop in heart rate to the 40s, but then a return to the 160s. Then amiodarone was loaded and the pt's heart rate improved to the 100s, and blood pressure was initially low, but then systolics returned to the 100s. During the episode of tachycardia, there were morphologies suggesting AVNRT and afib. After initial amio dosing, heart rate was subsequently normal and rhythm was sinus and he required no more antiarrhythmics. Amiodarone was stopped. 3. PVD: Vascular saw the pt on admission in the ED and felt that the gangrene was not the cause of the pt's symptoms. The patient will be seen as an outpatient by Vascular surgery to determine a date for outpatient right AKA. . 4. Elevation in troponin: On admission the pt's Troponin T was at recent baseline (0.26-0.37). Chronically elevated troponins likely secondary to chronic renal failure. No chest pain, no change on EKG. 5. End stage renal disease: During this admission nephrology saw the pt and continued dialysis. Dialysis was limited at time by hypotension and chest pain. Last HD was on [**2181-3-12**] and was finished with no complications. 6. CAD: At rehab the pt was on ASA, statin and verapamil. ASA and statin were continued, but verapamil was held in the setting of hypotension. 7. Pain control: Patient vague regarding chronic pain, but may be due to gangrenous right foot. Controlled with fentanyl patch 25mcg and oxycodone prn. Was cautious about uptitrating because of tenious BP. 8. Rash/Eosinophilia: Pt developed rash and peripheral eosinophilia which was stable at time of discharge. This was thought to be possible med related. He should have follow up CBC with diff as outpatient when off antibiotics. Zosyn was stopped and he completed a course of Vanco on [**3-10**]. Strongyloides antibody was sent. . 9. VRE/URI: Found on surveillence urine culture for fever spike. Patient barely makes urine bc of ESRD. D/ced foley but need to d/w urology as it was placed under cystoscopy. Started on 14 day course of linezolid 600mg PO BID for VRE UTI (day 1=[**3-11**]). Urology was consulted for management of foley and transitional cell cancer. They recommend keeping foley out if possible since he does not have a history of retention. He will follow up with Dr. [**Last Name (STitle) 770**] who is his outpatient urologist. Medications on Admission: Fentanyl 25mcg/h patch change q72h Xalatan 0.005% eye drops 1 drop right eye qhs Vancomycin 1g, HD protocol Levitiracetam 100mg/ml 500mg [**Hospital1 **] Aranesp 200mcg/0.4ml with HD Novolin 300u/3ml per SS Cal carbonate 1250mg/5ml tid Heparin 5000 subq [**Hospital1 **] Aspirin 325 daily Verapamil 40 q12h Timolol maleate 0.5% eye gtt 1 drop [**Hospital1 **] right eye Simvastatin 40 2tab daily Omeprazole 20mg daily Diflucan 200 qod Oxycodone 5mg 1cap prn Miconazole nitrate 2% cream tid Folic acid 1mg tab daily Lidocaine 5% adhesive patch Ipratropium bromide 0.02% soln inh q6h Discharge Medications: 1. Latanoprost 0.005 % Drops [**Hospital1 **]: One (1) Drop Ophthalmic HS (at bedtime). 2. Levetiracetam 100 mg/mL Solution [**Hospital1 **]: Five (5) mL PO BID (2 times a day): (500 mg [**Hospital1 **]). 3. Aspirin 325 mg Tablet [**Hospital1 **]: One (1) Tablet PO DAILY (Daily). 4. Timolol Maleate 0.5 % Drops [**Hospital1 **]: One (1) Drop Ophthalmic [**Hospital1 **] (2 times a day). 5. Simvastatin 40 mg Tablet [**Hospital1 **]: Two (2) Tablet PO DAILY (Daily). 6. Folic Acid 1 mg Tablet [**Hospital1 **]: One (1) Tablet PO DAILY (Daily). 7. Lansoprazole 30 mg Tablet,Rapid Dissolve, DR [**Last Name (STitle) **]: One (1) Tablet,Rapid Dissolve, DR [**Last Name (STitle) **] DAILY (Daily). 8. Camphor-Menthol 0.5-0.5 % Lotion [**Last Name (STitle) **]: One (1) Appl Topical [**Hospital1 **] (2 times a day) as needed for itching. 9. Heparin (Porcine) 5,000 unit/mL Solution [**Hospital1 **]: One (1) syringe Injection TID (3 times a day). 10. Heparin (Porcine) 5,000 unit/mL Solution [**Hospital1 **]: 4000-[**Numeric Identifier 2249**] units Injection PRN (as needed) as needed for line flush: DIALYSIS NURSE ONLY: Withdraw 4 mL prior to flushing with 10 mL NS followed by Heparin as above according to volume per lumen. . 11. Oxycodone 5 mg/5 mL Solution [**Numeric Identifier **]: Five (5) mg PO Q4H (every 4 hours) as needed. 12. Acetaminophen 325 mg Tablet [**Numeric Identifier **]: 1-2 Tablets PO every eight (8) hours as needed for pain or fever. 13. Sodium Chloride 0.9% Flush 3 mL IV Q8H:PRN line flush Peripheral line: Flush with 3 mL Normal Saline every 8 hours and PRN. 14. Linezolid 600 mg Tablet [**Numeric Identifier **]: One (1) Tablet PO Q12H (every 12 hours) for 14 days: if on a dialysis day, please given dose after dialysis, last dose [**2181-3-26**]. 15. Calcium 500 mg Tablet [**Month/Day/Year **]: One (1) Tablet PO three times a day. 16. Folic Acid 1 mg Tablet [**Month/Day/Year **]: One (1) Tablet PO once a day. 17. Fentanyl 50 mcg/hr Patch 72 hr [**Month/Day/Year **]: One (1) patch Transdermal every seventy-two (72) hours. Discharge Disposition: Extended Care Facility: [**Hospital3 7**] & Rehab Center - [**Hospital1 8**] Discharge Diagnosis: Primary Diagnosis: End Stage Renal Disease on Hemodialysis Peripheral vascular Disease Line associated bacteremia Supraventricular tachycardia Dry Gangrene right foot Discharge Condition: Hemodynamically stable, BPs 90s/40s-50s, lower with HD Discharge Instructions: You were admitted to the hospital with low blood pressures. It was unclear exactly why you had low blood pressures, but this may have been related to an infection. You were treated for a blood infection with an antibiotic called vancomycin and your blood pressures improved. You were continued on hemodialysis for your kidney failure. While you were here, you also developed a urinary tract infection which we treated with another antibiotic called linezolid. While you were hospitalized, you saw the vascular surgeons who decided that you need to have your right foot amputated but this can wait until you are healthier. You will need to follow-up with Dr. [**First Name8 (NamePattern2) **] [**Name (STitle) **] for this. . Please tell your doctor if you develop chest pain, shortness of breath, increased swelling of your arms or legs, or any other concerning symptoms. Followup Instructions: Vascular surgery: Provider: [**Name10 (NameIs) 251**] [**Last Name (NamePattern4) 1490**], MD Phone:[**Telephone/Fax (1) 1237**] Date/Time:[**2181-3-28**] 10:00 . Cardiology: [**Last Name (LF) **],[**First Name3 (LF) **] J. [**Telephone/Fax (1) 7960**] Date/time: [**4-4**] at 4:00pm. . Nephrology: Will be decided once [**Hospital **] clinic used as outpt is decided. Please call [**Doctor First Name 12906**] [**Location (un) 21659**] who is a social worker for updates. . Urology: Dr. [**First Name8 (NamePattern2) 1158**] [**Last Name (NamePattern1) 770**] Phone: ([**Hospital1 21660**] [**Location (un) 86**], [**Numeric Identifier 21661**] Date/time: [**4-10**] at 1:45pm. Completed by:[**2181-3-13**] ICD9 Codes: 5856, 5990, 4280, 4589
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Medical Text: Admission Date: [**2138-11-3**] Discharge Date: [**2138-11-17**] Service: ADMISSION DIAGNOSIS: 1. Status post fall with epidural hematoma and C6 fracture. DISCHARGE DIAGNOSIS: 1. C6 burst fracture with epidural hematoma. 2. Paroxysmal atrial fibrillation requiring Amiodarone. 3. Cardiac pacer requiring interrogation. 4. Left lower lobe pneumonia. 5. Chronic ventilatory dependence with inability to wean. 6. Left upper extremity deep vein thrombosis. 7. Ability to anti-coagulate requiring IVC filter placement for pulmonary embolism prophylaxis. 8. Malnutrition requiring tube feeds. 9. Fever of unclear origin. PROCEDURES: 1. Evacuation of epidural hematoma C6 corpectomy and fusion with cage on [**2138-11-4**]. 2. Spinal fusion [**2138-11-7**]. HISTORY OF PRESENT ILLNESS: The patient is an 83-year-old man with a past medical history significant for hypertension, paroxysmal atrial fibrillation, sick sinus syndrome, status post pacer in [**2134**], left lower lobe pneumonia and polypectomy. He also has a past medical history significant for hernia repair times three, transurethral resection of prostate, left total knee replacement and lumbosacral decompression for spinal stenosis in [**2130**]. The patient fell approximately a week prior to admission and had upper back and neck pain. A CT at that time was negative. He was diagnosed with a left lower lobe pneumonia and treated with Levaquin. The patient continued with syncopal episodes and fell on the night prior to admission. On the day of admission, in the PCP's office the patient had a syncopal episode with a blood pressure in the 50's. He was unresponsive for several minutes but had a carotid pulse. He was transferred to [**Hospital3 3834**] which CT of the C-spine revealed a C6 fracture. Solu Medrol was bolused and started as a drip. The patient was unable to move his lower extremities, was insensitive from above the nipple to his toes. He had minimal motor function in his bilateral upper extremities and complained of C-spine pain. PAST MEDICAL HISTORY: 1. Hypertension. 2. Paroxysmal atrial fibrillation. 3. Sick sinus syndrome. 4. Pacer [**2134**]. 5. Left lower lobe pneumonia. 6. Tachybrady syndrome. 7. Syncope. 8. Hearing loss. PAST SURGICAL HISTORY: 1. Sigmoid polypectomy. 2. Hernia repair times three. 3. Transurethral resection of prostate. 4. Left total knee replacement. 5. Benign skin cancer removal on his forehead. 6. Lumbosacral decompression for spinal stenosis. ALLERGIES: Sulfa. MEDICATIONS ON ADMISSION: 1. Norvasc 5 mg once a day. 2. Amiodarone 200 mg once a day. 3. Coumadin three times a week. 4. Klonopin. SOCIAL HISTORY: Noncontributory. PHYSICAL EXAMINATION: On admission the patient was afebrile with normal vital signs. His GCS was 15, his pupils are equal, round, and reactive to light and accommodation. His heart was irregular. Lungs clear. Abdomen was soft, nontender, nondistended. He had decreased rectal tone and he was heme positive. He had no sensation from just above the nipple line to his feet. He was unable to move his trunk or lower extremities. He had bilateral upper extremity weakness with 3/5 wrist extension and [**11-24**] grip. His dorsalis pedis pulses were palpable bilaterally. He had no gross deformities of his thoracic lumbar spine but was tender over his cervical spine. Of significance the patient's INR on admission was 5.1. His electrocardiogram was V-paced with no acute ischemia. IMAGING: CT of the spine showed a C6 burst fracture. Chest x-ray with a question of a right seventh rib fracture. Pelvis x-ray: No fracture. TLS: No fracture. CT of abdomen and pelvis was no free fluid negative. HOSPITAL COURSE: The patient was seen and evaluated by Neurosurgery service in the Emergency Room. He was felt to have a C6 burst fracture and there was concern of an epidural hematoma given the fact that the patient had a pacemaker he was unable to undergo an magnetic resonance scan and was therefore scheduled for a CT myelogram. The patient was given Factor VII emergently to reverse his anti-coagulation as well as FFP. He was resuscitated, access was obtained and he was transferred to the Intensive Care Unit. The rest of his hospital course will be done by systems. 1. Neurologic. The patient was seen and evaluated by Neurosurgery. He was taken to the operating room in the early morning of [**2138-11-4**] for an evacuation of an epidural hematoma and C6 corpectomy and cage placement. Postoperatively the patient had little return of neurologic function with minimum movement of his toes bilaterally and triple flexion. On [**2138-11-7**] the patient returned to the O.R. for a posterior fusion. Again, his neurologic postoperative course showed minimal neurologic improvement. The patient was awake, alert and following commands and was transferred out of bed to the chair throughout his postoperative course when it was felt to be safe by Neurosurgery. 2. Cardiovascular. Given the fact that the patient had several bouts of syncope prior to admission and had a history of tachybrady syndrome, paroxysmal atrial fibrillation as well as sick sinus syndrome he was seen and evaluated by the Cardiology service. His pacemaker was interrogated and felt to be functioning fine. He was kept on his home dose of Amiodarone. His cardiac enzymes were cycled and were found to be negative. Cardiology felt that no further intervention was needed during his hospital course. 3. Respiratory. The patient was intubated in the operating room for his first surgery and was extubated postop. He had an episode where he desated however and was felt to be unable to maintain his respiratory drive. He was therefore, semi-electively reintubated on postop day zero. The patient had a prolonged ventilatory course and was unable to be weaned off the ventilator despite diuresis, aggressive pulmonary toilet and multiple bronchoscopies. He was admitted with a left lower lobe infiltrate and did spike fevers throughout his hospital course that were felt to be secondary to this infiltrate. 4. Gastrointestinal: The patient had no issue from the gastrointestinal standpoint. He was started on tube feeds and advanced to goal uneventfully. 5. Genitourinary. The patient had Foley throughout his hospital course. His urine output was adequate and he was diuresed with Lasix with a good response. He did have an episode of hypernatremia and hyperkalemia and thus free water was given to the patient with resolution of this problem. [**Name (NI) 227**] his fever spikes his urine was cultured throughout his hospital stay. 6. Heme/Vascular. Given the fact that the patient was unable to be anti-coagulated and was felt to be high risk for pulmonary embolism, an IVC filter was placed in the patient, was done on [**2138-11-4**] without problem. The patient's coagulopathy was reversed with FFP. Given the fact that the patient continued to have recurrent fevers he underwent bilateral lower extremity ultrasounds to rule out deep vein thrombosis as well as upper extremity ultrasound at the site of PICC line given his left upper extremity swelling. His lower extremity ultrasounds were negative but he did have a left upper extremity deep vein thrombosis. Vascular surgery was consulted and given the fact that this was asymptomatic I felt this could be treated conservatively. 7. ID. The patient was placed on Levofloxacin for left lower lobe pneumonia when he was admitted. Ancef was then added for periop coverage given his prosthetic material in his spine. He continued to spike fevers throughout his hospital course and on [**2138-11-13**] did grow out gram positive rods in his sputum. Otherwise, no clear source was found for his fever. 8. FEN. As mentioned in gastrointestinal section the patient was maintained on tube feeds. He did have an episode of hypernatremia and hyperkalemia which was treated with free water. His electrolytes were repleted as needed, otherwise he had no issues. 9. General Disposition: Given the patient's inability to wean off the vent and his family wishes on [**2138-11-17**] it was decided that the patient would be removed from ventilatory support. His daughter understood that the patient would not survive this but she felt it was his wish to not live in his current status therefore on [**2138-11-17**] he was extubated and expired. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], M.D. [**MD Number(1) 11889**] Dictated By:[**Dictator Info **] MEDQUIST36 D: [**2139-1-5**] 15:13 T: [**2139-1-5**] 15:17 JOB#: [**Job Number 54139**] ICD9 Codes: 5185, 9971, 4280
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Medical Text: Admission Date: [**2186-10-20**] Discharge Date: [**2187-1-10**] Date of Birth: [**2186-10-20**] Sex: F Service: NB HISTORY: Baby Girl [**Known lastname **] is the 24-4/7-week gestation infant born at 595 grams to a 25-year-old G3, P0 now 1 mother with prenatal screens: [**Name (NI) **] type O-positive, antibody negative, HBsAg negative, RPR nonreactive, rubella immune, GBS unknown. [**Hospital 37544**] medical history was significant for IDDM, asthma, 1st pregnancy TBA, 2nd pregnancy fetal demise at 23-weeks gestation, history of tobacco. This pregnancy was complicated by cervical incompetence. A cerclage was placed at 20-weeks gestation at [**Hospital 1474**] Hospital. Mom reported a history of domestic violence by the father who is currently incarcerated. Approximately a few days prior to delivery, the mother was transferred from [**Name (NI) 1474**] hospital to [**Hospital1 18**]. Mother was on bed rest at [**Hospital1 18**] and she received betamethasone 2 doses. Rupture of membranes occurred the morning of delivery with fluid reported to be greenish-yellow. There was no maternal fever at time of ruptured membranes. The mother was given ampicillin and erythromycin. A decision to deliver infant by C-section was made due to breech position under general anesthesia. The infant emerged floppy and no spontaneous respirations. Was bulb suctioned, dried, and stimulated. Provided PPV. Heart rate was about 100, but remained floppy. No grimace and no spontaneous respirations. The infant had good bilateral aeration, heart rate, and color. Though the tone and grimace remained depressed likely secondary to general anesthesia. Initial Apgars were 3 and 6. PHYSICAL EXAM ON ADMISSION: Birth weight of 595 grams which is 10-25th percentile, head circumference of 20 cm which is less than 10 percentile, length of 30.5 cm which is 10-25th percentile. Infant's exam showed extremely premature infant, nondysmorphic, intubated, pink with scattered bruising. AFSS. Fused eyelids. Ears: Normally set. Palate: Intact. Clavicles: Intact. Neck: Supple. CV: Regular rate and rhythm, no murmur, 2+ pulses, good peripheral perfusion. Abdomen: Soft, no bowel sounds, no hepatosplenomegaly. GU: Normal preterm female, patent anus, no sacral anomalies. Hips: Stable. Tone: Reduced overall likely from anesthesia demonstrating slightly steady improvement over time. On the skin, there was a right scapular laceration with full thickness approximately 3/4-1 inch in length with no active bleeding. SUMMARY OF HOSPITAL COURSE BY SYSTEMS: The infant was intubated at delivery and admitted to the NICU on the ventilator. Received single dose of surfactant and weaned to low ventilator quickly thereafter. Caffeine citrate was initiated on [**10-23**], day of life 3 and the infant weaned to CPAP on day of life 5 which is [**10-25**]. She remained on CPAP up until [**10-31**] at which time, due to increased respiratory effort, she was reintubated and placed on low ventilator settings again. She remained intubated on low ventilator settings through til [**2186-11-25**] which is day of life 36 at which time, she extubated to CPAP and remained on nasal prong CPAP until [**2187-10-18**] which is day 59 when she presented with bloody stools. She was diagnosed with NEC. She was noted to have apnea and lethargy. She was reintubated because of the severity of her illness and her poor respiratory effort. She remained intubated through til [**2186-12-27**] which is day of life 68 when she then weaned to nasal cannula oxygen, and she has remained on nasal cannula oxygen since that time. She weaned off caffeine citrate on [**2187-1-3**]. She is presently on nasal cannula at 50 cc per minute flow and 100% FIO2 not having any apnea or bradycardic spells at this time. Clear and equal breath sounds with mild retractions. Cardiovascular: On day 2 of life, she presented with clinical symptoms of a patent ductus arteriosus. Symptoms included bounding pulses, a murmur, and metabolic acidosis. She was treated with Indocin for a single course. A follow-up echocardiogram was done on [**2187-10-24**] which showed no PDA, a question of a small ASD or PFO at that time. Murmur resolved just after the Indocin, and she has been free of a murmur up until [**2186-12-10**], day of life 51, at which time she presented with an intermittent murmur which has continued through to this time and is thought to be a benign PPS murmur. Heart rate and [**Year (4 digits) **] pressure have remained hemodynamically stable. Also initially at birth, she did require 1 normal saline bolus for hypotension which quickly resolved after the normal saline infusion. She has never required any dopamine for [**Year (4 digits) **] pressure stability. Fluid, electrolytes, and nutrition: She was NPO at birth, and UAC and UVC were both placed. She was started on parenteral nutrition on the day of birth. Enteral feedings were initiated on day of life 6 with slow trophic feeds at that time. She achieved full feedings by [**2186-11-3**] which is day of life 14. Her calories were then increased to maximum caloric density of 30 calories per ounce of PE 30 with Promod which she achieved on [**2186-11-10**]. As stated above, when she developed NEC her feeds were discontinued. [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] was placed and remained in place for 4 days. She remained NPO on PN and Intralipids through until feeds were reintroduced. She slowly advanced on feedings again and achieved full feedings by [**2186-12-3**] which is day of life 44. At that time, her calories were then further advanced to a maximum caloric intake of PE 30 with Promod. Her feedings were well tolerated until [**2186-12-18**]. At that time, she had a recurrance of grossly [**Year (4 digits) **] y stool. Her KUB was abnormal with large dilated loops. She was felt to have a recurrance of medical NEC. She was made NPO and [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 37079**] placed at that time. She has remained NPO since that time. She is presently on PN with intralipids. Her most recent tryglyceride level is 76 done on [**2187-1-7**]. She was started on iron and vitamin E on day of life 50,[**2186-12-9**] and also earlier, day of life 15. Both times they were discontinued when enteral feedings were discontinued. She had a barium enema on [**2187-1-2**] which showed a colonic stricture at the splenic flexture likely related to medical NEC. Her most recent nutrition labs were done on [**2186-12-18**] with albumin 3.1, calcium 9.3, magnesium 2.0, and phosphorous 5.2. On [**2187-1-9**], her most recent set of electrolytes are sodium 141, potassium 4.3, chloride 103, and CO2 27. Her LFT's AST18 ALT 42 Alk Phos 1387. Most recent length is 45 cm and head circumference of 27.5 cm which were done on [**2187-1-8**]. She is presently NPO with a peak bilirubin level of 4.6/0.4 and received a total of 10 days of phototherapy, and she has had medical neck x2. Remains NPO at this time with a benign abdomen. IV access: A central PICC line was placed on [**2186-12-23**]. PICC line is remains in place at this time. Hematology: Her hematocrit at birth was 44.8. Her most recent hematocrit was 34.2 with a reticulocytes of 7.5 and that was on [**2187-1-8**]. Prior to surgery, her coagulation studies were noted to be elevated on [**2187-1-8**] with PT 14.2, PTT 65.5, INR of 1.4. These studies were repeated on [**2187-1-9**] PT 15.2 PTT 70.5 INR 1.6. Despite being given a dose at birth, she was given a vitamin K injection on [**1-9**]. She was then given 30 cc/kg of FFP in divided into two aliquots. Her repeat coagulation studies on [**1-10**] in the a.m., a PT of 14.8, PTT 55.2, and INR 1.3. During her life, she has received total of 7 pack red [**Month (only) **] cell transfusions. She does not have any [**Month (only) **] from previous transfusion left in the [**Month (only) **] bank. Infectious disease: Due to suspected sepsis at birth, a CBC and [**Month (only) **] culture were done on admission. The CBC was benign. The [**Month (only) **] culture remains stable. But due to presumed sepsis and chorioamnionitis at birth, she was treated for a total of 14 days, a decent sample due to a bloody tap. A repeat [**Month (only) **] culture was drawn on day of life 8 which grew gram-positive cocci which was felt to be a contaminant, but her antibiotic therapy was changed from ampicillin to vancomycin at that time. She received an additional 42 hours of antibiotics for the total of 14 days at that time when the repeat [**Month (only) **] culture did come back negative. She was again treated day of life 22 for what was medical neck at that time. Her CBC was left shifted with an oddity of 0.3. She was treated for a total of 14 days of ampicillin, gentamicin, and clindamycin for medical neck. She, again, presented with medical neck on [**2186-12-18**], day of life 59. Had a CBC at that time that was also left shifted. Abnormal KUB with bloody stool. She was started on vancomycin and gentamicin, and continued on those antibiotics through until day of life 63 or [**12-22**], at which time the vancomycin and gentamicin were changed to Zosyn; and she continued the Zosyn for a total of 14 days of antibiotics for that bout of medical neck. She has remained off of antibiotics since that time and showed no signs of sepsis. She did have a repeat lumbar puncture done prior to coming off the Zosyn on [**2186-12-29**] and that LP wbc 3 rbce 18 pro 128 glu 37, and the CSF culture remained sterile. Neurologic: She had a urine tox screen sent on [**1186-10-27**] which was negative for benzos, barbituates, opiates, cocaine, ampheatamines, and methadone. She had 3 cranial ultrasounds on [**2186-10-20**], [**2186-10-30**], [**2186-11-20**] that were all within normal limits. She will need another head ultrasound prior to discharge from the NICU. Sensory: A hearing screen will need to be done prior to discharge to home. Ophthalmology: Her most recent eye exam was done on [**2187-1-8**] which showed stage II, zone II ROP and followup is needed the last week of [**Month (only) 404**] or the first week of [**Month (only) 956**]. She is followed by O'[**First Name9 (NamePattern2) **] [**Doctor Last Name **]. Endocrine: Numerous state screens have been sent on [**2186-10-23**], [**2186-11-4**], [**2186-11-16**], [**2186-11-26**], [**2187-1-3**]. The samples from [**2186-10-23**] through til [**2187-11-16**] all show borderline low T4 anywhere from 4.8-5. She has not been treated for any endocrine issues thus far, and most recent state screens thus far have been normal. Psychosocial: A [**Hospital1 **] social worker has been involved with this family. Her name is [**Name (NI) 5036**] [**Name (NI) **], and she can be reached at [**Telephone/Fax (1) 8717**] if there are any social service concerns. Infant's condition at discharge is stable. DISCHARGE DISPOSITION: Infant is to be transferred to [**Hospital3 1810**] for colonic stricturoplasty scheduled for [**2187-1-10**] with Dr. [**Last Name (STitle) **] [**Name (STitle) 1022**] as the pediatric surgeon. PRIMARY PEDIATRICIAN: The family has not decided on a primary care pediatrician at this time. CARE RECOMMENDATIONS: NPO until ready to feed. The infant is on no medications at this time. She will need her two month vaccinations. She will need to have a head ultrasound prior to discharge to home. Will need a car seat test prior to discharge to home. State screens will need to be followed up. IMMUNIZATIONS RECEIVED: The hepatitis B vaccine was given on [**2186-11-29**], and she is due for her 2-month immunizations which have not been given at this time due to her clinical status. IMMUNIZATIONS RECOMMENDED: Synagis RSV prophylaxis should be considered from [**Month (only) **] through [**Month (only) 958**] for infants who meet any of the following 3 criteria: 1. Born at less than 32 weeks gestation; 2. Born between 32 and 35 weeks gestation with 2 of the following: Daycare during the RSV season, a smoker in the household, neuromuscular disease, airway abnormalities, or school-age siblings; or 3. With chronic lung disease. Influenza immunization is recommended annually in the fall for all infants once they reach 6 months of age. Before this age and for the 1st 24 months of the child's life, immunization against influenza is recommended for household contacts and out-of-home caregivers. DISCHARGE DIAGNOSES: Respiratory distress syndrome, extremely low birth weight premature infant, sepsis suspect, medical NEC x2, back laceration from delivery, patent ductus arteriosus treated, hyperbilirubinemia resolved, chronic lung disease ongoing, presumed meningitis treated, distal transverse colon stricture, retinopathy of prematurity, anemia of prematurity, and coagulopathy. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 48738**], MD [**MD Number(2) 55708**] Dictated By:[**Name8 (MD) 65298**] MEDQUIST36 D: [**2187-1-9**] 20:51:10 T: [**2187-1-10**] 04:55:46 Job#: [**Job Number 66303**] ICD9 Codes: 769
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Medical Text: Admission Date: [**2174-4-2**] Discharge Date: [**2174-4-9**] Date of Birth: [**2099-2-19**] Sex: M Service: MEDICINE Allergies: Gluten Attending:[**First Name3 (LF) 1377**] Chief Complaint: Altered mental status Major Surgical or Invasive Procedure: Esophagogastroduodenoscopy History of Present Illness: 75 yo M with refractory HCC on cycle 1 of 5FU, Hep B cirrhosis, tumor obstruction of left portal vein, partial obstruction on right followed by Dr. [**Last Name (STitle) **] for chemotherapy presents from home via [**Location (un) 620**] ED. This morning he was found to be minimally responsive and had flecks of blood on the pillow noted by family the morning of admission. At [**Hospital1 **] [**Location (un) 620**] he was intubated for airway protection in setting GCS 8, Head Ct was obtained and negative for acute bleed, he recieved 5L IVF. Patient has HD stable and was guiac + from rectal vault with brown stool. On arrival to [**Hospital1 18**] ED, he was HD stable, afebrile, intubated. Labs repeated and notable HCt 25, INR 1.7. Stools were guiac positive [**Doctor Last Name 352**] stools, NG tube placed to suction red tinged gastric contents without lavage. He was noted to develop progressive abdominal distention. Given h/o ruptured hepatoma in 04 with hemoperitoneum he was sent for CT ab/pelvis prior to trasfer to the floor which showed moderate ascites, no intraperitoneal bleed, atelectasis vs consolidation at lung bases and distended urinary bladder. It was also noted that his BP was trending down and he was started on PRBCs, protonix IV, octreotide gtt, cipro. The liver/omed teams were made aware of the admission. At the time of transfer, vital signs: T97.5 BP 124/72 HR 76 RR 16 POx100% on AC. Past Medical History: -Hepatocellular CA recently treated with sorafenib (stopped [**2174-3-2**]), planning to try 5-FU/leucovorin vs. palliative care - he initially presented with a ruptured hepatoma in [**2168**]. He underwent surgical resection and has had for recurrent disease, radiofrequency ablation as well as trans arterial chemoembolization. He tolerated the TACE poorly and has had subsequent progression of disease and is not a candidate for RFA or cyberknife therapy. -Hepatitis B cirrhosis -h/o reptured hematoma -Prostate Ca Social History: -(+) EtOH/Tobacco in past; not anymore -military (Korean/[**Country 3992**]) -Lives with 2 supportive sisters and GF from [**Name (NI) 2784**] Family History: Non-contributory Physical Exam: GENERAL - well-appearing man in NAD, comfortable, appropriate HEENT - NC/AT, PERRLA, EOMI, sclerae anicteric, MMM, OP clear NECK - supple, no thyromegaly, no JVD, no carotid bruits LUNGS - CTA bilat, no r/rh/wh, good air movement, resp unlabored, no accessory muscle use HEART - PMI non-displaced, RRR, no MRG, nl S1-S2 ABDOMEN - NABS, soft/NT/ND, no masses or HSM, no rebound/guarding EXTREMITIES - WWP, no c/c/e, 2+ peripheral pulses (radials, DPs) SKIN - no rashes or lesions LYMPH - no cervical, axillary, or inguinal LAD NEURO - awake, A&Ox3, CNs II-XII grossly intact, muscle strength [**4-19**] throughout, sensation grossly intact throughout, DTRs 2+ and symmetric, cerebellar exam intact, steady gait Pertinent Results: Admission Labs: [**2174-4-2**] 06:56PM ASCITES TOT PROT-0.6 [**2174-4-2**] 06:56PM ASCITES WBC-470* RBC-85* POLYS-52* LYMPHS-6* MONOS-0 MACROPHAG-42* [**2174-4-2**] 03:30PM HCT-28.0* [**2174-4-2**] 10:15AM PO2-225* PCO2-26* PH-7.46* TOTAL CO2-19* BASE XS--2 COMMENTS-SPECIMEN T [**2174-4-2**] 09:20AM COMMENTS-GREEN TOP [**2174-4-2**] 09:20AM GLUCOSE-113* LACTATE-2.9* [**2174-4-2**] 09:15AM GLUCOSE-121* UREA N-35* CREAT-1.0 SODIUM-126* POTASSIUM-4.0 CHLORIDE-97 TOTAL CO2-20* ANION GAP-13 [**2174-4-2**] 09:15AM estGFR-Using this [**2174-4-2**] 09:15AM ALT(SGPT)-22 AST(SGOT)-36 CK(CPK)-35* ALK PHOS-249* TOT BILI-3.4* [**2174-4-2**] 09:15AM LIPASE-111* [**2174-4-2**] 09:15AM cTropnT-<0.01 [**2174-4-2**] 09:15AM CK-MB-NotDone [**2174-4-2**] 09:15AM CALCIUM-8.0* PHOSPHATE-3.2 MAGNESIUM-2.0 [**2174-4-2**] 09:15AM AMMONIA-86* [**2174-4-2**] 09:15AM WBC-7.4 RBC-3.13* HGB-8.1* HCT-25.3* MCV-81* MCH-26.0* MCHC-32.1 RDW-24.7* [**2174-4-2**] 09:15AM NEUTS-85.0* LYMPHS-8.7* MONOS-5.6 EOS-0.6 BASOS-0.1 [**2174-4-2**] 09:15AM PLT COUNT-168 [**2174-4-2**] 09:15AM PT-18.6* PTT-34.5 INR(PT)-1.7* . Labs on discharge: [**2174-4-8**] 05:10AM BLOOD WBC-3.5* RBC-3.69* Hgb-10.1* Hct-30.9* MCV-84 MCH-27.3 MCHC-32.6 RDW-22.6* Plt Ct-80* [**2174-4-8**] 05:10AM BLOOD PT-18.6* PTT-64.1* INR(PT)-1.7* [**2174-4-8**] 05:10AM BLOOD Glucose-91 UreaN-23* Creat-0.6 Na-132* K-4.3 Cl-105 HCO3-19* AnGap-12 [**2174-4-7**] 05:35AM BLOOD ALT-19 AST-38 AlkPhos-201* TotBili-3.6* [**2174-4-8**] 05:10AM BLOOD Calcium-8.5 Phos-2.5* Mg-2.0 . IMAGING: CT Abd: IMPRESSION: 1. Moderate-to-large amount of ascites in the abdomen. No evidence of intraperitoneal or retroperitoneal bleeding. 2. Markedly distended urinary bladder with Foley catheter balloon within the urethra, repositioning required. 3. Cirrhotic liver with hypoattenuating lesions consistent with hepatocellular carcinoma, and hyperattenuating foci consistent with prior chemoembolization. . RUQ Ultrasound: ([**4-2**]) IMPRESSION: 1. Moderate ascites, spot marked for bedside paracentesis. 2. Doppler examination difficult given the abdominal ascites. Nonocclusive thrombus in the main portal vein, with slow flow. Hepatopetal flow in the left portal vein. Right portal vein not seen. Recommend repeat Doppler examination following paracentesis. 3. Cirrhotic liver, with limited evaluation for focal lesions. . RUQ U/S ([**4-6**]): IMPRESSION: 1. Moderate ascites is slightly decreased since [**2174-4-2**]. 2. No evidence of flow in the main and right portal veins, consistent with known thrombus, similar to [**2174-2-11**]. 3. Cirrhotic liver with large infiltrative mass again seen. . . MICRO: [**2174-4-2**] 6:56 pm PERITONEAL FLUID PERITONEAL FLUID. GRAM STAIN (Final [**2174-4-2**]): 4+ (>10 per 1000X FIELD): POLYMORPHONUCLEAR LEUKOCYTES. NO MICROORGANISMS SEEN. This is a concentrated smear made by cytospin method, please refer to hematology for a quantitative white blood cell count.. FLUID CULTURE (Preliminary): NO GROWTH. ANAEROBIC CULTURE (Preliminary): NO GROWTH. . Brief Hospital Course: In short, Mr [**Known lastname 11257**] is a 75M with metastatic treatment-refractory HCC (Dx [**2168**]), course c/b ascites and portal vein thrombosis, who presented with altered mental status and concern for UGIB, s/p intubation for airway protection, now improved to baseline. His hospital course is as follows: . # Altered mental status: Most likely hepatic encephalopathy. Was given aggressive lactulose with marked improvement in his mental status. He was also diagnosed with SBP as a possible precipitant. CT head was unremarkable. He was extubated without complications. RUQ ultrasound was negative for acute thrombosis. EGD was negative for bleed. We continued his lactulose and CTX with good effect. AOx3 on discharge. . # Respiratory failure: Intubated largely for airway protection. Weaned quickly and extubated on [**2174-4-3**]. Was stable in the MICU and on the floor thereafter. . # SBP: Diagnostic paracentesis on [**4-2**] with close to 250 PMNs. Gram stain with PMNs. Given his clinical picture, pt treated with a 5-day CTX course as well as with albumin. . # Metastatic HCC: s/p 5FU on [**2174-3-24**]. Poor prognosis. Discussed possible hospice, but pt did not feel ready to make the decision. Plan was discussed with Dr [**Last Name (STitle) **] and Dr [**First Name (STitle) 679**]. . # Pancytopenia: Likely the result of his chemotherapy. EGD was negative for acute bleeding. . # Urinary Retention: Urology was consulted for elevated bladder scan and difficult Foley. They recommended keeping the Foley catheter in place x2 weeks and to follow up as an outpatient. Pt also developed low urine output, likely [**1-17**] low flow from severe liver disease. Since pt comfortable and Cr 0.6, no intervention done. Mild intermittent oozing at urethral meatus likely from foley trauma. . # Full code # Contact: [**Name (NI) 28814**] (sister) [**Telephone/Fax (1) 28815**] (home), [**Telephone/Fax (1) 28816**] (cell) [**Name (NI) **] (brother) [**Telephone/Fax (1) 28817**] (home) [**Name (NI) 3551**] (sister) [**Telephone/Fax (1) 28818**] (cell) Medications on Admission: Spironolactone 25mg daily Lactulose 15gm/15ml 1 tbsp daily Omeprazole 20mg po daily Prochlorperazine 10mg Q6-8hrs prn nausea Discharge Medications: 1. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 2. Lactulose 10 gram/15 mL Syrup Sig: Fifteen (15) ML PO TID (3 times a day): Please titrate to [**2-16**] bowel movements per day. Disp:*1350 ML(s)* Refills:*2* 3. Spironolactone 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Discharge Disposition: Home With Service Facility: [**Company 1519**] Discharge Diagnosis: hepatic encephalopathy . metastatic hepatocellular carcinoma hepatitis B cirrhosis prostate cancer Discharge Condition: improved, mental status at baseline. there is some oozing/bleeding at the urethral meatus [**1-17**] foley trauma; foley flushes without any obstruction or clot to suggest internal hemorrhage Discharge Instructions: You were admitted to the hospital with altered mental status likely from hepatic encephalopathy. Please continue taking lactulose to have [**2-16**] bowel movements a day. Take more lactulose if you feel confused. . Your medications changes are as follows: 1. continue your spironolactone 25mg daily 2. continue your lactulose 3. changed your prilosec to high-dose pantoprazole (40mg twice daily) . If you have any fevers, chills, chest pain, shortness of breath, abdominal pain or any other concerning symptoms, please call your physician. Followup Instructions: Please call your primary care physician for followup upon your discharge: [**Last Name (LF) **],[**First Name3 (LF) **] [**Telephone/Fax (1) 682**] . Please follow up with urology in 2 weeks for voiding trial and PSA check: Dr [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 770**] ([**Telephone/Fax (1) 5727**]) or Dr [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 9125**] ([**Telephone/Fax (1) 6445**]). . Other appointments: Provider: [**First Name4 (NamePattern1) 539**] [**Last Name (NamePattern1) 10603**], RN Phone:[**Telephone/Fax (1) 22**] Date/Time:[**2174-4-14**] 11:00 Provider: [**First Name4 (NamePattern1) 539**] [**Last Name (NamePattern1) 10603**], RN Phone:[**Telephone/Fax (1) 22**] Date/Time:[**2174-4-21**] 11:00 Provider: [**First Name4 (NamePattern1) 539**] [**Last Name (NamePattern1) 10603**], RN Phone:[**Telephone/Fax (1) 22**] Date/Time:[**2174-4-28**] 11:00 [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] MD [**MD Number(1) 1379**] Completed by:[**2174-4-9**] ICD9 Codes: 2761, 5715
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Medical Text: Admission Date: [**2127-4-17**] Discharge Date: [**2127-4-21**] Date of Birth: [**2048-3-5**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 5755**] Chief Complaint: fever Major Surgical or Invasive Procedure: none History of Present Illness: 79M with metastatic cholangiocarcinoma s/p metal biliary stent placement [**11-8**], who presents with fever x 1 day following repeat ERCP. Pt is a very poor historian, so most of the history is obtained through chart review and ED providers. The patient stated that he had the ERCP done, returned home, felt really fatigued and unable to walk ([**3-7**] leg pain and weakness). His wife called 911 and he was taken to [**Hospital1 18**] ED. Denied any chest pain, abd pain, nausea, vomiting. +fevers to 104 at home, + chills. No headaches. No LOC, no h/o syncope. . Patient had second, outpatient ERCP by Dr. [**Last Name (STitle) **] the day prior to admission due to increasing pruritis and a CT at [**Hospital1 **] that suggesting tumor ingrowth into the stent. He was pretreated with ampicillin 2gm IV, and gentamicin 80mg IV. ERCP demonstrated a malignant-appearing biliary stricture affecting the hilumand right and left ducts. There was debris visible with in the stent at early cholangiogram. Occulsion cholangiograqm revealed extensive stricturing of both left and right intrahepatic ducts. Although a small left intrahepatic radical opacified, it was not possible to advance the balloon catheter in this direction. For this reason, no stent could be introduced. Balloon sweeps were performed from just above the stent and down through the stent, and a moderate amount of debris was removed. Even after multiple sweeps, there was some filling defect left in the upperprotion of the stent, consistent with a degree of tumor ingrowth. Sticture not amenable to ERCP, and suggested PTCA as next intervention if futher obstructive symptoms occur. He was NOT discharged on any anti-biotic ppx. . Today pt presents with fever to 103.8, no [**Last Name (un) 103**] pain. no nausea/no vomiting. c/o fatigue, with reported fevers at home of 103.8--pt took tylenol. In ED, hemodynamically stable. clinically appears well. wcc is 20. pt was pancultured and started on levo and flagyl per ercp fellow who review pt in am for consideration of ir guided drainage if abscess present. ct in er was equivocal regards to this. pt was therefore admitted for iv rehydration, iv abx and possible ir procedure. Apparently had an episode of unresponsiveness in the ED + incontinence. Stat Head CT ordered--negative. Dr. [**Last Name (STitle) 3271**] requested a neuro consult on the floor. . In the ED, initial VS were T98.8; HR 63; BP 107/57; rr 16, O2 sat 96%. No nausea/vomting reported. No abdominal pain. Blood cx sent. IVF given, levo, flagyl given as well. Pt was schdeduled to go to the regular floor but at 2305; pt was found to be unresponsive, diaphoretic and incontinent of stool. T 102.0(R); hr 57; BP 104/45; rr 21 O2 sat 97%2L. BS 246 at the time. Per nsg report, got up to go to the bathroom, felt off, ? syncopal event; got back into bed, was found by nurse to be unresponsive and was incontinent of stool. Pt woke up after sternal rub, alert and oriented x 3. CT scan was ordered in the ED--negative. Of note, but had a recent 40-50lbs weight loss over last year. . Upon arrival to the [**Hospital Unit Name 153**], the patient's complaint was fatigue and leg pain. Vital signs were stable. No abdominal pain, no nausea, no vomiting. Past Medical History: 1) Metastatic cholangiocarcinoma, diagnosed [**11-8**], s/p metal stent placement. 2) Glucose intolerance 3) CAD, s/p old inferior MI, s/p cath [**2121**] demonstrating 60% LCx lesion, no intervention . EF 45%. 4) PVD 5) hyperlipidemia 6) s/p pacemaker placement for bradycardia 4 yrs ago--[**Company 1543**] Sigma 300 SDR. placed for sx bradycardia. programmed DDD with max rate 80. PSH: 7) intussusception repair as a child 8) herniorraphy Social History: The patient has been married for 47 years, has four children and 11 grandchildren. He does not smoke though he did in the remote past having quit 20 years ago. Family History: [**Name (NI) **] father died of heart disease at age 88. [**Name (NI) **] mother had [**Name (NI) 4522**] disease, and apparently died of complications of that in her late 60's. Two of the patient's children are physicians. . Physical Exam: PE: Temp: 99.5; HR 100; BP 106/63; RR 17; O2 sat 98%ra HEENT: very dry mucus membranes. no thyromegaly. no scleral icterus appreciated. CV: regular S1 and S2. No murmurs, rubs or gallops appreciated. LUNG: CTAB. no wheezes, rales, rhonchi ABD: scar from previous surgery. +BS. soft, non-tender, non-distended, no organomegaly appreciated. no RUQ tenderness EXT: WWP, good palpable pulses. NEUR: a and o x 3. responds to questions appropriately, but at times tangential and a poor historian SKIN: no rashes Pertinent Results: [**2127-4-16**] 10:00AM WBC-8.4 RBC-4.43* HGB-13.6* HCT-41.6 MCV-94 MCH-30.7 MCHC-32.7 RDW-14.2 [**2127-4-16**] 10:00AM NEUTS-78.9* LYMPHS-13.8* MONOS-5.1 EOS-0.8 BASOS-1.3 [**2127-4-16**] 10:00AM PLT COUNT-224 [**2127-4-16**] 10:00AM PT-15.2* INR(PT)-1.4* [**2127-4-16**] 10:00AM ALBUMIN-3.8 [**2127-4-16**] 10:00AM ALT(SGPT)-99* AST(SGOT)-101* ALK PHOS-516* TOT BILI-1.8* DIR BILI-0.4* INDIR BIL-1.4 [**2127-4-16**] 10:00AM UREA N-18 CREAT-1.1 SODIUM-138 POTASSIUM-6.0* CHLORIDE-102 TOTAL CO2-25 ANION GAP-17 [**2127-4-16**] 11:00AM URINE BLOOD-TR NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-7.0 LEUK-NEG [**2127-4-16**] 11:00AM URINE RBC-2 WBC-0 BACTERIA-NONE YEAST-NONE EPI-0 troponin 0.04->0.02 ck-mb 7->3 . AEROBIC BOTTLE (Final [**2127-4-20**]): REPORTED BY PHONE TO [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) **] [**2127-4-18**] 11AM. ENTEROBACTER CLOACAE. FINAL SENSITIVITIES. This organism may develop resistance to third generation cephalosporins during prolonged therapy. Therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. For serious infections, repeat culture and sensitivity testing may therefore be warranted if third generation cephalosporins were used. Trimethoprim/Sulfa sensitivity testing available on request. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ ENTEROBACTER CLOACAE | CEFEPIME-------------- <=1 S CEFTAZIDIME----------- <=1 S CEFTRIAXONE----------- <=1 S CIPROFLOXACIN---------<=0.25 S GENTAMICIN------------ <=1 S IMIPENEM-------------- <=1 S MEROPENEM-------------<=0.25 S PIPERACILLIN---------- <=4 S TOBRAMYCIN------------ <=1 S ANAEROBIC BOTTLE (Final [**2127-4-20**]): ENTEROBACTER CLOACAE. IDENTIFICATION AND SENSITIVITIES PERFORMED FROM AEROBIC BOTTLE. . surveillance blood cx from [**4-19**] and [**4-20**]: no growth to date . EKG: Sinus rhythm with atrial sensing and ventricular pacing. No previous tracing available for comparison. . CT OF THE ABDOMEN WITH IV CONTRAST: There are mild dependent changes at the lung bases. A biliary stent is noted in the common duct. Moderate intrahepatic biliary ductal dilatation is noted. Near the porta hepatis and adjacent to the proximal end of the biliary stent is an approximately 5.7 x 3.7-cm area of hypodensity of the hepatic parenchyma with ill-defined borders. Multiple smaller satellite low-attenuation hepatic foci with similar ill- defined appearance are noted. There is associated moderate intrahepatic biliary ductal dilatation. There is no defined fluid collection and no subcapsular or perihepatic fluid. There is no ascites or intraperitoneal focal fluid collection or abscess. The pancreas, spleen, adrenal glands, stomach and bowel are unremarkable. At the upper pole of the right kidney is a 3.1-cm exophytic lesion which measures 28 Hounsfield units, higher than expected for a simple cyst. Smaller bilateral parapelvic cysts are noted. There are bilateral extrarenal pelves. There is no pathologic mesenteric or retroperitoneal lymphadenopathy. CT OF THE PELVIS WITH IV CONTRAST: The rectum, urinary bladder and pelvic loops of bowel are unremarkable. The prostate is mildly enlarged. There is no free pelvic fluid or lymphadenopathy. BONE WINDOWS: No suspicious osteoblastic or osteolytic lesions are identified. IMPRESSION: 1. 5.7 x 3.7 cm region of low attenuation of the hepatic parenchyma near the porta hepatis with ill-defined borders and multiple smaller satellite hypodense foci. These findings are thought more likely to represent primary cholangiocarcinoma with intrahepatic metastases. The possibility of superinfection cannot be definitively excluded. Evaluation with ultrasound could be helpful to determine if there is a fluid component. If so, this could be aspirated for diagnostic purposes. 2. Bilateral parapelvic renal cysts. 3. 3.1-cm exophytic lesion of the right kidney measures greater density than expected for a simple cyst. Ultrasound is suggested to determine if this is a cyst or possibly a solid lesion. . RUQ ULTRASOUND: FINDINGS: There is mild edema within the gallbladder wall which may be seen with liver disease. The gallbladder is relaxed and no pericholecystic fluid is identified to suggest cholecystitis. As noted on prior CT, there is intrahepatic biliary ductal dilatation. Upper pole cyst is identified on the right kidney measuring 3.1 cm x 3 cm x 2.1 cm. No fluid collections around the liver or gallbladder are identified. IMPRESSION: 1. No fluid collections identified in or around the liver or gallbladder. 2. Intrahepatic biliary ductal dilatation also noted on CT one day previous. 3. Edema within the gallbladder wall which may be seen with liver disease. No evidence of acute cholecystitis identified. . AP CXR: Heart size top normal. Lungs clear. No edema or pleural effusion. Fullness in the mediastinum at the thoracic inlet to the right of midline could be due to goiter or tortuous head and neck vessels. Transvenous right atrial and right ventricular pacer leads in standard placements. No pneumothorax or pleural effusion. . HEAD CT W/O CONTRAST: FINDINGS: No definite evidence of acute intracranial hemorrhage. There is no shift of normally midline structures or hydrocephalus. [**Doctor Last Name **]-white matter differentiation appears grossly preserved. Several areas of relative [**Name (NI) 33214**] is seen within vessels, including the MCAs and vertebrals, possibly secondary to recent contrast administration. Visualized paranasal sinuses appear normally aerated. IMPRESSION: No evidence of acute intracranial hemorrhage. MRI with diffusion-weighted images is more sensitive in the evaluation for acute ischemia/infarct and for vascular detail. Brief Hospital Course: 1) Gram negative septicemia due to cholangitis: Bacteremia may have been secondary to manipulation during ERCP. RUQ ultrasound showed no evidence of cholecystitis. Culture grew enterobacter. Patient received ampicillin and gentamicin while in house and was discharged on po cipro. Surveillance blood cultures remain negative. Plan for total of 14 days of antibiotics. Patient is hemodynamically stable. LFTs are steadily improving. Percutaneous biliary drain was discussed but was not necessary given bili trending down with the cleaning of the stent done on initial ERCP. . 2) Cholangiocarcinoma/locally metastatic, growing into the stent, obstructing bile ducts: Patient is currently under hospice care. . 3) Syncope: Pacer was interrogated. Episode of ? VT noted but did not temporally correlate with patient's episode. More likely this was due to transient hypotension in the setting of his sepsis. However, could certainly consider AICD once bacteremia completely treated given concurrent low EF (EF 20-30%). However, patient is in hospice and likely would refuse. This was not discussed during his inhospital course. Neuro exam was normal and head CT was negative. Orthostatics were negative. No significant arrhythmias on tele other than a transient tachycardia EP believes was possibly afib/flutter, ventricularly paced. . 4) Renal cyst: Incidental finding on CT. Consider follow-up ultrasound to better characterize, as recommended, if patient agreeable. . 5) h/o CAD: Patient is on an aspirin and a beta blocker. He denied any chest pain. His statin was held due to bump in LFTs. Could consider restarting at follow-up but likely little benefit given overall prognosis and patient will continue to be at risk of recurrent transaminitis. . 6) h/o colitis: Patient was continued on his home Asacol, Anaspaz . 7) ARF: Resolved with IVF. Likely prerenal. Please resume diovan at follow-up visit if creatinine and blood pressure remain stable. . 8) Coagulopathy: Resolved with vitamin K. Inr 1.9 on admit, now 1.4. . 9) Dispo: discharged home with prior hospice services . 10) Code status: DNR/DNI Medications on Admission: Meds from records--need to confirm with wife in AM ASACOL 400MG--2 tabs three times a day per dr [**Last Name (STitle) 96328**] ASPIRIN 81MG--One tablet twice a day DIOVAN 80MG--One tablet by mouth every day HYOSCYAMINE SULFATE 0.375MG--One tablet twice a day METOPROLOL TARTRATE 25MG--One tablet twice a day PRAVACHOL 20MG--One tablet at bedtime TIMOLOL 0.25%--One gtt twice a day Discharge Medications: 1. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). Disp:*30 Tablet(s)* Refills:*2* 2. Mesalamine 400 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO TID (3 times a day). 3. Hyoscyamine Sulfate 0.125 mg Tablet, Sublingual Sig: One (1) Tablet, Sublingual Sublingual QID (4 times a day). Disp:*120 Tablet, Sublingual(s)* Refills:*0* 4. Ciprofloxacin 750 mg Tablet Sig: One (1) Tablet PO twice a day for 11 days. Disp:*22 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: Old [**Hospital **] Hospice Discharge Diagnosis: primary: enterobacter septicemia due to cholangitis secondary: cholangiocarcinoma syncope Discharge Condition: good: hemodynamically stable, afebrile, LFTs improved Discharge Instructions: Please call your doctor or go to the emergency room for temperature > 100.5, worsening abdominal pain or fullness, or other concerning symptoms. Please take the antibiotics, as prescribed, until they are gone. Please note you have been started on a new blood pressure medication, which also helps with controlling the rate of your heart. Please take, as prescribed. Followup Instructions: Please follow-up with your primary care doctor, Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 6164**], on Monday, [**2127-4-28**] at 4:30 PM to follow-up this hospital admission. Phone: [**Telephone/Fax (1) 4475**] You can call to schedule follow-up with Dr. [**First Name (STitle) **] [**Name (STitle) **], only as needed. Phone: ([**Telephone/Fax (1) 10532**] ICD9 Codes: 5849, 4019, 4439, 2724, 412
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Medical Text: Admission Date: [**2121-11-20**] Discharge Date: [**2121-11-28**] Date of Birth: [**2052-7-31**] Sex: F Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 598**] Chief Complaint: abdominal pain Major Surgical or Invasive Procedure: [**2121-11-20**] 1. Exploratory laparotomy. 2. Extensive lysis of adhesions. 3. Segmental small-bowel resection with primary anastomosis. 4. Repair of enterotomy History of Present Illness: The patient is a 69-year-old lady with a history of ulcerative colitis and colectomy/ileoanal anastamosis/J-pouch in [**2114**] at [**Hospital 26928**] Clinic. She presents with complaints of abdominal pain, mostly left sided as well as nausea and small amounts of emesis since yesterday morning. Reports she has not had any episodes of small bowel obstructions in the past. Reports last bowel movement was yesterday morning and that she does not pass gas secondary to her prior surgery. Of note she was seen by her gastroenterologist on [**2121-10-16**] with complaints of lower abdominal pain. She has been treated with a one month course of protonix. She was also worked up for pouchitis in [**2120-1-28**] and was treated with flagyl. Her last sigmoidoscopy was at that time and included biopsies, which were unremarkable. Past Medical History: Past Medical History: Ulcerative Colitis (since [**2080**]), fibromyalgia Past Surgical History: colectomy and ileoanal anastomosis, J-pouch ([**Hospital 26928**] Clinic), benign breast biopsy, TAH/BSO ([**2090**]) Social History: The patient was a former smoker but stopped over 30 years ago. She does drink wine with dinner and maybe [**12-28**] glasses after dinner. She has 1 cup of coffee a day. Family History: Remarkable for a mother, who died in her 80s from an acute myocardial infarction. She does not know her father's medical history. Her brother had complications of congestive heart failure. No other family members have had an idiopathic inflammatory bowel disease Physical Exam: Temp 96.1 HR 87 BP 143/82 RR 17 O2 sat 95RA GEN: A&O, NAD HEENT: No scleral icterus, mucus membranes moist CV: RRR, No M/G/R PULM: Clear to auscultation b/l, No W/R/R ABD: distended and tympanitic throughout, tender to palapation in left mid-abdomen, voluntary guarding, no rebound DRE: refusing Ext: No LE edema, LE warm and well perfused Pertinent Results: [**2121-11-20**] 11:55AM WBC-9.8 RBC-3.98* HGB-11.3* HCT-33.6* MCV-84 MCH-28.3 MCHC-33.6 RDW-14.4 [**2121-11-20**] 11:55AM NEUTS-85.5* LYMPHS-10.4* MONOS-3.4 EOS-0.6 BASOS-0.1 [**2121-11-20**] 11:55AM PLT COUNT-307 [**2121-11-20**] 11:55AM PT-12.3 PTT-23.6 INR(PT)-1.0 [**2121-11-20**] 11:55AM GLUCOSE-135* UREA N-17 CREAT-0.7 SODIUM-139 POTASSIUM-3.9 CHLORIDE-105 TOTAL CO2-24 ANION GAP-14 [**2121-11-23**] Chest CTA : 1. No evidence of pulmonary embolism. 2. Airway thickening and patchy opacities right upper and middle lobes consistent with bronchopneumonia. 3. Small to moderate, bilateral pleural effusions with adjacent, compressive atelectasis. 4. Oblong, 5mm perifissural nodule on the right has a benign appearance. According to [**Last Name (un) 8773**] society guidelines, in a low risk patient 12 month interval follow is recommended versus 6 month follow-up in a high risk patient. Brief Hospital Course: Mrs. [**Last Name (STitle) 10840**] was evaluated by the Acute Care service in the Emergency Room and based on the CT scan from the referring hospital and her exam she was taken to the Operating Room urgently for an exploratory laparotomy as her small bowel was completely obstructed. She tolerated the procedure well and returned to the PACU in stable condition. She maintained stable hemodynamics after extubation and her pain was controlled with Dilaudid. Following transfer to the Surgical floor she did well for about 24 hours then developed problems with desaturation, confusion and rapid atrial fibrillation. She was subsequently transferred to the ICU for further management. Her atrial fibrillation was initially controlled with IV Lopressor and eventually an amiodarone drip. Serial EKG's and enzymes were drawn which were negative and her rate was eventually controlled. The Cardiology service was consulted and recommended weaning the Amiodarone and using oral Lopressor. Her chest xray showed some new right perihilar consolidation suspicious for pneumonia or aspiration but she was afebrile with a normal WBC. Her respiratory status improved with nebulizers and incentive spirometry. She did have a CTA to rule out PE which was negative. After returning to the Surgical floor she began to make progress. She was tolerating a regular diet without any nausea or fullness and her abdominal wound was healing well. Her pain was controlled with Tylenol and Oxycodone and she was up and walking though fatigued easily. The Physical Therapy service evaluated her and recommended home PT at discharge to help her get back to her baseline. She also remained in NSR for 48 hours prior to discharge. After a longer than expected hospital course she was discharged to home on 12//[**3-5**] and will have VNA services along with follow up in the [**Hospital 2536**] Clinic in 2 weeks. Medications on Admission: vitB12, prozac 10', omperazole 20', imitrex 100', trazadone 50 qhs, Ca/vitD3, MVI Discharge Medications: 1. metoprolol tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 2. acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed for fever/pain. 3. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 4. oxycodone 5 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*60 Tablet(s)* Refills:*0* 5. Prozac 10 mg Capsule Sig: One (1) Capsule PO once a day. 6. Calcium 500 + D 500 mg(1,250mg) -400 unit Tablet Sig: One (1) Tablet PO once a day. 7. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day. Discharge Disposition: Home With Service Facility: VNA [**Hospital1 **] of [**Hospital1 1559**] Discharge Diagnosis: 1. Complete small bowel obstruction 2. Atrial fibrillation Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Please call your doctor or nurse practitioner or return to the Emergency Department for any of the following: *You experience new chest pain, pressure, squeezing or tightness. *New or worsening cough, shortness of breath, or wheeze. *If you are vomiting and cannot keep down fluids or your medications. *You are getting dehydrated due to continued vomiting, diarrhea, or other reasons. Signs of dehydration include dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. *You see blood or dark/black material when you vomit or have a bowel movement. *You experience burning when you urinate, have blood in your urine, or experience a discharge. *Your pain in not improving within 8-12 hours or is not gone within 24 hours. Call or return immediately if your pain is getting worse or changes location or moving to your chest or back. *You have shaking chills, or fever greater than 101.5 degrees Fahrenheit or 38 degrees Celsius. *Any change in your symptoms, or any new symptoms that concern you. Please resume all regular home medications , unless specifically advised not to take a particular medication. Also, please take any new medications as prescribed. Please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. Avoid lifting weights greater than [**5-5**] lbs until you follow-up with your surgeon. Avoid driving or operating heavy machinery while taking pain medications. Incision Care: *Please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *Avoid swimming and baths until your follow-up appointment. *You may shower, and wash surgical incisions with a mild soap and warm water. Gently pat the area dry. *If you have staples, they will be removed at your follow-up appointment or by the VNA. Followup Instructions: Call the Acute Care Clinic at [**Telephone/Fax (1) 600**] for a follow up appointment in [**1-29**] weeks. Call Dr. [**Last Name (STitle) 26929**] for a follow up appointment in [**12-28**] weeks. [**First Name8 (NamePattern2) **] [**Name8 (MD) **] MD [**MD Number(2) 601**] Completed by:[**2121-11-28**] ICD9 Codes: 2930
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Medical Text: Admission Date: [**2196-10-17**] Discharge Date: [**2196-10-20**] Date of Birth: [**2129-8-12**] Sex: M Service: NEUROLOGY Allergies: Tegretol / Dilantin Kapseal / Penicillins / Sulfa (Sulfonamide Antibiotics) / Bactrim Attending:[**First Name3 (LF) 13017**] Chief Complaint: Seizure/Possible GI Bleed Major Surgical or Invasive Procedure: none History of Present Illness: This is a 67 year old man with history of diabetes, dyslipidemia, hypertension, coronary artery disease (s/p multilple stents and CABG in [**2189**]), seizure disorder (on lamotrigine only), macrocytic anemia, who initially presented to the ED after finding himself down on the ground. He was brought int to the ED by EMS, and initially evaluted, with trauma survey overall negative, but facial/nasal bone fractures. During his initial presentation to the ED he was not complaining of any problems other than facial pain. He stated that his blood sugar might have been low, but EMS stick was FS of 250s. While in the ED he had a seizure ( described as Jerking Tonic/Clonic, generlized, with face deviating to the left, looked like grand-mal, brief). At this time he was incontinent of stool, but not urine. He was not given anything, and seizure spontaneosly resolved. FS of 85, given some glucose. ? Epistaxis running down back of his throat. He had an episode of coffee-ground emesis. Guaiac negative from below. Per report, he was diaphoretic, and "sick looking". . At this time Patient was not given any medications other than glucose to correct his episode of hypoglycemia. Prior to transfer he was started on Protonix IV, Zofran. Nurse also noted "compartment syndrome in left forearm" - could be IV infiltrating, and patient is not complaining of painin that arm. Doppler was done - radial pulse present. . . His presentation, vs were: 96.1-76-132/68-18-98%RA Timing of Events in ED: - Emesis 15 minutes prior to transfer to ICU. - Seizure - 40 minutes prior to transfer. - Neuro came by but patient was vomiting, thus deferred evaluation. - Prior to transfer, the patient had another episode of seizure, and was given ativan and sent for another CT scan of his head to rule out bleed. . Vitals prior to transfer - 83 Pulse, 18 Resp 100% Room Air, BP 125/55 (but had as low as 105 SBP). Afebrile entire ED stay. . Initial CT spine was notable for: 1. No acute cervical spine fracture or malalignment. 2. Mild degenerative changes, worst at C4-C5. . Initial CT head was notable for: 1. No acute intracranial abnormality. 2. Bilateral nasal bone fractures and nasal septal fracture. 3. New mild bifrontal prominence of CSF spaces. . The patient then was reportedly worse, had another seizure, was given a total of 4 ativan IV, noted to have worsening mental status. ED was concerned for evolving intracranial process, and repeated CT, which was unchanged. . On arrival to the floor, the patient was only responding to painful stimuli. His vitals were stable and he did not grimace on palpation of his extremities, his abdomen or back, and was moving his extremities spontaneously. Past Medical History: - DM-1: for almost 50 years, he has neuropathy and retinopathy. -- CAD: 4 stents [**2180**], RCA stent [**11/2189**], 3v-cabg [**9-/2190**], NSTEMI [**2190**] - Syncopal episode in [**Month (only) 205**], attributed to arrhythmia. Underwent cath. without stent placement. - GTC Seizures (wife describes that normal semiology = "lets out a cry," shakes all limbs for ~30 sec, groggy afterwards): ? related to hypoglycemia, stable on Lamictal, no seizures for several years (previously on PHB, stopped in [**2190**]) - Onychodystrophy - Seborrheic dermatitis Social History: Lives with wife. Retired H.S. English teacher (retired early [**12-16**] encephalopathy). [**Month/Day (2) **] several times weekly. -Tobacco history: 2 cigars per week (equivalent to a 25 py hx). -ETOH: Has 1 EtOH drink with dinner. -Illicit drugs: Denies. Family History: Father and sister with [**Name2 (NI) **] at young age (40-50). No family history of arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. Physical Exam: Vitals: Afebrile, HR 81 regular, BP 133/47 RR 14 SpO2 98% RA fingerstick 213 General: Responds to painful stimuli by grimacing, not talking, not responding to commands. HEENT: Sclera anicteric, pupils 4mm, reactive to light, Neck: supple, JVP not elevated, no LAD, Lungs: Clear to auscultation bilaterally, no wheezes, rales, rhonchi CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly GU: foley in place Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema, with the exception of his left arm, but radial is dopplerable. Skin Exam: Small abrasion on top of scalp, several excoriative, well healed lesions throughout. Overall dry skin. Some dried blood around nares. Neurological: Mental status: Groans to noxious stimuli, but not rousable. Cranial Nerves: I: Not tested. II: Pupils equally round and reactive to light, 3 to 2 mm bilaterally. Visual fields are full to confrontation. III, IV, VI: Extraocular movements could not be assessed, but gaze is conjugate. V, VII: Face symmetric. VIII: Hearing not evaluable. IX, X: Not tested. [**Doctor First Name 81**]: Not tested. XII: Not tested. Tone normal in legs, gegenhalten in arms. Power: Strong withdrawal in legs and arms. Reflexes: B T BR Pa Ac Right 2 2 2 3 0 Left 2 2 2 3 0 Right toes up; left down. Sensation intact to noxious stimuli. At discharge: Pertinent Results: [**2196-10-17**] 12:00PM BLOOD WBC-8.5 RBC-3.92* Hgb-12.8* Hct-40.0 MCV-102* MCH-32.7* MCHC-32.1 RDW-15.2 Plt Ct-527* [**2196-10-18**] 03:46AM BLOOD WBC-14.3* RBC-3.36* Hgb-11.2* Hct-34.6* MCV-103* MCH-33.4* MCHC-32.4 RDW-15.2 Plt Ct-431 [**2196-10-17**] 12:00PM BLOOD Glucose-156* UreaN-15 Creat-0.7 Na-142 K-4.9 Cl-104 HCO3-29 AnGap-14 [**2196-10-18**] 03:46AM BLOOD Glucose-244* UreaN-17 Creat-0.8 Na-135 K-4.7 Cl-101 HCO3-24 AnGap-15 [**2196-10-17**] 12:00PM BLOOD ALT-20 AST-27 AlkPhos-61 TotBili-0.5 [**2196-10-17**] 12:00PM BLOOD cTropnT-<0.01 [**2196-10-17**] 12:00PM NEUTS-83.9* LYMPHS-10.5* MONOS-3.4 EOS-1.4 BASOS-0.8 [**2196-10-17**] 12:00PM LIPASE-9 [**2196-10-17**] 12:11PM GLUCOSE-145* LACTATE-1.8 K+-4.4 [**2196-10-17**] 03:50PM URINE MUCOUS-RARE [**2196-10-17**] 03:50PM URINE RBC-1 WBC-<1 BACTERIA-NONE YEAST-NONE EPI-0 [**2196-10-17**] 12:00PM ALBUMIN-4.1 CALCIUM-9.7 PHOSPHATE-1.3*# MAGNESIUM-2.1 [**2196-10-17**] 03:50PM URINE RBC-1 WBC-<1 BACTERIA-NONE YEAST-NONE EPI-0 [**2196-10-17**] 03:50PM URINE BLOOD-NEG NITRITE-NEG PROTEIN-TR GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-7.0 LEUK-NEG [**2196-10-17**] 03:50PM URINE COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.012 [**2196-10-17**] 06:07PM URINE bnzodzpn-NEG barbitrt-NEG opiates-NEG cocaine-NEG amphetmn-NEG mthdone-NEG [**2196-10-17**] 06:07PM URINE BLOOD-NEG NITRITE-NEG PROTEIN-TR GLUCOSE-70 KETONE-10 BILIRUBIN-NEG UROBILNGN-NEG PH-6.0 LEUK-NEG ECG: Sinus rhythm. Prolonged Q-T interval. Early R wave transition. Low QRS voltage in the limb leads. T wave inversions in leads V1-V3 which are new compared to tracing of [**2196-6-1**]. Cannot exclude myocardial ischemia. Clinical correlation is suggested. Intervals Axes Rate PR QRS QT/QTc P QRS T 63 144 102 460/465 76 17 87 CT Head without contrast: FINDINGS: There is no evidence of acute hemorrhage edema, shift of midline structures or major vascular territorial infarction. There is new bifrontal prominence of the CSF spaces, likely representing old subdural hematoma or CSF hygroma. The ventricles and sulci are prominent consistent with age-related atrophy. Atherosclerotic calcifications of the carotid and vertebral arteries are noted. There are fractures of the bilateral nasal bones and nasal septum. There is mild mucosal thickening and a mucus-retention cyst in the right maxillary sinus. The remaining visualized paranasal sinuses, mastoid air cells, and middle ear cavities are clear. IMPRESSION: 1. No acute intracranial abnormality. 2. Bilateral nasal bone fractures and nasal septal fracture. 3. New mild bifrontal prominence of CSF spaces. CT C-spine without contrast: FINDINGS: There is no acute fracture, dislocation, or malalignment of the cervical spine. There is no prevertebral soft tissue edema. The craniocervical junction is intact. There is a posterior disc-osteophyte complex at C4-C5 causing mild spinal canal narrowing. There is mild facet spondylosis on the left at this level. The visualized portions of the lung apices again demonstrate chronic fibrotic changes in the medial aspect of the left lung. There is no cervical lymphadenopathy. The thyroid gland is unremarkable. There are bilateral atherosclerotic calcifications of the carotid bifurcations. IMPRESSION: 1. No acute cervical spine fracture or malalignment. 2. Mild degenerative changes, worst at C4-C5. Head CT without contrast - repeat: FINDINGS: There is no evidence of acute hemorrhage, edema, shift of midline structures, or major vascular territorial infarction. Again noted is bifrontal prominence of the CSF spaces, likely representing old subdural hematomas or CSF hygromas. The ventricles and sulci are prominent consistent with age-related atrophy. Atherosclerotic calcifications of the carotid and vertebral arteries are again noted. There are fractures of the bilateral nasal bones and nasal septum. There is mild mucosal thickening and a mucus retention cyst in the right maxillary sinus. The remaining visualized paranasal sinuses, mastoid air cells, and middle ear cavities are clear. IMPRESSION: 1. No acute intracranial abnormality. 2. Bilateral nasal bone fractures and nasal septal fracture. 3. Bifrontal prominence of CSF spaces. CXR - 1 view: FINDINGS: In comparison with study of [**2195-8-10**], the cardiac silhouette remains within overall normal limits. Minimal indistinctness of pulmonary vessels raises the possibility of increased pulmonary venous pressure. There is suggestion of some increased opacification at the right base and in the retrocardiac region on this side. This could merely reflect crowded vessels or atelectasis and a lateral view would be ideal if clinically possible to better assess for possible pneumonia. ECG: Sinus rhythm with atrial premature depolarization. Low QRS voltage in limb leads. Diffuse non-diagnostic repolarization abnormalities. Rightward precordial R wave transition point. Compared to the previous tracing of [**2196-10-17**] there is no diagnostic change. Intervals Axes Rate PR QRS QT/QTc P QRS T 74 142 102 448/472 59 49 110 Brief Hospital Course: This is a 67 year old man with history of diabetes, dyslipidemia, hypertension, coronary artery disease (s/p multilple stents and CABG in [**2189**]), seizure disorder (on lamotrigine only), macrocytic anemia, who initially presented to the ED after finding himself down on the ground, became more unresponsive and confused after witnessed seizures, now in the MICU, responsive only to painful stimuly. Neurology was urgently consulted and he was subsequently transferred to the general neurology service when altered mental status improved. . # Altered Mental status - due to post-ictal state. Resolved over the next few days. The patient returned to his baseline mental status. . # Seizure disorder - The etiology of his fall was most likely due to low blood sugars. The EMS team did not find this due to the [**Last Name (un) 56493**] effect ([**Last Name (un) **] has repeatedly counseled the patient and his family on this). We loaded the patient on Keppra and started maintance dosing. He tolerated this well and was discharged on his prior home dose Lamictal as well as Keppra 750mg po bid. Of note, Lamictal level has now come back and shows a level of 2.3. The level was drawn likely after the patient had missed 2 doses, but this level indicates that the patient may have missed a few doses at home prior to the initial seizure. . # Nasal fracture - The patient arrived to the ED with bloody mouth and nose. CT shows that he fractured his bilateral nasal bones and nasal septum. Plastic surgery consulted and recommended follow up in clinic on Friday [**2196-10-21**] with possible closed reduction the following week. Plastics is concerned for difficulties with breathing in the future. Respiratory status remained stable while in house. The patient was provided with their clinic phone number on discharge. . # Coffee-ground emesis - had o/ne episode of what was described as coffee- ground emesis, after the seizure. At the time he was diaphoretic, and looked unwell. He was hemydynamically stable however. His [**Doctor Last Name 80870**] score is 1 (Score predicting resolution without intervention: <4) thus he is unlikely to benefit from Upper GI endoscopy. He is Guaiac negative and his likely source of bleeding is epistaxis given trauma of his face. He was Guaiac Negative in ED. - GI consulted - HCT remained stable - no further emesis . **** OF NOTE - In regard to future ED Visits: [**Known firstname **] [**Known lastname **] has a strong history of having generalized seizures early in the morning when his blood glucose is low. Often by time EMS checks his blood glucose after the event, the result is normal or high due to the [**Last Name (un) 56493**] effect. If he arrives in the emergency room in such a context, he should be either loaded on an anti-epileptic medicine or started on a standing IV ativan bridge (e.g.: ativan 1mg IV q6 hours) in order to prevent further generalized seizures within 24 hours. This is important as when the patient has several seizures within a 24 hour period, he becomes very somnolent for days due to a post-ictal state. Thank you for taking this into consideration. Medications on Admission: -One Touch Ultra - Strips Strips 5-6 times a day as directed -Bd Ultra-fine Iii - Pen Needles 31g [**3-28**]" as directed injecting 5 times daily -Levemir 100 Unit/ml 14 in am and 2 in pm -Simvastatin 40 Mg take 1 tablet (40MG) by ORAL route every day in the evening -Humalog 100 Unit/ml pen approx 15 units a day as directed -Glucagon Emergency Kit 1 Mg Use as directed -Ketostix Reagent Check for ketones when BS > 250 and cannot explain one time -Insulin Syringe 31 Gauge X [**3-28**]" 2 per day -Bd Ultra-fine - Syringes 30g 1/2cc 3 times a day -Toprol Xl 25mg 1 per day -One Touch Ultra Soft - Lancets Lancet as directed -Bd Ultra-fine Iii - Syringes 30g 5/16l 1/2 cc. Use one daily. -Ketostix - Strips Bottle Use as directed -Pen Needle 29 Gauge X [**11-15**]" as directed -Bd Ultra-fine - Syringes 29g [**11-15**] C as directed -Aspirin Ec 81mg 1 per day -Enalapril Maleate 10 Mg 1 per day -Lamictal 100mg twice a day -Plavix once a day Discharge Medications: 1. simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 4. enalapril maleate 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. lamotrigine 200 mg Tablet Sig: One (1) Tablet PO twice a day. 6. levetiracetam 750 mg Tablet Sig: One (1) Tablet PO twice a day. Disp:*60 Tablet(s)* Refills:*2* 7. metoprolol tartrate 25 mg Tablet Sig: 0.5 Tablet PO twice a day. 8. Levemir 100 unit/mL Solution Sig: 10 units in the morning and 2 units at night unit Subcutaneous twice a day: as directed by [**Last Name (un) **]. 9. Humalog 100 unit/mL Solution Sig: as directed Subcutaneous once a day: as directed by [**Last Name (un) **]. Discharge Disposition: Home Discharge Diagnosis: seizure nasal fracture Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Neuro: no deficits Discharge Instructions: Dear Mr. [**Known lastname **], It was a pleasure caring for you during your stay. You were admitted to the hospital after a fall, suspected to be due to a seizure related to low blood glucose. During your stay you had 2 more seizures. You were started on a new anti-seizure medicine by the name of Keppra. Please take Keppra 750mg by mouth twice daily in addition to your home Lamictal. Please avoid swimming for at least the next 6 months to ensure your safety as it would be extremely dangerous and possibly deadly if you were to have a seizure while swimming. Likewise, it is [**State 350**] state law that anyone who has suffered a loss of consciousness such as a seizure, may not drive until they have been seizure-free for at least 6 months. Unfortunately, your fall prior to admission resulted in a fracture of your nose. The plastic surgeon team was consulted and are concerned that you may need a closed reduction of your nasal bone in order to prevent breathing problems in the future. Please follow up with them in clinic to further discuss this. Please call their clinic as listed below. Followup Instructions: The Plastic Surgery team asks that you please call their clinic tomorrow, [**2196-10-21**], to arrange follow up with Dr. [**Last Name (STitle) 90769**]. Their phone number is ([**Telephone/Fax (1) 2868**]. They ask that you call tomorrow as the nasal fracture may need to be fixed sooner than later. We have left a message for Dr.[**Name (NI) 10444**] assistant to call you to schedule an appoinment within the next 2-4 weeks. If you do not hear from her, please call ([**Telephone/Fax (1) 2528**] to schedule this appointment. Please attend your previously scheduled appointments: Provider: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 10490**], [**MD Number(3) 13795**]:[**Telephone/Fax (1) 1690**] Date/Time:[**2196-10-26**] 11:00 Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1008**], M.D. Phone:[**Telephone/Fax (1) 62**] Date/Time:[**2196-11-1**] 3:00 Provider: [**First Name8 (NamePattern2) 870**] [**Last Name (NamePattern1) **], [**Name Initial (NameIs) **].D. Phone:[**Telephone/Fax (1) 62**] Date/Time:[**2197-1-19**] 11:20 ICD9 Codes: 5789, 3572
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Medical Text: Admission Date: [**2178-7-6**] Discharge Date: [**2178-7-9**] Service: REASON FOR ADMISSION: Transfer from an outside hospital for chest pain/pressure presumed to be acute myocardial infarction. HISTORY OF PRESENT ILLNESS: This is a [**Age over 90 **]-year-old female with known coronary artery disease, status post acute myocardial infarction the week prior to admission. The patient was taken to the cath laboratory the week prior and found to have three vessel disease with a significant right coronary artery stenosis of 90%. She received a thrombectomy and percutaneous transluminal coronary angioplasty with a [**Age over 90 **] in the distal right coronary artery. The other significant disease was a 30% left main coronary artery and a 70% proximal left anterior descending, as well as left circumflex 99% lesion were not intervened upon at that time. On her last hospital admission, she was found by echocardiogram to have an ejection fraction of 50% with 2+ mitral regurgitation and inferolateral akinesis. On the day of admission, [**2178-7-6**], the patient presented to an outside hospital Emergency Room complaining of "abdominal tightness" and pain between the shoulder blades, similar to the symptoms that brought her to the [**Hospital1 **] hospital the week prior. An electrocardiogram showed ST elevations in the posterolateral leads. Integrilin was started and the patient was transferred to [**Hospital6 1760**] for emergency percutaneous transluminal coronary angioplasty. Catheterization findings: Hemodynamics: Initial normal-low PA pressure, intermittent marked elevation with reflected V wave. At conclusion of case, PA pressure was 22/12. Coronary angiography: Right dominant circulation: Left main coronary artery normal. Left anterior descending: 70%. Left circumflex artery: 99% long occlusion from AV groove, left circumflex into marginal, supplying lateral wall and papillary muscle. Some collaterals from right to left. Right coronary artery: Patent stented right coronary artery. Small diseased posterior descending artery. TIMI three flow. Intervention: Successful percutaneous transluminal coronary angioplasty and stenting of the proximal circumflex to distal OM1 was performed using five overlapping 2.5 mm stents for a total [**Hospital6 **] length of approximately 80 mm. Left femoral arteriotomy closure was performed using angioseal. The patient was taken to the Coronary Care Unit for observation. PAST MEDICAL HISTORY: 1. Hypertension. 2. Coronary artery disease with right coronary artery [**Hospital6 **] as mentioned (see history of present illness). MEDICATIONS: 1. Plavix 75 mg q.d. 2. Aspirin 325 mg po q.d. 3. Lescol 80 mg q.d. 4. Toprol XL 25 mg q.d. 5. Lisinopril 5 mg q.d. 6. Lansoprazole 30 mg q.d. ALLERGIES: Penicillin leads to rash. SOCIAL HISTORY: The patient lives alone. FAMILY HISTORY: Unremarkable. PHYSICAL EXAMINATION: Vital signs: Temperature 100.8. Blood pressure 117/37. Heart rate 87. Respiratory rate 15. Oxygen saturation 96% on four liters. General: Patient lying in bed in no apparent distress, appears younger than stated age, breathing comfortably. Head, eyes, ears, nose and throat: Pupils equal, round and reactive to light and accommodation. Mucous membranes moist. Neck supple, no jugular venous distention. Chest: Coarse breath sounds with upper airway noises. Cardiac: Regular rate and rhythm, 2/6 systolic murmur at the apex. Nondisplaced point of maximal impulse. Abdomen: Nontender, nondistended, soft, positive bowel sounds. Extremities: Warm, 2+ dorsalis pedis pulse bilaterally, 2+ pitting edema, halfway up the leg to the knee. Neurological: Awake, alert and nonfocal. LABORATORY FINDINGS/INITIAL STUDIES: White blood cell count 9.0, hematocrit 28.8, platelet count 273,000. Chem-7: Sodium 130, potassium 3.6, chloride 95, bicarbonate 26, BUN 15, creatinine 1.0, glucose 119. CK 150, arterial blood gas 7.5/33/94. Electrocardiogram showed a normal sinus rhythm at 98 beats per minute with normal axis and intervals. ST depressions in leads V2 through V4. Catheterization report: See history of present illness. BRIEF HOSPITAL COURSE: The patient was admitted to the Coronary Care Unit and placed on aspirin, Plavix, fluvastatin, Integrilin. The patient was switched from Toprol XL to Lopressor b.i.d. Her ACE was held given the large dye load. Patient was placed on telemetry. A chest x-ray was obtained and the patient was transfused one unit of packed red blood cells due to a hematocrit of 26%. [**2178-7-7**], the patient's Metoprolol was changed to 25 q.a.m., 12.5 q.p.m. Lisinopril was started at 5 mg after creatinine came back at 1.1. The patient was asymptomatic, but did complain of occasional dyspepsia. The hematocrit after one unit of packed red blood cells was at 26.9. The patient was transfused an additional two units of packed red blood cells which brought her hematocrit to 34.3. A chest x-ray was obtained the previous day which showed a small bilateral pleural effusions. An echocardiogram was obtained which showed: 1. The left ventricular cavity size as normal. Overall left ventricular systolic function is difficult to assess, but is probably normal (left ventricular ejection fraction greater than 55%). 2. There is a pericardial effusion. The valves were not well visualized. [**2178-7-8**]: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1008**], M.D. [**MD Number(1) 1009**] Dictated By:[**First Name3 (LF) 51146**] MEDQUIST36 D: [**2178-7-15**] 09:11 T: [**2178-7-19**] 14:33 JOB#: [**Job Number 51147**] ICD9 Codes: 4280, 4240, 4019
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Medical Text: Admission Date: [**2178-7-24**] Discharge Date: [**2178-8-3**] Date of Birth: [**2100-7-6**] Sex: M Service: CARDIOTHORACIC Allergies: Penicillins Attending:[**First Name3 (LF) 165**] Chief Complaint: Myocardial infarction Major Surgical or Invasive Procedure: CABG x3 (LIMA->LAD, SVG->OM/PDA) History of Present Illness: Mr. [**Known lastname 79800**] is a 78M smoker with a history of end-stage renal disease (on hemodialysis), hypertension, hyperlipidemia, and stroke who presented to [**Hospital3 4107**] on [**2178-7-19**] after waking up in the middle of the night with SOB. He was found to have pulmonay edema and a new left bundle branch block, and he ruled in for myocardial infarction with positive cardiac enzymes (troponin peak of 30). He received heparin, which was discontinued after his dialysis A-V fistula began to bleed, but he was continued on clopidogrel. He [**Year (4 digits) 1834**] a pharmacologic MIBI which showed an infero-posterior MI and lateral ischemia. He was transferred to the [**Hospital1 18**] for further evaluation. At [**Hospital1 18**], he had a cath on [**2178-7-24**] that showed three-vessel disease and severe left ventricular systolic dysfunction. No stents were placed, as the patient's anatomy was more amenable to CABG. Cardiothoracic surgery saw the patient and plan to take him for CABG on Tuesday. He also received HD before arriving on the cardiology floor. . Past Medical History: s/p CABG x 3 NSTEMI CAD HTN DM ESRD (on HD) CVA Social History: Has not smoked cigarettes in 15 years but previously had a >120 pack-year history. No alcohol. Family History: No family history of premature CAD. Physical Exam: Vitals: T 98.7 BP 156/58 HR 72 RR 20 97RA General: AO3 NAD HEENT: PERRL EOMI Neck: supple, no significant JVD or carotid bruits appreciated Pulmonary: markedly decreased BS at R lung base, decreased BS b/l Cardiac: RRR, nl S1 S2, no murmurs, rubs or gallops appreciated Abdomen: soft, NT, ND, normoactive bowel sounds, no masses or organomegaly noted Extremities: mild edema, 2+ radial, DP pulses b/l Lymphatics: No cervical, supraclavicular, axillary or inguinal lymphadenopathy noted Skin: no echymoses Labs: See below Pertinent Results: [**2178-7-24**] 10:00AM GLUCOSE-135* UREA N-69* CREAT-6.4* SODIUM-133 POTASSIUM-4.5 CHLORIDE-96 TOTAL CO2-22 ANION GAP-20 [**2178-7-24**] 10:00AM estGFR-Using this [**2178-7-24**] 10:00AM ALT(SGPT)-17 AST(SGOT)-30 CK(CPK)-74 ALK PHOS-73 AMYLASE-36 TOT BILI-0.3 [**2178-7-24**] 10:00AM cTropnT-3.88* [**2178-7-24**] 10:00AM ALBUMIN-3.6 [**2178-7-24**] 10:00AM %HbA1c-5.5 [**2178-7-24**] 10:00AM TYPE-ART PO2-107* PCO2-40 PH-7.36 TOTAL CO2-24 BASE XS--2 [**2178-7-24**] 10:00AM GLUCOSE-129* NA+-133* K+-4.5 [**2178-7-24**] 10:00AM HGB-10.1* calcHCT-30 O2 SAT-97 [**2178-7-24**] 10:00AM WBC-5.5 RBC-3.17* HGB-9.7* HCT-27.6* MCV-87 MCH-30.5 MCHC-35.1* RDW-15.2 [**2178-7-24**] 10:00AM PT-13.8* PTT-24.3 INR(PT)-1.2* Cardiac Cath [**2178-7-24**]: 1. Selective coronary angiography of this right dominant system demonstrated 3 vessel coronary artery disease. The LMCA was moderately calcified with a distal 30% lesion. The LAD was moderately calcified with a proximal 50% lesion after the take-off of D1. There was mild diffuse disease in the mid-LAD. The LCx was moderately calcified with an ostial 60-70% lesion. There was a proximal hazy 80% lesion and a large OM/LPL. There were multiple collaterals to the distal RCA. The RCA had a proximal 50% lesion, a mid 60% lesion and a mid total occlusion. There was faint filling of the mid-distal RCA. 2. Limited resting hemodynamics revealed mildly elevated left sided filling pressures with LVEDP of 17mmHg. The right sided filling pressure was relatively normal, with [**Name (NI) 79801**] of 10mmHg. The pulmonary artery pressure was mildly elevated, at 37/14 mmHg. The systemic arterial pressure was elevated at 171/46 mmHg. There was no gradient between the LVEDP and the PCW. There was no gradient on pullback from the left ventricle to the aorta. 3. Left ventriculography showed left ventricular systolic dysfunction, with calculated ejection fraction of 40%. There was moderate to severe global hypokinesis, worst in the infero-lateral and infero-basal segments. There was no mitral regurgitation. FINAL DIAGNOSIS: 1. Three vessel coronary artery disease. 2. Severe left ventricular systolic dysfunction. 3. Mild left ventricular diastolic dysfunction. 4. Mild pulmonary artery hypertension. [**2178-8-3**] 01:00PM BLOOD WBC-6.9 RBC-2.91*# Hgb-8.6* Hct-26.3* MCV-90 MCH-29.6 MCHC-32.7 RDW-15.2 Plt Ct-276 [**2178-8-1**] 08:30AM BLOOD PT-15.1* PTT-30.2 INR(PT)-1.3* [**2178-8-3**] 05:50AM BLOOD Glucose-120* UreaN-53* Creat-7.8*# Na-134 K-4.7 Cl-97 HCO3-24 AnGap-18 [**Known lastname **],[**Known firstname 79802**] [**Medical Record Number 79803**] M 78 [**2100-7-6**] Radiology Report CHEST (PORTABLE AP) Study Date of [**2178-7-31**] 2:07 PM [**Last Name (LF) **],[**First Name3 (LF) **] CSURG CSRU [**2178-7-31**] SCHED CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 79804**] Reason: s/p ct removal [**Hospital 93**] MEDICAL CONDITION: 78 year old man with REASON FOR THIS EXAMINATION: s/p ct removal Final Report REASON FOR EXAMINATION: Followup of a patient after removal of the chest tube. Portable AP chest radiograph was compared to prior study obtained yesterday on [**2178-7-30**]. The patient was extubated with removal of the NG tube, Swan-Ganz catheter, as well as mediastinal drain and left chest tube. The cardiomediastinal silhouette is stable. No appreciable change in bibasilar opacities consistent with atelectasis is demonstrated, left more than right, expected at this stage. No appreciable pneumothorax is seen. There is no evidence of failure or significant increase in pleural effusion. DR. [**First Name4 (NamePattern1) 2618**] [**Last Name (NamePattern1) 2619**] Approved: FRI [**2178-7-31**] 5:23 PM Imaging Lab [**Hospital1 18**] ECHOCARDIOGRAPHY REPORT [**Known lastname **], [**Known firstname 79802**] [**Hospital1 18**] [**Numeric Identifier 79805**] (Complete) Done [**2178-7-30**] at 8:35:00 AM FINAL Referring Physician [**Name9 (PRE) **] Information [**Name9 (PRE) **], [**First Name3 (LF) **] Division of Cardiothoracic [**Doctor First Name **] [**First Name (Titles) **] [**Last Name (Titles) **] [**Hospital Unit Name 4081**] [**Location (un) 86**], [**Numeric Identifier 718**] Status: Inpatient DOB: [**2100-7-6**] Age (years): 78 M Hgt (in): BP (mm Hg): / Wgt (lb): HR (bpm): BSA (m2): Indication: intraop management ICD-9 Codes: 402.90, 440.0 Test Information Date/Time: [**2178-7-30**] at 08:35 Interpret MD: [**Name6 (MD) 3892**] [**Name8 (MD) 3893**], MD Test Type: TEE (Complete) Son[**Name (NI) 930**]: [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 3319**], MD Doppler: Full Doppler and color Doppler Test Location: Anesthesia West OR cardiac Contrast: None Tech Quality: Adequate Tape #: 2008AW3-: Machine: 3 Echocardiographic Measurements Results Measurements Normal Range Left Atrium - Long Axis Dimension: *5.5 cm <= 4.0 cm Left Ventricle - Septal Wall Thickness: *1.3 cm 0.6 - 1.1 cm Left Ventricle - Inferolateral Thickness: *1.2 cm 0.6 - 1.1 cm Left Ventricle - Diastolic Dimension: 5.6 cm <= 5.6 cm Left Ventricle - Ejection Fraction: 45% >= 55% Aorta - Sinus Level: *3.8 cm <= 3.6 cm Aorta - Ascending: 3.0 cm <= 3.4 cm Aorta - Arch: *3.1 cm <= 3.0 cm Aortic Valve - Peak Velocity: 1.0 m/sec <= 2.0 m/sec Findings LEFT ATRIUM: Normal LA and RA cavity sizes. No spontaneous echo contrast or thrombus in the LA/LAA or the RA/RAA. RIGHT ATRIUM/INTERATRIAL SEPTUM: Normal RA size. No ASD by 2D or color Doppler. LEFT VENTRICLE: Normal LV wall thickness. Inferobasal LV aneurysm. Mild regional LV systolic dysfunction. LV WALL MOTION: Regional left ventricular wall motion findings as shown below; remaining LV segments contract normally. RIGHT VENTRICLE: Normal RV chamber size and free wall motion. AORTA: Normal aortic arch diameter. Complex (>4mm) atheroma in the aortic arch. Complex (>4mm) atheroma in the descending thoracic aorta. AORTIC VALVE: Normal aortic valve leaflets (3). Mildly thickened aortic valve leaflets. MITRAL VALVE: Normal mitral valve leaflets with trivial MR. Mildly thickened mitral valve leaflets. Physiologic MR (within normal limits). TRICUSPID VALVE: Normal tricuspid valve leaflets with trivial TR. PULMONIC VALVE/PULMONARY ARTERY: Normal pulmonic valve leaflet. No PS. Physiologic PR. PERICARDIUM: No pericardial effusion. GENERAL COMMENTS: A TEE was performed in the location listed above. I certify I was present in compliance with HCFA regulations. The patient was under general anesthesia throughout the procedure. No TEE related complications. The patient appears to be in sinus rhythm. Results were personally reviewed with the MD caring for the patient. See Conclusions for post-bypass data REGIONAL LEFT VENTRICULAR WALL MOTION: N = Normal, H = Hypokinetic, A = Akinetic, D = Dyskinetic Conclusions PRE-BYPASS: The left atrium and right atrium are normal in cavity size. No spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. No atrial septal defect is seen by 2D or color Doppler. Left ventricular wall thicknesses are normal. There is an inferobasal left ventricular aneurysm. There is mild regional left ventricular systolic dysfunction with the mid and apical inferior and inferoseptal walls. The remaining left ventricular segments contract normally. Right ventricular chamber size and free wall motion are normal. There are complex (>4mm) atheroma in the aortic arch. There are complex (>4mm) atheroma in the descending thoracic aorta. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion. The aortic valve leaflets are mildly thickened. The mitral valve appears structurally normal with trivial mitral regurgitation. The mitral valve leaflets are mildly thickened. Physiologic mitral regurgitation is seen (within normal limits). There is no pericardial effusion. Dr. [**First Name (STitle) **] was notified in person of the results on [**Known lastname 79800**] at 8AM. Post_Bypass: Intact thoracic aorta. Normal RV systolic function. LVEF 45%. Valves similar to prebypass study POST-BYPASS: I certify that I was present for this procedure in compliance with HCFA regulations. Electronically signed by [**Name6 (MD) 3892**] [**Name8 (MD) 3893**], MD, Interpreting physician [**Last Name (NamePattern4) **] [**2178-7-31**] 11:27 ?????? [**2172**] CareGroup IS. All rights reserved. Brief Hospital Course: On [**2178-7-30**] Mr.[**Known lastname 79800**] [**Last Name (Titles) 1834**] CABG x3 (LIMA->LAD, SVG->OM/PDA) with Dr.[**First Name8 (NamePattern2) **] [**Name (STitle) **]. Please refer to Dr[**Doctor Last Name 14333**] operative note for further details. XCT=54min, CPB=61minutes. He was intubated and sedated when transferred to CVICU. The drips were weaned to off and he was extubated that night. POD#1 he went into AFib and was started on Amiodarone, beta-blockers were optimized as BP would tol. Renal was following due to Mr.[**Known lastname 79806**] ESRD and dependence on hemodialysis.All lines and tubes were discontinued in a timely fashion and he was transferred to the SDU for further telemetry monitoring and recovery. The remainder of his postoperative course was essentially uneventful. During dialysis on POD#4 he was transfused one unit of PRBCs for a hematocrit of 21.3. Follow-up HCT =26, and he Dr.[**First Name (STitle) **] cleared him for discharge. POD#4 he was doing well and was discharged to home with VNA. All follow-up appointments were advised. Medications on Admission: Hydralazine 50(2) Labetolol 400(2) Colace 100(2) Ferrous 325(1) Lipitor 80(1) Plavix 75(1) Lopid 300(2) Levoquin 250(1) Nephrocaps(1) Neurontin 300(1) prevacid 30(1) ASA 325(1) Tiazac CD 360(1) Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*0* 2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 3. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*45 Tablet(s)* Refills:*0* 4. Amiodarone 200 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day): x 7 days then decrease to 200(2)x 7 days, then decrease to 200(1). Disp:*120 Tablet(s)* Refills:*0* 5. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 6. Ferrous Gluconate 325 mg (37.5 mg Iron) Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* 7. Gemfibrozil 600 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). Disp:*30 Tablet(s)* Refills:*0* 8. B Complex-Vitamin C-Folic Acid 1 mg Capsule Sig: One (1) Cap PO DAILY (Daily). Disp:*30 Cap(s)* Refills:*0* 9. Gabapentin 300 mg Capsule Sig: One (1) Capsule PO DAILY (Daily). Disp:*30 Capsule(s)* Refills:*0* 10. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital1 1376**] Discharge Diagnosis: s/p CABG x3 Coronary artery disease endstage renal failure Diabetes mellitus hypertension COPD GERD h/o CVA s/p NSTEMI Discharge Condition: good Discharge Instructions: take all medications as prescribed Shower daily, no baths or swimming No creams, lotions or powders to incisions No lifting more than 10 pounds for 10 weeks No driving for 4 weeks and off all narcotics report any temperature of more than 101 report any drainage or redness of incisions Followup Instructions: Dr.[**First Name (STitle) **] in 4 weeks ([**Telephone/Fax (1) 170**]) Dr.[**Last Name (STitle) **] in [**11-19**] weeks([**Telephone/Fax (1) 4475**]) [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 173**] Completed by:[**2178-8-3**] ICD9 Codes: 5856, 9971, 2720
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Medical Text: Unit No: [**Numeric Identifier 71609**] Admission Date: [**2154-5-1**] Discharge Date: [**2154-8-25**] Date of Birth: [**2154-5-1**] Sex: F Service: NB HISTORY OF PRESENT ILLNESS: Baby Girl [**Known lastname 71610**] was born at 27- 2/7 weeks gestation by cesarean section for severe pre- eclampsia and breech presentation. The mother is a 25-year- old, gravida 3, para 0, now 1, woman. Her prenatal screens were blood type O positive, antibody negative, rubella immune, RPR nonreactive, hepatitis surface antigen negative, and Group B strep unknown. This pregnancy was complicated by the onset of severe preeclampsia 48-hours prior to delivery and intrauterine growth retardation. The mother was treated with betamethasone and magnesium sulfate. The infant emerged with Apgars of 6 at one minute and 8 at five minutes. The birth weight was 829 gm (20th percentile), birth length 34 cm (25th percentile), and the birth head circumference 24.5 cm (25th percentile). NICU COURSE BY SYSTEMS: 1. Respiratory Status: The infant was intubated at the time of admission and received 1 dose of Surfactant. She extubated to nasopharyngeal continuous positive airway pressure on day of life #1 and then she transitioned to nasal cannula oxygen on day of life #2. She was treated with caffeine citrate for apnea of prematurity from day of life #1 until day of life #21. She continues to have 1-4 episodes of apnea and bradycardia in a 24- hour period. On [**6-21**] she she began to have worsening apnea/bradycardia.On [**6-24**] she was restarted on caffeine citrate and placed on high flow nasal cannula with improvement, on [**6-28**] she went back to low flow cannula of 13 cc's liter flow. Caffeine was D'C d on [**7-3**]. It appears that her respiratory situation is compromised by her abdominal girth impinging on her chest capacity. She breaths with deep retractions out of proportion to her mild chronic lung disease. On [**7-18**] Pulmonary consult was obtained (Dr. [**Last Name (STitle) 37305**]. He will follow patient in Pulmonary Clinic on [**8-16**] at CHMC. He requested an ultrasound to determine diaphragmatic movement and this was done on [**7-23**] with normal bilateral and symmetrical movement. Her most recent cap blood gas on [**7-24**] was 7.37/50. She will be going home on 25 cc's liter flow of oxygen and a saturation monitor to maintain oxygen saturation greater than 90% 2. Cardiovascular Status: She has remained normotensive throughout her NICU stay. She has the presentation of a new heart murmur on [**2154-5-14**] and a cardiac echo at that time revealed a structurally normal heart, no patent ductus, and mild PPS. I am unable currently to hear her intermittant murmur. 3. Fluids/Electrolytes/Nutrition Status: Enteral feeds were begun on day of life #6 and advanced to full volume feedings by day of life #18 with a slow progression due to abdominal distention. She worked up to total fluids 140 mL/kg/day of Neosure 26- calorie per ounce formula and takes about 140 cc/kg /day of feeding. Her weight at discharge is 2780 grams. Endocrine: On routine nutrition labs it was noted that her alkaline phosphatase was rising with normal calciums and boarderline phosphate, extra Vitamin D was added to her diet to give her a total intake of [**2147**] units/kg. Follow-up alkaline phosphatase on [**6-27**] was was higher at 1627 with normal liver transaminases. Consult with endocrine was obtained at which time they recommended parathyroid hormone levels which was elevated at 191 (15-65), Ca,Phosperous and 25 hydroxy vitamin D and alk phos . Of note her Vit D, 25-OH total was 15, whereas the desired levels are > 30 and closer to 40 NG/ML. Endocrinology thought in the face of us having been giving her adequate levels of Vit D in her formula, this deficiency represented poor maternal intake. I have notified her mother about this and she will speak to her physician about checking her Vit D levels and the possibility she might need supplements. They recommended repeating these labs prior to discharge with the goal of having her Vit D levels 30-40 aiming for closer to 40 and at that time one could D'C the Vitamin D and follow. On [**7-24**] Ca was 10, P 6.8, PTH 146 down from 191(nl 15-65) and 25 hydroxy vitamin D is pending. Endocrine recommends repeating these levels in 1 month post discharge. 4. Gastrointestinal Status: She was treated with phototherapy for hyperbilirubinemia of prematurity from day of #2 until day of life #10. Her peak bilirubin occurred on day of life #2 and was total 5.3, direct 0.3. Her last bilirubin on [**2154-5-12**] was total 2, direct of 0.4. Her baseline exam was a distended abdomen. No visile loops, and active bowel sounds. Her abdomen remained markedly distended, such that it appeared to compromise her pulmonary function. KUB done on [**6-25**] was read as normal, however radiology recommended an abdominal ultrasound to better look at liver and kidney size. This was done on [**2154-6-26**] with normal liver, spleen and pancreas, kidneys by verbal report were normal. 5. Hematology: She has never received any blood products or transfusions. Her last hematocrit on [**7-24**] was 37.3 with a reticulocyte count of 3. 6. Infectious Disease Status: She was started on ampicillin and gentamicin at the time of admission for sepsis risk factors. She completed 7 days of antibiotics for presumed sepsis. Her blood culture did remain negative. She stayed off antibiotics until day of life #51 when she presented with nasal secretions which changed from clear to green to yellow in color. She was started on oral Keflex but increasing symptomatology (apnea/bradycardia) resulted in a blood culture and complete blood count with a white count of 13.6 with 15 polys and 6 bands. At time she was started on vancomycin and gentamicin. The blood culture remained negative and at 48 hours vanc and gent were D'C d. She remained on oral Keflex for 7 days for nasal cultures positive for staph aureus. 7. Neurology: Her first head ultrasound on [**5-8**] was without any abnormalities. A follow-up ultrasound on [**5-31**], [**2154**] showed bilateral germinal matrix hemorrhage. A follow-up on [**2154-6-14**] showed no change, with stable, grade 1 hemorrhages. 8. Ophthalmology: Her eyes were last examined on [**2154-7-22**] showing mature retina OD and stage 1, retinopathy 3 clock hours os . F/U in [**3-2**] weeks at [**Location (un) 2274**]/Dr.[**Last Name (STitle) 40944**] 9. Psychosocial: Parents have been involved in the infant's care throughout her NICU stay. MEDICATIONS Calciferol ([**2147**] units/0.05 mL) dose 0.25 mL daily. Ferrous sulfate (25 mg/mL) 0.25 mL daily. 1. Iron supplementation is recommended for preterm and low birth weight infants until 12 months corrected age. 2. All infants fed predominantly breast milk should receive vitamin D supplementation at 200 international units which may be provided as a multivitamin preparation daily until 12 months corrected age. Her state newborn screen was sent on [**5-4**] and [**5-15**]. IMMUNIZATIONS: She received her first hepatitis B vaccine on [**5-30**], HIB on [**7-1**] Pneumoccocal [**7-1**] Pediarix on [**7-2**]. F/U at [**Location (un) 2274**]/WROX with Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 42446**] [**7-29**]. VNA to visit home day post discharge. Early Intervention Referral made. Opthamology f/u at [**Location (un) 2274**]/Dr. [**Last Name (STitle) 40944**] within 2-3 weeks of discharge. Appt to be made by Dr. [**Last Name (STitle) 42446**]. Repeat labs of Ca/P/PTH and 25 hydroxy vitamin D in 1 month. DISCHARGE DIAGNOSES: 1. Status post prematurity at 27 weeks. 2. Status post respiratory distress syndrome. 3. Retinopathy of Prematurity 4. Status post hyperbilirubinemia of prematurity. 5. Vitamin D deficiency/. 6. Chronic lung disease. 7. S/P Apnea of prematurity. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 37691**], [**MD Number(1) 55783**] Dictated By:[**Last Name (NamePattern1) **] MEDQUIST36 D: [**2154-6-23**] 07:33:39 T: [**2154-6-23**] 15:10:51 Job#: [**Job Number 71611**] ICD9 Codes: 769, 7742, V053
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5928 }
Medical Text: Admission Date: [**2174-5-3**] Discharge Date: [**2174-5-10**] Date of Birth: [**2132-10-7**] Sex: F Service: NEUROSURGERY Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 1835**] Chief Complaint: Two week history of short term memory loss Major Surgical or Invasive Procedure: [**5-4**] Right EVD placement [**5-9**] R frontal VPS History of Present Illness: This is a 41 y/o African American female brought to the ED by her husband for a two week history of percieved short therm memory loss. Patient was driving to church in the past day or two and had to have her daughter tell her how to get there and when taken to see her PCP she did not remmber being in his office in the past. Past Medical History: HTN, Hospitalized last year at [**Hospital3 5365**] for w/u hysterectomy for fibroids Social History: No Tobacco No ETOH Works as a manager Family History: NC Physical Exam: On Admssion: PHYSICAL EXAM: O: T: 98.2 BP: 148/103 HR:71 R 17 O2Sats 100% RA Gen: WD/WN, comfortable, NAD. HEENT: NCNT Neck: Supple. Abd: Soft, NT, BS+ Extrem: Warm and well-perfused. Neuro: Mental status: Awake and alert, cooperative with exam. Orientation: Oriented to person, place, but not date Language: Speech fluent with good comprehension and repetition. Naming intact. No dysarthria or paraphasic errors. Cranial Nerves: I: Not tested II: Pupils equally round and reactive to light,5 to 3 mm bilaterally. Visual fields are full to confrontation. III, IV, VI: Extraocular movements intact bilaterally without nystagmus. V, VII: Facial strength and sensation intact and symmetric. VIII: Hearing intact to voice. IX, X: Palatal elevation symmetrical. [**Doctor First Name 81**]: Sternocleidomastoid and trapezius normal bilaterally. XII: Tongue midline without fasciculations. Motor: Normal bulk and tone bilaterally. No abnormal movements, tremors. Strength full power [**4-30**] throughout. No pronator drift Sensation: Intact to light touch Coordination: normal on finger-nose-finger AT DISCHARGE: Gen: WD/WN, comfortable, NAD. HEENT: NCNT, dressing over R scalp c/d/i Neck: Supple. Abd: Soft, NT, BS+ Extrem: Warm and well-perfused. Neuro: Mental status: Awake and alert, cooperative with exam. Orientation: Oriented to person, place, and date Language: Speech fluent with good comprehension and repetition. Naming intact. No dysarthria or paraphasic errors. Cranial Nerves: I: Not tested II: Pupils equally round and reactive to light, 2 to 1 mm bilaterally. Visual fields are full to confrontation. III, IV, VI: Extraocular movements intact bilaterally without nystagmus. V, VII: Facial strength and sensation intact and symmetric. VIII: Hearing intact to voice. IX, X: Palatal elevation symmetrical. [**Doctor First Name 81**]: Sternocleidomastoid and trapezius normal bilaterally. XII: Tongue midline without fasciculations. Motor: Normal bulk and tone bilaterally. No abnormal movements, tremors. Strength full power [**4-30**] throughout. No pronator drift Sensation: Intact to light touch Coordination: normal on finger-nose-finger Gait: narrow based, good arm swing, independent Pertinent Results: CT head [**2174-5-3**] 1. Severe hydrocephalus with transependymal flow of CSF and associated effacement of the sulci. 2. No evidence of hemorrhage or obstructing mass. MRI Brain [**5-3**] - 1. Moderate dilatation of all the ventricles with associated transependymal CSF flow. The etiology of hydrocephalus is not identified on this study. 2. No evidence of acute infarct or intracranial hemorrhage. 3. No abnormal leptomeningeal or parenchymal enhancement CXR [**2174-5-4**] The lung volumes are normal. No pleural effusions. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No evidence of pneumonia or other acute lung changes. CT head [**2174-5-4**] Interval decrease in ventricular size status post external ventricular drain placement. CSF: [**2174-5-5**] 09:36AM CEREBROSPINAL FLUID (CSF) WBC-85 RBC-1650* Polys-PND Lymphs-PND Monos-PND [**2174-5-5**] 09:36AM CEREBROSPINAL FLUID (CSF) TotProt-156* Glucose-57 LD(LDH)-72 [**2174-5-4**] 10:00AM CEREBROSPINAL FLUID (CSF) WBC-2 RBC-19* Polys-1 Lymphs-75 Monos-24 CSF culture [**2174-5-4**] GRAM STAIN (Final [**2174-5-4**]): NO POLYMORPHONUCLEAR LEUKOCYTES SEEN. NO MICROORGANISMS SEEN. This is a concentrated smear made by cytospin method, please refer to hematology for a quantitative white blood cell count.. MRI Head CSF study [**5-5**] 1. Incomplete study as CSF flow study could not be performed. Consider performing when the patient is cooperative. 2. Moderate dilation of the lateral and the third ventricles with narrowing of the superior portion of cerebral aqueduct/near-total occlusion. 3. Ventricular catheter appears to be outside the confines of the lateral ventricle. To correlate with catheter function and the position if necessary. CT Chest [**5-6**] 1. No evidence of sarcoid. 2. Sub 4 mm pulmonary nodule in the left lower lobe. If there is no history of smoking or other lung cancer risk factors, this does not need followup. Otherwise, 12 month followup is recommended. 3. Fatty liver and cholelithiasis. CTA Chest [**5-8**] 1. No pulmonary embolus or acute intrathoracic process. 2. Cholelithiasis. [**5-9**] CT head postop: Interval decrease in ventricular size status post placement of right frontal external ventricular drain with the catheter tip located in the frontal [**Doctor Last Name 534**] of the right lateral ventricle. ADMISSION LABS: [**2174-5-3**] 12:12PM BLOOD WBC-5.9 RBC-4.87 Hgb-13.2 Hct-43.0 MCV-88 MCH-27.0 MCHC-30.6* RDW-12.9 Plt Ct-355 [**2174-5-3**] 12:12PM BLOOD Glucose-100 UreaN-11 Creat-0.9 Na-139 K-4.0 Cl-103 HCO3-27 AnGap-13 [**2174-5-3**] 12:12PM BLOOD Calcium-9.4 Phos-3.0 Mg-2.3 DISCHARGE LABS: [**2174-5-10**] 06:00AM BLOOD WBC-7.3 RBC-4.10* Hgb-11.2* Hct-35.6* MCV-87 MCH-27.3 MCHC-31.4 RDW-13.2 Plt Ct-366 [**2174-5-10**] 06:00AM BLOOD Glucose-100 UreaN-8 Creat-0.8 Na-135 K-3.9 Cl-102 HCO3-24 AnGap-13 [**2174-5-10**] 06:00AM BLOOD Calcium-8.8 Phos-3.9 Mg-2.1 [**2174-5-6**] 03:25AM BLOOD HIV Ab-NEGATIVE Brief Hospital Course: Ms. [**Known lastname 4427**] [**Last Name (Titles) 1834**] a head CT in the Emergency room which revealed enlargement of her ventricular system with transependymal flow. She was admitted to the Neurosurgery service in the ICU for close monitoring. Her exam remained stable, but to prevent progression of hydrocephalus, patient was taken to OR on [**5-4**] for placement of R EVD. She was made NPO and was consented for the procedure. On [**5-4**], patient was taken to the OR for placement of R EVD. There were no complications and patient was transferred back to SICU for monitoring. CSF was sent in OR for evaluation. She remained intact on exam throughout the day, overnight she was seen to have religious delusions. For concern of worsening hydrocephalus, a head CT was done which was stable. On [**5-5**], patient was back to baseline. CSF was sent for further evaluation and MRI CSF study was ordered to help determine etiology of hydrocephalus and this was inconclusive. She had a CT head on [**5-5**] and this showed decompression of the ventricular system. Repeat CSF studies were sent. On [**5-6**] she was transferred to the SDU in stable condition. Her EVD continued at 10cm above the tragus. She remained stable until [**5-8**] when she became tachycardic and tachypneic and a CTA chest was obtained. This showed no evidence of pulmonary embolus. She was kept NPO on the morning of [**5-9**] in preparation for a Right frontal VPS. She tolerated the procedure well with no complications and post operatively she was transferred back to the floor. She has a programmable valve set at 1.5. On [**5-10**] Patient was deemed fit for discharge. She was given instructions for followup and prescriptions for required medications. TRANSITIONAL CARE ISSUES: Pt will need a repeat chest CT in 12 months to follow up the lung nodule found incidentally on our scan here. She will need one in 6 months if she has any tobacco or cancer hx we are unaware of. Medications on Admission: Labetalol PO Discharge Medications: 1. labetalol 100 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 2. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 3. senna 8.6 mg Tablet Sig: One (1) Tablet PO twice a day as needed for constipation. Disp:*60 Tablet(s)* Refills:*0* 4. oxycodone-acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*90 Tablet(s)* Refills:*0* 5. ondansetron HCl 4 mg Tablet Sig: One (1) Tablet PO Q4H PRN () as needed for nausea. Disp:*42 Tablet(s)* Refills:*0* Discharge Disposition: Home Discharge Diagnosis: hydrocephalus aqueductal stenosis delerium tachycardia cholelithiasis pulmonary nodule Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: ?????? Have a friend/family member check your incision daily for signs of infection. ?????? Take your pain medicine as prescribed. ?????? Exercise should be limited to walking; no lifting, straining, or excessive bending. ?????? Dressing may be removed on Day 2 after surgery. ?????? You have dissolvable sutures so you may wash your hair and get your incision wet day 3 after surgery. You may shower before this time using a shower cap to cover your head. ?????? Increase your intake of fluids and fiber, as narcotic pain medicine can cause constipation. We generally recommend taking an over the counter stool softener, such as Docusate (Colace) while taking narcotic pain medication. ?????? Unless directed by your doctor, do not take any anti-inflammatory medicines such as Motrin, Aspirin, Advil, and Ibuprofen etc. ?????? Clearance to drive and return to work will be addressed at your post-operative office visit. ?????? Make sure to continue to use your incentive spirometer while at home, unless you have been instructed not to. CALL YOUR SURGEON IMMEDIATELY IF YOU EXPERIENCE ANY OF THE FOLLOWING ?????? New onset of tremors or seizures. ?????? Any confusion or change in mental status. ?????? Any numbness, tingling, weakness in your extremities. ?????? Pain or headache that is continually increasing, or not relieved by pain medication. ?????? Any signs of infection at the wound site: redness, swelling, tenderness, or drainage. ?????? Fever greater than or equal to 101?????? F. We made the following changes to your medications: 1) We STARTED you on DOCUSATE 100mg twice a day to prevent constipation while taking opiate pain medications. 2) We STARTED you on SENNA 8.6mg twice a day as needed for constipation. 3) We STARTED you on PERCOCET 1-2 tabs every 4 hours as needed for pain. Each tablet has 325mg of tylenol in it. Do not exceed 4,000mg of tylenol in a 24 hour period as this can cause fatal liver damage. In addition, do not drive, operate heavy machinery, drink alcohol or take other sedating medications while taking this medication until you know how it will effect you, as it can make you dangerously sleepy. 4) We STARTED you on ZOFRAN 4mg every 4 hours as needed for nausea. Please continue to take your other medications as previously prescribed. It was a pleasure taking care of you on this hospitalization. Followup Instructions: Follow-Up Appointment Instructions ??????Please return to the office in [**7-5**] days(from your date of surgery) for removal of your staples/sutures and/or a wound check. This appointment can be made with the Nurse Practitioner. Please make this appointment by calling [**Telephone/Fax (1) 1669**]. If you live quite a distance from our office, please make arrangements for the same, with your PCP. ??????Please call ([**Telephone/Fax (1) 88**] to schedule an appointment with Dr. [**Last Name (STitle) **], to be seen in 6 weeks. ??????You will need a CT scan of the brain without contrast. Completed by:[**2174-5-10**] ICD9 Codes: 2930, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5929 }
Medical Text: Admission Date: [**2122-12-23**] Discharge Date: [**2123-1-28**] Date of Birth: [**2068-1-5**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2969**] Chief Complaint: Mr. [**Known lastname **] is a 54-year-old gentleman with biopsy-proven locally advanced T3N1M1A carcinoma of the mid esophagus. He continues to have intense pain with increased PET activity at the superior and inferior aspect of the stent. Major Surgical or Invasive Procedure: thoraco-abdominal esophagectomy, esophagogastroduodenoscopy, J-tube revision [**2122-12-23**] Port-O-Cath removal [**2123-1-22**] EGD w/ pylorus dilitation History of Present Illness: 54 yr old man cervical esophageal cancer requiring Mr. [**Known lastname **] is a 54-year-old gentleman with biopsy-proven locally advanced T3N1M1A carcinoma of the mid esophagus. He has recently completed chemoradiotherapy on an induction protocol. He has had a remarkable reduction in his documented nodal disease as well as in the T stage. He continues to have intense pain with increased PET activity at the superior and inferior aspect of the stent. Past Medical History: Hepatitis C Virus Hypertension Prostate Cancer s/p brachytherapy. Poorly differentiated squamous esophageal CA (stage III) -dx'ed [**2122-7-20**] on multiple biopsies with EGD -PET found supraclavicular nodes that appeared positive. -s/p esophageal stent -planned for surgery in 6 weeks Gastric esophogeal reflux disease Social History: Previously worked at Digital and Polaroid. Lives with his daughter. [**Name (NI) **] ?girlfriend. Used to smoke, quit after cancer diagnosis. No EtOH currently, never heavy drinker. No IVDU. Family History: both brothers have prostate cancer, one passed away 2 month ago from this Physical Exam: General: cachetic appearing African American male w/ c/o epigastric pain on -chronic sq dilaudid PTA chest: lungs CTA bilat. POC Cor: RRR S1, S2 Abd: flat, soft, NT, J-tube in place. Extrem: no LE edema. Neuro: A+OX3 w/no focal neuro deficits Pertinent Results: [**2122-12-23**] 05:57PM GLUCOSE-147* UREA N-17 CREAT-0.7 SODIUM-134 POTASSIUM-5.0 CHLORIDE-100 TOTAL CO2-22 ANION GAP-17 [**2122-12-23**] 05:57PM WBC-17.2*# RBC-3.98* HGB-12.0* HCT-34.1* MCV-86 MCH-30.1 MCHC-35.2* RDW-14.4 Hematology COMPLETE BLOOD COUNT WBC RBC Hgb Hct MCV MCH MCHC RDW Plt Ct [**2123-1-27**] 06:25AM 6.5 2.91* 8.2* 25.6* 88 28.2 32.2 14.5 391 BASIC COAGULATION (PT, PTT, PLT, INR) PT PTT Plt Ct INR(PT) [**2123-1-27**] 06:25AM 391 Chemistry RENAL & GLUCOSE Glucose UreaN Creat Na K Cl HCO3 AnGap [**2123-1-26**] 11:00AM 144* 11 0.6 139 3.9 104 261 13 1 NOTE UPDATED REFERENCE RANGE AS OF [**2122-8-14**] ENZYMES & BILIRUBIN ALT AST LD(LDH) CK(CPK) AlkPhos Amylase TotBili DirBili [**2122-12-27**] 03:09AM 742* 160* 190 108 0.9 Source: Line-arterial OTHER ENZYMES & BILIRUBINS Lipase [**2122-12-26**] 03:33AM 8 CHEMISTRY TotProt Albumin Globuln Calcium Phos Mg UricAcd Iron Cholest [**2123-1-26**] 11:00AM 8.3* 4.0 1.5* HEMATOLOGIC calTIBC Ferritn TRF [**2123-1-4**] 06:10AM 160* 859* 123* LIPID/CHOLESTEROL Cholest Triglyc [**2123-1-4**] 06:10AM 109 851 1 LDL(CALC) INVALID IF TRIG>400 OR NON-FASTING SAMPLE ANTIBIOTICS Vanco [**2123-1-27**] 06:25AM 14.4* LAB USE ONLY GreenHd EDTA Ho CHEST (PA & LAT) [**2123-1-26**] 10:23 AM [**Hospital 93**] MEDICAL CONDITION: 54 year old man with esoph ca now s/p thoraco-abd esophagectomy. REASON FOR THIS EXAMINATION: ?interval change TWO VIEW CHEST X-RAY [**2123-1-26**]: COMPARISON: Deceember 11, [**2122**]. INDICATION: Status post esophagectomy. IMPRESSION: Stable postoperative appearance of mediastinum. Improving multifocal pulmonary opacities. BAS/UGI AIR/SBFT Reason: please evaluate follow-through of barium from oral-pharynx t COMPARISON: Upper GI study of [**2122-8-31**]. LIMITED SINGLE CONTRAST UPPER GI STUDY: Contrast passes freely down the remaining esophagus and gastric pull-up. Trace aspiration was noted. Adjacent to the site of the drain, there is appears to be a focal area of contrast extravasation. There is delayed and slow emptying of contrast from the stomach. Barium was administered through the J- tube which demonstrated filling of the jejunal loops. The patient vomited approximately 150 cc of barium and the study was terminated due to patient intolerance. IMPRESSION: 1. Mild aspiration. 2. Focal contrast extravasation at the site of the leftsided drain. The study and the report were reviewed by the staff radiologist. RADIOLOGY Final Report CHEST (PORTABLE AP) [**2123-1-27**] 2:47 PM Reason: Please obtain UPRIGHT CXR to assess for pneumothorax [**Hospital 93**] MEDICAL CONDITION: 54 year old man with esoph ca now s/p thoraco-abd esophagectomy now s/p EGD w/ balloon dilation of stricture REASON FOR THIS EXAMINATION: Please obtain UPRIGHT CXR to assess for pneumothorax PORTABLE CHEST, [**2123-1-27**] COMPARISON: [**2123-1-26**]. INDICATION: Status post EGD procedure. Evaluate for pneumothorax. There is no evidence of pneumothorax or pneumomediastinum. Postoperative changes are noted in the mediastinum following esophagectomy and pull-up procedure. There remains asymmetrical perihilar haziness on the right as well as a moderate-sized right pleural effusion. Minor atelectatic changes are seen within the left lung base, also without interval change. IMPRESSION: No evidence of pneumothorax or pneumomediastinum. CXRY - protable [**2123-1-28**] s/p PICC line placement Placement of PICC line tip in distal SVC. Confirmed by visualization of film by NP and IVRN. MICROBIOLOGY DATA [**2123-1-24**] SPUTUM GRAM STAIN-FINAL; RESPIRATORY CULTURE-PRELIMINARY {STAPH AUREUS COAG +} INPATIENT [**2123-1-24**] URINE URINE CULTURE-FINAL INPATIENT [**2123-1-24**] BLOOD CULTURE AEROBIC BOTTLE-PENDING; ANAEROBIC BOTTLE-PENDING INPATIENT [**2123-1-24**] BLOOD CULTURE AEROBIC BOTTLE-PENDING; ANAEROBIC BOTTLE-PENDING INPATIENT [**2123-1-22**] CATHETER TIP-IV WOUND CULTURE-FINAL {STAPHYLOCOCCUS, COAGULASE NEGATIVE, STAPHYLOCOCCUS, COAGULASE NEGATIVE} INPATIENT [**2123-1-21**] BLOOD CULTURE AEROBIC BOTTLE-FINAL {STAPHYLOCOCCUS, COAGULASE NEGATIVE}; ANAEROBIC BOTTLE-FINAL {STAPHYLOCOCCUS, COAGULASE NEGATIVE} INPATIENT [**2123-1-21**] BLOOD CULTURE AEROBIC BOTTLE-FINAL {STAPHYLOCOCCUS, COAGULASE NEGATIVE}; ANAEROBIC BOTTLE-FINAL {STAPHYLOCOCCUS, COAGULASE NEGATIVE} INPATIENT [**2123-1-21**] BLOOD CULTURE AEROBIC BOTTLE-FINAL {STAPHYLOCOCCUS, COAGULASE NEGATIVE}; ANAEROBIC BOTTLE-FINAL {STAPHYLOCOCCUS, COAGULASE NEGATIVE} INPATIENT [**2123-1-21**] SPUTUM GRAM STAIN-FINAL; RESPIRATORY CULTURE-FINAL INPATIENT LIMITED SINGLE CONTRAST UPPER GI STUDY: Contrast passes freely down the remaining esophagus and gastric pull-up. Trace aspiration was noted. Adjacent to the site of the drain, there is appears to be a focal area of contrast extravasation. There is delayed and slow emptying of contrast from the stomach. Barium was administered through the J- tube which demonstrated filling of the jejunal loops. The patient vomited approximately 150 cc of barium and the study was terminated due to patient intolerance. IMPRESSION: 1. Mild aspiration. 2. Focal contrast extravasation at the site of the leftsided drain. The study and the report were reviewed by the staff radiologist. Weight [**2123-1-28**] 51.5kg Brief Hospital Course: 54-year-old gentleman with biopsy-proven locally advanced T3N1M1A carcinoma of the mid-esophagus esophagoscopy,bronchoscopy, transthoracic near total esophagectomy with rightthoracotomy, laparotomy and left cervicotomy, left cervical esophagogastrostomy and left tube thoracostomy. Patient tolerated procedure well. Transferred to ICU for observation, intubated, sedated, neo gtt, IVF, NPO, CT to sx- no leak,. Pain control w/ fentanyl gtt iv due to non-effective epidural. ICU course significant for: POD#2 pt was extubated and new epidural placed, w/ dilaudid PCA,+ BS, + flatus; IVF, NPO.Abd JP drains intact and draining. Inc- C/D/I. POD#3- tube feedings started- probalance at 10/hr. O2 wean trial - 90% on 4Lnc. POD#5-Tube feedings held for residual >200cc overnight, IVF. CT to waterseal; ambulation- physical therapy, lytes repleated. Patient transferred out of ICU to floor. Pain control w/ PCA, epidural d/c. On Floor: REsp- pod#6 O2 sat 94% on RA, improving to 98-99% RA pod#33 at time of discharge. CT d/c pod#7 w/o complication. Periodic CXRY-wnl, w/ some atelectasis improving over hospital course. GI- POD#6-+ flatus, + BM; j-tube accidently d/c'd and replaced w/o complication. Tube feeding resumed @30-40cc/hr w/ c/o nausea, therefore held. Patient developed prolonged ileus (bloating, nausea, distention) w/ multiple unsuccessful tube feeding restarts until [**2123-1-17**]-(pod#24). J-tube placed to gravity during this time. TPN started as below. Tube feedings tolerated w/ slow advancement to max rate of 50/hr w/ goal as stated. Patient has persistant c/o nausea and therefore [**2123-1-27**]- EGD w/ pyloric dilitation. Pylorus patent on visualization, dilitation done to affirm continued patency. Diet advanced to clear, then full liquids post-op, then to mechanical soft [**2123-1-28**]. See below and page 1 for specific tube feeding/nutrition instructions. Nutrition/ electrolytes-IVF w/ electrolyte replacement until TPN started pod#21- [**2123-1-4**] and cont until [**2123-1-18**] when tube feedings at 2/3 goal rate on pod#25([**2123-1-20**]). Lytes routinely monitored and repleated. Diet advanced to clear, then full liquids post-op, then to mechanical soft [**2123-1-28**]. See below and page 1 for specific tube feeding/nutrition instructions. Weight [**2123-1-28**] 51.5kg RAD- UGI- SBFT pod#8- + ileus. Incisions and Drains- Chest tube d/c pod# 7; JP drain d/c pod#8; Incisions - thorocotomy, abdominal and cervical all healed, staples removed, steri-strips off. Port-o-cath removal site- left upper chest- C/D/I, change dsd qd. Sutures remain, to be assessed and removed at follow-up appointment [**2123-2-4**]. Infectious Disease- Course of zosyn(prophylaxis) and fluconazole (?esophogeal candidiasis). POD#27([**2123-1-21**]) patient developed fever to 102, elevated WBC- cx results- [**5-18**] + BC, staph- MRSA, Vancomycin started and cont per therapeutic levels for 14 day course, levofloxacin- 10 day course. Source- infected port site- removed in OR [**2123-1-22**]. Peripheral line placed. PICC line placed [**2123-1-28**], confirmed placement in distal SVC by CXRAY [**2123-1-28**]. Pain control- Transitioned to percocet elixer and MSO4iv prn pod#6. Slowly weaned to off over next 3-4 weeks.Pain med restarted post-op [**2123-1-22**] for port removal. At discharge pt receiving minimal pain med on prn basis. Activity-Physical therapy, ambulation with encouragement. Pt gradually independent w/ ambulation with encouragement. Consistant encouragement w/ activity necessary. Medications on Admission: MS contin, Roxanol, magic mouthwash Discharge Medications: 1. Nystatin 100,000 unit/mL Suspension Sig: Five (5) ML PO QID (4 times a day) as needed. 2. Albuterol Sulfate 0.083 % Solution Sig: One (1) Inhalation Q6H (every 6 hours) as needed. 3. Ipratropium Bromide 0.02 % Solution Sig: One (1) Inhalation Q6H (every 6 hours). 4. Fentanyl 25 mcg/hr Patch 72HR Sig: One (1) Patch 72HR Transdermal Q72H (every 72 hours). 5. Lisinopril 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily): give via j-tube. 6. Vancomycin in Dextrose 1 g/200 mL Piggyback Sig: One (1) gm Intravenous Q 12H (Every 12 Hours) for 11 days. 7. Prochlorperazine Edisylate 5 mg/mL Solution Sig: One (1) Injection Q6H (every 6 hours) as needed for nausea. 8. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal DAILY (Daily) as needed. 9. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO twice a day: give via j-Tube. 10. Hydromorphone 2 mg/mL Syringe Sig: 0.5 mg Injection Q6H (every 6 hours) as needed for Breakthrough pain. 11. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO once a day for 4 days. 12. Protonix 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. Discharge Disposition: Extended Care Facility: [**First Name4 (NamePattern1) 3504**] [**Last Name (NamePattern1) **] Rehabilitation & Nursing Center - [**Location (un) 538**] Discharge Diagnosis: esophageal CA prolonged post op ileus POC bacteremia resulting in removal Discharge Condition: stable Discharge Instructions: Please call Dr.[**Name (NI) **] office at ([**Telephone/Fax (1) 1504**] if you have fever, nausea/vomiting, inability to take in your feeds, or dizziness/weakness, aor any other post surgical issues. Followup Instructions: Follow up appointment with Dr. [**Last Name (STitle) **] in Thoracic Surgery Clinic [**2123-2-4**] at 3pm. [**Hospital1 18**], [**Hospital Ward Name 23**] Clinical Center, [**Location (un) 8939**]. Please call [**Telephone/Fax (1) 170**] for any questions. Completed by:[**2123-1-28**] ICD9 Codes: 7907, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5930 }
Medical Text: Admission Date: [**2157-10-6**] Discharge Date: [**2157-10-13**] Date of Birth: [**2087-4-12**] Sex: F Service: CARDIOTHORACIC Allergies: Penicillins Attending:[**First Name3 (LF) 1505**] Chief Complaint: Emergent Aortic Dissection Major Surgical or Invasive Procedure: [**2157-10-7**] Emergent Ascending Aortic Replacement History of Present Illness: Mrs. [**Known lastname **] is a 70-year-old female who was transferred emergently from [**Hospital6 3872**] emergency room with diagnosis of ascending aortic type A dissection documented by CT scan and echocardiography. Review of the CT scans here confirmed that. She was mentating and clinically stable upon presentation to the CSRU and was taken emergently to the operating room. Past Medical History: HTN Current Smoker Glaucoma Hyperlipidemia Physical Exam: NEURO: Awake, alert, moving all extremities PULM: Clear HEART: RRR, normal s1-s2 ABD: Soft, nontender, nondistended, normoactive bowel sounds EXT: Warm, no edema, + pulses Pertinent Results: [**2157-10-12**] 05:38AM BLOOD WBC-8.0 RBC-3.06* Hgb-9.0* Hct-27.5* MCV-90 MCH-29.4 MCHC-32.9 RDW-13.8 Plt Ct-231 [**2157-10-12**] 05:38AM BLOOD Plt Ct-231 [**2157-10-12**] 05:38AM BLOOD Glucose-95 UreaN-35* Creat-0.8 Na-142 K-4.1 Cl-104 HCO3-31 AnGap-11 [**2157-10-12**] CXR 1) No pneumothorax. 2) Improved left lower lobe atelectasis. 3) Increased small right pleural effusion with no change in a small left effusion. [**2157-10-7**] EKG Sinus rhythm 90. There has been arm lead reversal. Non-diagnostic repolarization abnormalities. Brief Hospital Course: Ms. [**Name13 (STitle) 62701**] was admitted urgently to the [**Hospital1 18**] on [**2157-10-6**] for surgical repair of her aortic dissection. She was taken directly to the operating room where she underwent an ascending aortic replacement. Postoperatively she was taken to the cardiac surgical intensive care unit for monitoring. On postoperative day one, Ms. [**First Name (Titles) 62701**] [**Last Name (Titles) 5058**] neurologically intact and was extubated. Her drains were removed. A right pneumothorax was noted on chest xray and a right chest tube was placed without difficulty. Her blood pressure was elevated postoperatively and labetalol was started. Ms. [**Name13 (STitle) 62701**] was noted to have a weak gag reflex and cough and a swallowing evaluation was performed. After completing a bedside swallowing evaluation, it was found that Ms. [**Name13 (STitle) 62701**] was able to appropriately swallow thin liquids and solids without signs of aspiration. On postoperative day three, Ms. [**Name13 (STitle) 62701**] was transferred to the cardiac surgical step down unit for further recovery. She was gently diuresed towards her preoperative weight. The physical therapy service was consulted for assistance with her strength and mobility. Labetalol and an ace inhibitor were used to effectively control her hypertension. Ms. [**Name13 (STitle) 62701**] continued to make steady progress and was discharged to her home on postoperative day six. She will follow-up with Dr [**Last Name (STitle) **], her cardiologist and her primary care physician as an outpatient. Medications on Admission: Norvasc Multiple Brazilian medications. Discharge Medications: 1. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*0* 3. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* 4. Pravastatin Sodium 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 5. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*40 Tablet(s)* Refills:*0* 6. Nicotine 21 mg/24 hr Patch 24HR Sig: One (1) Patch 24HR Transdermal DAILY (Daily) for 7 days. Disp:*30 Patch 24HR(s)* Refills:*0* 7. Captopril 12.5 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). Disp:*90 Tablet(s)* Refills:*0* 8. Furosemide 20 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours) for 10 days. Disp:*20 Tablet(s)* Refills:*0* 9. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig: One (1) Tab Sust.Rel. Particle/Crystal PO twice a day for 10 days. Disp:*20 Tab Sust.Rel. Particle/Crystal(s)* Refills:*0* 10. Labetalol 300 mg Tablet Sig: Two (2) Tablet PO twice a day. Disp:*120 Tablet(s)* Refills:*2* 11. Nicotine 14 mg/24 hr Patch 24HR Sig: One (1) Transdermal once a day for 7 days: Start when you are done with the 21 mg patches. Disp:*7 patches* Refills:*0* 12. Nicotine 7 mg/24 hr Patch 24HR Sig: One (1) Transdermal once a day for 7 days: Start when you are done with the 14 mg patches. Disp:*7 patches* Refills:*0* Discharge Disposition: Home Discharge Diagnosis: Type A Aortic DissectionHTN Glaucoma Tobacco Abuse Discharge Condition: Good. Discharge Instructions: [**Month (only) 116**] shower, wash incision with soap and water and pat dry. No lotions, creams, powders or baths. No lifting morethan 10 pounds or driving until follow up with surgeon. Call with temperature more than 101, redness or drainage from incision, or weightgain more than 2 pounds in one day or five in one week. Followup Instructions: Dr. [**Last Name (STitle) **] 2 weeks Make an appointment with a primary care physician as soon as possible. Completed by:[**2157-11-7**] ICD9 Codes: 4019, 3051
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Medical Text: Admission Date: [**2170-2-20**] Discharge Date: [**2170-2-28**] Service: MEDICINE Allergies: Celexa Attending:[**First Name3 (LF) 905**] Chief Complaint: Resp distress/hypglycemia Major Surgical or Invasive Procedure: endotracheal intubation History of Present Illness: Pt is a [**Age over 90 **] yo male with a h/o CAD, s/p CABG [**2160**]; CHF ( EF 25%); DM, CRF, NH resident, who was diagnosed with lobar PNA on [**2170-2-17**] and was started on levofloxacin, but was noted to be in increasing resp distess today and hypoxic to 79% on RA. No fevers were reported but he had increased lethargy and decreased po intake. Past Medical History: CAD s/p CABG [**60**], LIMA-LAD, SVG-OM, PDA CHF EF 25%, CRI (Cre 1.3-1.7) Dysphagia Depression HTN, s/p appendectomy and cholecystectomy DJD, knee pain DMII, Severe valvular disease: 3+ MR, [**1-18**]+ TR, RV/RA dilatation Social History: nursing home resident. Intermittent confusion at baseline. Distant tobacco history. NO ETOH Family History: non contributory Physical Exam: VS 100.0 152/98 142 36 100% on AC 500x16 5 100% Gen: intubated, sedated HEENT: surgical pupils Neck: +JVD CV: tachy, irregularly irregular, nl S1/S2, no murmurs appreciated Pulm: coarse breath sounds bilaterally Abd: soft, NT/ND, +BS Ext: no edema, ulcerations/scabs on arms and legs Neuro: sedated Pertinent Results: Labs on Admission: URINE BLOOD-LGE NITRITE-NEG PROTEIN-30 GLUCOSE-100 KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-NEG RBC-63* WBC-5 BACTERIA-NONE YEAST-NONE EPI-<1 TYPE-ART PO2-110* PCO2-28* PH-7.46* TOTAL CO2-21 BASE XS--1 NOT INTUBA GLUCOSE-54* LACTATE-3.1* NA+-135 K+-4.6 CL--106 HGB-12.3* calcHCT-37 O2 SAT-98 LACTATE-3.7* GLUCOSE-36* UREA N-41* CREAT-1.8* SODIUM-138 POTASSIUM-5.0 CHLORIDE-101 TOTAL CO2-25 ANION GAP-17 CK(CPK)-219* CK-MB-7 cTropnT-0.15* ALBUMIN-3.9 CALCIUM-9.5 PHOSPHATE-4.1 MAGNESIUM-2.1 WBC-15.8*# RBC-4.11* HGB-12.6* HCT-38.8* MCV-94 MCH-30.6 MCHC-32.4 RDW-13.8 NEUTS-93* BANDS-3 LYMPHS-1* MONOS-3 EOS-0 BASOS-0 ATYPS-0 METAS-0 MYELOS-0 NUC RBCS-1* HYPOCHROM-1+ ANISOCYT-NORMAL POIKILOCY-NORMAL MACROCYT-NORMAL MICROCYT-NORMAL POLYCHROM-NORMAL PLT SMR-NORMAL PLT COUNT-203 PT-13.7* PTT-29.2 INR(PT)-1.2 Studies: Echo [**2-21**]: The left atrium is moderately dilated. The right atrium is moderately dilated. There is mild symmetric left ventricular hypertrophy. The left ventricular cavity size is top normal/borderline dilated. There is severe global left ventricular hypokinesis. [Intrinsic left ventricular systolic function may be more depressed given the severity of valvular regurgitation.] No masses or thrombi are seen in the left ventricle. The right ventricular cavity is moderately dilated. Right ventricular systolic function appears depressed. The ascending aorta is mildly dilated. There are complex atheroma in the descending thoracic aorta. The aortic valve leaflets are moderately thickened. There is no aortic valve stenosis. Mild (1+) aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. Moderate (2+) mitral regurgitation is seen. The tricuspid valve leaflets are mildly thickened. Moderate to severe [3+] tricuspid regurgitation is seen. There is borderline pulmonary artery systolic hypertension. There is a trivial/physiologic pericardial effusion. CXR [**2-21**]: New left retrocardiac opacity, likely due to atelectasis and effusion. Worsening right middle and lower lobe pneumonia Brief Hospital Course: [**Age over 90 **] yo NH resident with a h/o CAD, s/p CABG [**2160**]; CHF ( EF 25%); DM, CRF (baseline Cr 1.5 diagnosed with lobar PNA on [**2170-2-17**] and was started on levofloxacin, but was noted to be in increasing resp distess, hypoxic to 79% on RA, increased lethargy, and decreased po intake. In ED, he had a low grade temp and was in AF with RVR at 150; SBP of 190 and tachypnic to 40's. First ABG was 7.46/28/110. He was initially oriented to "hopsital" but later became increasingly confused and somnolent and was intubated (code status confirmed). He had an episode of hypoglycemia in ED (poor po intake, given am dose of glyburide) and was started on D50 gtt. CXR revealed large RML and RLL PNA. Got CTX and Azithro in ED. Initial lactate was 3.7. Got 1.5 L IVF and AF slowed to 120s. Four sets of Trop were positive but stable with a negative MB fraction, thought to be secondary to demand ischemia as per Cardiololgy. He continues to be in AFib with controlled rate. Pt was successfully extubated on [**2-22**]. OGT removed but noted to have decreased gag reflex and he was kept npo initially while awaiting swallow evaluation. Speech and swallow felt he was at significant aspiration risk, however his daughter did NOT wish to place an NGT or PEG, and wanted to allow him to eat despite risk. He was given ground solids and thickened liquids and restarted on his oral meds. 1. Pneumonia - pt with NH-acquired bilateral LL and RML PNA. Pt was initially intubated in the ED, and he was kept intubated for a couple of days while his mental status improved. He was extubated on HD #2 and was able to maintain protection of his airway. He received 7 days of Vanco and Zosyn for broad spectrum coverage including gram negatives and MRSA, however his sputum culture was w/o growth. He was continued on IV levo and flagyl for the next 8 days until discharge. He was discharged on po levo to complete a 14 day course. He was continued on supplemental O2 and his sats remained > 93%. He was given alb/atrovent nebs as needed. 2. Pt developed diarrhea while on ABX for his PNA, likely secondary to C.diff given leukocytosis and current ABX therapy. Stool culture was negative for C. diff however given the high suspician and improvement on flagyl he will be continued on po flagyl for an additional 7 day course. 3. Delirium. Pt was unresponsive upon admission. This was thought to be multifactorial in this elderly gentleman, due to hypoglycemia, pneumonia, heart failure, and renal failure. As these metabolic abnormalities improved, pt's mental status improved, as well. His sedation was stopped around the time of extubation, and pt was more alert and somewhat conversant thereafter. His mental status improved back to baseline during his stay. 4. CHF. A repeat echo showed EF 15-20%, 1+ AR, 2+ MR, 3+ TR, no significant change since 3/[**2164**]. He was 8 L liters positive during his ICU stay. He was diuresed with lasix IV prn until he appeared clinically dry and his urine output decreased. He had minimal po intake and was started on maintanence fluids. He will need to be evaluated clinically and restarted on his standing dose of lasix if indicated. His B-B was d/c'ed given LAFB and RBBB and symptomatic hypotension and bradycardia. His HR remained well controlled during his stay. His ASA and statin were restarted once he was taking po's. 5. a fib - Pt was initially in a fib with RVR. This was a new diagnosis and was thought to be multifactorial, due to the combination of infection, dehydration, and underlying cardiac disease (bifascicular block, significant TR). All AV nodal blocking agents were held as pt became hypotensive after giving 12.5mg IV metoprolol. Pt was not anticoagulated due to risks of bleeding versus benefit given his overall clinical situation. Of note, pt had mildly elevated cardiac enzymes, including troponins around 0.16. This was thought to be due to demand ischemia in the setting of rapid a fib. His TSH was high, free T4 low, thought to be secondary to sick euthyroid (will not start med at this time). 6. acute on chronic renal failure secondary to prerenal azotemia in the setting of infection, dehydration; Cr back to baseline at discharge. 7. DM. His initial hypoglycemia resolved. Etiology thought to be due to oral hypoglycemics in setting of renal failure and infection. As per family's request we stopped checking finger sticks and held oral agents while pt taking minimal po's. He was on Glyburide 2.5 mg daily as an outpt. His blood sugars should be followed and he should be restarted on Glyburide if indicated. 8. Code - DNR/DNI. Spoke with pt's daughter and she emphasized the goals of care for her father are to be "gentle with him". She does not want aggressive treatment. Medications on Admission: atenolol 50mg po daily lasix 60mg po daily lisinopril 10mg po daily spironolactone 25mg po daily (? d/c'ed) aspirin 81mg po daily lipitor 20mg po daily senna [**Hospital1 **] colace timolol 0.5% 1 gtt [**Hospital1 **] dorzolamide 2% gtt tid prednisolone acetate 1% 1 gtt daily atropine 1% 1 drop tid erythromycin 5mg/g ointment ophtho tid glyburide 2.5mg po daily seroquel 75mg po daily, 62.5mg po qHS reglan 5mg po tid vit C Zinc Discharge Medications: 1. Atorvastatin Calcium 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily): please crush. 2. Lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily): please crush. 3. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily): please crush. 4. Albuterol Sulfate 0.083 % Solution Sig: One (1) Inhalation every six (6) hours as needed for shortness of breath or wheezing. 5. Ipratropium Bromide 0.02 % Solution Sig: One (1) Inhalation Q4H (every 4 hours) as needed for shortness of breath or wheezing. 6. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO once a day for 5 days: please crush. 7. Metronidazole 500 mg Tablet Sig: One (1) Tablet PO three times a day for 7 days. Discharge Disposition: Extended Care Facility: [**Location (un) 2716**] [**Last Name (un) **] - [**Location (un) 55**] Discharge Diagnosis: Multilobar Pneumonia Atrial Fibrillation with Rapid Ventricular Response C. diff Congestive Heart Failure Renal Failure Diabetes Hypoglycemia Discharge Condition: Fair Discharge Instructions: Please call your primary care physician if you experience worsening cough or shortness of breath. He was diuresed with lasix IV prn until he appeared clinically dry and his urine output decreased. He had minimal po intake and was started on maintanence fluids. He will need to be evaluated clinically and restarted on his standing dose of lasix if indicated. His Glyburide 2.5 mg daily is being held while he is taking minimal po's. His blood sugars should be followed and he should be restarted on Glyburide if indicated. Followup Instructions: 1. Please follow up with Dr. [**Last Name (STitle) 2204**] in one to two weeks. [**Telephone/Fax (1) 2936**] 2. Provider: [**First Name11 (Name Pattern1) 354**] [**Last Name (NamePattern4) 3013**], M.D. Where: [**Hospital6 29**] [**Hospital3 1935**] CENTER Phone:[**Telephone/Fax (1) 253**] Date/Time:[**2170-3-12**] 2:45 [**Name6 (MD) 251**] [**Name8 (MD) **] MD [**MD Number(1) 910**] ICD9 Codes: 5070, 5849, 2765
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Medical Text: Admission Date: [**2155-10-24**] Discharge Date: [**2155-10-27**] Date of Birth: [**2111-2-26**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2009**] Chief Complaint: SI, ethylene glycol ingestion Major Surgical or Invasive Procedure: none History of Present Illness: This is a 44year-old generally healthy male who was transferred from an OSH s/p suicide attempt with ethylene glycol and klonipin ingestion ~24h PTA. Pt notes that he has been depressed for couple of years, but for the past couple of weeks has been "wanting to die" which had not been the case before. He notes that 2 weeks ago he ingested a cup full of antifreeze which caused him to have N/V NBNB, abdominal pain, dizzyness and suffer falls, no head trauma noted. All sx resolved this week except for mild stomach upset. However, at 11pm on night PTA, he ingested "1 coffee cup full" of ethylene glycol and 5 klonipin as well as smoked 2 joints. Per report, he received the klonipin from a friend, unknown dose, and had never taken benzos before. He was found by his best friend this AM who brought him to the OSH ED. . There, his vitals were T 98.1 BP 156/90 HR 78 RR 12. He had ABG 7.26/20/116, AG was 24 and osmolar gap of 28. He was given a loading dose of fomepizole and received 1LD5W w/3amps of bicarb, and had CT head negative for ICH. He was section XIIed and transferred to [**Hospital1 18**] for further management. Before the past couple of weeks, he has no h/o prior SI, no treaters. . ROS: The patient endorses episode of blood tinged stool 2 weeks ago, otherwise denies any fevers, chills, weight change, diarrhea, constipation, melena, chest pain, shortness of breath, orthopnea, PND, lower extremity oedema, cough, urinary frequency, urgency, dysuria, focal weakness, vision changes, headache, rash or skin changes except as above. . Past Medical History: chronic tension type headaches heart murmur since childhood s/p BL inguinal hernia repairs seasonal allergies . Social History: works at [**Company 80079**] Tech - Lighting department, smokes 1/2ppd, 4 hard liquor drinks/week. + marijuana, no other illicits, no IVDU. . Family History: none known Physical Exam: Vitals: T: 97.5 BP: 150/84 HR: 82 RR: 23 O2Sat:100%RA wt 69.7kg GEN: Well-appearing, well-nourished, no acute distress HEENT: EOMI, PERRL, sclera anicteric, no epistaxis or rhinorrhea, dry MM, OP Clear NECK: No JVD, carotid pulses brisk, no bruits, no cervical lymphadenopathy, trachea midline COR: RRR, +systolic murmur, no G/R, normal S1 S2, radial pulses +2 PULM: Lungs CTAB, no W/R/R ABD: Soft, NT, ND, +BS, no HSM, no masses EXT: No C/C/E, no palpable cords NEURO: alert, oriented to person, place, and time. CN II ?????? XII grossly intact. Moves all 4 extremities. Strength 5/5 in upper and lower extremities. No asterixis. No cerebellar dysfunction. SKIN: No jaundice, cyanosis, or gross dermatitis. No ecchymoses. . Pertinent Results: OSH at 15:12 [**10-24**]: ABG: 7.26/20/116 AG: 24 Serum osm 327, calculated osm 299, Osmolar gap:28 bicarb 24 serum tox: etoh <10, acetaminophen <2, TCA (-), salicylate 2, +cannabinoids o/w negative WBC 12.2 N 64.3 L 25.7 E 1.7 B 2.0 HCT 41.7 PT 12.4 INR 0.98 PTT 33.4 Micro OSH: U/A (-) . [**2155-10-24**] 10:40PM URINE bnzodzpn-NEG barbitrt-NEG opiates-NEG cocaine-NEG amphetmn-NEG mthdone-NEG [**2155-10-24**] 10:40PM URINE BLOOD-NEG NITRITE-NEG PROTEIN-NEG GLUCOSE-TR KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-SM [**2155-10-24**] 10:40PM URINE RBC-1 WBC-11* BACTERIA-FEW YEAST-NONE EPI-0 . [**2155-10-24**] 10:49PM TYPE-ART PO2-127* PCO2-29* PH-7.41 TOTAL CO2-19* BASE XS--4 . [**2155-10-24**] 11:10PM ALBUMIN-1.9* PHOSPHATE-1.2* [**2155-10-24**] 11:10PM ALT(SGPT)-9 AST(SGOT)-9 LD(LDH)-93* ALK PHOS-29* TOT BILI-0.1 . Trend: Cr: OSH 1.4, [**Hospital1 18**] 0.6 -> 1.3 -> 1.4 -> 1.7 . Admit CXR: IMPRESSION: No active disease Brief Hospital Course: 44 year-old generally healthy male who was transferred s/p suicide attempt with ethylene glycol ingestion ~24h PTA. Currently stable w/resolution in acidosis. . # Ethylene glycol ingestion: 24 hours PTA, ~500cc. At outside hospital, he was initially acidotic w/pH 7.26, then improved to 7.41. He received loading dose of fomepizole there. Initial osmolar gap 28. He subsequently received 2 more doses of fomepizole here, with a final level of 19. He was seen and followed by toxicology who recommended discontinuation of the fomepizole after the third dose. . # Acute Renal failure: On admission, he had a creatinine of 0.6, which rose to a peak of 1.7. This has now plateaued at 1.5. This acute renal failure is likely secondary to ethylene glycol toxicity, and should improve over the next several weeks. . # Suicide attempt: He presented with a high lethality, low rescue potential suicide attempt, with significant premeditation. He had no outside treaters. He was section XIIed and followed by psychiatry. He will be transferred to an psychiatric facility at discharge. . # Systolic murmur: Patient claims he has had this since birth. Patient will need outpatient echocardiogram. Until then, patient will need endocarditis prophylaxis for procedures. . # Diastolic hypertension: While hospitalized, he has had intermittent diastolic blood pressures of 90. This most likely reflects chronic essential hypertension. He will be started on low dose amlodipine at discharge, and should subsequently be followed by his PCP. . # Comm: best friend, [**Name (NI) **], [**Telephone/Fax (1) 80080**] Medications on Admission: none Discharge Disposition: Extended Care Facility: [**Hospital3 934**] Discharge Diagnosis: Ethylene glycol ingestion Suicidality Acute renal failure Diastolic hypertension Discharge Condition: Good. Section XII. Discharge Instructions: You were admitted with a suicide attempt with ethylene glycol. . You were initially in the ICU, and then transferred to the floor. You had renal damage from the ingestion, but your kidney function has stabilized. . You should return to the emergency room for any concerning symptoms. Followup Instructions: Follow up with your PCP on discharge from the psychiatric hospital. . BMP should be checked on [**10-30**], results sent to his PCP or by [**Name Initial (PRE) **] medical team ( Dr. [**Last Name (STitle) 41445**] in [**Location (un) 5503**]). ICD9 Codes: 5849, 2762, 4019
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Medical Text: Admission Date: [**2108-2-15**] Discharge Date: [**2108-2-24**] Date of Birth: [**2041-7-11**] Sex: F Service: [**Hospital1 **] CHIEF COMPLAINT: Shortness of breath, malaise, difficulty lying flat secondary to increased labored breathing HISTORY OF PRESENT ILLNESS: Ms [**Known lastname 33876**] is a 60 year old female with end-stage Alzheimer's dementia, severe peripheral vascular disease, chronic obstructive pulmonary disease and a history of Hodgkin's disease who presents with several weeks of increasing shortness of breath. Two days prior to admission the patient completed a ten day course of Levofloxacin with bronchitis. Since then the patient has demonstrated increase in labored breathing, particularly with lying flat, worsening wheezes and a nonproductive cough. She has also demonstrated malaise and refused to get out of bed for the last two days. The patient has also notably been increasingly confused and disoriented over the last two days. Of note, the patient has been contact[**Name (NI) **] by the patient's adult day group where she goes for dementia and they have noted there decreased energy, confusion and decreased p.o. intake. According to the patient's daughter there have been no fevers, nausea, vomiting, diarrhea, headache nor rash. However, the patient has noticed significant orthopnea and paroxysmal nocturnal dyspnea. PAST MEDICAL HISTORY: 1. Hodgkin's lymphoma 14 years ago, status post radiation splenectomy and lymph node dissection; 2. Hypercholesterolemia; 3. Hypertension; 4. Dementia, Alzheimer's; 5. Hypothyroidism; 6. Lung diseases, quarterly quantified, the patient has had pulmonary function tests which demonstrated neither restrictive nor obstructive pattern, but she has a 200 year pack year of smoking; 7. Cerebrovascular accident with no residual deficit; 8. Peripheral vascular disease; 9. Bilateral carotid disease status post left endarterectomy; 10. Congestive heart failure, stress test [**2107-2-24**] showed an ejection fraction of 54%, no reversible defects noted; 11. History of cellulitis. ALLERGIES: Erythromycin causes nausea and vomiting. MEDICATIONS ON ADMISSION: Metoprolol 25 mg p.o. b.i.d.; Aspirin 81 mg p.o. b.i.d.; Humibid 600 mg b.i.d., discontinued on the [**2-13**]; Lipitor 20 mg p.o. q.d.; Ruminal 4 mg p.o. b.i.d.; Seroquel 25 mg p.o. q.h.s.; Unithroid 75 mcg p.o. q.d.; Flovent dose unavailable; Ventolin dose unavailable; ten day course of Levofloxacin discontinued on [**2-16**]. PHYSICAL EXAMINATION: The patient's vital signs on presentation were as follows, temperature 98.0, blood pressure 136/70, heartrate 96. She was breathing at 28, sating 96% on room air. Physical examination was remarkable for the following. General, she was mildly tachypneic but she was orthoptic when laid flat. The patient had no obvious jugulovenous distension at that point. Cardiovascular was significant for borderline tachycardia and lung examination was notable for diffuse end expiratory wheezes and prolonged expiratory phase. There were no rhonchi or crackles. She had no hepatosplenomegaly and there was trace bilateral pitting edema. LABORATORY DATA: Electrocardiogram on admission showed decreased voltage, normal sinus rhythm of 96 with premature ventricular contractions, normal axis, normal intervals, normal right atrial enlargement. Right ventricular and poor R wave progression that was not new. The patient's complete blood count on admission was as follows, white count 16.3, of note the patient has a baseline leukocytosis which is chronic and has been worked up extensively per the daughter. The hematocrit was 34.5, platelets 34 showing 1% neutrophils, 20% lymphocytes and 60% monos. Her PT was 12.3, PTT 27.2 and INR 1.0. Her urinalysis was unremarkable. Her chem-7 was significant for a sodium of 133, total carbon dioxide 21, BUN 20, creatinine 1.1. Chest x-ray showed no congestive heart failure or cardiomegaly, no infiltrates or effusions. On [**2-23**], she had the following laboratory data, white blood cell count was up to 26.5, hematocrit 35.8 and her platelets 280. Her total carbon dioxide had increased to 29, her sodium to 143, her BUN 59 and her creatinine ranged stable at 1.0. The patient had a computerized tomography/angiography which was limited by the patient's motion but there was no obvious pulmonary embolus. The patient had creatinine kinases of 153, 298 and 340. The patient had a chest x-ray on [**2108-2-20**] which showed evidence of prior granulomatous infection. She had a video swallowing study which demonstrated no overt evidence of aspiration. [**First Name11 (Name Pattern1) 312**] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 313**], M.D. [**MD Number(1) 314**] Dictated By:[**Last Name (NamePattern1) 11801**] MEDQUIST36 D: [**2108-2-23**] 15:25 T: [**2108-2-24**] 15:03 JOB#: [**Job Number 33877**] ICD9 Codes: 4280, 2720, 4019, 4439
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Medical Text: Admission Date: [**2188-2-11**] Discharge Date: [**2188-2-13**] Date of Birth: [**2104-1-17**] Sex: F Service: MEDICINE Allergies: Penicillins / Ditropan XL / Norvasc Attending:[**First Name3 (LF) 4327**] Chief Complaint: Atrial fibrillation with rapid ventricular response Major Surgical or Invasive Procedure: None History of Present Illness: 84 year old female with chronic afib, HTN, HLD, CAD, stage IV CKD (HD MWF), COPD, dCHF (EF >55%) with multiple admissions for CHF exacerbations, and with recent thrombosis of her left upper extremity AV [**First Name3 (LF) **] treated with thrombectomy on [**2187-12-21**], who c/o dyspnea and was noted to be in RAPID AFIB at HD. . Today, 1.5 hrs into HD, the pt became tachycardic w/ HRs in the 170s, so HD was stopped with 15 min left, after having gotten 2L IVF off. She was mentating okay per EMS and had no sx. EMS gave 2.5 mg cardizem. Pt has been noted to be fluid responsive on previous admissions. . In the ED, she was given 500 cc and another 500 cc, w/ hr going down to 130, and bp in the 100s. She got 10+5mg of dilt IV w/ pressures dropping to the 70s, with some change in mentation, so dilt was held. 2nd bolus of 500cc + 500cc was given and since she had labile bp, it was decided to trasnfer her to CCU. She got 25 mg po metoprolol and 5 mg metoprolol IV. . Vitals on transfer were hr 86, bp 85/45, rr 20, 100% RA. Rhythm was reported to be still in afib. . On review of systems, s/he denies any prior history of stroke, TIA, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. S/he denies recent fevers, chills or rigors. S/he denies exertional buttock or calf pain. All of the other review of systems were negative. . Cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. Past Medical History: PAST MEDICAL HISTORY: 1.) Stage 4-5 CKD c/b anemia and secondary hyperparathyroidism; on HD since [**2187-5-9**], does make some urine 2.) Hypertension 3.) Hyperlipidemia 4.) CAD: per patient, no records at [**Hospital1 18**] 5.) dCHF 6.) R carotid stenosis 7.) Depression 8.) Asthma 9.) Osteoporosis 10.) Osteoarthritis 11.) Thyroid disease- h/o both hypo and hyperthyroidism 12.) Vitamin D deficiency - 25 OH 19 in [**2-/2186**] 13.) Benign adnexal cyst: followed [**8-/2186**] and planned again for imaging [**8-/2187**] 14.) Chronic Aspiration: based on video swallow eval [**8-/2186**] 15.) Chronic labyrinthitis 16.) h/o L pneumothorax . PAST SURGICAL HISTORY: 1.) [**4-/2187**] LUE AV [**Year (4 digits) **] (Dr. [**First Name (STitle) **] 2.) hx bilat cataract surgery 3.) R hip fx s/p ORIF 4.) [**10/2187**] LUE AV [**Year (4 digits) **] thrombectomy and stent placement Social History: Patient is widowed, and she lives with her son, [**Name (NI) **] [**Name (NI) 96427**], and his fiance, [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 1169**], with [**Last Name (NamePattern1) 269**] assistance and private home care services. Denies any current or past smoking, current or past alcohol, or current or past drug use. Has care at the [**Location (un) 3137**] Center. Dialysis in [**Location (un) 1468**]. Family History: Son with heart surgery for unknown reason in [**2187**]. No family history of kidney disease. Physical Exam: ADMISSION EXAM: 95.2 126/59 60 100% CMV assist control 400/14 FIO2 40%, PEEP 5 GENERAL: NAD. Oriented x3. Mood, affect appropriate. HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. No xanthalesma. NECK: Supple with JVP of not visualised. CARDIAC: PMI located in 5th intercostal space, midclavicular line. RR, normal S1, S2. [**2-12**] holosystolic mumur in apex LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp were unlabored, no accessory muscle use. Some inspiratory crackles in the bases. ABDOMEN: Soft, NTND. No HSM or tenderness. Abd aorta not enlarged by palpation. No abdominial bruits. EXTREMITIES: No c/c/e. No femoral bruits. Purpura on shins bilaterally. SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. NEURO: AAOx3, CNII-XII intact, 5/5 strength biceps, triceps, wrist, knee/hip flexors/extensors, 2+ reflexes biceps, brachioradialis, patellar, ankle. PULSES: Right: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ Left: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ . DISCHARGE EXAM: 98.9 126/46 70 19 99%2LNC GENERAL: NAD. Oriented x3. Mood, affect appropriate. HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. No xanthalesma. NECK: Supple with JVP of not visualised. CARDIAC: PMI located in 5th intercostal space, midclavicular line. RR, normal S1, S2. [**2-12**] holosystolic mumur in apex LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp were unlabored, no accessory muscle use. Some inspiratory crackles in the bases. ABDOMEN: Soft, NTND. No HSM or tenderness. Abd aorta not enlarged by palpation. No abdominial bruits. EXTREMITIES: No c/c/e. No femoral bruits. Purpura on shins bilaterally. SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. NEURO: AAOx3, CNII-XII intact, 5/5 strength biceps, triceps, wrist, knee/hip flexors/extensors, 2+ reflexes biceps, brachioradialis, patellar, ankle. PULSES: Right: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ Left: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ Pertinent Results: LABS ON ADMISSION: [**2188-2-11**] 10:15PM BLOOD WBC-10.8 RBC-3.29*# Hgb-9.7* Hct-28.9* MCV-88# MCH-29.6 MCHC-33.6 RDW-15.6* Plt Ct-300 [**2188-2-11**] 10:15PM BLOOD Neuts-87.3* Lymphs-8.1* Monos-2.7 Eos-1.4 Baso-0.5 [**2188-2-11**] 10:15PM BLOOD PT-22.7* PTT-35.1 INR(PT)-2.2* [**2188-2-11**] 10:15PM BLOOD Glucose-95 UreaN-13 Creat-2.0*# Na-141 K-3.9 Cl-100 HCO3-32 AnGap-13 [**2188-2-11**] 10:15PM BLOOD cTropnT-0.02* [**2188-2-11**] 10:15PM BLOOD Calcium-7.8* Phos-2.3* Mg-2.0 . LABS ON DISCHARGE: [**2188-2-13**] 05:12AM BLOOD Hct-27.0* [**2188-2-12**] 05:08AM BLOOD WBC-7.0 RBC-3.04* Hgb-9.1* Hct-27.2* MCV-89 MCH-29.9 MCHC-33.5 RDW-16.1* Plt Ct-250 [**2188-2-13**] 05:12AM BLOOD PT-16.6* PTT-34.9 INR(PT)-1.6* [**2188-2-13**] 05:12AM BLOOD Glucose-93 UreaN-36* Creat-3.6* Na-140 K-4.5 Cl-100 HCO3-30 AnGap-15 [**2188-2-13**] 05:12AM BLOOD Calcium-8.8 Phos-4.2# Mg-2.2 . [**2188-2-11**] pCXR FINDINGS: Single supine AP portable view of the chest was obtained. Again seen, there are increased diffuse interstitial opacities bilaterally, may be due to pulmonary edema, although appears less severe than on the prior study. Slight blunting of the bilateral costophrenic angles may be due to small bilateral pleural effusions. Cardiac and mediastinal silhouettes are stable. Left subclavian stent is again seen. Brief Hospital Course: 84 year old female with chronic afib, HTN, HLD, CAD, stage IV CKD (HD MWF), COPD, dCHF (EF >55%) who presented w/ AFIB w/ RVR and labile BPs after undergoing HD. . # AFIB w/ RVR: Pt has a hx of chronic AFIB and presented today with RVR, likely in the setting of being over diuresed. Per prior cardiology consult note, "It is most likely that the patient has baseline low blood pressures from poor autonomic tone and other factors, and her blood pressures are further reduced during tachycardic episodes in the setting of her diastolic dysfunction and left ventricular hypertrophy. Midrodrine should help the poor autonomic tone. She cannot augment her cardiac output enough when she is hemodynamically challenged (such as during fluid removal). It is also possible that because of her hyperdynamic LV function and LVOT gradient, she develops severe LVOT obstruction when her stroke volume is reduced and when she is tachycardic - similar to a patient with hypertrophic cardiomyopathy. We would also recommend reducing the rate of fluid removal during HD." Pt was placed on amiodarone and metoprolol, and converted to sinus rhythm. Of note, she did not have, but needs to be, continued on the above nodal blocking agents on discharge. She was continued on warfarin. Discharge INR is 1.6 and this should be checked daily with goal INR [**1-11**]. CXR, TSH and LFTs were checked upon initiation of amio. CXR was negative for evidence of fibrosis, TSH was wnl, LFTs were normal except for an alk phos of 116, which is stable from prior vales. These can be trended by her new cardiologist. . # Hypotension: Pt had labile blood pressures in the ED and on transfer to the CCU. However, urine output was good and pt was mentating well so displayed no signs of end-organ ischemia. Pt has had previous episodes of becoming hypotensive after HD, also in the setting of possible worsening of baseline LVOT obstruction. Hypotension improved with rate control and with conversion to normal sinus rhythm. Patient will also continue midodrine with HD, as before. . # DHF: pt has known DHF w/ hyperdynamic LV and gradient across LVOT. Likely exacerbated by aggressive diuresis per HD. Favor slow rate of removal of IVF during HD. Patient tolerated Wednesday HD session and -1L fluid was removed without complication. . # CKD: Pt HD dependant since [**2187-5-9**] MWF. Underwent HD w/ likely resultant hypovolemia. Continuing midodrine with HD, and plan as above. Patient's renagel pills were too big to swallow. Per renal, these can be stopped for now given low phosphate. . # HLD: stable. Pt continued on atorvastatin 40 mg daily. . # CAD: pt has previous hx of CAD, but no record in BDIMC and last MIBI normal, recent echo showed no WMAs. Continued on aspirin 81 mg daily. . # Constipation: continued senna, colase, polyethylene glycol prn . # Nutrition: continued multivitamin, folic acid . # Depression: continued home venlaflaxine Medications on Admission: 1) Coumadin 5mg PO daily 2) Renegel 800mg PO TID 3) 1200 cc fluid restriction 4) Effexor 75mg PO daily 5) Vit B complex 1 tab PO daily 6) Colace 100mg PO BID 7) Lactulose 22.5mL 15gm PO BID 8) Lipitor 40mg PO QHS 9) Aspirin 650mg PO TID 10) Bumex 1mg tab PO 4x weekly on non-HD days 11) Midodrine 2.5mg PO daily on MWF before HD 12) Protonix 40mg PO daily before meals 13) Iron 325mg PO daily 14) Folic acid 1mg PO daily 15) Nephrocaps 1mg PO daily 16) Ipratroprium and Albuterol PRN but never given 17) Zofran 4mg Q8H PRN nausea/vomitting but nothing given recently 18) Bisacodyl 1 tab PR PRN constipation Discharge Medications: 1. warfarin 5 mg Tablet Sig: One (1) Tablet PO Once Daily at 4 PM. 2. Renagel 800 mg Tablet Sig: One (1) Tablet PO three times a day. 3. venlafaxine 75 mg Capsule, Ext Release 24 hr Sig: One (1) Capsule, Ext Release 24 hr PO DAILY (Daily). 4. Nephrocaps 1 mg Capsule Sig: One (1) Capsule PO once a day. 5. Colace 100 mg Capsule Sig: One (1) Capsule PO twice a day. 6. lactulose 10 gram/15 mL (15 mL) Solution Sig: One (1) PO twice a day as needed for constipation. 7. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 8. midodrine 5 mg Tablet Sig: 0.5 Tablet PO MWF (Monday-Wednesday-Friday): take with HD. 9. pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 10. ferrous sulfate 300 mg (60 mg iron)/5 mL Liquid Sig: One (1) PO DAILY (Daily). 11. folic acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 12. ipratropium bromide 0.02 % Solution Sig: One (1) puff Inhalation Q6H (every 6 hours) as needed for SOB. 13. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) Inhalation Q6H (every 6 hours) as needed for wheezing. 14. amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 15. atorvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 16. acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO TID (3 times a day) as needed for pain. 17. metoprolol succinate 25 mg Tablet Extended Release 24 hr Sig: One (1) Tablet Extended Release 24 hr PO once a day. Discharge Disposition: Extended Care Facility: [**Hospital 3137**] Care Center - [**Location (un) 1468**] Discharge Diagnosis: PRIMARY: 1. atrial fibrillation with rapid ventricular rate 2. end stage renal disease, on hemodialysis Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: Dear Ms. [**Known lastname 96427**], . You were admitted to the hospital for atrial fibrillation with fast heart rate during your dialysis session. The cause was likely aggressive fluid removal during dialysis, and your heart which can only tolerate gentle fluid removal. . Your heart rate was controlled with two medications, amiodarone and metoprolol. Please continue these medications as prescribed. You tolerated hemodialysis here, with one liter of fluid removed, without complication, on your date of discharge. . MEDICATION CHANGES: - START amiodarone 200 mg daily - START metoprolol tartrate 12.5 mg twice a day . Please seek medical attention for any concerns. Please attend your follow-up appointments below. Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight goes up more than 3 lbs. Followup Instructions: Department: CARDIAC SERVICES When: TUESDAY [**2188-3-11**] at 10:00 AM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2385**], MD [**Telephone/Fax (1) 62**] Building: [**Hospital6 29**] [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Completed by:[**2188-2-13**] ICD9 Codes: 5856, 496, 2724, 4240, 4280, 311
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Medical Text: Unit No: [**Numeric Identifier 61203**] Admission Date: [**2148-5-11**] Discharge Date: [**2148-5-16**] Date of Birth: [**2148-5-11**] Sex: M Service: NB HISTORY OF PRESENT ILLNESS: Baby boy [**Name2 (NI) **] is a 32 and 3/7 weeks gestational age twin II admitted for prematurity. MATERNAL HISTORY: Mother is a 33-year-old G1/P0 (to 2) [**Location 61204**] woman with the following prenatal screens; O positive, antibody negative, RPR nonreactive, rubella immune, hepatitis B surface antigen negative, GBS unknown. ANTENATAL COURSE: Estimated date of delivery was [**2148-7-3**] by last menstrual period which was [**2148-9-26**] for an estimated gestational age of 32 and 3/7 weeks. This was a diamniotic-dichorionic twin gestation complicated by preterm labor leading to admission for tocolysis and betamethasone on [**5-2**]. Progression of labor led to a cesarean section today under spinal anesthesia. Rupture of membranes was at delivery yielding clear amniotic fluid. No intrapartum fever noted or other clinical evidence of chorioamnionitis. NEONATAL COURSE: The infant was vigorous at delivery. Orally and nasally bulb suctioned, dried, subsequently pink, and in no distress on room air. Apgar's were 8 and 9 at one and five minutes of age. PHYSICAL EXAMINATION ON ADMISSION: In general, this is a well-appearing infant in no distress. Birth weight of 1640 grams, head circumference of 29 cm, length of 42 cm. Heart rate of 170, respiratory rate of 30s to 40s, blood pressure of 60/45 with a mean of 52, oxygen saturation of 95% on room air. HEENT with anterior fontanel open and soft, nondysmorphic, palate intact. Neck and mouth normal. Normocephalic with no nasal flaring. Chest reveals no retractions with good breath sounds bilaterally. No crackles. Cardiovascular exam was well perfused, a regular rate and rhythm. Femoral pulses normal with no murmur. The abdomen was soft and nondistended. No organomegaly. No masses. Bowel sounds were active. The anus was patent with a 3-vessel umbilical cord. GU revealed a normal penis with right testicle descended but left testicle undescended. CNS exam revealed active and alert. Tone was appropriate and symmetric, moved all extremities symmetrically. Grasp was symmetric, and gag was intact. Skin exam was normal. Musculoskeletal exam with normal spine, limbs, hips, and clavicles. HOSPITAL COURSE BY SYSTEM: 1. RESPIRATORY: The patient has been stable on room air since the time of admission. Has had no apnea of bradycardia of prematurity. 2. CARDIOVASCULAR: The patient has been stable from a hemodynamic standpoint throughout his admission with no murmur noted on exam. 3. FLUIDS, ELECTROLYTES AND NUTRITION: The patient was initially NPO on total fluids of 100 cc/kg per day and then was started on enteral feedings on day of life 1 and worked slowly up by 15 cc/kg twice daily. Is currently feeding breast milk or Special Care 20 calories per ounce at 120 cc/kg per day and total fluids of 140 cc/kg per day. Was planned to continue and advance to 15 cc/kg b.i.d. 4. GI: Most recent bilirubin was 6.4/0.3 on the day of transfer, which is day of life #5. The patient has never been under phototherapy. 5. INFECTIOUS DISEASE: Initial CBC was obtained which was benign with a white count of 12.1 with 32 polys and 7 bands. The patient was started on ampicillin and gentamicin which were stopped after 48 hours of negative blood culture. 6. NEUROLOGY: A head ultrasound was not indicated. 7. SENSORY: A hearing screen was not yet performed. CONDITION ON DISCHARGE: Good. DISCHARGE DISPOSITION: [**Hospital1 1474**] level II nursery. NAME OF PRIMARY CARE PEDIATRICIAN: A primary care pediatrician has not yet been identified. CARE AND RECOMMENDATIONS AT DISCHARGE: 1. Feedings at discharge are breast milk or Special Care at 20 calories per ounce at 120 cc/kg per day with plan to advance 15 cc/kg twice daily to a maximum feed of 150 cc/kg per day. 2. The patient is on no medications. 3. State screening will be sent on the day of transfer. 4. The patient has not yet received any immunizations. DISCHARGE DIAGNOSES: 1. Prematurity at 32 and 3/7 weeks gestation. 2. Twin gestation. 3. Rule out sepsis; resolved. [**Name6 (MD) **] [**Last Name (NamePattern4) **], [**MD Number(1) 55472**] Dictated By:[**Last Name (NamePattern1) 58729**] MEDQUIST36 D: [**2148-5-16**] 11:58:38 T: [**2148-5-16**] 12:38:12 Job#: [**Job Number 61205**] ICD9 Codes: V290
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Medical Text: Admission Date: [**2173-7-19**] Discharge Date: [**2173-7-28**] Date of Birth: [**2092-3-10**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 30**] Chief Complaint: Fever. Major Surgical or Invasive Procedure: None. History of Present Illness: 81 yo M with h/o COPD, dementia, Parkinson's, schizophrenia, who was BIBA from [**Doctor First Name 3504**] [**Doctor First Name **] NH where he was found to be febrile to 102.8 today. Per report, the patient had T 102.8, P 100, BP 130/80, RR 24, O2 sat 90% RA. The patient needs assistance with ADLs, is combative and non-verbal at baseline. In the ED: T 101.8; HR 130s; BP 120/92; RR 36; O2 sat 95% on 5L NC. Lactate 2.8. WBC 9.9. EKG wtih afib. CXR with multifocal opacities. Received Vanco, Levo, Flagyl. Blood cx drawn. Patient received Diltiazem 10 mg IV once. Past Medical History: 1. COPD/emphysema 2. A fib 3. Parkinsons 4. Osteomyelitis 5. Schizophrenia Social History: Lives in the nursing home. At baseline, needs assistance with ADL. The rest of Social history is unknown. Family History: Unknown. Physical Exam: VS: 100.2 rectal; HR 121; BP 95/71; RR 33; O2sat 95% on 5L GENERAL: cachectic; combative; non-verbal HEENT: NC, AT, poor dentition Neck: No JVP CV: irregulary irregular; no m/r/g PULM: CTA bilaterally ABD: + BS, soft, NT, ND EXTR: no edema Pertinent Results: EKG: afib rate 128; no comparison available CXR: 1. Multifocal airspace opacities, likely representing aspiration or aspiration pneumonia, given mostly dependent distribution. Followup radiograph recommended in six weeks to document resolution. 2. 9-mm nodular opacity in the left upper lung zone, which may represent a lung nodule. This can be further evaluated with concomitant PA and lateral views at the time of pneumonia followup. Brief Hospital Course: 1. Aspiration pneumonia: Initially treated for an aspiration pneumonia (Vanc/Zosyn). His saturations improved and he was weaned off oxygen. When the patient was made CMO, antibiotic were stopped and he was treated supportively. 2. Failure to thrive: The patient was 43 kg on admission and dehydrated. He had an NGT placed and was started on tube feeds given an inability to take any PO. After the NG was pulled, an attempt was made to replace - the patient did not tolerate this. Given his lack of quality of life and poor long-term prognosis, he was made comfort measures only. 3. Atrial fibrillation: Initially difficult to rate control, however, improved after hydration. He was continued on outpatient digoxin and low dose diltiazem while NG was in place. IV Lopressor was used after NG was pulled. 4. Psych/Schizophrenia: Continued on fluphenazine and benzotropine while NG was in place. Later, for intermittent agitation, the patient was given zyprexa. Medications on Admission: 1. Benztropine Mesylate 0.5 mg PO BID 2. Carbidopa-Levodopa (10-100) 2 TAB PO TID 3. Prilosec [**Hospital1 **] 4. Multivitamins 1 CAP PO DAILY 5. Digoxin 0.125 mg PO DAILY 6. Senna 2 tabs qd 7. Colace 8. Fluphenazine 4 mg PO QHS 9. Compazine prn 10. MOM prn 11. Dulcolax prn 12. Tylenol Discharge Medications: 1. Olanzapine 5 mg Tablet, Rapid Dissolve Sig: One (1) Tablet, Rapid Dissolve PO TID (3 times a day) as needed for agitation. 2. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed for fever, apparent discomfort. Discharge Disposition: Extended Care Facility: [**First Name4 (NamePattern1) 3504**] [**Last Name (NamePattern1) **] Rehabilitation & Nursing Center - [**Location (un) 538**] Discharge Diagnosis: Primary Diagnoses: 1. Multifocal Pneumonia. 2. Delirium. 3. Failure to Thrive Secondary: 1. Dementia. 2. Schizophrenia 3. Parkinson's disease 4. COPD 6. Atrial fibrillation Discharge Condition: Stable. Discharge Instructions: Patient was hospitalized in the ICU with an aspiration pneumonia which was treated with antibiotics. Given his ongoing risk of aspiration, we attempted to place an NG tube. The patient did not tolerate this intervention. We then had a discussion with his health care proxy and [**Name2 (NI) 73091**] that given his end-stage dementia a PEG tube was not indicated. The decision was made to transition the patient to comfort care. Followup Instructions: Patient will be discharged to long-term care facility for ongoing comfort care. ICD9 Codes: 5070
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Medical Text: Admission Date: [**2188-7-12**] Discharge Date: [**2188-7-18**] Date of Birth: [**2136-5-20**] Sex: F Service: PODIATRY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 4342**] Chief Complaint: Left foot infection Major Surgical or Invasive Procedure: Left foot I&D [**2188-7-12**], Left foot debridement [**2188-7-16**] History of Present Illness: 52 yo DM2, IVDU, many foot infections in the past, presents to the ED 3 days after stepping on a nail with her left foot. . Since that time, she has been experiencing fevers (but patient is unsure how high), rigors, and nausea/vomitting x1. She has been noticing drainage from a ulcer over the area of the foot where the nail impaled her foot. She reports that she was unable to come to the ER because ambulating was painful and she could not obtain a ride. She reports poor po intake x1 day. Pain is located in the anterior left foot and ankle, and is rated as [**10-10**]. . Of note, patient was admitted [**5-10**] with a right fourth digit ulceration and osteomyelitis. Though surgery was planned, the patient left AMA after her boyfriend was not allowed to sleep in her hospital bed. . In the [**Hospital1 18**] ER, she was febrile to 104. She was noted to be tachycardi with an EKG apparently consistent with MAT vs Afib, which is new for her. Glucose was noted to be 500 but there was no gap. A dime size necrotic lesion was noted over the plantar sufrace of the first MTP joint. She received a 2L NS, tetanus booster, morphine 4 mg IV, regular insulin 10 U, Vancomycin 1 g IVx1, and Zosyn, 4 g IV x1. LEFT IJ was placed. . Patient was transferred to the OR by podiatry for I and D of left foot. There was minimal blood loss, of about 15 cc. She received 500 cc of saline. Local anesthesia was utilized with MAC. The patient was transferred to the ICU for further monitoring. . In the ICU patient reports [**10-10**] left foot pain, but otherwise feels well. She was occassionally tachy to 140 and had HTN to 240's. This improved with morphine and lisinopril. Her cr fell from 1.3 to 1.2. Iron studies had a pattern (low TIBC, Tf) c/w Anemia of chronic inflammation Past Medical History: H/o multiple diabetic ulcers s/p toe amputations -Poorly controlled DM II -Anxiety -Depression -H/o non-compliance and behavioral problems -Peripheral neuropathy -Hepatitis B core Ab positive, surface Ab and Ag negative -Hx of Hepatitis C (neg vl since [**2182**]) -H/o IVDU and ETOH abuse -HTN -Peripheral vascular disease -H/o osteomyelitis -hysterectomy and removal of uterus and cervix due to persistent, severe cervical dysplasia -vaginal pap 2/09 WNLs -terminated in [**2182**] from [**Hospital1 **] Psych (Dr. [**Last Name (STitle) 6496**] because pt not keeping appts, abusing klonopin and doxepin b/c not fufulling terms of contract with providers Social History: The patient was evicted from an apartment in [**Hospital1 778**] in [**5-8**] after her boyfriend was arrested for drugs. She moved into a room in an apartment in [**Location (un) 686**]. She denies current drug use but her urine tox was positive for cocaine. Past notes indicate heroin use as well. She was on methadone for many years. She currently denies any smoking saying she quit in [**6-7**], but has smoked in the past. She drinks ETOH occasionally. Domestic violence: has experienced violence in the past. She currently has a male partner who is >15 years younger than her and is an alcoholic who is HIV+. Her adult daughter lives nearby. She is on disability and does not work. Family History: She had one brother who was a police officer who committed suicide. Diabetes runs in her family. She has no FH of cancer. Physical Exam: ICU Vitals: T: 102.2 BP: 162/84 P: 124 R: 14 O2: 100% 2lNC . General: Alert, oriented, no acute distress HEENT: Sclera anicteric, MMM, oropharynx clear Neck: supple, JVP not elevated, no LAD Lungs: Clear to auscultation bilaterally, no wheezes, rales, rhonchi CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly GU: no foley Ext: dressing to LLE, c/d/i, no swelling or edema CN 2-12 intact - No JPS in RLE. Sensitive only to deep palpation. Poor JPS of Hands. Preserved light touch. Pertinent Results: ADMISSION LABS: [**2188-7-12**] 04:45PM BLOOD WBC-7.3# RBC-3.01* Hgb-8.1* Hct-23.8* MCV-79* MCH-27.0 MCHC-34.1 RDW-14.3 Plt Ct-335# [**2188-7-12**] 04:45PM BLOOD Neuts-82.1* Lymphs-13.0* Monos-4.3 Eos-0.2 Baso-0.5 [**2188-7-12**] 04:45PM BLOOD PT-14.3* PTT-31.4 INR(PT)-1.2* [**2188-7-12**] 04:45PM BLOOD Glucose-510* UreaN-17 Creat-1.3* Na-127* K-3.4 Cl-94* HCO3-27 AnGap-9 [**2188-7-12**] 10:42PM BLOOD Calcium-7.2* Phos-1.0*# Mg-1.5* Iron-7* [**2188-7-12**] 10:42PM BLOOD calTIBC-146* Ferritn-219* TRF-112* DISCHARGE LABS: [**2188-7-18**] 06:00AM BLOOD WBC-3.8* RBC-2.92* Hgb-8.2* Hct-24.8* MCV-85 MCH-28.1 MCHC-33.2 RDW-15.0 Plt Ct-376 [**2188-7-18**] 06:00AM BLOOD Plt Ct-376 [**2188-7-18**] 06:00AM BLOOD Glucose-282* UreaN-10 Creat-1.1 Na-139 K-3.3 Cl-100 HCO3-34* AnGap-8 [**2188-7-18**] 06:00AM BLOOD Calcium-8.2* Phos-4.4 Mg-1.7 FOOT XR [**7-12**] There is a large ulcer crater at the plantar aspect of the forefoot, at the second and third distal metatarsals. There is associated periosteal reaction and ill definition of the cortex of the head of the second metatarsal, suspicious for osteomyelitis. Significant circumferential foot swelling noted. This is on a background of extensive postsurgical changes, which otherwise are grossly stable. CXR [**7-12**] No acute pulmonary process. Right internal jugular central line as above with no pneumothorax noted. [**2188-7-16**] Radiology CHEST PORT. LINE PLACEM: IMPRESSION: 1. New bibasilar consolidations which are prominent on the left are concerning for pneumonia. 2. New left small pleural effusion. [**2188-7-16**] Radiology CHEST (PA & LAT): (WET READ): Interval repositioning of left PICC line which is not seen beyond the mid-SVC where it may terminate versus become obscurred by the right internal jugular central venous catheter. No catheter is seen within the right atrium. Ill- defined costophrenic opacity could represent early infection. Small left pleural effusion unchanged. [**2188-7-17**] Radiology CHEST (PA & LAT): No change in right costophrenic opacity and pleural effusion since exam of [**2188-7-16**]. Left PICC terminates in proximal SVC. [**2188-7-16**] Radiology FOOT AP,LAT & OBL LEFT: FINDINGS: In comparison with the study of [**7-12**], there has been resection of the distal half of the second metatarsal and the proximal portion of the proximal phalanx. Gas is seen projected over the region, though it could merely be trapped underneath the overlying bandage. [**2188-7-16**] Pathology Tissue: LEFT 2nd DIGIT PHALAX, Left: Not finalized. [**2188-7-12**] 5:02 pm SWAB Source: left foot. **FINAL REPORT [**2188-7-16**]** GRAM STAIN (Final [**2188-7-12**]): NO POLYMORPHONUCLEAR LEUKOCYTES SEEN. 4+ (>10 per 1000X FIELD): GRAM NEGATIVE ROD(S). 2+ (1-5 per 1000X FIELD): GRAM POSITIVE COCCI. IN PAIRS AND CLUSTERS. 1+ (<1 per 1000X FIELD): GRAM POSITIVE ROD(S). SMEAR REVIEWED; RESULTS CONFIRMED. WOUND CULTURE (Final [**2188-7-16**]): Due to mixed bacterial types (>=3) an abbreviated workup is performed; P.aeruginosa, S.aureus and beta strep. are reported if present. Susceptibility will be performed on P.aeruginosa and S.aureus if sparse growth or greater.. STAPH AUREUS COAG +. HEAVY GROWTH. Staphylococcus species may develop resistance during prolonged therapy with quinolones. Therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. Testing of repeat isolates may be warranted. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ STAPH AUREUS COAG + | CLINDAMYCIN-----------<=0.25 S ERYTHROMYCIN----------<=0.25 S GENTAMICIN------------ <=0.5 S LEVOFLOXACIN---------- 0.25 S OXACILLIN------------- 0.5 S TRIMETHOPRIM/SULFA---- <=0.5 S ANAEROBIC CULTURE (Final [**2188-7-16**]): Mixed bacterial flora-culture screened for B. fragilis, C. perfringens, and C. septicum. None isolated. [**2188-7-16**] 10:45 am SWAB Site: FOOT LEFT 2ND FOOT ULCER. GRAM STAIN (Final [**2188-7-16**]): 1+ (<1 per 1000X FIELD): POLYMORPHONUCLEAR LEUKOCYTES. NO MICROORGANISMS SEEN. WOUND CULTURE (Preliminary): RESULTS PENDING. [**2188-7-16**] 8:28 pm SPUTUM Source: Expectorated. **FINAL REPORT [**2188-7-17**]** GRAM STAIN (Final [**2188-7-17**]): >25 PMNs and >10 epithelial cells/100X field. Gram stain indicates extensive contamination with upper respiratory secretions. Bacterial culture results are invalid. PLEASE SUBMIT ANOTHER SPECIMEN. RESPIRATORY CULTURE (Final [**2188-7-17**]): TEST CANCELLED, PATIENT CREDITED. [**2188-7-12**] BLOOD CULTURE Blood Culture, Routine-FINAL [**2188-7-12**] BLOOD CULTURE Blood Culture, Routine-FINAL [**2188-7-13**] BLOOD CULTURE Blood Culture, Routine-PENDING [**2188-7-14**] BLOOD CULTURE Blood Culture, Routine-PENDING Brief Hospital Course: This is a 52 yo DM2, IVDU, many foot infections in the past, presents to the ED 3 days after stepping on a nail with her left foot. She was found to be septic (fever, tachycardia, leukocytosis) and was admitted to the medicine service. She was started on broad spectrum antibiotics and local wound care. Podiatry performed a bedside debridement and wound cultures grew MSSA. She was then switched to Nafcillin IV q6h. Daily wet to dry dressing changes were performed. Daily labs were drawn and electrolytes repleted as necessary. On [**2188-7-16**], she was taken to the OR for left foot debridement packed open. Cultures were taken. Please see operative report for full details. All of her home medications were continued. On [**2188-7-16**], a PICC line was placed. Upon awaiting her PICC line placement, the radiologist contact[**Name (NI) **] Dr. [**Last Name (STitle) **] regarding new bilateral infiltrates concerning for pneumonia. She was switched back to vancomycin and zosyn with a medicine consult. Repeat CXR showed no change in the opacity. Sputum culture was sent which was contaminated and pt refused a repeat culture. Her vitals and O2 sats remained stable during her admission. Outpatient [**Company 191**] follow up was obtained and pt was encouraged to keep appointment. She was also given the [**Hospital **] clinic number to establish follow up for her diabetes insulin regimen. Physical therapy was consulted but the patient refused to be evaluated. Pt also refused rehab facility. Her OR wound cultures showed no growth to date and pathology was not finalized at the time of discharge. On [**2188-7-18**] her PICC line was pulled and she was discharged with 10 days course of Augmentin with instructions to perform daily dressing changes and to ambulate to left heel in a surgical shoe with assistance of a walker. Medications on Admission: -insulin regular human recombinant 100 units/mL 0.1 units/kg [**Hospital1 **] -metformin [**2178**] mg once a day (does not appear to be using) -GlipiZIDE XL 10 mg once a day (does not appear to be using) -Lantus 100 units/mL 12 units at bedtime -Klonopin 1 mg q6hours prn -doxepin 150mg qhs -clonidine 0.1 mg/24 hr 1 PATCH 1X/W (does not appear to be using) -Neurontin 600 mg TID -lisinopril 40 mg once a day -Celexa 20mg once a day -ibuprofen 800 mg TID prn with food -Fioricet 325 mg-50 mg-40 mg 2 tab(s) Q4H prn -Flonase 2 spray(s) once a day Discharge Medications: 1. Augmentin 875-125 mg Tablet Sig: One (1) Tablet PO twice a day for 10 days. Disp:*20 Tablet(s)* Refills:*0* 2. Insulin Insulin SC Fixed Dose Orders Bedtime Glargine 21 Units Insulin SC Sliding Scale Breakfast Lunch Dinner Bedtime Regular Regular Regular Regular Glucose Insulin Dose Insulin Dose Insulin Dose Insulin Dose 0-70 mg/dL Proceed with hypoglycemia protocol Proceed with hypoglycemia protocol Proceed with hypoglycemia protocol Proceed with hypoglycemia protocol 71-150 mg/dL 0 Units 0 Units 0 Units 0 Units 151-200 mg/dL 2 Units 2 Units 2 Units 2 Units 201-250 mg/dL 4 Units 4 Units 4 Units 4 Units 251-300 mg/dL 6 Units 6 Units 6 Units 6 Units 301-350 mg/dL 8 Units 8 Units 8 Units 8 Units 351-400 mg/dL 10 Units 10 Units 10 Units 10 Units 3. Clonazepam 1 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for anxiety. 4. Lisinopril 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 5. Chlorthalidone 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Gabapentin 300 mg Capsule Sig: One (1) Capsule PO Q12H (every 12 hours). 7. Citalopram 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. Doxepin 25 mg Capsule Sig: Six (6) Capsule PO HS (at bedtime). Discharge Disposition: Home Discharge Diagnosis: Left foot ulcer infection Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: Please resume all pre-admission medications. If you were given new prescriptions, please take as directed. . Keep your dressing clean and dry at all times. You will need to change your dressings daily. . You are to remain WEIGHT BEARING to your left heel in a surgical shoe at all times with the assistance of a walker. . Call your doctor or go to the ED for any increase in LEFT foot redness, swelling or purulent drainage from your wound, for any nausea, vomiting, fevers greater than 101.5, chills, night sweats or any worsening symptoms. Followup Instructions: Follow up with Dr. [**Last Name (STitle) **] next week. #[**Telephone/Fax (1) 543**] [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 542**] DPM 48-135 Completed by:[**2188-7-18**] ICD9 Codes: 0389, 5849, 4019, 4439
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Medical Text: Admission Date: [**2111-4-4**] Discharge Date: [**2111-4-20**] Date of Birth: [**2031-10-2**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 30**] Chief Complaint: respiratory distress and hypoglycemia Major Surgical or Invasive Procedure: None History of Present Illness: Ms. [**Known lastname **] is a 79F w/ DM type 2, s/p recent admission to [**Hospital1 18**] in [**2111-1-31**] -[**2111-2-18**] for subdural hematoma/ intraparenchymal bleed after a fall with hospital course complicated by altered mental status requiring intubation, DKA, PNA, UTI and s/p PEG, and recent admission following that for aspiration PNA, which was treated with Vancomycin and Cefepime. The patient was discharged from the hospital on [**2111-4-4**] and represented with respiratory distress and hypoglycemia. Her baseline mental status since her subdural hematoma is non-verbal, not following commands, sometimes opens eyes, therefore history is obtained through records. According to the NH records the patient was found several hours after admission to be minimially responsive and in respiratory distress. A fingerstick glucose revealed hypoglycemia at 25. She was given an amp of D50 and was more arousable, however she continued to be in respiratory distress with O2sats in the 60s. She was transferred to the [**Hospital1 18**] for further workup. In the ED, the pt presented with the following VS: 36.2 C, HR 117, BP 140/66, RR 36, O2Sat 87% on NRB. Pt maintained her pressure throughout her ED stay, HR ranged between 108-117. Her O2Sats subsequently were 100% on Facemask. She was given empiric Vancomycin, Zosyn and Levoquin for HAP before a CXR was done. As the patient appeared wheezy on exam she also received Solumedrol 80mg x1 as well as Ipratropium and Albuterol nebs. CXR revealed no new infiltrate. She was admitted to the intensive care unit initially, where she was treated supportively with IVF and Pain Control. Her oxygen requirement abated upon admission to the MICU and she was weaned easily off of her nasal canula. Past Medical History: - recent SDH followed by neurosurgery, new aphasic baseline - DM2 w/retinopathy and neuropathy - Arthritis - Right Hip fracture [**2108**] ADMISSION MEDS Levetiracetam 1000 mg PO QAM, 500mg QPM Cholecalciferol (Vitamin D3) 400 unit DAILY Calcium Carbonate 500 mg PO BID Lansoprazole 30 mg PO DAILY Amantadine 100mg DAILY Bisacodyl 5 mg DAILY as needed. Senna 8.6 mg [**Hospital1 **] as needed. Heparin 5,000 TID sc Oxycodone 5 mg PO Q12H as needed Acetaminophen liquid 325-650 mg PO Q6H as needed. Albuterol Sulfate Neb Q6H Insulin Glargine 50 units Subcutaneous qAM. Insulin Regular per sliding scale. Social History: Previously lived at home with her husband, one -two drinks per night, no tobacco, walked with a walker Family History: non-contributory Physical Exam: VITAL SIGNS ON FLOOR: 97.0 130/62 118 24 95% PHYSICAL EXAM: Gen: lying in bed, NAD, not following commands Heent: No JVD. CV: tachycardic, RRR, no audible murmurs/rubs or gallops Pulm: CTAB anteriorly Abd: soft, non-tender, + BS, non-distended, PEG tube in place Extremities: lower extremities contracted, no open wounds, 1+ DP, cool, upper extremities with increased tone R>L Neuro: open eyes, tracks movement and blinks to threat, no focal cranial neuropathies noted on limited exam as pt cannot follow commants, upgoing toes bilaterally, unable to speak, 1+ reflexes in upper extremities Pertinent Results: ADMISSION LABORATORIES [**Age over 90 **]|99|18 / 249 AGap=21 92 4.7|20|0.5\ 24.0 \______/ 715 Ca: 9.4 Mg: 1.7 P: 4.5 / 32.6 \ Fibrinogen: 895 N:95.5 Band:0 L:2.1 M:1.6 E:0.7 Bas:0 Hypochr: 2+ Anisocy: 1+ Macrocy: 1+ Microcy: 1+ BLOOD CULTURES [**2111-4-4**]: NGTD C. DIFF [**2111-4-6**] 12:38 pm STOOL POSITIVE CXR [**2111-4-5**]: Patchy density in the left lower lobe may represent linear atelectasis or infection. Healed rib fractures are seen in the left side. No frank consolidation or failure. KUB [**2111-4-10**]: A gastrostomy tube overlies the expected region of the stomach. There is no supine evidence of free intra-abdominal air. No dilated loops of small or large bowel are detected to suggest obstruction. Air and stool is identified within the colon without evidence of pneumatosis or wall thickening. Osseous screws are identified within the left proximal femur. Degenerative changes in the lower lumbar spine are not well evaluated on this study. HEAD CT [**2111-4-3**]: Bifrontal areas of encephalomalacia and contusion are identified which have further evolved since the previous CT and MRI examination. No new hemorrhage is identified. No mass effect or midline shift seen. There is moderate brain atrophy seen including dilatation of the fourth ventricle and prominence of temporal horns, which could be due to mild communicating hydrocephalus. There is no midline shift seen. There is no new area of hemorrhage identified. EEG: This 24-hour bedside EEG telemetry with video captured no clear electrographic seizures. Interictal discharges were seen independently in the left temporal region, right temporal region, or more broadly over the right hemisphere. The background was slow and disorganized with frequent bursts of generalized delta frequency slowing suggestive of an encephalopathy. Infections, medication effects, and metabolic disturbances are among the most frequent causes of encephalopathy. Delta frequency slowing was also seen independently in the left and right temporal regions suggestive of subcortical dysfunction. PERTINENT LABS HEMATOLOGY [**2111-4-4**] 07:53AM BLOOD WBC-11.8* RBC-3.32* Hgb-10.3* Hct-30.0* MCV-91 MCH-30.9 MCHC-34.2 RDW-18.0* Plt Ct-690* [**2111-4-4**] 07:25PM BLOOD WBC-10.6 RBC-3.44* Hgb-10.5* Hct-31.5* MCV-92 MCH-30.5 MCHC-33.2 RDW-17.4* Plt Ct-767* [**2111-4-5**] 03:39AM BLOOD WBC-24.0*# RBC-3.54* Hgb-10.6* Hct-32.6* MCV-92 MCH-29.8 MCHC-32.5 RDW-17.8* Plt Ct-715* [**2111-4-6**] 05:55AM BLOOD WBC-18.2* RBC-2.91* Hgb-8.7* Hct-26.9* MCV-93 MCH-29.8 MCHC-32.2 RDW-17.9* Plt Ct-713* [**2111-4-7**] 05:55AM BLOOD WBC-11.5* RBC-3.43* Hgb-10.2* Hct-31.9* MCV-93 MCH-29.7 MCHC-32.0 RDW-17.8* Plt Ct-730* [**2111-4-11**] 06:00AM BLOOD WBC-11.0 RBC-3.52* Hgb-10.6* Hct-32.8* MCV-93 MCH-30.1 MCHC-32.3 RDW-16.8* Plt Ct-676* [**2111-4-17**] 05:45AM BLOOD WBC-14.7* RBC-3.58* Hgb-10.6* Hct-32.9* MCV-92 MCH-29.5 MCHC-32.1 RDW-17.2* Plt Ct-598* [**2111-4-18**] 06:30AM BLOOD WBC-15.4* RBC-3.65* Hgb-10.9* Hct-33.3* MCV-91 MCH-29.8 MCHC-32.7 RDW-18.0* Plt Ct-619* COAGULATION [**2111-4-11**] 06:00AM BLOOD PT-13.3 PTT-29.8 INR(PT)-1.1 CHEMISTRIES [**2111-4-4**] 07:53AM BLOOD Glucose-260* UreaN-17 Creat-0.4 Na-129* K-4.8 Cl-96 HCO3-25 AnGap-13 [**2111-4-5**] 03:39AM BLOOD Glucose-249* UreaN-18 Creat-0.5 Na-135 K-4.7 Cl-99 HCO3-20* AnGap-21* [**2111-4-10**] 10:00AM BLOOD Glucose-180* UreaN-23* Creat-0.4 Na-140 K-4.5 Cl-103 HCO3-27 AnGap-15 [**2111-4-11**] 06:00AM BLOOD Glucose-193* UreaN-26* Creat-0.4 Na-141 K-4.7 Cl-102 HCO3-25 AnGap-19 [**2111-4-16**] 05:40AM BLOOD Glucose-101 UreaN-17 Creat-0.4 Na-135 K-4.8 Cl-99 HCO3-24 AnGap-17 [**2111-4-17**] 05:45AM BLOOD Glucose-129* UreaN-17 Creat-0.4 Na-133 K-4.9 Cl-96 HCO3-25 AnGap-17 [**2111-4-18**] 06:30AM BLOOD Glucose-189* UreaN-15 Creat-0.3* Na-127* K-4.9 Cl-93* HCO3-25 AnGap-14 Brief Hospital Course: 79 year old woman s/p recent admissions for SDH and aspiration PNA, who presents with respiratory distress and hypoglycemia. Given that her CXR was essentially without changes (new liner atelectasis vs infection) and more importantly that her oxygen requirement abated upon initial admission to the MICU, this was likely a mucous plug or aspiration pneumonitis that quickly resolved. 1 RESPIRATORY DISTRESS/ASPIRATION/MUCOUS PLUGGING She was given steroids in the ED. She was briefly admitted to the medicine ICU. Upon arrival to the unit, her oxygen equirement was abating without further intervention. This was felt to be mucous plugging vs aspiration pneumonitis. Chest PT was started in the hospital. HOB was elevated at 30 degrees. She had one additional desaturation episode that was likely aspiration pneumonitis that improved without antibiotics. 2 APHASIA/INTRACRANIAL BLEED Extensive workup including CT head, EEG, MRI, large volume LP recently for MS changes, were unrevealing except for large hematoma of the right frontal lobe with bifrontal gliosis and small SDH. She was previously started on amantadine, as the drug can be used for some frontal lobe disorders; however, with no significant improvement seen, this was discontinued. She was continued on Levetiracetam for seizure prophylaxis. She has neurosurgical follow-up Neurology was consulted and recommended EEG. This showed no epileptiform activity. Per neurology, the prognosis for meaninful recovery was poor. Palliative care was consulted and involved with discussion of hospice options. 3. C. DIFFICILE The patient had leukocytosis and frequent loose stools, and tested newly positive for the C. diff A toxin. She was started on flagyl on [**2111-4-6**] for planned 14 day course. Her stool became more formed, but she developed a worsening WBC and higher stool output; she was transitioned to PO vancomycin to run from [**Date range (1) 14233**]. 4 SINUS TACHYCARDIA Persistent chronic tachycardia without apparent etiology. Recent CTA negative for PE. TSH was within normal limits. 5. REACTIVE THROMBOCYTOSIS stable, elevated 6. HYPONATREMIA Tube feeds and free water boluses adjusted accordingly. 7 DIABETES MELLITUS: Patient was hypoglycemic on admission being transferred without tube feeds running. Her glargine was halved and later titrated upwards while she had consistent tube feeds. She is being discharged on 45 units of glargine daily. 8 PPx: heparin SQ 9 FEN: continued tube feeds 10 Code status - DNR/DNI 12 Communication - husband [**Name (NI) **] ([**Telephone/Fax (1) 14234**]) Medications on Admission: Levetiracetam 1000 mg PO QAM, 500mg QPM Cholecalciferol (Vitamin D3) 400 unit DAILY Calcium Carbonate 500 mg PO BID Lansoprazole 30 mg PO DAILY Amantadine 100mg DAILY Bisacodyl 5 mg DAILY as needed. Senna 8.6 mg [**Hospital1 **] as needed. Heparin 5,000 TID sc Oxycodone 5 mg PO Q12H as needed Acetaminophen liquid 325-650 mg PO Q6H as needed. Albuterol Sulfate Neb Q6H Insulin Glargine 50 units Subcutaneous qAM. Insulin Regular per sliding scale. Discharge Disposition: Extended Care Facility: [**First Name4 (NamePattern1) 1188**] [**Last Name (NamePattern1) **] Discharge Diagnosis: Intraparenchymal hemorrhage Subdural Hemorrhage Aphasia C. difficile associated diarrhea C. difficile infection, new Discharge Condition: Stable Discharge Instructions: You were admitted with respiratory distress, thoguht to be a mucous plug that resolved on its own. While you were here you had diarrhea and were diagnosed with an infection called C. difficile. You were started on antibiotic called flagyl. If you develop worsening breathing or worsening respiratory symptoms, please return to the hospital. Followup Instructions: Provider: [**Name10 (NameIs) **] [**Last Name (NamePattern4) 9151**], MD Phone:[**Telephone/Fax (1) 1669**] Date/Time:[**2111-4-14**] 11:00 ICD9 Codes: 5070, 5185, 2761, 3572
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5939 }
Medical Text: Admission Date: [**2120-1-30**] Discharge Date: [**2120-2-3**] Date of Birth: [**2062-12-27**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1283**] Chief Complaint: Mild dyspnea on exertion and decreased exercise tolerance Major Surgical or Invasive Procedure: [**2120-1-30**] Minimally Invasive Mitral Valve Replacement utilizing a 33 millimeter CE Pericardial Valve History of Present Illness: Mr. [**Known lastname 101992**] in a 56 year old male with history of childhood heart murmur. Prior to this year, he has not undergone cardiac evaluation. An echocardiogram in [**2119-9-28**] revealed mod-severe MR [**First Name (Titles) 151**] [**Last Name (Titles) 32922**] prolapse and an LVEF of 65%. There was moderate left atrial enlargement and only trace AI. Stress echocardiogram in [**2119-10-28**] found no evidence of ischemia and did not produce anginal symptoms. Subsequent cardiac catheterization in [**2119-10-28**] confirmed [**3-1**]+ MR and an LVEF of 55%. Coronary angiography revealed a right dominant system and normal coronary arteries. Based on the above results, he was referred for cardiac surgical intervention. Overall, Mr. [**Known lastname 101992**] remains mostly asymptomatic. He admits to mild DOE, slightly decreased exercise tolerance and occasional palpitations. Prior to his diagnosis of MR, he had been exercising several times per week, including biking and tennis. He denies chest pain, SOB, syncope, presyncope, orthopnea, PND, cough and pedal edema. He denies history of rheumatic fever. Past Medical History: Mitral regurgitation; History of Gingival Disease and excessive Tooth Decay; Legally Deaf in Right Ear - s/p Inner Ear Surgery; s/p Hernia Repair; s/p Tonsillectomy Social History: Quit tobacco over 4 years ago but currently enjoys an occasional cigar. He admits to occasional ETOH drink. No history of excessive ETOH abuse. He is single and without children. Works in finance, and currently lives with a friend. Family History: Father died of CHF at age 69. Mother and Sister have "mitral valve disease". Physical Exam: Vitals: BP 132/66, HR 65, RR 14, SAT 96% on room air General: well developed male in no acute distress HEENT: oropharynx benign, EOMI, sclera anicteric Neck: supple, no JVD, Heart: regular rate, normal s1s2, 3/6 systolic murmur best heard LLSB which radiates to axilla Lungs: clear bilaterally Abdomen: soft, nontender, normoactive bowel sounds Ext: warm, no edema, no varicosities Pulses: 2+ distally Neuro: alert and oriented, CN 2-12 grossly intact, MAE, [**5-31**] strength, no focal motor deficits noted Pertinent Results: [**2120-2-1**] 06:10AM BLOOD WBC-9.4 RBC-2.98* Hgb-9.3* Hct-26.4* MCV-89 MCH-31.2 MCHC-35.3* RDW-13.6 Plt Ct-100* [**2120-2-1**] 06:10AM BLOOD Glucose-121* UreaN-15 Creat-1.0 Na-138 K-4.4 Cl-105 HCO3-26 AnGap-11 [**2120-2-1**] 06:10AM BLOOD Mg-1.7 Brief Hospital Course: Mr. [**Known lastname 101992**] was admitted and underwent a minimally invasive mitral valve replacment utilizing a 33 mm CE pericardial tissue valve. For further details, see operative note. Following the operation, he was brought to the CSRU for invasive monitoring. He required no inotropic support. Within 24 hours, he awoke neurologically intact and was extubated. He did well and transferred to the SDU on postoperative day one. Chest tubes were removed without complication. Low dose beta blockade was resumed. He was gently diuresed toward his preoperative weight. He remained in a normal sinus rhythm. He made steady progress and by postoperative day 4, he was cleared for discharge to home. . Medications on Admission: Toprol XL 25 mg qd Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*0* 2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 3. Furosemide 20 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours) for 7 days. Disp:*14 Tablet(s)* Refills:*0* 4. Potassium Chloride 10 mEq Capsule, Sustained Release Sig: Two (2) Capsule, Sustained Release PO Q12H (every 12 hours) for 7 days. Disp:*28 Capsule, Sustained Release(s)* Refills:*0* 5. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). Disp:*30 Tablet(s)* Refills:*2* 6. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO every 6-8 hours as needed for pain. Disp:*50 Tablet(s)* Refills:*0* 7. Ibuprofen 600 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for pain. Disp:*100 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: Mitral regurgitation - s/p Minimal Invasive Mitral Valve Replacement utilizing a 33 millimeter CE Pericardial Valve History of Gingival Disease and excessive Tooth Decay Legally Deaf in Right Ear - s/p Inner Ear Surgery s/p Hernia Repair s/p Tonsillectomy Discharge Condition: Good Discharge Instructions: Patient may shower, no baths. No creams, lotions or ointments to incisions. Monitor wounds for signs of infection. Please call with any concerns or questions. Followup Instructions: Dr. [**Last Name (STitle) 1290**] in [**5-1**] weeks Dr. [**Last Name (STitle) **] in 2 weeks Dr. [**Last Name (STitle) **] in 2 weeks Completed by:[**2120-2-3**] ICD9 Codes: 4240
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5940 }
Medical Text: Admission Date: [**2162-11-9**] Discharge Date: [**2162-11-16**] Date of Birth: [**2085-10-26**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1505**] Chief Complaint: increasing chest discomfort and a positive thallium stress test Major Surgical or Invasive Procedure: s/p off pump cabg x1 History of Present Illness: 77 yo male with known CAD and prior stenting to RCA and PTCA to diagonal. Re- presented with chest discomfort and had a positive thallium stress test. Admitted for cardiac cath. Past Medical History: CAD with RCA stenting ( [**2154**] and [**2159**]) and PTCA of diagonal [**2159**] HTN elev. chol. prostate CA with XRT/ seeding/ hormonal therapy s/p appy [**2115**] Social History: retired lieutenant firefighter quit tobacco 15 years ago, smoked [**1-28**] cigars/day for 20 years drinks 2 glasses of wine per day lives with wife Family History: brother died of MI at age 82 Physical Exam: 5'5" 165# 140/60 HR 54 RR 20 sat 94% on RA NAd S1 S2, RRR, no murmur, rub or gallop no carotid bruits glasses lungs CTAB extrems with positive peripheral pulses, warm, without varicosities abd soft, NT, ND Pertinent Results: [**2162-11-15**] 05:01AM BLOOD WBC-6.4 RBC-3.24*# Hgb-10.7* Hct-29.0* MCV-89 MCH-33.0* MCHC-36.9* RDW-15.6* Plt Ct-161 [**2162-11-10**] 06:10AM BLOOD WBC-5.2 RBC-3.50* Hgb-12.3* Hct-35.3* MCV-99* MCH-35.2* MCHC-35.5* RDW-14.4 Plt Ct-177 [**2162-11-15**] 05:01AM BLOOD Plt Ct-161 [**2162-11-14**] 10:44AM BLOOD PT-12.4 PTT-27.3 INR(PT)-1.0 [**2162-11-10**] 08:57AM BLOOD PT-13.2 PTT-66.7* INR(PT)-1.2 [**2162-11-15**] 05:01AM BLOOD Glucose-135* UreaN-21* Creat-0.7 Na-137 K-4.1 Cl-98 HCO3-29 AnGap-14 [**2162-11-10**] 06:10AM BLOOD Glucose-112* UreaN-22* Creat-0.9 Na-139 K-3.6 Cl-101 HCO3-29 AnGap-13 [**2162-11-10**] 06:10AM BLOOD ALT-38 AST-36 CK(CPK)-50 AlkPhos-73 TotBili-0.6 [**2162-11-10**] 06:10AM BLOOD Albumin-4.0 Mg-2.1 [**2162-11-10**] 10:44AM BLOOD %HbA1c-5.4 [Hgb]-DONE [A1c]-DONE [**2162-11-10**] 06:10AM BLOOD TSH-1.3 cath: LM mild dz LAd 90% Cx mild dz. RCA patent stents, 50% mid lesion LAd with residual dissection, 60% after PTCA CXR; tortuous ascending aorta, mediastinum full at thoracic inlet, deflection of trachea to right and indenting of anterior aspect of trachea above aortic arch, likely secondary to enlarged thyroid Brief Hospital Course: Admitted [**11-9**] for elective cath with Dr. [**Last Name (STitle) **]. See cath results above. Referred to Dr. [**Last Name (STitle) **] for CABG. Underwent off pump CABG x1 (LIMA to LAD)on [**2162-11-11**]. Transferred to the CSRU in stable condition on titrated neosynephrine and propofol drips. Extubated that evening, alert and oriented, on no drips. Swan removed and gentle diuresis was started. He continued on ASA and plavix. Transferred to the floor on POD #1 to begin increasing his activity level. He went into AFIB on the floor and was treated and started on amiodarone. He was transfused 2 units of PRBCs for a HCT of 25. Chest tubes were removed on POD #4. He was in sinus rhythm 73 on POD #4.Pacing wires were removed and lopressor was DCed. CXR showed no evidence of PTX, with small bilat. pleural effusions.He continued to make good progress and was discharged to home with services on POD #5. T 97.8 HR 77 138/78 R 20 95% RA sat. 74.5 kg (pre-op 75) Medications on Admission: Plavix 75 mg daily ASA 325 mg daily HCTZ 12.5 mg daily cardizem 300 mg daily lipitor 80 mg daily zetia 10 mg daily cardura 2 mg daily MVI one daily folate 80-0 mcg daily B6 100 mcg daily B12 250 mcg daily Discharge Medications: 1. Furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day for 5 days. Disp:*10 Tablet(s)* Refills:*0* 2. Potassium Chloride 10 mEq Capsule, Sustained Release Sig: Two (2) Capsule, Sustained Release PO once a day for 5 days. Disp:*20 Capsule, Sustained Release(s)* Refills:*0* 3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 4. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 5. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*40 Tablet(s)* Refills:*0* 6. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily) for 3 months. Disp:*90 Tablet(s)* Refills:*0* 7. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 8. Multivitamin Capsule Sig: One (1) Cap PO DAILY (Daily). Disp:*30 Cap(s)* Refills:*2* 9. Thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 10. Amiodarone 200 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily) for 7 days: [**11-15**] to [**11-21**]. Disp:*14 Tablet(s)* Refills:*0* 11. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO once a day: starting [**11-22**] and then continuing. Disp:*30 Tablet(s)* Refills:*2* 12. Protonix 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 13. Diltiazem HCl 120 mg Capsule, Sust. Release 24HR Sig: One (1) Capsule, Sust. Release 24HR PO once a day. Disp:*30 Capsule, Sust. Release 24HR(s)* Refills:*0* 14. Lipitor 80 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*0* 15. Zetia 10 mg Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Home With Service Facility: [**Hospital 2255**] [**Name (NI) 2256**] Discharge Diagnosis: s/p off pump cabg x1 htn elev. chol. prostate Ca with XRT, seeding and hormonal therapy CAD with prior PTCA and stenting Discharge Condition: good Discharge Instructions: may shower over incicsion and pat dry no lotions, powders or creams on incisions no driving for one month no lifting greater than 10 pounds for 10 weeks call with fever, redness or drainage from incision, or weight gain more than 2 pounds in one day or five in one week Followup Instructions: see Dr.[**Doctor Last Name 23605**] in [**12-27**] weeks; please follow up with PCP [**Last Name (NamePattern4) **]: enlarged thyroid see Dr. [**Last Name (STitle) **] in the office in 4 weeks [**Telephone/Fax (1) 170**] see Dr. [**Last Name (STitle) **] in 3 weeks Completed by:[**2162-12-6**] ICD9 Codes: 4111, 2851, 4019, 2720
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5941 }
Medical Text: Admission Date: [**2110-6-5**] Discharge Date: [**2110-6-6**] Date of Birth: [**2032-12-15**] Sex: F Service: MEDICINE Allergies: Codeine / Sulfonamides Attending:[**Last Name (NamePattern1) 495**] Chief Complaint: Tachypnea/ectopy/altered mental status Major Surgical or Invasive Procedure: Endotracheal intubation Central venous line placement History of Present Illness: Ms. [**Known lastname 6930**] is a 77 yo F with h/o COPD and h/o NSCLC, CAD, longstanding hypertension, CHF with preserved EF, recurrent c diff infections and diabetes who was brought into the hospital for dyspnea, transferred to the floor initially and then transferred soon after to the MICU for tachypnea, ectopy, and altered mental status. According to her family, she did not sound like her usual self on the day of admission, and they stopped by to check on her as they live in adjacent apartments. She was found to be short of breath and tripoding. She was hypertensive on arrival of EMTs to 200 systolic. In the ED, she was initiated on CPAP but was off around one half hour later. She was thought to be in CHF exacerbation, and received lasix 80mg IV x1 and SL NTG x2. When she arrived to the floor, she was tachypneic and tachycardic with frequent ectopy. She was sent to the unit for further management shortly after arrival to medical floor. Past Medical History: 1. Non-small-cell lung cancer: CT guided needle biopsy for diagnosis. PET/CT scan [**10-20**] demonstrated left lower lobe cancer and 1.1cm left upper lobe nodule. s/p RFA and fiducial seed placement [**2-20**] since patient is not a surgical candidate for wedge resection. Saw Dr. [**Last Name (STitle) **] with radiation oncology. 2. COPD: on 2L O2 at home, spirometry [**10-21**] showed FEV1 0.84L(42% predicted) 3. CHF: ECHO [**1-20**] showed severe TR and EF ~ 55-60% 4. 3 vessel CAD s/p drug-eluting stent to mid-LAD and OM1 in [**1-19**] 5. Atrial Fibrillation on coumadin 6. HTN s/p bilateral renal artery stenting 7. Anemia 8. Type 2 Diabetes Mellitus: on insulin 9. Peripheral Neuropathy 10. Ischemic ulcer s/p femoral-popliteal bypass 11. s/p Amputation of right and left second toes ([**1-20**]) 12. s/p R hallux arthroplasty ([**8-20**]) 13. s/p bilateral cataract surgery [**16**]. Depression 15. s/p Cholecystectomy [**18**]. s/p Hysterectomy 17. Chronic low back pain 18. Lumbar radiculopathy 19. Hemorrhoids 20. Ulcerative proctitis Social History: [**Female First Name (un) 100604**] lives in [**Location 686**] on the [**Location (un) 448**] of the family house. She has to climb 13 steep steps to reach her home, which she finds very difficult and tiring. She sleeps upright in bed and uses a walker at baseline. Her sister, cousin, nephew and [**Name2 (NI) 802**] live in the same building and they are in frequent contact. [**Name (NI) **] boyfriend, aged 71, stays with her on the [**Location (un) 19201**] and takes good care of her, doing most of the household chores. She is also cared for by a visiting nurse who comes every day, a home health aide 3x/week, a homecare provider 2x/week, PT 2x/week, and a social worker 1x/week. The patient was previously a hairdresser, beautician and saleslady. Until the age of 40, she smoked 2 packs per day and drank a 6-pack of beer almost every day. When she turned 40, she quit her alcohol and tobacco use and returned to school to become a social worker. She [**Location (un) **] ever working in a shipyard or plumbing. She attends St. [**First Name4 (NamePattern1) 26785**] [**Last Name (NamePattern1) 9125**] in [**Location (un) 65712**] with her family. Family History: Diabetes, CHF: Mother, Brother, Grandparents, Uncle Does not know information about father's health. Son is age 60 and is healthy. Daughter is age 58 and had a cancerous growth excised from her knee. Physical Exam: VS - 96.6 101 122/72 30 97% 2L NC Gen: 77 yo F with mild agitation, mild respiratory distress HEENT: EOMI, anicteric, PERRL. MM moist. OP clear. Neck: Large neck veins, JVP at earlobes CV: irregularly irregular distant Chest: scattered rhonchi with basilar rales Abd: soft distended, hypoactive BS nontender Ext: no edema, cool feet Neuro: a&o x 2. strange affect. Pertinent Results: [**2110-6-5**] 10:00AM WBC-22.7* RBC-5.47* HGB-12.5 HCT-43.2 MCV-79* MCH-22.8* MCHC-28.9* RDW-17.0* [**2110-6-5**] 10:00AM NEUTS-87* BANDS-7* LYMPHS-6* MONOS-0 EOS-0 BASOS-0 ATYPS-0 METAS-0 MYELOS-0 [**2110-6-5**] 10:00AM cTropnT-0.05* [**2110-6-5**] 10:00AM CK-MB-NotDone proBNP-[**Numeric Identifier **]* [**2110-6-5**] 10:00AM GLUCOSE-134* UREA N-14 CREAT-0.9 SODIUM-148* POTASSIUM-2.5* CHLORIDE-96 TOTAL CO2-27 ANION GAP-28* [**2110-6-5**] 10:10AM LACTATE-7.7* [**2110-6-5**] 11:53AM LACTATE-5.0* [**2110-6-5**] 04:00PM cTropnT-0.15* [**2110-6-5**] 07:45PM WBC-18.7* RBC-5.43* HGB-12.7 HCT-42.2 MCV-78* MCH-23.4* MCHC-30.1* RDW-18.0* [**2110-6-5**] 07:45PM CK-MB-NotDone cTropnT-0.16* [**2110-6-5**] 07:53PM LACTATE-8.4*->17 INR 8 -> 16 Brief Hospital Course: Ms. [**Known lastname 6930**] is a 77yo female with history of COPD, NSCLC, CAD, longstanding hypertension, CHF and recurrent c. diff infections presents with septic shock and profound lactic acidosis and ultimately abdominal catastrophe. 1)Respiratory Failure: The patient was breathing in the 40's to compensate for her acidemia and was beginning to tire out overnight, neccesitating intubation. She is being maximized on her minute ventilation to facilitate blowing off the acid, while avoiding breath stacking given her severe underlying obstructive disease. Once the lactate returned so high, this seemed to explain that her hyperventilation was in compensation for significant acidosis and not because of heart failure as initially believed. ABGs were closely monitored and she remained acidemic. Once the decision was made to withdraw care by her family, the breathing tube was removed and the she expired soon after. 2)Septic Shock: Unclear source. The assumption is an intraabdominal catastrophe, possibly bowel ischemia given her distended abdomen (which was not present on presentation to the ED). While it is possible that the bowel abnormalities developed secondary to hypotension, it still remains the only obvious source of infection, given that she has a history of recurrent c. diff infections. KUB was unrevealing. She was not stable enough to undergo CT scan. She may have had a cardiac event with a sudden decrease in CO, resulting in lactic acidosis and gut ischemia. More likely she has stunned myocardium in the setting of sepsis. Once the central line was placed, she was agressively resuscitated with normal saline to maintain MAP>65 and CvO2>70. Surgical consult was obtained and declined the patient as a surgical candidate. . #. Rhythm: afib. patient has frequent short runs of NSVT which improved on amiodarone. The ectopy was likely secondary to her profound acidemia and electrolyte derangements. . #. Coronaries: shock could have been ischemic in etiology, ekg was concerning for ectopy with NSVT, afib with RVR, but no STTWC. Initial troponins were slightly elevated in the setting of renal failure, tachycardia and sepsis. Held [**Known lastname 4532**] and statin. . #. Leukocytosis: See sepsis discussion above. Had history of recurrent c diff infections. She was pancultured. CXR did not reveal consolidation. We were considering GI source with elevation in LDH, concern for ischemic bowel. She was maintained on vanco po, vanco iv and levo, zosyn for double gram negative coverage. . #. Acute renal failure: creatinine was elevated above baseline - it has bumped in the past when dehydrated from infection. This was likely secondary to prerenal azotemia with poor forward flow. . #. Coagulopathy: Patient appeared to be in DIC, but never bleed actively. . . . . . . Medications on Admission: Albuterol Sulfate Chlorothiazide 250 mg DAILY Citalopram 40 mg every morning Clopidogrel 75 mg Tablet DAILY Fluticasone-Salmeterol 250-50 twice a day Furosemide 100 mg twice a day Gabapentin 600 mg twice a day Hydromorphone 4 mg every four (4) hours as needed for pain Humalog Mix 75-25 36 units am and 16 units pm Ipratropium Bromide Imdur 60 mg once a day Metoprolol XL 150 mg twice a day OxyContin 10 mg twice a day oxygen - 2 liters per minute continuous flow as needed. O2 saturation at rest 93%, with minimal execise 84% Potassium Chloride 60 mEq Tab once a day Simvastatin 40 mg once a day Trazodone 100 mg HS as needed Warfarin 2 mg once a day Aspirin 325 mg DAILY Discharge Disposition: Expired Discharge Diagnosis: Patient expired on [**2110-6-6**] at 3:15pm. ICD9 Codes: 0389, 2762, 4271, 5849, 4280, 4019, 4439, 496
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5942 }
Medical Text: Admission Date: [**2105-8-10**] Discharge Date: [**2105-8-20**] Date of Birth: [**2038-4-1**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1973**] Chief Complaint: fever and coccygeal pain Major Surgical or Invasive Procedure: 1. bedside debridement of right ischial necrotic tissue [**2105-8-11**] History of Present Illness: 67-year-old man with paraplegia (as a result of an inflammatory spinal cord process of unknown etiology), a chronic indwelling Foley catheter, and a known sacral decubitus ulcer was evaluated on an outpatient basis on [**8-1**] and was found to have a leukocytosis (WBC 14K); Staph aureus was cultured from his sacral decub. Cefpodoxime 200 mg twice daily was started. Despite this intervention, he remained febrile, and he began having yellow drainage from his ulcer. He was therefore brought to the ED on [**8-10**]. There, he was hypotensive (80s/60s). Blood and urine cultures were drawn, dexamethasone was given, empiric vanc, levoflox, and flagyl were started, and 3.6 liters of fluid were infused. He was admitted to the ICU. On further review of systems, the patient reports a history of progressive night sweats with chills over the past 5-6 months. He's also had a cough productive of increasing amounts of white sputum for the two months PTA. He has limited sensation but has felt increased pain in his sacral decub recently. His left-sided, burning chest pain, right-sided abdominal pain, and R>L shoulder pain all started with the onset of his paresis and have progressed steadily since then. Blood pressure promptly returned to the range of the patient's relatively low baseline with early goal directed therapy. He was admitted to the ICU under the sepsis protocol but required ICU-level care for less than 48 hours. Fevers are most likely due to sacral osteomyelitis. Bone scan non-diagnostic, but suggestive of osteomyelitis. MRI likely not possible due to IVC filter; would confirm this with radiology. Since we can probe to bone on physical exam, then the diagnosis becomes increasingly likely. Referred to orthopedics consult for bone biopsy and discussion of possible ulcer debridement. Vancomycin and ciprofloxacin were started pending biopsy. Continue aggressive wound care. 3. Pulmonary Embolism: Goal INR [**3-14**]. Warfarin currently being held. Anticipate resuming it today; will need to monitor INR closely on combination of warfarin and cipro. 4. Asthma: Continue advair and albuterol. 5. CAD: ASA, simvastatin 6. CHF: Monitor fluid status and respiration; if flashes in context of fluid loading for sepsis protocol diurese. 7. Depression: continue citalopram. 8. Back Pain/Chronic Pain: Continue Dilaudid, baclofen, and gabapentin. 9. FEN/GI: On HH diet. Replete lytes as indicated. 10. PPX: Bowel regimen, anti-coagulation with coumadin, PPI. 11. Communication: Patient declines to name family members or other persons who could make decisions on his behalf or be contact[**Name (NI) **] regarding this admit. 12. Code: Full-discussed admit, no advanced directives or HCP. 13. Access: RIJ CVC (presep) placed in ED [**8-10**], R AC PIV. 14. Dispo: Pending osteomyelitis work-up. Past Medical History: 1. Inflammatory disease of the spinal cord of uncertain etiology. MRA [**10-15**] negative for vascular malformation. Initial CSF analysis showed elevated protein (82) without oligoclonal bands. NMO blood titer negative, RPR negative, Lyme serology negative, [**Doctor First Name **] negative, Ro and La negative, ACE level normal, neuromyelitis IgG negative, ESR 70, CRP 66.8. Ultimately treated with broad spectrum antibiotics, corticosteroids (two weeks of Solu-Medrol followed by a prednisone taper), and 5 days of mannitol without improvement. He is followed by neurology for a dense paraplegia (T4) with neuropathic pain, restrictive shoulder arthropathy, and a neurogenic bladder requiring a chronic indwelling foley. 2. Chronic sacral decubitus ulcer, previously treated with a VAC dressing 3. Multiple UTI (including Pseudomonas) 4. Pulmonary embolus [**11-14**] s/p IVC filter placement 5. Asthma 6. Two-vessel coronary artery disease s/p CABG 4-5 years ago 7. Systolic CHF (EF 25-30% on [**2-15**] TTE) 8. Repaired liver laceration 9. Chronic back pain 10. Vitiligo 11. Feeding tube 12. Depression 13. MRSA from sacral swab and sputum 14. Prior transient episodes of leg paralysis 15. Right frontal lobe brain lesion biopsied [**11-14**] and c/w gliosis; resolved on repeat imaging 16. Abnormal visual evoked potentials Social History: He moved here from [**Country 3594**] (after living in many different countries) in the [**2068**]. He is retired from a job in the maritime industry. Divorced 24 years ago. Three children. Quit smoking [**2076**]. Quit drinking [**2080**]. No history of illicit drug use or abuse. Family History: No stroke, aneurysm, no seizure, no AAA. Physical Exam: 97.7, 98/68, 80, 20, 97% Gen: Well appearing male in NAD lying in bed. HEENT: MMM, lips slightly pale, smooth tongue. Chest: CTA bilaterally, no w/r/r. CV: RRR, physiologic splitting S2, no m/r/g. Abd: Soft, nontender/nondistended, g-tube in place, c/d/i. Extremities: Warm, well perfused, no C/C. Trace pedal edema bilaterally. Skin: Vitiligo on hands. Large round 10 cm diameter pressure decubitus ulcer on sacrum with appropriate dressing. Appears clean with granulation tissue in center, no s/sx of infection. Neuro: CN grossly intact. A&O x 3, pleasantly conversant. Pertinent Results: [**2105-8-20**] 07:25AM BLOOD WBC-7.6 RBC-3.66* Hgb-9.8* Hct-30.4* MCV-83 MCH-26.9* MCHC-32.3 RDW-18.8* Plt Ct-319 [**2105-8-19**] 05:00AM BLOOD PT-14.3* PTT-30.4 INR(PT)-1.3* [**2105-8-20**] 07:25AM BLOOD Glucose-142* UreaN-9 Creat-0.5 Na-140 K-4.3 Cl-104 HCO3-29 AnGap-11 [**2105-8-13**] 06:55AM BLOOD ALT-10 AST-8 AlkPhos-100 TotBili-0.1 [**2105-8-20**] 07:25AM BLOOD Calcium-8.9 Phos-3.4 Mg-2.2 [**2105-8-10**] 07:00PM BLOOD Cortsol-7.9 [**2105-8-10**] 07:00PM BLOOD CRP-120.3* [**2105-8-10**] 08:25PM BLOOD Lactate-0.8 [**2105-8-10**] 07:09PM BLOOD Lactate-0.7 [**2105-8-10**] 02:22PM BLOOD Lactate-2.5* [**2105-8-17**] 4:00 pm TISSUE ISCHIAL BONE. GRAM STAIN (Final [**2105-8-17**]): NO POLYMORPHONUCLEAR LEUKOCYTES SEEN. NO MICROORGANISMS SEEN. TISSUE (Final [**2105-8-20**]): ESCHERICHIA COLI. RARE GROWTH. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ ESCHERICHIA COLI | AMPICILLIN------------ =>32 R AMPICILLIN/SULBACTAM-- =>32 R CEFAZOLIN------------- <=4 S CEFEPIME-------------- <=1 S CEFTAZIDIME----------- <=1 S CEFTRIAXONE----------- <=1 S CEFUROXIME------------ 4 S CIPROFLOXACIN--------- =>4 R GENTAMICIN------------ =>16 R IMIPENEM-------------- <=1 S MEROPENEM-------------<=0.25 S PIPERACILLIN/TAZO----- <=4 S TOBRAMYCIN------------ 4 S TRIMETHOPRIM/SULFA---- =>16 R ANAEROBIC CULTURE (Preliminary): NO ANAEROBES ISOLATED. ACID FAST SMEAR (Final [**2105-8-18**]): NO ACID FAST BACILLI SEEN ON DIRECT SMEAR. ACID FAST CULTURE (Pending): FUNGAL CULTURE (Preliminary): NO FUNGUS ISOLATED. POTASSIUM HYDROXIDE PREPARATION (Final [**2105-8-18**]): NO FUNGAL ELEMENTS SEEN. URINE CULTURE (Final [**2105-8-12**]): ENTEROCOCCUS SP.. >100,000 ORGANISMS/ML.. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ ENTEROCOCCUS SP. | AMPICILLIN------------ <=2 S NITROFURANTOIN-------- <=16 S TETRACYCLINE---------- =>16 R VANCOMYCIN------------ <=1 S STUDY: Left upper extremity venous ultrasound. INDICATION: 67-year-old male with redness, swelling, and pain in the left upper arm. Assess for DVT. FINDINGS: Grayscale and Doppler son[**Name (NI) 1417**] of the left internal jugular, left subclavian, left axillary, left basilic, left cephalic, and left brachial veins are performed. Normal compressibility and waveforms are demonstrated. IMPRESSION: No evidence of deep vein thrombosis of the left upper extremity. MRI OF THE PELVIS WITHOUT AND WITH IV CONTRAST: IMPRESSION: 1. Large right decubitus ulcer involving the right posteromedial buttock and right proximal medial thigh with right ischial tuberosity osteomyelitis. 2. Midline sacral decubitus ulcer with probable osteomyelitis involving the S4 vertebral body and absence of the S5 vertebral body and coccyx suggesting osseous destruction. 3. No evidence of fistulous connection between the GI tract with either the sacral or decubitus ulcer. No focal fluid collections to suggest an abscess are present. 4. Diffuse signal abnormality and enhancement of the visualized pevlic musculature suggestive of a myositis which may be inflammatory in nature. BONE SCAN: IMPRESSION: Limited study but findings consistent with osteomyelitis of the distal sacrum, coccyx, and right ischium. CXR: Clear Chest Brief Hospital Course: 1. Acute Osteomyelitis secondary to Decubitus Ulcer due to E. Coli - S/p Bone Biopsy - E. Coli -> Vancomycin/Zosyn for total 6 weeks - Flagyl x 6 weeks - PRS was consulted for wound care, and recommended Dakins solution with wtd dressings - ID consultation - Follow up with [**Hospital **] clinic 8/20/07@0930 2. Hypotension - Chronic - Presumed neurogenic due to spinal cord injury 3. UTI - Enterococcal - Vancomycin day [**10-23**] (for this) 4. Pulmonary Embolism - IVC Filter - Coumadin held for biopsy, restarted at 2 QHS 5. Depression - Antidepressants were continued 6. CAD Native Vessle, Systolic CHF - Aspirin - B-Blocker - ACEI 7. Parapalegia - Kinaire Bed - Turns Q2h - PT evaluation 8. Lung Nodule - Outpatient Workup 11. Communication: Patient declines to name family members or other persons who could make decisions on his behalf or be contact[**Name (NI) **] regarding this admit. 12. Code: Full-discussed admit, no advanced directives or HCP. Medications on Admission: 1. trazadone 25 mg at bedtime 2. coumadin 2 mg qPM 3. tylenol 650 mg q8h prn 4. dilaudid 2 mg q4h prn 5. prostat 30 cc tid 6. xanax 0.25 mg po bid (started [**8-8**]) 7. vitamin C 500 mg [**Hospital1 **] 8. aspirin 81 mg po daily 9. baclofen 5 mg po three times daily 10. bisacodyl supp every other day 11. cefpodoxime 200 mg twice daily 12. citalopram 40 mg po daily 13. docusate 100 mg po bid 14. omeprazole 40mg po daily 15. senna 2 tabs [**Hospital1 **] 16. simvastatin 40mg po qhs 17. advair 250/50 [**Hospital1 **] 18. neurontin 800mg tid 19. magnesium gluconate 500mg po bid 20. MVI with minerals daily Discharge Medications: 1. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for constipation. 2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 3. Trazodone 50 mg Tablet Sig: 0.5 Tablet PO HS (at bedtime) as needed. 4. Acetaminophen 500 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed. 5. Albuterol Sulfate 0.083 % (0.83 mg/mL) Solution Sig: One (1) neb Inhalation Q4H (every 4 hours) as needed for wheeze. 6. Aluminum-Magnesium Hydroxide 225-200 mg/5 mL Suspension Sig: 15-30 MLs PO QID (4 times a day) as needed. 7. Lactulose 10 g/15 mL Syrup Sig: Thirty (30) ML PO Q8H (every 8 hours) as needed. 8. Alprazolam 0.25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed. 9. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 10. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 11. Baclofen 10 mg Tablet Sig: 0.5 Tablet PO TID (3 times a day). 12. Citalopram 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 13. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 14. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed. 15. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 16. Fluticasone-Salmeterol 250-50 mcg/Dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). 17. Gabapentin 400 mg Capsule Sig: Two (2) Capsule PO TID (3 times a day). 18. Multivitamin,Tx-Minerals Tablet Sig: One (1) Tablet PO DAILY (Daily). 19. Sodium Hypochlorite 0.5 % Solution Sig: One (1) Appl Miscellaneous ASDIR (AS DIRECTED). 20. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) syringe Injection TID (3 times a day). 21. Hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO Q2H (every 2 hours) as needed for pain. 22. Ipratropium Bromide 17 mcg/Actuation Aerosol Sig: One (1) puff Inhalation Q6H (every 6 hours) as needed. 23. Warfarin 2 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 24. Vancomycin 1,000 mg Recon Soln Sig: One (1) gram Intravenous twice a day for 5 weeks. 25. Piperacillin-Tazobactam 4.5 g Recon Soln Sig: One (1) Recon Soln Intravenous Q8H (every 8 hours) for 5 weeks. 26. BED Kinair Bed Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - MACU Discharge Diagnosis: Acute Osteomyelitis Septic Shock - E. Coli Decubitus Ulcer Chronic Hypotension (neurogenic) UTI Bacterial (Enterococcal) Pulmonary Embolism Depression CAD Native Vessle Systolic CHF Parapalegia Lung Nodule Discharge Condition: Good Discharge Instructions: Return to the hospital if you experience high fevers, chills, nausea/vomitting, bleeding from the ulcers Followup Instructions: Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 7447**], MD Phone:[**Telephone/Fax (1) 457**] Date/Time:[**2105-9-28**] 9:30 ICD9 Codes: 4280, 5990
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5943 }
Medical Text: Admission Date: [**2133-2-20**] Discharge Date: [**2133-2-25**] Date of Birth: [**2054-5-20**] Sex: F Service: MEDICINE Allergies: Penicillins / Vancomycin Attending:[**First Name3 (LF) 2901**] Chief Complaint: Chest pain, dark stools Major Surgical or Invasive Procedure: Endoscopy History of Present Illness: 78 yo female with significant history of coronary artery disease s/p CABG, ischemic cardiomyopathy s/p BiV-ICD placement and ventricular tachycardia who presents with acute onset of likely GI bleed and left-sided chest pain. The pain was located under her left breast radiating to her back that awoke her from sleep around 3 AM on the day of admission, [**8-7**] in severity. She reports taking a few nitroglycerin tablets with some relief in her pain. The pain was reported as being constant in nature as achey in character. She also reports that she had significant dyspnea on exertion this morning, upon walking to the bathroom, which is not typical for her, no shortness of breath at rest. At baseline, she can walk less than a city block without stopping for rest. She received nitroglycerin and aspirin prehospital. She reports no fever or chills, no cough. On further questioning the patient does report having some dark stool intermittently for the last month or so. . In the ED, initial VS were pain [**4-7**], T 97.2, P 64, BP 163/64, R 16, Sat 97%. On physical exam, patient had guaiac positive black stool. ECG reportedly showed paced rhythm, with LAD, RBBB, new ST depressions in V3 and V5, as well as new TWF in V3. Labs were significant for hematocrit of 25 from baseline 34. Troponin was noted to 0.04, which is below her baseline. In addition, potassium was elevated at 5.5, creatinine elevated at 1.8 from baseline of 1.5, and INR was 1.3. Patient was administered full-dose aspirin and started on a nitroglycerin gtt. GI was consulted for GI bleed, and recommended protonix bolus and gtt, transfusion of 2 units PRBCs and possible EGD on [**2-20**]. Transfusion has not started at the time of transfer. Chest X-ray was performed and showed no acute cardiopulmonary process. Patient was chest pain free at the time of transfer. Peripheral line and EJ line was placed in ED. . On review of systems, she denies any prior history of stroke, TIA, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. She denies recent fevers, chills or rigors. She denies exertional buttock or calf pain. All of the other review of systems were negative. . Cardiac review of systems is notable for absence of paroxysmal nocturnal dyspnea, orthopnea, ankle edema, syncope or presyncope. Past Medical History: 1. CARDIAC RISK FACTORS: + Diabetes, + Dyslipidemia, + Hypertension 2. CARDIAC HISTORY: - CAD status post inferoposterior wall MI, CABG in [**2106**] (LIMA-LAD, SVG-OM, SVG-PDA, known SVG to PDA stenosis)--> Taxus stent to SVG - PDA in [**2125-2-26**]--> stenting of anterograde limb of PDA in [**2127-9-28**]. Demonstration of SVGSVG-rPDA demonstrated 40%ostial lesion consistent with in-stent restenosis. - Permanent atrial fibrillation - Ischemic CM, EF 22% on PMIBI [**2130-7-29**]. NYHA Class III. - [**2131-5-2**] Biventricular ICD implant ([**Company 2267**] Cognis). - [**2131-5-4**] LV lead revision - Ventricular tachycardia status post ICD placement; generator change 6.05 3. OTHER PAST MEDICAL HISTORY: - Hypertension/LVH. - Type 2 diabetes (HbA1c 7.5 in 6.10), followed at the [**Last Name (un) **] by [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 10083**]. - Mild AS/AR. - Hypothyroidism - Irritable bowel syndrome/diverticulosis - Chronic kidney disease - Anemia - Arthritis - Breast CA, s/p R mastectomy and XRT [**2108**] - Gastritis on EGD, w/ hiatal hernia - diverticulosis Social History: - Widowed. Previously owned toy stores with husband. Lives independently at home in [**Location (un) **]. Independent for all ADLs. - Tobacco history: none - ETOH: none - Illicit drugs: none Family History: Mother died at 53 of an MI, also had a stroke. Brother died of MI at 40; sister died of MI in her 60s, another brother died of congenital heart defect at 32(valve). Father died at 86. Children both have diabetes. Physical Exam: ADMISSION PHYSICAL EXAM: GENERAL: NAD. Oriented x3. Mood, affect appropriate. HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. No xanthalesma. NECK: Supple with JVD at level of the jaw. CARDIAC: PMI located in 5th intercostal space, midclavicular line. RR, normal S1, S2. No m/r/g. No thrills, lifts. No S3 or S4. LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp were unlabored, no accessory muscle use. CTAB, no crackles, wheezes or rhonchi. ABDOMEN: Soft, NTND. No HSM or tenderness. Abd aorta not enlarged by palpation. No abdominial bruits. EXTREMITIES: No c/c/e. No femoral bruits. SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. NEURO: AAOx3, CNII-XII intact, 5/5 strength biceps, triceps, wrist, knee/hip flexors/extensors, 2+ reflexes biceps, brachioradialis, patellar, ankle. PULSES: Right: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ Left: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ . DISCHARGE PHYSICAL EXAM: Vitals - Tm/Tc 97.8 HR 59-66 BP 110-125/55-64 RR 18-20 02 sat 100% RA In/Out: Last 24H: -300, Last 8H: 0/1100 Weight: 67.9 (up 0.2 kg from yesterday) Tele: paced FS: 129 GENERAL: 78 yo female in NAD. Oriented x3. Mood, affect appropriate. HEENT: Conjunctiva pink with injection on right side only that extends to lower eyelid, no pallor or cyanosis of the oral mucosa. NECK: Supple with JVD at 3cm above clavicle CARDIAC: PMI located in 5th intercostal space, midclavicular line. RRR, normal S1, S2. Systolic mumur [**2-2**] in RUSB. Murmur radiating to bilateral carotids. No thrills, lifts. LUNGS: CTAB no w/r/r ABDOMEN: Soft, NTND. No HSM or tenderness. EXTREMITIES: 2+ DP/PT, no pedal edema GAIT: in bed, awaiting PT to see. ambulated with PT using walker, steady on feet Pertinent Results: ADMISSION LABS: WBC-5.0 RBC-2.76*# Hgb-8.2*# Hct-0*# MCV-90 MCH-29.9 MCHC-33.1 RDW-13.4 Plt Ct-164 Neuts-63.9 Lymphs-24.6 Monos-7.3 Eos-3.4 Baso-0.8 PT-14.1* PTT-57.0* INR(PT)-1.3* Glucose-161* UreaN-65* Creat-1.8* Na-135 K-6.7* Cl-103 HCO3-22 AnGap-17 CK-MB-4 . CHEST X-RAY ([**2133-2-20**]): Compared with prior, there has been no significant interval change. The lungs remain clear. There is no pleural effusion. There is no pulmonary vascular engorgement. Cardiac silhouette is enlarged, but stable in configuration. Biventricular pacing device again seen with multiple leads in stable positions. Atherosclerotic calcifications seen throughout the aorta. Median sternotomy wires and mediastinal clips again noted. IMPRESSION: No acute cardiopulmonary process. . DC LABS: [**2133-2-25**] 06:30AM BLOOD WBC-6.5 RBC-3.38* Hgb-10.3* Hct-30.1* MCV-89 MCH-30.4 MCHC-34.2 RDW-13.7 Plt Ct-145* [**2133-2-25**] 06:30AM BLOOD Glucose-104* UreaN-47* Creat-2.2* Na-137 K-4.6 Cl-101 HCO3-30 AnGap-11 [**2133-2-25**] 06:30AM BLOOD Calcium-10.4* Phos-3.5 Mg-2.6 . ENDOSCOPY [**2133-2-23**]: Impression: Irregular z-line. Abnormal mucosa in the esophagus (biopsy) Slightly thickened gastric folds. Polyp in the first part of the duodenum (biopsy) Otherwise normal EGD to third part of the duodenum Recommendations: Follow-up biopsy results. If duodenal polyp is adenomatous, may need repeat endoscopy. The findings do not account for the symptoms Brief Hospital Course: Ms. [**Known lastname **] is a 78 year old woman with significant history of coronary artery disease s/p CABG, ischemic cardiomyopathy s/p BiV-ICD placement and ventricular tachycardia who presented with acute onset of likely GI bleed with resultant exertionalleft-sided chest pain. She underwent an endoscopy which didnt show any active signs of bleeding and was dc/ed to [**Hospital 100**] Rehab d/t orthostatic hypotension. . # Gastrointestinal bleed: Ms. [**Known lastname **] experienced a hematocrit drop from baseline of 34 to 24 in setting of guaiac positive dark stool. Differential diagnosis for upper GI bleed included bleeding ulcer, gastritis, or variceal bleed. She has history of gastritis on previous EGD and diverticulosis on prior colonoscopy. On admission, Ms. [**Known lastname **] was started on a protonix drip, and GI was consulted who performed EGD on [**2-23**] which demonstrated no acitve site of bleeding and no lesion that may have been responsible for the GIB. Ms. [**Known lastname **] [**Last Name (Titles) 35325**] 3 units of blood on the first day of admission which resulted in resolution of her chest pain. . # Chest pain: Ms. [**Known lastname **] experienced left-sided chest pain which is similar to her prior anginal symptoms. There were no discernible EKG changes but these are difficult to interpret in the setting of BiV pacing. Her MB was flat and troponins were less than baseline (normally elevated secondary to CKD). Patient received full-dose aspirin and was initiated on a nitroglycerin gtt in the ED with resolution of her pain. Pain did not recur after weaning the nitroglycerin drip and receiving 3 units of PRBCs until 2 days later on [**2-22**]. Beta blockade and lisinopril were initially held but were restarted at lower dose on [**2-21**]. Lisinopril however was held at the time of dc due to a Cr bump. . # Ischemic cardiomyopathy: Ms. [**Known lastname 96778**] furosemide and spironolactone were initially held given concern for GI bleed. Before d/c her Cr was high so lasix and lisinopril were held. . # Atrial fibrillation: CHADS2 score of 4. Ms. [**Known lastname **] states that her physicians told her to stop dabigatran several months ago and according to GI note from [**Month (only) 404**] her dabigatran had already been stopped. Her outpatient cardiologist, Dr. [**Last Name (STitle) **], was contact[**Name (NI) **] and an appt was set up. On discharge, she was prescribed dabigatran 75 [**Hospital1 **] and set up with outpt f/up. . # Type 2 diabetes mellitus: Home lantus and a sliding scale were continued in lieu of her januvia and sulfonyluea. . # Hypothyroidism: Continued home levothyroxine . TRANSITIONAL ISSUES: The pt developed some orthostatic hypotension just before the time of discharge and her Cr spiked, likely in the setting of being NPO for a long period and getting lisinopril and lasix. These meds were held at the time of dc and she will need a CHEM 7 before these meds can be restarted. Medications on Admission: Metoprolol succinate 200 mg PO daily Lisinopril 10 mg PO daily Furosemide 40 mg PO daily Aspirin 81 mg PO daily Isosorbide mononitrate 30 mg PO daily Rosuvastatin 20 mg PO daily Levothyroxine 0.1 mcg PO daily Omeprazole 20 mg PO daily Insulin glargine 16 units PO QAM Insulin Humalog per sliding scale patient only takes when BS>400 Januvia 50 mg PO PO daily Glipizide 2mg [**Hospital1 **] Ferrous sulfate 325 mg PO daily Vitamin B6 100 mg PO daily Vitamin B12 100 mcg PO daily Doxercalciferol Multivitamin 1 tab PO daily Loperamide PO PRN Discharge Medications: 1. Outpatient Lab Work Please have your labs drawn at rehab [**2-27**] and have those results faxed to your PCP: [**Last Name (NamePattern4) **]. [**First Name (STitle) **] [**Name (STitle) 1728**] [**Telephone/Fax (1) 7922**] 2. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 3. isosorbide mononitrate 30 mg Tablet Extended Release 24 hr Sig: One (1) Tablet Extended Release 24 hr PO DAILY (Daily). 4. rosuvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. levothyroxine 100 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO twice a day. Disp:*60 Capsule, Delayed Release(E.C.)(s)* Refills:*2* 7. Januvia 50 mg Tablet Sig: One (1) Tablet PO once a day. 8. glipizide 5 mg Tablet Sig: 0.5 Tablet PO twice a day. 9. ferrous sulfate 325 mg (65 mg iron) Tablet Sig: One (1) Tablet PO once a day. 10. Vitamin B-6 100 mg Tablet Sig: One (1) Tablet PO once a day. 11. multivitamin Tablet Sig: One (1) Tablet PO once a day. 12. insulin glargine 100 unit/mL Cartridge Sig: Sixteen (16) units Subcutaneous qAM. 13. Toprol XL 200 mg Tablet Extended Release 24 hr Sig: One (1) Tablet Extended Release 24 hr PO once a day. 14. Vitamin B-12 500 mcg Tablet Sig: One (1) Tablet PO once a day. 15. nitroglycerin 0.4 mg Tablet, Sublingual Sig: One (1) tab Sublingual Q 5 minutes x3 as needed for chest pain: take as directed. 16. Pradaxa 75 mg Capsule Sig: One (1) Capsule PO twice a day. 17. Hectorol 0.5 mcg Capsule Sig: Two (2) Capsule PO twice a day. 18. Fish Oil 1,000 mg Capsule Sig: One (1) Capsule PO once a day. Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - MACU Discharge Diagnosis: Primary diagnosis: Blood loss from unknown source (likely GI) Chest pain from blood loss Secondary diagnosis: Coronary artery disease Cardiomyopathy (weak heart muscle) Hypertension Diabetes Chronic kidney disease Atrial fibrillation Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: Dear Ms. [**Known lastname **], It was a pleasure taking care of you at [**Hospital1 18**]. You were admitted to the hospital for chest pain and dark stools. You met with the GI doctors, and an EGD scope procedure was performed. You also had a biopsy done, the results of which are pending on discharge. Your bleeding stopped after 3 units of blood, and your blood counts remained stable. Your chest pain was felt to be related to the bleeding, and this improved. . You had mild worsening of your kidney function, which was likely related to dehydration. This improved with IV fluids. You will require a repeat blood test to ensure that your blood counts and kidney function are stable. You should have this test done on friday, if the kidneys look better, we will restart you on your lasix and lisinopril. . MEDICATION CHANGES: - INCREASE omeprazole to 20 mg twice a day - HOLD your Lasix (Furosemide) - HOLD your Lisinopril *if your kidney function is improving on Friday [**2-27**], please resume both Lasix 40mg daily and Lisinopril 10mg daily For your heart failure diagnosis: Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight goes up more than 3 lbs in 2 days or 5 lbs in 3 days, follow a low salt diet and restrict your fluids to 1500 ml/ day. Please have your hematocrit and BMP drawn on Friday [**2-27**] Followup Instructions: Please draw Hct and BMP on Friday [**2-27**] and fax to Dr. [**First Name (STitle) **] [**Name (STitle) 1728**] [**Telephone/Fax (1) 7922**] Department: GASTROENTEROLOGY When: THURSDAY [**2133-3-5**] at 10:30 AM With: [**First Name11 (Name Pattern1) 1730**] [**Last Name (NamePattern4) 2301**], M.D. [**Telephone/Fax (1) 463**] Building: LM [**Hospital Unit Name **] [**Location (un) 858**] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage Department: [**State **]When: MONDAY [**2133-3-9**] at 9:45 AM With: [**Name6 (MD) **] [**Name8 (MD) 9862**], MD [**Telephone/Fax (1) 2205**] Building: [**State **] ([**Location (un) **], MA) [**Location (un) **] Campus: OFF CAMPUS Best Parking: On Street Parking Department: CARDIAC SERVICES When: FRIDAY [**2133-7-10**] at 10:00 AM With: [**Name6 (MD) **] [**Last Name (NamePattern4) **], MD [**Telephone/Fax (1) 62**] Building: [**Hospital6 29**] [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage *Dr. [**Last Name (STitle) **] is working on a [**Month (only) 958**] appointment for you. She will contact you directly if she can fit you in. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2908**] MD, [**MD Number(3) 2909**] ICD9 Codes: 5789, 2851, 2724, 5859, 2449
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5944 }
Medical Text: Admission Date: [**2167-7-25**] Discharge Date: [**2167-7-30**] Date of Birth: [**2090-9-18**] Sex: M Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 2279**] Chief Complaint: Weakness/fever Major Surgical or Invasive Procedure: None History of Present Illness: 76 yo Male with hx of AVR, CAD s/p CABG, MDS- pancyopenia, non-hodgkins lymphoma, and Parkinson's who was relaeased from the hospital 2 months ago for a pneumonia. He brought in from his ECF because of fever to 105 and new weakness, and sob. He says he has had a cough and SOB for the last few weeks. Today he was unable to get up and go to the bathroom. He denies any fevers prior to today. He denies any pains including chest and abdominal pain. In the ED a CXR showed possible RLL PNA versus atelectasis. His UA was neg, he got 3 sets of blood cultures. He was given Vanc/zosyn/azithro in the ED for emperic coverage of a HCAP, tylenol 325 after 650 earlier in the day for his fever and 4L of IVF. His EKG showed sinus tachycardia in the ED. On arrival to the MICU, in rigors, not febrile at this time, has cough, no pain. Review of systems: (+) Per HPI (-) Denies night sweats, recent weight loss or gain. Denies headache, sinus tenderness, rhinorrhea or congestion. Denies chest pain, chest pressure, palpitations, or weakness. Denies nausea, vomiting, diarrhea, constipation, abdominal pain, or changes in bowel habits. Denies dysuria, frequency, or urgency. Denies arthralgias or myalgias. Denies rashes or skin changes. Past Medical History: 1. AS s/p porcine Aortic Valve Replacement ([**2162-3-3**]) 2. CAD s/p CABG x 2 (LIMA to LAD, SVG to OM [**2162-3-3**]) 3. CKD 4. Depression / anxiety, currently treated only with diazepam qhs. Previously on Effexor and benzo and Seroquel (stopped in [**2157**] due to EPS/?PD) 5. hyperlipidemia on crestor 6. Hypothyrodism 7. Tremor 8. Gait disorder, thought by Dr. [**Last Name (STitle) **] to be primarily due to posterior column dysfunction 9. BPH s/p TURP, no longer on Flomax; nocturia x hourly 10. non-Hodgkin's Lymphoma s/p chemo/BMT @OSH was in remission until current thrombocytonia 11. OSA on prior sleep study; pt refuses CPAP; wife says no snoring. M-III to M-IV airway, with extra neck soft tissues. Social History: Married, kids in CA (just visited, as above), lives with wife. Retired from cigarette sales ~15y ago.Chronic/progressive health problems as above. Smoked heavily in military ~50y ago, but quit cigs and now smokes occasional cigars "do not inhale" for many years. Says 1-2 beers per night, but formerly drank heavily (up to ~15 years ago when he retired). Denies any h/o illicit drug use or supplements. Family History: Non-contributory Physical Exam: Admission Exam: Vitals: T: 98.6 BP: 166/87 P: 136 R: 39 O2: 99 General: Alert, rigors HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, PERRL Neck: supple, no LAD CV: Tachycardic, crisp S1, s2, no rubs, gallops Lungs: Scattered wheezes Abdomen: soft, non-tender, non-distended, bowel sounds present GU: no foley Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Neuro: CNII-XII intact, 5/5 strength upper/lower extremities, grossly normal sensation Discharge exam: Pertinent Results: [**2167-7-25**] 04:50PM WBC-6.9# RBC-3.59* HGB-10.4* HCT-32.3* MCV-90# MCH-29.1# MCHC-32.2 RDW-22.5* [**2167-7-25**] 04:50PM NEUTS-57 BANDS-4 LYMPHS-23 MONOS-11 EOS-0 BASOS-0 ATYPS-4* METAS-0 MYELOS-0 BLASTS-1* NUC RBCS-1* [**2167-7-25**] 04:50PM HYPOCHROM-1+ ANISOCYT-3+ POIKILOCY-OCCASIONAL MACROCYT-2+ MICROCYT-1+ POLYCHROM-NORMAL OVALOCYT-OCCASIONAL [**2167-7-25**] 04:50PM PLT SMR-VERY LOW PLT COUNT-31* [**2167-7-25**] 04:50PM PT-13.6* PTT-28.1 INR(PT)-1.3* [**2167-7-25**] 04:50PM CALCIUM-8.7 PHOSPHATE-1.2*# MAGNESIUM-1.8 [**2167-7-25**] 04:50PM CK-MB-1 cTropnT-<0.01 [**2167-7-25**] 04:50PM CK(CPK)-71 [**2167-7-25**] 04:50PM GLUCOSE-113* UREA N-22* CREAT-1.4* SODIUM-133 POTASSIUM-4.1 CHLORIDE-100 TOTAL CO2-23 ANION GAP-14 [**2167-7-25**] 05:04PM LACTATE-0.9 [**2167-7-25**] 06:30PM URINE RBC-1 WBC-<1 BACTERIA-FEW YEAST-NONE EPI-<1 [**2167-7-25**] 06:30PM URINE BLOOD-TR NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-NEG [**2167-7-25**] 06:30PM URINE COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.012 [**2167-7-25**] 06:30PM URINE UHOLD-HOLD [**2167-7-25**] 06:30PM URINE HOURS-RANDOM CXR [**7-25**] PA and lateral The patient is status post median sternotomy for CABG. Heart remains mildly enlarged with left ventricular predominance. The patient is status post aortic valve replacement. The mediastinal contours are unchanged, with mild calcification of the aortic knob again demonstrated as well as a mildly tortuous course of the thoracic aorta. The pulmonary vascularity is not engorged. Streaky opacities in the lung bases are nonspecific, possibly reflecting atelectasis though infection cannot be excluded. No pleural effusion or pneumothorax is visualized. There are no acute osseous abnormalities. IMPRESSION: Streaky bibasilar opacities, which could reflect atelectasis though infection cannot be completely excluded. Brief Hospital Course: 76 yo Male with hx of AVR, CAD s/p CABG, MDS- pancyopenia, non-hodgkins lymphoma, and Parkinson's who was relaeased from the hospital 2 months ago for a pneumonia who returns with a HCAP and new a. fib w/ rvr. Was treated in the ICU and transferred to the floor to complete 10 day course of antibiotics. 1) HCAP pneumonia/sepsis- Pt initially sirs criteria, and presented with dry cough x2 weeks, new weakness, and his CXR was concerning for a new RLL inflitate. With the pt's history of Parkinson's disease, was at risk for aspiration due to dysphagia, and thus cause recurrent pneumonia. Pt's fever curve improved with vancomycin, cefepime and azithromycin for a 10 day course (through [**2167-8-6**]). Blood cultures were negative. Pt's dry cough did not improve with cough syrup, tessalon perles and nebulizer treatments and thus had an ENT consult which found mild irritation of vocal cords most likely related to acid reflux or viral infection. Laryngoscopy did not show vocal cord paralysis and structurally normal. Cough mildly improved while on the floor, but still with significant cough at discharge. He was started on prednisone 40 mg PO daily for a 4 day total course to end on [**2167-8-2**]. 2) New Atrial fib w/ rvr in 120s likely due to stress of increasing cardic output in septic picture. Other concerns included his thyroid medicine and new ischemia but TSH normal and cardiac enzymes were negative. Pt was rate controlled with metoprolol 50mg TID and was successfully converted to NS rhythm. Echo was done which showed LVEF>55%, no thrombus. Pt's CHADS2 score at 1. Aspirin was held due to thrombocytopenia. Metoprolol was discontinued given his reactive airways and wheezing. On stopping, patient tended to be borderline tachyardia with intermittent atrial fibrillation and bigeminal PACs. When his pulmonary symptoms resolve, metoprolol should be considered if his tachycardia/afib persists at rehab. 3) Parkinson's disease: Was continued on home pramipexole during course and was evaluated by speech and swallow for dysphagia; pt was cleared for regular solid PO intake. 4) MDS/Non-Hodgkin's lymphoma: s/p chemo and BMT, chronic thrombocytopenia. Pt had no bleeding issues. Patient required transfusion of 1 unit of platelets prior to PICC line placement but otherwised remained above transfusion threshold without evidence of bleeding. 5) Hyperlipidemia: Rosuvastatin was continued throughout course. 6) BPH: Tamsulosin was continued throughout course. 7) Depression/Anxiety: Stable, PRN diazepam. Was requiring approximately one additional dose of diazepam daily. 8) Hypothyroid: continue home Levothyroxine Sodium 50 mcg PO DAILY. TSH normal. 9) Left ear ceurmen: Stable. 10) Constipation: Continued Lactulose, Polyethylene Glycol, Docusate Sodium 100 mg PO BID, and Senna 1 TAB PO BID. # Transitional issues: - Consider starting patient on metoprolol for new atrial fibrillation, was started in house, then discontinued given reactive airways. Should be restarted if he continues to have tachycardia/afib once pulm symptoms resolve. - Patient should continue full treatment for HCAP with vancomycin 1g IV Q12 and Cefepime 2 g IV Q12H through is PICC line, both through [**2167-8-6**]. - PICC line okay to use by nursing staff at rehab. CXR confirmed placement on [**7-29**] and has been used here. - Patient started on prednisone 40 mg PO daily for reactive airways, which should continue through [**8-2**]. - Patient started on high dose PPI while in house given ENT evaluation of laryngeal inflammation from possible reflux. This should be discussed with PCP and [**Name9 (PRE) 31042**] in 2 weeks. Continued high dose PPI has multiple risks and these should be weighed. Medications on Admission: Preadmission medications listed are correct and complete. Information was obtained from Record. 1. Diazepam 5 mg PO DAILY:PRN anxiety 2. Lactulose 15 mL PO DAILY constipation 3. Polyethylene Glycol 17 g PO DAILY:PRN constipation 4. Ondansetron 4 mg PO Q8H:PRN nausea 5. Acetaminophen 325-650 mg PO Q4H:PRN pain/fever 6. Codeine Sulfate 15-30 mg PO Q4H cough 7. Guaifenesin-Dextromethorphan 15 mL PO Q4H:PRN cough 8. Benzonatate 200 mg PO TID:PRN cough 9. Docusate Sodium 100 mg PO BID 10. Senna 1 TAB PO BID 11. pramipexole *NF* 0.5 mg Oral TID Parkinson's 12. Albuterol 0.083% Neb Soln 1 NEB IH Q4H:PRN SOB 13. Levofloxacin 500 mg PO Q24H PNA Duration: 13 Days 14. Levothyroxine Sodium 50 mcg PO DAILY 15. Tamsulosin 0.4 mg PO HS BPH 16. Carbamide Peroxide 6.5% 5 DROP AD QHS Duration: 4 Days Left ear at bedtime 17. Rosuvastatin Calcium 10 mg PO DAILY Discharge Medications: 1. Carbamide Peroxide 6.5% 5 DROP AD QHS Duration: 4 Days Left ear at bedtime 2. Acetaminophen 325-650 mg PO Q4H:PRN pain/fever 3. Albuterol 0.083% Neb Soln 1 NEB IH Q4H:PRN SOB 4. Benzonatate 200 mg PO TID:PRN cough 5. Codeine Sulfate 15-30 mg PO Q4H cough 6. Diazepam 5 mg PO DAILY:PRN anxiety 7. Docusate Sodium 100 mg PO BID 8. Guaifenesin-Dextromethorphan 15 mL PO Q4H:PRN cough 9. Lactulose 15 mL PO DAILY constipation 10. Levothyroxine Sodium 50 mcg PO DAILY 11. Ondansetron 4 mg PO Q8H:PRN nausea 12. Polyethylene Glycol 17 g PO DAILY:PRN constipation 13. pramipexole *NF* 0.5 mg Oral TID Parkinson's 14. Rosuvastatin Calcium 10 mg PO DAILY 15. Senna 1 TAB PO BID 16. Tamsulosin 0.4 mg PO HS BPH 17. CefePIME 2 g IV Q12H Continue through [**8-6**]. 18. Vancomycin 1000 mg IV Q 12H Continue through [**8-6**]. 19. PredniSONE 40 mg PO DAILY Duration: 3 Days Continue through [**8-2**]. Discharge Disposition: Extended Care Facility: [**First Name8 (NamePattern2) 3075**] [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] for Living Discharge Diagnosis: Primary: Health care associated pneumonia New atrial fibrillation Secondary: Myelodysplastic syndrome Thrombocytopenia Discharge Condition: Patient is afebrile with stable vitals. Satting mid 90s on RA. He is in and out of a fib and borderline tachycardic in the 90s-100s. Lung exam with inspiratory and expiratory wheezing and transmitted upper airway sounds, breathing is nonlabored. Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - With walker or aid. Discharge Instructions: Dear Mr. [**Known lastname 35501**], You were admitted to the [**Hospital1 69**] for symptoms concerning for pneumonia. We treated your pneumonia with antibiotics and your fevers resolved. You will need to continue taking antibiotics at the rehab facility. A PICC line was placed in your left arm and it's placement was confirmed with an x-ray, so your antibiotics can be given at rehab. You were also started on steroids (prednisone) for a total of 5 days to help with your breathing. It was a pleasure taking care of you at the [**Hospital1 18**]. Followup Instructions: Department: CARDIAC SERVICES When: THURSDAY [**2167-8-6**] at 3:20 PM With: [**First Name8 (NamePattern2) **] [**Known firstname **] [**Last Name (NamePattern1) **], MD [**Telephone/Fax (1) 62**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage We are working on a follow up appt with Dr. [**Last Name (STitle) 35507**] at [**Hospital 10596**]. You will be called at home/rehab with the appointment. If you have not heard or have questions, please call ([**Telephone/Fax (1) 35513**]. Department: DERMATOLOGY When: MONDAY [**2167-8-17**] at 9:30 AM With: [**Doctor Last Name 3833**] [**Telephone/Fax (1) 1971**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 551**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: CARDIAC SERVICES When: THURSDAY [**2167-10-15**] at 2:20 PM With: [**First Name8 (NamePattern2) **] [**Known firstname **] [**Last Name (NamePattern1) **], MD [**Telephone/Fax (1) 62**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: [**Hospital3 249**] When: WEDNESDAY [**2167-11-25**] at 9:00 AM With: [**First Name11 (Name Pattern1) 198**] [**Last Name (NamePattern4) 199**], M.D. [**Telephone/Fax (1) 2010**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 895**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] MD [**MD Number(2) 2285**] Completed by:[**2167-7-30**] ICD9 Codes: 0389, 486, 2724, 2449, 3051
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5945 }
Medical Text: Admission Date: [**2130-3-20**] Discharge Date: [**2130-3-31**] Date of Birth: [**2080-6-9**] Sex: F Service: SURGERY Allergies: Tegretol Attending:[**First Name3 (LF) 5880**] Chief Complaint: Coffee Ground Emesis Urinary Tract Infection Fever Hypotension Major Surgical or Invasive Procedure: Right subclavian central line History of Present Illness: 49 F with developmental delay, RA, paraplegia [**2-10**] L1-L2 compression fx, anasarca [**2-10**] FSGS, s/p recent prolonged hospitalization from [**2130-1-25**] to [**2130-3-15**]. The discharge summary was reviewed, and is briefly summarized below. . She initially presented with diffuse edema involving the entire body, that had worsened over the past 2-3 months. She was found to have FSGS by renal biopsy. Her hospitalization was also significant for an L1-L2 vertebral compression fracture with near paralysis of her lower extremities. She underwent T10-L4 posterior fusion that was complicated by wound infection and VRE bacteremia. She underwent wound exploration with incision and debridement on [**3-10**]. She was discharged to [**Hospital1 **] on [**3-15**] to complete a course of linezolid. . At [**Hospital1 **], she was found to have a UTI and was started on Amikacin on [**3-19**]. Also had multiple episodes of emesis o/n. Febrile to 102.7 at 01:00 on [**3-20**]. Then on am of [**3-20**], had approx 200 cc of coffee ground emesis. Sent to [**Hospital1 18**] for further management. . In [**Hospital1 18**] ED, NG lavage with return of blood that did not clear after 500 cc saline. Received 2L NS for BP 84/64, and levoflox / Flagyl. Also received 2 units FFP for INR 1.4. . Admitted to MICU where bedside EGD showed grade 3 esophagitis without active bleed. Past Medical History: 1. Osteoarthritis. 2. Rheumatoid arthritis. 3. Osteoporosis with vertebral compression fractures - normal BMD at the femoral neck, osteopenia at the trochanter, and osteoporosis at the total hip ([**2129**]) 4. Developmental delay. 6. Sleep apnea; since [**2116**] on nocturnal ventilation with BiPAP at 18/12 cm H20 plus 4 liters of nasal cannular oxygen titrated in, else will desaturate to 45% 7. Obesity. 8. History of leg ulcers. 9. Leg swelling - since [**2116**], followed by podiatry and vascular surgery (Dr. [**Last Name (STitle) **] 10. Pilonidal cyst removal - [**2117**], complicated by wound dehiscence 11. R knee replacement - [**2126**] 12. SLE - dx [**2120**], diagnosis not documented well Social History: Developmentally delayed. Had been living with mother and sister until recent hospitalization, now at [**Hospital1 **]. Family History: Non-contributory Physical Exam: Vitals - T 98.1, BP 119/66, HR 99, RR 29, O2 sat 100% on 2L NC, wt 87.6 kg General - obese female, appears comfortable, in NAD, speeking full sentences HEENT - PERRL, OP clr, MM sl dry Chest - CTAB CV - RRR, nl s1, s2, no m/r/g Abdomen - NABS, soft, mild tenderness to palpation in RLQ, no g/r Extremities - diffuse 3+ bilat edema Back - incision intact, with serous drainage from inferior aspect; min surrounding erythema at inferior; ~4cm R gluteal stage II decub with serousanguinous drainage with min surrounding erythema Pertinent Results: Admission Labs: [**2130-3-20**] 12:30PM BLOOD WBC-25.1*# RBC-3.28* Hgb-9.4* Hct-29.7* MCV-91 MCH-28.8 MCHC-31.8 RDW-15.8* Plt Ct-281 [**2130-3-20**] 12:30PM BLOOD PT-15.7* PTT-33.4 INR(PT)-1.4* . Labs at Transfer From MICU to Floor [**2130-3-25**] 05:36AM BLOOD WBC-12.6* RBC-3.22* Hgb-9.5* Hct-28.4* MCV-88 MCH-29.4 MCHC-33.3 RDW-16.6* Plt Ct-173 [**2130-3-25**] 05:36AM BLOOD Neuts-89.8* Lymphs-7.2* Monos-2.2 Eos-0.7 Baso-0.2 [**2130-3-25**] 05:36AM BLOOD Hypochr-2+ Anisocy-1+ Poiklo-1+ [**2130-3-25**] 05:36AM BLOOD PT-15.5* PTT-37.3* INR(PT)-1.4* [**2130-3-25**] 05:36AM BLOOD Glucose-101 UreaN-3* Creat-0.2* Na-141 K-4.1 Cl-112* HCO3-25 AnGap-8 [**2130-3-25**] 05:36AM BLOOD ALT-7 AST-5 LD(LDH)-213 AlkPhos-92 TotBili-0.3 [**2130-3-25**] 05:36AM BLOOD Albumin-1.6* Calcium-8.1* Phos-2.7 Mg-2.2 . CHEST (PORTABLE AP) [**2130-3-20**] 12:52 PM AP CXR: Nasogastric tube has been placed, coiling in the proximal stomach. Cardiac and mediastinal contours are stable allowing for marked patient rotation. No focal areas of consolidation within the lungs, and there are no definite pleural effusions. Right costophrenic angle has been excluded from the study and cannot be assessed. Mild elevation of right hemidiaphragm is noted. . CHEST (PORTABLE AP) [**2130-3-25**] 5:55 AM 1. Slightly increased right pleural effusion, unchnaged left pleural effusion. 2. Mild interstitial pulmonary edema, stable. . CT L-SPINE W/ CONTRAST [**2130-3-21**] 12:02 PM IMPRESSION: While no abnormal enhancement is noted, significant metallic streak artifact and subcutaneous soft tissue stranding extending down to the spinal canal is present. It is indeterminate how much of this represents postoperative change vs. possible infection/phlegmon. . CT ABDOMEN W/CONTRAST; CT PELVIS W/CONTRAST [**2130-3-21**] 11:43 AM 1. Acute cholecystitis. 2. Bilateral small pleural effusions and adjacent atelectasis. 3. Right adrenal mass, unchanged. 4. Abdominal rectus sheath hematoma and left-sided abdominal wall fluid collection, unchanged. 5. Status post posterior fusion of multiple thoracolumbar vertebrae, unchanged in construct from [**2130-3-2**]. . ECG (MICU admission [**3-20**]): Sinus tach @ 114; baseline artifact; diffuse TWF across precordium; aside from tachycardia, no change from [**2130-2-9**] . EGD (MICU admission [**3-20**]): Impression: Grade 3 esophagitis in the lower third of the esophagus and middle third of the esophagus. Otherwise normal EGD to second part of the duodenum. . [**2130-3-23**] 8:24 am STOOL CLOSTRIDIUM DIFFICILE TOXIN ASSAY (Final [**2130-3-23**]): FECES NEGATIVE FOR C. DIFFICILE TOXIN BY EIA. . [**2130-3-21**] 6:12 pm SWAB Source: sacral. Staphylococcus aureus and beta streptococcus). PROBABLE ENTEROCOCCUS. SPARSE GROWTH. PSEUDOMONAS AERUGINOSA. SPARSE GROWTH. YEAST. RARE GROWTH. . SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ PSEUDOMONAS AERUGINOSA | CEFEPIME-------------- 8 S CEFTAZIDIME----------- 4 S CIPROFLOXACIN--------- =>4 R GENTAMICIN------------ =>16 R IMIPENEM-------------- =>16 R MEROPENEM------------- =>16 R PIPERACILLIN---------- 16 S PIPERACILLIN/TAZO----- 8 S TOBRAMYCIN------------ =>16 R . ANAEROBIC CULTURE (Final [**2130-3-25**]): NO ANAEROBES ISOLATED. . Brief Hospital Course: She was admitted to MICU under the care of the Medicine Service. A bedside EGD was performed which showed grade 3 esophagitis without active bleed, and UGI bleed resolved with PPI's. Her Hct was stable at 28 after receiving 2units of FFP (in ED) and 2units of PRBC (on the floor). Her hypotension was persistent thought secondary to her cholecystitis seen on her abdominal CT as well as her MDR-resistant pseudomonal UTI. A CVL was placed and she was started on Levophed for blood pressure support. She was continued on Amikacin for her pseudomonal UTI and started on Zosyn for her cholecystitis. Her linezolid from a previous VRE bacteremia was continued until [**3-24**]. General Surgery was consulted and initially felt that she did not require surgical intervention at the time and she was planned for percutaneous cholecystotomy. She managed to defervesce without percutaneous drainage and was weaned off pressors on [**3-23**] and her blood pressure normalized. Foley was changed and repeat UA improved. A one week course of Amikacin was completed for her pseudomonal UTI, her course of Linezolid completed on [**3-24**], and she was transferred to the floor on Zosyn. She was re-evaluated by General Surgery on [**3-26**], the decision to proceed with a lap chole on [**3-27**] was made. She was taken to the operating room where the laporascopic chole was converted into an open cholecystectomy secondary to a gangrenous gallbladder. Postoperatively her care was transferred to the General Surgery service. Her staples were removed on day of discharge; she will require follow up with Dr. [**Last Name (STitle) **] mid [**Month (only) 547**]. On HD#10 she was given a clear diet, this was slowly advanced. Her nutritional status will require close monitoring; it is being recommended that calorie counts be initiated once at rehab. She had been on Megace prior to hospitalization, this was restarted prior to her discharge. Boost Plus supplements have also been added to her diet. She previously had a rectal tube that was placed while on the Medicine service; this was discontinued. She was hypernatremic with a Na of 148 during her early hospitalization while on the Medicine service; it was felt iatrogenic secondary to IV fluid. Her last Na on [**3-30**] was 143. She did require intermittent IV Lasix for diuresis and was continued on 20 mg IV BID. Her Lasix was changed to 20 mg po daily; she was not on this medication prior to her hospitalization. It is being continued as she still has some volume overload issues; continued use should be re-evaluated once her volume status stabilizes. Physical and Occupational therapy consults were placed and they have recommended rehab stay after her acute hospitalization. Medications on Admission: Cyanocobalamin 1000 mcg SQ Q30d Aranesp 0.06 mg SQ QTh fondaparinox 2.5 mg SQ QD Zofran 8 mg IV Q8h PRN Amikacin 250 IV Q12h Lipitor 80 QD Iron 300 QD Vit D 50000Qsu Megace 400 QD Linezolid 600 [**Hospital1 **] Calcium 500 TID Reglan 10 Q6h prn Senna [**Hospital1 **] Colace 100 [**Hospital1 **] Bisacodyl 5 QD Calcitriol 0.25 QD Lisinopril 5 QD MVI QD Vit C 500 [**Hospital1 **] Tylenol prn Calcitonin 200 IU QD Dilaudid [**2-12**] PO Q4h prn Ketoconazole 2% cream Ketoconazole 2% shampoo Discharge Medications: 1. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). 2. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO QID (4 times a day). 3. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: Two (2) Tablet PO DAILY (Daily). 4. Insulin Regular Human 100 unit/mL Solution Sig: One (1) dose Injection four times a day as needed for per insulin sliding scale. 5. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4-6H (every 4 to 6 hours) as needed. 6. Erythromycin 5 mg/g Ointment Sig: One (1) dose Ophthalmic QID (4 times a day): administer OS. 7. Linezolid 600 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours). 8. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) ML Injection TID (3 times a day). 9. Oxycodone 5 mg Tablet Sig: 1-2 Tablets PO every four (4) hours as needed for pain. 10. Lasix 20 mg Tablet Sig: Two (2) Tablet PO once a day. 11. Megace Oral 40 mg/mL Suspension Sig: Ten (10) ML's PO once a day. Discharge Disposition: Extended Care Facility: [**Hospital1 700**] - [**Location (un) 701**] Discharge Diagnosis: Upper GI Bleed MDR-psuedomonal Urinary Tract Infection (sensitive to amikacin) VRE Wound Infection Sepsis Acute Cholecystitis Discharge Condition: Stable Followup Instructions: Follow up next with Dr. [**Last Name (STitle) **] in General Surgery Clinic; call [**Telephone/Fax (1) 92654**] to schedule a time for this appointment for sometime in [**Month (only) 547**]. Previous scheduled appointments: . Provider: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] [**Name8 (MD) **], MD Phone:[**Telephone/Fax (1) 435**] Date/Time:[**2130-3-28**] 11:30 . Provider: [**Name10 (NameIs) 251**] [**Last Name (NamePattern4) 16624**], MD Phone:[**Telephone/Fax (1) 1803**] Date/Time:[**2130-5-1**] 2:00 . Provider: [**Name10 (NameIs) 706**] Phone:[**Telephone/Fax (1) 327**] Date/Time:[**2130-5-22**] 3:00 Completed by:[**2130-3-31**] ICD9 Codes: 0389, 4280, 5990, 5180, 2760, 2768, 2859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5946 }
Medical Text: Unit No: [**Numeric Identifier 62011**] Admission Date: [**2198-5-8**] Discharge Date: [**2198-5-30**] Date of Birth: [**2198-5-8**] Sex: F Service: NB HISTORY OF PRESENT ILLNESS: [**Known lastname 8665**] [**Known lastname **], twin number two, was born at 32 weeks gestation by Cesarean section for worsening pregnancy induced hypertension. Mother is a 36 year-old, Gravida I, Para 0 now II woman. Prenatal screens included blood type B positive, antibody negative, Rubella immune, RPR nonreactive, hepatitis B surface antigen negative and group B strep negative. This pregnancy was complicated by pregnancy induced hypertension, prompting maternal admission six days prior to delivery. The mother received a complete course of Betamethasone prior to delivery. The infant emerged vigorous. Rupture of membranes occurred at the time of delivery. Apgars were 7 at 1 minute and 8 at 5 minutes. Birth weight was 1,705 grams. Birth length was 43 cm. Birth head circumference was 29.5 cm. PHYSICAL EXAMINATION: Admission physical examination reveals an active, pink, non dysmorphic, preterm infant. Anterior fontanel soft and flat. Positive bilateral red reflex. Comfortable respirations. Lungs clear. Heart was regular rate and rhythm. No murmur. Benign abdomen. Non focal and age appropriate neurologic examination. Skin without lesions. Normal hips. Spine intact. HOSPITAL COURSE: NICU course by systems: Respiratory status: She has remained in room air throughout her NICU stay. She has had rare episodes of apnea and bradycardia, but none for greater than 5 days by the time of discharge. On examination, her respirations are comfortable. Lung sounds are clear and equal. Cardiovascular status: [**Known lastname 8665**] has remained normotensive throughout her NICU stay. On examination, her heart has regular rate and rhythm, no murmur. She is pink and well perfused. Fluids, electrolytes and nutrition: At the time of discharge, her weight is 2,245 grams. Her length is 45.5 cm and her head circumference is 32 cm. Enteral feeds were begun on day of life number one and advanced without difficulty to full volume feeding. At the time of discharge, she is breast feeding and supplementing with 24 calories per ounce breast milk on an ad lib schedule. Gastrointestinal: She never received phototherapy. Her peak bilirubin occurred on day of life number four and was total of 5.2, direct of 0.2. Hematology: Her hematocrit on day of life number one was 48.9. That is her most recent hematocrit. She never received any blood product transfusions during her NICU stay. Infectious disease: She was started on Ampicillin and Gentamycin at the time of admission for sepsis risk factors. The antibiotics were discontinued after 48 hours and the blood culture was negative and the infant was clinically well. On day of life 17, she completed a 5 day course of Nystatin powder for a milial diaper rash. Neurology: Patient maintained a normal neurologic examination during hospitilization. Screening HUS was not performed given advanced gestational age and benign course. Audiology: Hearing screening was performed with automated auditory brain stem responses and the infant passed in both ears. Psychosocial: Parents have been very involved in the infants' care throughout their NICU stay. CONDITION: The infant is discharged in good condition. She is discharged home with her parents. PRIMARY PEDIATRIC CARE: Provided by Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 44797**] at [**Apartment Address(1) 62009**], [**Hospital1 8**], MA, [**Telephone/Fax (1) 62012**]. RECOMMENDATIONS AFTER DISCHARGE: 1. Feedings: Breast feeding with supplemental 24 calorie per ounce breast milk or formula as needed to maintain weight gain. 2. Medications: Tri-Vi-[**Male First Name (un) **] 1 ml p.o. daily. Ferrous sulfate (25 mg/ml) 0.2 ml p.o. daily. 3. She passed a car seat position screening test. 4. Her last state screen was sent on [**2198-5-11**]. 5. She received her first hepatitis B vaccine on [**2198-5-23**]. 6. Recommended immunizations: Synagis RSV prophylaxis should be considered from [**Month (only) **] through [**Month (only) 958**] for infants who meet any of the following three criteria: (1) Born at less than 32 weeks; (2) Born between 32 and 35 weeks with two of the following: Daycare during RSV season , a smoker in the household, neuromuscular disease, airway abnormalities or school age siblings; or (3) with chronic lung disease. Influenza immunization is recommended annually in the Fall for all infants once they reach six months of age. Before this age, and for the first 24 months of the child's life, immunization against influenza is recommended for house hold contacts and out of home caregivers. FOLLOW UP: 1. Early intervention at the [**Hospital1 8**]-[**Location 17065**] Early Intervention Program, telephone number [**Telephone/Fax (1) 45540**]. 2. Care group [**Hospital6 **]. Telephone number [**Telephone/Fax (1) 14297**]. 3. Lactation consultant support by [**First Name8 (NamePattern2) 4457**] [**Last Name (NamePattern1) 62013**]. Telephone number [**Telephone/Fax (1) 61687**]. DISCHARGE DIAGNOSES: 1. Status post prematurity at 32 weeks gestation. 2. Twin number two. 3. Sepsis ruled out. 4. Status post apnea of prematurity. 5. Status post milial diaper rash. DR.[**Last Name (STitle) **],[**First Name3 (LF) **] 50-ABQ Dictated By:[**Last Name (NamePattern1) 56160**] MEDQUIST36 D: [**2198-5-30**] 16:00:54 T: [**2198-5-30**] 16:39:03 Job#: [**Job Number 62014**] ICD9 Codes: V290, V053
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5947 }
Medical Text: Admission Date: [**2134-10-14**] Discharge Date: [**2134-10-21**] Date of Birth: [**2062-5-25**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 613**] Chief Complaint: fevers, MS changes, increased upper respiratory congestion Major Surgical or Invasive Procedure: CT scan of the abdomen, head central venous line placement Peripheral intravenous central catheter placement nasogastric tube placement History of Present Illness: 72 y/o male nursing home resident brought in by ambulance for fever to 103.6, mental status change, and increased upper respiratory congestion. Nurses noted change in mental status since 6AM on morning of admission, as well as low grade fevers starting the day prior with max to 103.6 at 6AM th emornig of admission. At baseline he is disoriented to person, place, and time. He is exclusively bedbound. He has had several days of non productive cough, distended abdomen, and large-loose/oozing stools. EMS noted patient lying in bed, extremely diaphoretic, with fever to 103.6, and distended abdomen. . In ED, code sepsis initiated, right IJ sepsis line placed, intubated for airway protection, blood, urine cultured, given Vanco 1g IV, levofloxacin 500 mg IV, clindamycin 600 mg IV, and 1g Ceftriaxone IV. CXR did not show any infiltrate, CT of Abdomen showed enlarged sigmoid colon and bibasilar consolidations, and Head CT showed old infarct and atrophy. He was admitted for treatment of sepsis. Past Medical History: Hypertension h/o right MCA CVA and left PCA CVA with severe encephalomalacia predominantly within the right temporal parietal and left occipital lobes and residual left sided weakness Seizures Dementia h/[**Initials (NamePattern4) **] [**Last Name (NamePattern4) 3696**] Syndrome (colonic pseudo-obstruction) h/o aspiration PNA Gastritis with h/o GI bleed Anemia of CHronic Disease s/p laminectomy for disc herniation with internal fixation s/p left total hip replacement s/p IVC filter for DVT legally blind Social History: Lives in [**Location **] St. [**Doctor Last Name 11042**]/[**First Name4 (NamePattern1) 3504**] [**Last Name (NamePattern1) **] in [**Location (un) 16174**]. His son is his health care proxy. [**Name (NI) 4084**] a smoker. No alcohol use in the past ten years. Family History: NC Physical Exam: T 97.8 BP 133/72 HR 78 on Vent AC 500 x 14 with FiO2 0.60 PEEP 5 General: Intubated and sedated, responds with eye opening and mouth opening to sternal rub PERRL NG tube in place with bloody output. ET tube in mouth. Poor dentition. NO LAD, normal carotid pulses No supraclaviular or axilllary LAD Lungs clear anterioroly without wheezing. Mild decreased breath sounds at right base, otherwise claer posteriorly without wheezes. Heart: RRR. No M/G/R. ABD: high pitched bowel sounds, distened, tense, tympanic RECTAL: no masses, normal prostate, guaiac positive, no gross blood or melena BACK: sacral decubitus ulcer EXT: tight, shiny skin, bood upper ext pulses, good femoral and popliteal pulses, weak DP pulses. Left heel with ulcer and tendon exposure. NEURO: Hyperreflexic and tonic/clonic on the left upper and lower ext compared to right. Toes upgoing bilaterally. Myoclonus of left lower extremity with ankle flexion. Pertinent Results: [**2134-10-14**] 10:40AM BLOOD WBC-12.2*# RBC-6.46*# Hgb-19.7*# Hct-58.0*# MCV-90 MCH-30.5 MCHC-34.1 RDW-15.0 Plt Ct-156 [**2134-10-14**] 11:59PM BLOOD WBC-13.0* RBC-4.02* Hgb-12.3* Hct-35.9* MCV-89 MCH-30.7 MCHC-34.3 RDW-15.1 Plt Ct-64* [**2134-10-16**] 03:33AM BLOOD WBC-10.6 RBC-3.93* Hgb-12.0* Hct-34.6* MCV-88 MCH-30.5 MCHC-34.7 RDW-15.0 Plt Ct-66* [**2134-10-20**] 05:35AM BLOOD WBC-7.6 RBC-3.33* Hgb-10.4* Hct-29.4* MCV-88 MCH-31.1 MCHC-35.2* RDW-14.7 Plt Ct-109* [**2134-10-21**] 05:49AM WBC 6.7 RBC 3.40* HGB 10.6* HCT 30.0* MCV 88 MCH 31.3 MCHC 35.5* RDW 14.7 PLT 127* [**2134-10-14**] 10:40AM BLOOD Neuts-79.1* Lymphs-16.3* Monos-4.4 Eos-0 Baso-0.2 [**2134-10-15**] 03:02AM BLOOD Neuts-79.7* Bands-0 Lymphs-16.3* Monos-3.2 Eos-0.1 Baso-0.7 [**2134-10-14**] 12:05PM BLOOD PT-15.2* PTT-29.3 INR(PT)-1.4* [**2134-10-15**] 03:02AM BLOOD PT-14.5* PTT-40.0* INR(PT)-1.3* [**2134-10-18**] 12:07PM BLOOD PT-13.4* PTT-70.2* INR(PT)-1.2* [**2134-10-14**] 08:33PM BLOOD Fibrino-269 D-Dimer->[**Numeric Identifier 961**]* [**2134-10-14**] 08:33PM BLOOD FDP-160-320* [**2134-10-15**] 03:02AM BLOOD Fibrino-287 [**2134-10-14**] 12:05PM BLOOD Glucose-165* UreaN-70* Creat-4.4*# Na-160* K-2.5* Cl-120* HCO3-23 AnGap-20 [**2134-10-14**] 11:59PM BLOOD Glucose-162* UreaN-58* Creat-3.0* Na-159* K-4.1 Cl-128* HCO3-20* AnGap-15 [**2134-10-15**] 11:55AM BLOOD Glucose-150* UreaN-46* Creat-2.6* Na-156* K-3.8 Cl-129* HCO3-18* AnGap-13 [**2134-10-17**] 08:17PM BLOOD Glucose-135* UreaN-28* Creat-1.7* Na-149* K-3.1* Cl-117* HCO3-22 AnGap-13 [**2134-10-20**] 05:35AM BLOOD Glucose-127* UreaN-20 Creat-1.5* Na-144 K-3.4 Cl-114* HCO3-22 AnGap-11 [**2134-10-21**] 05:49AM GLU 116* BUN 15 Cr 1.4* Na 144 K 3.5 Cl 114* HCO3 23 AG 11 [**2134-10-14**] 12:05PM BLOOD ALT-753* AST-531* CK(CPK)-440* AlkPhos-117 Amylase-202* TotBili-0.6 [**2134-10-14**] 11:59PM BLOOD ALT-494* AST-249* Amylase-338* [**2134-10-16**] 03:33AM BLOOD ALT-291* AST-90* LD(LDH)-307* CK(CPK)-421* AlkPhos-66 Amylase-170* TotBili-0.5 [**2134-10-20**] 05:35AM BLOOD ALT-166* AST-94* LD(LDH)-325* Amylase-143* [**2134-10-14**] 12:05PM BLOOD Lipase-126* [**2134-10-14**] 11:59PM BLOOD Lipase-650* [**2134-10-18**] 12:07PM BLOOD Lipase-180* [**2134-10-14**] 12:05PM BLOOD CK-MB-2 cTropnT-0.37* [**2134-10-14**] 08:33PM BLOOD CK-MB-5 cTropnT-0.28* [**2134-10-15**] 03:02AM BLOOD CK-MB-6 cTropnT-0.20* [**2134-10-16**] 03:33AM BLOOD CK-MB-3 cTropnT-0.12* [**2134-10-14**] 08:33PM BLOOD Albumin-2.8* Calcium-6.7* Phos-4.2 Mg-2.1 Iron-36* [**2134-10-16**] 03:33AM BLOOD Albumin-2.4* Calcium-6.9* Phos-2.0* Mg-2.0 [**2134-10-20**] 05:35AM BLOOD Calcium-7.9* Phos-3.1 Mg-2.1 [**2134-10-14**] 08:33PM BLOOD calTIBC-178* Ferritn-1353* TRF-137* [**2134-10-17**] 08:17PM BLOOD Triglyc-83 HDL-34 CHOL/HD-3.6 LDLcalc-73 [**2134-10-14**] 08:33PM BLOOD Osmolal-359* [**2134-10-16**] 03:33AM BLOOD Osmolal-320* [**2134-10-14**] 12:05PM BLOOD Cortsol-54.9* [**2134-10-15**] 06:40AM BLOOD Vanco-9.6* [**2134-10-14**] 12:26PM BLOOD Type-[**Last Name (un) **] pO2-46* pCO2-35 pH-7.43 calTCO2-24 Base XS-0 Comment-GREEN TOP [**2134-10-14**] 08:47PM BLOOD Type-MIX Temp-37.9 Rates-/20 Tidal V-470 PEEP-5 FiO2-60 pO2-54* pCO2-52* pH-7.19* calTCO2-21 Base XS--8 -ASSIST/CON Intubat-INTUBATED [**2134-10-15**] 06:02AM BLOOD Type-ART Temp-36.7 pO2-177* pCO2-31* pH-7.34* calTCO2-17* Base XS--7 Intubat-INTUBATED [**2134-10-15**] 07:02PM BLOOD Type-[**Last Name (un) **] Temp-38.4 pO2-39* pCO2-38 pH-7.33* calTCO2-21 Base XS--5 [**2134-10-14**] 12:26PM BLOOD Lactate-3.1* [**2134-10-14**] 02:36PM BLOOD Glucose-140* Lactate-1.7 Na-160* K-2.3* Cl-131* [**2134-10-15**] 06:02AM BLOOD Lactate-2.0 [**2134-10-14**] 02:36PM BLOOD O2 Sat-99 [**2134-10-14**] 08:47PM BLOOD O2 Sat-77 [**2134-10-15**] 12:01PM BLOOD O2 Sat-81 [**2134-10-14**] 02:36PM BLOOD freeCa-1.07* [**2134-10-15**] 03:36AM BLOOD HEPARIN DEPENDENT ANTIBODIES- NEG NEGATIVE HEPARIN PF4 ANTIBODY BY [**Doctor First Name **] [**2134-10-14**] 12:05 pm URINE Site: NOT SPECIFIED **FINAL REPORT [**2134-10-17**]** URINE CULTURE (Final [**2134-10-16**]): ESCHERICHIA COLI. 10,000-100,000 ORGANISMS/ML.. PRESUMPTIVE IDENTIFICATION. Trimethoprim/Sulfa sensitivity testing confirmed by [**First Name8 (NamePattern2) 3077**] [**Last Name (NamePattern1) 3060**]. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ ESCHERICHIA COLI | AMPICILLIN------------ 8 S AMPICILLIN/SULBACTAM-- 4 S CEFAZOLIN------------- <=4 S CEFEPIME-------------- <=1 S CEFTAZIDIME----------- <=1 S CEFTRIAXONE----------- <=1 S CEFUROXIME------------ 16 I CIPROFLOXACIN--------- =>4 R GENTAMICIN------------ <=1 S IMIPENEM-------------- <=1 S LEVOFLOXACIN---------- =>8 R MEROPENEM-------------<=0.25 S NITROFURANTOIN-------- <=16 S PIPERACILLIN---------- <=4 S PIPERACILLIN/TAZO----- <=4 S TOBRAMYCIN------------ <=1 S TRIMETHOPRIM/SULFA---- <=1 S [**2134-10-14**] 8:39 pm urine/serology **FINAL REPORT [**2134-10-15**]** Legionella Urinary Antigen (Final [**2134-10-15**]): NEGATIVE FOR LEGIONELLA SEROGROUP 1 ANTIGEN. Performed by Immunochromogenic assay. Reference Range: Negative. A negative result does not rule out infection due to other L. pneumophila serogroups or other Legionella species. Furthermore, in infected patients the excretion of antigen in urine may vary. [**2134-10-14**] 11:30 am BLOOD CULTURE **FINAL REPORT [**2134-10-20**]** AEROBIC BOTTLE (Final [**2134-10-20**]): NO GROWTH. ANAEROBIC BOTTLE (Final [**2134-10-20**]): NO GROWTH. [**2134-10-14**] 11:00 am BLOOD CULTURE **FINAL REPORT [**2134-10-20**]** AEROBIC BOTTLE (Final [**2134-10-20**]): NO GROWTH. ANAEROBIC BOTTLE (Final [**2134-10-20**]): NO GROWTH. [**2134-10-15**] 1:01 am STOOL CONSISTENCY: WATERY **FINAL REPORT [**2134-10-15**]** CLOSTRIDIUM DIFFICILE TOXIN ASSAY (Final [**2134-10-15**]): FECES NEGATIVE FOR C. DIFFICILE TOXIN BY EIA. Reference Range: Negative. [**2134-10-15**] 6:32 am STOOL CONSISTENCY: SOFT Source: Stool. **FINAL REPORT [**2134-10-15**]** CLOSTRIDIUM DIFFICILE TOXIN ASSAY (Final [**2134-10-15**]): FECES NEGATIVE FOR C. DIFFICILE TOXIN BY EIA. Reference Range: Negative. Time Taken Not Noted Log-In Date/Time: [**2134-10-15**] 7:24 am ASPIRATE Source: Nasopharyngeal aspirate. VIRAL CULTURE (Preliminary): No Virus isolated so far. Rapid Respiratory Viral Antigen Test (Final [**2134-10-15**]): Respiratory viral antigens not detected. CULTURE CONFIRMATION PENDING. SPECIMEN SCREENED FOR: ADENO,PARAINFLUENZA 1,2,3 INFLUENZA A,B AND RSV. This kit is not FDA approved for direct detection of parainfluenza virus in specimens; interpret parainfluenza results with caution. [**2134-10-19**] 05:14PM CLOSTRIDIUM DIFFICILE TOXIN B ASSAY Results Pending EKG: Sinus Tach at 118, Q waves in II, III, aVF (old), no ST segment depression or elevations, no T wave inversions . Radiology: CXR: Gas distention, mostly in colon results in relatively high-positioned diaphragms obscuring slightly the lung bases. There is, however, no evidence of any acute parenchymal infiltrate in either side of the thorax nor is there evidence of pulmonary congestion. No pneumothorax identified. Heart size difficult to assess, but no gross enlargement suspected. . CT ABDOMEN: 1. Distended loop of sigmoid colon with no transition point is again identified. There is no evidence of obstruction. The diagnosis of [**Last Name (un) **] syndrome should again be considered. There is no evidence of perforation. 2. Bilateral lower lobe dense consolidations consistent with pneumonia or aspiration. 3. Hypodensities within the kidneys are not completely characterized with this non-contrast enhanced-study. . CT HEAD: Extensive encephalomalacic changes are again noted in right parietal and temporal lobes and the left occipital lobe. Hypodensity in the periventricular white matter is also seen in both cerebral hemispheres. Findings are unchanged from the prior examination. There is no new acute intracranial hemorrhage, shift of midline structures, or hydrocephalus. There is a moderate amount of atrophy. Moderate mucosal thickening is seen in the ethmoid sinuses. Soft tissues and osseous structures are normal. . [**2134-10-18**] ECHO: The left atrium is normal in size. There is mild symmetric left ventricular hypertrophy with normal cavity size and systolic function (LVEF>55%). Regional left ventricular wall motion is normal. Right ventricular chamber size and free wall motion are normal. The ascending aorta and arch are mildly dilated. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. Mild (1+) aortic regurgitation is seen. The mitral valve appears structurally normal with trivial mitral regurgitation. There is an anterior space which most likely represents a fat pad. IMPRESSION:Mild symmetric left ventricular hypertrophy with preserved globall and regional biventricular systolic function. Mild aortic regurgitation. . [**10-18**] Abd xray for NGT placement: FINDINGS: A single supine abdominal radiograph reviewed. NG tube overlies the left upper quadrant likely in the stomach. Multiple gas-filled bowel loops are identified, mostly large bowel. No distended small bowel loops are identified. Note is made of particularly distended gas-filled sigmoid colon, relatively unchanged from [**2134-10-14**]. IVC filter, lower lumbar fusion device, and total left prostheses again noted. Surgical clips present in the pelvis. IMPRESSION: Distended air-filled sigmoid unchanged from [**10-14**], [**2133**]. NG tube in stomach. Brief Hospital Course: A/P: 72 y/o male nursing home resident with h/o HTN, h/o CVA, dementia, Ogilve's Syndrome, and h/o aspiration PNA presented with fevers, altered mental status, and cough with upper respiratory congestion, from his nursing home and was intubated for airway protection, and given broad spectrum antibiotics for sepsis. . ICU Course: 1. Sepsis: The initial differential diagnosis included infectious sources from: Respiratory (Institutional Acquired PNA, asp PNA, Influenza, Legionella), GI (given distended abdomen), and GU (though less likely given negative initial U/A, prostate not boggy on exam), decubitus ulcers (less likely given no evidence of cellulitis). He got vanco, levo, clinda, ceftriaxone in ED. - The infection was treated with Vanco to cover MRSA given nursing home dwelling, Levofolxacin for possible GI source/asp PNA, and Flagyl for C.Diff given abd distention/diarrhea. - IJ CVL was placed to help give IV fluids to keep MAP>65 and venous O2 sat >70%. - Blood cultures, urine cultures were sent and blood cultures were negative x2 and the urine culture came back positive for e. coli that was later determined to be resistant to cipro and levofloxacin. Pt was kept on the broad spectrum antibiotics until the culture returned and pt was left on just levofloxacin on HD#3 but was switched to ceftriaxone on HD#4 when the sensitivities showed that the e. coli was resistant to levo and susceptible to ceftriaxone. - Legionella urinary antigen was negative. - Sputum for gram stain, culture, and viral screen was negative - Influenza was ruled out and droplet precautions were removed. - Pt became afebrile HD#2. . 2. Respiratory Distress: Pt was intubated for airway protection given altered mental status. CT showed a possible lower lobe PNA vs Asp PNA. Oxygenation and ventilation were sufficient on pre intubation blood gases. - Pt was originally put on AC ventilation HD#1 and was weaned the next day. Repeat arterial blood gas showed good oxygenation and ventilation. Pt was extubated on HD#2. . 3. Hypernatremia: Pt was severely hypernatremic to 160 on admission. He appeared dry in the ED and received 9 L NS HD#1. Once he was volume repleted (CVP >10), the hypernatremia was slowly corrected with D5 1/2 NS. . 4. Non Gap Acidosis: Primary mild metabolic acidosis with respiratory compensation. Likely renal losses given hypokalemia. No diarrhea was noted. - HCO3 and chemistries were followed and corrected. . 5. Acute Renal Failure: Likely prerenal due to sepsis and was corrected with volume repletion. . 6. Elevated Cardiac Enzymes: Elevated in the setting of sepsis and RF. Trending down with treatment of sepsis, no EKG changes. Likely due to demand ischemia given tachycardia. Enzymes did trend down. EKG showed q waves evident of old infarct. . 7. Transaminitis and elevated Amylase/Lipasewas likely due to tissue hypoxia, and was not high enough for shock liver and with no recent alcohol use and no evidence of biliary tract obstruction to suggest alternate reason for increase. LFTs and anylase and lipase trended down. . 8. Anemia: History of ACD - Iron studies c/w ACD. . 9. Mild Coagulapathy/thrombocytopenia: HIT Antibody neg. DIC labs neg. Likely decreased from inflammatory/infectious process of sepsis. Plt returned to nl at time of discharge. . 10. FEN: Tube feedings started HD#3 through NGT and free water replacement through NGT also to help correct Na. . 11. PPX: SQ heparin, PPI, HOB elevation at 30% ****HD#3 Pt was HD stable and transferred to the floor. **** . 1. Sepsis: Resolved and hemodynamically stable on HD#3. A urinary source was suspected given E.Coli UTI. Blood cultures were negative, Leigonella negative, CXR w/equivocal lower lobe pneumonia. Initially with broad spectrum abx, now HD stable on monotherapy with levofloxacin day 4 (started [**2134-10-14**]). HD#4 e coli from urine was noted to be levofloxacin and cipro resistant but susceptible to everything else and ceftriaxone was started. Pt is to continue on total of 14 day course of ceftriaxone (started [**2134-10-18**]) requiring 10 more days of treatment after discharge. Pt remained afebrile. Pt's BPs remained low in 100-110s but stable. . 2. Altered Mental Status: Baseline disorientation due to dementia. Likely metabolic encephalopathy, hypernatremia. Pt had improving alertness following antibiotics, correction of serum sodium. . 3. Hypernatremia: Pt was severely hypernatremic to 160 on admission and appeared dry in ED. He was s/p 9 L NS on HD#3. The sodium was down-trending to 150 with free water flushes through NGT on HD#3. The pt received a PICC line HD#5 because labs could not be drawn and to help rehydrate the pt more. A right arm PICC was placed in IR. D5W was given at 100cc an hr for 2500cc with 40 of K to help correct his hypernatremia and hypokalemia. HD#6 his labs were wnl. He was maintained on D5 1/2 NS at 125cc/hr with 40mEq of K to keep his labs wnl. Pt was being given free water and K through the NGT also to help correct his electrolyte imbalances, but the NGT came out the evening of HD#5 and was replaced HD#6 and tube feeds and free water replacement were continued. . 4. Acute Renal Failure: Likely prerenal due to sepsis. Improving with fluid hydration. Creatinine down-trending to 1.4 on discharge. . 5. NSTEMI: Elevated in the setting of sepsis and renal failure. Now trending down with treatment of sepsis. no EKG changes. Likely due to demand ischemia given tachycardia. Start b-blocker, aspirin now that HD stable. Check ECHO to eval for systolic [**Last Name (LF) 69556**], [**First Name3 (LF) **]-motion abnormality. Restart low dose metoprolol, ASA, statin. - ECHO done [**10-18**]: Mild symmetric left ventricular hypertrophy with preserved globall and regional biventricular systolic function. Mild aortic regurgitation. . 6. Transaminitis/Chemical Pancreatitis: Likely due to tissue hypoxia, not high enough for shock liver. No recent alcohol use. No evidence of biliary tract obstruction to suggest gallstone pancreatitis. LFTs were consistently returning to baseline. Should be rechecked one week post-discharge to reassess. . 8. Anemia: Pt has a history of anemia of chronic disease and iron studies obtained on this admission were consistent with that diagnosis. His HCT was stable at 30 at time of discharge and his PLT count had returned to [**Location 213**]. . 9. h/o CVA with seizures. Not on antiseizure meds. Plavix was continued for secondary prevention. . 10. h/o dementia: Chronic. Likely conmination of CVA's and organic dementia (evidence of atrophy on CT of head). . 11. h/o Gastritis: PPI was continued. Hct was stable at time of discharge. Stool was guaiac positive. Pt had rectal tube inserted while in ICU that was removed once on the floor. . 12. Bowel distension - Had been noted in past hospitalizations and rectal tube inserted to relieve distention and given a diagnosis of Ogilve's Syndrome. - Rectal exam was grossly positive for blood (pt did have a rectal tube two days prior), no stool impaction noted. - C diff B toxin was sent but was still pending at time of discharge. Stool tested negative for c diff A toxin. - GI suggested aggressive bowel regimen and outpt f/u colonoscopy (pt on home regimen of senna, colace, lactulose). . 13. FEN: - TF down NGT. - NGT came out [**10-17**] and S&S saw and assessed pt prior to new NGT being put in. They recommended pt be NPO as he was not able to handle secretions, and to continue the NGT, TF, suctioning. They recommended reassessing within 1-2wks. - NGT was replaced, xray confirmed placement, TF and free water replacement restarted. . 14. PPX: SQ heparin, PPI . CODE: FULL per son, possibility of pt requiring a PEG tube was discussed as was fact that with each illness and hospitalization, pt's mental status is likely to deteriorate further. . COMMUNICATION: with son, HCP [**Name (NI) **] [**Name (NI) **] cell [**Telephone/Fax (1) 69557**], home [**Telephone/Fax (1) 69558**], work [**Telephone/Fax (1) 69559**] Medications on Admission: Vit D 400 units Daily MVA 1 tablet Daily Clopidogrel 75 mg Daily Propoxy/APAP 100-650 mg with dressing changes Colace 100 mg [**Hospital1 **] Heparin 5,00o units TID Lactulose 30 ml TID Baclofen 5 mg TID Senna 2 Tab QHS Risperdal 0.25 mg QHS Discharge Medications: 1. Lansoprazole 30 mg Tablet,Rapid Dissolve, DR [**Last Name (STitle) **]: One (1) Tablet,Rapid Dissolve, DR [**Last Name (STitle) **] DAILY (Daily). 2. Cholecalciferol (Vitamin D3) 400 unit Tablet [**Last Name (STitle) **]: One (1) Tablet PO DAILY (Daily). 3. Therapeutic Multivitamin Liquid [**Last Name (STitle) **]: One (1) Cap PO DAILY (Daily). 4. Docusate Sodium 150 mg/15 mL Liquid [**Last Name (STitle) **]: One (1) PO BID (2 times a day). 5. Baclofen 10 mg Tablet [**Last Name (STitle) **]: 0.5 Tablet PO TID (3 times a day). 6. Senna 8.6 mg Tablet [**Last Name (STitle) **]: Two (2) Tablet PO HS (at bedtime). 7. Risperidone 0.25 mg Tablet [**Last Name (STitle) **]: One (1) Tablet PO HS (at bedtime). 8. Clopidogrel 75 mg Tablet [**Last Name (STitle) **]: One (1) Tablet PO DAILY (Daily). 9. Metoprolol Tartrate 25 mg Tablet [**Last Name (STitle) **]: 0.5 Tablet PO BID (2 times a day). 10. Aspirin 81 mg Tablet, Chewable [**Last Name (STitle) **]: One (1) Tablet, Chewable PO DAILY (Daily). 11. Atorvastatin 40 mg Tablet [**Last Name (STitle) **]: One (1) Tablet PO HS (at bedtime). 12. Lactulose 10 g/15 mL Syrup [**Last Name (STitle) **]: Thirty (30) ML PO TID (3 times a day). 13. Heparin (Porcine) 5,000 unit/mL Solution [**Last Name (STitle) **]: One (1) Injection TID (3 times a day). 14. Ceftriaxone-Dextrose (Iso-osm) 1 g/50 mL Piggyback [**Last Name (STitle) **]: One (1) gm Intravenous Q24H (every 24 hours) for 10 days. Disp:*10 gm* Refills:*0* 15. Heparin Lock Flush (Porcine) 100 unit/mL Syringe [**Last Name (STitle) **]: Two (2) ML Intravenous DAILY (Daily) as needed. 16. Acetaminophen 325 mg Tablet [**Last Name (STitle) **]: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed for pain. Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - MACU Discharge Diagnosis: urosepsis altered mental status acute renal failure transaminitis/chemical pancreatitis large bowel distention Secondary: dementia amemia Discharge Condition: stable Discharge Instructions: You were admitted for a urinary tract infection that caused you to become septic and hypotensive. You required a stay in the ICU in order to treat your infection and low blood pressure. You needed a lot of fluid resuscitation and antibiotics. You are requiring a nasogastric tube in order to receive nutrition. You will be re-evaluated in approximately a week to see if you are able to safely handle your own secretions. You may be able to have the NGT out at that time. Please notify a doctor if pt experiences: - fever >101.5 - severe abdominal distention - is unable to tolerate tube feedings - severely decreased urine output - severe constipation - breathing difficulties - signs/sx of stroke - changes in mental status - any other questions or concerns Please take all medications as directed. Please follow up with your PCP and GI for your colonoscopy. Followup Instructions: Please follow up with your PCP or the doctor who takes care of you at the rehabilition center within 1-2wks of discharge. You will need to call the gastroenterology department at: [**Telephone/Fax (1) 463**], in order to schedule a colonoscopy to examine your large bowel. If you wish you may also set up an appointment to see a gastroenterologist by calling [**Telephone/Fax (1) 69560**]. [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) **] MD [**MD Number(2) 617**] ICD9 Codes: 0389, 5070, 5849, 5990, 2760, 2762, 2875, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5948 }
Medical Text: Admission Date: [**2172-3-11**] Discharge Date: [**2172-3-16**] Date of Birth: [**2110-7-17**] Sex: M Service: NEUROLOGY Allergies: Penicillins / Shellfish Attending:[**First Name3 (LF) 5018**] Chief Complaint: RIght sided weakness Major Surgical or Invasive Procedure: MRI/MRA TTE History of Present Illness: 61yo M with recent admission for Fournier's gangrene s/p debridement, longstanding DM1, HTN, CRI now presenting with sudden onset nonfluent aphasia and right hemiparesis. He has been doing quite well at home following a prolonged hospitalization one month ago, ambulating without assist, feeling well. Off all antibiotics. His wife heard him yelling upstairs around 4:45pm. She went to him to notice him slumped to his right side and she inquired what was wrong and he reported "I don't know." No apparent speech deficit at that time per wife. taken to [**Hospital3 **] where head CT revealed left thalamic hemorrhage with left posterior [**Doctor Last Name 534**] lateral ventricle spread. The patient given dilantin IV, and was med-flighted to [**Hospital1 18**] for further care. Here the patient has a nonfluent aphasia and cannot provide further history, his speech comprehension is intact and he is quite frustrated by his productive speech deficit. He denies any headache at present. He is aware of his right arm weakness. Denies diplopia. He is now off all antiobiotics and has been afebrile recently. No chills. no SOB. no CP. No diarrhea or constipation of late. No change in urinary habits. no new rashes. Past Medical History: IDDM diagnosed age 10, CRI baseline 2.0, CAD s/p MI [**2165**], HTN, Depression, PVD, Hypercholesterolemia, GERD, OA, Carotid artery disease (L ICA occlusion, R ICA 39% stenosis) PAST SURGICAL HISTORY: s/p CABG x4 [**2-21**], s/p L CFA-AKPop BPG w/ NRSVG [**6-18**], s/p R TMA [**6-17**], s/p R BKPop-Peroneal w/ NRVSG [**4-17**], s/p L cataract [**2166**], R cataract [**2165**] Social History: Married, no alcohol, no tobacco use, no illicit drug use. Family History: Patient with strong family history of DM-I with his father and siblings affected at age < 15, most with chronic sequelae of disease. Father passed away from MI. Physical Exam: T 98, BP 162/85, HR 72, R 18, 100% RA gen- well appearing, cooperative with exam, NAD HEENT- NCAT, MMM, OP clear Neck- no nuchal rigidity, no bruits bilat CV- RRR, no MRG Pulm- CTA B Abd- soft, nt, nd, BS+ Groin/genitalia- granulating tissue with surgical packing, no eschar or apparent purulent discharge. Skin- chronic venous changes, weak distal pulses (1+) but present. -Mental Status: Speech is nonfluent. he follows all midline and appendicular commands. He is Attentive to the exam. he is unable to read. -Cranial Nerves: Olfaction not tested. pupils with slight irregularity barely reactive 3 to 2mm and sluggish. He appears to have a slight R sided field cut to visual threat. There is no ptosis bilaterally. Funduscopic exam revealed multiple cotton wool spots, no hemorrhages, unable to see optic discs. EOMI without nystagmus. No gaze preference. Facial sensation reduced to light touch. Slight R NLF effacement. Hearing intact to finger-rub bilaterally. Palate elevates symmetrically. 5/5 strength in trapezii and SCM bilaterally. Tongue protrudes in midline. -Motor: Normal bulk. No adventitious movements noted. No asterixis noted. prominent right drift. Delt Bic Tri WrE FFl FE IP Quad Ham TA [**First Name9 (NamePattern2) 2339**] [**Last Name (un) 938**] EDB L 5 5 5 5 5 5 5 5 5 5 5 5 5 R 3 4 4 3 4 4 3 5 * * * * * * unable to test -Sensory: Diminished to all modalities on the left. s/p R metatarsal amp. -Coordination: No intention tremor. [**Doctor First Name 6361**] nl on the left. No dysmetria on FNF on the left. -DTRs: [**Name2 (NI) **] Tri [**Last Name (un) 1035**] Pat Ach L 1 1 1 1 0 R 1 1 1 2 0 Plantar response was flexor bilaterally. Pertinent Results: [**2172-3-13**] 06:25AM BLOOD WBC-7.7# RBC-3.77* Hgb-12.0* Hct-34.0* MCV-90 MCH-31.7 MCHC-35.2* RDW-14.4 Plt Ct-343 [**2172-3-12**] 02:03AM BLOOD WBC-4.4 RBC-3.63* Hgb-11.3* Hct-32.2* MCV-89 MCH-31.2 MCHC-35.2* RDW-14.5 Plt Ct-268 [**2172-3-11**] 07:27PM BLOOD WBC-5.4 RBC-3.75* Hgb-11.5* Hct-33.2* MCV-88# MCH-30.7 MCHC-34.7 RDW-14.4 Plt Ct-303 [**2172-3-11**] 07:27PM BLOOD Neuts-61.1 Lymphs-24.1 Monos-8.2 Eos-6.1* Baso-0.6 [**2172-3-13**] 06:25AM BLOOD PT-14.0* PTT-27.5 INR(PT)-1.2* [**2172-3-12**] 02:03AM BLOOD PT-13.3 PTT-28.6 INR(PT)-1.1 [**2172-3-11**] 07:27PM BLOOD PT-13.2 PTT-27.7 INR(PT)-1.1 [**2172-3-12**] 03:50PM BLOOD Glucose-154* UreaN-27* Na-135 K-4.6 Cl-103 HCO3-27 AnGap-10 [**2172-3-11**] 07:27PM BLOOD Glucose-69* UreaN-38* Creat-1.4* Na-134 K-4.8 Cl-99 HCO3-29 AnGap-11 [**2172-3-12**] 02:03AM BLOOD Glucose-103 UreaN-35* Creat-1.1 Na-135 K-7.0* Cl-104 HCO3-29 AnGap-9 [**2172-3-12**] 03:50PM BLOOD CK(CPK)-50 [**2172-3-12**] 02:03AM BLOOD CK(CPK)-51 [**2172-3-13**] 06:25AM BLOOD Calcium-9.3 Phos-3.3 Mg-1.5* [**2172-3-12**] 02:03AM BLOOD Calcium-8.4 Phos-4.1 Mg-1.7 Cholest-115 [**2172-3-12**] 02:03AM BLOOD %HbA1c-7.0* [**2172-3-12**] 02:03AM BLOOD Triglyc-52 HDL-36 CHOL/HD-3.2 LDLcalc-69 CY Head: Left basal ganglia hemorrhage with intraventricular extension and mild mass effect, unchanged in copmarison to CT from approximately two hours prior. MRI Head: Absence of flow signal in the left internal carotid which could be secondary to occlusion in the neck. MRA of the neck can help for further assessment. Faint flow in the left middle cerebral artery secondary to collateral across the circle of [**Location (un) 431**]. Brief Hospital Course: Pt admitted to the Neuro-ICU for further management of his hemorrhage. He was monitored with cardiac telemetry and frequent neuro checks. He had follow-up imaging which revealed stable size of bleed. He was transfered to the neuro step down unit. On the floor he had elevated BP's and was started on his home medications. His blood sugars were markedly elevated and [**Last Name (un) 3208**] was consulted for help with control. He was restarted on his home regemin and a sliding scale. PT/OT and Speech were consulted. Plastics was contact[**Name (NI) **] to help in wound care recs for his recent sacral infection. They recommended wet to dry dressing changes twice a day. His BP improved on his home medications. He continued to imrpove throughout the stay. He will follow-up in stroke clinic as an outpt. Medications on Admission: Aspirin 325mg daily Piroxicam (? paroxitine) 20mg daily Gabapentin 600mg TID metoprolol 50mg [**Hospital1 **] HCTZ 25mg daily Omeprazole 40mg daily Diovan 320mg QPM Atorvastatin 80mg daily temazepam 15mg QHS Protonix 40mg daily Humalin Humalog sliding scale Discharge Medications: 1. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for pain/fever. 2. Atorvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Insulin Regular Human Injection 5. Oxycodone 5 mg Tablet Sig: 1-2 Tablets PO Q8H (every 8 hours) as needed for pain. 6. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 7. Hydrochlorothiazide 12.5 mg Capsule Sig: Two (2) Capsule PO DAILY (Daily). 8. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. Oxycodone 5 mg Tablet Sig: 1-2 Tablets PO Q8H (every 8 hours) as needed for pain. 10. Hydrochlorothiazide 12.5 mg Capsule Sig: Two (2) Capsule PO DAILY (Daily). 11. Valsartan 160 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime). 12. Gabapentin 300 mg Capsule Sig: Two (2) Capsule PO TID (3 times a day). 13. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: Two (2) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 14. Atorvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 15. Temazepam 15 mg Capsule Sig: One (1) Capsule PO HS (at bedtime). 16. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 17. Isosorbide Dinitrate 10 mg Tablet Sig: Two (2) Tablet PO TID (3 times a day). 18. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours) as needed for anxiety. 19. Insulin NPH & Regular Human Subcutaneous Discharge Disposition: Extended Care Facility: [**Hospital3 1107**] [**Hospital **] Hospital - [**Location (un) 38**] Discharge Diagnosis: Left thalamic hemorrhage Discharge Condition: Right hemiparesis, aphasia Discharge Instructions: You were admitted because of a bleed in your brain. It has caused weakness and numbness on your right side and difficulty speaking. You will need rehab after discharge. If you have any new weakness or tingling, please return to the ER. Followup Instructions: Provider: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], MD Phone:[**Telephone/Fax (1) 457**] Date/Time:[**2172-3-20**] 10:00 Provider: [**Name10 (NameIs) 4267**] [**Last Name (NamePattern4) 4268**], MD, PHD[**MD Number(3) 708**]:[**Telephone/Fax (1) 657**] Date/Time:[**2172-4-28**] 3:00 Provider: [**Name10 (NameIs) **] STUDY Phone:[**Telephone/Fax (1) 327**] Date/Time:[**2172-7-1**] 10:00 [**Name6 (MD) 4267**] [**Last Name (NamePattern4) 4268**] MD, [**MD Number(3) 5023**] ICD9 Codes: 431, 5859, 4439, 2720, 311, 412
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5949 }
Medical Text: Admission Date: [**2151-4-2**] Discharge Date: [**2151-4-9**] Date of Birth: [**2084-9-21**] Sex: M Service: Coronary Care Unit ADMISSION DIAGNOSIS: ST-elevation myocardial infarction. HISTORY OF PRESENT ILLNESS: The patient is a 66-year-old male with a past medical history of prostate cancer who is admitted to the [**Hospital1 69**] for a ST-elevation myocardial infarction. The patient reported chest discomfort on the evening prior to admission. He subsequently ate dinner and went outside to shovel snow. At that time, he developed [**7-29**] substernal chest pain that was nonradiating. He denied any shortness of breath, nausea, or vomiting. He denied diaphoresis. The patient was taken to an outside hospital where an electrocardiogram showed ST elevations in the inferior leads. At the outside hospital, the patient was given aspirin, heparin, and morphine. The patient underwent thrombolysis with TNK. He substernal chest pain persisted, and he was transferred to [**Hospital1 69**] for rescue cardiac catheterization. In the Catheterization Laboratory, the patient was found to have a totally occluded distal right coronary artery and diffuse left anterior descending artery disease. Stenting of the right coronary artery led to TIMI-II flow from the midvessel. The patient was randomized to the Cool myocardial infarction protocol. A transvenous pacer was placed in the setting of Wenckebach and bradycardia to the 30s with hypotension. The patient was then transferred to the Coronary Care Unit with an intra-aortic balloon pump and on dopamine. PAST MEDICAL HISTORY: Prostate cancer; status post prostatectomy in [**2150-10-20**]. MEDICATIONS ON ADMISSION: None. ALLERGIES: No known drug allergies. SOCIAL HISTORY: The patient is married. He quit smoking five months prior to admission. FAMILY HISTORY: Family history was unremarkable. REVIEW OF SYSTEMS: No shortness of breath, diabetes, or strokes. PHYSICAL EXAMINATION ON PRESENTATION: Physical examination on admission revealed temperature was 97.8 degrees Fahrenheit, heart rate was 74, blood pressure was 110/68, respiratory rate was 16, and oxygen saturation was 99% with an FIO2 of 40%. The patient was on a dopamine and with an intra-aortic balloon pump. In general, the patient was alert by not oriented. His pupils were dilated. The mucous membranes were moist. There was no lymphadenopathy in the head or neck. The sclerae were anicteric. There were no bruits. The heart sounds revealed normal first heart sounds and second heart sounds. The rate was regular. The chest was clear to auscultation anteriorly. The abdomen was nontender and nondistended. Bowel sounds were present. The extremities revealed no clubbing, cyanosis, or edema. The right groin had an intra-aortic balloon pump. The left groin had a pacer wire with a small hematoma. PERTINENT LABORATORY VALUES ON PRESENTATION: Laboratories revealed white blood cell count was 13.5, hematocrit was 39.7, and platelets were 345. INR was 1.2 and partial thromboplastin time was 26. Sodium was 138, potassium was 3.8, chloride was 103, bicarbonate was 29, blood urea nitrogen was 15, creatinine was 1.2, and blood glucose was 132. Creatine kinase was 1244. MB was 128. ALT was 23, AST was 122, amylase was 196, and alkaline phosphatase was 62. Troponin was greater than 50. Albumin was 3.1. PERTINENT RADIOLOGY/IMAGING: Arterial blood gas showed 7.21/41/82 with a lactate of 54. Electrocardiogram revealed a sinus rhythm at a rate of 70. There was Mobitz type I block. There were persistent ST elevations of 2 mm in leads II, III, and aVF. There were ST depressions of 1 mm in V1 through V5, I, and aVL. HOSPITAL COURSE BY ISSUE/SYSTEM: 1. CARDIOVASCULAR SYSTEM: The patient was admitted to the Coronary Care Unit after cardiac catheterization for an acute inferior ST-elevation myocardial infarction. He returned from the Catheterization Laboratory on a dopamine drip with an intra-aortic balloon pump. The patient was initially maintained on aspirin. Beta blockers and ACE inhibitors were initially held as the patient was requiring pressors on the balloon pump. A lipid profile was checked, and the patient was initially started Lipitor. On the evening of his admission to the Coronary Care Unit, it was noted that his pacer wire was not sensing or pacing. It was subsequently discontinued. The patient's dopamine was weaned off. The patient was then started on a low-dose ACE inhibitor as well as Plavix. A beta blocker was not started as the patient was noted to have a Wenckebach heart block. The patient's intra-aortic balloon pump was weaned from 1:1 to 1:2. The patient underwent an echocardiogram on [**4-4**] which revealed an ejection fraction of 25% with severe global left ventricular hypokinesis. There was akinesis in the inferior, inferolateral, and inferoseptal areas with relative sparing of the apex and anterior walls. The patient was noted to volume overloaded on [**4-3**] and was diuresed with a dose of Lasix. On the evening of [**4-3**], the patient complained of left shoulder pain which was sharp in nature and radiated to the anterior chest wall. The pain was worse with coughing. The patient denied any nausea, vomiting, or shortness of breath at that time. He stated that the pain was different from his pain when he had his myocardial infarction. A STAT echocardiogram was obtained which showed no change from the echocardiogram the day before. A rub was heard at this time. It was felt that the patient was suffering from post myocardial infarction pericarditis. Nonsteroidal antiinflammatory drugs were avoided to treat this given the risk after myocardial infarction. The patient was started on Tylenol. At this time, the patient was also noted to be in atrial fibrillation, and he was started on a heparin drip. The patient was given morphine for his pain at this time and subsequently developed hypotension with a systolic blood pressure of 80. He transiently required dopamine to maintain his blood pressure; however, this was quickly weaned off. The intra-aortic balloon pump was discontinued on [**4-3**]. It was felt that the patient would eventually require a coronary artery bypass graft. The Cardiothoracic Surgery Service was consulted on [**4-4**]. At that time, the patient had developed a cough and a likely pneumonia. Therefore, the Surgery Service felt that it would be best to delay a coronary artery bypass graft until that had resolved. On [**4-4**], the patient was noted to be in atrial flutter with some episodes of Wenckebach and pauses up to four seconds. The patient was maintained on heparin and was eventually transitioned to Coumadin. He remained relatively stable from a cardiovascular point of view and was transferred to the Cardiology floor on [**4-6**]. The patient's pain from his pericarditis resolved on the standing Tylenol regimen. The patient was monitored on telemetry and his pauses resolved. On [**4-8**], the patient was started on a beta blocker. It was felt that the patient should be risk stratified, and an Electrophysiology consultation was obtained. The patient was to follow up with the Electrophysiology Service for risk stratification as an outpatient. The patient underwent a repeat echocardiogram on [**4-8**] which showed an ejection fraction of 30%, with 1+ mitral regurgitation, and inferior hypokinesis. The patient was felt to be safe for discharge home on [**4-9**]. He was to follow up with the Cardiothoracic Surgery Service for coronary artery bypass graft after resolution of his pneumonia. He was also to follow up with the Electrophysiology Service for risk stratification. 2. RENAL ISSUES: Upon admission, the patient was noted to have an anion gap acidosis with an elevated lactate which was felt to be secondary to poor perfusion. The patient improved with improved perfusion with the intra-aortic balloon pump. Repeat arterial blood gases study were normal. 3. INFECTIOUS DISEASE ISSUES: On [**4-4**], the patient was noted to have a cough. He was initially started on azithromycin. A chest x-ray was checked which showed a likely pneumonia, and the patient was then started on levofloxacin. The patient subsequently developed a right-sided pleural effusion associated with his pneumonia which was noted on [**4-7**]. The patient underwent a thoracentesis on [**4-7**]. Analysis of the pleural fluid revealed a white blood cell count of 490, red blood cells of [**Pager number **], neutrophils of 46, lymphocytes of 18, monocytes of 14, with a protein ratio of less than 0.5, and an LDH ratio of less than 0.6. The pH was 7.55. Given the LDH in the fluid, it was sent for cytology to rule out malignancy. At the time of discharge, this was still pending. After his thoracentesis, the patient's respiratory status improved and he was felt to be safe for discharge on [**4-9**]. He was to complete a 14-day course of Levaquin. The patient was to return for coronary artery bypass graft after resolution of his pneumonia. 4. HEMATOLOGIC ISSUES: The patient was noted to have a drop in his hematocrit to 28 from 34 after his cardiac catheterization. He was transfused 2 units of packed red blood cells on [**4-5**]. MEDICATIONS ON DISCHARGE: 1. Aspirin 325 mg p.o. once per day. 2. Plavix 75 mg p.o. once per day. 3. Pravastatin. 4. Captopril 12.5 mg p.o. three times per day. 5. Lopressor 12.5 mg p.o. twice per day. 6. Levofloxacin 500 mg p.o. every day (for a 14-day course). 7. Coumadin 5 mg p.o. once per day. DISCHARGE DIAGNOSES: 1. Status post acute ST-elevation myocardial infarction (involving the inferior area). 2. Cardiogenic shock. 3. Ejection fraction of 30%. 4. Post myocardial infarction pericarditis. 5. Atrial flutter. 6. Pneumonia; complicated by peripneumonic effusion. 7. Lactic acidosis. 8. Prostate cancer; status post prostatectomy in [**2150-3-20**]. DISCHARGE STATUS: The patient was discharged to home. DISCHARGE INSTRUCTIONS/FOLLOWUP: The patient was to complete his course of levofloxacin for his pneumonia and was then to follow up with the Cardiothoracic Surgery team for coronary artery bypass graft in approximately one month's time. [**First Name8 (NamePattern2) 2064**] [**Last Name (NamePattern1) **], M.D. [**MD Number(2) 2139**] Dictated By:[**Last Name (NamePattern1) 222**] MEDQUIST36 D: [**2151-7-8**] 10:43 T: [**2151-7-15**] 19:18 JOB#: [**Job Number 49432**] ICD9 Codes: 486
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Medical Text: Admission Date: [**2148-2-28**] Discharge Date: [**2148-3-4**] Service: SURGERY Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 3200**] Chief Complaint: Abdominal right upper quadrant pain Major Surgical or Invasive Procedure: [**2148-3-2**] Laparoscopic cholecystectomy [**2148-2-29**] ERCP History of Present Illness: 88M hx of CAD s/p MI and [**Name Prefix (Prefixes) **] [**2147-1-20**] off plavix, HTN, HLD, distant bladder Ca [**2137**]. On day of presentation out of his usual state of health noticed mid-epigastric and anterior chest pain that woke him up from his post lunch nap. He described as pressure-like, [**8-28**] starting in mid-epigastrium and radiating to anterior chest. He subsequently developed chills at home. He came to the ED as was concerned that pain was similar to previous MI. Had N w/ V x 1 in the ED waiting room NB/NB. Pain subsided after maalox and gingerail in the ED. Pnt denies diarrhea. Reports relative constipation over the past few weeks. Last BM 1 day prior to presentation. Passing gas normally since. His daughter notice that he has appeared yellow over the past week. He reports 30lb unintentional weightloss over the past 3 months. He denies any chronic abdominal pain, but does mention similar pain 3 weeks ago which resolved with vomiting. Denies feeling more tired than usual. Denies night sweats, fevers or chills except as above. No recent sick contacts or suspicious meals. No recent travel. Pain worse with inspiration. Of note, per his medical chart has ongoing leukocytosis (13-18) of unclear cause for the past several months. . In the ED Initial vitals were 98.6 HR 78 BP 173/73 RR 20 O2 97%, physical exam was notable for jaundice and distended abdomen with mild epigastric tenderness. EKG was unchanged from baseline and trop X1 was negative. Her other labs were notable for Alkp 1112, T.Bili 3.3, ALT/AST = 218/269, Lip =80, WBC = 15.8 with 79% neutrophils. Cr/BUN 1.3/35 was at the lower end of his baseline. RUQ US revealed stones in the gallbladder, a distended CBD 1.5cm with sludge, no ductal stone but distal end was not visualized. Patient was given IV Got IV cipro 400 + flagyl 500mg + IV NS 1000cc. He also ate in the ED w/o N or V. Pnt was seen in the ED by GI who recommended Abx coverage with Unacyn and doing ERCP tomorrow. Past Medical History: - Coronary artery disease s/p NSTEMI with DES to RCA in [**1-29**] at [**Hospital1 18**] (Dr. [**Last Name (STitle) **] - Echo [**4-/2147**]: mod MR, Mod TR, Mod PHTN, LVEF = 45% - Hypertension - Hyperlipidemia - Macular Degeneration - Cataracts - Bladder cancer s/p BCG injection - Depression / anxiety - BPH on finasteride and tamsulosin - Diverticulosis with Hx of GIB [**4-/2147**] - On [**8-/2147**] was hospitalized for syncope and found to have Hct of 24 and guiac positive stools. Pnt refused in house colonoscopy. Was followed as outpatient with subsequent stable hematocrits. - Leukocytosis: per OMR WBC counts have been ranging from 11.8 to 18 since [**4-/2147**], unclear whether this was worked up. Social History: Patient lives with his wife. [**Name (NI) **] has four daughters. [**Name (NI) **] does not drink alcohol. He smoked from ages 19 to 23, approximately 1 PPD. He is independent and very active, does not use any ambulatory devices at baseline. Former Navy. Family History: - Father died of CHF - Mother died of breast cancer - Sister died of lung cancer - No family history of sudden death Physical Exam: Upon presentation to [**Hospital1 18**]: Temp:98.6 HR:78 BP:173/73 Resp:20 O(2)Sat:97 Normal Constitutional: Comfortable HEENT: Normocephalic, atraumatic, Extraocular muscles intact sclera anicteric. Surgical pupils bilat Chest: Clear to auscultation Cardiovascular: Regular Rate and Rhythm, Normal first and second heart sounds Abdominal: Nondistended, Soft epigastric tenderness with guarding no rebound mild right upper quadrant tenderness negative [**Doctor Last Name **] sign GU/Flank: No costovertebral angle tenderness Extr/Back: No cyanosis, clubbing or edema Skin: Warm and dry, No rash Neuro: Speech fluent Pertinent Results: [**2148-2-28**] 09:30PM URINE RBC-[**3-23**]* WBC-0-2 BACTERIA-NONE YEAST-NONE EPI-0 [**2148-2-28**] 08:56PM LACTATE-1.2 [**2148-2-28**] 05:45PM GLUCOSE-147* UREA N-35* CREAT-1.3* SODIUM-136 POTASSIUM-3.8 CHLORIDE-96 TOTAL CO2-28 ANION GAP-16 [**2148-2-28**] 05:45PM ALT(SGPT)-218* AST(SGOT)-269* ALK PHOS-1125* TOT BILI-3.3* [**2148-2-28**] 05:45PM cTropnT-<0.01 [**2148-2-28**] 05:45PM WBC-15.8* RBC-4.00* HGB-11.7*# HCT-35.6* MCV-89 MCH-29.2 MCHC-32.8 RDW-15.4 [**2148-2-28**] 05:45PM NEUTS-79.0* LYMPHS-17.3* MONOS-2.7 EOS-0.6 BASOS-0.4 [**2148-2-28**] 05:45PM PLT COUNT-227 [**2148-2-28**] 05:45PM PT-12.1 PTT-23.8 INR(PT)-1.0 [**2148-2-28**] Gallbladder Ultrasound IMPRESSION: 1. Marked intrahepatic biliary dilatation which is new since the previous study of [**2147-1-21**]. Common bile duct measures up to 1.5 cm, slightly increased in size since the previous study. In addition, echogenic material within the common bile duct likely represents sludge. No discrete duct stone is identified; however, the distal common bile duct is not visualized on this study due to overlying bowel gas. MRCP/ERCP could be performed for further evaluation. 2. Cholelithiasis. [**2148-2-29**] ERCP IMPRESSION: Severe bulging of the major papilla with an impacted stone partially protruding was noted. Pus was noted draining around the impacted stone. A single periampullary diverticulum with large opening was found at the major papilla Cannulation of the biliary duct was performed with a sphincterotome using a free-hand technique Multiple large stones ranging 1-1.5cm in size were noted in the CBD. The CBD was dilated to approximately 18mm diffusely. A sphincterotomy was performed in the 12 o'clock position using a sphincterotome over an existing guidewire. Given the large size of the biliary stones, a sphincteroplasty was performed with a balloon to 12mm. Five large brown stones were extracted successfully using a balloon catheter. No further large filling defects were noted in the CBD, however, given suspicion of smaller stone fragments, A 5cm by 10FR Double pigtail biliary stent was placed successfully. Excellent drainage of contrast and bile was noted Brief Hospital Course: 88M hx of CAD s/p MI and [**Name Prefix (Prefixes) **] [**2147-1-20**] off plavix, HTN, HLD, distant bladder cancer who is admitted with picture concerning for acute cholangitis s/p ERCP with stone removal and sphincterotomy. Patient admitted to the Medicine Service initally; his hospital course as follows per dictation of Medical house staff: . # Ascending cholangitis: He initially presented with RUQ pain, new jaundice, but no fevers. Leukocytosis and CBD dilatation on RUQ U/S. ERCP was performed and several stones were removed, with evidence of purulence around a larged impacted stone. A double pigtail stent was placed and his abdominal pain subsided. He was started on Unasyn and will continue on antibiotics for a 14-day course. He was initially kept NPO for 24 hours, then his diet was advanced slowly, as tolerated. He did not have any recurrence of his epigastric pain. Of note, he has had chronic leukocytosis as of late, which will likely improve now that stones have been removed. Per surgery, the patient was transferred to their service for likely cholecystectomy during this admission. He will return in 6 weeks for an ERCP and stent evaluation. . #. Weight loss: He reported a 30lb weight loss over 3 months. He is otherwise active and feels well beyond the present illness. He did have an episode of gross GIB in [**4-/2147**] which was not investigated. These may warrant malignancy workup focusing on the GI tract if this should be relevant to the patient's wishes and goals of care as an outpatient. . # Coronary artery disease: He is s/p NSTEMI with DES to RCA in 1/[**2147**]. He is off Plaxix. Trop was neg x1 and EKG unchanged from baseline. Suspicion for ACS was low. Once he was no longer NPO, he was restarted on his home aspirin, statin, lisinopril and metoprolol post procedure. . # BPH: His home doses of finasteride and tamsulosin restarted after procedure. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ________________________________________________________________ [**Hospital **] hospital course after care transferred to the Acute Care Surgery Service on [**2148-3-1**]: He underwent ERCP on [**2148-2-29**] with sphincterotomy where large brown stones were extracted successfully. His post-ERCP labs were followed and on [**2148-3-2**] he was taken to the operating room for laparoscopic cholecystectomy without any complications. On POD#1 his diet was advanced for which he is tolerating without any issues. His pain is controlled on oral medication and he is ambulating independedntly. He will follow up in [**Hospital 2536**] clinic in [**2-22**] weeks and with GI in 6 weeks for ERCP and possible stent removal. During her hospitalization the patient was cared for by the rotating acute care surgical service. Medications on Admission: FINASTERIDE - 5 mg Tablet - one Tablet(s) by mouth one daily - No Substitution LISINOPRIL - 5 mg Tablet - one Tablet(s) by mouth one daily - No Substitution METOPROLOL TARTRATE - 25 mg Tablet - one Tablet(s) by mouth twice daily - No Substitution PAROXETINE HCL - 10 mg Tablet - one Tablet(s) by mouth daily - No Substitution SIMVASTATIN - 40 mg Tablet - two Tablet(s) by mouth daily - No Substitution TERAZOSIN - 5 mg Capsule - one Capsule(s) by mouth one daily - No Substitution IRON - 325 mg (65 mg Iron) Capsule, Sustained Release - one Capsule(s) by mouth one daily - No Substitution Discharge Medications: 1. lisinopril 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. finasteride 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. simvastatin 40 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 4. metoprolol tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 5. terazosin 5 mg Capsule Sig: One (1) Capsule PO HS (at bedtime). 6. paroxetine HCl 10 mg Tablet Sig: 1.5 Tablets PO DAILY (Daily). 7. multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. Tylenol 325 mg Tablet Sig: Two (2) Tablet PO every 4-6 hours as needed for pain. 9. oxycodone 5 mg Tablet Sig: 0.5-1 Tablet PO every 4-6 hours as needed for pain. Disp:*20 Tablet(s)* Refills:*0* 10. Colace 100 mg Capsule Sig: One (1) Capsule PO twice a day as needed for constipation. 11. senna 8.6 mg Tablet Sig: 1-2 Tablets PO once a day as needed for constipation. 12. Milk of Magnesia 400 mg/5 mL Suspension Sig: Thirty (30) ML's PO twice a day as needed for constipation. Discharge Disposition: Home Discharge Diagnosis: Cholelithiasis Discharge Condition: Mental Status: Clear and coherent. Activity Status: Ambulatory - Independent. Discharge Instructions: You were admitted to the hospital with gallstones and underwent an operation to remove your gallbladder. You may be discharged on medications to treat the pain from your operation. These medications will make you drowsy and impair your ability to drive a motor vehicle or operate machinery safely. You MUST refrain from such activities while taking these medications. Please call your doctor or return to the emergency room if you have any of the following: * You experience new chest pain, pressure, squeezing or tightness. * New or worsening cough or wheezing. * If you are vomiting and cannot keep in fluids or your medications. * You are getting dehydrated due to continued vomiting, diarrhea or other reasons. Signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * You see blood or dark/black material when you vomit or have a bowel movement. * You have shaking chills, or a fever greater than 101.5 (F) degrees or 38(C) degrees. * Any serious change in your symptoms, or any new symptoms that concern you. * Please resume all regular home medications and take any new meds as ordered. Activity: No heavy lifting of items [**11-2**] pounds for 6 weeks. You may resume moderate exercise at your discretion, no abdominal exercises. Wound Care: You may shower, no tub baths or swimming. If there is clear drainage from your incisions, cover with clean, dry gauze. Your steri-strips will fall off on their own. Please remove any remaining strips 7-10 days after surgery. Please call the doctor if you have increased pain, swelling, redness, or drainage from the incision sites. Followup Instructions: Follow up in [**Hospital 2536**] clinic in [**2-22**] weeks, call [**Telephone/Fax (1) 600**] for an appointment. Follow up with [**Name6 (MD) **] [**Name8 (MD) 84650**], MD, Gastroenterology in 6 weeks for ERCP and for evaluation of removal of biliary stent and re-evaluate biliary tree. Call [**Telephone/Fax (1) 13246**] for an appointment. The following appointment was made prior to your hospital stay; if you are unable to keep this appointment you [**First Name8 (NamePattern2) **] [**Doctor First Name **] to contact the provider to cancel/reschedule: Provider: [**First Name8 (NamePattern2) 3296**] [**Last Name (NamePattern1) 3297**],[**First Name7 (NamePattern1) 3295**] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] IM (NHB) Date/Time:[**2148-3-6**] 2:30 Completed by:[**2148-3-4**] ICD9 Codes: 0389, 412, 4019
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Medical Text: Admission Date: [**2147-4-5**] Discharge Date: [**2147-4-11**] Date of Birth: [**2070-6-27**] Sex: F Service: CARDIOTHORACIC Allergies: Codeine / Morphine / Pentothal / Percodan / Talwin Attending:[**First Name3 (LF) 1283**] Chief Complaint: DOE/ presyncopal events Major Surgical or Invasive Procedure: [**2147-4-5**] - AVR with 21 mm CE pericardial valve History of Present Illness: 76 yo female with several episodes of pre-syncope while dancing . Has DOE and ETT was positive. Echo revealed AS with normal EF. Cath showed severe AS with [**Location (un) 109**] 0.6 cm2, minimal CAD, AV gradient 56 mm mean. Referred to Dr. [**Last Name (STitle) 1290**] for AVR Past Medical History: AS HTN elev. chol. NIDDM diverticulosis hiatal hernia obesity PNA X 3 PSH: C-sections x3, right TKR, chole, bladder suspension with urethral sling,appy,coccygectomy, Social History: lives with husband quit smoking 30 years ago rare ETOH Family History: brother had CABG at age 66 mother/brother/sister with CHF Physical Exam: HR 88 RR 16 BP 106/60 5'3" 195# NAD no jaundice EOMI, carotid bruits versus transmitted AS murmur CTAB 3/6 SEM radiates throughout precordium abdomen midline scar 2+ radial/DP/PT pulses RKR scar no varicosities neuro nonfocal Pertinent Results: [**2147-4-7**] 05:40AM BLOOD WBC-15.3* RBC-2.66* Hgb-7.9* Hct-23.5* MCV-88 MCH-29.7 MCHC-33.6 RDW-15.6* Plt Ct-126* [**2147-4-9**] 09:25AM BLOOD Hct-30.9*# [**2147-4-7**] 05:40AM BLOOD Plt Ct-126* [**2147-4-11**] 05:49AM BLOOD UreaN-11 Creat-0.6 K-4.0 [**2147-4-9**] 09:25AM BLOOD Mg-2.0 [**2147-4-9**] CXR Small left-sided effusion. Status post aortic valve replacement. No consolidation demonstrated. [**2147-4-5**] ECHO PRE-CPB: No spontaneous echo contrast is seen in the left atrial appendage. Left ventricular wall thickness, cavity size, and systolic function are normal (LVEF>55%). Right ventricular chamber size and free wall motion are normal. There are simple atheroma in the descending thoracic aorta. There are three aortic valve leaflets. The aortic valve leaflets are severely thickened/deformed. Mild to moderate ([**1-30**]+) aortic regurgitation is seen. The mitral valve appears structurally normal with trivial mitral regurgitation. Moderate [2+] tricuspid regurgitation is seen. There is no pericardial effusion. Insufficient time to measure MV or AO valve gradient/area before beginning CPB. LVOT = 1.8. Annulus = 2.2. Post-CPB: Well seated and functioning aortic valve prosthesis. No leak, no AI. Other parameters remain as pre-bypass. Intact aorta. Good biventricular systolic function. [**Last Name (NamePattern4) 4125**]ospital Course: Mrs. [**Known lastname **] was admitted to the [**Hospital1 18**] on [**2147-4-5**] for surgical management of her aortic valve disease. She was taken to the operating room where she underwent an aortic valve replacement utilizing a 21mm pericardial valve. Postoperatively she was taken to the cardiac surgical intensive care unit. On postoperative day one, she awoke neurologically intact and was extubated. She was then transferred to the cardiac surgical step down unit for further recovery. Mrs. [**Known lastname **] was gently diuresed towards her preoperative weight. The physical therapy service was consulted for assistance with her postoperative strength and mobility. Her pacing wires and drains were removed per protocol without incident. On postoperative day five, Mrs. [**Known lastname **] had a fever spike. She was pan cultured and empirically started on ciprofloxacin.Her urine culture was positive for E.Coli and ciprofloxacin was continued. She complained of numbness of her right lateral thigh which improved slowly. It was presumed that this was related to a right lateral femoral cutaneous nerve neuropathy likely from positioning. Mrs [**Known lastname **] continued to make steady progress and was discharged home on postoperative day six. She will follow-up with Dr. [**Last Name (Prefixes) **], her cardiologist and her primary care physician as an outpatient. Medications on Admission: zocor 40 mg daily glucotrol 5 mg daily zestril 10 mg daily ASA daily fish oil daily folic acid daily Vit. C daily Discharge Medications: 1. Glipizide 5 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). Disp:*30 Tablet(s)* Refills:*2* 2. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day) for 1 months. Disp:*60 Capsule(s)* Refills:*0* 4. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 5. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) for 1 months. Disp:*60 Tablet(s)* Refills:*0* 6. Furosemide 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) for 5 days. Disp:*10 Tablet(s)* Refills:*0* 7. Hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*40 Tablet(s)* Refills:*0* 8. Metoprolol Tartrate 100 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 9. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) for 1 months. Disp:*60 Tablet(s)* Refills:*0* 10. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 11. Lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 12. Ferrous Gluconate 300 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 13. Ciprofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours) for 5 days. Disp:*10 Tablet(s)* Refills:*0* 14. Potassium Chloride 20 mEq Packet Sig: One (1) PO BID (2 times a day) for 5 days. Disp:*10 * Refills:*0* Discharge Disposition: Home With Service Facility: [**Location (un) 6138**] VNA Discharge Diagnosis: s/p AVR AS elev. chol. HTN UTI NIDDM diverticulosis GERD hiatal hernia obesity s/p bladder suspension Discharge Condition: stable Discharge Instructions: 1) You may shower and pat wound dry 2) No lotions, creams or powders on incisions 3) No driving for one month 4) No lifting greater than 10 pounds for 10 weeks 5) Call for fever, redness, or drainage 6) Take lasix with potassium for five days then stop. 7) Take ciprofloxacin for five days then stop. 8) Take vitamin C and iron for 1 month and stop. 9) Call with any questions or concerns. Followup Instructions: see Dr. [**Last Name (STitle) 1290**] in the office in 4 weeks [**Telephone/Fax (1) 170**] see Dr. [**Last Name (STitle) 58201**] in [**1-30**] weeks see Dr. [**Last Name (STitle) 5310**] in [**3-3**] weeks Completed by:[**2147-4-28**] ICD9 Codes: 4241, 5180, 5990, 4019, 2720
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Medical Text: Admission Date: [**2110-1-6**] Discharge Date: [**2110-1-14**] Date of Birth: [**2057-11-19**] Sex: F Service: Cardiovascular Surgery HISTORY OF PRESENT ILLNESS: This is a 52 year old female patient with worsening dyspnea on exertion. Her workup has revealed significant aortic stenosis. Cardiac catheterization also revealed 70% occlusion of her left main coronary artery, and she was referred for a coronary artery bypass as well as aortic valve replacement. PAST MEDICAL HISTORY: Significant for aortic stenosis, gastroesophageal reflux disease, hypercholesterolemia, asthma, and osteoporosis. The patient has had Hodgkin's disease as a teenager which was treated with x-ray therapy as well as chemotherapy. She has hyperthyroidism treated with Iodine therapy. She has a history of ovarian cancer. In [**2096**] she underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy. She is status post splenectomy, status post appendectomy, status post right thigh lipoma, she has a remote smoking history. MEDICATIONS ON ADMISSION: Synthroid 150 mcg alternating with 125 mcg. Lipitor 20 mg p.o. q.d. Omeprazole 20 mg p.o. q.d. Claritin 10 mg p.o. q.d. TUMS, Miacalcin nasal spray. Hycosamine cough syrup prn. Serevent 2 puffs b.i.d. Flovent 2 puffs b.i.d. Rhinocort b.i.d. as well. ALLERGIES: Penicillin, Sulfa, Entex, Amoxicillin and Lescol. HOSPITAL COURSE: Cardiac catheterization revealed a left ventricular end diastolic pressure of 24 and aortic valve area of 0.79 with 2+ aortic regurgitation, a left ventricular ejection fraction of 49%, 2+ mitral regurgitation and 70% left main coronary artery occlusion. The patient was an outpatient admission directly to the Preoperative Holding Area. She went to the Operating Room on [**2110-1-6**] where she underwent an aortic valve replacement with a #21 [**Last Name (un) 3843**]-[**Doctor Last Name **] pericardial valve. She also had ascending aortic graft in the super coronary position which was the #22 Gel-weave graft. She also underwent coronary artery bypass graft times two with left internal mammary artery to the left anterior descending and the saphenous vein to the obtuse marginal. Postoperatively she was on Levophed and transported from the Operating Room to the Cardiac Surgery Recovery Unit in good condition. The night of surgery the patient was weaned from mechanical ventilation and successfully extubated. The following morning, the patient was noted to have noncapture of her atrial and epicardial wires requiring pacing and she had a Mobitz II second degree heartblock. For this reason the Electrophysiology Service was consulted and after some manipulation of her epicardial pacing wires as well as the pacemaker itself they did have adequate capture and they continued to follow the patient. The patient remained in the Intensive Care Unit for the next 48 hours or so. On postoperative day #2 the patient was noticed to be in normal sinus rhythm with a rate in the 90s. The electrophysiology Service signed off of her case and they felt it was very unlikely that she would need any further intervention as far as the heartblock or rhythm issue. her chest tubes were discontinued on postoperative day #2 as well. On postoperative day #3 the patient remained hemodynamically stable. She was on no vasoactive drips. She was in normal sinus rhythm with a rate of approximately 100 and blood pressure was 1-teens/50s on 2 liters of nasal cannula, her oxygen saturation was 94% and she as initiated on Lopressor and did not have any detrimental blocking effect from that. The patient was ultimately transferred on postoperative day #3 to the Telemetry Floor from the Cardiac Surgery Recovery Unit. The patient had a physical therapy evaluation and was begun on increasing mobility and cardiac rehabilitation. On postoperative day #4 the patient remained asymptomatic, she remained on a 2 liter nasal cannula with stable vital signs. She was continuing with diuresis and physical therapy was progressing her from an ambulation standpoint. The following day, postoperative day #5, the patient remained on Bumex for diuresis. She remained on Lopressor 25 mg b.i.d. and was progressing well from a rehabilitation standpoint, although she was not yet ambulating independently. Over the next couple of days, the patient continued to progress although was noted to have significant diarrhea, on postoperative day #6 Clostridium difficile cultures were sent and ultimately were negative, however, her symptoms did improve once she was started on Flagyl orally. Today, postoperative day #8, [**1-14**], the patient remains in good condition and ready to be discharged home. Her condition today reveals she is afebrile with normal sinus rhythm with a rate in the 60s. Her blood pressure is 104/51. She is on room air with an oxygen saturation of 92%. Her weight today is 64 kg which is up marginally from her preoperative weight of 60 kg. On physical examination her wounds are clean, dry and intact. Her cardiac examination is regular rate and rhythm. Her lungs are clear to auscultation bilaterally. Her abdomen is soft, nontender. She still has 1 to 2+ edema bilaterally in both of her feet. The patient has a chest x-ray pending from today, this has not yet been obtained. The most recent laboratory values are from today [**2110-1-14**], which revealed a white blood cell count of 16,900 which is down from 17.1 which was previously 20. Today her hematocrit is 28.4, her platelet count is 492,000. Her most recent potassium is from [**1-13**] which was 4.0. DISCHARGE MEDICATIONS: 1. Aspirin 325 mg p.o. q.d. 2. Metoprolol 25 mg p.o. b.i.d. 3. Tylenol #3 q. 4-6 hours prn pain 4. Prilosec 20 mg p.o. q.d. 5. Lipitor 20 mg p.o. q.d. 6. Salmeterol inhaled b.i.d. 7. Flovent inhaled b.i.d. 8. Synthroid 150 mcg alternating with 125 mg every other day 9. Multivitamin 10. Ferrous Sulfate and zinc 11. Bumex 1 mg p.o. t.i.d. 12. Potassium chloride 20 mEq p.o. b.i.d. 13. Flagyl 500 mg p.o. t.i.d. times one more week 14. Colace 100 mg p.o. b.i.d. as long as needed 15. She is also using Lidocaine and Chlorhexidine mouthwash prn 16. She has Ativan prn as well for anxiety DISCHARGE CONDITION: Good. DISCHARGE DIAGNOSIS: 1. Aortic stenosis, status post aortic valve replacement 2. Coronary artery disease, status post coronary artery bypass graft [**Doctor Last Name 412**] [**Last Name (Prefixes) 413**], M.D. [**MD Number(1) 414**] Dictated By:[**Name8 (MD) 964**] MEDQUIST36 D: [**2110-1-14**] 12:14 T: [**2110-1-14**] 12:58 JOB#: [**Job Number 30571**] ICD9 Codes: 2449
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Medical Text: Admission Date: [**2199-4-29**] Discharge Date: [**2199-5-6**] Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 7651**] Chief Complaint: worsening shortness of breath Major Surgical or Invasive Procedure: Cor Valve placement History of Present Illness: Patient is a [**Age over 90 **]yo male with hx CAD s/p CABG x1([**2173**]), PCI ([**2185**]), afib, dual chamber PPM, CVA, renal insufficiency s/p rt renal artery stent, carotid disease, with known aortic stenosis s/p valvuloplasy ([**8-/2197**]) who presents with symptoms of shortness of breath after slowly walking 1 block, inability to climb stairs without stopping due to shortness of breath. He denies chest pain, lightheadedness. Past medical history includes B-cell lymphoma for which he was treated with chemotherapy, no radiation, now in remission ([**2192**]). He was seen 4 months prior for evaluation for aortic treatment options and was found to be of prohibitively high risk for surgical AVR. He was considered for [**Year (4 digits) 10723**]/TAVR but did not meet criteria for available high risk arm of study. He has been stable on medical management, however, his family notes a decline in function and worsening fatigue over the last 3 weeks. He admits to frequent naps, and shortness of breath after walking 20 feet. He was again seen and evaluated for conventional surgical AVR. He was deemed of prohibitive surgical risk due to advance age and comorbidities. After informed consent and extensive discussions with patient and his son and daughter, he was screened for the [**Name (NI) 10723**]/TAVR continued access extreme risk arm of the study. He met all inclusion criteria, and did not meet any of the exclusion criteria. He was screened and accepted and now returns for elective [**Name (NI) 10723**]/TAVR. NYHA Class: III Past Medical History: CAD, s/p CABG in [**2173**] [**2185**] s/p Cx stenting Atrial fibrillation [**Company 1543**] Adapta dual-chamber pacemaker Aortic stenosis - s/p valvuloplasty [**8-/2197**] Renal artery stenosis, s/p left renal artery stenting [**5-22**] Hypertension ? Hyperlipidemia Hypothyroidism CVA, TIA x 2 s/p remote inguinal hernia repair Cataract surgery Hard of hearing [**2192**]: Large cell Lymphoma, s/p R-CHOP (completed treatment in [**9-21**]). Currently in remission right axillary node dissection tonsillectomy Social History: Patient lives alone in [**Location (un) **], CT. He lives close to his daughter, [**Name (NI) **] [**Name (NI) 24715**], who is his primary caretaker. [**Name (NI) **] denies any hx of smoking, EtOH, or drug use Family History: Family History: Brother died of an MI in his late 50's-early 60s. Sister died of a heart condition her 60's. Physical Exam: Physical Exam on Admission: Pulse: 66 B/P: 96/50(right) 90/50(left) Resp: 18 O2 Sat: 99 Temp: 97.8 Height: Weight: 170 lbs General: alert, pleasant well-developed elderly male in NAD at rest. Noticealbly SOB with ambulation Skin: color pale pink, skin warm and dry, well healed sternal incisional scar, no lesions. HEENT: normocephalic, anicteric, good dentition, oropharynx moist, upper bridge. Carotid bruits vs. referred murmer Neck: supple, trachea midline, carotid bruits vs. referred murmer Chest: prominent clavicles, well healed sternotomy Heart: murmer throughout Abdomen: soft, nontender,nondistended, (+)BS, 80%meal intake Extremities: no peripheral edema, no obvious deformities Neuro: pleasant, A+Ox3, gross FROM Pulses: palpable peripheral pulses. Physical Exam on Discharge: Tmax/Tcurrent: 98.5/98.5 HR: 74 RR: 20 BP: 116-127/51-57O2 sat: 98% RA I/O: 24h: 940/850 8H; none General Appearance: No acute distress, AAOx2 Eyes / Conjunctiva: PERRL Cardiovascular: [**1-21**] sys murmur with 3/6 diastolic murmur, +s1 and s2, no JVD seen Peripheral Vascular: 2+ DP Respiratory / Chest: CTAB Abdominal: Soft, Non-tender Extremities: no edema Skin: intact Neurologic: Attentive, Follows simple commands, strength 5/5 upper and lower extremeties, speech clear, no focal defecits. Pertinent Results: Labs on Admission: [**2199-4-29**] 01:10PM WBC-3.6* RBC-3.23* HGB-8.9* HCT-28.9* MCV-90 MCH-27.6 MCHC-30.8* RDW-17.2* [**2199-4-29**] 01:10PM GLUCOSE-72 UREA N-32* CREAT-1.6* SODIUM-136 POTASSIUM-4.5 CHLORIDE-105 TOTAL CO2-23 ANION GAP-13 [**2199-4-29**] 01:10PM ALT(SGPT)-13 AST(SGOT)-22 CK(CPK)-32* ALK PHOS-127 TOT BILI-0.7 [**2199-4-29**] 01:10PM proBNP-6595* [**2199-4-29**] 01:10PM ALBUMIN-3.4* [**2199-4-29**] 01:10PM PT-14.6* PTT-31.7 INR(PT)-1.4* [**2199-4-29**] 01:08PM URINE COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.015 [**2199-4-29**] 01:08PM URINE BLOOD-NEG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-NEG Imaging: Chest x-ray pre op There is interval increase in right pleural effusion, currently moderate. Small amount of left pleural effusion is new as well. Patient is in mild interstitial edema. Heart size and mediastinum are unremarkable. Pacemaker leads terminate in the expected location of right atrium and right ventricle. TTE [**2199-4-30**] There is moderate symmetric left ventricular hypertrophy. The left ventricular cavity size is normal. Overall left ventricular systolic function is normal (LVEF>55%). Right ventricular chamber size is normal. with mild global free wall hypokinesis. An aortic [**Month/Day/Year **] prosthesis is present. The transaortic gradient is normal for this prosthesis. A paravalvular aortic valve leak is probably present. Moderate to severe (3+) aortic regurgitation is seen (with holodiastolic flow reversal demonstrated in the descending thoracic aorta in suprasternal notch views). The mitral valve leaflets are mildly thickened. Mild to moderate ([**12-17**]+) mitral regurgitation is seen. Moderate [2+] tricuspid regurgitation is seen. There is borderline pulmonary artery systolic hypertension. There is no pericardial effusion TTE [**2199-5-1**] Overall left ventricular systolic function is normal (LVEF>55%). An aortic [**Month/Day/Year **] prosthesis is present. The prosthesis is well seated with thin/mobile leaflets and normal gradients. An eccentric anterior perivalvular jet of at least mild (1+) aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Mild to moderate ([**12-17**]+) mitral regurgitation is seen. Moderate [2+] tricuspid regurgitation is seen. There is moderate pulmonary artery systolic hypertension. There is an anterior space which most likely represents a prominent fat pad. Compared with the prior study (images reviewed) of [**2199-4-30**], the severity of aortic regurgitation is now reduced. The other findings are similar. TTE [**2199-5-2**] Overall left ventricular systolic function is normal (LVEF 70%). An aortic [**Month/Day/Year **] prosthesis is present. A paravalvular aortic valve leak is present at the aorticopulmonic crux/septum. The [**Month/Day/Year **] stent may not be fully expanded at the aorticopulmonic crux/septum. A component of intravalvular regurgitation cannot be excluded. The aortic regurgitation appears moderate (2+) by color flow Doppler. Compared with the findings of the prior study (images reviewed) of [**2199-5-1**], the appearance of aortic regurgitation by color flow Doppler is increased. TTE [**2199-5-3**] The right atrium is moderately dilated. There is mild symmetric left ventricular hypertrophy. The left ventricular cavity size is normal. Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. Overall left ventricular systolic function is normal (LVEF>55%). An aortic [**Month/Day/Year **] prosthesis is present. Mild to moderate ([**12-17**]+) aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. Mild to moderate ([**12-17**]+) mitral regurgitation is seen. The tricuspid valve leaflets are mildly thickened. There is mild pulmonary artery systolic hypertension. There is no pericardial effusion. Compared with the prior study (images reviewed) of [**2199-5-2**], no change. TTE [**2199-5-6**]: PRELIM: The estimated right atrial pressure is 0-5 mmHg. Overall left ventricular systolic function is low normal (LVEF 50-55%). Moderate (2+) aortic regurgitation is seen. Moderate (2+) mitral regurgitation is seen. Moderate [2+] tricuspid regurgitation is seen. There is no pericardial effusion. DISCHARGE LABS: [**2199-5-6**] 07:22AM BLOOD WBC-5.2 RBC-3.11* Hgb-8.7* Hct-29.0* MCV-94 MCH-28.0 MCHC-29.9* RDW-18.3* Plt Ct-182 [**2199-5-6**] 07:22AM BLOOD PT-20.8* PTT-34.1 INR(PT)-2.0* [**2199-5-6**] 07:22AM BLOOD Glucose-75 UreaN-31* Creat-1.2 Na-136 K-4.6 Cl-105 HCO3-22 AnGap-14 [**2199-5-4**] 04:42AM BLOOD ALT-11 AST-30 LD(LDH)-283* AlkPhos-147* TotBili-0.9 [**2199-5-6**] 07:22AM BLOOD Calcium-8.0* Phos-3.0 Mg-2.2 [**2199-5-6**] 07:22AM BLOOD proBNP-2941* Brief Hospital Course: [**Age over 90 **] year old male with severe aortic stenosis s/p [**Age over 90 **] placement x 2 c/b AR. # Aortic stenosis s/p [**Age over 90 **]: 2 corevalves were placed due to complicated aortic anatomy. He received 2 units PRBC during procedure for bleeding. Patient was hemodynamically stable upon arrival to CCU, briefly requiring phenylephrine. He received a third unit PRBC on arrival to CCU for Hct 25 and bumped appropriately, after which his Hct stabilized and he required no further transfusions. He was extubated the same evening he arrived to the CCU. Bedside echo post-procedure showed moderate to severe aortic regurgitation. After groin hemostasis was achieved, he was started on a heparin drip. CK and LFTs checked 8 hours post-procedure were normal. He was monitored for PAD pressures with swan ganz catheter and gently diuresed for pressures consistently > 25. HR optimized already by pacemaker. blood pressure was optimized with nitro gtt (for HTN) and phenylephrine gtt (for hypotension) per study protocol during the post-op period. Pt was quickly weaned off the drips and remained hemodynamically stable. Swan ganz removed on POD#2. Repeat echo on POD#4 showed mild to mod aortic regurgitation and on POD#6 showed mod AR. Pt felt well so was discharged. Per pt, his son lives next door and visits daily, so would be able to help out at home and with medications if needed. # AR: expected to improved somewhat post-procedure as pt stabilizes out. He remained hemodynamically stable and repeat echo did show some improvement in AR. Immediately post-procedure, AR was measured as mod to severe, while subsequent measurements were graded as mild to mod vs mod. Optimized BP and HR as above to manage this. # Anemia: pt lost approximately one liter of blood during procedure, received 3 units with appropriate increase to Hct 31.Pt also experienced some oozing at the site of his neck catheter and was thought to have a hematoma there. patient was a difficult cross match so 6 units were matched prior to his arrival and another 3 after he required 3 units PRBC post-procedure. He stabilized, however, so received only a total of 3 units. # CAD: s/p CABG in [**2173**] with patent LIMA-LAD: continued ASA. restarted metoprolol on POD#1. held lisinopril due to contrast load and expectation of contrast nephropathy. started 2.5mg lisinopril daily on [**5-4**]. # Afib/ pacemaker: held coumadin for procedure and started pt on heparin drip after groin hemostasis achieved. When Hct stable and there was no evidence of bleeding at the swan ganz catheter site, coumadin was restarted at home dose with heparin subQ for DVT ppx. pacemaker interrogated prior to procedure. # confusion: pt intermittently experienced mild confusion at night and in early AM in ICU, thought to be mild delirium [**1-17**] pt not sleeping well at night. He cleared during the day as was AAOx3. On the day of discharge, he admitted to feeling like he "wasn't sure what was going on" and noted that his surroundings just seemed unfamiliar. However, he was AAOx3 at this time and could still say he was in the hospital for [**Month/Day (2) **]. Pt thought to benefit most by getting home to familiar environment. Assurances were made that family would be present and closely monitor the patient once he went home (they live next door). # Hypertension: restarted metoprolol on POD#2 as above # Hyperlipidemia: continued pravastatin # h/o renal artery stenosis: s/p stenting so pt started on lisinopril as above for HTN/cardioprotection # foley catheter: nurse had trouble getting foley out on POD#3. It was lodged at urethral opening and balloon would not fully deflate. called urology. they said to pull really hard on empty syringe attached to balloon's port and if it would not deflate to just pull the foley. said they would not do anything beyond that so instructed them the primary team could go forward with their suggestions. able to deflate the balloon a little more with large empty syringe but it never fully deflated and a small ridge persisted where the balloon was supposed to fully deflate. pulled foley without any apparent complications. nurse filed incident report on the device. TRANSITIONAL ISSUES: - follow up AR with hemodynamic monitoring and echo - f/u with Dr. [**Last Name (STitle) **] re: [**Last Name (STitle) **] protocol s/p discharge - f/u patient status at home for safety Medications on Admission: Levothyroxine 100 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). Metoprolol tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). Pravastatin 20 mg Tablet Sig: Four (4) Tablet PO DAILY (Daily). Dipyridamole-aspirin 200-25 mg Cap, ER Multiphase 12 hr Sig: One (1) Cap PO DAILY (Daily). Escitalopram 10 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day. Warfarin 2 mg Tablet Sig: Two (2) Tablet PO Once Daily at 4 PM - discontinued 5 days ago Discharge Medications: 1. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). Disp:*30 Tablet, Chewable(s)* Refills:*0* 2. escitalopram 20 mg Tablet Sig: One (1) Tablet PO once a day. 3. levothyroxine 100 mcg Tablet Sig: One (1) Tablet PO once a day. 4. pravastatin 80 mg Tablet Sig: One (1) Tablet PO once a day. 5. warfarin 4 mg Tablet Sig: One (1) Tablet PO once a day. 6. furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day. 7. potassium chloride 20 mEq Tablet, ER Particles/Crystals Sig: One (1) Tablet, ER Particles/Crystals PO once a day. 8. lisinopril 5 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). Disp:*15 Tablet(s)* Refills:*2* 9. metoprolol succinate 25 mg Tablet Extended Release 24 hr Sig: One (1) Tablet Extended Release 24 hr PO DAILY (Daily). Disp:*30 Tablet Extended Release 24 hr(s)* Refills:*2* Discharge Disposition: Home With Service Facility: VNA of Southeast [**State 2748**] Discharge Diagnosis: aortic stenosis coronary artery disease hypertension Discharge Condition: Mental Status: Confused - sometimes. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: Dear Mr. [**Known lastname 24716**], It was a pleasure caring for you. You were admitted to the [**Hospital1 1535**] for treatment of your aortic valve disease. You received a [**Hospital1 **] replacement of your aortic valve and needed to have the new valve replaced within 24 hours. It now appears to be functioning well. It is important for you to follow-up closely with your cardiologist and to take all of your medications as prescribed. Weigh yourself every morning, call Dr. [**Last Name (STitle) 24717**] if weight goes up more than 3 lbs in 1 day or 5 pounds in 3 days. Please get your INR checked when you see Dr. [**Last Name (STitle) 24717**] this week. . We have made the following changes to your medication regimen: 1. STOP taking Aggrenox 2. START taking a baby aspirin daily 3. Change metoprolol to a long acting version that you only need to take once a day, stop taking the twice daily metoprolol 4. START lisinopril to lower your blood pressure and help your heart pump better Followup Instructions: . Department: CARDIAC SERVICES When: MONDAY [**2199-6-17**] at 9:00 AM With: DEVICE CLINIC [**Telephone/Fax (1) 62**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage . Name: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 24718**], MD Specialty: Primary Care Provider [**Name Initial (PRE) **]: Thursday [**5-9**] at 11:15am Address: 27 [**Location (un) 24719**] DR, [**Location (un) **],[**Numeric Identifier 24720**] Phone: [**Telephone/Fax (1) 24721**] Please get your INR checked at this visit . Department: CARDIAC SERVICES When: THURSDAY [**2199-5-30**] at 3:40 PM With: [**First Name8 (NamePattern2) **] [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], MD [**Telephone/Fax (1) 62**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage ICD9 Codes: 4241, 2930, 2851, 4280, 2449, 2724
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Medical Text: Admission Date: [**2167-4-20**] Discharge Date: [**2167-4-28**] Date of Birth: [**2103-2-26**] Sex: F Service: ORTHOPAEDICS Allergies: morphine Attending:[**First Name3 (LF) 3190**] Chief Complaint: Back pain Major Surgical or Invasive Procedure: L3-S1 anterior spinal fusion [**2167-4-20**] T10-S1 posterior spinal fusion [**2167-4-21**] History of Present Illness: Ms. [**Known lastname **] has a long history of back pain due to scoliosis. She is electing to proceed with surgical intervention. Past Medical History: HTN hyperlipidemia hypothyroidism arthritis gout GERD scoliosis Social History: Denies tobacco Family History: N/C Physical Exam: A&O X 3; NAD RRR CTA B Abd soft NT/ND BUE- good strength at deltoid, biceps, triceps, wrist flexion/extension, finger flexion/extension and intrinics; sensation intact C5-T1 dermatomes; - [**Doctor Last Name 937**], reflexes symmetric at biceps, triceps and brachioradialis BLE- good strength at hip flexion/extension, knee flexion/extension, ankle dorsiflexion and plantar flexion, [**Last Name (un) 938**]/FHL; sensation intact L1-S1 dermatomes; - clonus, reflexes symmetric at quads and Achilles Pertinent Results: [**2167-4-25**] 01:50PM BLOOD WBC-8.2 RBC-3.60* Hgb-10.9* Hct-30.9* MCV-86 MCH-30.4 MCHC-35.4* RDW-14.9 Plt Ct-167 [**2167-4-25**] 03:16AM BLOOD WBC-8.0 RBC-3.34* Hgb-10.2* Hct-28.9* MCV-86 MCH-30.4 MCHC-35.2* RDW-15.5 Plt Ct-142* [**2167-4-24**] 02:04AM BLOOD WBC-10.5 RBC-3.09* Hgb-9.6* Hct-26.7* MCV-87 MCH-31.0 MCHC-35.8* RDW-15.0 Plt Ct-113* [**2167-4-23**] 04:19AM BLOOD WBC-9.5 RBC-2.98* Hgb-9.2* Hct-25.8* MCV-86 MCH-31.0 MCHC-35.9* RDW-14.6 Plt Ct-86* [**2167-4-25**] 01:50PM BLOOD Glucose-97 UreaN-12 Creat-0.4 Na-139 K-3.6 Cl-100 HCO3-33* AnGap-10 [**2167-4-24**] 02:04AM BLOOD Glucose-99 UreaN-14 Creat-0.5 Na-139 K-4.2 Cl-105 HCO3-30 AnGap-8 [**2167-4-22**] 01:54AM BLOOD Glucose-183* UreaN-16 Creat-0.5 Na-138 K-4.6 Cl-109* HCO3-27 AnGap-7* [**2167-4-25**] 01:50PM BLOOD Calcium-8.5 Phos-3.2 Mg-1.9 [**2167-4-24**] 02:04AM BLOOD Calcium-8.8 Phos-1.4* Mg-1.9 [**2167-4-21**] 04:48PM BLOOD Calcium-8.6 Phos-3.1 Mg-1.3* Brief Hospital Course: Ms. [**Known lastname **] was admitted to the [**Hospital1 18**] Spine Surgery Service on [**2167-4-20**] and taken to the Operating Room for L3-S1 interbody fusion through an anterior approach. Please refer to the dictated operative note for further details. The surgery was without complication and the patient was transferred to the PACU in a stable condition. TEDs/pnemoboots were used for postoperative DVT prophylaxis. Intravenous antibiotics were given per standard protocol. Initial postop pain was controlled with a PCA. On HD#2 she returned to the operating room for a scheduled T10-S1 decompression with PSIF as part of a staged 2-part procedure. Please refer to the dictated operative note for further details. The second surgery was also without complication and the patient was transferred to the PACU in a stable condition. Postoperative HCT was low and she was transfused multiple units PRBCs. Her large blood loss necessetated an ICU stay. A bupivicaine epidural pain catheter placed at the time of the posterior surgery remained in place until postop check when it was removed due to a LLE motor block. She was kept NPO until bowel function returned then diet was advanced as tolerated. The patient was transitioned to oral pain medication when tolerating PO diet. Foley was removed on POD#2 from the second procedure. She was fitted with a TLSO brace. Physical therapy was consulted for mobilization OOB to ambulate. Hospital course was otherwise unremarkable. On the day of discharge the patient was afebrile with stable vital signs, comfortable on oral pain control and tolerating a regular diet. Medications on Admission: famotidine synthroid losartan gabapentin Discharge Medications: 1. oxycodone 5 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4 hours) as needed for pain. 2. famotidine 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 3. levothyroxine 25 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. losartan 50 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 5. diazepam 2 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for spasm. 6. multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 8. senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed for constipation. 9. gabapentin 300 mg Capsule Sig: Two (2) Capsule PO TID (3 times a day). 10. oxycodone 20 mg Tablet Extended Release 12 hr Sig: One (1) Tablet Extended Release 12 hr PO Q12H (every 12 hours). Discharge Disposition: Extended Care Facility: [**Hospital **] Rehabilitation Discharge Diagnosis: Scoliosis Acute post-op blood loss anemia Discharge Condition: Good Discharge Instructions: You have undergone the following operation: ANTERIOR/POSTERIOR Thoracolumbar Decompression With Fusion Immediately after the operation: -Activity: You should not lift anything greater than 10 lbs for 2 weeks. You will be more comfortable if you do not sit or stand more than ~45 minutes without getting up and walking around. -Rehabilitation/ Physical Therapy: o2-3 times a day you should go for a walk for 15-30 minutes as part of your recovery. You can walk as much as you can tolerate. oLimit any kind of lifting. -Diet: Eat a normal healthy diet. You may have some constipation after surgery. You have been given medication to help with this issue. -Brace: You have been given a brace. This brace is to be worn when you are walking. You may take it off when sitting in a chair or while lying in bed. -Wound Care: Remove the dressing in 2 days. If the incision is draining cover it with a new sterile dressing. If it is dry then you can leave the incision open to the air. Once the incision is completely dry (usually 2-3 days after the operation) you may take a shower. Do not soak the incision in a bath or pool. If the incision starts draining at anytime after surgery, do not get the incision wet. Cover it with a sterile dressing. Call the office. -You should resume taking your normal home medications. No NSAIDs. -You have also been given Additional Medications to control your pain. Please allow 72 hours for refill of narcotic prescriptions, so please plan ahead. You can either have them mailed to your home or pick them up at the clinic located on [**Hospital Ward Name 23**] 2. We are not allowed to call in or fax narcotic prescriptions (oxycontin, oxycodone, percocet) to your pharmacy. In addition, we are only allowed to write for pain medications for 90 days from the date of surgery. Please call the office if you have a fever>101.5 degrees Fahrenheit and/or drainage from your wound. Physical Therapy: Activity: Activity: as tolerated Thoracic lumbar spine: when OOB Treatment Frequency: Please continue to change the dressing daily with dry, sterile gauze. Followup Instructions: With Dr. [**Last Name (STitle) 363**] in 10 days Completed by:[**2167-4-27**] ICD9 Codes: 2851, 4019, 2720, 2749, 2449
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Medical Text: Admission Date: [**2175-4-18**] Discharge Date: [**2175-4-24**] Date of Birth: [**2114-1-19**] Sex: M Service: CARDIOTHORACIC Allergies: No Drug Allergy Information on File Attending:[**First Name3 (LF) 1283**] Chief Complaint: Dyspnea on exertion. Fatigue. Major Surgical or Invasive Procedure: Coronary artery bypass graft x 4 [**2175-4-18**]. History of Present Illness: Mr. [**Known lastname 61380**] is a 61 yo male pt who had a physical exam in [**11-24**] leading to a new diagnosis of type 2 diabetes with abnormal EKG referred to Dr. [**Last Name (STitle) 32255**]. Subsequent stress test positive leading to cardiac cath [**2175-3-8**]. Cath showed EF 39%, apical AK, HK distal/anterior walls, LAD 99%, OM1 50-60%, OM2 90%, RCA 60-70%. Past Medical History: Hypertension. Diabetes. Asthma. Intermittent claudication. Myocradial infarction. Social History: Lives in [**Location 5289**] with wife. Drives. Retired school teacher. Quit tobacco 30 years ago with 36 pack year history. Denies ETOH use -- history of abuse. Family History: Unknown. Pertinent Results: [**2175-4-20**] 06:50AM BLOOD WBC-10.4 RBC-3.17* Hgb-9.4* Hct-27.9* MCV-88 MCH-29.8 MCHC-33.8 RDW-14.4 Plt Ct-157 [**2175-4-20**] 06:50AM BLOOD Plt Ct-157 [**2175-4-19**] 01:56AM BLOOD PT-13.0 PTT-30.3 INR(PT)-1.1 [**2175-4-20**] 06:50AM BLOOD Glucose-113* UreaN-26* Creat-1.2 Na-143 K-4.6 Cl-108 HCO3-28 AnGap-12 [**2175-4-19**] 10:42AM BLOOD Mg-2.0 [**2175-4-19**] 10:55AM BLOOD Glucose-199* K-5.0 Brief Hospital Course: 61 yo male pt admitted [**2175-4-18**] and proceeded to the OR for CABG x 4 with LIMA to the LAD, SVG to the OM1, SVG to the OM2, SVG to the PDA with Dr. [**Last Name (STitle) **]. He was extubated on her operative day. On POD one he was transferred to the inpatient/telemetry floor for ongoing management. On PODs three through five he became hypotensive with ambulation/stairs and was thus kept in-house to monitor hemodynamics. On POD six ([**4-24**]) he was cleared by physical therapy without further hypotensiona dn was discharged home. Medications on Admission: Aspirin 81 mg daily. Multivitamin daily. Atenolol 50 mg daily. Metformin 1000 mg daily Lisinopril 10 mg daily. Lipitor 10 mg daily. Diazepam 5 mg [**Hospital1 **]. Primatene mist PRN. Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*0* 2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 3. Metformin HCl 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* 4. Atorvastatin Calcium 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 5. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). Disp:*90 Tablet(s)* Refills:*0* 6. Hydromorphone HCl 2 mg Tablet Sig: 1-2 Tablets PO every [**4-26**] hours as needed. Disp:*40 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital **] homecare Discharge Diagnosis: Coronary artery disease. Hypertension. Diabetes type 2. Asthma. Discharge Condition: Stable. Discharge Instructions: Shower daily wash incisions with soap and water and rinse well. Do not apply any creams, lotions, powders, and ointments. No driving x 6 weeks. No lifting greater than 10 pounds. Followup Instructions: Follow-up with Dr. [**Last Name (STitle) **] in 4 weeks. Follow-up with Dr. [**Last Name (STitle) 22980**] in [**1-22**] weeks. Follow-up with cardiologist in [**2-24**] weeks. Completed by:[**2175-4-25**] ICD9 Codes: 4019
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Medical Text: Admission Date: [**2129-9-5**] Discharge Date: [**2129-9-9**] Date of Birth: [**2067-3-28**] Sex: M Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**Last Name (un) 11974**] Chief Complaint: Dyspnea Major Surgical or Invasive Procedure: SVT ablation Cardiac catheterization History of Present Illness: 62 yo male with a history of tobacco abuse and regular alcohol use as well as little interaction with the medical system who presented to the ED with a 1 week history of worsening dyspnea. Pt reports he began feeling short of breath the monday previous to presentation worse with lying flat and exertion. He states previously he could climb several flights of stairs while presently he can only walk 50 ft without becoming extremely short of breath. Additionally he has been unable to sleep for the past week [**2-23**] to being unable to lie flat. He denies similar symptoms in the past but does note increased fatigue and left sided chest heaviness for the past 2 years. He also notes a history of dizziness with standing and one episode of LOC in [**2128-1-23**] for which he was seen in the ED. He denies that his work as a construction worker has been affected by his symptoms. . He was seen at the [**Hospital 778**] clinic and sent to the ED due to tachycardia. In the ED he was noted to be in a wide complex regular tachycardia concerning for V-tach. On evaluation by cardiology the rhythm was noted to be an SVT and he was transferred to the cath lab for an ablation procedure. Carotid massage resulted in termination of the rhythm on a p-wave. However, pre-op holding, pt was found to be very tachypnic and using abdominal/accessory muscles to breathe. CXR showed pulmonary edema. He was given 30mg total IV lasix, 1mg Inderal, and 2mg IV morphine. He was placed on a NRB mask and was then moved up to the CCU. At time of transfer he had put out 400cc pale urine. He was denying chest pain, palpitations, tachypnea. He did have recurrence of his SVT x 3 during which he was asymptomatic and which broke with carotid massage. Echo showed LVEF of [**11-5**]%. Past Medical History: 1. CARDIAC RISK FACTORS: tobacco abuse 2. CARDIAC HISTORY: No known cardiac history 3. OTHER PAST MEDICAL HISTORY: No significant past medical history or surgical history Social History: - Tobacco history: patient quit smoking a few weeks ago but previously endoresed a 20 pack year history. - ETOH: The patient notes consuming [**8-30**] drinks per week. He states he normally has 4-5 beers per night on the weekend. His last drink was 8 days prior to admission. - Illicit drugs: denies Family History: His grandfather died from unknown cardiac disease in his 50s. He denies known CAD or arrythmias in his family. Physical Exam: Admission Physical Exam: VS: T=98.4 BP=88/57 HR=71 RR=24O2 sat=97% on 100% non rebeather GENERAL: tachypnic, sitting straight up in bed, mildly distressed HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. No xanthalesma. NECK: Supple with JVP of 18-20 cm. CARDIAC: PMI located in 5th intercostal space, midclavicular line. RR, normal S1, S2. No m/r/g. No thrills, lifts. No S3 or S4. LUNGS: No chest wall deformities, scoliosis or kyphosis.Tachypnic, no accessory muscle use. Crackles bilaterally. ABDOMEN: Soft, NTND. No HSM or tenderness. Abd aorta not enlarged by palpation. EXTREMITIES: No c/c/e. No femoral bruits. SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. PULSES: Right: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ Left: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ . Discharge Physical Exam: Vitals - Tm/Tc:99.2/98.1 BP: 102-104/57-70 HR: 74-83 RR: 20 02 sat: 95% RA Tele: SR, no SVT GENERAL: 62 yoM in no acute distress HEENT: PERRLA, no pharyngeal erythemia, mucous membs moist, no lymphadenopathy, JVP at 14 cm CHEST: CTABL no wheezes, crackles right base, no rhonchi CV: S1 S2 Normal in quality and intensity RRR no murmurs rubs or gallops ABD: soft, non-tender, non-distended, BS normoactive. EXT: wwp, no edema. DPs, PTs 2+. NEURO: CNs II-XII intact. 5/5 strength in U/L extremities. SKIN: no rash, left antecub area with improving erythema, mod tenderness. No drainage. PSYCH: A/O Pertinent Results: Admission labs/studies: WBC 6.5 Hgb 13.9 Hct 40.7 Plts 225 Na 139 K 5.0 Cl 106 HCO3 24 BUN 20 Cr 0.9 Gluc 122 Ca 9.5 Mag 1.8 Phos 3.6 Lactate 1.8 CKMB 5 Trop-T <0.01 proBNP 2803 ALT 53 AST 30 LDH 162 alkphos 74 Tbili 0.6 Endocrine Studies: [**2129-9-5**] 03:41PM BLOOD TSH-<0.02* [**2129-9-6**] 05:59AM BLOOD T4-11.6 T3-259* calcTBG-0.73* TUptake-1.37* T4Index-15.9* Free T4-2.2* [**2129-9-7**] 04:55AM BLOOD Anti-Tg-952* antiTPO-GREATER TH Iron Studies: [**2129-9-6**] 05:59AM BLOOD calTIBC-264 Ferritn-179 TRF-203 A1c: [**2129-9-6**] 05:59AM BLOOD %HbA1c-5.5 eAG-111 Lipid Panel: [**2129-9-6**] 05:59AM BLOOD Triglyc-80 HDL-36 CHOL/HD-4.4 LDLcalc-107 EKG: Wide complex tachycardia at 125 BPM, left axis deviation TTE: Left ventricular wall thicknesses are normal. The left ventricular cavity is moderately dilated. There is severe global left ventricular hypokinesis (LVEF = [**11-5**] %). No masses or thrombi are seen in the left ventricle. RV with depressed free wall contractility. No aortic regurgitation is seen. Mild (1+) mitral regurgitation is seen. Tricuspid regurgitation is present but cannot be quantified. There is no pericardial effusion. Pertinent studies: TTE ([**2129-9-6**])- Biventricular hypokinesis suggestive of a diffuse process (apical function suggests a non-ischemic etiology). Pulmonary artery systolic hypertension. Mild mitral regurgitation. Increased PCWP. Compared with the prior study (images reviewed) of [**2129-9-5**], left ventricular cavity size is slightly smaller and global left ventricular systolic function is improved. The heart rate is much slower. Cardiac cath ([**2129-9-7**])- 1. Coronary arteries had no angiographically-apparent flow-limiting lesions. 2. Severe systolic ventricular dysfunction. Discharge Labs: [**2129-9-9**] 07:10AM BLOOD WBC-6.5 RBC-3.93* Hgb-12.4* Hct-34.9* MCV-89 MCH-31.5 MCHC-35.5* RDW-13.0 Plt Ct-166 [**2129-9-9**] 07:10AM BLOOD Glucose-115* UreaN-21* Creat-0.8 Na-137 K-4.3 Cl-102 HCO3-28 AnGap-11 [**2129-9-8**] 04:46AM BLOOD ALT-30 AST-16 LD(LDH)-141 AlkPhos-68 [**2129-9-9**] 07:10AM BLOOD Calcium-9.2 Phos-3.2 Mg-1.8 Brief Hospital Course: Primary Reason for Hospitalization: 62 yo male with significant alcohol and tobacco use who presents with dyspnea secondary to flash pulmonary edema in the setting of CHF and SVT. Active Issues: # Flash pulmonary edema- Patient was acutely dyspneic with pulmonary edema on CXR and without peripheral edema at the time of admission. pro BNP was also elevated. He diuresed well with IV Lasix boluses, and was immediately weaned from non rebreather to nasal cannula and maintained good saturations. With continued diuresis, patient's respiratory status improved and he tolerated lying flat without issue. At the time of discharge he was maintaining good oxygen saturations on room air. . # SVT: Given termination of arrythmia on a p wave with carotid massage, felt to be consistent with either a bypass tract, AVNRT and less likely an atrial tachycardia. SVT responded to carotid massage on multiple occasions, but returned shortly after. Patient was started on metoprolol 25 mg po BID for rate control which was increased to QID. TSH was low with mildly elevated T4, consistent with hyperthyroidism. Patient was started on methimazole. On HD3, patient was taken for an ablation of his atrial tachycardia. A left sided bypass tract was identified and ablated. He tolerated the procedure well with no ongoing tachycardia. Metoprolol was changed carvedilol prior to discharge. . # Acute CHF: Unclear etiology of CHF but likely acute exacerbation of chronic disease. There was initially concern for ischemic causes given LBBB on EKG, however cardiac catheterization on HD2 and had no flow-limiting lesions. It was felt that his cardiomyopathy was likely multi-factorial in nature and a result of his alcohol use, thyroid disease in addition to his tachyrhythmia. A cardiac MRI was performed to assess for other causes of cardiomyopathy, results were pending at the time of discharge. The patient was successfully diuresed as noted above with IV Lasix and transitioned to 40 mg of PO Lasix daily. He was also started on 5 mg lisinopril and 6.25 mg daily carvedilol [**Hospital1 **] when blood pressures tolerated. These medications were continued at discharge. . #Hyperthyroidism: Given new onset of tachycardia, patient was checked for underlying endocrine or electrolyte abnormalities on admission. TSH was low, and free T4 was elevated. Patient was started on methimazole 10mg po BID. Liver function tests were checked 2 days after starting the medication and were normal. Anti-Tg and Anti-TPO were significantly elevated. The patient has follow-up with endocrine as an outpatient and will require a thyroid US and thyroid scan. . Fever: Pt had one fever to 100.8. This was not associated with an elevation in white blood cell count or any symptoms of infection. Urine cultures were negative and blood cultures were pending at the time of discharge. . #Transitional issues: -Patient maintained full code status throughout hospitalization. -He will follow up with [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 85803**] NP[**MD Number(3) **] [**Hospital 778**] clinic on [**9-14**], Endocrinology on [**9-28**] and Dr. [**Last Name (STitle) **] from Cardiology on [**9-30**]. . Pending Studies: Cardiac MRI report Thyroid stimulating immunoglobulin Blood cultures Medications on Admission: None Discharge Medications: 1. methimazole 10 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 2. furosemide 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 3. lisinopril 5 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). Disp:*15 Tablet(s)* Refills:*2* 4. carvedilol 6.25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Acute Systolic Congestive Heart Failure Hyperthyroidism Supraventricular Tachycardia Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: You had trouble breathing and it was found that your heart was very weak. This is possibly because of a combination of your high heart rate, your alcohol intake and your high thyroid hormone levels. We have done an ablation of your heart that has interrupted the cause of the fast heart rate. You were seen by an endocrinologist who prescribed a medicine to lower your thyroid levels. You will need follow up with them after you go home to get the thyroid hormone level right. It is very important for your heart and general health to stop smoking and drinking alcohol. This will allow your heart to get stronger. Weigh yourself every morning, call Dr. [**Last Name (STitle) **] if weight goes up more than 3 lbs in 1 day or 5 pounds in 3 days. . We made the following changes to your medicines: 1. Start taking Carvedilol twice daily to slow your heart rate and help your heart 2. Start Lisinopril to lower your blood pressure and help your heart pump better 3. Start methimazole to treat your high thyroid levels 4. Start furosemide to remove extra fluid. Followup Instructions: Name: [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) 85803**] PA Location: [**Hospital6 5242**] CENTER Address: [**Location (un) 5243**], [**Location (un) **],[**Numeric Identifier 2260**] Phone: [**Telephone/Fax (1) 798**] When: Wednesday, [**9-14**], 1:00 PM Department: MEDICAL SPECIALTIES When: WEDNESDAY [**2129-9-28**] at 5:00 PM With: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], MD & [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 2164**], MD [**Telephone/Fax (1) 1803**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: CARDIAC SERVICES When: FRIDAY [**2129-9-30**] at 2:20 PM With: [**Name6 (MD) **] [**Name8 (MD) **], MD [**Telephone/Fax (1) 62**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 11975**] ICD9 Codes: 4254, 4280, 3051
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Medical Text: Unit No: [**Numeric Identifier 106721**] Admission Date: [**2133-11-4**] Discharge Date: [**2133-11-13**] Date of Birth: Sex: M Service: Cardiothoracic Surgery HISTORY OF PRESENT ILLNESS: This is a 65-year-old male with known history of coronary artery disease, who reported recent episodes of chest pain without radiation to jaw or shoulder. Episodes always alleviated with rest. Two stress tests in the past were negative. His last episode of chest pain was seemingly on [**2133-10-25**]. He underwent a stress test on [**2133-11-4**]. The patient had chest pain, and his EKG showed ST changes. The patient was admitted to the ER of [**Hospital1 18**] and underwent a cardiac catheterization, which revealed 3-vessel disease. The catheterization results were as follows: 80 percent proximal RCA, 80 percent left main, 60 percent mid LAD, 70 percent diagonal 1, 40 percent left circumflex, 80 percent OM2, 80 percent PDA with an EF of 56 percent. PAST MEDICAL HISTORY: His past medical history is significant for: Hypertension. BPH. Hypercholesterolemia. Aortic stenosis. He has GERD, gastroesophageal reflux disease. He has osteoarthritis of his hips. He suffers from anemia and anxiety. PAST SURGICAL HISTORY: He has had no prior surgical history. MEDICATIONS AT HOME: His medications at home are as follows: 1. Lipitor 40 mg q.d. 2. Lisinopril 40 mg q.d. 3. Doxazosin 2 mg q.d. 4. Atenolol 25 mg q.d. 5. Aldactone 25 mg q.d. 6. HCTZ 12.5 mg q.d. 7. Norvasc 10 mg q.d. 8. ASA 81 mg q.d. 9. Zantac p.r.n. 10. Tums p.r.n. 11. Imitrex p.r.n. ALLERGIES: He really has no known drug allergies except a GI upset to AMPICILLIN. FAMILY HISTORY: His family history is significant for coronary artery disease. His dad died from MI at the age of 79. Both his brother and his mom have CHF. REVIEW OF SYSTEMS: His review of systems is positive for migraines, positive for lichen planus on his shins. PHYSICAL EXAMINATION: His physical examination preoperatively is as follows: His height was 5 feet 7 inches, his weight 168 pounds. He was alert and oriented x3. His lungs were clear to auscultation. Heart rate was regular rate and rhythm, positive S1, S2, positive 3/6 systolic ejection murmur. His abdomen was soft, nontender, and nondistended, positive for bowel sounds. His extremities were warm, well perfused, no cyanosis, no clubbing or edema, no varicosities. His pulses were 2 plus throughout, and he had a question of carotid bruits with the murmurs from his heart that were also radiating to his right carotid. LABORATORY DATA: His preoperative laboratories were as follows: His chest x-ray was normal. His UA was negative. His EKG with sinus bradycardia at 56 beats per minute. His white blood cell count was 10.9. His hematocrit was 32.4. His platelets 202,000. Sodium 142, potassium 4.2, chloride 106, bicarbonate 26, BUN 20, creatinine 1.1, glucose 83, PT 14, PTT 57.1, INR 1.2, ALT 25, AST 21, amylase 105, total bilirubin 1.0, and hemoglobin A1c 4. HOSPITAL COURSE: On [**2133-11-6**], the patient went to the operating room and underwent a coronary artery bypass graft x5, mid LAD, saphenous vein graft, OM1, OM2 direct, and right ventricular branch of the RCA. The patient tolerated the procedure well. His bypass time was 91 minutes, the cross- clamp time was 65 minutes. His vitals when he was admitted to the CSRU are as follows: His heart rate was 80 beats per minute, apaced, mean arterial pressure was 70, CVP was 11, PA diastolic was 15, PA mean was 23. He was on a propofol drip being titrated and Neo-Synephrine at 0.3 mcg/kg per minute, and he was transferred successfully to the CSIU. On postoperative day 1, the patient was hemodynamically stable. His blood pressure was 116/39, heart rate 79. He was extubating and saturating at 96 percent. He received Neo- Synephrine 1.5 and Lasix. Plan was to wean him off. On postoperative day 2, chest tubes were discontinued. Lasix was at 20 b.i.d., and the plan was to have him transferred to the floor. He was hemodynamically stable at that time. On postoperative day 3, the patient was hemodynamically stable. His physical examination was as follows: He had 1 to 2 plus edema in his extremities. His left lower extremity vein harvest site was clean, dry, and intact. His sternal incision was also clean, dry, and intact and no erythema, no drainage. His tracing wires were removed. His lungs were clear throughout. His heart was regular rate and rhythm. The patient was ambulating well, but had some increasing blood pressure and heart rate while ambulating. The plan was to start Lopressor at 12.5 mg b.i.d. and disconnect the PCA wires if his heart rate was okay. The plan was also to continue diuresis and change his Lasix to p.o. On postoperative day 4, the patient was doing well, continued to be out of ventilator, and his creatinine had increased this morning to 1.7, and wires were discontinued, and his physical examination was unremarkable, and he was hemodynamically stable. On postoperative day 5, his creatinine decreased. Today, his physical examination was unremarkable except for 1 to 2 edema in his extremities, and he had some rhonchi in the bases bilaterally. His hematocrit had dropped from 26 to 23, and a Foley was reinserted 2 days ago for BPH. The patient also received a chest x-ray today that revealed a left lower lobe atelectasis. On postoperative day 6, the patient was hemodynamically stable, 91 sinus rhythm, blood pressure 120/52. His chest x-ray results were he had a small left effusion and left-sided atelectasis. He had some trace edema, and his lungs were clear, and his heart rate was regular in rhythm and in rate. The patient continued to receive diuretics, and his Lasix was increased to 40 mg b.i.d., and he was encouraged to ambulate. On postoperative day 7, which was [**2133-11-13**], the patient was stable with temperature 99, pulse 83, sinus rhythm, blood pressure 112/46. The patient was doing well. The patient today was discharged. His discharge physical examination was as follows: He was alert and oriented x3. His lungs were clear bilaterally. His heart was regular in rate. His abdomen was soft and nontender. His extremities were warm with trace edema. His external incision site was clean, dry, and intact, no erythema, no drainage. His left lower extremity, where he received his vein harvest, was clean and dry. CONDITION ON DISCHARGE: The patient was discharged in good condition to home with VNA. DISCHARGE DIAGNOSES: His discharge diagnoses are as follows: Status post coronary artery bypass graft x5. Hypertension. Hypercholesterolemia. Benign prostatic hyperplasia. Gastroesophageal reflux disease. FOLLOWUP: The patient was recommended to follow up with Dr. [**Last Name (STitle) 311**] in 2 to 3 weeks, Dr. [**Last Name (STitle) **] in 2 to 3 weeks, and Dr. [**Last Name (STitle) **] in 4 weeks. DISCHARGE MEDICATIONS: Discharge medications were as follows: 1. Aspirin 325 mg p.o. q.d. 2. Colace 100 mg p.o. b.i.d. 3. Hydromorphone 2 mg 1 to 2 tablets p.o. q.4-6h. p.r.n. 4. Doxazosin 2 mg p.o. h.s. 5. Lasix 40 mg 2 tablets p.o. b.i.d. 6. Lopressor 25 mg p.o. b.i.d. 7. Ibuprofen 400 mg 1 tablet p.o. q.8h. p.r.n. 8. FeSO4 325 mg 1 tablet p.o. q.d. 9. Pantoprazole 40 mg 1 tablet q.d. 10. Ascorbic acid 500 mg 1 tablet p.o. b.i.d. [**Name6 (MD) **] [**Name8 (MD) **], M.D. [**MD Number(2) 5897**] Dictated By:[**Last Name (NamePattern1) 11830**] MEDQUIST36 D: [**2133-11-13**] 15:30:40 T: [**2133-11-14**] 07:14:00 Job#: [**Job Number **] ICD9 Codes: 4241, 2859, 4019
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Medical Text: Admission Date: [**2160-10-16**] Discharge Date: [**2160-11-18**] Date of Birth: [**2092-2-20**] Sex: F Service: Surgery HISTORY OF PRESENT ILLNESS: Ms. [**Known lastname 44935**] is a 68-year-old primarily Russian-speaking female who has been diagnosed with myeloproliferative disorder several years ago. The patient has been closely followed by her primary care physician, [**Name10 (NameIs) **] she also has a hematologist/oncologist. The patient has undergone radiation treatment for her splenomegaly several years ago. The spleen has recently increased in size, and the patient has been somewhat symptomatic. The patient's comorbidities included coronary artery disease (with a myocardial infarction in [**2153**]) as well as a history of hypertension. In addition, she had a left-sided nephrectomy and breast carcinoma with a left-sided mastectomy in [**2148**]. The patient presented to General Surgery for a possible surgical solution of her splenomegaly due to her myeloproliferative disorder. The patient received all of her previous treatments at outside facilities. The patient was consequently scheduled for an elective open splenectomy by the General Surgery staff. On [**2160-10-16**], the patient underwent open splenectomy by Dr. [**Last Name (STitle) **]. The procedure was without any complications. The estimated blood loss was approximately 600 cc, and the patient received one unit of packed red blood cells. Please see the full Operative Report for details. PAST MEDICAL HISTORY: 1. Myeloproliferative disorder. 2. Coronary artery disease. 3. Status post myocardial infarction in [**2153**]. 4. Hypertension. 5. Breast carcinoma; status post left-sided mastectomy in [**2148**]. PAST SURGICAL HISTORY: 1. Left-sided mastectomy for breast carcinoma in [**2148**]. 2. Status post left-sided nephrectomy. 3. Status post eye surgery. MEDICATIONS ON ADMISSION: 1. Hydroxyurea 500 mg p.o. q.d. 2. Ambien 10 mg p.o. q.h.s. as needed. 3. Trazodone 50 mg p.o. as needed. 4. Lopressor 50 mg p.o. b.i.d. 5. Allopurinol 300 mg p.o. q.d. 6. Norvasc 5 mg p.o. q.d. 7. Prilosec. PHYSICAL EXAMINATION ON PRESENTATION: Physical examination revealed alert and oriented, in no apparent distress. An elderly, primarily Russian-speaking, female. Temperature was 98.4, blood pressure was 142/74, heart rate was 78, respiratory rate was 17, oxygen saturation was 97% on room air. Head, eyes, ears, nose, and throat examination was within normal limits. No signs of lymphadenopathy. Full range of motion in the neck. No carotid bruits were detected. Cardiovascular examination revealed a regular rate and rhythm. No murmurs, rubs, or gallops. Pulmonary examination revealed clear to auscultation bilaterally. The abdomen was soft, nontender, and nondistended. An enlarged spleen extending below the umbilicus was palpable in the left upper quadrant. Bowel sounds were present. Chest examination revealed the site of prior mastectomy. Extremities were warm and well perfused. No signs of edema. HOSPITAL COURSE: Given the history of myeloproliferative disorder and significant splenomegaly, a surgical intervention was undertaken. On [**2160-10-16**], the patient underwent open splenectomy. The procedure was without any complications with an estimated blood loss of approximately 600 cc. Please see the full Operative Report for details. The patient was extubated successfully and transferred to the Postanesthesia Care Unit in stable condition. She was originally made nothing by mouth and was adequately resuscitated with intravenous fluids. She was transfused with one unit of packed red blood cells in the operating room. She was placed on a beta blocker and subcutaneous heparin. Her pain was adequately controlled. She was placed on prophylactic antibiotics. The patient maintained a low-grade fever and remained somewhat tachycardic. She was further resuscitated with fluids given her low urine output. A nasogastric tube was placed. Her postoperative hematocrit was 34.2 with a white blood cell count of 11. Given the symptoms of nausea, a KUB of the abdomen was obtained which showed diffuse dilatation of the small bowel and colon; consistent with postoperative ileus. On postoperative day three, the patient was noted to be hypotensive, and she was noted to have her hematocrit decrease from 36 to 21.2. At that point, she was taking aspirin. The patient was quickly taken to the operating room on [**2160-10-19**] for exploratory laparotomy and evaluation of the bleed. Intraoperatively, the patient was found to be coagulopathic, but no discrete source of the bleed was found. The patient was transfused with several units of packed red blood cells as well as platelets. Several liters of blood were aspirated from the abdomen. Before the exploratory laparotomy, she was found to have an INR of 4.3. She had been on Lovenox and Coumadin. After the exploration, the patient was transferred to the Intensive Care Unit. A central line was placed. The patient remained intubated. Her hematocrit was increased with several transfusions. Her urine output remained adequate. She was maintained on intravenous fluids. Several blood cultures were taken which showed no growth. The patient was extubated on postoperative day five and two. Total parenteral nutrition was started given that the patient had been without any oral intake for several days. She continued to have a low-grade fever. The patient was consequently transferred to the regular floor on postoperative day six and three. The Nutrition Service was consulted, who followed the patient throughout her hospitalization. An electrocardiogram performed at the time showed a sinus rhythm, and no change compared to the baseline tracing available. The patient continued to be coagulopathic even without receiving any Coumadin or other anticoagulation products. Her wound remained clean, dry, and intact. There was some abdominal distention noted. She was started on clear liquids, and her diet was very slowly advanced; which she tolerated well. Given the persistent elevated temperatures and distended abdomen, a computed tomography of the abdomen was performed on [**2160-10-25**]. There was no evidence of abscess. However, diffuse ascites were noted. In addition, bilateral pleural effusions were noted; which were associated with atelectasis at both lung bases. A successful ultrasound-guided paracentesis of the ascites was performed on [**2160-10-25**]. The patient would have several such paracentesis procedures. Cultures were obtained from the fluid which showed no microorganisms; only polymorphonuclear leukocytes. In addition, the white blood cell count in the fluid was low and not suggestive of any infection. The patient was consequently placed on Unasyn for empiric coverage. The patient also had several urine cultures obtained which grew Escherichia coli as well as Corynebacterium species. In addition, her sputum grew yeast. As perviously mentioned, her blood cultures grew nothing. The patient continued to be diuresed. Her hematocrit remained stable; although, she continued to be anemic, and at some point required more blood. The patient was consequently restarted on Coumadin. In addition, the Renal Service was consulted given the ascites; with the specific question of whether ascites were from a renal etiology and also the significance of proteinuria which was noted on routine urinalysis. In addition, the CAT scan that was obtained on [**2160-10-25**] showed evidence of portal vein thrombosis which was confirmed by the ultrasound. It was thought that the significant ascites that seemed to reaccumulate after therapeutic paracenteses were due to the portal vein thrombosis and not renal failure. The patient's creatinine did increase slightly but then returned back to the patient's baseline of approximately 1.5. On [**2160-10-27**], the patient appeared to have a relatively sudden onset of chest discomfort as well as tachypnea. There was no nausea, vomiting, or diaphoresis. She appeared to be tachypneic with a respiratory rate of approximately 35, but her blood pressure and heart rate were stable, and her oxygen levels remained the same. A arterial blood gas was obtained at that time which showed a pH of 7.53, PO2 of 75, and PCO2 of 19, with a base excess of -3, and total CO2 of 16. She ruled out for a myocardial infarction by cardiac enzymes, and her lung scan was low probability of any pulmonary embolism. A venous ultrasound of the lower extremities was also negative for any clots. Given these symptoms, the patient was again admitted to the Intensive Care Unit for closer monitoring. She was continued on Unasyn and intravenous heparin. She continued to make adequate urine. She remained on beta blocker. Her electrocardiogram showed no changes. However, the chest x-ray did show left lower lobe consolidation. The patient remained stable and was transferred out of the Intensive Care Unit to the regular floor. She continued to be coagulopathic with an INR of 2.6 on [**2160-10-30**]. She was also noted to have a white blood cell count of 48 and a platelet count of approximately 2 million. Her liver function tests were elevated; consistent with portal vein thrombosis seen on the CAT scan and ultrasound. The Hematology/Oncology Service was consulted given the elevated white blood cell count and platelets. The patient was restarted on Hydroxyurea. Her white blood cell count and platelet count decreased slowly with this medication. In addition, the patient underwent one round of plasmapheresis which she tolerated well. While on Hydroxyurea, the patient's white blood cell count decreased significantly and was noted to be 0.4 several days later. Consequently, Hydroxyurea was stopped. The patient was placed on neutropenic precautions. Hydroxyurea was discontinued. The patient was place G-CSF (growth factor) to which she responded well, and G-CSF was discontinued several days later. The Renal Service continued to follow the patient, and they thought that her proteinuria was secondary to a nephrotic syndrome. They recommended further diuresis and oral fluid restriction. The patient continued to improve, and her ascites decreased significantly toward the end of her hospitalization. She was making significant urine. Her liver function tests improved and were essentially normal. She was continued on Coumadin with a stable regimen of 2.5 mg toward the end of her hospitalization. She continued to tolerate an oral diet without any difficulties. The staples were removed on postoperative day 18. While the patient was on neutropenic precautions; secondary to a low white blood cell count, she was maintained on cefepime intravenously which was discontinued when the neutropenic precautions were removed. Her lower extremity edema decreased significantly as well. DISCHARGE DISPOSITION: The patient continued to improve significantly and was discharged to home on [**2160-11-18**]. PERTINENT LABORATORY VALUES ON DISCHARGE: Her laboratories upon discharge were as follows: White blood cell count was 7.9 and hematocrit was 27.8 (differential with 70% neutrophils), platelet count was 389. INR was 2.2. CONDITION AT DISCHARGE: Condition on discharge was good. DISCHARGE STATUS: Discharge status was to home. DISCHARGE DIAGNOSES: 1. Myeloproliferative disorder. 2. Status post open splenectomy; complicated by intra-abdominal bleed, status post re-exploration and aspiration of intra-abdominal bleed. 3. Portal vein thrombosis. 4. Anemia. 5. Coagulopathy. 6. Hypertension. 7. Coronary artery disease. MEDICATIONS ON DISCHARGE: 1. Coumadin 2.5 mg p.o. q.d. 2. Potassium chloride 20 mEq p.o. b.i.d. (while the patient is taking lasix). 3. Lasix 80 mg p.o. b.i.d. 4. Lisinopril 5 mg p.o. q.d. 5. Ambien 5 mg p.o. q.h.s. as needed (for insomnia). 6. Colace 100 mg p.o. b.i.d. 7. Allopurinol 200 mg p.o. q.d. 8. Protonix 40 mg p.o. q.d. 9. Lopressor 75 mg p.o. b.i.d. 10. Artificial Tears one to two drops as needed. DISCHARGE INSTRUCTIONS/FOLLOWUP: 1. The patient was to take 2.5 mg of Coumadin q.d., and she was to see her primary care physician (Dr. [**Last Name (STitle) 44936**] in approximately two to three days for an INR check and any adjustment of Coumadin. The INR goal is approximately 2.5; but one needs to be careful given the history of coagulopathy with this patient. 2. The patient was to follow up with her hematologist/oncologist (Dr. [**First Name8 (NamePattern2) 565**] [**Last Name (NamePattern1) **]) in approximately one week. 3. The patient was to follow up with her surgeon (Dr. [**First Name8 (NamePattern2) 333**] [**Last Name (NamePattern1) **]) in approximately two to three weeks. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], M.D. [**MD Number(1) 6066**] Dictated By:[**Last Name (NamePattern1) 1741**] MEDQUIST36 D: [**2160-11-18**] 15:32 T: [**2160-11-18**] 16:11 JOB#: [**Job Number 19921**] cc:[**Hospital6 44937**] ICD9 Codes: 2761
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Medical Text: Admission Date: [**2105-8-18**] Discharge Date: [**2105-8-21**] Date of Birth: [**2037-7-19**] Sex: F Service: MEDICINE Allergies: Zestril Attending:[**First Name3 (LF) 2297**] Chief Complaint: Chief Complaint: Bradycadia . Reason for MICU transfer: hyperkalemia Major Surgical or Invasive Procedure: Attempt to remove a blood clot from the AV graft (thrombectomy), not successful placement of left subclavian tunnelled hemodialysis line History of Present Illness: 68 year old female with ESRD on HD who presented from AV Care with bradycardia to the 30. The pt went to her normal HD yesterday at the [**Hospital **] Clinic where her R AVG was found to be thrombosed. She was unable to get her HD, last HD was last Friday. She set up for a thrombectomy at AV Care today, but when on the table for the procedure, her heart rate was noted to be 32. The procedure was aborted and the patient and sent to the ER for evaluation. . K on arrival to the ED was 7.4. Bradycardic to the 30s with a junctional rhythm. She received Calcium, insulin, and D50 with improvement in K to 6.9 and HR to 60s. Renal and transplant surgery were both contact[**Name (NI) **] in the [**Name (NI) **]. She was noted to be going back into a junctional rhythm prior to transfer. Another 2g of calcium carbonate were ordered, but there were no doses availible in the ED. She is being admitted for emergent HD. . On the floor, she has no complaints other than being hungry. Past Medical History: ESRD [**2-4**] diabetic nephropathy, on renal transplant list, HD MWF @ [**Location (un) **] [**Location (un) **] Dialysis Center Type II DM HTN asthma Social History: She is married. She and her husband are independent in their ADLs. She emmigrated from Barbados in [**2084**]. She used to work baby sitting for a physician here at [**Hospital1 18**], but she is not working due to disease. She never smoked or drank alcohol. She denies IVDU but has received blood transfusions. Family History: (per OMR, confirmed) Her parents both had DM (deceased age 71-mother and 80-father). She has 2 siblings with DM2 and one of her children as well, who also has CKD. Physical Exam: Vitals: T: BP:113/97 P: 46 R9: 18 O2: 97% General: Alert, oriented, no acute distress HEENT: Sclera anicteric, MMM, oropharynx clear Lungs: Clear to auscultation bilaterally, no wheezes, rales, ronchi CV: bardycardia, irregular, no murmurs, rubs, gallops Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly GU: no foley Ext: warm, well perfused, no clubbing, cyanosis or edema Pertinent Results: Admission Labs: [**2105-8-18**] 12:15PM BLOOD WBC-6.6 RBC-5.46* Hgb-11.8* Hct-38.8 MCV-71* MCH-21.6* MCHC-30.3* RDW-18.4* Plt Ct-263 [**2105-8-18**] 12:15PM BLOOD Neuts-60.4 Lymphs-24.4 Monos-5.6 Eos-8.7* Baso-0.8 [**2105-8-18**] 12:15PM BLOOD PT-12.1 PTT-26.4 INR(PT)-1.0 [**2105-8-18**] 12:15PM BLOOD Glucose-276* UreaN-72* Creat-13.3*# Na-129* K-7.4* [**2105-8-18**] 12:15PM BLOOD Calcium-8.7 Phos-6.9*# Mg-2.6 [**2105-8-18**] 12:20PM BLOOD Glucose-262* Lactate-1.6 Na-127* K-8.3* Cl-91* calHCO3-22 . Echo: The left atrium is mildly dilated. There is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (LVEF>55%). Tissue Doppler imaging suggests an increased left ventricular filling pressure (PCWP>18mmHg). Right ventricular chamber size and free wall motion are normal. The right ventricular free wall is hypertrophied. The ascending aorta is mildly dilated. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. The mitral valve leaflets are mildly thickened. Trivial mitral regurgitation is seen. There is mild pulmonary artery systolic hypertension. Significant pulmonic regurgitation is seen. There is no pericardial effusion. IMPRESSION: Mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. Right ventricular hypertrophy. Diastolic dysfunction. No pathologic valvular abnormality seen. No evidence of restrictive filling of left ventricle. The findings could be consistent with infiltrative process but are more likely due to effects of hypertension/renal failure. Compared with the prior study (images reviewed) of [**2103-7-5**], mild symmetric LVH and right ventricular hypertrophy are seen on the current tracing. . Discharge Labs: [**2105-8-21**] 05:58AM BLOOD WBC-8.2 RBC-4.87 Hgb-10.5* Hct-35.2* MCV-72* MCH-21.5* MCHC-29.7* RDW-18.2* Plt Ct-211 [**2105-8-21**] 05:58AM BLOOD Glucose-166* UreaN-31* Creat-7.4*# Na-134 K-5.7* Cl-94* HCO3-30 AnGap-16 [**2105-8-21**] 05:58AM BLOOD Calcium-9.0 Phos-4.7* Mg-2.1 Brief Hospital Course: 68yo F with ESRD, type II DM, and HTN who missed HD yesterday [**2-4**] graft thrombosis who presented to the ED after thrombectomy was aborted in the setting of bradycardia. . # Bradycardia: Initial junctiona rhythm resolved with HD and resolution of hyperkalemia. On HD 3, patient had sinus bradycardia with ventricular escape beats. Potassium was not elevated at the time. EP felt related to high doses nodal agents for BP control. Her labetolol and am clonidine were held, she underwent HD, and her rhythm improved. BPs remained in the 130s for most of the day but eventually increased to 190. Per discussion with patient??????s nephrologist we continued nifedipine and hydralazine. Clonidine was given in place of home guafacine. Pt did not have any more bradycardic episodes and remained in sinus rythm in the 60s for teh rest of the admission. LFTs checked for reduced hepatic clearance of labetolol? but were normal. D/c home on regimen of nifedipine, hydralazine, and guafacine. Her regimen will be further adjusted by her nephrologist, Dr. [**Last Name (STitle) 4883**]. . # Hypertension: Had restarted home regimen (labetolol, nifedipine, hydralazine, clonidine in place of home guafacine), but pt developed a second episode of bradycardia concerning for medication toxicity (see above). She required a nitro gtt for control on hospital day #1, but for > 24 hours prior to discharge she maintained BP < 180 on just nifedapine, clonidone, hydralazine (held labetolol). . # Thrombosed HD graft: IR unable to perform thrombectomy. Got tunneled HD line. She will need a thrombectomy to reopen her AV graft. She is scheduled to follow up at [**Hospital **] Care Center with Dr [**Last Name (STitle) **]. . # ESRD: Awaiting transplant. Continued nephrocaps. Low K/phos diet, and phos binder was uptitrated. . # DM: Pt takes 30 units of 50/50 [**Hospital1 **]. Had some hypoglecemia, maintained just on sliding scale while admitted. Per pt, eats more sugary food at home. resume home regimen upon d/c. . # Asthma: Well-controlled per pt history. Con't home Advair with albuterol PRN. Medications on Admission: (per OMR) amitriptyline 25 mg Tablet 1 Tablet(s) by mouth HS B complex-vitamin C-folic acid [Nephrocaps] 1 mg Capsule by mouth once a day calcium acetate 667 mg Capsule 3 Capsule(s) by mouth three times a day fluticasone-salmeterol [Advair Diskus] 100 mcg-50 mcg/Dose Disk with Device 1 Disk(s) inhaled twice a day guanfacine 1 mg Tablet 1 Tablet(s) by mouth hs insulin lispro protam & lispro [Humalog Mix 50-50] 100 unit/mL (50-50) Insulin Pen 30 units SC twice a day labetalol 200 mg Tablet 1 Tablet(s) by mouth twice a day nifedipine 90 mg Tablet Extended Release 1 Tablet(s) by mouth once a day pantoprazole 40 mg Tablet, Delayed Release (E.C.) 1 Tablet(s) by mouth every twenty-four(24) hours sevelamer carbonate [Renvela] 800 mg Tablet 1 Tablet(s) by mouth three times a day aspirin 81 mg Tablet, Chewable 1 Tablet(s) by mouth DAILY docusate sodium 100 mg Capsule 1 Capsule(s) by mouth twice a day sennosides [senna] 8.6 mg Tablet 2 Tablet(s) by mouth HS . Per CVS (do not have inhalers or phos binders on record there) hydralazine 50mg TID Sensipar (cinacalcet) 30mg qd labetolol 300mg 2 tablets [**Hospital1 **] guansacine 2mg at HS . Per [**Location (un) **] labetolol 300mg 2 tablets [**Hospital1 **] guansacine 2mg at HS Hydralazine 100mg TID sevelamer carbonate [Renvela] 800 mg Tablet 1 Tablet(s) by mouth three times a day nifedipine 90 mg Tablet Extended Release 1 Tablet(s) by mouth once a day amitriptyline 25 mg Tablet 1 Tablet(s) by mouth HS B complex-vitamin C-folic acid [Nephrocaps] 1 mg Capsule by mouth once a day Discharge Medications: 1. senna 8.6 mg Tablet Sig: Two (2) Tablet PO at bedtime as needed for Constipation. 2. amitriptyline 25 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 3. B complex-vitamin C-folic acid 1 mg Capsule Sig: One (1) Cap PO DAILY (Daily). 4. albuterol sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig: Two (2) Puff Inhalation Q4H (every 4 hours) as needed for SOB, wheeze. 5. fluticasone-salmeterol 100-50 mcg/dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). 6. insulin lispro protam & lispro 100 unit/mL (50-50) Suspension Sig: Thirty (30) units Subcutaneous twice a day. 7. nifedipine 90 mg Tablet Extended Release Sig: One (1) Tablet Extended Release PO HS (at bedtime). 8. sevelamer carbonate 800 mg Tablet Sig: Four (4) Tablet PO three times a day: with meals. Disp:*360 Tablet(s)* Refills:*0* 9. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 10. hydralazine 50 mg Tablet Sig: Two (2) Tablet PO Q8H (every 8 hours). 11. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 12. guanfacine 2 mg Tablet Sig: One (1) Tablet PO at bedtime. Discharge Disposition: Home Discharge Diagnosis: Primary: Dialysis dependent chronic renal failure/End Stage Renal Disease Hyperkalemia Bradycardia AV graft thrombosis . Secondary: hypertension Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Ms. [**Known lastname 8631**] [**Known lastname **], . It was a pleasure taking part in your care. You were admitted to [**Hospital1 18**] intensive care unit because of elevated potassium. Your potassium level is controlled by dialysis, however your AV fistula was found to have a clot in it. Because of that you were unable to get dialysis and as a result your potassium elevated causing your heart rate to slow. . You were admitted, had a temporary line placed to resume dialysis, and with treatment your potassium normalized and your heart rate and rhythm, normalized. . Also, you had severely elevated blood pressure, because your blood pressure medications were held prior to your procedure. You required IV medications to help control it. We think that because we gave you extra IV blood pressure medicines, your heart rate slowed down again, but this got better on it's own. We are not giving you your labetolol right now. Dr. [**Last Name (STitle) 4883**] will be adjusting your blood pressure medicines when you see him at dialysis. . We made the following changes to your medications: - Please STOP taking labetolol for now. - Please increase your sevelemer to 3200mg (4 tablets) with each meal. Followup Instructions: Please resume your typical dialysis schedule. . Department: ADVANCED VASC. CARE CNT When: TUESDAY [**2105-8-25**] at 9:00 AM With: [**Name6 (MD) 5536**] [**Name8 (MD) **], MD [**Telephone/Fax (1) 5537**] Building: [**Street Address(2) 7298**] ([**Location (un) 583**], MA) [**Location (un) **] Campus: OFF CAMPUS Best Parking: Free Parking on Site . Department: TRANSPLANT CENTER When: THURSDAY [**2105-9-10**] at 2:20 PM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1330**], MD [**Telephone/Fax (1) 673**] Building: LM [**Hospital Unit Name **] [**Location (un) **] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage . Department: TRANSPLANT CENTER When: TUESDAY [**2106-3-23**] at 9:00 AM With: [**First Name4 (NamePattern1) 971**] [**Last Name (NamePattern1) 970**], MD [**Telephone/Fax (1) 673**] Building: LM [**Hospital Unit Name **] [**Location (un) **] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage ICD9 Codes: 5856, 2767
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Medical Text: Admission Date: [**2193-2-28**] Discharge Date: [**2193-3-7**] Date of Birth: [**2174-10-24**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 613**] Chief Complaint: Tylenol Overdose Major Surgical or Invasive Procedure: None History of Present Illness: Mr. [**Known lastname 12649**] is an 18yo man with no significant past medical history who is transferred to [**Hospital1 18**] for liver transplant evaluation following toxic acetaminophen ingestion. He told the team at [**Hospital1 2177**] that he laid hands on gf on [**2-22**], was put in jail briefly, seen in court and lost custody on [**2-26**]. He took the overdose of about 10 extra strength tylenol pills on the evening of [**2-26**], went to sleep, then called 911 and went to ED about 12 hrs later. He denies that this was a suidice attempt, but reportedly has told some physicians that it was. Initial acetaminophen level was 162 at 12 hrs. He did well at [**Hospital1 2177**], eating but his transaminases began rising and he had recurrent nausea, emesis. He refused several NAC doses. He was transferred to [**Hospital1 18**] due to concerns pt might need liver transplant. Past Medical History: -denies hx of suicide attempts -no hx of inpatient psychiatric tx -though patient denied seeing a psychiatrist in the past, mother notes the pt. has been tx'd for anxiety/panic with Prozac and Klonopin Social History: Difficult childhood with reported DYS/ DSS involvement. Did not finish senior year of high school. Was at [**Location (un) 18488**] Vocational school. Wants to go to college and possibly obtain radiology tech or culinary training. Has very supportive grandmother living in [**Name (NI) 12000**] to whom he has been close and with whom he has been in contact recently. [**Name2 (NI) **] 3 brothers, 1 sister, helps family wi childcare - not employed. Hx of multiple sexual partners since age 13. Has had jail time in past. Smokes 4 cig/ day per prior note from pediatrics at [**Hospital1 2177**] Pt reports occasional use of MJ q 2-3 weeks, last 1 wk ago, but denies IVDU, cocaine, or other illicit drugs. Only drinks EtOH occasionally by report. Family History: Patient does not know Physical Exam: AF 120's/70's 50's 12 95%RA Gen: Blunted affect, NAD Heent: Icteric sclera. MMM Heart: RRR no rmg Lungs: CLear Abd: Slight pain to palapation over R and LUQ's. No peritoneal signs. +BS Ext: No c/c/e. Pertinent Results: [**2193-2-28**] 7:28p 146 107 23 / AGap=22 ------------- 93 4.1 21 3.5 \ Ca: 9.4 Mg: 1.3 P: 3.0 ALT: 5480 AP: 241 Tbili: 5.4 Alb: 3.9 AST: 6014 LDH: Dbili: TProt: [**Doctor First Name **]: Lip: Comments: Verified By Dilution Other Blood Chemistry: HBsAg: Negative HBs-Ab: Positive HBc-Ab: Negative HAV-Ab: Negative HCV-Ab: Negative 78 9.1 \ 16.1 / 181 / 44.8 \ PT: 26.8 PTT: 38.4 INR: 4.5 Fibrinogen: 185 [**2193-3-1**] 10:45AM BLOOD HIV Ab-NEGATIVE [**2193-3-5**] 05:55AM BLOOD Type-[**Last Name (un) **] pO2-103 pCO2-39 pH-7.29* calHCO3-20* Base XS--6 Comment-GREEN TOP [**2193-2-28**] 07:28PM BLOOD Glucose-93 UreaN-23* Creat-3.5* Na-146* K-4.1 Cl-107 HCO3-21* AnGap-22* [**2193-3-1**] 03:01AM BLOOD Glucose-122* UreaN-27* Creat-4.4* Na-140 K-3.7 Cl-106 HCO3-21* AnGap-17 [**2193-3-1**] 05:44PM BLOOD Glucose-152* UreaN-27* Creat-4.8* Na-147* K-3.2* Cl-106 HCO3-18* AnGap-26* [**2193-3-4**] 05:20AM BLOOD Glucose-111* UreaN-56* Creat-8.9* Na-140 K-4.1 Cl-105 HCO3-16* AnGap-23* [**2193-3-5**] 05:33AM BLOOD Glucose-134* UreaN-64* Creat-8.5* Na-140 K-3.7 Cl-105 HCO3-18* AnGap-21* [**2193-3-5**] 05:33AM BLOOD ALT-845* AST-42* LD(LDH)-320* AlkPhos-197* TotBili-2.7* [**2193-2-28**] 07:28PM BLOOD ALT-5480* AST-6014* AlkPhos-241* TotBili-5.4* Approved: SAT [**2193-3-2**] 6:46 PM [**2193-3-6**] 05:21AM BLOOD PT-13.4 INR(PT)-1.1 [**2193-3-6**] 05:21AM BLOOD Glucose-97 UreaN-62* Creat-7.6* Na-141 K-3.8 Cl-107 HCO3-19* AnGap-19 [**2193-3-6**] 05:21AM BLOOD ALT-609* TotBili-2.0* [**2193-3-6**] 05:21AM BLOOD Calcium-8.9 Phos-6.1* Mg-2.1 ABDOMEN U.S. (COMPLETE STUDY) [**2193-3-1**] 8:18 AM ABDOMEN U.S. (COMPLETE STUDY) Reason: tylenol od [**Hospital 93**] MEDICAL CONDITION: 18 year old man with REASON FOR THIS EXAMINATION: tylenol od HISTORY: Tylenol overdose. COMPARISON: No previous studies. FINDINGS: The liver appears normal in echotexture without focal lesions. The portal vein is patent with appropriate direction of flow. There is a small amount of perihepatic free fluid. The gallbladder wall is edematous, but the gallbladder is not distended. This finding is likely related to the presence of ascites. The spleen is normal in size. The pancreas appears unremarkable. The right kidney measures 10.4 cm, and the left kidney measures 11.4 cm. Both kidneys appear echogenic, suggestive of intrinsic renal disease. There is no hydronephrosis or renal stones. The aorta is normal in caliber. IMPRESSION: 1) Perihepatic free fluid. 2) Gallbladder wall edema without gallbladder distention, likely related to ascites. 3) Echogenic kidneys, suggestive of intrinsic renal disease. The study and the report were reviewed by the staff radiologist. DR. [**First Name11 (Name Pattern1) 95**] [**Initial (NamePattern1) **]. [**Last Name (NamePattern1) 96**] DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 7832**] Discharge labs: [**2193-3-7**] 05:29AM BLOOD Hct-37.9* [**2193-3-6**] 05:21AM BLOOD PT-13.4 INR(PT)-1.1 [**2193-3-7**] 05:29AM BLOOD Glucose-77 UreaN-55* Creat-6.1*# Na-144 K-3.9 Cl-109* HCO3-20* AnGap-19 [**2193-3-7**] 05:29AM BLOOD ALT-473* TotBili-1.8* [**2193-3-7**] 05:29AM BLOOD Calcium-9.0 Phos-6.3* Mg-2.1 Brief Hospital Course: 1) Tylenol toxicity: The patient ingested a toxic amount of acetaminophen in a likely suicide attempt with a peak level of 162 at 12 hours post presentation. He was managed at [**Hospital1 2177**] and then transferred to the [**Hospital1 18**] SICU for liver transplant evaluation. He received 16 doses of NAC at [**Hospital1 2177**] and was continued on N-acetyl cysteine which was stopped on [**3-2**]. His AST/ALT peak were on admission at 3742/4615 and they consistently trended down until discharge. He was somewhat encephalopathic on presentation but this improved by the time of transfer to the medical team. His PT/INR peaked at 21.0/2.8 and then trending to normal levels at discharge. Because his LFT's and synthetic function recovered, he was not a transplant candidate. Hepatology expects a full recovery of his liver function and he likley will not need hepatology follow up as an outpatient but this can be arranged if LFT abnormalities persist after [**12-20**] weeks from now. 2) Acute tubular necrosis (ATN): He developed acute renal failure, with a creatinine that went from 3.5 to a peak of 8.9. Renal was consulted who felt that this was ATN, commonly seen following acetanimophen toxicity from nephrotoxic metabolites. He was oliguric but his urine output did not drop below 500 cc per day. As he continued to have adequate urine output, he did not need dialysis. He developed an anion gap acidosis, peak AG of 25 likely secondary to uremia, and was put on sodium citrate twice daily which he refused to take. Despite this, his acidosis improved to AG of 15 at discharge. At the time of this summary, his creatinine was 7.6 which had trended down from a peak 2 days previous of 8.9. Nephrology expects this to recover completely as complete renal recovery is the normal prognosis of ATN. His BUN peaked at 64 and was down slightly to 62 at discharge. This should normalize completely as well, as increases in BUN often accompany renal insufficiency. His phosphorous trended upward to a peak of 6.3 at the time of this summary. This should improve along with creatinine clearance as phosphorous is cleared by the kidney. Nephrology service recommended a normal diet at the time of discharge. If his phosphorous goes above 8, nephrology service recommends Amphogel 30 ml PO TID with meals. However, as the patient was refusing medications and his phosphorous was below 8, this was not started in the hospital. Oral fluid intake should be strongly encoraged with a goal of at least 2-3 liters of total fluid daily. Electrolytes should be checked every other day, with the first check on [**2193-3-9**]. Potassium should be repleted with the following sliding scale: 3.8-4.0 - 20 meq PO KCL 3.6-3.7 - 40 meq PO KCL 3.3-3.5 - 60 meq PO KCL <3.3 - 80 meq PO KCL Magnesium should be repleted with the following scale: 1.9-2.0 - 400 mg MagOx PO once 1.6-1.8 - 800 mg MagOx PO once <1.5 - 800 mg MagOx PO x 2 doses, 12 hours apart 3) Probable suicide attempt: The patient denied that this was a suicide attempt. A 24 hour sitter was continued due to the patient's flight risk. Psychiatry was consulted and recommended inpatient psych admission. The patient did not feel that he needed inpatient psychiatric admission, however this is required given the patient's chance of repeating this episode. The patient is expected to be discharged to an inpatient psychiatric facility. 4) HTN - The patient was noted to be consistently slightly hypertensive, and had a systolic blood pressure averaging in the 140's - 150's. This should be followed as an outpatient, and an antihypertensive such as HCTZ can be considered after his kidney function normalized completely. A beta blocker would be contraindicated with his low pulse, and ACE would be contraindicated in the setting of acute renal failure. 5) Microcytic anemia - The patient was noted to have microcytic anemia of unknown etiology. His hematocrit trended down from baseline around 42 to 37 at the time of discharge. The patient had no signs or symptoms of blood loss and was not transfused. Iron studies showed decreased TIBC and transferrin, and elevated ferritin with normal iron level. The slight decrease could be explained by hydration in addition to the metabolic insult leading to decreased production. His hematocrit is felt from a medical perspective to be stable at this time. The patient could be evaluated as an outpaitent for alpha and beta thalessemia by hemogloibin electrophoresis. Despite the above issues, the patient was medically stable for discharge to an outpatient level of care as of [**2193-3-6**] with primary care follow up. Medications on Admission: none Discharge Medications: none - potassium/magnesium repletion as indicated above. Amphogel if needed for phosphorous about 8.0 as above. Discharge Disposition: Extended Care Discharge Diagnosis: Tylenol overdose Liver Failure, resolved Acute Renal Failure, resolving probable hypertension Microcytic anemia suicide attempt Discharge Condition: Patient had > 1000 cc urine output daily. He was eating and drinking well and medically stable to leave the hospital. Discharge Instructions: You are being discharged to [**Doctor Last Name 1263**] for mental health reasons. If you have these symptoms, call your doctor or go to the ER: - lack of urine output - belly pain - nausea/vomiting - headaches/visual changes - feelings of hurting yourself Followup Instructions: With psychiatry as indicated at discharge from your facility. With the [**Hospital **] Care Center at [**Hospital6 **], ([**Telephone/Fax (1) 60565**]. You are currently scheduled for an appointment on Friday [**3-15**] at 10:40 am with Dr. [**First Name8 (NamePattern2) 2048**] [**Last Name (NamePattern1) **]. The Adolescent Center is located on the [**Location (un) 442**] of the [**Hospital **] Care Center (ACC) at [**Location (un) 24902**]. You should have basic laboratory tests (CBC, Chem 10, INR) drawn at this time. [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) **] MD [**MD Number(2) 617**] ICD9 Codes: 5845, 2762
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Medical Text: Admission Date: [**2157-10-24**] Discharge Date: [**2157-11-4**] Date of Birth: [**2109-1-23**] Sex: F Service: MEDICINE Allergies: Shellfish / Flexeril Attending:[**First Name3 (LF) 949**] Chief Complaint: Hyponatremia, Altered Mental Status Major Surgical or Invasive Procedure: None History of Present Illness: 48yo F w/ HCV cirrhosis c/b encephalopathy, ascites, edema/TIPS [**11-8**], hydrothorax, thrombocytopenia, chronic hyponatremia (baseline 124-128), adrenal insufficiency, GERD, anxiety directly admitted for worsening hyponatremia. Diagnosis of adrenal insufficiency made [**12-12**] during hospitalization for SOB, hyponatremia, fluid overload. Cortisol [**2156-12-10**] was 0.1. At 30 min, cortisol was 1.6. at 60 min, cortisol was 2.4. ACTH < 5. CBG [**2156-12-11**] 27 (nl). Endo Inpt consulting team recommended stress dose steroids if needed but did not recommended chronic replacement steroids as outpatient since she was on inhaled steroids. Pt was seen by Dr [**Last Name (STitle) 10759**] on [**2156-12-28**]. She noted that diagnosis of AI was based on hyponatremia, relative hyperkalemia and eosinophilia. She did note that HypoNa could be [**1-7**] third spacing [**1-7**] cirrhosis and chronic diuretics. She noted that pt only had mildly orthostatic symptoms but these were unchanged whether or not patient was on oral steroids. She also noted that pt never had N, V, weight loss, decreased appetite, hypotension. She did note that off diuretics, patient became short of breath. She then repeated cortisol and ACTH levels which were persistently low and subsenquently started Prednisone 5 mg po qd. Adrenal glands were noted to be normal on abdominal US. Patient has most recently been on Hydrocortisone 20 mg po q am and 10 mg po qhs. On [**10-8**] Na 137, [**10-17**] Na 126, [**10-20**] Na 120 (OSH), [**10-24**] Na 115. On [**10-20**], her diuretics were held [**1-7**] hyponatremia. She reports good compliance with medical regimen and has been avoiding free water. She reports compliance with her low salt diet. She has had increasing dizziness, nausea, worsening LBP over the last few days. She arrived directly on the floor and labs showed the Na of 115. She was transferred to the unit for closer monitoring and potential need for hypertonic saline. On admission to the unit, she reported dizziness, nausea, and fatigue. She has had no seizure like activity or LOC. She denies [**Last Name (LF) **], [**First Name3 (LF) **], photophobia, CP, palpitations. With abdominal pain in RUQ which is unchanged from previous. She denies any fevers, chills. Denied change in BMs (normally [**1-8**] daily). No increased peripheral edema. Past Medical History: 1. HCV cirrhosis s/p TIPS [**11-8**] c/b hydrothorax, encephalopathy, and ascites 2. Hyponatremia baseline 128-133 3. Asthma 4. Adrenal insufficiency (thought to be [**1-7**] chronic advair use) 5. GERD 6. Anxiety 7. Hyperglycemia thought [**1-7**] cirrhosis 8. Recent intubation thought [**1-7**] transfusion-related acute lung injury. Led to prolonged ICU stay then rehab. Also treated for PNA 9. Recent UTI Social History: - Recreational drugs: Past IV drug use with needle sharing, last use 7 years ago. Past drug-snorting. - Alcohol: Past alcohol use, last drink at age 46. - Tobacco: Past [**Month/Day (2) 1818**] with 10 pack-year history - Personal: Single with one child. Lives with mother, who manages medications - Employment: Former waitress, unemployed on disability. Family History: Mother w/ DM2, HTN, and hyperlipidemia. Father w/ COPD and EtOH cirrhosis. Physical Exam: VS: 97.7 102 122/51 16 96% i/o 1120/805 Gen: alert to person, place, time, situation. comfortable, Neuro: fields nl to confrontation HEENT: EOMI OP clear Breast: no disharge expressed from nipple Cards: RRR + murmur Resp: Clear bilat. nl effort Abd: BS+, mildly protuberant. no rebound or guarding. soft Ext: no edema, no hyperpigmentation of scars. Pertinent Results: [**2157-10-24**] 09:31PM PT-18.9* PTT-53.9* INR(PT)-1.7* [**2157-10-24**] 09:31PM WBC-11.5* RBC-3.21* HGB-11.7* HCT-32.9* MCV-103* MCH-36.6* MCHC-35.6* RDW-18.5* NEUTS-79.8* LYMPHS-11.9* MONOS-7.0 EOS-1.0 BASOS-0.2 [**2157-10-24**] 09:31PM ALBUMIN-3.6 CALCIUM-9.3 PHOSPHATE-2.7 MAGNESIUM-2.1 LIPASE-125* [**2157-10-24**] 09:31PM ALT(SGPT)-120* AST(SGOT)-200* LD(LDH)-325* ALK PHOS-447* AMYLASE-185* TOT BILI-7.6* [**2157-10-24**] 09:31PM GLUCOSE-100 UREA N-19 CREAT-0.6 SODIUM-115* POTASSIUM-5.8* CHLORIDE-83* TOTAL CO2-27 ANION GAP-11 [**2157-10-24**] 10:24PM LACTATE-1.8 [**2157-10-24**] 11:00PM URINE RBC-0-2 WBC-0-2 BACTERIA-RARE YEAST-NONE EPI-0-2 BLOOD-NEG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-SM UROBILNGN-NEG PH-6.5 LEUK-NEG OSMOLAL-449 [**2157-10-24**] 11:00PM URINE [**2157-10-24**] 11:00PM URINE HOURS-RANDOM UREA N-644 CREAT-60 SODIUM-22 POTASSIUM-38 Brief Hospital Course: A/P: 48yo woman with history of HCV and ETOH induced cirrhosis complicated by encephalopathy, ascites, s/p TIPS [**11-8**], hydrothorax, thrombocytopenia, adrenal insufficiency, and chronic hyponatremia admitted for worsening hyponatremia. # Hyponatremia: Upon admission patient was noted to have sodium of 115. She has been admitted multiple times with similar problems. [**Name (NI) **] was admitted to the ICU and improved with 3%NS and fluid restriction. She has a long history of being noncompliant with fluid restriction as an outpatient. During her hospital course her sodium slowly improved from 121--> 126--> 127. Was continued on fluid restriction with continued diuresis via lasix and spironolactone. As there was also a question that some of this could be adrenal insufficiency, she was continued on [**Hospital1 **] hydrocortisone 20mg and 10mg for physiologic dosing. Briefly treated with IV lasix and albumin with good effect. Discharged on lasix, spironolactone and 1000ml fluid restriction. # Hyperkalemia: Potassium initially elevated on admission to 5.8. No ECG changes. Transtubular potassium gradient was suggestive of hypoaldosteronism at 5.6. However, it was difficult to determine TTKG in patient with decreased distal delivery of sodium. Ultimately it was unclear if patient is truly adrenally insufficienct as hyponatremia is also result of cirrhosis. Resolved with treatment as described above. Upon discharge K was 4.0 # HCV cirrhosis s/p TIPS [**11-8**] complicated by hydrothorax, encephalopathy, ascites, and thrombocytopenia. T. Bili has improved since prior admission and trending down upon this admit. ALT/AST, Alk phos, and amylase were increasingly elevated with unclear etiology. LFTs were trended and resolved to baseline. MELD calculated and found to be 20. Was continued on lactulose and rifaximin. Continued on diuresis as described above, with the brief addition of IV lasix. # Vertebral compression fractures: Evaluated by IR for vertebroplasty on last admission. IR determined that she was not to be candidate during this admission secondary to continued coagulopathy. Was continued on lidocaine transdermal patch, ice packs, and oxycodone prn. Also on MS contin [**Hospital1 **]. PT was consulted and evaluated the patient, stating she was able to discharge to home. Did have acute episodes of increase pain, but always relieved by oxycodone 5mg. Patient was concerned upon discharge that her pain would be difficult to control at home as her mother is her primary caregiver and does not give her PRNs. Discussed at great length that we could not increase scheduled as she becomes too somnolent and it is not safe. Discharged on MS contin and oxycodone for breakthrough. # History of Adrenal Insufficiency: Upon evaluation she had no sodium wasting in urine or othrostatic hypotension. Potassium levels were noted to be fluctuating. Hydrocortisone continued at physiologic dosing. To follow-up with Endocrine as an outpatient. # Asthma: Not an active inpatient issue, continued on inhalers. # Type 2, DM: Managed as on outpatient with humalog ISS and glargine. While in patient her glargine and ISS were adjusted for improved glycemic control. Discharged on both these medications. Medications on Admission: Albuterol Calcium Carbonate Clotrimazole Dexamethasone 4 mg IV bid Fluticasone-Salmeterol (100/50) FoLIC Acid Insulin Lactulose Lidocaine 5% Patch Magnesium Oxide Montelukast Sodium Morphine Sulfate Morphine SR (MS Contin) OxycoDONE (Immediate Release) Pantoprazole Rifaximin Vitamin D Discharge Medications: 1. Oxycodone 5 mg Tablet [**Hospital1 **]: One (1) Tablet PO every six (6) hours as needed for 20 doses. Disp:*20 Tablet(s)* Refills:*0* 2. Albuterol 90 mcg/Actuation Aerosol [**Hospital1 **]: 1-2 Puffs Inhalation Q4H (every 4 hours) as needed. 3. Clotrimazole 10 mg Troche [**Hospital1 **]: One (1) Troche Mucous membrane 5X DAY (). Disp:*150 Troche(s)* Refills:*0* 4. Fluticasone-Salmeterol 100-50 mcg/Dose Disk with Device [**Hospital1 **]: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). 5. Folic Acid 1 mg Tablet [**Hospital1 **]: Five (5) Tablet PO DAILY (Daily). 6. Lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated [**Hospital1 **]: One (1) Adhesive Patch, Medicated Topical DAILY (Daily). 7. Rifaximin 200 mg Tablet [**Hospital1 **]: Two (2) Tablet PO TID (3 times a day). 8. Calcium Carbonate 500 mg Tablet, Chewable [**Hospital1 **]: One (1) Tablet, Chewable PO three times a day. 9. Morphine 15 mg Tablet Sustained Release [**Hospital1 **]: One (1) Tablet Sustained Release PO Q12H (every 12 hours). Disp:*60 Tablet Sustained Release(s)* Refills:*0* 10. Spironolactone 100 mg Tablet [**Hospital1 **]: One (1) Tablet PO DAILY (Daily). 11. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) [**Hospital1 **]: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). 12. Hydrocortisone 20 mg Tablet [**Hospital1 **]: 0.5-1 Tablet PO Twice daily, 20mg at 10AM and 10mg at 5pm: Take one tablet each morning at 10AM and [**12-7**] tablet each evening at 5pm. Disp:*45 Tablet(s)* Refills:*2* 13. Furosemide 80 mg Tablet [**Month/Day (2) **]: One (1) Tablet PO twice a day. 14. Lactulose 10 gram/15 mL Syrup [**Month/Day (2) **]: Forty Five (45) ML PO TID (3 times a day). 15. Cholecalciferol (Vitamin D3) 400 unit Tablet [**Month/Day (2) **]: Two (2) Tablet PO once a day. 16. Insulin Lispro 100 unit/mL Insulin Pen [**Month/Day (2) **]: One (1) unit Subcutaneous four times a day as needed for glucose correction: Please give as directed on your discharge insulin sliding scale. Check fingersticks four times daily. Disp:*QS pen* Refills:*2* 17. Lancets Misc [**Month/Day (2) **]: One (1) lancet Miscellaneous four times a day. Disp:*QS lancet* Refills:*2* 18. Alcohol Prep Pads Pads, Medicated [**Month/Day (2) **]: One (1) pad Topical four times a day. 19. Insulin Syringes (Disposable) Syringe [**Month/Day (2) **]: One (1) syringe Miscellaneous twice a day. 20. Calcitonin (Salmon) 200 unit/Actuation Aerosol, Spray [**Month/Day (2) **]: One (1) spray Nasal twice a day: Alternate nostrils daily. Disp:*QS unit* Refills:*1* 21. Insulin Glargine 300 unit/3 mL Insulin Pen [**Month/Day (2) **]: Thirty Four (34) unit Subcutaneous at bedtime. Disp:*1 month supply* Refills:*2* Discharge Disposition: Home With Service Facility: [**Location (un) 6138**] Home Care Services Discharge Diagnosis: Primary: Hyponatremia, adrenal insufficiency Secondary: Hepatitis C, Cirrhosis Discharge Condition: Hemodynamically stable and afebrile. Discharge Instructions: 1)You were admitted to the hospital with low sodium. You also developed worsening fluid in your legs while you were in the hospital. We increased your dose of diuretics. You were kept on a strict regimen of 1000ml (1 liter) of fluid intake. Please continue to monitor your intake of fluids and keep it within the 1 liter. 2)In the hospital you had a test to rule out tuberculosis on your arm. Please schedule an appointment with your primary care physician (you may not need an appointment, but can just stop by) on Monday to have this looked at. 3)Please take all medications as listed in the discharge instructions. Your ipratroprium bromide was held while in the hospital, please discuss this medication with your regular doctor [**First Name (Titles) 5001**] [**Last Name (Titles) 9533**] it. You have also been prescribed a new medication called Clotrimazole. Please continue to take this medication as directed. 4)Please attend all appointments as listed below. 5)If you experience any fevers, chills, chest pain, shortness of breath, dizziness or any other concerning symptoms please return to the emergency room. Followup Instructions: Please keep all your appointments. You have the following appointment scheduled to see how you are doing after discharge: Dr. [**Last Name (STitle) **] [**Name (STitle) 3628**] [**Location (un) **] [**2157-11-24**] at 8am ([**Telephone/Fax (1) 1582**] Please see you primary care physician on [**Name9 (PRE) 766**], [**2157-11-7**] to have your TB test read. This was placed on your left arm. ICD9 Codes: 2761, 5715, 2767
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Medical Text: Admission Date: [**2107-7-19**] Discharge Date: [**2107-7-31**] Date of Birth: [**2051-5-31**] Sex: M Service: COLORECTAL SURGERY/GREEN SURGERY HISTORY OF PRESENT ILLNESS: This is a 56-year-old man with a history of ulcerative colitis since [**2098**]. The patient was hospitalized almost annually for flareups. His current flare began three weeks ago at which time he was admitted to [**Hospital3 9683**] for the past three weeks. He was recently started on IV hydrocortisone and sent home several days prior this admission. The patient complained of increasing symptoms over the weekend with severe lower abdominal pain with po intake, low grade fevers, nausea, vomiting, and [**6-26**] bloody bowel movements per day. PAST MEDICAL HISTORY: Ulcerative colitis. PAST SURGICAL HISTORY: None. MEDICATIONS: 1. Hydrocortisone 100 mg tid. 2. Two Ativan prn. 3. Iron. 4. Folic acid. 5. Prevacid. ALLERGIES: 6-mercaptopurine, reaction jaundice. SOCIAL HISTORY: No tobacco and occasional alcohol. FAMILY HISTORY: Mother with [**Name (NI) 4522**] disease. REVIEW OF SYSTEMS: No chest pain, shortness of breath, palpitations, no dysuria, hematuria, or hematemesis. PHYSICAL EXAMINATION ON ADMISSION: Vital signs: Temperature at 99.4, heart rate 100, blood pressure 117/86, respirations 16, and pulse oxygenation 98% on room air. He was alert and oriented times three in no acute distress. His sclerae were anicteric. His mucous membranes were moist. His heart rate was regular, rate, and rhythm with no murmurs, rubs, or gallops. His lungs were clear to auscultation bilaterally. His abdomen was soft, tender in the lower quadrants to palpation, with no guarding and positive bowel sounds. Rectal examination was grossly heme positive, with positive external hemorrhoid visualized. His extremities were warm and well perfused with no edema. A CT scan of the abdomen on admission showed no evidence of free air obstruction or abscess with diffuse colonic thickening and loss of haustral folds and multiple nodular filling defects in the transverse colon. Please see full report for details. LABORATORIES ON ADMISSION: A complete blood count is as follows: White blood cell count 8.0, hematocrit 33.1, platelet count 201. White blood cell count differential 90% neutrophils, no band neutrophils, 6.4 lymphocytes, 3.2% monocytes. Electrolytes as follows: Sodium 136, potassium 3.9, chloride 100, HCO3 29, BUN 15, creatinine 0.8, glucose of 187. The patient was admitted to the Colorectal Service under Dr. [**Last Name (STitle) 1888**], and he was written for a diet of nothing by mouth, IV fluids, medicated with IV steroids, antibiotics, and was given a routine preoperative assessment with electrocardiogram and chest x-ray. On postoperative day two, the patient received a peripherally inserted central catheter line for administration of total parenteral nutrition. He was started on a morphine sulfate PCA for pain control. He was visited by the enterostomal nurse therapist for education and discussion of ileostomy care. On hospital day four, the patient was taken to the operating room for a restorative proctocolectomy, diverting ileostomy. Please see full operative report for details of the procedure. Following the procedure, the patient was hypotensive with elevated heart rate and decreased urine output. He was infused with both his Lactated Ringers as well as Hespan for volume resuscitation. His urine output responded marginally to these boluses. The patient's postoperative hematocrit and electrolytes were all within normal limits except for a magnesium of 1.3 for which he was given 2 grams of magnesium intravenously. After several hours of time postoperatively, the patient was noted to have dysnomia and difficulty speaking a Neurology consult was obtained at the time. Please see full Neurology consult note for details. A CT scan of the head was obtained with no abnormalities noted. The patient was transferred to the Surgical Intensive Care Unit team care for monitoring and volume resuscitation on a Neo-Synephrine drip. On postoperative day one, the patient's blood pressure stabilized, and the patient was taken to MRI for further evaluation of his speech difficulties. The MRI was suggestive of an acute left temporal infarct with no mass effect or midline shift and no acute occlusion. Please see full MRI report for details. The patient was further worked up for cause of the left temporal infarct and on an transesophageal echocardiogram was noted to have a small atrioseptal defect with right to left flow. Clinically, the patient's aphasia was improving. His colostomy was viable and putting out small amounts of liquid brown stool. The patient remained on total parenteral nutrition with consultation from a nutritionist on staff, and the patient was seen by Dr. [**Last Name (STitle) **] for evaluation of closure of the atrioseptal defect. On hospital day 11, postoperative day six, the patient was deemed stable enough to return to the surgical floor and was transferred from the Intensive Care Unit. He was able to tolerate regular diet. His pain was well controlled. He was able to ambulate and had no further neurological changes or complaints. On postoperative day eight, he was deemed in stable enough condition to transfer to home with visiting nurse services. Addendum: Patient underwent a colonoscopy on hospital day two, which showed severe ulcerations of the colon. Please see full colonoscopy report for details of procedure. DISCHARGE DIAGNOSIS: 1. Ulcerative colitis primary status post restorative proctocolectomy with diverting ileostomy. 2. Left temporal lobe cerebral infarct. 3. Atrioseptal defect. 4. Secondary hypotension, hypovolemia. CONDITION ON DISCHARGE: Good and stable. DISCHARGE STATUS: To home with visiting nurses. DISCHARGE MEDICATIONS: 1. Aspirin 325 mg tablet one tablet po q day. 2. Clopidogrel 75 mg tablet one tablet po q day. 3. Tylenol #3 30/300 1-2 tablets po q4h as needed for pain. 4. Loperamide 2 mg one capsule po qid. 5. Prednisone 5 mg tablets three tablets po q day x1 week, then two tablets 10 mg po until followup with Dr. [**Last Name (STitle) 1888**]. 6. Pravastatin 20 mg tablet one tablet po q day. FOLLOW-UP PLANS: 1. Patient is to followup with Dr. [**Last Name (STitle) 1888**] in Colorectal Surgery in [**1-20**] weeks, and has been the office number to call for an appointment. 2. Dr. [**Last Name (STitle) **], Interventional Cardiology for repair of atrioseptal defect. The patient has been given office number to call for an appointment. In addition, the patient is referred to Visiting Nurses Association Services for dressing changes, dry gauze twice a day as well as ostomy care routine twice a day. He is instructed to take a regular diet and regular activity as tolerated. [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern4) **], M.D. Dictated By:[**Last Name (NamePattern1) 5657**] MEDQUIST36 D: [**2107-8-8**] 11:17 T: [**2107-8-16**] 08:12 JOB#: [**Job Number 51943**] ICD9 Codes: 5180
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Medical Text: Admission Date: [**2185-6-26**] Discharge Date: [**2185-6-30**] Date of Birth: [**2108-12-9**] Sex: M Service: MEDICINE Allergies: Penicillins Attending:[**First Name3 (LF) 2009**] Chief Complaint: Dyspnea Major Surgical or Invasive Procedure: None History of Present Illness: 76M oxygen-dependent COPD (on 3 L with baseline pOx 90-92%) presents with 2 week history of dyspnea on exertion with associated neck discomfort he describes as "chest heaviness," and new productive cough. Current "exacerbation" was similar to prior exacerbation a couple of years ago; however, his associated neck discomfort was not present. Dr. [**Last Name (STitle) **], his outpatient pulmonologist, placed him on a prednisone burst and avelox on [**6-13**], for presumed COPD exacerbation. He completed a 7-day course of Avelox, and then was renewed for another 7 day course 2 days ago for persistent symptoms. He was put on 60mg daily of prednisone and two days ago weaned down to 40mg daily. He continued to have difficulty with SOB and breathing. He has had sick contacts including a son with pneumonia recently. He denies fever, chills, but does endorse mild productive cough. No smoking or recent healthcare exposures. He endorses dyspnea when laying flat, but he does not endorse any weight gain or increased swelling in his lower extremities. He takes lasix 20mg prn at home and took one tablet 1.5 weeks ago, but hasn't needed it since. Given his persistent dyspnea and his chest heaviness, he called Dr. [**Last Name (STitle) **] today, who recommended he presented to ER. He describes the chest heaviness as located in the top of his chest, at the base of his neck, that does not radiate and has been fairly constant recently. It is exacerbated with exertion and improved with rest. In the ED, initial VS were: 97.6 109 154/73 18 88% 3L Nasal Cannula. Initially trigerred for respiratory distress given solumedrol, ipratroprium/albuterol nebs with improved respiratory status. Labs revealed elevated white count thought secondary to recent prednisone burst. D-Dimer was negative. ABG on 3 liters of oxygen 7.4/36/53. BNP/Troponin T were 527 and < 0.01, respectively. CXR was performed without significant change from prior. EKG with scooped ST segments in the inferior leads. Given neck pain noted and concern that this could represent a cardiac equivalent, Aspirin 325mg was given. Vitals on transfer: BP 125/59, HR 90, RR 18, pOx 89 on RA. On arrival to the MICU, patient's VS 97.8, 155/61, 97, 25, 90% 3L. Pt resting comfortably in the chair, speaking in full sentences, in NAD. Currently complaining of the same chest heaviness he has been having recently, but otherwise feels well and much better than when he initially presented. Past Medical History: COPD Stage II (moderate) based FEV1 63% of predicted, based on spirometry [**12/2184**] Sub 5-mm noncalcified nodule in the right middle lobe [**3-20**] CT Obstructive sleep apnea, moderate per sleep study [**3-20**] Diastolic CHF Hypertension Osteoarthritis Herniated disc L2-3 s/p bilateral knee replacements Social History: Married and works as a funeral home director. Denies ETOH or drugs, quit smoking 11 years ago but smoked [**3-18**] ppd x > 50 yrs. Family History: Father died of lung cancer, no fam h/o heart disease or MIs. Physical Exam: ADMISSION EXAM: Vitals: 97.8, 155/61, 97, 25, 90% 3L General: Alert, oriented, no acute distress HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, PERRL Neck: supple, JVP not elevated CV: Tachycardic, reg rhythm, normal S1/S2, no murmurs/rubs/ gallops Lungs: Clear to auscultation bilaterally, no wheezes, rales, ronchi Abdomen: soft, non-distended, bowel sounds present, no tenderness to palpation, no rebound or guarding GU: no foley Ext: Warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema DISCHARGE EXAM: ital signs: Tmax 98.2 BP 137/68 HR 96 91-93% 5L O2 sat General: in NAD, appears stated age. HEENT: OP moist, no LAD, PERRL. JVP not elevated Lungs diminished bilaterally, prolonged expiratory phase with forced expiration CV tachycardic without murmurs Abdomen soft, NT, ND, NABS Ext: no edema Neuro: alert/oriented X3, moving all extremities. Pertinent Results: ADMISSION LABS: [**2185-6-26**] 01:45PM BLOOD WBC-19.5*# RBC-5.82 Hgb-16.8 Hct-54.1* MCV-93 MCH-28.8 MCHC-31.0 RDW-14.4 Plt Ct-280 [**2185-6-26**] 01:45PM BLOOD Neuts-90.8* Lymphs-6.7* Monos-1.7* Eos-0.4 Baso-0.4 [**2185-6-26**] 01:45PM BLOOD PT-10.1 PTT-26.8 INR(PT)-0.9 [**2185-6-26**] 01:45PM BLOOD Glucose-135* UreaN-27* Creat-1.0 Na-140 K-4.5 Cl-107 HCO3-20* AnGap-18 [**2185-6-26**] 10:18PM BLOOD CK(CPK)-47 [**2185-6-26**] 01:45PM BLOOD cTropnT-<0.01 proBNP-527 [**2185-6-26**] 01:45PM BLOOD Calcium-8.8 Phos-3.3 Mg-2.3 [**2185-6-26**] 01:56PM BLOOD Type-ART pO2-53* pCO2-36 pH-7.40 calTCO2-23 Base XS--1 Intubat-NOT INTUBA Vent-SPONTANEOU [**2185-6-26**] 01:56PM BLOOD Lactate-2.1* CE Trend: [**2185-6-26**] 01:45PM BLOOD cTropnT-<0.01 proBNP-527 [**2185-6-26**] 10:18PM BLOOD CK-MB-4 cTropnT-<0.01 [**2185-6-26**] 10:18PM BLOOD CK(CPK)-47 [**2185-6-27**] 03:27AM BLOOD CK-MB-4 cTropnT-<0.01 [**2185-6-27**] 03:27AM BLOOD CK(CPK)-41* [**2185-6-27**] ECHO: Poor image quality. The left atrium is elongated. The right atrium is moderately dilated. There is mild symmetric left ventricular hypertrophy with normal cavity size and global systolic function (LVEF>55%). Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. There is no ventricular septal defect. The right ventricular cavity is dilated The ascending aorta is mildly dilated. The aortic valve is not well seen. No aortic regurgitation is seen. No mitral regurgitation is seen. The tricuspid valve leaflets are mildly thickened. Tricuspid regurgitation is present but cannot be quantified. There is severe pulmonary artery systolic hypertension. There is no pericardial effusion. Compared with the prior study (images reviewed) of [**2183-11-3**], the degree of pulmonary hypertension detected is now severe. Imaging: CXR [**6-26**] - no infiltrates, bibasilar atelectasis. Chest CT [**6-29**] IMPRESSION: 1. Suspected tracheobronchomalacia as described. 2. Extensive diffuse atherosclerosis. 3. Evidence of small airway disease. 4. Several pulmonary nodules as described that should be reevaluated in [**7-26**] months interval with chest CT. Lung scan [**6-30**]: Low probability for PE Micro [**6-26**] MRSA screen negative, blood cultures pending Brief Hospital Course: 76 yo M w/ COPD stage II (on 3L O2 at home) p/w dyspnea and neck discomfort for the past 2 weeks, after failing outpt therapy with avelox and prednisone, found to have acute respiratory failure, likely multifactorial, as well as secondary polycythemia. ACUTE ISSUES # Acute hypoxic respiratory failure - Pt p/w 2 week of dyspnea, failing outpt treatment with Avelox and prednisone for presumed COPD exacerbation. He was initially admitted to the ICU, and treated supportively with antibiotics of CTX/azithromycin, prednisone and nebulizers, briefly and then transferred to the floor. He was seen by the pulmonary consult service of Dr. [**Last Name (STitle) **] and Dr. [**Last Name (STitle) **]. He was continued on prednisone, just azithromcyin with no evidence of pneumonia on imaging, and nebulizers. He was also diuresed given concern that there was a component of volume overload leading to his worsening hypoxia. He was ultimately discharged home on a prednisone taper, spiriva and increased home oxygen. ## Chronic hypoxic respiratory failure, with chronic COPD. He was admitted with acute exacerbation of chronic hypoxia. His chronic hypoxia was evaluated with chest CT, ECHO, repeat PFTs and lung scan. ECHO showed worsening pulmonary artery hypertension. Thus lung scan was performed to identify chronic thromboembolic disease as a cause of PAH, which was negative. Chest CT showed question of TBM, and bronchiolitis, and lung nodules, but not significant interestitial disease. PFTS were stable. He was discharged home with O2 at 5L, with plan for further outpt pulmonary workup. He was discharged on advair,,spiriva, albuterol and prednisone. # Neck discomfort - Pt has associated neck discomfort with dyspnea that did not accompany pt's last COPD exacerbation. He ruled out for MI, but did have ST depressions on EKG. Consideration could be made for stress test as outpatient. # Chronic diastolic CHF - Pt w/ EF > 55% and mild symmetric left ventricular hypertrophy with normal cavity size and moderately dilated right ventricular cavity with moderate global free wall hypokinesis. HE was diuresed with some improvement in his respiratory status, and discharged on 20 mg po daily of furosemide. # Leukocytosis - Most likely due to prednisone he was on as an outpatient as he is afebrile and non-toxic appearing and so do not have a high suspicion that this is from infection. He remained afebrile. # Polycythemia, secondary - Pt noted to have a HCT of 54.1 and unclear how long this as persisted as last HCT hasn't been since [**84**]/[**2184**]. Likely polycythemia due to chronic hypoxia. # Obstructive sleep apnea - Pt has hx OSA and uses CPAP at home. - cont CPAP at night. Transitional issues: 1. Lung nodules. Will need repeat Chest CT 6-12 months. Communicated by letter to pcp, [**Name10 (NameIs) **] and patient. 2. ST depressions on ekg. Could consider stress test if respiratory status improves. 3. Chronic diastolic CHF. Discharged on higher dose of furosemide, 20 mg po daily - will need bmp in 1 week. 4. Pending tests. Blood cultures from admission pending at discharge. Medications on Admission: Albuterol sulfate 90 mcg HFA Aerosol Inhaler: 2 puffs q4-6h prn chest tightness/SOB Fluticasone-salmeterol [Advair Diskus] 250-50 mcg: 1 inhalation [**Hospital1 **] Furosemide 20 mg Tablet: 1 Tablet PO daily prn increased dyspnea Ibuprofen 800 mg Tablet: 1 Tablet(s) by mouth three times a day Moxifloxacin [Avelox] 400 mg Tablet: 1 Tablet PO daily x 7 days Portable oxygen 2 liters/minute with exertion Prednisone 20 mg Tablet: 3 Tablets PO daily Sennosides-docusate sodium [PERI-COLACE] 8.6 mg-50 mg PO BID Discharge Medications: 1. fluticasone-salmeterol 250-50 mcg/dose Disk with Device Sig: One (1) puff Inhalation [**Hospital1 **] (2 times a day). 2. Spiriva with HandiHaler 18 mcg Capsule, w/Inhalation Device Sig: One (1) capsule Inhalation once a day. Disp:*30 capsules* Refills:*1* 3. albuterol sulfate 90 mcg/actuation HFA Aerosol Inhaler Sig: Two (2) puffs Inhalation every 4-6 hours as needed for shortness of breath or wheezing. 4. furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day. 5. prednisone 10 mg Tablet Sig: Taper PO once a day for 21 days: 5.5 tabs for 2 days, 5 tabs for 2 days, then decrease by 5 mg ([**2-14**] tab) every 2 days, until at 20 mg. Disp:*qs Tablet(s)* Refills:*0* 6. Oxygen 3-5L O2 continuouis via nasal cannula; pulse dose for portability Diagnosis: COPD Discharge Disposition: Home Discharge Diagnosis: Acute respiratory failure Chronic hypoxia Pulmonary hypertension Acute bronchitis Hypertension Discharge Condition: 90% on 5L. ambulating independently. Discharge Instructions: You were admitted with difficulty breathing. You did not have a pneumonia, and likely this was caused by a bronchitis, that made your breathing worse than usual. We did several tests to look for other causes,and to find out why your oxygen is always low, and Dr. [**Last Name (STitle) **] is going to continue that evaluation.\ Weigh yourself every day, and call Dr. [**First Name (STitle) 572**] or Dr. [**Last Name (STitle) **] if your weight drops or increases by more than 2 lbs over 2 days. Your oxygen is still lower than usual, but you feel well. You will need to continue to use 5L of oxygen at all times, and especially when you are walking. Use your CPAP at night. If you get more short of breath, you should call Dr.[**Name (NI) 6005**] office. Medication changes: Start: Prednisone taper - 55 mg for 2 days, decrease by 5 mg every other day until you are taking 20 mg, then stop tapering until you see Dr. [**Last Name (STitle) **] [**Name (STitle) **] Spiriva 1 capsule daily Increase: Furosemide 20 mg to every day Followup Instructions: Department: GASTROENTEROLOGY When: FRIDAY [**2185-7-8**] at 8:40 AM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 4465**], MD [**Telephone/Fax (1) 463**] Building: LM [**Hospital Unit Name **] [**Location (un) 858**] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage Department: MEDICAL SPECIALTIES With: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], M.D. [**Telephone/Fax (1) 612**] Building: [**Hospital6 29**] [**Location (un) **] ****The Pulmonary Dept is working on an appt for you in the next few weeks and will call you at home with the appt. If you dont hear from them by Friday, please call them directly to book. ICD9 Codes: 4168, 4280, 4019
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Medical Text: Admission Date: [**2113-3-2**] Discharge Date: [**2113-3-10**] Date of Birth: [**2033-12-18**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 5368**] Chief Complaint: fever Major Surgical or Invasive Procedure: s/p lumbar puncture History of Present Illness: 78 year old russian speaking male who presents with two days of fever. He has also been complaining of headache and increased lethargy. In addition he had some cloudy urine today. Initial history was obtained from his daughter. [**Name (NI) **] denies any neck stiffness or pain. Says he only has headache which is located at the top of his head. He has no chest pain, no abdominal pain. He was feeling slightly lightheaded at home but this has resolved. His temperature in the ED was 102. A LP was performed and he was treated with 2 g Ceftriaxone, Tylenol, Vancomycin, Ampicillin, Dexamethasone, and ASA. Past Medical History: 1. hypertension 2. BPH s/p TURP X2 3. prostate cancer s/p XRT 4. colonic polyps Social History: Married. No smoking, no alcohol. He is retired engineer from [**Country 532**]. He exercises avidly doing calisthenics every day, 20 minutes. Family History: NC Physical Exam: VS: Temp 102.6, Pulse 96, BP 126/70, RR 24, 97% on RA Gen: alert, oriented, cooperative male in NAD HEENT: MM dry, OP clear, PERRL Neck: supple, no lymphadenopathy Lungs: clear to auscultation bilaterally CV: RRR, nl S1S2, no murmers Abd: soft, non-tender, non-distended, positive BS Ext: no edema Neuro: grossly intact, moving all extremities, no sensory deficits Pertinent Results: EKG: NSR at 82, nl axis, nl intervals, no old to compare Imaging: CXR: 1. Markedly tortuous aorta with prominance of the arch contour. 2. No definite pneumonia. Head CT: No evidence of intracranial hemorrhage or no evidence of mass effect. [**2113-3-2**] 10:10PM CORTISOL-29.5* [**2113-3-2**] 09:27PM CORTISOL-18.5 [**2113-3-2**] 08:42PM GLUCOSE-118* UREA N-24* CREAT-0.9 SODIUM-143 POTASSIUM-4.2 CHLORIDE-118* TOTAL CO2-17* ANION GAP-12 [**2113-3-2**] 08:42PM CALCIUM-7.0* PHOSPHATE-1.8*# MAGNESIUM-1.7 [**2113-3-2**] 08:42PM CORTISOL-4.6 [**2113-3-2**] 08:42PM WBC-10.9 RBC-3.10* HGB-9.9* HCT-27.8* MCV-90 MCH-31.8 MCHC-35.6* RDW-13.4 [**2113-3-2**] 08:42PM PLT COUNT-139* [**2113-3-2**] 03:02PM POTASSIUM-3.8 [**2113-3-2**] 03:02PM HCT-28.0* [**2113-3-2**] 11:49AM URINE COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.013 [**2113-3-2**] 11:49AM URINE BLOOD-MOD NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-7.0 LEUK-NEG [**2113-3-2**] 11:49AM URINE RBC-0-2 WBC-0-2 BACTERIA-MOD YEAST-NONE EPI-0-2 [**2113-3-2**] 11:40AM SODIUM-141 POTASSIUM-2.8* [**2113-3-2**] 11:40AM CK(CPK)-246* [**2113-3-2**] 11:40AM CK-MB-2 cTropnT-0.01 [**2113-3-2**] 11:40AM WBC-10.3 RBC-3.05*# HGB-9.7*# HCT-27.1*# MCV-89 MCH-31.9 MCHC-35.9* RDW-13.2 [**2113-3-2**] 11:40AM PLT COUNT-133* [**2113-3-2**] 11:40AM PT-14.2* PTT-25.2 INR(PT)-1.3* [**2113-3-2**] 10:34AM LACTATE-1.4 [**2113-3-2**] 10:32AM TYPE-ART PO2-103 PCO2-27* PH-7.52* TOTAL CO2-23 BASE XS-1 [**2113-3-2**] 10:32AM GLUCOSE-160* LACTATE-1.2 NA+-136 K+-3.1* CL--106 [**2113-3-2**] 10:32AM freeCa-1.14 [**2113-3-2**] 07:56AM GLUCOSE-146* UREA N-25* CREAT-1.1 SODIUM-138 POTASSIUM-3.9 CHLORIDE-101 TOTAL CO2-22 ANION GAP-19 [**2113-3-2**] 07:56AM CALCIUM-8.7 PHOSPHATE-3.6 MAGNESIUM-2.0 [**2113-3-2**] 07:56AM WBC-7.6 RBC-4.13* HGB-12.8* HCT-36.8* MCV-89 MCH-30.9 MCHC-34.7 RDW-13.3 [**2113-3-2**] 07:56AM PLT COUNT-168 [**2113-3-2**] 12:30AM CEREBROSPINAL FLUID (CSF) PROTEIN-73* GLUCOSE-77 [**2113-3-2**] 12:30AM CEREBROSPINAL FLUID (CSF) WBC-156 RBC-10* POLYS-78 LYMPHS-3 MONOS-0 MACROPHAG-19 [**2113-3-1**] 10:55PM K+-3.1* [**2113-3-1**] 10:49PM CK(CPK)-585* [**2113-3-1**] 10:49PM CK-MB-4 cTropnT-<0.01 [**2113-3-1**] 10:35PM URINE COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.026 [**2113-3-1**] 10:35PM URINE BLOOD-LG NITRITE-NEG PROTEIN-100 GLUCOSE-NEG KETONE-TR BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-NEG [**2113-3-1**] 10:35PM URINE RBC-[**2-12**]* WBC-0 BACTERIA-FEW YEAST-NONE EPI-0-2 [**2113-3-1**] 10:35PM URINE MUCOUS-OCC [**2113-3-1**] 09:49PM LACTATE-1.6 [**2113-3-1**] 09:40PM GLUCOSE-161* UREA N-32* CREAT-1.2 SODIUM-128* POTASSIUM-6.8* CHLORIDE-95* TOTAL CO2-22 ANION GAP-18 [**2113-3-1**] 09:40PM CK(CPK)-787* [**2113-3-1**] 09:40PM CK-MB-4 cTropnT-<0.01 [**2113-3-1**] 09:40PM WBC-9.8# RBC-4.06* HGB-13.1* HCT-35.4* MCV-87 MCH-32.2* MCHC-37.0*# RDW-13.3 [**2113-3-1**] 09:40PM NEUTS-83.7* LYMPHS-10.0* MONOS-5.4 EOS-0.3 BASOS-0.5 [**2113-3-1**] 09:40PM PLT COUNT-206 TEE: [**2113-3-8**] No atrial septal defect is seen by 2D or color Doppler. Left ventricular wall thickness, cavity size, and systolic function are normal. The sinuses of Valsalva are dilated. There are simple atheroma in the descending thoracic aorta. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion. No masses or vegetations are seen on the aortic valve. Mild (1+) aortic regurgitation is seen. The mitral valve leaflets are structurally normal. No mass or vegetation is seen on the mitral valve. Mild (1+) mitral regurgitation is seen. No vegetation/mass is seen on the pulmonic valve. IMPRESSION: No echocardiographic evidence for endocarditis. Mild mitral regurgitation. Mild aortic regurgitation. [**2112-3-8**]: CT of C/A/P IMPRESSION: 1. No evidence of aortic dissection. No evidence of proximal pulmonary embolism. Please note that evaluation of small peripheral pulmonary arteries in lower lobes are somewhat limited due to atelectasis and technique. 2. Bilateral pleural effusion with atelectasis. 3. Incidentally noted aberrant right subclavian artery with dilated origin, probably representing Kommerell diverticulum. 4. Cholelithiasis. Brain MRI: [**2113-3-7**] Findings consistent with leptomeningitis most prominently demonstrated in the left frontal region. There is no evidence of abscess formation Brief Hospital Course: A/P: 78 year old male with fevers, headache - LP c/w meningitis. . 1. Fever and headache: Patient's LP consistent with bacterial meningitis. He was initially covered with Vancomycin, Ampicillin, Ceftriaxone, Decadron and Acyclovir. Patient quickly defervesed initially, but became hypotensive. Patient had 3 large bore IVs placed on the floor, when his SBP dropped to 70s. Patient received > 7L NS boluses and was eventually taken to the ICU for observation. There, he received a L of Ringer's Lactate and his SBP stabilized in 110s range. Patient was mentating throughout. His lactates remained flat. Patient then returned to the medical floor. His HSV PCR was negative and Acyclovir was stopped. Patient's Vanco also stopped. Patient then developed a severe headache and an MRI of the brain revealed evidence of leptomential infection w/o abscess. ID consulted. Patient's Vancomycin, Ampicillin and decadron discontinued and patient continued on Caftriaxone. Patient's initial blood cultures from day of admission returned positive for peptostreptococcus and patient continued on Ceftriaxone. Patient then began to spike temps to > 102 and all subsequent blood cx negative. Patieent also had CT of the chest/abdomen/pelvis, which was negative for embolic disease. A TEE was negative for vegetation. ID then recommended changing abx to Ampicillin form Ctx for better peptostreptococcus coverage. Patient continued on ampicillin as ID attempted to get sensitivities for the peptostreptococcus. The patinent will need to continue on Ampicillin for 2 weeks, or until the Infectious Disease team at the [**Hospital3 **] instructs differently. Patient will need to have blood cultures drawn for fever > 101.5. He will also need Urinalysis and urine culture if he complains of dysuria and chest X-Ray if he develops hypoxia or shortness of breath. Patient's headache was managed with tylenol. . 2. Hypotension - Patient dropped SBP down to 70's and c/o dizziness. SBP returned to 110s with > 7L fluid bolus challeng. Initially had EKG to eval for cardiac cause of hypotension, which was nonfocal. His lactates remained flat and did not point to septic source. Patient felt to be profoundly hypovolemic. Patient's SBP remained stable after fluid resisitation. Patient was noted to have brown trace guiac positive stool, and his HCT dropped from mid 30s to 28 in setting of fluid resisitation. He was NG lavaged and this was negative. His HCT remained [**Last Name (un) 2677**] in 30 range. Patient also had no further episodes of hypotension. . 3. Hypoxia: Patient was noted to be slightly hypoxic on the medicine floor after fluid resusitation. By exam and CXR, he was is CHF. Patient given PRN lasix and O2 sats remained stable on room air from that point onwards. Patient was restarted on his HCTZ and beta blockers were held. . 4. PPx - SC heparin - Bowel regimen . 4. FEN - regular diet . 5. Access: PICC . 6. Code: FULL Medications on Admission: 1. HCTZ 25mg daily 2. Univasc 7.5 mg daily Discharge Medications: 1. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO BID (2 times a day). 2. Hydrochlorothiazide 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Ampicillin Sodium 2 g Recon Soln Sig: One (1) Recon Soln Injection Q6H (every 6 hours) for 14 days. 4. Protonix 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. 5. Tylenol 325 mg Tablet Sig: 1-2 Tablets PO every 6-8 hours for 4 days. Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - Acute Rehab Discharge Diagnosis: Meningitis Peptostreptococcus Bacteremia Hypovolemia/Hypotension Hypertension Benign Prostatic Hypertrophy Discharge Condition: stable Discharge Instructions: Please take all medications as perscribed. Please report to your primary care physician or the emergency room with ahy fevers, chills, headache, nausea, light-headedness, light sensitivity, neck stiffness, abdominal pain. Patient will need a CBC with diff and chem 10 and liver function tests checked on [**2113-3-15**] and on [**2113-3-20**]. PLEASE BRING YOU [**2113-3-15**] labs results with you to your [**First Name (Titles) **] [**Last Name (Titles) **] infectious disease appointment on [**2113-3-16**] Followup Instructions: Provider: [**Name10 (NameIs) **],[**Name11 (NameIs) **] [**Name Initial (NameIs) **]. [**Telephone/Fax (1) 250**] Call to schedule appointment Provider: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 2505**] MD [**Telephone/Fax (1) 457**]- [**2113-3-16**] at 3PM-PLEASE SEND PATIENT's LABS results from [**2113-3-15**] with him to this appointment Completed by:[**2113-3-10**] ICD9 Codes: 5119, 2762, 4280, 7907, 4589, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5965 }
Medical Text: Admission Date: [**2173-2-11**] Discharge Date: [**2173-2-18**] Service: SURGERY Allergies: Iodine; Iodine Containing Attending:[**First Name3 (LF) 5547**] Chief Complaint: PERFORATED DUODENUM Major Surgical or Invasive Procedure: None. History of Present Illness: Pt is a 88yoF with c/o abd pain and n/v/d x 3 days. Pt reports being unwell x 3 days - initially generalized malaise, followed by n/v and diarrhea (worsened than usual diarrhea). After vomiting, she had sudden onset of periumbilical pain. Pain sharp, constant, worsens w/ movement. She denies fever/chills. Denies NSAIDS. She was initially admitted to [**Hospital3 3765**] [**2173-2-10**] w/ diagnosis of pancreatitis ([**Doctor First Name **] 196, Lipase 140). CT abdomen performed [**2173-2-11**] (after prep for ? IV contrast allergy) showed retroperitoneal air concerning for posterior perforated duodenal ulcer. Pt transferred to [**Hospital1 18**]. On arrival, pt reports mild generalized abd pain, despite IV morphine. Of note, pt has had chronic diarrhea which has been worked up w/o final diagnosis. Initially, celiac disease was suspected and trial on gluten-free diet seemed to improve diarrhea. However, she was told by her physician she did not have celiac disease. Past Medical History: htxn, hypothyroidism, chronic diarrhea (? celiac disease), diverticulosis, s/p hysterectomy & appy '[**56**], lower back pain Social History: daily brandy 2oz HS, widow, lives at [**Location **] Commons [**Hospital3 12272**] Family History: mother had chronic diarrhea as well Physical Exam: At discharge: V.S: 98.2, 63, 121/65, 18, 94% RA Gen: A and O x 3, NAD Resp: LSCTA bilat, denies SOB CV: RRR, no m/r/g Abd: soft, nt, nd, + bs Ext: no c/c/e Pertinent Results: [**2173-2-13**] 07:35AM BLOOD WBC-7.2# RBC-3.50* Hgb-11.3* Hct-34.6* MCV-99* MCH-32.4* MCHC-32.7 RDW-13.4 Plt Ct-247 [**2173-2-11**] 03:36PM BLOOD Neuts-32* Bands-37* Lymphs-20 Monos-3 Eos-0 Baso-0 Atyps-3* Metas-5* Myelos-0 Other-0 [**2173-2-11**] 03:36PM BLOOD Hypochr-NORMAL Anisocy-1+ Poiklo-NORMAL Macrocy-OCCASIONAL Microcy-OCCASIONAL Polychr-OCCASIONAL [**2173-2-13**] 07:35AM BLOOD PT-12.3 PTT-26.2 INR(PT)-1.0 [**2173-2-17**] 07:00AM BLOOD Glucose-66* UreaN-17 Creat-0.6 Na-137 K-3.4 Cl-103 HCO3-26 AnGap-11 [**2173-2-15**] 09:10PM BLOOD CK(CPK)-31 [**2173-2-11**] 03:36PM BLOOD Lipase-74* [**2173-2-16**] 07:25AM BLOOD CK-MB-2 cTropnT-0.03* [**2173-2-17**] 07:00AM BLOOD Calcium-8.4 Phos-3.1 Mg-1.7 . CLOSTRIDIUM DIFFICILE TOXIN A & B TEST: negative x 2 . HELICOBACTER PYLORI ANTIBODY TEST: NEGATIVE BY EIA. . MRSA SCREEN: No MRSA isolated . Blood Culture, Routine [**2173-2-17**]: NO GROWTH X2 . UGI SGL CONTRAST W/ KUB [**2173-2-15**] No gross extravasation of contrast on this technically limited examination. Known retroperitoneal free air on CT examination, compatible with duodenal ulcer perforation. . CHEST (PORTABLE AP) [**2173-2-13**] Features of worsened CHF along with new opacities at the lung bases. The latter could be due to atelectasis or pneumonia. . ABDOMEN (SUPINE ONLY) [**2173-2-12**] Significant free intraperitoneal air largely unchanged from prior study. Retroperitoneal air is likley present; however its evaluation is limited. No bowel obstruction or dilatation. . Brief Hospital Course: Pt was admitted to the TICU from OSH, she was evaluated by surgery, abx and a protonix drip were started, NGT was placed, CXR done without evidence of free air and she was closely assessed overnight and schedule for upper GI in the am. . She was transferrd to [**Hospital Ward Name 1950**] 5 with IV hydration secondary to dehydration/NGT, a foley and telemetry secondary to new IV beta blocker. Her protonix drip was changed to IV q 12 hrs. The patient had an upper GI study which indicated no gross extravasation of contrast on this technically limited examination, because patient could not shift positions as requested. Known retroperitoneal free air on CT examination, compatible with duodenal ulcer perforation. Her NGT was removed and she was continued on po protonix and her medications were changed to oral. . Patient was fluid overloaded and several doses of IV lasix were administered with good effect and electrolytes were repleated as necessary. [**2173-2-15**] the patient had an episode of new onset tachycardia/A-Fib. She was administered IV lopressor with good effect and her electrolytes were rechecked and repleated as needed. . The patient's foley was d/c'd and she voided with out any issues. C-dif x2 was sent secondary to loose stool-both negative. She was started on her home dose of immodium. . Physical therapy recommended home physical therapy or rehab. The patient and family discussed this issue and decided on home physical therapy, the patient is already set up with the VNA and will continue this. . Discharge paperwork was reviewed with paitent and family. She was started on protonix, handout was provided and the purpose of the medication was reviewed. Her PCP was [**Name (NI) 653**] regarding her situation, change in medications and an appointment was made for 1 week. She will also follow up with Dr. [**Last Name (STitle) 1924**] on [**2173-3-2**] Medications on Admission: quinapril 10mg daily, aldactone 25mg daily, HCTZ 25mg daily, levoxyl 75mcg daily, ativan 0.5mg HS prn, glucosamine, chondroitin, Ca, vitamin D, ibuprofen? Discharge Medications: 1. Hydrochlorothiazide 12.5 mg Capsule Sig: One (1) Capsule PO DAILY (Daily). 2. Levothyroxine 75 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Spironolactone 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Quinapril 5 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 5. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) as needed. 6. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for Pain: For neck pain. Please do not exceed more than 4000 mg in 24 hours. . 7. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 8. Loperamide 2 mg Capsule Sig: Two (2) Capsule PO TID (3 times a day). Discharge Disposition: Home With Service Facility: deaconness abundant life homecare Discharge Diagnosis: Primary: Perforated Duodenum Pancreatitis Dehydration Fluid over load New on set A-fib . Secondary: htxn, hypothyroidism, chronic diarrhea (? celiac disease), diverticulosis, s/p hysterectomy & appy '[**56**], lower back pain Discharge Condition: Stable. Tolerating regular diet. Pain well controlled with oral medications. Discharge Instructions: Please call your doctor or return to the ER for any of the following: * You experience new chest pain, pressure, squeezing or tightness. * New or worsening cough or wheezing. * If you are vomiting and cannot keep in fluids or your medications. * You are getting dehydrated due to continued vomiting, diarrhea or other reasons. Signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * You see blood or dark/black material when you vomit or have a bowel movement. * Your pain is not improving within 8-12 hours or not gone within 24 hours. Call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. * You have shaking chills, or a fever greater than 101.5 (F) degrees or 38(C) degrees. * Any serious change in your symptoms, or any new symptoms that concern you. * Please resume all regular home medications and take any new meds as ordered. * Continue to ambulate several times per day. . Medications: 1. Protonix: -You were started on this medication because of your duodenal ulcer. -This medication will help prevent future ulcerations, by decreasing stomach acid swallowing. -You should take this every 12 hrs. Followup Instructions: 1. Please follow up with Dr. [**Last Name (STitle) 1924**] on [**2173-3-2**]. Please call his office for the time [**Telephone/Fax (1) 7508**]. 2. An appointment has been made for you to see [**Name8 (MD) 80591**] [**First Name5 (NamePattern1) 80592**] [**Last Name (NamePattern1) 80593**] on [**2173-3-1**]. If you can not make this appointment please call to reschedule [**Telephone/Fax (1) 21640**]. Completed by:[**2173-2-18**] ICD9 Codes: 4019, 2449
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Medical Text: Admission Date: [**2117-1-4**] Discharge Date: [**2117-1-7**] Date of Birth: [**2077-4-22**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1973**] Chief Complaint: Malignant Hypertension Major Surgical or Invasive Procedure: none History of Present Illness: 39 year-old male with a history of untreated hypertension who presents with headache, neck pain, dizziness and back pain on the morning of admission. Notably, the patient was diagnosed with uncontrolled hypertension when he lived in [**Country 2045**] and was on nifedipine for this (which he took intermittently). Since coming to the US several years ago, he has neither seen a medical doctor nor been on any medications. He states he has intermittent back and neck pain for several weeks. Neck pain was especially bad the morning of admission and associated with pain on head movement. In the past, he has used Motrin PRN for this pain but has not taken in at least 1 week. In the ED, 270/140. Given Labetalol bolus and then started on labetalol drip and admitted to the ICU for management. Not given any PO except for 40 KCL mEQ PO x1. He was actually weaned off of labetlol drip prior to arrival to the floor. On the floor her received labetelol, HCTZ and norvasc, with highly labile blood pressures (systolic ranging from 140-190 and diastolic ranging from 105-120). He remained asymtpomatic. An echocardiogram was performed with results as below, but given the concern of coarctation of the aorta, the patient was sent for urgent MRA-Aortogram, which did not demonstrate coarctation. Past Medical History: Hypertension diagnosed in [**Country 2045**] and on medication. Has not taken medication or been to a physician since emigrating to the US several yrs ago. No other medical problems, past surgeries or hospitalization. Social History: Denies past drug use. No current EtOH or tobacco use. Social smoker briefly several yrs ago. Lives with wife, 12 yo daughter and 1 [**Name2 (NI) **] son. [**Name (NI) 1403**] as a valet at [**Hospital 86**] [**Hospital3 1810**]. Several siblings in [**State 108**] and [**Country 6607**]. No other family members in the [**Name (NI) 86**] area. Family History: Mother with severe hypertension. None of his 8 siblings is known to have HTN. No FH of CAD, DM, cancer. Physical Exam: 98.5, 186/120, 81, 20, 100%RA GEN: Well-appearing, well-nourished, no acute distress HEENT: EOMI, PERRL, sclera anicteric, no epistaxis or rhinorrhea, MMM, OP Clear NECK: No JVD, carotid pulses brisk, no bruits, no cervical lymphadenopathy, trachea midline COR: RRR, S1/wide split S2, II/VI systolic ejection murmur PULM: Lungs CTAB, no W/R/R ABD: Soft, NT, ND, +BS, no HSM, no masses EXT: No C/C/E, no palpable cords NEURO: alert, oriented to person, place, and time. CN II ?????? XII intact. 5/5 strength all 4 extremities. No cerebellar dysfunction on FTN or [**Doctor First Name **]. SKIN: No jaundice, cyanosis, or gross dermatitis. No ecchymoses Pertinent Results: [**2117-1-6**] 05:20AM BLOOD WBC-4.4 RBC-4.42* Hgb-13.3* Hct-36.7* MCV-83 MCH-30.0 MCHC-36.2* RDW-12.9 Plt Ct-186 [**2117-1-5**] 05:55AM BLOOD WBC-4.5 RBC-4.54* Hgb-13.7* Hct-38.2* MCV-84 MCH-30.2 MCHC-35.9* RDW-13.0 Plt Ct-187 [**2117-1-4**] 09:36AM BLOOD WBC-4.2 RBC-5.17 Hgb-15.8 Hct-42.4 MCV-82 MCH-30.6 MCHC-37.3* RDW-12.9 Plt Ct-229 [**2117-1-4**] 09:36AM BLOOD Neuts-52.4 Lymphs-38.3 Monos-6.0 Eos-2.2 Baso-1.0 [**2117-1-4**] 09:36AM BLOOD PT-12.6 PTT-23.7 INR(PT)-1.1 [**2117-1-6**] 05:20AM BLOOD Glucose-108* UreaN-19 Creat-1.8* Na-139 K-3.0* Cl-99 HCO3-31 AnGap-12 [**2117-1-5**] 05:55AM BLOOD Glucose-102 UreaN-18 Creat-1.7* Na-138 K-2.8* Cl-102 HCO3-28 AnGap-11 [**2117-1-4**] 02:51PM BLOOD Glucose-108* UreaN-17 Creat-1.5* Na-141 K-3.4 Cl-106 HCO3-28 AnGap-10 [**2117-1-4**] 09:36AM BLOOD Glucose-132* UreaN-19 Creat-1.8* Na-138 K-2.6* Cl-98 HCO3-29 AnGap-14 [**2117-1-5**] 05:55AM BLOOD CK(CPK)-5409* [**2117-1-4**] 02:51PM BLOOD ALT-19 AST-54* LD(LDH)-337* CK(CPK)-3687* AlkPhos-74 TotBili-0.8 [**2117-1-4**] 09:36AM BLOOD CK(CPK)-3681* [**2117-1-4**] 09:36AM BLOOD cTropnT-<0.01 [**2117-1-4**] 09:36AM BLOOD CK-MB-6 [**2117-1-6**] 05:20AM BLOOD Calcium-9.1 Phos-4.2 Mg-2.0 [**2117-1-5**] 05:55AM BLOOD Calcium-8.8 Phos-3.5 Mg-2.0 [**2117-1-4**] 02:51PM BLOOD Calcium-8.8 Phos-2.7 Mg-1.9 [**2117-1-4**] 09:36AM BLOOD ASA-NEG Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG [**2117-1-4**] 11:14PM URINE Color-Straw Appear-Clear Sp [**Last Name (un) **]-1.008 [**2117-1-4**] 12:00PM URINE Color-Straw Appear-Clear Sp [**Last Name (un) **]-1.008 [**2117-1-4**] 11:14PM URINE Blood-MOD Nitrite-NEG Protein-TR Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-NEG pH-5.0 Leuks-NEG [**2117-1-4**] 12:00PM URINE Blood-MOD Nitrite-NEG Protein-100 Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-NEG pH-7.0 Leuks-NEG [**2117-1-4**] 11:14PM URINE RBC-<1 WBC-<1 Bacteri-NONE Yeast-NONE Epi-0 [**2117-1-4**] 12:00PM URINE RBC-0-2 WBC-0-2 Bacteri-RARE Yeast-NONE Epi-0 [**2117-1-4**] 11:14PM URINE Mucous-RARE [**2117-1-4**] 11:14PM URINE Hours-RANDOM Creat-51 Na-144 K-22 TotProt-27 Prot/Cr-0.5* [**2117-1-4**] 11:14PM URINE Osmolal-444 [**2117-1-4**] 11:14PM URINE bnzodzp-NEG barbitr-NEG opiates-NEG cocaine-NEG amphetm-NEG mthdone-NEG ECG Study Date of [**2117-1-4**] 10:39:32 AM Sinus rhythm. Left atrial abnormality. Left ventricular hypertrophy. Marked repolarization abnormalities consistent with left ventricular strain pattern. No previous tracing available for comparison. Intervals Axes Rate PR QRS QT/QTc P QRS T 94 168 102 404/463 59 61 -124 CT HEAD W/O CONTRAST Study Date of [**2117-1-4**] 9:35 AM FINDINGS: Non-contrast head CT. There is no intra-axial or extra-axial hemorrhage, shift of normally midline structures, mass effect, or evidence of acute infarction. Ventricles and sulci appear normal for a patient of this age. Basilar cisterns are patent. Paranasal sinuses, mastoid air cells, and middle ear cavities are well aerated. The calvarium is intact. IMPRESSION: No acute intracranial process. CHEST (PA & LAT) Study Date of [**2117-1-4**] 10:22 AM IMPRESSION: Mild cardiomegaly with LV configuration. Consider echocardiogram to further assess. TTE (Congenital, complete) Done [**2117-1-5**] at 2:51:51 PM FINAL The left atrium is normal in size. No atrial septal defect is seen by 2D or color Doppler. There is moderate symmetric left ventricular hypertrophy. The left ventricular cavity size is normal. Left ventricular systolic function is hyperdynamic (EF 70-80%). Tissue Doppler imaging suggests an increased left ventricular filling pressure (PCWP>18mmHg). There is no left ventricular outflow obstruction at rest or with Valsalva. There is no ventricular septal defect. Right ventricular chamber size and free wall motion are normal. The aortic arch is mildly dilated. The aortic valve is bicuspid (true bicuspid valve with equal anterior and posterior leaflets). There is a minimally increased gradient consistent with minimal aortic valve stenosis. Mild (1+) aortic regurgitation is seen. The aortic regurgitation jet is eccentric, directed toward the anterior mitral leaflet. The mitral valve appears structurally normal with trivial mitral regurgitation. There is no mitral valve prolapse. The left ventricular inflow pattern suggests impaired relaxation. The pulmonary artery systolic pressure could not be determined. There is no pericardial effusion. Impression: true bicuspid aortic valve with minimal stenosis and mild regurgitation; moderate concentric left ventricular hypertrophy with hyperdynamic left ventricle; coarctation of the aorta could not be excluded on the basis of this study, and should be strongly considered DUPLEX DOPP ABD/PEL Study Date of [**2117-1-5**] 8:11 AM IMPRESSION: 1. No evidence for renal artery stenosis by Doppler ultrasound. 2. Increased echogenicity of the renal parenchyma bilaterally consistent with diffuse parenchymal disease. Normal sized kidneys. MRA CHEST W/O CONTRAST Study Date of [**2117-1-6**] 9:53 AM IMPRESSION: 1. Normal appearance of the thoracic aorta. No evidence of aortic coarctation. 2. Bicuspid aortic valve. Brief Hospital Course: 1. Malignant Hypertension - Initially treated with Labatelol drip in [**Hospital Unit Name 153**], transitioned to oral agents - Labatelol, Norvasc and HCTZ - Still with highly labile BP, with severe diastolic hypertension - Will likely need ACE inhibitor given hypertensive nephropathy, but this should be started in the outpatient setting given need to follow electrolytes over next several weeks - No signs of coarctation on MRA despite suspicion on TTE - Would obtain urine metanepharines as an outpatient, given would not return prior to discharge here. This is not an unreasonable diagnosis, given not only severe hypertension but relatively high heart rates while in house (90's) - No signs of renal artery stenosis on ultrasound - Mother also with hypertension - Patient will need medication education (although his wife is a pharmacy technician and is very concerned about his compliance and will work with him on this) 2. Acute Renal Failure on acute on Chronic Kidney Disease Stage II: - concern for hypertensive nephropathy with CK-induced nephropathy causing the acute renal failure - Pt not in grossly proteinuric range of note - Cr mildly improved since here with hydration though FeNa>3% - Renal US consistent with hypertensive nephropathy - should be started on outpatient ACE - Will need outpatient nephrology referral 3. Left Ventricular Hypertrophy - Would keep his heart rate on the lower side given high wall thickness and liekly diastolic dysfunction - Echo as above Patient has a new PCP: [**Name10 (NameIs) **],[**Name11 (NameIs) **] [**Telephone/Fax (1) 6087**] through [**Hospital1 3278**] Health Plan. he has a follow up initial appointment in 8 days. Medications on Admission: Motrin PRN (last taken >1 wk PTA) Discharge Medications: 1. Labetalol 200 mg Tablet Sig: Two (2) Tablet PO TID (3 times a day). Disp:*180 Tablet(s)* Refills:*2* 2. Hydrochlorothiazide 12.5 mg Capsule Sig: Two (2) Capsule PO DAILY (Daily). Disp:*60 Capsule(s)* Refills:*2* 3. Amlodipine 5 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Disp:*60 Tablet(s)* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Malignant Hypertension Acute Renal Failure Chronic Kidney Disease Stage II Hypokalemia Left Ventricular Hypertrophy Discharge Condition: Good Discharge Instructions: It is critically important that you follow up with your new PCP [**Name Initial (PRE) 7928**]. Your medications are not at their final doses, and will continue to need adjustments. Your kidneys have been damaged by the high blood pressure, and you will likely be referred to a kidney doctor by your new PCP. Take all your blood pressure medications. Return to the hospital with headache, change in vision, confusion, chest pain, fever/chills Followup Instructions: You have an appointment on [**2116-12-15**] at 09:40 with your new PCP [**Name9 (PRE) **],[**First Name7 (NamePattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] at Address: 26 CITY [**Doctor Last Name **] MALL, [**Location (un) **],[**Numeric Identifier 81247**] Phone: [**Telephone/Fax (1) 6087**] ICD9 Codes: 5849, 2768
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5967 }
Medical Text: Admission Date: [**2157-5-27**] Discharge Date: [**2157-5-31**] Date of Birth: [**2091-4-2**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1505**] Chief Complaint: Dizziness Major Surgical or Invasive Procedure: s/p Minimally invasive Aortic Valve Replacement (#25mm [**Company 1543**] Mosaic Porcine) and Drug eluding Stent to Right Coronary artery [**5-27**] History of Present Illness: 66 year old male with history of aortic stenosis followed by serial echocardiograms. Underwent cardiac catherization which revealed right coronary artery stenosis. Past Medical History: aortic stenosis hyperlipidemia Social History: Occupation: CONSTRUCTION WORKER Lives with: WIFE [**Name (NI) 1139**]:QUIT 18 YRS AGO ETOH: OCCASIONAL WINE Family History: noncontributory Physical Exam: Pulse: 65 Resp: 12 O2 sat: B/P Right: 105/55 Left: 110/60 Height: Weight: General: Skin: Dry [x] intact [x] no rash HEENT: PERRLA [x] EOMI [x] Neck: Supple [x] Full ROM [x] Chest: Lungs clear bilaterally [x] Heart: RRR [] Irregular [x] Murmur 3/6 SEM Abdomen: Soft [x] non-distended [x] non-tender [x] bowel sounds + [x] Extremities: Warm [x], well-perfused [x] Edema Varicosities: None [x] Neuro: Grossly intact x Pulses: Femoral Right: 1+ Left: 1+ DP Right: 1+ Left: 1+ PT [**Name (NI) 167**]: 1+ Left: 1+ Radial Right: 2+ Left: 2+ Carotid Bruit Right: Left: radiation of cardiac murmur Pertinent Results: [**2157-5-31**] 05:50AM BLOOD WBC-7.1 RBC-3.35* Hgb-10.2* Hct-29.9* MCV-89 MCH-30.4 MCHC-34.0 RDW-14.0 Plt Ct-98* [**2157-5-27**] 02:00PM BLOOD WBC-17.2*# RBC-3.14*# Hgb-9.4*# Hct-28.1*# MCV-90 MCH-29.9 MCHC-33.3 RDW-13.5 Plt Ct-99* [**2157-5-31**] 05:50AM BLOOD PT-14.3* PTT-27.6 INR(PT)-1.2* [**2157-5-27**] 02:00PM BLOOD PT-16.3* PTT-40.3* INR(PT)-1.5* [**2157-5-30**] 05:55AM BLOOD Glucose-126* UreaN-19 Creat-0.9 Na-140 K-4.1 Cl-100 HCO3-30 AnGap-14 [**2157-5-28**] 02:28AM BLOOD Glucose-132* UreaN-14 Creat-0.9 Na-138 K-6.0* Cl-110* HCO3-25 AnGap-9 [**2157-5-30**] 05:55AM BLOOD ALT-6 AST-27 LD(LDH)-262* AlkPhos-52 Amylase-26 TotBili-0.7 [**Hospital1 18**] ECHOCARDIOGRAPHY REPORT [**Known lastname **], [**Known firstname **] [**Hospital1 18**] [**Numeric Identifier 82232**] (Complete) Done [**2157-5-27**] at 11:46:31 AM FINAL Referring Physician [**Name9 (PRE) **] Information [**Name9 (PRE) **], [**First Name3 (LF) **] R. [**Hospital1 18**], Division of Cardiothorac [**Hospital Unit Name 4081**] [**Location (un) 86**], [**Numeric Identifier 718**] Status: Inpatient DOB: [**2091-4-2**] Age (years): 66 M Hgt (in): 66 BP (mm Hg): 109/67 Wgt (lb): 185 HR (bpm): 56 BSA (m2): 1.94 m2 Indication: Intraoperative TEE for AVR - minimaly invasive. Aortic valve disease. Chest pain. Coronary artery disease. Left ventricular function. Mitral valve disease. Preoperative assessment. Prosthetic valve function. Right ventricular function. ICD-9 Codes: 786.05, 786.51, 440.0, 424.1, 424.0, 799.02, 963.1, 441.2, 394.0, 424.2 Test Information Date/Time: [**2157-5-27**] at 11:46 Interpret MD: [**Name6 (MD) 1509**] [**Name8 (MD) 1510**], MD Test Type: TEE (Complete) Son[**Name (NI) 930**]: [**Last Name (NamePattern5) 9958**], MD Doppler: Full Doppler and color Doppler Test Location: Anesthesia West OR cardiac Contrast: None Tech Quality: Adequate Tape #: 2009AW5-: Machine: AW5 Echocardiographic Measurements Results Measurements Normal Range Left Ventricle - Septal Wall Thickness: 1.0 cm 0.6 - 1.1 cm Left Ventricle - Diastolic Dimension: *6.2 cm <= 5.6 cm Left Ventricle - Ejection Fraction: 25% to 30% >= 55% Aorta - Annulus: 2.5 cm <= 3.0 cm Aortic Valve - Peak Velocity: *3.8 m/sec <= 2.0 m/sec Aortic Valve - Peak Gradient: *38 mm Hg < 20 mm Hg Aortic Valve - Mean Gradient: 23 mm Hg Aortic Valve - Valve Area: *1.0 cm2 >= 3.0 cm2 Findings RIGHT ATRIUM/INTERATRIAL SEPTUM: A catheter or pacing wire is seen in the RA and extending into the RV. No ASD by 2D or color Doppler. LEFT VENTRICLE: Normal LV wall thickness. Severe regional LV systolic dysfunction. Severely depressed LVEF. RIGHT VENTRICLE: Normal RV chamber size and free wall motion. AORTA: Simple atheroma in ascending aorta. Simple atheroma in aortic arch. Simple atheroma in descending aorta. AORTIC VALVE: Severely thickened/deformed aortic valve leaflets. Severe AS (area 0.8-1.0cm2). Mild (1+) AR. MITRAL VALVE: Moderately thickened mitral valve leaflets. Mild (1+) MR. TRICUSPID VALVE: Moderate [2+] TR. GENERAL COMMENTS: A TEE was performed in the location listed above. I certify I was present in compliance with HCFA regulations. The patient was under general anesthesia throughout the procedure. No TEE related complications. The patient appears to be in sinus rhythm. Results were personally reviewed with the MD caring for the patient. REGIONAL LEFT VENTRICULAR WALL MOTION: N = Normal, H = Hypokinetic, A = Akinetic, D = Dyskinetic Conclusions Prebypass 1.No atrial septal defect is seen by 2D or color Doppler. 2. Left ventricular wall thicknesses are normal. There is severe regional left ventricular systolic dysfunction with hypokinesia of the apex, anterior wall, anteroseptal, septal and anterolateral walls. Overall left ventricular systolic function is severely depressed (LVEF= 25-30 %). 3.Right ventricular chamber size and free wall motion are normal. 4.There are simple atheroma in the ascending aorta. There are simple atheroma in the aortic arch. There are simple atheroma in the descending thoracic aorta. 5.The aortic valve leaflets are severely thickened/deformed. There is severe aortic valve stenosis (valve area 0.8-1.0cm2). Mild (1+) aortic regurgitation is seen. 6.The mitral valve leaflets are moderately thickened. Mild (1+) mitral regurgitation is seen. Moderate [2+] tricuspid regurgitation is seen. 7.Dr. [**Last Name (STitle) **] was notified in person of the results on [**2157-5-27**] at 1000am. Post bypass 1. Patient is AV paced and receiving an infusion of phenylephrine, milrinone and epinephrine. 2. Biventricular systolic function is unchanged. 3. Bioprosthetic valve seen in the aortic position. Leaflets move well and the valve appears well seated. 4. Peak gradient across the aortic valve is 15 mm Hg. 5. Trace mitral regurgitation. 6. Aorta is intact post decannulation. 7. However just before leaving the room an echo dense mass about 2 cm in size seen in the ascending aorta about 3 cm above the aortic valve. Images reviewed by Drs [**First Name (STitle) 6507**], [**Name5 (PTitle) 168**] and [**Name5 (PTitle) **]. Mostly likely an artifact. No action to be taken at this time. No evidence of aortic dissection. I certify that I was present for this procedure in compliance with HCFA regulations. Electronically signed by [**Name6 (MD) 1509**] [**Name8 (MD) 1510**], MD, Interpreting physician [**Last Name (NamePattern4) **] [**2157-5-27**] 18:45 ?????? [**2151**] CareGroup IS. All rights reserved. Brief Hospital Course: Was admitted same day and went to operating room and underwent cardiac intervention and aortic valve replacement. See operative reports for further details. He was transferred to the intensive care unit for hemodynamic monitoring. In the first twenty four hours he was weaned from sedation, awoke neurologically intact, and was extubated without complications. Episodes of atrial fibrillation was treated with betablockers and amiodarone, he converted back to normal sinus rhythm. He was weaned from nitroglycerin and milirone on post operative day one. On post operative day two he was transfered to the floor for the remainder of his care. Physical therapy worked with him on strength and mobility. He continued to have episodes of atrial fibrillation requiring amiodarone and betablockers, last episode of [**5-30**]. Due to thrombocytopenia he was checked for HITT which was negative and platelet count improving. He was started on coumadin for atrial fibrillation, carvediolol and lisinopril for heart failure. He was ready for discharge home with services post operative day four. Medications on Admission: lopressor 100 twice a day multivitamin Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 2. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 3. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 4. Atorvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 5. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 6. Carvedilol 3.125 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 7. Amiodarone 200 mg Tablet Sig: Two (2) Tablet PO once a day: please take two tablets for 7 days then decrease to 1 tablet daily . Disp:*37 Tablet(s)* Refills:*0* 8. Lisinopril 2.5 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*0* 9. Furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* 10. Warfarin 2.5 mg Tablet Sig: One (1) Tablet PO once a day: please take 2.5mg [**6-1**] and have blood drawn [**6-2**] with results to Dr [**Last Name (STitle) 1147**] for further dosing. . Disp:*30 Tablet(s)* Refills:*0* 11. Outpatient [**Name (NI) **] Work PT/INR for coumadin dosing for atrial fibrillation goal INR 2.0-2.5 Results to Dr [**Last Name (STitle) 1147**] office # [**0-0-**] fax # [**Telephone/Fax (1) 60930**] Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: Aortic stenosis s/p Minimally invasive Aortic Valve Replacement (#25mm [**Company 1543**] Mosaic Porcine) Coronary artery disease s/p stent to Right coronary artery (DES) Acute on chronic systolic heart failure Post operative atrial fibrillation hyperlipidemia Discharge Condition: Good Discharge Instructions: Please shower daily including washing incisions, no baths or swimming Monitor wounds for infection - redness, drainage, or increased pain Report any fever greater than 101 Report any weight gain of greater than 2 pounds in 24 hours or 5 pounds in a week No creams, lotions, powders, or ointments to incisions No driving for approximately one month No lifting more than 10 pounds for 10 weeks Please call with any questions or concerns [**Telephone/Fax (1) 170**] Followup Instructions: Please call to schedule appointments Dr. [**Last Name (STitle) **] in 4 week ([**Telephone/Fax (1) 170**]) Dr. [**Last Name (STitle) 12167**] in [**2-15**] weeks ([**0-0-**]) [**Year (4 digits) **]: PT/INR for coumadin dosing: goal INR 2.0-2.5 for atrial fibrillation first draw [**6-2**] with results to Dr [**Last Name (STitle) 1147**] office phone # [**0-0-**] fax # [**Telephone/Fax (1) 60930**] Completed by:[**2157-5-31**] ICD9 Codes: 4241, 9971, 2875, 4280, 2724
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5968 }
Medical Text: Admission Date: [**2189-9-2**] Discharge Date: [**2189-9-8**] Date of Birth: [**2126-8-23**] Sex: M Service: CARDIOTHORACIC Allergies: Nifedipine / Metoprolol Attending:[**First Name3 (LF) 1505**] Chief Complaint: Dyspnea on exertion Major Surgical or Invasive Procedure: [**2189-9-2**] - Aortic valve replacement (23mm St. [**Male First Name (un) 923**] mechanical valve), Ascending aorta replacement(30mm Gelweave tube graft). History of Present Illness: 62 year old gentleman with a history of a bicuspid Aortic valve and moderate Aortic stenosis who has been followed by serial echocardiograms. He notes increasing exertional dyspnea and fatigue over the past several months. Past Medical History: Bicuspid aortic valve Aortic stenosis Aortic aneurysm Hypertension GERD Social History: Lives with: significant other, [**Name (NI) **] Occupation: Retired maintainance technician Tobacco: None ETOH: 7/week Family History: Father had bicuspid Ao valve and AVR-died 69yo of "clot". Brother has bicuspid valve and arrhythmia problem. Physical Exam: Pulse: 55 Resp: 16 O2 sat: B/P Right: 110/74 Left: 118/70 Height: 72" Weight: 210 lbs General: NAD, well appearing Skin: Dry [x] intact [x] HEENT: NCAT [] PERRLA [x] EOMI [x] Neck: Supple [x] Full ROM [x] JVD[x] Chest: Lungs clear bilaterally [x] Heart: RRR [x] Irregular [] [**2-14**] sys murmur Abdomen: Soft [x] non-distended [x] non-tender [x] bowel sounds + [x] Extremities: Warm [x], well-perfused [x] Edema -none right groin cath site- no erythema or drainage, tiny hematoma at puncture site, non-tender Varicosities: None [] small spider veins Neuro: Grossly intact, nonfocal exam Pulses: Femoral Right: 2+ Left: 2+ DP Right: 2+ Left: 2+ PT [**Name (NI) 167**]: 2+ Left: 2+ Radial Right: 2+ Left: 2+ Carotid Bruit- Right: Left: none Pertinent Results: [**2189-9-2**] ECHO PREBYPASS No spontaneous echo contrast is seen in the body of the left atrium or left atrial appendage. Left ventricular wall thicknesses are normal. The left ventricular cavity size is normal. Overall left ventricular systolic function is normal (LVEF>55%). Overall right ventricular systolic function is normal with normal free wall contractility. The aortic root is mildly dilated at the sinus level. There is a focal calcification in the aortic root measuring 8mm x 4mm. The ascending aorta is markedly dilated with a maximum diameter of 5.1 cm. The aortic arch is normal. The descending thoracic aorta is mildly dilated. There are simple atheroma in the descending thoracic aorta. The aortic valve is bicuspid with severely thickened/deformed aortic valve leaflets. A fibrinous echodensity is present on the aortic side of the non-coronary cusp of the aortic valve, consistent degenerative disease (suggest clinical correlation). There is severe aortic valve stenosis (valve area 0.8-1.0cm2). Trace aortic regurgitation is seen. The mitral valve leaflets are structurally normal. Mild (1+) mitral regurgitation is seen. There is no pericardial effusion. Dr. [**Last Name (STitle) **] was notified in person of the results at the time of the study. POSTBYPASS The patient is A-paced and is on an intermittent phenylephrine infusion. A new mechanical aortic valve is seen. It is well-seated with washing jets in the expected locations. There is trace aortic insufficiency in total. Calculated aortic valve area is 2.0 cm2 with peak and mean gradients of 36 mmHg and 18 mmHg respectively at a cardiac output of about 6 liters/minute. An ascending aortic graft is seen. Thoracic aorta is otherwise normal. Left ventricular systolic function continues to be normal (LVEF>55%). Mild (1+) mitral regurgitation persists. Pre-op [**2189-9-2**] 09:38AM HGB-13.5* calcHCT-41 [**2189-9-2**] 09:38AM GLUCOSE-103 LACTATE-1.2 NA+-137 K+-3.7 CL--105 [**2189-9-2**] 12:30PM PT-16.2* PTT-31.0 INR(PT)-1.4* [**2189-9-2**] 12:30PM WBC-13.6*# RBC-2.70*# HGB-8.8*# HCT-26.2*# MCV-97 MCH-32.7* MCHC-33.6 RDW-12.9 [**2189-9-2**] 02:07PM UREA N-10 CREAT-0.6 SODIUM-140 POTASSIUM-4.4 CHLORIDE-111* TOTAL CO2-22 ANION GAP-11 [**2189-9-6**] 07:15AM BLOOD WBC-6.9 RBC-2.88* Hgb-9.4* Hct-28.2* MCV-98 MCH-32.8* MCHC-33.5 RDW-13.0 Plt Ct-255# [**2189-9-7**] 09:25AM BLOOD PT-22.5* PTT-59.2* INR(PT)-2.1* [**2189-9-6**] 07:15AM BLOOD Glucose-104* UreaN-7 Creat-0.8 Na-140 K-4.0 Cl-104 HCO3-29 AnGap-11 Brief Hospital Course: Mr. [**Known lastname 85120**] was admitted to the [**Hospital1 18**] on [**2189-9-2**] for surgical management of his aortic valve stenosis and ascending aortic aneurysm. He was taken directly to the operating room where he underwent an aortic valve replacement with a 23mm St. [**Male First Name (un) 923**] mechanical valve and replacement of his ascending aorta. His bypass time was 89 minutes with a crossclamp time of 66 minutes. Please see operative note for details. Postoperatively he was taken to the intensive care unit for monitoring. Over the next several hours, he awoke neurologically intact and was extubated. On POD 1 the patient was transferred to the telemetry floor for further recovery. All chest tubes and pacing wires and other lines were removed per cardiac surgery protocol. Initially beta blocker was started at a low dose due to a systolic blood pressure. Betablocker was increased slowly because the patient did have junctional rhythm with stable systolic pressure. Low dose lisinopril was also resumed. He was diuresed toward the preoperative weight. He was started on Coumadin with heparin bridge for aortic mechanical valve. The patient was evaluated by the physical therapy service for assistance with strength and mobility. By the time of discharge on POD #6 the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics and his INR was therapuetic. Couamdin dosing will be followed by the [**Hospital **] [**Hospital 197**] clinic with a goal INR 2.5-3.0. The patient was discharged home with visitng nurse services in good condition with appropriate follow up instructions. Medications on Admission: Lisinopril 5', HCTZ 25', protonix 40', MVI Discharge Medications: 1. Aspirin 81 mg [**Hospital 8426**], Delayed Release (E.C.) Sig: One (1) [**Hospital 8426**], Delayed Release (E.C.) PO DAILY (Daily). Disp:*100 [**Hospital 8426**], Delayed Release (E.C.)(s)* Refills:*2* 2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 3. Pantoprazole 40 mg [**Hospital 8426**], Delayed Release (E.C.) Sig: One (1) [**Hospital 8426**], Delayed Release (E.C.) PO Q24H (every 24 hours). Disp:*30 [**Hospital 8426**], Delayed Release (E.C.)(s)* Refills:*0* 4. Oxycodone-Acetaminophen 5-325 mg [**Hospital 8426**] Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*30 [**Hospital 8426**](s)* Refills:*0* 5. Acetaminophen 325 mg [**Hospital 8426**] Sig: Two (2) [**Hospital 8426**] PO Q4H (every 4 hours) as needed for pain. 6. Potassium Chloride 10 mEq Tab Sust.Rel. Particle/Crystal Sig: Two (2) Tab Sust.Rel. Particle/Crystal PO twice a day: 20mEq [**Hospital1 **] x 1 week the 20mEq QD x 1 week. Disp:*45 Tab Sust.Rel. Particle/Crystal(s)* Refills:*0* 7. Lisinopril 2.5 mg [**Hospital1 8426**] Sig: One (1) [**Hospital1 8426**] PO once a day. Disp:*30 [**Hospital1 8426**](s)* Refills:*2* 8. Metoprolol Tartrate 25 mg [**Hospital1 8426**] Sig: One (1) [**Hospital1 8426**] PO TID (3 times a day). Disp:*90 [**Hospital1 8426**](s)* Refills:*2* 9. Lasix 20 mg [**Hospital1 8426**] Sig: One (1) [**Hospital1 8426**] PO twice a day: [**Hospital1 **] x 1 week then QD x1 week. Disp:*21 [**Hospital1 8426**](s)* Refills:*0* 10. Warfarin 5 mg [**Hospital1 8426**] Sig: One (1) [**Hospital1 8426**] PO ONCE (Once) for 1 doses. Disp:*1 [**Hospital1 8426**](s)* Refills:*0* 11. Warfarin 2 mg [**Hospital1 8426**] Sig: [**Name8 (MD) **] MD [**First Name (Titles) 8426**] [**Last Name (Titles) **] once a day: INR goal 2.5-3 mech AVR. Disp:*120 [**Last Name (Titles) 8426**](s)* Refills:*2* Discharge Disposition: Home With Service Facility: [**Hospital1 **] VNA, [**Hospital1 1559**] Discharge Diagnosis: Aortic stenosis/Ascending aortic aneurysm, s/p Aortic valve replacement (23mm St. [**Male First Name (un) 923**] mechanical valve), Ascending aorta replacement(30mm Gelweave tube graft). Hypertension GERD Discharge Condition: Alert and oriented x3 nonfocal Ambulating with steady gait Incisional pain managed with percocet Incisions: Sternal - healing well, no erythema or drainage Edema: trace bilateral pedal edema Discharge Instructions: 1) Please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. Look at your incisions daily for redness or drainage 2) Please NO lotions, cream, powder, or ointments to incisions 3) Each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart 4) No driving for approximately one month until follow up with surgeon 5) No lifting more than 10 pounds for 10 weeks 6) Please call with any questions or concerns [**Telephone/Fax (1) 170**] **Please call cardiac surgery office with any questions or concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call person during off hours** Followup Instructions: You are scheduled for the following appointments Surgeon: Dr. [**Last Name (STitle) **] at [**Hospital 18**] clinic [**2189-9-24**] at 1:45 PM, **Please have CXR done prior to clinic appointment Cardiologist Dr.[**Last Name (STitle) 4610**] [**2189-10-7**] at 2:00 PM Please call to schedule appointments with your: Primary Care Dr.[**Doctor Last Name 27303**] [**Telephone/Fax (1) 85121**] in [**4-13**] weeks **Please call cardiac surgery office with any questions or concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call person during off hours** Labs: PT/INR for Coumadin ?????? indication: Mechanical aortic valve Goal INR 2.5-3.0 First draw [**2189-9-9**] Then please do INR checks Monday, Wednesday, and Friday for 2 weeks then as directed by Dr [**Last Name (STitle) 4610**] through [**Hospital **] [**Hospital 197**] Clinic Results to [**Hospital1 **] coumadin clinic-fax [**Telephone/Fax (1) 33001**] Completed by:[**2189-9-8**] ICD9 Codes: 4241, 2762, 4019, 2859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5969 }
Medical Text: Admission Date: [**2123-10-8**] Discharge Date: [**2123-10-13**] Date of Birth: [**2052-2-14**] Sex: F Service: MEDICINE Allergies: Penicillins / Tegretol / Insulin,Beef / Insulin,Pork / Zaroxolyn Attending:[**First Name3 (LF) 14229**] Chief Complaint: 1. Hypotension, tachycardia Major Surgical or Invasive Procedure: none History of Present Illness: HPI: Pt is a 71 female, h/o PVD s/p right AKA [**2123-9-24**], DM, CHF, CAD s/p stents, chronic atrial fibrillation, and multiple other medical problems, who presents with hypotension, fever, and AMS. Pt was d/cd from [**Hospital1 **] on [**2123-10-4**] s/p right AKA. At rehab, pt was noted to be lethargic the past two days. Per report with bloody diarrhea x 2 on [**2123-10-7**]. As the day wore on yesterday, pt c/o tiredness and weakness. Notes said that despited many naps throughout the day, Ms. [**Known lastname 105375**] remained lethargic and tired. Pt was unable to answer basic questions, with poor memory. On labs [**2123-10-7**]- Total WBC 27.8, 90% neutrophils and 4% bands. BUN/cr 48/2.5 with baseline cr of 0.8-0.9. Yesterday, BP went to 50/30. Then noted to be stable in the 80s-90s/60, P 88-96, RR:[**9-17**], T: 100.2. U/A from rehab [**2123-10-8**] shows few bacteria, 2+ LE, [**11-25**] WBC, though [**11-25**] epi. She was transferred to [**Hospital1 18**] ED for further evaluation. . Upon arrival to ED, VS: T: 100.5; BP: 83/69; P: 95-115 (aflutter/fib), 97% on 3L. Pt got two units of fluids but was still hypotensive. A femoral line was placed and dopamine gtt started. HR increased to the 150s and dopamine titrated off and levophed started. Pt was given 1 g vancomycin, 500 mg levaquin, 500 mg flagyl in ED. . Upon arrival to [**Hospital Unit Name 153**] "I feel ok." No SOB/CP. No cough. No abdominal pain. +diarrhea x 2 days. No dysuria. Past Medical History: PMH: 1. CHF with diastolic dysfunction- Last LVEF was 65% with a normal MIBI in 01/[**2123**]. 2. Type 2 diabetes mellitus 3. Atrial fibrillation 4. Anemia 5. CAD s/p PTCA x3- Pt had a stent to her RCA in [**2109**], LCx in [**2110**], and RCA in [**2113**]. 6. Pulmonary HTN 7. COPD/[**Name (NI) 105500**] Pt is on intermittent oxygen at home. 8. Thyroid CA s/p resection- Pt is now hypothyroid. 9. Myoclonic tremors 10. H/O PE 11. OSA on CPAP 12. Depression 13. Anxiety 14. H/O MRSA and [**Name (NI) 105501**] Pt has two past ICU admissions for MRSA aortic valve endocarditis and pseudomonal sepsis. She has had two intubations. 15. S/P laproscopic cholecystectomy [**34**]. S/P right throcoscopy and decortication 17. S/P right lung biopsy 18. S/P right hip ORIF 19. S/P right ankle ORIF 20. s/p right AKA Social History: Social: Pt lives at [**Hospital1 100**] Senior Life. Divorced and has three children. She quit smoking in [**2104**] but has a history of 1 PPD for 15 years. No ETOH or drugs. . Family History: FHx: F: died at 47 of MI; M: died colon ca; B: DM Physical Exam: PE: VS: T: 98.4; HR: 108; BP: 80s systolic, RR: 14; O2: 96% 2L Gen: Laying in bed in NAD HEENT: MMM Neck: JVP difficult to assess [**3-10**] neck girth CV: irregularly irregular. S1S2 Lungs: Cta B/L anteriorly with decreased BS throughout Abd: Soft, mildly tender throughout. No rebound. No guarding. Ext: Right AKA with staples. C/D/I. LLE: browning of skin without edema. DP not felt Neuro: "[**Hospital3 **]", "[**10-8**]". No focal deficits. Pertinent Results: Admission Labs: [**2123-10-8**] 06:50PM PT-20.4* PTT-47.1* INR(PT)-2.8 [**2123-10-8**] 06:50PM PLT SMR-NORMAL PLT COUNT-391 [**2123-10-8**] 06:50PM HYPOCHROM-NORMAL ANISOCYT-OCCASIONAL POIKILOCY-OCCASIONAL MACROCYT-NORMAL MICROCYT-NORMAL POLYCHROM-NORMAL OVALOCYT-OCCASIONAL [**2123-10-8**] 06:50PM NEUTS-95.3* BANDS-0 LYMPHS-2.3* MONOS-1.9* EOS-0.4 BASOS-0 [**2123-10-8**] 06:50PM WBC-28.0*# RBC-3.96* HGB-11.2* HCT-33.8* MCV-85 MCH-28.2 MCHC-33.0 RDW-15.1 [**2123-10-8**] 06:50PM CRP-178.4* [**2123-10-8**] 06:50PM CORTISOL-25.8* [**2123-10-8**] 06:50PM CALCIUM-8.4 PHOSPHATE-4.5 MAGNESIUM-1.9 [**2123-10-8**] 06:50PM CK-MB-7 [**2123-10-8**] 06:50PM cTropnT-0.07* [**2123-10-8**] 06:50PM LIPASE-22 [**2123-10-8**] 06:50PM ALT(SGPT)-12 AST(SGOT)-26 CK(CPK)-503* ALK PHOS-86 AMYLASE-18 TOT BILI-0.4 [**2123-10-8**] 06:50PM GLUCOSE-102 UREA N-53* CREAT-2.0* SODIUM-121* POTASSIUM-5.1 CHLORIDE-92* TOTAL CO2-21* ANION GAP-13 [**2123-10-8**] 07:11PM LACTATE-1.6 [**2123-10-8**] 07:15PM URINE RBC-<1 WBC-[**12-26**]* BACTERIA-FEW YEAST-MANY EPI-[**12-26**] RENAL EPI-0-2 [**2123-10-8**] 07:15PM URINE BLOOD-MOD NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-MOD [**2123-10-8**] 07:15PM URINE COLOR-Straw APPEAR-Clear SP [**Last Name (un) 155**]-1.009 [**2123-10-8**] 09:47PM URINE OSMOLAL-183 [**2123-10-8**] 09:47PM URINE HOURS-RANDOM UREA N-123 CREAT-9 SODIUM-55 . Other Pertinent Labs: [**2123-10-9**]: Protein electrophoresis, pending [**2123-10-10**] 03:50AM BLOOD Fibrino-673*# [**2123-10-8**] 06:50PM BLOOD cTropnT-0.07* [**2123-10-9**] 05:35AM BLOOD CK-MB-5 cTropnT-0.05* [**2123-10-10**] 03:50AM BLOOD TSH-0.35 [**2123-10-10**] 03:50AM BLOOD Free T4-1.6 [**2123-10-9**] 07:17AM BLOOD Cortsol-36.1* . . Radiology [**2123-10-10**]: Chest Film - Tip of the left subclavian line lies at the junction of the SVC and innominate vein. Patchy opacifications are seen in the right upper and lower lobes and perihilar edema is seen suggesting the presence of failure and pneumonia. . [**2123-10-9**]: 1. Interval development of bowel wall thickening/edema best appreciated in the sigmoid colon and extending into the descending colon. The differential diagnosis includes infectious, inflammatory or ischemic etiologies. 2. Redemonstration of interstitial opacities and small pleural effusions at the bases . . Discharge Labs: [**2123-10-13**] 05:19AM BLOOD WBC-11.2* RBC-3.51* Hgb-9.9* Hct-31.0* MCV-88 MCH-28.3 MCHC-32.0 RDW-16.4* Plt Ct-254 [**2123-10-13**] 05:19AM BLOOD Plt Ct-254 [**2123-10-13**] 05:19AM BLOOD Glucose-198* UreaN-9 Creat-0.8 Na-138 K-4.6 Cl-105 HCO3-26 AnGap-12 [**2123-10-13**] 05:19AM BLOOD Calcium-8.4 Phos-3.7 Mg-1.7 Brief Hospital Course: Impression/Plan: 71 yo F with MMP h/o PVD s/p right AKA [**2123-9-24**], DM, CHF, CAD s/p stents, chronic atrial fibrillation, and multiple other medical problems, presents with hypotension and tachycardia. . 1. Hypotension and Tachycardia - patient was admitted to the [**Hospital Unit Name 153**] from rehab on [**2123-10-8**] with symptoms of hypotension, elevated WBC and tachycardia. Patient had recently undergone a right AKA on [**2123-10-4**]. Pt was febrile at rehab with question of bloody stool as well as dirty U/A. The patient was started on levaquin and Flagyl at [**Hospital 100**] REhab and transferred to the [**Hospital Unit Name 153**]. Based upon impression of chest film on admission, PNA did not seem as likely originally, C. Diff was sent as patient had previosuly been on antibiotics in hospital. [**Hospital Unit Name **] surgery was [**Hospital Unit Name 4221**] to see the patients Rigth AKA who agreed it did not look like a source of infection. As the patient [**Last Name (un) 19692**] hypotensive on admission in the ED a femoral line was placed and the patient was started on a dopamine drip. On admission to the [**Hospital Unit Name 153**] the patient met SIRS criteria with increased HR to the 150's while on dopamine. Dopamine was titrated off and Levophed was started as a pressor instead. Hypotension was thought likely to be secondary to SIRS vs. Afib with RVR. On [**2123-10-10**], the patient was weaned off levophed and remained hmeodynamically stable. The patient was transferred to the floor without pressors or fluid support, tolerating a PO diet. Patient had a left subclavian line placed in the [**Hospital Unit Name 153**] that was found to be erythematous. A PICC line was placed for continued antibiotics and the Left centeral line was discontinued. . 2. ID: initially thought to have a UTI and was treated with levo, vanc because of recent hospitalization and flagyl while awaiting c. diff studies given history that she has had c.diff colitis in the past. Upon transfer from the unit, the patient was found to have erythema of the right AKA stump that was new, thought possibly to be a cellulitis, as well as chronic right lower lobe opacity concerning for persistent nosocomial pneumonia. The patient was initially given Levofloxacin, Vancomycin, and Clindamycin on transfer from the [**Hospital Unit Name 153**] to the floor that was changed to Vancomycin and Imipenim to better cover possible nosocomial pneumonia. The patient will be discharged with plans to complete 14 day course of Vancomycin and Imipenim. Patient's stool should be followed for diarrhea with thoughts towards C. Diff. . 2. Hematocrit drop - on the day of transfer patient was noted to have a 4 point Hct drop, with guaiac positive stools. The patient was transfused one unit of blood with appropriate Hct bump and stable Hematocrit for remainder of stay on floor. She can have an outpatient colpnoscopy whenever infectious issues are resolved. Her hematocrit remained stable through the rest of her stay and did not require further blood transfusions. . 3. Afib with RVR- Patient with known afib. In setting of hypotension and tachycardia, patient was givena Diltiazem drip for rate control originally. The patient's tachycardia resolved and the patient was transitioned back to her normal regimen of dilt 30mg po [**Hospital Unit Name **] and metoprolol 25mg po tid. The patient was on 3mg coumadin on admission, with therapeutic INR, which was held in the setting of HCt drop described above. As the patient's Hct was stable thereafter, coumadin was reinitiated at 3mg po qhs, with 5mg given [**2123-10-12**] to reach therapeutic INR and will return back to 3mg dose at rehab with goa INR [**3-11**]. . 5. Acute renal failure- Creatinine 2.0 on admission to ED and 2.5 at rehab with baseline of 0.8. Likely in setting on renal hypoperfusion and decreased intravascular volume. With volume resuscitation patient's ARF resolved, with most recent creatinine 0.8 . 6. Increased troponin - Patient found to have troponin to 0.07. This was thought likely to be secondary from demand ischemia (atrial fib/flutter), hypotension, and elevated in setting of acute renal failure. Patient's second set of troponin's was trending downward and additional cardiac cycles were not repeated. EKG at time of troponin leak did not show any ischemic changes and MBI flat. . 7. Abdominal pain - With abdominal pain in ED. Prelim CT ab shows some bowel wall thickening which is non-specific. Abdominal pain resolved through hospital stay, C. Diff was negative. . b. CHF- With diastolic dysfunction. On lasix at home. Patient received 60mg IV Lasix day prior to discharge as found to be I > O. Patient will be discharged continuing home regimen of Lasix 40mg [**Hospital1 **]. . 9. DM- Patient was maintained on Glargine and insulin sliding scale. As finger sticks remained elevated, glargine was increased from 18 to 20 units on day of discharge. . 10. COPD- Continued combivent, fluticasone inhalers. . 11. Psych- Depression and anxiety. Patient maintained on home regimen of medications . 12. Myoclonic tremors: Continued on previous regimen of Gabapentin. . 13. Pain- Patient's pain well controlled with Fentanyl patch 75mg/hr as well as oxycontin 10mg po bid, oxy-acet 1-2tabs po q4-6hr PRN and morphine with dressing changes. . Medications on Admission: Medications on admission: Diltiazem SR 120 qday fentanyl 75 mcg/hr TD q3 Fluticasone 2 puffs [**Hospital1 **] combivent 2 puffs q6 ASA 325 qday Celexa 60 qday Lasix 80 mg qday neurontin 600 [**Hospital1 **], 900 qhs Lantus 18 units sc qhs RISS synthroid 200 mcg qday Lisinopril 5 mg qday Methylfenadate 10 qam, 5 at noon Metoprolol 25 tid Morphine 8 mg sl qam (with dressing changes) Oxycodone SR 10 po q12 Protonix 40 qday Zocor 20 qhs Topamax 25 [**Hospital1 **] Coumadin dosed by level Levaquin po qday x 10 days for PNA (unclear exact date started) Flagyl 500 po tid x 14 days (first dose [**2123-10-8**]) . Discharge Medications: 1. Simvastatin 10 mg Tablet Sig: Two (2) Tablet PO QHS (once a day (at [**Month/Day/Year 21013**])). 2. Levothyroxine Sodium 200 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Fentanyl 75 mcg/hr Patch 72HR Sig: One (1) Patch 72HR Transdermal Q72H (every 72 hours). 4. Citalopram Hydrobromide 20 mg Tablet Sig: Three (3) Tablet PO DAILY (Daily). 5. Oxycodone 10 mg Tablet Sustained Release 12HR Sig: One (1) Tablet Sustained Release 12HR PO Q12H (every 12 hours). 6. Gabapentin 300 mg Capsule Sig: One (1) Capsule PO Q12H (every 12 hours). 7. Topiramate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 8. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 9. Diltiazem HCl 30 mg Tablet Sig: One (1) Tablet PO [**Month/Day/Year **] (4 times a day). 10. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 11. Morphine 10 mg/5 mL Solution Sig: Ten (10) ml PO Q6H (every 6 hours) as needed for dressing changes. 12. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 13. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed. 14. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 15. Albuterol-Ipratropium 103-18 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation Q6H (every 6 hours). 16. Fluticasone 110 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation [**Hospital1 **] (2 times a day). 17. Methylphenidate 10 mg Tablet Sig: One (1) Tablet PO QAM (once a day (in the morning)). 18. Methylphenidate 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 19. Warfarin Sodium 3 mg Tablet Sig: One (1) Tablet PO at [**Hospital1 21013**]: Please dose based on levels with goal INR [**3-11**]. 20. Insulin Glargine 100 unit/mL Solution Sig: Twenty (20) units Subcutaneous at [**Month/Day (3) 21013**]: with sliding scale insulin per attached scale. 21. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). 22. Imipenem-Cilastatin 500 mg Recon Soln Sig: Five Hundred (500) mg Recon Soln Intravenous Q6H (every 6 hours) for 13 days. 23. Vancomycin 1,000 mg Recon Soln Sig: One (1) gm Intravenous Q 24H (Every 24 Hours) for 13 days. Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - LTC Discharge Diagnosis: SIRS hypotension nosocomial pneumonia cellulitis diastolic heart failure Atrial fibrillation with rapid ventricular rate anemia diabetes mellitus, insulin dependence depression anxiety myoclonic tremores pressure ulcers Discharge Condition: good, on 2L O2 with sats in upper 90'2, HR in 80's and normotensive and afebrile Discharge Instructions: Please continue to take all medications as prescibed. Please call or return if you have an increase in fevers, chills or shortness of [**Hospital6 1440**]. Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight > 3 lbs. Adhere to 2 gm sodium diet Fluid Restriction: 1500ml Followup Instructions: Please follow up with your PCP [**Last Name (NamePattern4) **] [**8-15**] days. ICD9 Codes: 0389, 486, 5849, 4280, 5990
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Medical Text: Admission Date: [**2131-9-20**] Discharge Date: [**2131-10-2**] Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1**] Chief Complaint: Wound infection Major Surgical or Invasive Procedure: [**9-20**] Exploratory laparotomy with resection of anastomosis, Hartmann's with ascending colostomy [**9-21**] Placement of central venous catheter [**9-21**] Left chest tube insertion [**9-22**] Left chest tube insertion (#2) [**9-26**] Left chest tube removal and left apical chest tube replacement [**9-28**] Left VATS exploration with doxycycline pleurodesis History of Present Illness: Mr. [**Known lastname 93929**] is a 82 year old male who was admitted to [**Hospital1 18**] on [**9-20**] from the surgical clinic with a wound infection. He is s/p a laparoscopic colectomy on [**9-10**] for an obstructing mass at splenic flexure which was biospy proven adenocarcinoma of the colon, he had an un-complicated post-operative course except for a localized wound cellulitis. He was discharged home on oral antibiotics for seven days. He was seen in the surgical clinic on [**9-20**] with reports of drainage from wound over the last four days, initially it was serous but it changed to more feculent material. The wound was completely opened in the ED with findings of wound dehiscence of th superior portion and feculent drainage. A CT scan revealed free air with no level of obstruction, contrast did not reach level of anastomosis. He was taken to the OR with findings of breakdown of the anastomosis with leakage of stool; he [**Month/Day (1) 1834**] a resection of anastomosis with placement of a colostomy. Past Medical History: Past Medical History: Adenocarcinoma of colon Aortic sclerosis Past Surgical History: [**9-10**] Laparoscopic colectomy Mastoid surgery at age 5 Remote testicular surgery at age 10 Social History: Non-smoker, has [**2-17**] drinks of alcohol each week Family History: Non-contributory Physical Exam: On admission to surgical service: 97.5 70 94/61 20 100% room air Gen: Alert and oriented to time, place, and person Lungs: Cleart to auscultation bilaterally CV: Regular rate and rhythm Abd: Soft, non-tender, non-distended; +erythema along wound, +feculent material from wound Pertinent Results: Admission: [**2131-9-20**] 01:10PM BLOOD WBC-15.0* RBC-4.08* Hgb-10.8* Hct-32.3* MCV-79* MCH-26.4* MCHC-33.3 RDW-14.8 Plt Ct-575*# [**2131-9-20**] 01:10PM BLOOD Neuts-79.4* Lymphs-15.2* Monos-4.0 Eos-1.4 Baso-0.1 [**2131-9-20**] 01:10PM BLOOD PT-12.5 PTT-25.7 INR(PT)-1.1 [**2131-9-20**] 01:10PM BLOOD Glucose-90 UreaN-13 Creat-1.0 Na-138 K-4.7 Cl-101 HCO3-27 AnGap-15 [**2131-9-20**] 01:10PM BLOOD Calcium-9.1 Phos-4.2 Mg-2.0 During hospitalization: [**2131-9-22**] 01:18AM BLOOD WBC-19.4*# RBC-3.03*# Hgb-8.3*# Hct-23.6*# MCV-78* MCH-27.3 MCHC-34.9 RDW-14.9 Plt Ct-505* [**2131-9-24**] 06:20AM BLOOD WBC-20.1* RBC-3.68* Hgb-10.1* Hct-29.1* MCV-79* MCH-27.5 MCHC-34.8 RDW-15.5 Plt Ct-544* [**2131-9-21**] 01:35AM BLOOD CK-MB-3 cTropnT-0.02* [**2131-9-21**] 05:46PM BLOOD CK-MB-7 cTropnT-<0.01 [**2131-9-22**] 01:18AM BLOOD CK-MB-5 cTropnT-<0.01 [**2131-9-21**] 01:35AM BLOOD CK(CPK)-88 [**2131-9-21**] 05:46PM BLOOD CK(CPK)-855* [**2131-9-22**] 01:18AM BLOOD CK(CPK)-826* [**2131-9-20**] 1:10 pm SWAB **FINAL REPORT [**2131-9-26**]** GRAM STAIN (Final [**2131-9-20**]): 2+ (1-5 per 1000X FIELD): POLYMORPHONUCLEAR LEUKOCYTES. 3+ (5-10 per 1000X FIELD): GRAM NEGATIVE ROD(S). WOUND CULTURE (Final [**2131-9-24**]): Due to mixed bacterial types ( >= 3 colony types) an abbreviated workup is performed appropriate to the isolates recovered from the site (including a screen for Pseudomonas aeruginosa, Staphylococcus aureus and beta streptococcus). GRAM NEGATIVE ROD #1. MODERATE GROWTH. GRAM NEGATIVE ROD(S). SPARSE GROWTH. OF TWO COLONIAL MORPHOLOGIES. PROBABLE ENTEROCOCCUS. SPARSE GROWTH. OF TWO COLONIAL MORPHOLOGIES. PSEUDOMONAS AERUGINOSA. SPARSE GROWTH. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ PSEUDOMONAS AERUGINOSA | CEFEPIME-------------- <=1 S CEFTAZIDIME----------- 2 S CIPROFLOXACIN---------<=0.25 S GENTAMICIN------------ 2 S IMIPENEM-------------- <=1 S MEROPENEM-------------<=0.25 S PIPERACILLIN---------- <=4 S PIPERACILLIN/TAZO----- <=4 S TOBRAMYCIN------------ <=1 S ANAEROBIC CULTURE (Final [**2131-9-26**]): BACTEROIDES FRAGILIS GROUP. MODERATE GROWTH. BETA LACTAMASE POSITIVE. [**2131-9-29**] 9:43 am URINE **FINAL REPORT [**2131-9-30**]** URINE CULTURE (Final [**2131-9-30**]): NO GROWTH. [**2131-10-1**] 7:06 am SWAB Site: ABDOMEN Source: abdominal wound. GRAM STAIN (Final [**2131-10-1**]): NO POLYMORPHONUCLEAR LEUKOCYTES SEEN. NO MICROORGANISMS SEEN. WOUND CULTURE (Pending): ANAEROBIC CULTURE (Pending): Discharge: [**2131-10-2**] 07:15AM BLOOD WBC-12.1* RBC-3.64* Hgb-9.9* Hct-29.3* MCV-81* MCH-27.2 MCHC-33.8 RDW-16.8* Plt Ct-410 [**2131-10-2**] 07:15AM BLOOD Plt Ct-410 [**2131-9-29**] 06:20AM BLOOD Glucose-86 UreaN-7 Creat-0.7 Na-139 K-4.0 Cl-104 HCO3-26 AnGap-13 [**2131-9-29**] 06:20AM BLOOD Calcium-8.0* Phos-4.3 Mg-2.3 OPERATIVE REPORT FIRST ASSISTANT: [**Doctor First Name **] [**Doctor Last Name **], RES PREOPERATIVE DIAGNOSIS: Anastomotic leak following partial colectomy with dehiscence of abdominal closure. POSTOPERATIVE DIAGNOSIS: Anastomotic leak following partial colectomy with dehiscence of abdominal closure. OPERATION: Exploratory laparotomy, lysis of adhesions, resection of colonic anastomosis and closure of distal colon and end colostomy. INDICATION: 82-year-old male had undergone transverse colectomy 10 days ago for colon cancer. He did well postoperatively and was discharged home. Shortly prior to his discharge home he had some erythema around some staples and was placed on Keflex for cellulitis. Once he went home, I was called about 3 days later to say he had a small amount of drainage from his wound but was otherwise feeling well and I advised him to apply gauze to this and keep me informed. On the night before admission I was called to say that he noted a temperature of 99.3. He was due to see me in the office this morning and therefore I said that we would address this issue then. When I saw the patient in the office, his wound was clearly contaminated with fecal material and I took out some staples which revealed more fecal material. I therefore transferred him to the emergency room and saw him after the Resident team had removed the rest of the staples and confirmed the findings of a partial dehiscence of his abdominal wall incision, as well as fecal matter within the wound. We did obtain a CAT scan to just make sure that there was not a significant collection of fluid anywhere in the peritoneal cavity that we might not be able to address readily in surgery and then took him to the operating room. PREPARATION: Once the patient was suitably anesthetized, the abdomen was prepared and draped appropriately. INCISION: The old incision was reopened and extended below. FINDINGS: There was actually a paucity of any reaction anywhere in the peritoneal cavity except for under the incision and by the anastomosis. The anastomosis was clearly the source of the problem. The small bowel was adherent to 1 area of this anastomosis and was taken off it without injuring it. TECHNIQUE: We dissected the small bowel off the anastomosis and mobilized the colon proximally and distally to the anastomosis. The bowel was controlled distally and then stapled closed with an Endo [**Female First Name (un) 3224**] green cartridge and then the colon was resected back past the anastomosis. At this point, the right colon was gently mobilized and enough of it brought medially to reach a right lower quadrant circular incision that we made to accommodate the colon as a colostomy. The colonic anastomosis was resected with another application of the [**Female First Name (un) 3224**] and the fresh colon was then brought out through the right lower quadrant incision which we made to accommodate the colostomy. We then irrigated copiously with saline and then closed the abdominal wall after debriding it with #1 PDS. We left the wound open and then matured the colostomy with 3-0 Vicryl. The patient tolerated the procedure well and was returned to the recovery room. CT ABDOMEN W/CONTRAST [**2131-9-20**] 2:53 PM CT ABDOMEN W/CONTRAST; CT PELVIS W/CONTRAST Reason: fistula Field of view: 35 Contrast: OPTIRAY [**Hospital 93**] MEDICAL CONDITION: 82 year old man with recent colectomy, now concerned for enterocut fistula REASON FOR THIS EXAMINATION: fistula CONTRAINDICATIONS for IV CONTRAST: None. INDICATION: 82-year-old man with a transverse colectomy for adenocarcinoma approximately one week ago now with concern for an enterocutaneous fistula. COMPARISON: No prior studies are available for comparison. TECHNIQUE: Multidetector CT scanning of the abdomen and pelvis was performed after the administration of oral and intravenous contrast. Coronal and sagittal reformations were obtained. CT OF THE ABDOMEN: The lung bases demonstrate small pleural effusions and dependent atelectasis. The liver, adrenal glands, spleen, and pancreas appear normal. A 4mm hypodensity in the right lobe of the liver is incompletely characterized. The gallbladder is distended but thin walled without any intraluminal stones or sludge identified. The kidneys enhance and excrete contrast symmetrically without hydronephrosis. Two small incompletely characterized cysts, the larger measuring 9 mm, are seen in the right kidney. There is a small cortical defect in the left kidney which could represent prior infection. No dilated loops of bowel are identified. The patient is status post a transverse colectomy and surgical suture material is seen in the mid abdomen connecting remaining loops of colon. There is a large anterior abdominal wall defect in the region of the anastomosis. Contrast has reached the mid small bowel. There is an extensive amount of free intraperitoneal air still evident. There is a small amount of subhepatic/subphrenic ascites. Mesenteric stranding in the region of the surgery is also seen as well as multiple surgical clips. Multiple small retroperitoneal lymph nodes are seen, which do not meet criteria for pathologic enlargement. There is atherosclerosis of the abdominal aorta and its branches. CT OF THE PELVIS: The bladder, prostate, seminal vesicles, and rectum appear unremarkable apart from minor prostatic calcifications. No free fluid is seen in the pelvis. No drainable fluid collections are seen in the abdomen or pelvis. OSSEOUS STRUCTURES: There is grade 1 anterolisthesis of L4 on L5 with extensive degenerative change at this level. There is a rounded region of sclerosis in the sacrum, likely a bone island. No concerning lytic or sclerotic lesions are identified. IMPRESSION: 1. Post-surgical changes in the abdomen and large anterior abdominal wall defect with persistent extensive pneumoperitoneum and a small amount of ascites. No drainable fluid collections. 2. Small bilateral pleural effusions with associated atelectasis. 3. 4-mm hypodensity in the right lobe of the liver, incompletely characterized. 4. IncoRADIOLOGY Final Report CHEST (PORTABLE AP) [**2131-9-21**] 3:18 PM Reason: improvement in L pneumo [**Hospital 93**] MEDICAL CONDITION: 82 year old man with s/p traverse colectomy, anastomic leak - s/p L chest tube for PTX REASON FOR THIS EXAMINATION: improvement in L pneumo AP CHEST, 3:19 P.M., [**9-21**]. HISTORY: Left chest tube. No pneumothorax. IMPRESSION: AP chest compared to 1:57 p.m.: Left pneumothorax has decreased only minimally, still quite large, despite placement of left pleural tube. Mediastinum, however, has returned to the midline. Heart mildly enlarged. Right lung is low in volume but essentially clear. Findings were discussed with the house officer caring for this patient, by telephone, at the time of dictation. RADIOLOGY Final Report CHEST PORT. LINE PLACEMENT [**2131-9-21**] 8:49 AM Reason: s/p triple lumen placement [**Hospital 93**] MEDICAL CONDITION: 82 year old man with REASON FOR THIS EXAMINATION: s/p triple lumen placement INDICATION: 82-year-old man status post central venous catheter placement. No prior studies are available for comparison. FINDINGS: Right-sided subclavian approach central venous catheter is noted with its tip projecting at the level of the right subclavian and internal jugular junction. A NG tube is visualized with its tip projecting over the stomach. The cardiac silhouette is within normal limits. The aorta is tortuous with calcification in its arch. Lung volumes are low. Bibasilar linear opacities likely represent atelectasis. Mild blunting of the left costophrenic angle may represent small pleural effusion. Free air below the right hemidiaphragm is noted. Thoracic scoliosis is noted. IMPRESSION: 1. Right central venous catheter with its tip projecting at the level of the right subclavian and internal jugular junction. 2. Pneumoperitoneum. 3. NG tube with its tip projecting over the stomach. Findings were discussed with Dr. [**Last Name (STitle) **] on [**2131-9-21**]. RADIOLOGY Final Report CHEST (PORTABLE AP) [**2131-9-22**] 12:20 PM CHEST (PORTABLE AP); -76 BY SAME PHYSICIAN Reason: Status of PTX [**Hospital 93**] MEDICAL CONDITION: 82 year old man with s/p traverse colectomy, anastomic leak - repositioning of L chest tube for PTX; assess for interval change in lung expansion REASON FOR THIS EXAMINATION: Status of PTX PORTABLE CHEST ON [**2131-9-22**] AT 12:15. INDICATION: Left chest tube placement. COMPARISON: [**2131-9-22**] at 05:28. FINDINGS: The left pneumothorax persists and is unchanged. The right lung appears better aerated. NGT has been removed and left CVL remains in place. IMPRESSION: No change in the left PTX. CHEST (PORTABLE AP) [**2131-9-27**] 7:57 AM Reason: assess for interval changes [**Hospital 93**] MEDICAL CONDITION: 82 year old man with s/p CT x2 for PTX. REASON FOR THIS EXAMINATION: assess for interval changes INDICATION: Status post chest tube placement, for evaluation of pneumothorax. PORTABLE AP CHEST. COMPARISON: [**2131-9-26**]. The heart size is normal. Aorta is unfolded. A small left-sided pneumothorax is noted. Two chest tubes are seen in place with interval removal of one of the chest tubes. Small bilateral pleural effusions are again noted with low lung volumes. IMPRESSION: 1. Small left-sided pneumothorax and bilateral small pleural effusions. Interval removal of the third chest tube from the left. 2. Low lung volumes. RADIOLOGY Final Report CT CHEST W/O CONTRAST [**2131-9-28**] 8:56 AM CT CHEST W/O CONTRAST Reason: Please eval PTX/chest tubes; please obtain in early AM [**Hospital 93**] MEDICAL CONDITION: 82 year old man w/ continuous air leak REASON FOR THIS EXAMINATION: Please eval PTX/chest tubes; please obtain in early AM CONTRAINDICATIONS for IV CONTRAST: None. REASON FOR EXAMINATION: Evaluation of a long standing pleural effusion. COMPARISON: Serial chest radiograph from [**2131-9-21**] to [**2131-9-28**]. FINDINGS: Multiple mediastinal nodes are mildly enlarged measuring up to 1 cm in the supracarinal location . The hilar lymphadenopathy is hard to estimate due to lack of contrast but no significant lymphadenopathy is present. There is no axillary lymphadenopathy. The heart is mildly enlarged with tiny pericardial effusion. Coronary calcification involves both right and left coronary arteries. Aortic valve calcifications are present. Several left intrapleural air collections are small involving the apex, the lateral and the anterior low pleural spaces. The apical chest tube ends anteriorly with adjacent pleural surfaces all apposed. Subcutaneous emphysema is minimal. The right pleural effusion is small, larger than the left. Bibasilar consolidation with is most likely atelectasis, but aspiration cannot be excluded. The images of the upper abdomen demonstrate mild ascites. No significant abnormalities demonstrated within the liver, kidneys, spleen, adrenals and pancreas. Surgical clips are in the left upper abdomen. There are no bone lesions suspicious for malignancy. IMPRESSION: 1. Several small intrapleural air pocket on the left. CT is not able to show a pleural defect from central venous line insertion; no large defect is present. The bilateral pleural effusions are small, right worse than left with adjacent consolidation most likely atelectasis. 2. Mild ascites. 3. Coronary calcifications. OPERATIVE REPORT [**Last Name (LF) 1533**],[**First Name3 (LF) 1532**] P. Signed Electronically by [**Doctor Last Name 1533**],[**Last Name (un) **] on TUE [**2131-10-2**] 8:56 AM Name: [**Known lastname **],[**Known firstname 870**] Unit No: [**Numeric Identifier 93930**] Service: Date: [**2131-9-28**] Sex: M Surgeon: [**Name6 (MD) **] [**Name8 (MD) **], [**MD Number(1) 67965**] PREOPERATIVE DIAGNOSIS: Left pneumothorax. POSTOPERATIVE DIAGNOSIS: Left pneumothorax. PROCEDURE: Left VATS exploration and doxycycline pleurodesis. ASSISTANT: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 33888**] ANESTHESIA: General endotracheal plus 40 cc of 0.375% Marcaine with epinephrine and local and rib blocks. IV FLUIDS: 1800 cc. URINE OUTPUT: 180 cc. ESTIMATED BLOOD LOSS: Less than 25 cc. INDICATIONS FOR PROCEDURE: Mr. [**Known lastname 93929**] is an 82-year-old gentleman who had recently undergone a transverse colectomy for colon cancer and subsequent to that developed an anastomotic leak requiring reoperation and creation of an end colostomy [**Doctor Last Name 3379**] pouch. The day after this reoperation, he was noted to have a left pneumothorax following placement of a central line. The initial attempts at treatment of this involved 2 tubes and finally a third tube was placed which was able to resolve the pneumothorax. However, the air leak did not resolve. CT scan was unrevealing of the problem. PROCEDURE IN DETAIL: The patient was positioned supine and through a single-lumen endotracheal tube, flexible bronchoscopy was performed at the segmental airway level bilaterally. There was no endobronchial obstruction. There was no blood, plugging, purulence encountered. There was no mucosal damage which would have potentially led to bronchopleural fistula. The patient then had the double-lumen endotracheal tube placed and he was positioned in the left thoracotomy position. He was prepped and draped in the usual sterile fashion. He had 3 chest tube wounds. Two of these 3 wounds were dehiscing and the third wound was opened as we had just removed the remaining chest tube. Therefore, I decided to prep these copiously using direct iodine application to the tract and tube site and then placed the initial videoscope through one of the chest tubes. Upon introduction of this into the chest, I noted that there were some filmy adhesions and some fibrinous material in the chest but that there was a good view. The lungs themselves looked slightly emphysematous and had quite a lot of anthracotic markings. There was no obvious bulla and clearly no obvious laceration or injury to the lung on initial glance. I placed a new port posteriorly at the tip of the scapula and then used one of the previously placed chest tube ports as the second utility incision for an instrument. I was able to free up the adhesions and then manipulate the lung so that I could view it in 360 degrees, including all aspects of the intralobar fissure. There was no obvious sign of visceral pleural defect whatsoever. I then, therefore, dunked the lung underneath 500 cc of sterile water. I systematically submerged the upper lobe in its entirety and then followed this was submersion of the lower lobe in its entirety. Even with this process and lung inflation to a pressure of 20 cm of water which resulted in good inflation, I did not observe any air streaming from the lung whatsoever. Therefore, we elected to perform doxycycline pleurodesis. We had 500 mg of doxycycline and we injected that into the chest and let it circulate around evenly. We placed two 19-French [**Doctor Last Name 406**] drains in the chest and brought these out through separate tunneled stab incisions. We closed the wounds very loosely with 3-0 and 4-0 Vicryl. All sponge and needle counts were correct x2 and I was present and scrubbed for the entire procedure. The patient was extubated and taken to the recovery room in good condition. RADIOLOGY Preliminary Report CHEST (PORTABLE AP) [**2131-9-29**] 8:05 AM CHEST (PORTABLE AP) Reason: r/o pneumo8am please [**Hospital 93**] MEDICAL CONDITION: 82 year old man with s/p CT x1, with pneumothorax REASON FOR THIS EXAMINATION: r/o pneumo8am please HISTORY: Pneumothorax. Single portable chest radiograph again demonstrates two left-sided chest tubes. There is a small left-sided pleural effusion. There is mild bibasilar atelectasis. Trachea is midline. Cardiomediastinal contours are unchanged. No pneumothorax is detected. S-shaped scoliosis of the cervical, thoracic and lumbar spine is again noted. Surgical clips project over the left upper quadrant. IMPRESSION: Left-sided pleural effusion. No pneumothorax. Bibasilar atelectasis persists. RADIOLOGY Final Report CHEST (PA & LAT) [**2131-9-30**] 12:08 PM [**Hospital 93**] MEDICAL CONDITION: 82 year old man s/p VATS/pleurodesis REASON FOR THIS EXAMINATION: Please eval for PTX, on water seal; please perform study between 12 noon and 1 PM PA AND LATERAL CHEST X-RAY, [**2131-9-30**] COMPARISON: [**2131-9-29**]. INDICATION: Chest tube placed to waterseal. Question pneumothorax. Two chest tubes remain in place in the left hemithorax. On the lateral view, there is a small air-fluid level present anteriorly consistent with an anterior loculated hydropneumothorax. The chest tubes are located posterior to this area. Cardiac and mediastinal contours are stable. Moderate right pleural effusion with intrafissural component is unchanged. Small-to-moderate left pleural effusion has slightly increased laterally, but there has been overall improved aeration in the left lower lobe with improving atelectasis in this region. IMPRESSION: 1. Small left loculated anterior hydropneumothorax. 2. Bilateral pleural effusions, right greater than left. 3. Improving aeration left lower lobe. Date: [**2131-10-1**] Signed by [**First Name11 (Name Pattern1) 2295**] [**Last Name (NamePattern4) 69152**], RN on [**2131-10-1**] Affiliation: [**Hospital1 18**] Mr [**Known lastname 93929**] was seen to apply an ABD binder and to adjust it around the colostomy. The pouch was starting to lift on the medial edge therefore it was changed. The stoma is dark burgundy and protruding. Peristomal skin and mucocutaneous junction are intact. Pouched with [**Location (un) **] high output pouch with [**First Name8 (NamePattern2) **] [**Last Name (un) **] seal. Have placed a medium ABD binder around his ABD and then made an opening in it to allow the pouch to hang out through the opening. He expects to go to rehab soon will update his referral and provide him with d/c ostomy supplies and written ostomy care instructions. Brief Hospital Course: Mr. [**Known lastname 93929**] had no intra-operative complications, he was given intravenous antibiotics of Levaquin and Flagyl pre-operatively which were continued post-operatively. His white blood cell count on admission was 15k. Post-operatively he was hypotensive with low urine outputs despite fluid boluses and was admitted to the surgical intensive care unit for further management and resuscitation. A cardiac work-up was negative for ischemia. Upon admission to the intensive care unit a central line was placed with difficulty on the right side and successful placement on the left internal jugular vein for central venous pressure monitoring, this was complicated by a left pneumothorax requiring placement of a chest tube. On POD 2 his urine output and creatinine had improved with fluid resuscitation from 1.8 to 1.3. His pain was well controlled with a Morphine PCA, he remained afebrile, and his abdominal wound dressing changes continued with wet to dry dressing changes of normal saline. On POD 3 a chest x-ray demonstrated persistent left pneumothorax which was treated with placement of a second chest tube, a thoracic surgery consult was placed with recommendation of continuing current treatment. He was transfused two units of PRBC's for a hematocrit of 24.3 with a repeat hematocrit of 28.2. On POD 4 he was stable for transfer to an in-patient nursing unit, his diet was advanced which he tolerated well, and he had +air from the ostomy. On POD 6 a chest x-ray demonstrated an increased pneumothorax; thoracic surgery removed one of the two left sided chest tubes and replaced one in the apex on the left side at the bedside, an air leak continued from both chest tubes. He tolerated the procedure well, his oxygenation was stable on 2 liters nasal cannula. A repeat chest x-ray showed minimal improvement in the pneumothorax. On POD 8 he had a CT scan of the chest which demonstrated small intrapleural air pockets with bibasilar atelectasis. Since the air leak continued and there was minimal improvement in the pneumothorax he was taken to the operating room on POD 8 for a left VATS, exploration, and mechanical pleurodesis with Doxycycline by thoracic surgery. He had no intra-operative complications and returned to an in-patient nursing unit. On POD [**12-26**] his pain was well controlled with Percocet, he remained afebrile, and two left sided chest tubes were maintained on suction. His abdominal wound was debrided at the bedside and was noted to be granulating well; his white blood cell count was elevated to 19k therefore an abdominal and pelvic CT scan was done. The CT scan demonstrated a large anterior abdominal wall defect involving the subcutaneous fat extending to the anterior abdominal musculature, he also had small loculated fluid collections in the abdomen and pelvis between loops of bowel which appeared to be benign. His diet was advanced to regular food which he tolerated well and his ostomy was functioning well. The abdominal wound dressing changes were changed to dry dressings three times a day since it still had "wet" appearance with cream colored drainage. He was also provided an abdominal binder to wear throughout the day with a hole cut out for the ostomy appliance. On POD [**9-17**] both chest tubes had no air leaks and were placed to water seal, a repeat chest x-ray demonstrated no pneumothorax so both chest tubes were removed by thoracic surgery; post removal chest x-ray demonstrated small stable apical pneumothorax. He was oxygenating well on 2 liters nasal cannula and continued to received aggressive pulmonary toileting. On POD [**11-18**] he was oxygenating well on room air, had minimal pain, was tolerating a regular diet, and his ostomy was functioning well. He remained afebrile with a white blood cell count of 12.1k. His abdominal wound measured 17cm by 3cm with visible fascia and sutures; he continued to receive dressing changes three times a day with packing of dry, sterile gauze. There was still cream colored drainage present with pink granulating tissue as well. He was discharged to [**Hospital1 **] Rehabilitation facility in good condition on [**10-2**]. He will receive 2 more days of oral antibiotics of Levaquin and Flagyl which will total 14 days of treatment. He will continue to receive physical therapy to increase his functional mobility. He will also receive further teaching and instruction regarding care of his ostomy. He will follow-up in the surgical clinic in [**12-18**] weeks for evaluation of his abdominal wound. He will follow-up in the ostomy clinic after discharge from the rehabilitation facility. Medications on Admission: Toprol XL Percocet prn Colace Keflex ASA Discharge Medications: 1. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 2. Metronidazole 500 mg Tablet Sig: One (1) Tablet PO TID (3 times a day) for 2 days: Last dose pm of [**10-4**]. 3. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours) for 2 days: Last dose on [**10-4**]. 4. Metoprolol Succinate 25 mg Tablet Sustained Release 24HR Sig: One (1) Tablet Sustained Release 24HR PO DAILY (Daily): Hold for HR < 60 Hold for SBP < 100. 5. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed for pain. 6. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection twice a day: Give until patient ambulating. Discharge Disposition: Extended Care Facility: [**Hospital1 700**] - [**Location (un) 701**] Discharge Diagnosis: Adenocarcinoma of colon with wound dehiscence Left pneumothorax Discharge Condition: Good Discharge Instructions: Notify MD/NP/PA/RN at rehabilitation facility if you experience: *Increased or persistent pain not relieved by pain medications *Fever > 101.5 or chills *Shortness of breath or difficulty breathing *Nausea or vomiting *Inability to pass gas or stool through ostomy; inability to pass urine *If abdominal wound develops erythema, drainage, or a foul odor *Any other symptoms concerning to you You need to wear the abdominal binder at all times throughout the day You may shower and wash incision and abdominal wound with soap and water, dresssing changes will be done three times a day by the nurses. Please take all medications as ordered Followup Instructions: Follow-up with Dr. [**Last Name (STitle) **] in [**12-18**] weeks, call ([**Telephone/Fax (1) 9011**] for an appointment. Follow-up with your PCP, [**Last Name (NamePattern4) **]. [**Last Name (STitle) **] after discharge from the rehabilitation facilty for review of your medications and physical exam, call [**Telephone/Fax (1) 904**] for an appointment. Completed by:[**2131-10-2**] ICD9 Codes: 4019
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Medical Text: Admission Date: [**2165-9-29**] Discharge Date: [**2165-10-9**] Date of Birth: [**2165-9-29**] Sex: M Service: NEONATOLOGY HISTORY: Baby [**Name (NI) **] [**Known lastname **] is a pre-term infant with respiratory distress, admitted to the Neonatal Intensive Care Unit for further management of prematurity and respiratory symptoms. para 0 now I mother. PRENATAL SCREENS: O positive, antibody negative, rubella immune, RPR nonreactive, hepatitis B surface antigen negative, GBS unknown. Reported benign antepartum until morning of delivery, with rupture of membranes followed by labor onset. Received one dose of antibiotics six hours for fetal bradycardia. Abjurers were 8 at one minute and 9 at five minutes. PHYSICAL EXAMINATION: On admission, weight 2735 grams (90th percentile), length 48 cm (75th percentile), head circumference 33.5 cm (75th percentile). Examination notable for [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **]-term infant with mild respiratory distress, color pink in oxygen, anterior fontanel soft and flat, normal facies, intact palate, mild retractions, intermittent grunting, fair air entry, no murmur, palpable femoral pulses, abdomen soft, flat, nontender, without hepatosplenomegaly, normal phallus, testes in scrotum, stable hips, fair perfusion, normal tone and activity. HOSPITAL COURSE BY SYSTEM: 1. Respiratory: Infant initially placed on CPAP of 6 cm of water and 40% FIO2. Initial blood gas was 7.36, 47, 76, 28. Due to increased FIO2 requirement to 60%, the infant was intubated on day of life one, and was placed on ventilator setting of 25/5 with a rate of 30. At that time, he received two doses of Survanta, and was weaned to 16/5 and a rate of 16 in room air. He was extubated on day of life two to CPAP, and was transect to nasal cannula by day of life four, and he remained in nasal cannula of 200 cc, 25%, until day of life eight. He currently remains in room air, with saturations greater than 95%, and respiratory rate 40 to 50. He has not had any apnea or bradycardia this hospitalization, and has not received methylxanthine therapy. 2. Cardiovascular: On day of life three, the infant was noted to have bradycardia with heart rate to the 60s. Cardiology was consulted at that time, and an electrocardiogram was done, which revealed a prolonged QTC interval of .455. Otherwise the electrocardiogram showed normal sinus rhythm. Two electrocardiograms were repeated prior to discharge for prolonged QTC. The electrocardiogram on [**10-3**] also revealed a normal newborn tracing with a QTC of .423, electrocardiogram on [**10-8**] revealed normal sinus rhythm with QTC of .441. Cardiology recommends only follow up 1-2 months after discharge. The infant's blood pressures have been stable, with mean blood pressure of 37 to 45, with heart rate 100 to 130, no murmur. 3. Fluids, electrolytes and nutrition: The infant was started on 60 cc/kg/day of D-10-W intravenously. He received one D-10-W bolus for a D-stick of 48 initially, and was nothing by mouth until day of life four, at which time he was started on enteral feedings of a minimum of 60 cc/kg/day of breast milk or Enfamil 20 calories/ounce. He was advanced to a minimum of 80 cc/kg/day of breast milk at 20 calories/ounce ad lib and has been taking approximately 148 cc/kg/day of breast milk 20 calories/ounce and breast feeding. The infant tolerated feeding advancement without difficulty. The most recent electrolytes on day of life six were sodium 145, chloride 110, potassium 4.3, TCO2 24, calcium 8.6, with an ionized calcium of 1.24. The most recent weight is 2675 grams, head circumference 33.5, length 48 cm. 4. Gastrointestinal: Maximum bilirubin level of 13.2 with a direct of 0.3 was on day of life five. The infant did not receive phototherapy this hospitalization. The most recent bilirubin on day of life seven was 10.8, with a direct of 0.3. 5. Hematology: The infant did not receive blood transfusion this hospitalization. The most recent hematocrit on day of delivery was 47.5%. 6. Infectious Disease: CBC and differential with blood culture were drawn on admission. The white blood cell count was 12.3, 32 polys, 1 band, 56 lymphs, 346,000 platelets. The infant was also started on ampicillin and gentamicin at that time, which was discontinued at 48 hours. The blood cultures remain negative to date. 7. Neurology: The infant does not meet criteria for head ultrasound. 8. Sensory: Hearing screening was performed with automated auditory brain stem responses. The infant passed both ears. Ophthalmology: The infant does not meet criteria for eye examination. 9. Psychosocial: Parents are involved. [**Hospital1 346**] social worker can be reached at [**Telephone/Fax (1) 8717**]. CONDITION AT DISCHARGE: Former 34 week gestation male, stable in room air. DISCHARGE DISPOSITION: Home with parents. NAME OF PRIMARY PEDIATRICIAN: [**Hospital 9583**] Pediatrics CARE RECOMMENDATIONS: 1. Feedings at discharge: Breast milk or Enfamil 20 calories/ounce, breast feeding ad lib, minimum 80 cc/kg/day. 2. Medications: None. 3. Car seat position screening was performed, infant passed. 4. State newborn screens were sent on [**10-3**] and [**10-4**], results are pending. 5. Immunizations received: The infant received hepatitis B vaccine on [**10-4**]. 6. Immunizations recommended: Synagis respiratory syncytial virus prophylaxis should be considered from [**Month (only) 359**] through [**Month (only) 547**] for infants who meet any of the following three criteria: (1) Born at less than 32 weeks gestation; (2) Born between 32 and 35 weeks, with plans for day care during respiratory syncytial virus season, with a smoker in the household, or with preschool siblings; or (3) With chronic lung disease. 7. Follow-up appointments: a. [**Hospital 9583**] Pediatrics within two days (Dr. [**Last Name (STitle) **] [**Last Name (NamePattern4) 45542**]). b. Cardiology Dr. [**Last Name (STitle) 45543**]/[**Location (un) 10123**] ([**Telephone/Fax (1) 37115**]) CH at 1-2 months. DISCHARGE DIAGNOSIS: 1. Premature male, 34 weeks gestation 2. Status post respiratory distress syndrome 3. Status post rule out sepsis 4. Sinus bradycardia [**Doctor Last Name **] [**Last Name (NamePattern5) 36094**], M.D. [**MD Number(1) 36095**] Dictated By:[**Last Name (NamePattern1) 43219**] MEDQUIST36 D: [**2165-10-9**] 03:33 T: [**2165-10-9**] 04:00 JOB#: [**Job Number **] ICD9 Codes: 769, V290, V053
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Medical Text: Unit No: [**Numeric Identifier 64121**] Admission Date: [**2179-7-14**] Discharge Date: [**2179-7-29**] Date of Birth: [**2100-10-28**] Sex: M Service: HISTORY OF PRESENT ILLNESS: [**First Name8 (NamePattern2) 5586**] [**Known lastname 64122**] was a 78-year-old man with a past medical history of diabetes, hypercholesterolemia, hypertension, AAA repair and colon cancer, who presented with fatigue and chest pain. He initially presented to [**Hospital6 **], where he was found to have atrial fibrillation and a non-ST elevation myocardial infarction with a troponin I of 0.91 and a CK of 84. While at [**Hospital6 **] he developed recurrent symptoms and was transferred to [**Hospital1 188**] for further care. Upon his arrival he was found to have cardiogenic shock and was intubated and taken urgently for cardiac catheterization. PHYSICAL EXAMINATION: Initial vital signs were temperature 99.4, blood pressure 78/48, heart rate 119, respiratory rate 20. In general he was intubated and sedated. His pupils were equal, round and reactive to light. He was lying flat so jugular venous distention could not be evaluated. There was no apparent goiter. His lungs were clear anteriorly. He had a regular rhythm and rate with a normal S1 and S2. There were no murmurs, rubs or gallops. The PMI was lateral. The abdomen was soft and mildly distended with normal bowel sounds. There was no guarding. His stool was OB positive. Extremities were cool with dopplerable pulses. Neurological exam was limited due to his sedation. PERTINENT LABORATORY/RADIOLOGY/OTHER FINDINGS: His initial ECG on [**2179-7-15**], showed sinus tachycardia at a rate of 110, there was a late transition consistent with possible prior anterior infarction, there was left axis deviation, nonspecific ST-T wave changes. Cardiac catheterization was performed on [**2179-7-14**]. This showed severe 3 vessel disease with severe systolic and diastolic ventricular dysfunction. An echocardiogram was performed on [**2179-7-15**]. This showed severe left ventricular systolic dysfunction on a poor quality study. A repeat echocardiogram was performed later that day that confirmed left ventricular systolic dysfunction and found no significant valvular dysfunction. He again went for cardiac catheterization on [**2179-7-15**], during which he had percutaneous intervention of the left main coronary artery, the left anterior descending, the left circumflex and a diagonal branch. A chest x-ray was performed on [**2179-7-15**] which showed pulmonary edema and an intra-aortic balloon pump. Another echocardiogram was performed on [**2179-7-16**], which again showed severe systolic dysfunction, with no significant valvular disease. On [**2179-7-21**] a CT of the chest, abdomen and pelvis showed a left upper lobe mass invading the left superior pulmonary vein, left iliac bone metastasis and liver lesions, likely metastases, and borderline thickening of the gallbladder. HOSPITAL COURSE: Mr. [**Name14 (STitle) 64123**] initially presented with cardiogenic shock in the setting of acute coronary syndrome. He was intubated and taken to the cardiac catheterization laboratory. Cardiac catheterization showed severe 3 vessel disease. Cardiac surgery consultation was obtained, but it was determined that he was not a good candidate for surgical revascularization. He, therefore, went back to the cardiac catheterization lab the next day for high-risk intervention with placement of an intra-aortic balloon pump. Over the next several days his cardiogenic shock improved and he was weaned off the intra-aortic balloon pump and pressors, however, he remained intubated due to hypoxia and congestive heart failure. Pulmonary consultation was obtained. A CT of the chest and abdomen was obtained for further evaluation and demonstrated metastatic cancer. The decision was made to treat him medically in consultation with his healthcare proxy, however, his hypoxia failed to improve. On [**2184-7-26**] there was a meeting with the family, the healthcare proxy and the clinical team, and the decision was made to pursue comfort measures only. He was subsequently extubated and died on [**2179-7-29**] at 4:08 a.m. Autopsy was declined. CONDITION ON DISCHARGE: Expired. DISCHARGE STATUS: Expired. DISCHARGE INSTRUCTIONS: Not applicable. DIAGNOSES: 1. Congestive heart failure. 2. Acute myocardial infarction. 3. Metastatic cancer from a probable lung source. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) **], MD Dictated By:[**Last Name (NamePattern1) 64124**] MEDQUIST36 D: [**2184-7-7**] 12:50:33 T: [**2184-7-7**] 13:38:15 Job#: [**Job Number 64125**] ICD9 Codes: 2762, 5070, 4280, 0389, 4019, 4168
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Medical Text: Admission Date: [**2164-10-23**] Discharge Date: Date of Birth: [**2138-6-3**] Sex: M Service: ADDENDUM: Under the Infectious Disease section; of note, the patient was found to have small bilateral pleural effusions, right greater than left, as well as some right atelectasis. The patient had an intermittent low-grade temperature during the hospitalization which resolved at the time of discharge; however, the patient was started on an oral course of levofloxacin 500 mg p.o. q.d. and he was to complete a 10-day course on [**11-3**], and was to continue this on discharge until [**11-3**]. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 2437**], M.D. [**MD Number(1) 2438**] Dictated By:[**Last Name (NamePattern1) 2396**] MEDQUIST36 D: [**2164-10-30**] 14:10 T: [**2164-10-30**] 16:16 JOB#: [**Job Number 16916**] (cclist) ICD9 Codes: 2765, 5119
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5974 }
Medical Text: Admission Date: [**2164-6-15**] Discharge Date: [**2164-6-23**] Date of Birth: [**2103-12-24**] Sex: M Service: MEDICINE Allergies: bupropion Attending:[**First Name3 (LF) 6565**] Chief Complaint: Cough Major Surgical or Invasive Procedure: none History of Present Illness: This is a 60 year old gentleman with a history of metastatic esophageal adenocarcinoma (HER-2 positive), s/p esophagectomy, s/p 2 cycles of cisplastin and 5-FU with last chemo on [**2163-7-22**], currently with a J-tube, who presents with cough and fever. In brief, with regards to his metastatic esophageal cancer he underwent esophagectomy in 9/[**2162**]. He subsequently was noted to have metastatic disease to the brain for which he underwent a craniotomy. He has had several anastomotic dilations for stricture/dysphasia which have been complicated by aspiration pneumonia. His last dilation was [**2164-4-2**]. This admission was also complicated by a pnemonia with radiographic evidence of a RLL opacity. He also underwent laparoscopic jejunostomy feeding tube placement as well as biopsy of an esophago-gastric conduit and bronchoscopy with bronchoalveolar lavage. Unfortunately the esophago-gastric anastomosis biopsy revealed adenocarcinoma. Since this discharge, he has had recurrent episodes of coughing and increased sputum production. His tube feeds have been decreased in an attempt to improve his symptoms w/ notable decrease in the amount of regurgitated fluid. For the past week, he has noted increase in cough and sputum production. He has been increasingly tired. Today, a family member took his vitals and noted HR 125 and RR 28 prompting referral to the ED by his oncology fellow. He also felt subjectively febrile. He reports always coughing and choking w/ eating. He denied abdominal pain, chills, diarrhea or constipation, chest pain or palpitations or any other symptoms that were concerning to him. In the ED, initial VS were: 101.0 131 101/61 2 90% 3L. A chest xray revealed a RLL opacity concerning for pna. He was given cefepime and tylenol. A request for ICU admission was made in setting of tachycardia and hypotension. He arrived in the MICU where he was stabilized on BiPap and then transferred to the floor. Review of systems: (+) Per HPI (-) Denies chills, recent weight gain. Denies headache, sinus tenderness, congestion. Denies chest pain, chest pressure, palpitations, or weakness. Denies nausea, vomiting, diarrhea, constipation, abdominal pain, or changes in bowel habits. Denies dysuria, frequency, or urgency. Denies rashes or skin changes. Past Medical History: Past Medical History: 1) severe rheumatoid arthritis, previously on enbrel and now on prednisone alone. History of multiple joint surgeries related to RA. 2) atrial fibrillation s/p cardioversion [**2163-8-19**] 3) RLL PE in [**7-4**] 4) right axillary DVT [**2163-8-17**] 5) LUL PE in [**2164-1-17**] - while on coumadin. Now on enoxaparin. . Past Surgical History: 1) R forearm surgery 2) minimally invasive eosphagectomy [**2163-9-19**] & J-tube placement 3) s/p Esophagogastroduodenoscopy and dilation of a stricture ([**1-5**]) . . Onccologic History: - [**2163-5-30**]: EGD with large circumferential mass at GE junction. Biopsy showed adenocarcinoma. - [**2163-5-31**]: CT abdomen/pelvis with distal esophageal mass and a 3 cm partially necrotic lymph node in the hepatogastric ligament. EUS staging on [**6-6**] - Tx, N2, Mx. FNA of gastrohepatic node positive for adenocarcinoma. - [**2163-6-8**]: PET with FDG avid left paratracheal lymph node immediately anterior to esophagus at level of aortic arch, 7 mm, SUV max 4.5, multiple small (2-6 mm) pulmonary nodules too small to fully characterize, and a large 2.9 cm lymph node in the gastrohepatic ligament with SUV max 11.4. The primary distal esophageal mass was also highly FDG avid. - [**Date range (2) 6545**]: chemoradiation with cisplatin (75 mg/m2, D1 and D29) and 5-FU (1000 mg/m2/day D1-4, D29-32) - [**Date range (1) 6546**]/11: admission for PE (RLL segmental) causing pleuritic chest pain; therapeutic lovenox initiated - [**Date range (3) 6547**]: admission with new atrial fibrillation and acute right axillary DVT. CT showed improving PE. Cardioverted. Therapeutic lovenox continued. - [**2163-8-26**] PET/CT: Gastrohepatic and left paratracheal lymph nodes now without FDG-avidity. - [**2163-9-19**]: Dr. [**First Name (STitle) **] performed minimally invasive esophagectomy showing pathologic complete response including 15 negative nodes. - [**2163-11-15**], [**2163-12-13**], [**2163-12-30**]: esophageal stricture dilation. Port removed on [**2163-12-13**] and J-tube removed on [**2163-12-30**]. - [**Date range (3) 6566**]: admission with aphasia. Brain MRI showed solitary 1.9 cm left frontal lobe mass. CT torso with segmental LUL PE (new since [**2163-10-26**]), stable 9 mm right hilar lymph nodes and right upper lobe pulmonary nodules, no clear metastatic disease. Resection of brain mass on [**2164-1-20**] ([**Doctor Last Name **]) showed metastatic adenocarcinoma, CK7/CK20 positive, TTF-1 negative, consistent with upper GI origin. HER-2 positive by FISH. - [**2164-2-7**]: Cyberknife to resection cavity - [**3-7**]: dilation of anastomotic stricture - [**2164-3-27**]: CT chest with 7 mm RUL subpleural nodule (previously 5 mm) and new 7 mm LUL nodule, and increased right hilar and mediastinal adenopathy (may be reactive) - [**2164-4-2**]: J-tube placement, dilation of stricture, biopsy of gastric conduit revealed adenocarcinoma - [**5-4**] MRI brain: Marked decrease in enhancement at left frontal resection site. No new lesion. Social History: - Tobacco: quit in [**2161**], 30-35 years 1ppd - Alcohol: [**12-26**] cocktails every few weeks - Illicits: negative - Housing: lives w/ wife - Employment: on disability for past 10 years related to RA, former manager of bottling plant and [**Location (un) 6350**] [**Location 6351**]. - Family: wife, four children . Family History: His mother and [**Name2 (NI) 1685**] sister have [**Name2 (NI) **]. There is no family history of cancer. No clotting disorders in the family. Physical Exam: Vitals: 115 96% on 4L 103/63 99.0. General: Alert, oriented, no acute distress HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, PERRL Neck: supple, JVP not elevated, no LAD CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops Lungs: There are significantly decreased breath sounds in the right lower lung base. + egophony. Abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly, his J-tube exit site is dressed w/ c/d/i. Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Neuro: CNII-XII intact Pertinent Results: ADMISSION LABS [**2164-6-15**] 03:00PM BLOOD WBC-6.8 RBC-4.25* Hgb-10.4* Hct-33.6* MCV-79* MCH-24.5* MCHC-31.0 RDW-16.7* Plt Ct-394 [**2164-6-15**] 03:00PM BLOOD Neuts-58 Bands-13* Lymphs-12* Monos-16* Eos-0 Baso-0 Atyps-1* Metas-0 Myelos-0 [**2164-6-15**] 03:00PM BLOOD Glucose-120* UreaN-17 Creat-0.6 Na-137 K-3.7 Cl-97 HCO3-29 AnGap-15 [**2164-6-15**] 03:11PM BLOOD Lactate-3.1* RELEVANT LABS [**2164-6-16**] 04:09AM BLOOD WBC-6.4 RBC-4.00* Hgb-9.7* Hct-31.4* MCV-79* MCH-24.3* MCHC-31.0 RDW-16.7* Plt Ct-397 [**2164-6-17**] 07:45AM BLOOD WBC-6.1 RBC-4.00* Hgb-9.7* Hct-31.2* MCV-78* MCH-24.2* MCHC-31.0 RDW-17.0* Plt Ct-432 [**2164-6-18**] 07:40AM BLOOD WBC-6.3 RBC-4.24* Hgb-9.8* Hct-33.4* MCV-79* MCH-23.2* MCHC-29.5* RDW-16.4* Plt Ct-504* [**2164-6-19**] 06:06AM BLOOD WBC-7.7 RBC-4.26* Hgb-10.0* Hct-33.6* MCV-79* MCH-23.5* MCHC-29.8* RDW-16.6* Plt Ct-534* [**2164-6-20**] 06:32AM BLOOD WBC-10.4 RBC-4.70 Hgb-11.3* Hct-37.6* MCV-80* MCH-24.0* MCHC-30.1* RDW-16.6* Plt Ct-532* [**2164-6-21**] 06:35AM BLOOD WBC-9.5 RBC-3.97* Hgb-9.4* Hct-31.6* MCV-80* MCH-23.7* MCHC-29.6* RDW-17.4* Plt Ct-468* [**2164-6-22**] 06:55AM BLOOD WBC-13.2* RBC-4.28* Hgb-10.0* Hct-34.6* MCV-81* MCH-23.4* MCHC-29.0* RDW-17.5* Plt Ct-459* DISCHARGE LABS [**2164-6-23**] 07:55AM BLOOD WBC-11.2* RBC-4.28* Hgb-10.1* Hct-34.1* MCV-80* MCH-23.7* MCHC-29.7* RDW-17.6* Plt Ct-450* PERTINENT MICRO/PATH 1. RESPIRATORY CULTURE (Final [**2164-6-23**]): SPARSE GROWTH Commensal Respiratory Flora. ALCALIGENES (ACHROMOBACTER) SPECIES. MODERATE GROWTH. Cefepime >16 MCG/ML. MEROPENEM <= 1 MCG/ML. sensitivity testing performed by Microscan. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ ALCALIGENES (ACHROMOBACTER) SPECIES | AMIKACIN-------------- =>64 R CEFEPIME-------------- R CEFTAZIDIME----------- =>32 R CEFTRIAXONE----------- =>64 R CIPROFLOXACIN--------- 1 S GENTAMICIN------------ =>16 R IMIPENEM-------------- <=1 S LEVOFLOXACIN---------- <=1 S MEROPENEM------------- S PIPERACILLIN/TAZO----- <=8 S TOBRAMYCIN------------ =>16 R TRIMETHOPRIM/SULFA---- <=2 S ACID FAST SMEAR (Final [**2164-6-20**]): NO ACID FAST BACILLI SEEN ON CONCENTRATED SMEAR. 2. [**2164-6-21**] 8:17 pm STOOL CONSISTENCY: NOT APPLICABLE Source: Stool. **FINAL REPORT [**2164-6-22**]** C. difficile DNA amplification assay (Final [**2164-6-22**]): Negative for toxigenic C. difficile by the Illumigene DNA amplification assay. (Reference Range-Negative). PERTINENT IMAGING 1. CXR ([**2164-6-15**]) IMPRESSION: There is continued opacification of the right lung base, possibly reflecting a combination of pleural effusion with atelectasis, though infection cannot be excluded. Small right pleural effusion is unchanged. 2. VIDEO OROPHARYNGEAL SWALLOW ([**6-19**]) Single aspiration event with thin barium. For details, please see report by the speech and swallow division on OMR. 3. Upper GI Series ([**6-19**]) No evidence of fistula formation. 4. CT Abdomen and Pelvis ([**6-20**]) No bowel obstruction. No reflux of contrast administered via the J-tube into the duodenum or proximal jejunum. No CT explanation for patient's presentation. Bilateral pleural effusions, increased on the right since [**2164-1-17**]. The small left effusion is unchanged. Brief Hospital Course: This is a 60 year old gentleman with a history of metastatic esophageal adenocarcinoma (HER-2 positive), s/p esophagectomy, s/p 2 cycles of cisplastin and 5-FU with last chemo on [**2163-7-22**], currently with a J-tube, who presents with cough and fever. . Aspiration pneumonia: The initial differential of his cough included aspiration pna vs pneumonitis vs fistula vs post obstructive pna. Pt reported chronic coughing/choking w/ eating suggesting aspiration. A possible fistula was suggested during recent endoscopy ([**3-/2163**]) which was covered by metal stent. Given ulcerated and friable esophagus noted, new or recurrent fistula possible. Patient was initially started on Ceftriaxone and Metronidazole (day 1 = [**6-15**]) IV to cover for aspiration pneumonia. CXR showed RLL opacity but there was a question of chronicity as this has been seen on prior imaging. GI was consulted in regards to a possible T-E fistula. He had a swallow study as well as upper GI series and CT abdomen, none of which saw evidence of a fistula. There was some concern for reflux of his tube feeds exacerbating his risk for aspiration, however the CT abdomen showed no evidence of reflux of tube feeds into the esophagus. The swallow study showed one aspiration event with thin liquids and new PO recommendations were made. Nutrition was also consulted and made recommendations re: tube feeds. See below for changes made to diet and tube feeds. The patient was clinically well after being placed on I.V. antibiotics. The GI service as well as thoracic surgery saw him and did not feel he would benefit from further aggressive intervention. Given his past history of TB, he was ruled out via induced sputums. One of these sputums grew gram negative rods, so he was switched to Zosyn. The organism was identified as Achromobacter. He was on IV antibiotics for 7 days and transitioned to Levofloxacin based on sensitivities. He will complete 7 days of Levofloxacin for a total of a 14 day course. . Metastatic Esophageal Adenocarcinoma (HER-2 positive): Metastatic to brain with extention to gastric-esophageal anastamosis. S/p chemoradiation, partial esophagectomy, craniomety and multiple anastomotic dilations for stricture/dysphasia symptoms. Due to have CT torso in [**Month (only) 205**] with anticipated discussion for further surgical intervention versus restarting chemo. Plan as per Dr. [**Last Name (STitle) **]. Patient will have appointment scheduled for within 1-2 weeks. . Atrial fibrillation: Sinus Rhythm. Patient was on amiodarone 200 [**Hospital1 **] as an outpatient as well as metoprolol 25 [**Hospital1 **]. During this hospitalization, he had brief episodes of afib with RVR to the 120s/130s. We uptitrated his metoprolol to 50 [**Hospital1 **] and these episodes resolved. He will f/u with Dr. [**First Name4 (NamePattern1) 1060**] [**Last Name (NamePattern1) 1520**] of [**Company 191**] for further management. . Recurrent DVT/PE: H/o RLL PE, right axillary DVT and LUL PE. He was continued on lovenox. . Hypothyroid: Continued levothyroxine daily. . Anxiety: Continued ativan 0.5 mg qHS for insomnia. . Rheumatoid Arthritis: Continued prednisone, oxycodone and sennosides. TRANSITIONAL ISSUES Patient has follow-ups with [**Company 191**] PCP as well as his Oncologist, Dr. [**Last Name (STitle) **]. His risk for readmission is significant given his morbidities relating to esophageal cancer treatment. Patient was satisfied with the new swallow recommendations as well as new tube feed formula. He is a poor candidate for more invasive surgical interventions at this time and this was explained to him by GI as well as Thoracic surgery. Discharge Disposition: Home With Service Facility: [**Location (un) 6549**] O2 provider Discharge Diagnosis: Primary Diagnosis: aspiration pneumonia Secondary Diagnosis: esophageal cancer atrial fibrillation Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Dear Mr. [**Known lastname 6352**], It was a pleasure taking care of you at [**Hospital1 18**]. You presented to the hospital because of cough and difficulty breathing secondary to pneumonia. You were admitted and placed on broad spectrum antibiotics. You will need to continue antibiotics when you leave. We did imaging to rule out concerning pathology in your esophagus as well as at the site of your J-tube. You were evaluated by Nutrition Services as well as Speech Therapy who recommended some changes to your tube feeds as well as swallowing technique. Please make the following changes to your medications: - Please STOP Metoprolol Tartrate 25mg twice a day - Please START Metoprolol Tartrate 50 mg, take twice a day, until your next primary care physician [**Name Initial (PRE) 648**]. - Please START Levofloxacin 750mg by mouth once daily for 7 more days starting today, [**6-23**], last day is [**2164-6-29**] Please continue with your other home medications as prescribed. Followup Instructions: Please follow-up with the following appointments: Department: [**Hospital3 249**] When: WEDNESDAY [**2164-7-4**] at 12:30 PM With: Dr. [**First Name4 (NamePattern1) 1060**] [**Last Name (NamePattern1) 1520**] in the [**Company 191**] POST [**Hospital 894**] CLINIC Phone: [**Telephone/Fax (1) 2010**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 895**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Notes: This appointment is with a hospital-based doctor as part of your transition from the hospital back to your primary care provider. [**Name10 (NameIs) 616**] this visit, you will see your regular primary care doctor in follow up. Department: Hematology/ Oncology Name: Dr. [**Known firstname **] [**Last Name (NamePattern1) **] When: Dr. [**Last Name (STitle) 6567**] office is working on a follow up apointment for you in [**9-8**] days after your hospital discharge. You will be called by the office with your appointment date and time. If you have not heard from the office in 2 business days please call the office number listed below. Location: [**Hospital1 18**]-DIVISION OF HEMATOLOGY/ONCOLOGY Address: [**Location (un) **], [**Hospital Ward Name **] 9, [**Location (un) **],[**Numeric Identifier 718**] Phone: [**Telephone/Fax (1) 6568**] Department: RHEUMATOLOGY When: TUESDAY [**2164-7-3**] at 1:30 PM With: [**Name6 (MD) **] [**Name8 (MD) **], MD [**Telephone/Fax (1) 2226**] Building: LM [**Hospital Ward Name **] Bldg ([**Last Name (NamePattern1) **]) [**Location (un) 861**] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage [**First Name4 (NamePattern1) 2946**] [**Last Name (NamePattern1) **] MD [**MD Number(1) 3218**] Completed by:[**2164-6-25**] ICD9 Codes: 5070, 2449
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5975 }
Medical Text: Admission Date: [**2158-5-4**] Discharge Date: [**2158-5-8**] Date of Birth: [**2102-7-28**] Sex: F Service: MEDICINE Allergies: Penicillins / Nsaids / Sulfa (Sulfonamide Antibiotics) / Peanut / Shellfish / Bactrim Attending:[**First Name3 (LF) 2290**] Chief Complaint: Hypoxia. Major Surgical or Invasive Procedure: None. History of Present Illness: 55 y/o F PMH fibromyalgia, osteoarthritis, HTN, DM who presents with hypoxia. Patient presented to pre-op eval for right knee replacement and found to have O2 sat 86% consequently referred to ED. On arrival to ED VS T 96.7, BP 115/49, 117, 22, 67% RA. 100% NRB and 92-95% 4L. HR 95-112. Afebrile. Patient given 125mg solumedrol IV, tylenol 1 gm po, Azithromycin 500 mg, Duonebs x 3, Oxycodone 30 mg po x 2, Lasix 20 mg IV, Vancomycin 1 gm IV. Patient admitted to the ICU for close monitoring. . Patient reports progressive SOB for the last several months - with minimal exertion and at rest. Reports orthopnea, PND ("gasping for air") for the past several months and lower extremity edema for the last 1 month. Occasionally associated chest pain. Patient recently treated for bronchitis and finished levaquin 4 days ago - no fevers since completing ABx. No worsened cough. Patient denies recent sick contacts. Denies recent travel but is immobile at baseline. Extensive review of systems revealed bloody nose for the past 1 month at night with hemoptysis. Patient reports that oxygen level has been reported to be low at prior doctor's appointment. She had a sleep study in [**2127**] - does not sleep well and has daytime sleepiness. Past Medical History: - Fibromyalgia - Lumbar disc degeneration - Osteoarthritis - Obesity - Chronic Opiate Use and Chronic pain - HTN - Pre-diabetic - Depression, Anxiety, PTSD - GERD Social History: Lives with partner. Non-[**Name2 (NI) 1818**], non-drinker. No IV drug use. Family History: Mother passed away age 80 - breast cancer. Father age 80 - liver and pancreatic cancer. Physical Exam: Upon admission: Tmax: 37.1 ??????C (98.7 ??????F) Tcurrent: 36 ??????C (96.8 ??????F) HR: 112 (107 - 119) bpm BP: 130/92(99) {130/74(87) - 148/92(100)} mmHg RR: 24 (12 - 24) insp/min SpO2: 88% Heart rhythm: ST (Sinus Tachycardia) GEN: obese, slow speech but alert and oriented x 3. HEENT: PERRL, EOMI, anicteric, MMM, unable to assess jvd RESP: Decreased breath sounds throughout due to body habitus. CV: RR, distant heart sounds due to body habitus. ABD: obese, nd, +b/s, soft, nt, no masses or hepatosplenomegaly EXT: + 3 pitting edema SKIN: no rashes/no jaundice/no splinters NEURO: AAOx3. Cn II-XII intact. 5/5 strength throughout. . At discharge: Vitals: 98.8 97.9 108/61 109 20 95% on 2L I/O: 0/[**Telephone/Fax (1) 26490**]/3100 FS: 125-166-119-140 General: Alert, oriented, no acute distress, morbidly obese HEENT: Sclera anicteric, MMM, oropharynx clear Neck: supple, JVD at 8cm, no LAD, no thyromegaly Lungs: Bibasilar crackles CV: RRR, normal S1 + S2, no murmurs, rubs, gallops Abdomen: +BS, soft, non-tender, non-distended, no rebound tenderness or guarding, no organomegaly Ext: warm, well perfused, 2+ pulses, 3+ bilateral LE edema to thighs Neuro: CNs2-12 intact, motor function grossly normal Pertinent Results: Labs upon admission: [**2158-5-4**] 10:00AM BLOOD WBC-6.6 RBC-4.01* Hgb-13.1 Hct-39.3 MCV-98 MCH-32.5* MCHC-33.2 RDW-14.6 Plt Ct-211 [**2158-5-4**] 11:14AM BLOOD PT-12.2 INR(PT)-1.0 [**2158-5-4**] 10:00AM BLOOD UreaN-9 Creat-0.7 Na-142 K-4.0 Cl-100 HCO3-34* AnGap-12 [**2158-5-4**] 10:00AM BLOOD ALT-51* AST-41* AlkPhos-111* TotBili-0.3 [**2158-5-4**] 10:00AM BLOOD proBNP-243* [**2158-5-4**] 11:14AM BLOOD cTropnT-<0.01 [**2158-5-5**] 04:55AM BLOOD CK-MB-1 cTropnT-<0.01 [**2158-5-4**] 10:00AM BLOOD Calcium-8.8 Phos-4.5 Mg-2.2 [**2158-5-4**] 11:35AM BLOOD Type-ART pO2-215* pCO2-60* pH-7.36 calTCO2-35* Base XS-6 Intubat-NOT INTUBA [**2158-5-4**] 03:04PM BLOOD Type-ART pO2-70* pCO2-65* pH-7.37 calTCO2-39* Base XS-8 Labs prior to discharge: [**2158-5-8**] 08:25AM BLOOD WBC-6.9 RBC-4.44 Hgb-14.3 Hct-43.7 MCV-98 MCH-32.1* MCHC-32.7 RDW-14.3 Plt Ct-282 [**2158-5-8**] 08:25AM BLOOD Glucose-111* UreaN-23* Creat-1.0 Na-145 K-4.7 Cl-97 HCO3-38* AnGap-15 [**2158-5-5**] 04:55AM BLOOD CK(CPK)-50 [**2158-5-4**] 10:00AM BLOOD ALT-51* AST-41* AlkPhos-111* TotBili-0.3 [**2158-5-5**] 04:55AM BLOOD CK-MB-1 cTropnT-<0.01 [**2158-5-4**] 11:14AM BLOOD cTropnT-<0.01 [**2158-5-4**] 10:00AM BLOOD proBNP-243* [**2158-5-5**] 04:55AM BLOOD TSH-0.77 [**2158-5-8**] 12:49PM BLOOD Type-ART Temp-36.7 pO2-59* pCO2-55* pH-7.42 calTCO2-37* Base XS-8 Intubat-NOT INTUBA Micro: [**2158-5-4**] blood culture negative [**2158-5-4**] MRSA screen negative Imaging: [**2158-5-4**] CXR: The lung volumes are low. Hazy perihilar opacities are suggestive of mild pulmonary edema. Bibasilar opacities are likely due to atelectasis. No definite pleural effusion is idnetified. The visualized cardiomediastinal and hilar contours are within normal limits. IMPRESSION: 1. New mild pulmonary edema. 2. Bibasilar opacities, probable atelectasis. [**2158-5-4**] CTA: 1. No evidence of pulmonary embolism. 2. Bilateral ground-glass opacities, possibly related to areas of edema: bilateral subsegmental atelectasis as well as areas of bilateral ground-glass opacity, possibly edema. 3. Hepatic steatosis. [**2158-5-4**] EKG: sinus tachycardia at 115 [**2158-5-5**] CXR: In comparison with the study of [**5-4**], there has been some improvement in the degree of pulmonary edema, especially since this is a AP rather than PA view. Continued enlargement of the cardiac silhouette. Mild atelectatic changes at the bases. [**2158-5-5**] TTE: Suboptimal image quality. The left atrium is normal in size. No atrial septal defect is seen by 2D or color Doppler. There is mild symmetric left ventricular hypertrophy. The left ventricular cavity size is normal. Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. Overall left ventricular systolic function is normal (LVEF>55%). There is no ventricular septal defect. with normal free wall contractility. The diameters of aorta at the sinus, ascending and arch levels are normal. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion. There is no valvular aortic stenosis. The increased transaortic velocity is likely related to high cardiac output. No aortic regurgitation is seen. Tricuspid regurgitation is present but cannot be quantified. There is mild pulmonary artery systolic hypertension. There is no pericardial effusion. Brief Hospital Course: 55 yo morbidly obese female with history of fibromyalgia, osteoarthritis, HTN, and DM presented to the ED with hypoxemia, likely a combination of underlying hypoventilation likely secondary to obesity and narcotics with a component of diastolic heart failure. ICU Course: Admitted for hypoxia. ABG consistent with chronic hypoventilation. CTA negative for PE, but with evidence of pulmonary edema. Working diagnosis was pulmonary edema (hypoxia, peripheral edema, orthopnea) in setting of chronic hypoventilation of obesity. She was diuresed with IV Furosemide and negative 4L in 24 hours. Oxygen saturation improved to 92-94% on 3-4L by NC. No antibiotics were given on arrival to ICU as felt likely to not have pneumonia. Echo was done at bedside that showed....... Additionally, she was noted to be on multiple sedating medications for chronic pain/depression. Doses were confirmed with pharmacy. Her large doses of sedating meds at night likely contributing to chronic retention. Medical floor course: # Hypoxemia: Likely combination of decompensated heart failure, and hypoventilation from narcotics and obesity. Diuresed well to lasix, with improvement in SOB and hypoxemia. She will benefit from an outpatient sleep study. # Diastolic heart failure: Signs and symptoms of acute on potentially undiagnosed chronic dHF with an mildly elevated BNP which is often underestimated in the setting of obesity. She was diuresed with lasix boluses. Her beta blocker was continued, and an ACE inhibitor was initiated. # Tachycardia: Stable for patient given prior office notes. CTA negative for PE. Most likely a result of chronic pain. Improved with diuresis. # Fibromyalgia/Chronic pain: She was continued on her home dose of Cymbalta, Oxycontin, and Oxycodone. # Hypertension: Normotensive during admission. A clonidine taper was initiated while in house and will be continued as an outpatient. She was started on an ACE inhibitor which was uptitrated as the clonidine was decreased. # Diabetes: A1C 6.4 in 3/[**2158**]. Held Metformin while inpatient and in setting of recent CTA. Sugars well controlled, did not required insulin coverage. # Depression: Mood stable and appropriate. Continued on home duloxetine, trazodone, diazepam, and keppra. Medications on Admission: Medications according to pharmacy: ([**Location (un) 2274**] list not up to date) - DIAZEPAM 5 MG TAB 3 tablets [**Hospital1 **] ([**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) 26491**]) - CLONIDINE 0.2 MG TAB 2 tablets by mouth at bedtime - IRON, FERROUS SULFATE, ORAL - MULTIVITAMIN ORAL - Acetaminophen (TYLENOL) 325 mg Oral Tablet - Trazodone 100 mg Oral Tablet - Duloxetine (CYMBALTA) 150 mg daily ([**Last Name (NamePattern1) 26492**]) - Keppra 500 mg qhs - Prochlorperazine Maleate 10 mg Oral Tablet 1 tablet two times daily as needed for nausea - confirmed - Metformin (GLUCOPHAGE XR) 500 mg Oral Tablet Extended Release 24 hr (2 tabs) - Oxycodone 30 mg Oral Tablet [**1-15**] po Q4-6 hours for breakthrough pain, no more than 6 per day - Oxycodone (OXYCONTIN) 80 mg Oral Tablet Extended Release 12 hr 1 po Q 8 hours - Lasix 10 mg daily (per patient not taking) Discharge Medications: 1. diazepam 5 mg Tablet Sig: Three (3) Tablet PO BID (2 times a day). 2. clonidine 0.1 mg Tablet Sig: see below Tablet PO HS (at bedtime): Take 0.3mg tonight on [**5-8**], then 0.2mg for the next three days ([**Date range (1) 11757**]), then 0.1 for the next three days (4/29-4/31), then STOP. 3. ferrous sulfate 325 mg (65 mg Iron) Tablet Sig: One (1) Tablet PO once a day. 4. multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed for pain. 6. trazodone 100 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 7. duloxetine 30 mg Capsule, Delayed Release(E.C.) Sig: Five (5) Capsule, Delayed Release(E.C.) PO DAILY (Daily): Per Dr. [**Last Name (STitle) 26492**]. 8. levetiracetam 500 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 9. prochlorperazine maleate 10 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours) as needed for nausea. 10. metformin 1,000 mg Tablet Sig: One (1) Tablet PO once a day. 11. oxycodone 30 mg Tablet Sig: 1-2 Tablets PO every six (6) hours as needed for pain: Do not take take more than 6 hours per day. Do not drive while on this medication. 12. oxycodone 80 mg Tablet Extended Release 12 hr Sig: One (1) Tablet Extended Release 12 hr PO every eight (8) hours: Do not drive while taking this medication. 13. lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 14. Lasix 40 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*0* 15. Home oxygen Home oxygen for sats >90%. Pt 85% on RA, 93% on 1L, and 96% on 2L. A handwritten script was given to the oxygen delivery person. Discharge Disposition: Home Discharge Diagnosis: Primary Diagnosis: Hypoxemia, Diastolic heart failure Secondary Diagnosis: Obesity, Osteoarthritis, Chronic pain Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Weight at discharge: 290.6 lbs Discharge Instructions: It was a pleasure taking care of you during your stay here at [**Hospital1 18**]. You were admitted for low oxygen levels. This is most likely a result of lower than normal respiratory rates, which are likely a result of being overweight, taking large doses of narcotics, and possibly sleep apnea, as we discussed. However, a sleep study would be required to confirm this, and you should discuss consultation with a pulmonary (lung) doctor with your primary care doctor. In addition, you have a component of diastolic heart failure where your heart is stiff and does not pump as effectively. This results in fluid accumulation. You were given diuretics to help remove some of this fluid. The following changes were made to your medication list: START lasix 40mg daily START lisinopril 10mg daily DECREASE clonidine: Take 0.3mg tonight on [**5-8**], then 0.2mg for the next three days ([**Date range (1) 11757**]), then 0.1 for the next three days (4/29-4/31), then STOP Followup Instructions: The following appointment was made for you: Name: [**Last Name (LF) 26493**],[**First Name3 (LF) 26494**] Location: [**Hospital1 641**] Address: [**Location (un) **], [**Location (un) **],[**Numeric Identifier 2260**] Phone: [**Telephone/Fax (1) 2261**] Appointment: Friday [**2158-5-12**] 10:10am You need to establish care with a Pulmonologist (lung doctor) and see them within 2 weeks. Please discuss this with your primary care physician, [**Name10 (NameIs) **] she will refer you to a physician. ICD9 Codes: 4280, 4168, 4019
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Medical Text: Admission Date: [**2141-3-21**] Discharge Date: [**2141-3-31**] Date of Birth: [**2061-12-17**] Sex: M Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 4748**] Chief Complaint: Abdominal pain and generalized malaise Major Surgical or Invasive Procedure: CT guided abdominal drain placement [**2141-3-22**], [**2141-3-27**], and [**2141-3-28**] History of Present Illness: 79 y/o male 3 weeks postop from open aortobifem c/b graft thrombosis requiring emergent embolectomy. Has been anticoagulated since that time. Now w/ 3-4d of progressive weakness, 1 day of abdominal pain and "discoloration" of his abdomen. Son measured low blood pressures at home. Of note patient with bacteremia with B.frag [**3-12**] 2of4 bottles. Past Medical History: PMHx: DM2, Aortic stenosis (mild per [**8-31**] echo), Hypertension, Peripheral Artery Disease, myelodysplasia/leukopenia/thrombocytopenia PSHx: [**2141-3-2**] Open abdominal aortic aneurysm repair with aortobifemoral bypass using a Dacron 18 x 9 bifurcated graft. [**2141-3-9**] Bilateral femoral exploration and iliofemoral embolectomy. Social History: Lives with wife, denies ETOH or drug use. Family History: N/C Physical Exam: Vital Signs: Temp: 98.8 RR: 28 Pulse: 75 BP: 91/55 Neuro/Psych: NAD. Heart: Regular rate and rhythm. Lungs: Clear, abnormal: Tachypnea. Gastrointestinal: Abnormal: Distended, mildly tender diffusely, no rebound or guarding, anasarca. Extremities: Abnormal: Cool LE bilaterally, pale, 4s cap refill, 2+b/l pitting LE edema. Brief Hospital Course: [**2141-3-21**], the patient was admitted via ED to the CVICU for c/o generalized malaise, and abdominal pain, CT abdomen showed presence of massive right retroperitoneal abscess. Patient started on broad spectrum antibiotics (Zosyn/Vanco/Cipro/Falgyl). Patient was hypotensive, and anuric, given fluids and started on Phynelephrine drip for BP support. Started on Lasix IV BID, started diuresing. Patient was referred to interventional radiology for retroperitoneal abcess drainage. Patient made NPO overnight for procedure in the morning. [**2141-3-22**], patient was lined for hemodynamic monitoring. General surgery consulted-recommended IR drainage of RP abcess. Central line was placed, started TPN, the patient was given FFP and Vitamin K to reverse INR in preparation for IR procedure. The patient underwent CT guided retroperitoneal abcess drainage and drain placement, returned to the CVICU post procedure. Patient was kept NPO. Started on Heparin drip. Continued on antibiotics, IV Lasix, and on RISS for glycemic control. [**2141-3-23**], noted to have right UE swelling, US was negative for DVT. Patient remained in the CVICU. Remains on quadruple antibiotics, Neo and heparin drips. Kept NPO, IV hydrated. Continued antibiotics, IV Lasix, and on RISS for glycemic control. [**Date range (1) 76386**], VSS, off Neo drip. Remains on Heparin drip. Blood cultures sent. Kept NPO on TPN. Patient was transfused 1 unit PRBCs for low HCT. Transferred to [**Hospital Ward Name 121**] 5 VICU. Continued antibiotics, IV Lasix, and on RISS for glycemic control. Physical therapy consult placed. [**2141-3-27**], VSS overnight. Repeat abdominal CT was done showing Fluid collection anterior to the iliac bifurcation with air-fluid level, slightly decreased from previous study. Retroperitoneal fluid collection and primarily in the posterior pararenal space now demonstrates no drain and appears larger than previous study. An additional fluid collection tracking laterally and anteriorly within the abdominal wall is markedly increased and portions of it cannot be separated from colonic wall. Both of these fluid collections would be amenable to drainage. Patient was prepped and consented, under CT guidance a 10 French drainage catheter into right lower abdominal abscess. The previous drainage catheter, which had been dislodged with tip in right anterolateral abdominal wall, was removed. Patient tolerated the procedure well, transferred back to floor. Continued antibiotics, IV Lasix, and on RISS for glycemic control [**2141-3-28**], patient had an episode of BP drop below 90's, was given Albumin w/ good BP response. Heparin drip was held for anticipated CT w/ possible drain placement. Patient had another abdominal CT, after which, patient was prpped and cosnented and under CT guidance, had successful insertion of percutaneous catheter into abscess in right anterior abdomen. Heparin resumed post procedure and dosed with Coumadin. Continued antibiotics, IV Lasix, and on RISS for glycemic control. Cultures from first abcess drainage came back positive for VRE, started on Linezolid. ID consulted- recommended to d/c Linezolid, switch to Daptomycin and Zosyn, continued with Cipro and Flagyl. [**Date range (1) 76387**], patient's vital signs stable. Started on clears then advanced to regular diet which was well tolerated. Cipro and Flagyl were discontinued per ID recommendations. Physical therapy evaluated patient and recommended rehab placement, rehab screening started. PICC line was placed in anticipation for longterm IV antibiotic therapy. IJ central line, A-line and foley were discontinued. Patient was transfused 2 units of PRBCs for low HCT, w/ appropraite post transfusion HCT rise. Continued IV lasix for diuresis, repleted electrolytes daily. 2 retroperitoneal drains remained in place and draining thick creamy material. Heparin drip continued while being dosed with Coumadin, on [**3-31**] INR was 2.2, Heparin drip was d/c'd. Physical therapy continued to work with patient while awaiting rehab bed. Home meds were resumed. Discharged to rehab on Daptomycin and Zosyn, to FU w/ Infectious Disease as planned to plan further antibiotic therapy, weekly labs will be sent to them as well. -Retroperitoneal drains remain in place as well, will be re-evaluated by general surgery on FU who will plan removal of drains. Patient will need abdominal CT prior to this follow-up visit. -Patient discharged on longterm [**Hospital **] rehab will continue to monitor INR (goal 2-5-3.5) unitl dose and INR is stable, should defer to PCP for further management. -Patient will FU with Dr. [**Last Name (STitle) 1391**] as planned. Details for all these follow ups were provided to patient and to rehab upon discharge. Discharge Medications: 1. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Piperacillin-Tazobactam-Dextrs 4.5 gram/100 mL Piggyback Sig: One (1) Intravenous Q8H (every 8 hours). 3. Daptomycin 500 mg Recon Soln Sig: One (1) Recon Soln Intravenous Q24H (every 24 hours). 4. Outpatient Lab Work 1. INR three times a week, until goal of 2.5-3.5 is attained 2. Weekly Chem 10, CBC with diff, Sed rate, CRP. Fax/call in results to Infectious Disease ([**Hospital1 18**]): Fax: :([**Telephone/Fax (1) 1353**] Attention: Dr. [**First Name8 (NamePattern2) **] [**Name (STitle) 4020**] 5. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 6. Regular Insulin Sliding Scale Q6h Glucose Insulin Dose 0-70 mg/dL Proceed with hypoglycemia protocol 71-119 mg/dL 0 Units 120-159 mg/dL 2 Units 160-199 mg/dL 4 Units 200-239 mg/dL 6 Units 240-279 mg/dL 8 Units 280-319 mg/dL 10 Units > 320 mg/dL Notify M.D. 7. Heparin, Porcine (PF) 10 unit/mL Syringe Sig: One (1) ML Intravenous every 6-8 hours as needed for line flush: and PRN. 8. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO every six (6) hours as needed for pain. 9. Warfarin 7.5 mg Tablet Sig: One (1) Tablet PO Once Daily at 4 PM: Goal INR 2.5-3.5. 10. Lisinopril 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 11. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 12. Actoplus MET 15-850 mg Tablet Sig: One (1) Tablet PO twice a day. 13. Diclofenac Sodium 75 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - MACU Discharge Diagnosis: Retroperitoneal abcesses related to ruptured appendix s/p multiple CT assisted drain placements, ID to follow, on longterm ABX Ruptured appendix-on antibiotics, general surgery to follow Anemia-myelodysplasia/leukopenia/thrombocytopenia- acute related to infection, frequent phlebotomy, hemodilution and bone marrow supression from medications History of: -DM2 -AS (mild per [**8-31**] echo) -HTN -PAD -myelodysplasia/leukopenia/thrombocytopenia, HIT negative [**2-/2141**] PSH: Aortobifem for AAA [**2141-3-2**], Graft thromboembolectomy [**2141-3-9**] Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory as tolerated- requires assistance. Discharge Instructions: [**Hospital1 69**] Discharge Instructions - You were admitted for abdominal pain, CAT scan showed that you had retro peritoneal abcesses that were most likely related to ruptured appendix, - Drains were placed in your abdomen to drain the abcesses, these will stay until the drainage stops, the drains will be removed by the General Surgery team or possibly in the interventional radiology, - You were treated with intravenous antibiotics, you will be on these antibiotics for a long time, you will follow-up with the infectious disease department, to determine when the antibiotics will be stopped, and possibly switch to oral antibiotics, ACTVITY: - walk/out of bed as tolerated, - you may shower, no tub baths. Diet: - continue your regular diet as tolerated Medications: - You were started on a blood thinner called Coumadin, - You will need blood tests to determine the dose of Coumadin until the level (INR is stable at goal) - You will also be on longterm antibiotics for the infection, the infectious disease doctors [**Name5 (PTitle) **] determine [**Name5 (PTitle) **] long you will need the antibiotics. Labs: - You will need at least three times a weeks INR until your Coumadin dose is stable with a therapeutic level INR. - While you are on antibiotcs you will need weekly labs (CBC, sed rate, Chem 10, CRP), results to be sent to the infectious disease department at [**Hospital1 18**] c/o Dr. [**First Name8 (NamePattern2) **] [**Name (STitle) 4020**]. Follow up: 1. Infectious Disease: Dr. [**Last Name (STitle) 4020**] 2. Vascular Surgery: Dr. [**Last Name (STitle) 1391**] 3. General Surgery: Dr. [**Last Name (STitle) **] Followup Instructions: Provider: [**First Name11 (Name Pattern1) 2295**] [**Last Name (NamePattern4) 11222**], MD Phone:[**Telephone/Fax (1) 22**] Date/Time:[**2141-5-31**] 3:30 Provider: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 3014**], RN Phone:[**Telephone/Fax (1) 22**] Date/Time:[**2141-5-31**] 3:30 ID: Dr. [**First Name8 (NamePattern2) **] [**Name (STitle) 4020**] Phone:([**Telephone/Fax (1) 4170**] Fax:([**Telephone/Fax (1) 10739**] Date/Time: [**2141-4-28**] 11:00 AM Location: [**Last Name (NamePattern1) **]., Basement, [**Hospital Unit Name **], Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 9325**], MD Phone:[**Telephone/Fax (1) 3201**] Date/Time:[**2141-4-21**] 1:30 Will need abdominal CT prior to this visit. ICD9 Codes: 5849, 5119, 2859, 4241, 4019, 2875
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Medical Text: Admission Date: [**2182-4-12**] Discharge Date: [**2182-4-23**] Date of Birth: [**2100-2-23**] Sex: F Service: MEDICINE Allergies: Iodine; Iodine Containing / Dust & Pollen Filter Mask / Hydralazine / Cyclophosphamide Attending:[**First Name3 (LF) 689**] Chief Complaint: BRBPR Major Surgical or Invasive Procedure: EGD Blood Transfusion History of Present Illness: 82yo F with h/o renal artery stenosis, CKD stage III, pAF on coumadin presents with BRBPR X 3 yesterday. Patient presented to [**Hospital1 18**] about 1 month ago with increased creatinine to 3 (from 1.6). A workup including renal biopsy revealed pauci-immune P-ANCA positive glomerulonephritis thought secondary to hydralazine. She was started on prednisone and cyclophosphamide at that point. In addition, according to the patient and records from [**Hospital **] she was also recently admitted to [**Hospital3 **] after a collapse one month ago. She was brought in and found to have AF with RVR. Was started on dilt and metoprolol with reportedly good control. Further workup there included an EGD and colonoscopy which revealed gastric ulcers and polyps as well as candidiasis. She received 2units pRBCs and her hct came up to 30. While there she was noted to be neutropenic. They thought this was possibly medication related. Cyclophosphamide, bactrim, and fluconazole were discontinued. She completed a course of caspofungin and a TTE was negative for vegetations. Her WBC count came up. She was discharged to [**Hospital3 **]. Today was feeling weak and tired and then had 3 episodes of BRBPR so decided to come to Ed. Presented to ED in AF with RVR to 160s. Received 10mg Iv Dilt with improvement in rate to high 90s/100. Received then 30mg PO dilt. Stable HRs since. Also received 5mg IV metoprolol. Initial VS: 97.8 137AF 111/78 16 99. No N/V/Abd pain. Just feels tired. Rectal exam revealed guaiac positive dark stool. Received IVF and 40mg IV protonix. Hct in ED is 27 consistent with baseline (25-30) here at [**Hospital1 18**]. Were going to do NGL but decided not to because didn't want her to go back into AF with RVR. GI called in Ed and will see her on the floor. . On the floor, patient complained of being sick of being in the hospital and dry mouth. Otherwise densies fevers, chills, abdominal pain, diarrhea, constipation, nausea, and vomiting. Has had some weight loss worked up in the past and possibly related to depression (per the patient) after her friend died recently. Complained of occasional flank pain at biopsy site and a developing bed sore. Rest of ROS negative including no CP, palps, sob, dysuria. . Past Medical History: Past Medical History: RAS, HTN CKD III, baseline GFR~30 with Cr 1.6 paroxysmal AFIB on sotalol for 2 yrs and coumadin Anemia of CKD Nephrolithiasis (prior oxalate stone) s/p appy, chole, and tubal ligation Social History: Lives alone, independent for ADLS, family lives in the area. Denies ETOH, tobacco, and illicits Family History: HTN, colon CA No DMII, no heritable kidney dz Physical Exam: Vitals: T: 96.2 BP:137/83 P:110 R:18 O2: 97% RA General: Alert, oriented, no acute distress HEENT: Sclera anicteric, dryMM, oropharynx clear Neck: supple, JVP not elevated, no LAD Lungs: Clear to auscultation bilaterally, no wheezes, rales, ronchi CV: irregularly irregular, normal S1 + S2, no murmurs, rubs, gallops Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly. Rectal: external hemorrhoids, good rectal tone, grossly bloody stool, guaiac positive GU: no foley Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Pertinent Results: [**2182-4-12**] 07:25PM HCT-30.8*# [**2182-4-12**] 07:25PM PT-20.4* PTT-26.0 INR(PT)-1.9* [**2182-4-12**] 09:26AM GLUCOSE-81 UREA N-69* CREAT-2.2* SODIUM-143 POTASSIUM-4.3 CHLORIDE-105 TOTAL CO2-27 ANION GAP-15 [**2182-4-12**] 09:26AM CALCIUM-8.3* PHOSPHATE-4.4 MAGNESIUM-1.7 [**2182-4-12**] 09:26AM PT-25.1* PTT-27.0 INR(PT)-2.4* [**2182-4-12**] 09:25AM HCT-24.0* [**2182-4-12**] 05:30AM GLUCOSE-106* UREA N-73* CREAT-2.2*# SODIUM-143 POTASSIUM-4.7 CHLORIDE-105 TOTAL CO2-26 ANION GAP-17 [**2182-4-12**] 05:30AM estGFR-Using this [**2182-4-12**] 05:30AM cTropnT-0.01 [**2182-4-12**] 05:30AM WBC-7.2 RBC-3.08* HGB-8.9* HCT-27.3* MCV-89 MCH-28.8 MCHC-32.6 RDW-18.3* [**2182-4-12**] 05:30AM NEUTS-80.7* LYMPHS-15.4* MONOS-3.5 EOS-0.1 BASOS-0.3 [**2182-4-12**] 05:30AM PLT COUNT-229 [**2182-4-12**] 05:30AM PT-22.9* PTT-25.3 INR(PT)-2.2* [**2182-4-13**] 02:48AM BLOOD WBC-6.1 RBC-3.61* Hgb-10.6* Hct-31.0* MCV-86 MCH-29.4 MCHC-34.2 RDW-18.4* Plt Ct-167 [**2182-4-14**] 07:53AM BLOOD WBC-7.1 RBC-3.64* Hgb-11.2* Hct-31.6* MCV-87 MCH-30.7 MCHC-35.4* RDW-19.1* Plt Ct-146* [**2182-4-15**] 06:20AM BLOOD WBC-7.4 RBC-3.66* Hgb-10.5* Hct-32.3* MCV-88 MCH-28.7 MCHC-32.6 RDW-18.9* Plt Ct-131* [**2182-4-16**] 06:25AM BLOOD WBC-8.4 RBC-3.88* Hgb-10.8* Hct-34.5* MCV-89 MCH-27.9 MCHC-31.4 RDW-17.9* Plt Ct-145* [**2182-4-12**] 07:25PM BLOOD PT-20.4* PTT-26.0 INR(PT)-1.9* [**2182-4-13**] 02:48AM BLOOD PT-18.4* PTT-25.5 INR(PT)-1.7* [**2182-4-14**] 07:53AM BLOOD PT-12.9 PTT-23.5 INR(PT)-1.1 [**2182-4-14**] 07:53AM BLOOD Glucose-97 UreaN-53* Creat-2.2* Na-142 K-3.7 Cl-102 HCO3-29 AnGap-15 [**2182-4-15**] 04:40PM BLOOD Glucose-165* UreaN-38* Creat-2.1* Na-142 K-4.2 Cl-106 HCO3-24 AnGap-16 [**2182-4-16**] 06:25AM BLOOD Glucose-159* UreaN-35* Creat-2.1* Na-141 K-4.3 Cl-105 HCO3-26 AnGap-14 [**2182-4-12**] 05:23PM BLOOD ANCA-POSITIVE* Brief Hospital Course: 82yo F with h/o PUD and CKD with recent acute renal failure from hydralazine induced pauci-immune glomerulonephritis admitted with BRBPR and atrial fibrillation with RVR. . # GIB: Given significant orthostasis, hct down to 24 (baseline 30) and history of PUD, initially concerned about UGIB. NG lavage was negative which was reassuring. She was given 2u pRBC with stable blood counts and hemodynamics. She had an EGD on [**4-13**] without e/o active bleeding. Per GI likely LGIB and will need c-scope sometime during this admission. She was also given 2u FFP given coagulopathy and concern for GIB and need for endoscopy. Bleeding ceased, however, colonoscopy deferred secondary to difficult to control AFib with RVR. She should follow-up as an outpatient for colonscopy. . # AF with RVR: She had been on sotolol for several years until her recent admission to [**Hospital1 18**] when this was discontinued in the setting of her worsening renal failure. She was noted to have AF with RVR to 140s. Initially felt to be worsened by volume depletion with GIB. However, despite blood products, she remained tachycardic and thus nodal agents were resumed. Anticoagulation was held in acute setting, with coagulopathy reversed in the setting of GIB. She was uptitrated on her PO regimen to Metoprolol 50mg TID and Diltiazem 30mg QID which kept her HR in reasonable control until she underwent a bowel prep for her colonoscopy. On the morning of the scheduled colonoscopy, she developed AFib with RVR in the setting of dehydration evidence by alkalosis and hypernatremia. She received agressive IV hydration and multiple IV medications to help control rate. Her heart rate initially responded and stabilized in the 90-100's. However, the following evening, she required another bowel prep and her heart rate escalated to the 150's. She received additional IV nodal agents and her PO regimen was increased. An electrophysiology consult was obtained and the recommendation was for rate control and uptitration with her current medications. Rhythm control was deferred. She was restarted on anti-coagulation on HD#5 with a heparin gtt. A TEE showed no evidence of thrombus. A cardioversion was attempted and was unsuccessful. The patient was loaded with amiodarone and the Metoprolol was uptitrated to 100mg [**Hospital1 **] to achieve adequate rate control. She was started on Diltiazem which was uptitrated to 45mg PO QID. HR was in the 80s on discharge. Her coumadin was re-started and heparin gtt was continued until the INR was therapeutic. Her INR became supratherapeutic and Coumadin was held on discharge. She should follow-up with Dr. [**Last Name (STitle) **] as an outpatient. She should have INR checked in 2 days and coumadin restarted. If her Amiodarone converts her to sinus rhythm or drops her heart rate as she becomes therapeutic, she may need to stop her Metoprolol. . # CHF: In the setting of Atrial Fibrillation with RVR, the patient was noted to develop signs and symptoms concerning for CHF, such as rales and O2 requirement. The patient was diuresed adequately with Lasix and symptoms improved. The patient was weaned off supplemental oxygen and was staturating 95% on RA. Her creatinine bumped and Lasix was stopped. Her peak creatinine was 2.8 on [**2182-4-21**] and came down to 2.5 on [**2182-4-23**]. Lasix can be considered as an outpatient if she develops signs and symptoms of congestive heart failure. . # CKD: Renal function improving. Per renal, taper prednsione to 40 mg and then to 30mg. She remained on prednisone 3omg Daily and her creatinine remained stable. Her steroid ppx including PCP [**Name9 (PRE) **], PPI, calcium, vit D were continued. She was followed by the renal consult service during her admission and Lasix was held when Creatinine was elevated. She is on Atovaquone Suspension 1500 mg PO/NG DAILY for prophylaxis. . There are no pending studies at the time of discharge. Medications on Admission: Nystatin S+S X 7 days ( day 3 today) Docusate Sodium 100 mg PO BID Ranitidine 150mg daily Diltiazem SR 120mg po daily Coumadin 2.5mg daily Atovaquone 1500mg daily Vit B12 500mcg daily Folate 1mg daily Prilosec 40mg [**Hospital1 **] Toprol XL 50mg daily Calcium/Vit D 600-400units twice daily Prednisone 50 mg daily Discharge Medications: 1. Atovaquone 750 mg/5 mL Suspension Sig: Two (2) PO DAILY (Daily). 2. Cyanocobalamin 500 mcg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 3. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 6. Prednisone 10 mg Tablet Sig: Three (3) Tablet PO DAILY (Daily). 7. Nystatin 100,000 unit/mL Suspension Sig: Five (5) ml PO Q8H (every 8 hours). 8. Menthol-Cetylpyridinium 3 mg Lozenge Sig: One (1) Lozenge Mucous membrane PRN (as needed) as needed for sore throat. 9. Trazodone 50 mg Tablet Sig: 0.5 Tablet PO HS (at bedtime) as needed for insomnia. 10. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO TID (3 times a day) for 2 days: on [**2182-4-25**], please change to 200mg PO BID for 1 week, then on [**2182-5-2**] change to 200mg daily. 11. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO twice a day: start on [**2182-4-25**] for 1 week, then change to 200mg PO daily. 12. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) as needed for insomnia, anxiety. 13. Metoprolol Tartrate 50 mg Tablet Sig: Two (2) Tablet PO TID (3 times a day). 14. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO TID (3 times a day). 15. Diltiazem HCl 30 mg Tablet Sig: 1.5 Tablets PO QID (4 times a day). 16. Outpatient Lab Work Please check electrolytes (Na, K, Cl, HCO3) and renal function (BUN, CREAT), and hematocrit in 1 week. 17. Outpatient Lab Work Please check INR and Hematocrit in 2 days. Please restart Coumadin at 2.5mg daily if INR less than 2.5. Recheck INR every 2 days. Discharge Disposition: Extended Care Facility: [**Hospital **] Healthcare Center - [**Location (un) **] Discharge Diagnosis: Bright Red Blood Per rectum Anemia requiring blood transfusion Atrial Fibrillation with RVR pauci-immune glomerulonephritis with p-anca positive Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Out of Bed with assistance to chair or wheelchair. Discharge Instructions: You were admitted to the hospital for bleeding from your rectum. You received a blood transfusion for anemia. You blood count improved and your bleeding stopped. The gatroenterologists performed an upper endoscopy which was normal. You were continued on a antacid. The plan was for you to undergo a colonoscopy. While undergoing the prep for the colonoscopy, you developed a very fast heart rate from your atrial fibrillation. Your blood pressure medications were increased to help control our heart rate. The cardiologists attempted to cardiovert you out of atrial fibrillation, but were unsuccessful. You were started on Amiodarone and continued on metoprolol. You were started on Diltiazem for heart rate control. You were given lasix for heart failure but this was stopped prior to discharge. When you came into the hospital, you were taking prednisone. The nephrologists recommended that your prednisone be decreased to 30mg per day. You should continue to take Prednisone 30mg Daily. CHANGES IN YOUR MEDICATION; 1. Amiodarone 200mg Three times per day for 1 week. On [**2182-4-25**], change to 200mg 2 times per day for 1 week and then 200mg Daily. 2. Metoprolol 100mg PO BID 3. Prednisone 30mg Daily 4. STOP Prilosec 40mg Daily 5. START Protonix 40mg Twice Daily 6. CHANGE Diltiazem to 45mg PO QID Followup Instructions: You need to schedule a follow-up appointment with the [**Hospital **] clinic. You can call them @ ([**Telephone/Fax (1) 2233**] to schedule an appointment and outpatient colonoscopy. Name: [**Last Name (LF) **], [**First Name7 (NamePattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] Specialty: Cardiology Address: [**Street Address(2) 2687**],STE 7C, [**Location (un) **],[**Numeric Identifier 822**] Phone: [**Telephone/Fax (1) 5768**] When: [**Last Name (LF) 766**], [**4-29**] at 11:30am We are working on a follow up appointment with Dr [**Last Name (STitle) **] in the Nephrology department in the next week. You will be called with this appointment. If you have not heard or have questions, please call :([**Telephone/Fax (1) 10135**] ICD9 Codes: 5789, 2851, 2760, 4280, 2768
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Medical Text: Admission Date: [**2184-10-16**] Discharge Date: [**2184-10-18**] Date of Birth: [**2131-1-2**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 4760**] Chief Complaint: Etoh withdrawal Major Surgical or Invasive Procedure: none History of Present Illness: 53year-old male with a history of Etoh abuse w/h/o seizures w/withdrawal who presented w/acute etoh intoxication to the ED 1 day PTA. His initial Etoh level was 429 w/last drink day 1 day PTA. He drink 2 bottles of vodka daily. He was observed overnight in the ED and appeared to be stable until this AM when he became hypertensive and tachycardic. . In the ED, he was afebrile, BP 162/103 HR 62 O2sat 97%RA. He received Thiamine, folate and Diazepam 5 mg IV x 1(once at 9AM and once at 10AM) per CIWA scale which was started this AM. . ROS: The patient denies any fevers, chills, weight change, nausea, vomiting, abdominal pain, diarrhea, constipation, melena, hematochezia, chest pain, shortness of breath, orthopnea, PND, lower extremity oedema, cough, urinary frequency, urgency, dysuria, lightheadedness, gait unsteadiness, focal weakness, vision changes, headache, rash or skin changes. Past Medical History: -Alcohol abuse h/o withdrawal c/b seizures -Hypertension -Hepatitis C -Seizure disorder Social History: Smokes a few cigarettes a day x many years. Heavy alcohol history, about 1pint vodka a day now. History IVDU, cocaine/crack use Multiple unprotected female partners. Homeless, living at shelter. Mainly around [**Hospital1 756**] Circle. PCP is [**Last Name (NamePattern4) **]. [**First Name8 (NamePattern2) 449**] [**Last Name (NamePattern1) **], [**Hospital 2025**] healthcare for the homeless. Lives with sister in [**Name (NI) 5110**] when sober. Works in trucking when sober. He was born in [**State 5111**], worked as a chef. He finished High School Family History: Non-contributory Physical Exam: Vitals: T 99.4 : BP 170/110 : HR 80 : RR 17 : O2Sat: 97% RA GEN: anxiouse appearing, well-nourished, in obviouse distress HEENT: EOMI, PERRL, no epistaxis or rhinorrhea, MMM, OP Clear NECK: No JVD, carotid pulses brisk, no bruits, no cervical lymphadenopathy, trachea midline COR: RRR, no M/G/R, normal S1 S2, radial pulses +2 PULM: Lungs CTAB, no W/R/R ABD: Soft, NT, ND, +BS, no HSM, no masses EXT: No C/C/E, no palpable cords, +tremor NEURO: alert, oriented to person, place, and time. CN II ?????? XII grossly intact. Moves all 4 extremities. Strength 5/5 in upper and lower extremities. Patellar DTR +1. Plantar reflex downgoing. No gait disturbance. No cerebellar dysfunction. SKIN: No jaundice, cyanosis, or gross dermatitis. No ecchymoses. Pertinent Results: Admission Labs: [**2184-10-16**] 10:00AM WBC-2.6* RBC-3.38* HGB-11.5* HCT-33.7* MCV-100* MCH-34.1* MCHC-34.1 RDW-16.3* [**2184-10-16**] 10:00AM NEUTS-56.8 LYMPHS-37.1 MONOS-4.4 EOS-0.9 BASOS-0.8 [**2184-10-16**] 10:00AM PLT COUNT-143* [**2184-10-15**] 09:30PM ASA-NEG ETHANOL-429* ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**2184-10-16**] 10:00AM GLUCOSE-84 UREA N-8 CREAT-0.8 SODIUM-145 POTASSIUM-3.2* CHLORIDE-104 TOTAL CO2-28 ANION GAP-16 [**2184-10-16**] 10:00AM ALT(SGPT)-84* AST(SGOT)-220* LD(LDH)-505* ALK PHOS-46 TOT BILI-0.5 [**2184-10-16**] 10:00AM ALBUMIN-4.2 . Brief Hospital Course: This is a 53 year-old male with a history of alcohol abuse who presented with acute intoxication. He was monitored for 1 day in the ICU prior to call out to the floor. Pt ultimately left AMA. . # Alcohol Withdrawal: Pt reported his last drink was 1 day PTA [**2184-10-15**]; has h/o seizures associated w/withdrawal and stated that his last seizure was 3 weeks prior to admission. During his ICU course the pt was kept on a PO valium CIWA scale q1 hours. In addition he received MVI/Thiamine/Folate, a social work consult called, and was placed on aspiration precautions. A dilantin level was checked and found to be sub-therapeutic. The pt was restarted on dilantin. Upon call out to the floor, he required 20 mg Valium in a period of 12 hours. He was noted to have a DBP of 115 with some mild tremors and diaphoresis, as well as difficulty ambulating. He was requesting to sign out AMA, at which point security sitters monitored the patient until it was deemed pt had capacity to leave. Several hours later, the patient was still agitated, stating he wanted to leave b/c he had obligations in the afternoon, and that he understood if he left he could die or have seizures. A psychiatry consult was requested, but the pt became extremely angry, was ambulating with mild staggering gait but mostly steady, and did appear to have capacity, so the patient was signed out AMA prior to psychiatry being able to formally evaluate pt. Attempt was made to call pts PCP, [**Name10 (NameIs) **] went into voicemail. Pt was asked to f/u with his PCP the following day, was seen by SW, and given phone numbers for detox centers. He stated he was going to go back to drinking after discharge. He was noted discharged on dilantin as this was stopped per prior d/c summary when PCP told the [**Name9 (PRE) **] at the time that the pt has no h/o seizure disorder. . # HTN: Upon admission the patient was hypertensive in the setting of EtOH withdrawl. The pt in on atenolol as an outpatient. The patient was started on Metoprolol TID titrated up to 37.5 TID at the time of transfer to the floor. The patients home dose of HCTZ was held in the setting of hypokalemia. He was restarted on his home BP meds at the time of discharge. Pts DBP was 115 at time of discharge, pt warned of symptoms of hypertensive urgency and risk of death with severe hypertension/withdrawl. Pt still decided to leave AMA, reiterated the risks of leaving back to me. . # HCV: The were no serologies in the [**Hospital1 18**] system. . # Pancytopenia: most likely due to alcohol abuse leading to vit deficiency. to be w/u as outpatient Medications on Admission: Hydrochlorothiazide 25mg daily Atenolol 50mg daily Dilantin 300mg daily Discharge Medications: 1. Atenolol 50 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Hydrochlorothiazide 12.5 mg Capsule Sig: One (1) Capsule PO DAILY (Daily). 3. Thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO once a day. 4. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Home Discharge Diagnosis: Alcohol intoxication Discharge Condition: leaving against medical advice, diastolic blood pressure 115, ambulating with a little gait abnormality but steady on the feet, mild tremors Discharge Instructions: You were admitted with alcohol intoxication. You were treated with valium. You were not quite finished withdrawing and your blood pressure was still very high. We discussed that you are at risk for death or stroke if your blood pressure remains high. You are also at risk for seizures if you are withdrawing. You were having difficulty ambulating while you were here, but this improved at the time of your discharge. . Please go to your doctor in the next day if able. . Go to the ER or call your doctor if you have any chest pain, shortness of breath, seizures, dizziness, blurred vision, falls, dehydration, vomiting, abdominal pain, fever, hallucinations, or any other concerning symptoms. Followup Instructions: You need to stop drinking. You were seen by social work, but you refused detox. . You can call any of the following for addictions counseling: [**Last Name (un) 5112**] ([**Telephone/Fax (1) 5113**]) [**Street Address(2) 5114**], [**Hospital1 3494**] * Outpt. Addictions Services ([**Telephone/Fax (1) 5115**]) [**Street Address(2) 5116**], [**Hospital1 3494**] * [**Hospital6 1597**] ([**Telephone/Fax (1) 5117**]) 330 [**Hospital3 **] St., [**Hospital1 8**] . Please see Dr.[**Name (NI) 5118**] in the next 1-2 days. ICD9 Codes: 4019, 2768
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Medical Text: Admission Date: [**2126-10-21**] Discharge Date: [**2126-11-25**] Date of Birth: [**2060-4-9**] Sex: M Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 4691**] Chief Complaint: s/p MVC with major chest injury Major Surgical or Invasive Procedure: [**2126-11-2**] tracheostomy, percutaneous endoscopic gastrostomy, inferior vena caval filter placement History of Present Illness: 66M with history of Afib on Coumadin, restrained driver v. truck, no LOC, presented to [**Hospital3 1443**] Hospital with L neck hematoma and R chest pain. CT at OSH demonstrated possible splenic laceration. Past Medical History: PMH: paroxysmal atrial fibrillation, hepatitis C, GERD, HTN, DMII Social History: Married. Works as a tailor. Alcohol about once per month. No tobacco use. Family History: Sister with CAD s/p CABG. Brother with CAD. Brother with pancreatitis. Physical Exam: On admission: 99.3 80 155/71 30 97%RA Gen: uncomfortable Neuro: GCS 15, A&O x 3, CN2-12 intact HEENT: PERRLA, EOMI, OP clear Neck: L neck tense hematoma in supraclavicular (Zone 1) area Chest: tender and crepitant to palpation over L anterior thorax. Visible central flail chest. CVS: RRR, nl S1S2 Pulm: CTA b/l, no stridor Abd/Rectal: soft, ND, NT, guiaic negative Spine: no tenderness Ext: no c/c/e, no deformities, FROM On [**2126-11-24**]: 98.7 72 178/74 27 100% CPAP+PS 0.4/430x27/5/5 Gen: alert, GCS 11 HEENT: PERRLA, EOMI CVS: RRR, no m/r/g Pulm: crackles at R base, otherwise CTA Abd: soft, NT, ND, +BS Ext: edema L>R Pertinent Results: On admission: [**2126-10-21**] 10:45PM WBC-6.9 RBC-3.79* HGB-11.8* HCT-33.2* MCV-88 MCH-31.1 MCHC-35.5* RDW-14.1 [**2126-10-21**] 10:45PM NEUTS-76.9* LYMPHS-15.3* MONOS-5.7 EOS-1.9 BASOS-0.2 [**2126-10-21**] 10:45PM PLT COUNT-149* [**2126-10-21**] 10:45PM PT-16.9* PTT-34.2 INR(PT)-1.5* [**2126-10-21**] 01:04PM LACTATE-2.0 [**2126-10-21**] 01:04PM HGB-13.4* calcHCT-40 [**2126-10-21**] 12:58PM UREA N-32* CREAT-0.9 [**2126-10-21**] 12:58PM AMYLASE-47 [**2126-10-21**] 12:58PM ASA-NEG ETHANOL-NEG ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**2126-10-21**] 12:58PM FIBRINOGE-245 . [**2126-10-21**] CTA head/neck: 1. Large left neck hematoma with active extravasation of IV contrast within the hematoma. Part of this extravasation appears to be arising from the left subclavian vein. The more superior active extravasation is located adjacent to a deep cervical artery branch of the right thyrocervical trunk. 2. There is compression and anterior displacement of the left internal jugular vein by the large neck hematoma. 3. Comminuted sternal fracture with stranding of the anterior mediastinal fat suggestive of mediastinal hemorrhage and likely hemorrhage along the left lung apex. Recommend further evaluation with a dedicated CTA of the chest. 4. Multiple nodular densities at the right lung apex, which may represent prior granulomatous disease, but this can be better evaluated by the dedicated chest CT. . [**2126-10-21**] CXR: Limited study with probable right middle and right lower lobe collapse. Left lower lobe collapse is also likely. Increased pleural thickening along the right lung may reflect blood in the pleural space with multiple right-sided rib fractures noted. . [**2126-10-21**] L subclavian arteriogram: No arterial bleeding or pseudoaneurysm was noted on left subclavian arteriogram. . [**2126-10-25**] sputum: Haemophilus influenzae (Beta lactamase negative) . [**2126-10-28**] sputum: MRSA, Haemophilus influenzae (Beta lactamase negative) . [**2126-10-28**] CXR: Endotracheal tube has been placed terminating 3 cm above the carina with the neck in a flexed position. New diffuse but asymmetrically distributed airspace opacities have developed affecting the right lung to a much greater degree than the left. It is uncertain whether this represents asymmetric edema or massive aspiration. Left lower lobe shows improved aeration, but there is persistent collapse of the right lower lobe. Moderate layering right pleural effusion is present as well as multiple right-sided rib fractures. Likely small left pleural effusion is also demonstrated. . [**2126-10-31**] CT chest: 1. No strong evidence of empyema, but there are small bilateral pleural effusions layer dependently, a portion of the right pleural effusion is loculated posteriorly. 2. Diffuse ground-glass opacity in both lungs, most likely edema, alternatively hemorrhage or pneumonia. 3. Multiple tharacic fractures, including the manubrium and right second through ninth ribs, multiple in the fifth and sixth ribs. 4. Coronary artery calcifications and atherosclerotic calcification of the aorta. . [**2126-11-5**] Renal US: No evidence of hydronephrosis, calculi, or renal masses. . [**2126-11-6**] CXR: In comparison with study of [**11-5**], there appears to be increasing opacification involving much of the left hemithorax, consistent with the clinical impression of widespread pneumonia. Lower lung volumes appear to accentuate the areas of atelectasis on the right. Tracheostomy tube and right central catheter remain in place. . [**2126-11-7**] echo: The left atrium is elongated. Left ventricular wall thickness, cavity size and regional/global systolic function are normal (LVEF >55%) There is no ventricular septal defect. Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis. No aortic regurgitation is seen. The mitral valve leaflets are structurally normal. No mitral regurgitation is seen. The pulmonary artery systolic pressure could not be determined. There is no pericardial effusion. There is an anterior space which most likely represents a fat pad. . [**2126-11-12**] RUE US: No ultrasonographic evidence of DVT involving the right upper extremity. . [**2126-11-14**] CXR: Previously cleared right lung has returned to severe consolidation, accompanied by worsening of left lung consolidation which was predominantly suprahilar. Most likely this is due to a somewhat asymmetric pulmonary edema, given the simultaneous increase in heart size and volume of small pleural effusions. Tracheostomy tube in standard placement. No pneumothorax. . [**2126-11-14**] sputum: Enterobacter cloacae (pan sensitive) [**2126-11-14**] BAL: Enterobacter cloacae . [**2126-11-15**] IR placement of tunneled catheter: Successful placement of a 15.5 French 23 cm cuff-to-tip length double-lumen hemodialysis catheter via the right internal jugular vein. The tip of the catheter is located in the right atrium. The catheter is ready for use. . [**2126-11-20**] CXR: 1. Status post insertion of double lumen central venous catheter with no evidence of complications. 2. Overall improvement of pleural effusion and parenchymal consolidation. . On [**2126-11-24**]: [**2126-11-24**] 01:44AM BLOOD WBC-10.1 RBC-3.02* Hgb-9.0* Hct-27.0* MCV-90 MCH-29.8 MCHC-33.3 RDW-14.9 Plt Ct-204 [**2126-11-24**] 01:44AM BLOOD PT-17.5* PTT-29.1 INR(PT)-1.6* [**2126-11-24**] 01:44AM BLOOD Glucose-145* UreaN-79* Creat-4.6* Na-136 K-4.3 Cl-99 HCO3-26 AnGap-15 [**2126-11-24**] 01:44AM BLOOD Calcium-7.4* Phos-3.2 Mg-2.1 [**2126-10-25**] 10:55AM BLOOD %HbA1c-5.9 Brief Hospital Course: Patient underwent CTA of the head/neck for his L neck hematoma; it demonstrated extravasation from the L subclavian vein and a deep cervical arterial branch of the R thyrocervical trunk. Patient underwent L subclavian arteriogram for possible embolization; no bleeding was noted. . His other injuries included a small splenic hematoma, flail chest (R 2nd-9th rib fractures), and a comminuted sternal fracture. He was admitted to the floor for observation, with serial hematocrits and serial exams, both of which were stable. . He had intermittent episodes of decreased O2 saturation. He underwent bronchoscopy on [**10-25**] for persistent RLL collapse; he was found to have a mild to moderate quantity of thick mucoid sputum on the R side, which was aspirated. Levofloxacin was started for CAP. Pulmonology recommended aggressive IS, albuterol nebs, and stronger pain control; PAP was felt to be unnecessary. On [**10-26**], he was triggered for "confusion" as reported by the patient's family. As per the HO note, he was "not remotely confused" and that he was "not hypoxic...acting as expected with manageable O2 requirements in the setting of PNA & multiple rib fractures." Vancomycin was added for broader CAP coverage. . On [**10-27**], he was transferred to the ICU for acute respiratory failure (RR 26-45 and O2 sats 85% on 6L). He was intubated. Levofloxacin was switched to Zosyn. He was placed on a dilt gtt for his A-fib. Diuresis was started. On [**10-28**], he underwent bronch with BAL. Dilt was d/c'd and switched to metoprolol. Methadone was started and fentanyl gtt was d/c'd. Tube feeds were started. On [**10-30**], an insulin gtt was started for poor RISS control. A chest tube was placed for his R pleural effusion. Dilt gtt was restarted for rapid A-fib. On [**10-31**], he underwent CT of the chest, which did not demonstrate empyema, and another bronchoscopy. On [**11-1**], dilt gtt was switched to amiodarone gtt. Lopressor was continued. Hydralazine was used prn for blood pressure control. Insulin gtt was weaned off. On [**11-2**], patient underwent tracheostomy, PEG, and IVC filter placement. On [**11-3**], his CT was d/c'd. Tube feeds were started via the PEG. . On [**11-4**], his creatinine rose from 1.2 to 1.7. Lasix was held. Vanc was also held for trough 32.8. He was oliguric. He was bolused and started on IVF. On [**11-5**], his Cr rose to 2.8. Nephrology was consulted. The etiology of his ATN was not clear, but it was attributable to many factors, including CTA contrast, vanc toxicity, relative kidney hypoperfusion in the setting of infection, and uric acid nephropathy ([**12-28**] to increased metabolism [**12-28**] infection). Conservative management was recommended; he was transfused, his medications were renally dosed, ASA was d/c'd, and his tube feeds were switched to Nutren Renal. On [**11-6**], citalopram was d/c'd. He received Kayexelate, Lasix, and Diuril for hyperkalemia, as recommended by Renal. His K decreased, but his urine output was unresponsive to the high dose diuretic administration. Aluminum hydroxide was started for hyperphosphatemia. A CXR demonstrated worsening PNA. On [**11-7**], his Cr was 5.2. CVVHD was started via a L groin Quinton catheter. Amiodarone was switched to sotalol. A transthoracic echo was normal. Tube feeds were restarted. On [**11-8**], antibiotics were d/c'd to complete a 10 day course. He was afebrile and his WBC was normal. His BP was labile, intermittently requiring neo; sotalol was decreased accordingly. Transplant Surgery was consulted on [**11-11**]; his dialysis requirement was felt to be too temporary to require a tunneled line. . On [**11-12**], CVVHD was stopped. Celexa was restarted. He tolerated trach mask for a period of time. RUE edema was noted, but an ultrasound was negative for DVT. Cardiology was consulted. As per their recommendations, sotalol was d/c'd secondary to renal clearance and long qT pauses on telemetry. Metoprolol and heparin gtt were started. On [**11-14**], he was febrile. His dialysis catheter was d/c'd. He underwent bronchoscopy with BAL, which had 4+ GNR on Gram stain. Zosyn and Cipro were started. One dose of vanc was given. On [**11-15**], a tunneled catheter was placed in IR. On [**11-16**], he underwent his first HD. Coumadin was also started. On [**11-17**], his BAL culture grew pan-sensitive Enterobacter; Zosyn was d/c'd. Mucomyst was added to aid with secretion clearance. On [**11-18**], heparin gtt was d/c'd as INR was therapeutic. TF were advanced to goal. For the remainder of his hospital course, HD was continued every other day, as per Renal (last [**2126-11-24**]). Vanc was administered at HD. He was transfused prn. . At discharge, he is afebrile with stable vital signs. He tolerates trach mask intermittently, requiring pressure support in between. His tube feeds are at goal. His urine output is increasing. PT and OT are following him. Medications on Admission: metoprolol 50', metoclopramide 5 prn, Humalog SS, sotalol 160", Lantus 50U qAM, Coumadin 2', Toprol XL 100 qAM/50 qHS, lisinopril 10", omeprazole 40' Discharge Medications: 1. Docusate Sodium 100 mg Capsule [**Month/Day/Year **]: One (1) Capsule PO BID (2 times a day). 2. Acetaminophen 500 mg Tablet [**Month/Day/Year **]: Two (2) Tablet PO Q6H (every 6 hours) as needed. 3. Albuterol 90 mcg/Actuation Aerosol [**Month/Day/Year **]: Four (4) Puff Inhalation Q4H (every 4 hours) as needed. 4. Ipratropium Bromide 17 mcg/Actuation Aerosol [**Month/Day/Year **]: Four (4) Puff Inhalation Q4H (every 4 hours) as needed. 5. Chlorhexidine Gluconate 0.12 % Mouthwash [**Month/Day/Year **]: Fifteen (15) ML Mucous membrane [**Hospital1 **] (2 times a day). 6. Zolpidem 5 mg Tablet [**Hospital1 **]: Two (2) Tablet PO HS (at bedtime). 7. Olanzapine 5 mg Tablet, Rapid Dissolve [**Hospital1 **]: One (1) Tablet, Rapid Dissolve PO BID (2 times a day). 8. Citalopram 20 mg Tablet [**Hospital1 **]: 0.5 Tablet PO DAILY (Daily). 9. Lansoprazole 30 mg Tablet,Rapid Dissolve, DR [**Last Name (STitle) **]: One (1) Tablet,Rapid Dissolve, DR [**Last Name (STitle) **] DAILY (Daily). 10. Metoprolol Tartrate 50 mg Tablet [**Last Name (STitle) **]: Two (2) Tablet PO TID (3 times a day). 11. Senna 8.6 mg Tablet [**Last Name (STitle) **]: Two (2) Tablet PO BID (2 times a day). 12. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) [**Last Name (STitle) **]: Two (2) Tablet, Delayed Release (E.C.) PO BID (2 times a day) as needed. 13. Oxycodone 5 mg Tablet [**Last Name (STitle) **]: 1-2 Tablets PO Q4H (every 4 hours) as needed. 14. Warfarin 1 mg Tablet [**Last Name (STitle) **]: One (1) Tablet PO DAILY (Daily). 15. Hydralazine 20 mg/mL Solution [**Last Name (STitle) **]: 0.5 ml Injection Q4-6H () as needed for prn sbp>180. 16. Outpatient Physical Therapy Fixed NPH Dose Breakfast 25 Units Bedtime 5 Units Regular Insulin Sliding Scale Check fingersticks q6 hours 0-50 mg/dL [**11-27**] amp D50 51-120 mg/dL 0 Units 121-140 mg/dL 7 Units 141-160 mg/dL 11 Units 161-180 mg/dL 15 Units 181-200 mg/dL 19 Units 201-220 mg/dL 23 Units 221-240 mg/dL 27 Units 241-260 mg/dL 31 Units 261-280 mg/dL 35 Units 281-300 mg/dL 39 Units > 300 mg/dL Notify M.D. Discharge Disposition: Extended Care Facility: [**Hospital3 7**] & Rehab Center - [**Hospital1 8**] Discharge Diagnosis: s/p MVC, L neck hematoma, comminuted sternal fracture, R 2-9th rib fractures with flail chest, pneumonia, acute renal failure Discharge Condition: Afebrile with stable vital signs, tolerating trach mask with intermittent pressure support as needed, tolerating tube feeds, on hemodialysis with improving urine output. Discharge Instructions: Please call your doctor or return to the ER for any of the following: * You experience new chest pain, pressure, squeezing or tightness. * New or worsening cough or wheezing. * If you are vomiting and cannot keep in fluids or your medications. * You are getting dehydrated due to continued vomiting, diarrhea or other reasons. * Signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * You see blood or dark/black material when you vomit or have a bowel movement. * Your skin, or the whites of your eyes become yellow. * Your pain is not improving within 8-12 hours or not gone within 24 hours. Call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. * You have shaking chills, or a fever greater than 101.5 (F) degrees or 38(C) degrees. * Any serious change in your symptoms, or any new symptoms that concern you. * Please resume all regular home medications and take any new meds as ordered. * Continue to ambulate several times per day. Followup Instructions: Provider: [**First Name8 (NamePattern2) **] [**Name11 (NameIs) **], [**Name Initial (NameIs) **].D. Phone:[**Telephone/Fax (1) 2422**] Date/Time:[**2127-5-5**] 9:00 Provider: [**Name10 (NameIs) 2194**],[**Name11 (NameIs) 900**] [**Name Initial (NameIs) **]. [**Telephone/Fax (1) 6429**] Follow-up appointment should be in 2 weeks Provider: [**Name10 (NameIs) 4343**],[**Name11 (NameIs) **] [**Telephone/Fax (1) 26330**] Follow-up appointment should be in 2 weeks Completed by:[**2126-11-24**] ICD9 Codes: 486, 5849, 5119, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5980 }
Medical Text: Admission Date: [**2169-10-27**] Discharge Date: [**2169-11-1**] Date of Birth: [**2119-7-26**] Sex: M Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 1185**] Chief Complaint: COFFEE-GROUND VOMIT Major Surgical or Invasive Procedure: ENDOSCOPIC GASTRODUODENOSCOPY with biopsy History of Present Illness: 50M with history of heavy ETOH use, Meniere's disease, psychiatric history including panic disorder, depression & anxiety, presented 2d ago with hematemesis, RUQ & R-sided chest pain, and intoxication after binge drinking. Binge drinks on vodka 1/5 L at a time, recurrent admissions for withdrawal management and detox. 3 days ago he started having severe RUQ pain, non-radiating, exacerbated by movement and eating, no known alleviating factors. Started vomiting 2 days PTA; vomiting progressively increasing frequency until admission. Vomiting intermittently streaked w/black blood. ROS positive for mild, productive cough x1 week & gradual weight loss x 2 years, negative for F/C. . Substance abuse history includes 30 yrs heavy drinking, several admissions for ETOH withdrawal, hx attending dual diagnosis detox programs, 2 withdrawal seizures (one at home, one while hospitalized). Past ICU admissions for DTs. Longest sober period was 5 years ([**2155**]-[**2160**]). Cocaine and marijuana use in the past, not currently using. . In the ED, initial VS were: 140 132/90 16 95%. Coffee ground emesis witness in the ED but unknown volume. RUQ US negative for cholecystitis. CXR showed RLL opacity, slightly more dense than prior. Labs notable for leukocytosis WBC 13 (w/ 87.4% PMN no bands), ETOH 202, plt 105, HCT 38 -> 33. Total 3L IVF received, no blood products given. Received diazepam 10mg x2, Ativan 2mg x2, morphine 4mg x1, PPI bolus/gtt, and zofran. Despite benzodiazepines, he remained tachycardic and tremulous. 2 large bore PIVs placed. . In the MICU over the past 2d he was retching frequently. No further hematemesis, but he did receive benzos on CIWA for tremor, anxiety & tachycardia. Reported similar vomiting episodes have occured with Meniere's disease flares previously. C/o persistent RUQ pain. He received IVF for low uop. . He has been followed in the MICU by GI who initially recommend EGD but delaying until patient no longer retching and withdrawing from ETOH. Suggested NGT placement (not done), antiemetics (on compazine), PPi drip, and transfusion for Hct <25. Hct stable >25 x3 today. When rectal exam showed guaiac positive brown stool, GI concluded no indication for EGD. CT chest showed R rib fracture (minimally displaced ninth and nondisplaced eighth). Also increased RLL opacity on CXR read as worsening atelectasis. Prior to MICU callout his benzos were decreased to q4H and diet advanced to clears. On the floor pt reports no appetite. Focused on R-sided chest pain where he says he has multiple rib fractures he suspects he sustained during his recent bender but cannot remember specifically. We note that although he reported suicidality w/plan (heroin o/d) during another recent admission, he denies suicidality at present. Past Medical History: Past Medical History: - COPD - Meniere's disease - diagnosed in [**2165**], has not followed up with outpatient care - Hypothyroidism - Hx of Borderline HTN - History of frostbite to bilateral toes ("my toes turned black") Past psychiatric history: -Diagnoses: Depression, anxiety, panic disorder -Hospitalizations: [**Hospital1 **], [**Location (un) **] , [**Hospital3 **]. Numerous detoxes ([**Location (un) 22870**], [**Location (un) 3244**] and [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **]). Thinks last inpatient psych was [**Hospital1 **] 4 11/[**2168**]. -SA/SIB: Denies -Violence: Denies -Therapist: [**Doctor First Name **] at [**Location 8391**] Behavioral Health until 2-3 months ago, when she fired him for coming to an appointment intoxicated. She now no longer works there. -Psychiatrist: Has been seeing someone at [**Location 8391**] BH Social History: He lives alone in an apartment in [**Location 8391**]. Divorced after he crashed 2 cars while intoxicated. He has been homeless in the past. Has been in jail for burglary and steeling whisky. He used to smoke 1-1.5 ppd (started smoking at age 10), but now smokes a few cig/day. He drinks daily ([**1-25**] vodka). He states the past 2 years have been very hard, mostly because of death of his sister. Family History: Father - alcoholism Mother - depression, anxiety, hospitalizations Two sisters - depression, anxiety, psych hospitalizations, EtOH. One sister died of cirrhosis, other is sober. Physical Exam: MICU ADMISSION EXAM VS: HR 108, BP 140/80s, 94% on 2L NC General: Alert, oriented, intermittently falls asleep during interview, slightly movement triggers wretching, came up from ED with emesis bin with approx 100 cc gastric contents with some red blood HEENT: Sclera anicteric, MMdry, no visible lice Neck: supple, no LAD CV: RRR, normal S1 + S2, no murmurs, rubs, gallops Lungs: Decreased breath sounds right base, otherwise no wheezes/rhonchi/rales Abdomen: soft, tender in RUQ to moderate palpation with voluntary guarding, no rebound, Skin: 1 cm blanching macules on abdomen Ext: warm, well perfused, 2+ pulses, no edema Neuro: CN2-12 intact, 5/5 strength, no sensory deficits . MICU->FLOOR TRANSFER EXAM VS 97.5 120/77 85 18 97/RA General: Alert, oriented, fatigued-appearing, not retching HEENT: NCAT EOMI sclera anicteric, MM dry, no visible lice Neck: supple, no LAD CV: RRR, normal S1 + S2, no murmurs, rubs, gallops Lungs: decreased breath sounds R base & halfway up, R-sided chest wall tenderness to palpation, lidocaine patch in place, prominent wheeze throughout all lung fields Abdomen: soft, distended RUQ ttp +voluntary guarding, no rebound, Skin: 1 cm blanching macules on abdomen (c/w tinea versicolor) Ext: WWP, 2+ pulses, no edema Neuro: CN2-12 intact, 5/5 strength, no sensory deficits, +mild UE tremor R>L . DISCHARGE PHYSICAL EXAM VS 98.9 98.4 127/92 73 18 98/RA General: Alert, oriented, lying comfortably in bed HEENT: NCAT EOMI sclera anicteric MM dry no visible lice Neck: supple no LAD CV: RRR, normal S1/S2, no murmurs, rubs, gallops Lungs: decreased breath sounds R base, R-sided chest wall mildly tender to palpation, lidocaine patch in place, no wheeze Abdomen: soft, distended RUQ mildly ttp no guarding, no rebound, Skin: no rash Ext: WWP, 2+ pulses, no edema Neuro: CN2-12 intact, 5/5 strength, no sensory deficits, +mild UE tremor R>L Pertinent Results: ADMISSION LABS [**2169-10-27**] 05:52AM BLOOD WBC-13.5*# RBC-3.97* Hgb-13.0* Hct-38.8* MCV-98 MCH-32.6* MCHC-33.4 RDW-16.1* Plt Ct-140* [**2169-10-27**] 05:52AM BLOOD Neuts-87.4* Lymphs-7.4* Monos-4.0 Eos-0.9 Baso-0.3 [**2169-10-27**] 08:20AM BLOOD PT-12.3 PTT-22.4 INR(PT)-1.0 [**2169-10-27**] 05:52AM BLOOD Glucose-201* UreaN-25* Creat-0.8 Na-131* K-5.5* Cl-84* HCO3-23 AnGap-30* [**2169-10-27**] 05:52AM BLOOD ALT-40 AST-81* AlkPhos-50 TotBili-0.5 [**2169-10-27**] 05:52AM BLOOD Albumin-4.6 Calcium-8.4 Phos-4.2 Mg-2.0 [**2169-10-27**] 08:20AM BLOOD TSH-3.2 [**2169-10-27**] 08:20AM BLOOD Free T4-0.52* [**2169-10-27**] 05:52AM BLOOD ASA-NEG Ethanol-202* Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG [**2169-10-27**] 01:07PM BLOOD Lactate-1.6 . MICRO . [**10-27**] BLOOD CULTURES - PENDING [**10-31**] R ANTECUBITAL FOSSA WOUND CULTURE (FROM SITE OF PIV) - PENDING . PATHOLOGY . [**10-31**] GI BIOPSY - PENDING . IMAGING . RUQ US: No imaging signs of acute cholecystitis. No gallstones. Normal CBD. . CXR: The RLL opacity with chronic pleuroparenchymal scaring and calcifications has slightly increased over time. Chest CT might be considered for further work-up. Otherwise, the lungs are clear, the hila and cardiac shilhouette are normal and there is no pneumothorax. . CT chest/abdomen [**10-28**]: Increased right lower lobe opacity on chest radiograph likely reflects superimposition of bibasilar atelectasis upon the preexisting chronic changes in the basal right pleura. 2. Minimally displaced right ninth rib fracture and nondisplaced eighth right rib fracture. . CT HEAD [**10-29**] FINDINGS: No acute intracranial hemorrhage, edema, mass effect or major vascular territorial infarction is seen. [**Doctor Last Name **]-white matter differentiation is preserved, with mild periventricular white matter hypodensity compatible with chronic small vessel ischemic disease. There is no shift of normally midline structures. The ventricles and sulci are mildly prominent, compatible with alcoholism, if diagnosed clinically. Mineralization is seen in the bilateral basal ganglia. There is no fracture. Imaged paranasal sinuses and mastoid air cells demonstrate minimal left maxillary mucosal thickening. IMPRESSION: No acute intracranial pathological process. . RUE DOPPLER ULTRASOUND [**10-31**] FINDINGS: The right and left subclavian vein are patent with normal color flow and symmetric waveforms with normal phasicity. The right internal jugular vein, subclavian vein, axillary vein, brachial and basilic veins demonstrate normal grayscale appearance, compressibility, color flow, and waveforms. At the antecubital fossa and just proximal to the antecubital fossa, there is echogenic clot distending the right cephalic vein which is noncompressible and has no color flow consistent with acute thrombus. Downstream, the right cephalic vein is patent (more proximally in the arm). IMPRESSION: 1. Partial thrombosis of the right cephalic vein at and just proximal to the antecubital fossa consistent with superficial thrombophlebitis. 2. No right upper extremity DVT. . EGD [**10-31**]: Ulcer in the gastroesophageal junction Erythema and congestion in the antrum and stomach body compatible with gastritis (biopsy) Otherwise normal EGD to third part of the duodenum Recommendations: Follow-up biopsy results Continue PPI daily. Gastritis likely [**2-22**] EtOH. Bleeding likely [**2-22**] clean-based esophageal erosion. Brief Hospital Course: 50 y/o w/ heavy ETOH use and depression/anxiety and panic disorder presented with coffee ground hematemesis and tachycardia, RUQ pain, found to have now-resolved UGIB and and R rib fractures. . #Alcohol Abuse/Withdrawal ETOH 202 on admission. Noted pt's hx of multiple presentations for detox. Current psychiatric/social issues likely barrier to ETOH cessation. Initially scored on CIWA for tremor, anxiety, nausea/vomiting, received valium initially q1H then spaced out. No DTs, no seizure, no hallucinations. No benzodiazepines received in last 4d prior to discharge. Patient reports that his post-dc plan is to return home and try to stay sober again, has an AA sponsor. Very high risk of recurrence esp given that this plan as it has failed him repeatedly in the past. Followed by social work. . #Upper GI Bleed Presented w/coffee-ground emesis. Initial ddx included gastritis/esophagitis, MW tear and/or PUD. Unknown amount of blood loss; Hct trending down from 38.8 on admission to a nadir of 25.8 one day later. Coffee-ground emesis also witnessed directly in the ICU. EGD initially deferred until patient was no longer actively withdrawing from alcohol; once he was stable, an EGD was performed which showed only a clean ulcer near the G-E junction, no active bleeding. Hct self-resolved and trended upward, Hct 34.7 upon discharge. No blood transfusion. We note here that we also suspected esophageal varices from presumed underlying alcoholic cirrhosis given years of heavy ETOH, but imaging showed no signs of cirrhosis and EGD revealed no varices. . #Recurrent vomiting Patient was actively retching in ED and MICU. This was thought to be [**2-22**] known Meniere's disease and alcohol withdrawal. Patient reported symptoms as similar to prior flares of his Meniere's. Resolved after 2d, concurrent with cessation of withdrawal symptoms but also received meclizine and PRN compazine. We also investigated possible head injury given rib fractures, but head CT showed no intracranial bleed nor signs of head trauma. . #Traumatic R rib fractures Patient reported R-chest pain and RUQ abdominal pain. No memory of trauma while intoxicated, but imaging showed new 8th and 9th R rib fractures. RUQ US and CT torso negative for other pathology. Pain initially treated with oxycodone which was weaned. Continued to receive tylenol PRN and daily lidocaine patch. CT chest/head negative for other injuries. . #RLL opacity Patient has chronic inflammation and scarring of his RLL [**2-22**] an old stab wound. CT torso showed increasingly dense effusion overlying this site, which could have represented pneumonia, effusion, or atelectasis. He has history of smoking and COPD. No leukocytosis or fever. Chest CT read as increasing bibasilar atelectasis superimposed on the chronic RLL plaque. No oxygen requirement. No sputum cultures sent. No antibiotics given. Initial leukocytosis (likely inflammation [**2-22**] rib fractures) self-resolved. . #Mild transaminitis RUQ US shows only fatty liver, no cirrhosis, not suggestive of cholecystitis or free RUQ fluid. Lipase wnl. CT abdomen showed normal liver, GB, and pancreas. LFTs only very mildly elevated in non-obstructive pattern. Chronic alcoholism and recent "bender" likely inflammed chronically-challenged liver. LFTs trended down towards wnl prior to discharge, and patient had no further abdominal pain, only reproducible R chest wall pain at rib fracture sites, as above. . #Thrombocytopenia He presented w/thrombocytopenia new since 1 month ago, although review of older labs shows prior episodes of thrombocytopenia too. Considered whether it might be due to underlying liver dysfunction, but INR was normal. No evidence of DIC/TTP or other consumptive process. Hemolysis labs negative. No clear history of HIT. Heparin was avoided. Platelets improved to wnl after UGIB resolved. . #COPD Chronic. We noted wheezing on exam despite Spiriva QD and albuterol nebs Q6H. Temporarily given q8H iprotoprium and q4H albuterol nebs until wheezing resolved, then restarted on home tiotoprium QD. RR and O2 sat remained >95%/RA throughout admission. . #Lice Treated with lindane shampoo in ED and permethrin in the MICU. Contact precautions maintained. No evidence of lice seen on the floor. . #Chronic hypothyroidism Patient takes synthroid at home, reportedly not fully complaint with medication when he is intoxicated. Labs showed TSH wnl, fT4 low. He was restarted on synthroid home dose 75 mcg QD. Will require outpatient follow-up for dose adjustment prn. . #Hx Depression/anxiety and panic disorder Longstanding. Likely contributing to ETOH dependence. Patient had been suicidal during recent admission but answered no to questions of current suicidal ideation during this admission. Denied depression and anxiety throughout this admission, and indeed he was very calm and well-appearing. He was continued on home citalopram. Did not re-start clonazepam at time of discharge given tendency toward addiction. . # TRANSITIONAL ISSUES I. Needs repeat chest CT in 3 months to monitor chronic changes in basal R pleura. II. Needs follow-up thyroid function testing in [**1-22**] months. III. Review biopsy results at GI appointment, eval any need for H pylori treatment. Medications on Admission: Of note, patient states he does not reliably take his medications while drinking ETOH 1. citalopram 40 mg daily 2. clonazepam 1 mg [**Hospital1 **] 3. omeprazole 40 mg daily 4. ferrous sulfate 325 mg daily 5. Spiriva daily 6. ProAir HFA 90 mcg/Actuation q4-6H PRN 7. folic acid 1 mg daily 8. thiamine HCl 100 mg daily 9. multivitamin daily 10. levothyroxine 75 mcg daily Discharge Medications: 1. omeprazole 40 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day. 2. ferrous sulfate 325 mg (65 mg iron) Tablet Sig: One (1) Tablet PO once a day. 3. folic acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. levothyroxine 75 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed for pain: maximum 3 grams per day. Disp:*100 Tablet(s)* Refills:*0* 8. lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: One (1) Adhesive Patch, Medicated Topical DAILY (Daily) as needed for pain for 2 weeks: apply to right chest near rib fractures. Disp:*14 Adhesive Patch, Medicated(s)* Refills:*0* 9. Spiriva with HandiHaler 18 mcg Capsule, w/Inhalation Device Sig: One (1) puff Inhalation once a day. 10. ProAir HFA 90 mcg/Actuation HFA Aerosol Inhaler Sig: Two (2) puffs Inhalation every 4-6 hours as needed for shortness of breath or wheezing. 11. citalopram 40 mg Tablet Sig: One (1) Tablet PO once a day. 12. meclizine 25 mg Tablet Sig: One (1) Tablet PO three times a day. Discharge Disposition: Home Discharge Diagnosis: PRIMARY DIAGNOSIS UPPER GASTROINTESTINAL BLEED . SECONDARY DIAGNOSES GASTRIC ULCER GASTRITIS ALCOHOL DEPENDENCE Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: You were admitted to the hospital after vomiting blood. You were in the intensive care unit. We watched your blood counts, which normalized. We also did an endoscopy which showed a healed ulcer in your stomach and generalized stomach inflammation called gastritis. This, in combination with nausea and vomiting from drinking alcohol, caused you to bleed. Bleeding like this can be life-threatening. This is another important reason to stop drinking alcohol. . We treated you for alcohol withdrawal symptoms. You saw a social worker here to discuss your efforts to stop drinking. We support your effort to quit drinking, and encourage you to get help from your AA sponsor and physicians when you are struggling. . You had bad nausea and vomiting related to alcohol withdrawal and Meniere's disease. This stopped several days before you went home. . You were also treated for lice. . We also found that you had rib fractures, which were very painful. We treated you with tylenol, oxycodone, and lidocaine patch. Your pain was resolving before you left the hospital. . You developed a blood clot in a vein near your right elbow. This was not a large clot and not very deep, so it should resolve by itself. . We made the following changes to your medications: 1. STOPPED CLONAZEPAM 2. STARTED LIDOCAINE PATCH, APPLY 1 PATCH TO RIGHT CHEST ONCE PER DAY FOR TWO WEEKS. 3. STARTED MECLIZINE, TAKE TWO 12.5 MG TABLETS (25 MG TOTAL DOSE) THREE TIMES PER DAY FOR NAUSEA OR VOMITING ASSOCIATED WITH YOUR MENIERE'S DISEASE. 4. STARTED TYLENOL, TAKE TWO 325 MG TABS EVERY 6 HOURS AS NEEDED FOR RIB FRACTURE PAIN. MAXIMUM TYLENOL DOSE 3 MG PER DAY. . Please review the attached medication list with your primary care doctor at your next appointment. Followup Instructions: Follow-up appointments: . Name: [**Last Name (LF) **],[**First Name7 (NamePattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 4094**]: INTERNAL MEDICINE Location: [**Hospital **] COMMUNITY HEALTH CENTER Address: 409 [**Location (un) 61346**], [**Location **],[**Numeric Identifier 46146**] Phone: [**Telephone/Fax (1) 6511**] Appointment: MONDAY [**11-6**] AT 12:10PM . Department: GASTROENTEROLOGY When: WEDNESDAY [**2169-11-15**] at 11:20 AM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 6953**], MD [**Telephone/Fax (1) 1983**] Building: LM [**Hospital Ward Name **] Bldg ([**Last Name (NamePattern1) **]) [**Location (un) 858**] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage [**Name6 (MD) **] [**Name8 (MD) **] MD [**Doctor Last Name 1189**] ICD9 Codes: 2875, 496, 2851, 2449, 4019, 3051
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5981 }
Medical Text: Admission Date: [**2120-12-24**] Discharge Date: [**2121-1-10**] Date of Birth: [**2055-4-28**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 3276**] Chief Complaint: SOB/fever Major Surgical or Invasive Procedure: Doboff tube placed by interventional radiology PICC Placement on Right arm Left sided thoracentesis History of Present Illness: Pt is a 65 y.o male with h.o esophageal ca s/p surgical intervention, chemo/radiation, MI, HTN, HL who presents with SOB/fever/orthopnea. Pt is a transfer from OSH where CTA performed showed a large R.sided consolidation with b/l effusion R>L. D-dimer 1.63, WBC 8.9, given 300CC NS, 40mg IV lasix. BNP 326. CK 33, CKMB 2.8, Trop 0.03 . In the ED at [**Hospital1 18**] initial vitals demonstrated T 99, HR 108, BP 125/85, RR 24 sat 95%. Due to BNP and CXR findings pt was given vanco/levo/ctx for PNA. . Vitals prior to transfer to ICU. HR 100-110, BP 149/70, RR 24, sat 91% on 5L . Pt reports 2 days of SOB, orthopnea, cough (acute on chronic, non-productive), +subjective fever, +sick contacts URI at home, -CP. Otherwise denies headache/lh/dizziness/blurred vision/+palpit chronic, -abd pain/n/v/d/c/melena/brbpr, dysuria/hematuria, joint pain/skin rash, +poor po intake. Reports sometimes difficulty with swallowing, unsure if chokes/coughs during eating. . Past Medical History: esophageal ca s/p esophagectomy [**8-5**], radiation+chemo weight loss HTN HL MI [**2109**] s/p CCY Social History: He is married. He has four children in their 20s. He lives in [**Location 5110**] with his wife. [**Name (NI) **] is retired from the meat cutting industry. He does not smoke cigarettes nor has he in the past. He drinks alcohol rarely about a six-pack per summer. Family History: His mother is alive at age 88 with breathing difficulties and memory loss and heart problems. His father is alive at age [**Age over 90 **] and was just recently diagnosed with gastric cancer. He has a sister who died at age 61 of pancreatic cancer and a sister who is alive at age 54. There is no other family history of breast, ovarian, uterine, or colon cancer. Physical Exam: Vitals: T. 97.6, BP 131/81 HR 101, RR 11 sat 98% GEN:cachetic, ashen, frail, cooperative, alert HEENT: nc/at, PERRLA, EOMI, anicteric. neck: +JVP to thyroid cartilage, supple no LAD chest: b/l ae, poor effort, decreased breath sounds RML/RLL, also LLL. No w/c heart:s1s2 rrr 2/6 systolic flow murmur, no r/g abd:cachetic, +bs, soft, NT, ND, well healed surgical scars. ext: thin, no c/c/e 2+pulses, warm Pertinent Results: Admission labs: [**2120-12-24**] 12:30AM PT-13.7* PTT-30.7 INR(PT)-1.2* PLT COUNT-245# NEUTS-94.2* LYMPHS-2.7* MONOS-3.1 EOS-0 BASOS-0 WBC-9.9# RBC-4.60# HGB-14.3# HCT-39.1*# MCV-85 MCH-31.0 MCHC-36.5*# RDW-14.2 proBNP-5268* GLUCOSE-139* UREA N-16 CREAT-0.8 SODIUM-142 POTASSIUM-3.0* CHLORIDE-100 TOTAL CO2-26 ANION GAP-19 LACTATE-1.7 [**2120-12-24**] 01:06AM URINE BLOOD-NEG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-15 BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-NEG COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.015 COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.018 [**2120-12-24**] 07:02AM ALBUMIN-3.7 CALCIUM-8.9 PHOSPHATE-3.4 MAGNESIUM-1.8 IRON-19* CK-MB-3 cTropnT-<0.01 ALT(SGPT)-40 AST(SGOT)-29 LD(LDH)-133 CK(CPK)-23* ALK PHOS-143* AMYLASE-55 TOT BILI-0.8 LACTATE-1.4 TYPE-ART PO2-112* PCO2-41 PH-7.50* TOTAL CO2-33* BASE XS-8 [**2120-12-24**] 04:51PM CK(CPK)-24* . ECHO [**12-24**]: Compared with the findings of the prior study (images reviewed) of [**2119-9-25**], anteroseptal hypokinesis with focal apical akinesis is now present. . CT ABDOMEN W/O CONTRAST Study Date of [**2120-12-24**] 3:38 PM IMPRESSION: 1. Bilateral pleural effusions that are increased compared to [**2120-7-30**]. 2. Compressive atelectasis of the right lower lobe with possible superinfection. 3. ALthough limited by lack of contrast, esophageal-gastric anastomosis appears intact. Collapse of the distal esophagus and stomach, which precludes evaluation for mass. Small amount of simple fluid just distal to the anastomosis of uncertain clinical significance. 4. No evidence of intra-abdominal fluid collection or abscess. Interval loss of the subcutaneous fat plane in the left mid abdomen. . [**2121-1-1**] CTA Chest: IMPRESSION: 1. Negative examination for pulmonary embolism. 2. Moderate pleural effusions, left greater than right. The left effusion is slightly smaller. The right pleural effusion is unchanged with persistent loculation laterally. 3. Unchanged right lower lobe consolidation. 4. Limited evaluation of the gastroesophageal pull-through and of the upper abdomen. Specifically, evaluation for upper abdominal lymphadenopathy is suboptimal. Thoracentesis: [**2120-12-30**] 12:37PM PLEURAL WBC-50* RBC-[**Numeric Identifier **]* Polys-6* Lymphs-83* Monos-10* Macro-1* [**2120-12-30**] 12:37PM PLEURAL TotProt-2.7 Glucose-84 LD(LDH)-84 Albumin-1.7 Pleural fluid cytology: NEGATIVE FOR MALIGNANT CELLS. Brief Hospital Course: The patient is a 65 year old man with a history of hypertension, hyperlipidemia and esophageal ca s/p surgerical intervention/chemo/radiation, admitted to the ICU with SOB, fever, orthopnea. . #SOB/fever: CXR on admission with bibasilar opacities; left side noted to be chronic. CT chest from OSH and CT torso from admission reviewed with unchanged pleural effusion, new RLL and RML infiltrates. Also, difficult to track esophagus but still a question of fistula or obstruction. Additionally, BNP elevated on admission and CHF was also considered (see below). Patient was initially started on VANC/levo/flag then switched to Levo/flagyl to cover for aspiration pneumonia. . A thoracentesis was performed to alleviate some of his SOB/O2 requirement and assess for a malignant effusion. Pleural fluid was negative for malignancy, but recurrence was still highly suspected with elevated CEA and continued weight loss. A trial of prednisone was started for his SOB and appetite. He did well and will continue a taper. He currently requires 3L O2. . Given tenuous status and discussion with Dr. [**Last Name (STitle) 3274**] about likely cancer recurrence, patient decided to shift goals of care to comfort oriented care. He was given morphine as needed for SOB. Still prescribing meds for comfort. He decided to work toward hospice. . #CAD- BNP elevated on admission. ECHO showed interval change from previous with moderately-to-severely depressed (ejection fraction 30 percent). Cardiac enzymes were negative. . #Esophageal ca: Paitent reported extensive weight loss and diminished appetite. Oncology was consulted; CEA noted to be elevated at 90. Given concern for possible malignant recurrance, pt was transferred to the oncology service once stable. . # Nutrition: Speech and swallow felt he was too ill for inital evaluation. He was made NPO for concern of aspiration risk. Dobhoff tube was placed via IR due to anatomy of his espohagus. Pt was started on tube feeds. Speech and swalloe re-evaluated on floor and clear patient for full diet. The dobhoff tube was pulled. Nutrition recomended calorie counts and ensure suplements. . # Acute likely systolic CHF: Patient with new diagnosis of CHF with pleural effusion and EF of 30%. He was diuresed until his Cr elevated slightly, but his effusions remained. He was then only diuresed for symtom management. . # Anemia: Iron studies consistent with ACD . # Goals of care: as noted above, Dr. [**Last Name (STitle) 3274**] discussed likelyhood of recurrence of cancer given elevated CEA and continued loss of appetite and weight. The patient decided to be DNR/DNI and to move towards hospice. He will be discharged to [**Last Name (un) 72158**] house. . Medications on Admission: lexapro 20mg daily lipitor 5mg daily megestrol 625mg/5ml, 5ml po daily ? metoprolol 50mg [**Hospital1 **] asa 325mg colace omeprazole 20mg daily Discharge Medications: 1. Acetaminophen 325 mg Tablet [**Hospital1 **]: 1-2 Tablets PO Q6H (every 6 hours) as needed. 2. Guaifenesin 100 mg/5 mL Syrup [**Hospital1 **]: 5-10 MLs PO Q6H (every 6 hours) as needed. 3. Prednisone 20 mg Tablet [**Hospital1 **]: One (1) Tablet PO DAILY (Daily) for 3 days. 4. Prednisone 10 mg Tablet [**Hospital1 **]: One (1) Tablet PO DAILY (Daily) for 5 days: Start after last 20 mg dose. 5. Prednisone 5 mg Tablet [**Hospital1 **]: One (1) Tablet PO DAILY (Daily) for 5 days: Start after last 20 mg dose. 6. Morphine Concentrate 20 mg/mL Solution [**Hospital1 **]: 10-20 mg PO Q1hrs as needed: for respiratory distress. 7. Lexapro 20 mg Tablet [**Hospital1 **]: One (1) Tablet PO once a day. Discharge Disposition: Extended Care Facility: [**Last Name (un) 14710**] House (Hospice Home) - [**Location (un) 620**] Discharge Diagnosis: Aspiration Pneumonia weight loss Esophogeal cancer Discharge Condition: Feeling well, on 3L O2, comfortable. Discharge Instructions: You were admitted to the hospital because of shortness of breath. You initially went to the intensive care unit because of your need for oxygen. You recieved IV antibiotics and had a tube placed in your nose to recieve nutrition. You were stable to leave the intensive care unit and go to the oncology floor. You were seen by speech and swallow team who said you were safe to eat and so the tube was pulled. While a tap of fluid around your lung did not show malignancy, we continue to suspect that you have a cancer recurrence. After discussion with Dr. [**Last Name (STitle) 3274**] about signs that indicate cancer recurrence, it was decided to shift goals of care to comfort oriented care. You were given morphine as needed for SOB and other meds as needed for comfort. You will be dischaged to hospice. . All of your medications have been changed. Please take as prescribed. . Please call your doctor or your hospice care if you have concerns. Followup Instructions: Please call Dr. [**Last Name (STitle) 3274**] at ([**Telephone/Fax (1) 3280**] as needed for an appointment. [**First Name8 (NamePattern2) 251**] [**Name8 (MD) **] MD [**MD Number(1) 3282**] Completed by:[**2121-1-10**] ICD9 Codes: 5070, 5119, 4280, 4019, 2724, 412
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Medical Text: Admission Date: [**2156-6-4**] Discharge Date: [**2156-6-8**] Service: Trauma Surgery HISTORY OF PRESENT ILLNESS: This is an 86-year-old gentleman with multiple medical problems who sustained a fall from a standing position and found to have a subarachnoid hemorrhage at an outside hospital. The patient was transferred to [**Hospital1 188**] for further care. Unknown whether he had loss of consciousness. The patient was oriented to self only at baseline and was unable to offer further history. PAST MEDICAL HISTORY: 1. Hypercholesterolemia. 2. Coronary artery disease; status post coronary artery bypass graft. 3. Congestive heart failure. 4. Benign prostatic hypertrophy. 5. Chronic renal insufficiency with left hydronephrosis. 6. Hypertension. 7. History of hematuria. 8. Gout. 9. Dementia. MEDICATIONS ON ADMISSION: 1. Lipitor 10 mg by mouth once per day. 2. Flomax 0.4 mg by mouth once per day. 3. Potassium chloride 10 mEq by mouth every day. 4. Allopurinol 100 mg every other day. 5. Colace 100 mg by mouth twice per day. 6. Multivitamin by mouth every day. 7. Vitamin C 500 mg by mouth once per day. 8. Aspirin 81 mg by mouth once per day. 9. Remeron 15 mg by mouth at hour of sleep. 10. Aricept 10 mg by mouth once per day. 11. Lasix 40 mg by mouth in the morning. 12. Lasix 80 mg by mouth at hour of sleep. 13. Synthroid 75 mcg every other day. 14. Synthroid 50 mcg every other day. 15. Trazodone 25 mg by mouth twice per day. 16. Zyprexa 7.5 mg by mouth every day. 17. Proscar 5 mg by mouth once per day. 18. Atenolol 25 mg by mouth once per day. ALLERGIES: The patient has no known drug allergies. SOCIAL HISTORY: The patient lives a [**Doctor First Name 391**] Bay nursing facility. PHYSICAL EXAMINATION ON PRESENTATION: Vital signs revealed a temperature of 96 degrees Fahrenheit, his blood pressure was 101/61, his heart rate was 66, his respiratory rate was 14, and he was saturating 98% on 2 liters of nasal cannula. The patient was alert and oriented to self only, which apparently is his baseline. Head, eyes, ears, nose, and throat examination revealed a right forehead laceration. The pupils were equal, round, and reactive to light. The tympanic membranes were clear bilaterally. The oropharynx was clear. The neck was in cervical collar. The tongue was midline. Pulmonary examination revealed the lungs were clear to auscultation bilaterally. Cardiovascular examination revealed the patient had a regular rate and rhythm. The abdomen was protuberant but soft, nontender, and nondistended. He had full range of motion of all extremities. The extremities were nontender, and no deformities. He was guaiac-negative with normal rectal tone. The back was nontender. PERTINENT LABORATORY VALUES ON PRESENTATION: White blood cell count was 6.6, his hematocrit was 28.4, and his platelets were 163. Sodium was 143, potassium was 4.5, chloride was 106, bicarbonate was 29, blood urea nitrogen was 51, creatinine was 2, and blood glucose was 108. The urinalysis was negative. The patient had a prothrombin time of 13.7, his partial thromboplastin time was 35.4, and his INR was 1.3. He had a troponin of 0.01. PERTINENT RADIOLOGY/IMAGING: His electrocardiogram showed no ST elevations. He had Q waves in II and III (which were likely old), and poor R wave progression. A computed tomography of the head showed a subarachnoid hemorrhage in the right cistern with an intraparenchymal hemorrhage. A computed tomography of the abdomen and pelvis showed a large right pleural effusion, a small left pleural effusion, fluid around the liver, gallstones, bilateral renal cysts, and mass at the prostate. No acute injuries were found. A chest x-ray confirmed a right pleural effusion. A computed tomography of the cervical spine showed slight widening of the C4-C5 disc space. The computed tomography was negative. SUMMARY OF HOSPITAL COURSE: The patient was admitted to the Trauma Surgical Intensive Care Unit for every 1-hour neurologic checks and cardiovascular monitoring. The patient was started on Dilantin for seizure prophylaxis. A Neurosurgery consultation was obtained for management of his intracranial hemorrhages. A magnetic resonance imaging/magnetic resonance angiography was obtained which showed no evidence of aneurysm but confirmed known head computed tomography intracranial hemorrhages. The cervical spine was cleared with a magnetic resonance imaging of the cervical spine. Throughout, the patient remained oriented to himself only (which apparently is his baseline). The patient had no neurological deficits during his hospital stay. Hematuria was noted in the Foley later on hospital day one, and a Urology consultation was obtained. Given a negative CTU, there was low suspicion for trauma etiology. Discussion with primary care physician confirmed that this was an ongoing issue and that the patient already had a urologist (Dr. [**Last Name (STitle) 43569**] who was aware. Hematocrit reached a nadir of 25, for which the patient was transfused one unit. His hematocrit stabilized at 31, and the patient was to be discharged with a Foley catheter. A Cardiology consultation was obtained for the unknown reason for the patient's fall and observed an erratic heart rate, alternating between tachycardia and bradycardia. Per Cardiology, they thought that he likely developed supraventricular bradycardia, and his beta blocker was held. Atenolol was decreased from 25 mg once per day to 12.5 mg once per day. An echocardiogram was performed which showed severe mitral regurgitation with a flail of the anterior leaflet of the mitral valve. The patient had an ejection fraction of 35% and severe hypokinesis of the inferior wall and apex. Given his multiple medical problems, the patient was not considered an operative candidate. The plan was for the patient to be discharged with [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] of Hearts monitor for further evaluation of possible dysrhythmias. A large right pleural effusion was noted on initial Radiology examinations. This improved somewhat on subsequent chest x-rays five days later. A discussion with the patient's primary care doctor confirmed that this was an ongoing issue which she is following. DISCHARGE DIAGNOSES: 1. Right subarachnoid hematoma in the sylvian fissure; which is stable. 2. Subdural hematoma in the right midbrain; which is stable. 3. Intraparenchymal hemorrhage; which is stable. 4. Closed head injury. 5. Scalp laceration. 6. Right pleural effusion. 7. Hematuria. 8. C4-C5 disc space widening. 9. Coronary artery disease. 10. Chronic renal insufficiency with left hydronephrosis. 11. Dementia. 12. Severe mitral regurgitation with partial flail of anterior mitral leaflet with an ejection fraction of 35% and severe hypokinesis of the inferior wall and apex. MEDICATIONS ON DISCHARGE: (The patient was to resume all of his regular medications except) 1. Atenolol 12.5 mg by mouth once per day (versus old dose of 25 mg once per day). 2. Discontinue aspirin until [**2156-7-6**]. 3. The patient was to be on Dilantin 150 mg by mouth three times per day (last dose to be given on [**6-9**]). DISCHARGE INSTRUCTIONS/FOLLOWUP: 1. The patient was to follow up in Neurosurgery with Dr. [**First Name8 (NamePattern2) **] [**Name (STitle) 1132**] in two weeks (telephone number [**Telephone/Fax (1) 1669**]). The patient needs a head computed tomography prior to this visit. 2. The patient was to follow up in Cardiology with Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 284**] in two weeks. The patient to call telephone number [**Telephone/Fax (1) 285**]. At this time, the patient is to have a primary cardiology evaluation as well as evaluation of the results from the [**Doctor Last Name **] of Hearts monitor. 3. The patient was instructed to follow up with his primary care physician (Dr. [**Last Name (STitle) 43570**] within one month. 4. The patient was instructed to follow up with his urologist (Dr. [**Last Name (STitle) 43569**] within one month. 5. The patient was to have suture removal by a medical doctor; either his primary care physician or the medical doctors at his [**Name5 (PTitle) **] nursing facility on [**2156-6-11**]. CONDITION AT DISCHARGE: The patient was discharged in stable condition. DISCHARGE DISPOSITION: To a [**Year (4 digits) **] nursing facility ([**Doctor First Name 391**] [**Hospital **] Nursing Home). [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], M.D. [**MD Number(1) 11889**] Dictated By:[**Last Name (NamePattern1) 37631**] MEDQUIST36 D: [**2156-6-8**] 15:31 T: [**2156-6-10**] 09:56 JOB#: [**Job Number 43571**] ICD9 Codes: 2851, 4280
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Medical Text: Admission Date: [**2162-5-2**] Discharge Date: [**2162-5-6**] Date of Birth: [**2103-7-8**] Sex: F Service: CARDIOTHORACIC Allergies: Penicillins Attending:[**First Name3 (LF) 281**] Chief Complaint: malignant central airway obstruction with necrotizing pneumonia Major Surgical or Invasive Procedure: [**5-5**] flexible bronchoscopy [**2162-5-4**] Flexible and rigid bronchoscopy, endobronchial biopsy, transbronchial needle aspiration of precarinal and subcarinal lymph nodes, balloon dilation and metal covered stent placement. [**2162-5-3**] Flexible bronchoscopy History of Present Illness: 58F with COPD, anxiety and bipolar, transferred from [**Hospital 1562**] Hospital with new diagnosis of large central lung mass causing respiratory distress that required emergent intubation. She was intially admitted to [**Hospital 1562**] Hospital 3 days ago with shortness of breath, cough, malaise x2 weeks s/p failing a trial of Avalox as an outpatient. CXR done in the OSH ER showed (by report only) a very large left mid and lower lobe infiltrate with air fluid level suggesting emypema. CT chest (report) showed complex, large [**Location (un) 21851**] in mediastinum obliterating L main PA, L main bronchus, and resulting in near complete opacification of mid-to-lower left lung. She was started on Zosyn and Levaquin for pneumonia, Solumedrol for COPD flare, and sedation for extreme anxiety. She then underwent bronchoscopy with FNA on [**4-30**], which showed >75% narrowing of left mainstem bronchus at its most proximal portion and then quickly leading into 100% obliteration secondary to extrinsic compression. FNA was done, which showed malignant cells, unclear whether nonsmall cell vs. small cell vs. potential mix of pathology. L vocal cord was also noted to be immobile, suggesting involvement of the left recurrent laryngeal nerve. On [**5-1**], she developed respiratory distress and became apneic, and had to be emergently intubated during a code blue. She was transfused 1U PRBC's and started on Fe for anemia. She was stabilized and sedated, and transferred here for further care by Interventional Pulmonology. Per the chart, she has >60 pack year smoking history, quit drinking 2 years ago, and has no known exposure history. FH significant for mother who died of lung CA. Past Medical History: PMH: 1. h/o ETOH dependence, sober x2 yrs 2. COPD - no record of PFT's, no h/o treatments for COPD in past 3. Hypothyroidism 4. Chronic anxiety disorder 5. Bipolar disorder 6. Osteoarthritis 7. Avascular necrosis of right hip 8. Anemia Past surgical history: none Social History: Social history: >60 pack year smoking, currently smoking, h/o ETOH dependence, quit 2 yrs ago, currently not working - previously worked doing farm labor. Lives alone in [**Hospital1 1562**] Family History: Mother died at 58 of lung CA, father died at 57 of sudden death. She was 2 healthy children. Physical Exam: VS: T 96.2 HR: 86-100 ST BP 138/80 Sats: 95% 4L NC General: appears in no apparent distress CV: RRR, normal S1,S2, no murmur/gallop or rub Pulm: Coarse rhonchi bilaterally Abd: soft, nondistended, normoactive bowel sounds Ext: no c/c/e Neuro: anxious, response appropiately, moves all extremities Pertinent Results: [**2162-5-6**] WBC-12.7* RBC-4.20 Hgb-11.1* Hct-34.8* Plt Ct-324 [**2162-5-5**] WBC-11.7* RBC-3.61* Hgb-9.7* Hct-30.6* Plt Ct-267 [**2162-5-2**] WBC-17.4* RBC-3.81* Hgb-10.1* Hct-32.7* Plt Ct-294 [**2162-5-6**] Glucose-122* UreaN-11 Creat-0.5 Na-147* K-3.6 Cl-104 HCO3-30 [**2162-5-5**] Glucose-134* UreaN-9 Creat-0.5 Na-146* K-3.7 Cl-106 HCO3-31 [**2162-5-2**] Glucose-134* UreaN-6 Creat-0.6 Na-145 K-4.5 Cl-110* HCO3-26 [**2162-5-5**] Calcium-9.6 Phos-3.6 Mg-2.1 [**2162-5-2**] Type-ART Temp-36.2 Rates-16/3 Tidal V-350 PEEP-5 FiO2-40 pO2-149* pCO2-51* pH-7.33* calTCO2-28 Base XS-0 -ASSIST/CON Intubat-INTUBATED [**2162-5-4**] Type-ART Rates-/20 PEEP-5 FiO2-40 pO2-99 pCO2-46* pH-7.44 calTCO2-32* Base XS-5 Intubat-INTUBATED Date/Time: [**2162-5-3**] BRONCHOALVEOLAR LAVAGE GRAM STAIN (Final [**2162-5-3**]): 1+ (<1 per 1000X FIELD): POLYMORPHONUCLEAR LEUKOCYTES. NO MICROORGANISMS SEEN. RESPIRATORY CULTURE (Preliminary): NO GROWTH, <1000 CFU/ml. FUNGAL CULTURE (Pending): ACID FAST SMEAR (Final [**2162-5-4**]): NO ACID FAST BACILLI SEEN ON CONCENTRATED SMEAR. ACID FAST CULTURE (Pending): CT CHEST W/CONTRAST [**2162-5-3**] IMPRESSION: 1. Central left upper lobe mas contiguous with a mediastinal lymph node conglomeration, most consistent with advanced lung cancer. There is direct contact and mild compression on the aortic arch, encasement and obstruction of the left pulmonary artery, and encasement of the left main stem bronchus with partially obstructing mass distally. 2. Dominant central cavity in left lung is likely related to necrotizing post- obstructive pneumonia, but cavity component of neoplasm is also possible. 3. Multifocal bilateral pneumonia. Multiple left-sided cavities are consistent with necrotizing pneumonia. 4. Diffuse right peribronchial thickening may be due to either neoplastic infiltration or infection. 5. Small bilateral pleural effusions and pericardial effusion. 6. Cirrhosis and small amount of ascites. CHEST (PORTABLE AP) [**2162-5-5**] 4:56 AM In the interim, there is worsening of calcification in the left hemithorax due to combined left pleural effusion and left post-obstructive pneumonitis from a left hilar mass, which is obscuring the left heart border and aortic shadow. There is also worsened air space disease in the right lung that is attributed either to pulmonary edema and/or pneumonia. A right subclavian central line is noted with tip in the mid-to-proximal SVC. Both diaphragms are partially visualized secondary to bibasilar atelectasis. A stent is noted in the left main bronchus. IMPRESSION: 1. Worsening of pneumonia and effusion in the left lung. Worsening edema and/or pneumonia in the right lung. Cytology Report PRE-COU Procedure Date of [**2162-5-3**] REPORT APPROVED DATE: [**2162-5-5**] DIAGNOSIS: Lymph node (precarinal), fine needle aspirate: Blood and mixed inflammatory cells. Note: Evidence of lymph node sampling is not identified. [**2162-5-5**] SPECIMEN RECEIVED: [**2162-5-3**] 08-[**Numeric Identifier **] MEDIASTINAL DIAGNOSIS: Mediastinal mass, fine needle aspirate: POSITIVE FOR MALIGNANT CELLS, consistent with squamous cell carcinoma. [**2162-5-5**] SPECIMEN RECEIVED: [**2162-5-3**] 08-[**Numeric Identifier **] BRONCHIAL WASHINGS CLINICAL DATA: BAL of left upper lobe. PREVIOUS BIOPSIES: [**2162-5-3**] 08-[**Numeric Identifier **] MEDIASTINAL DIAGNOSIS: Bronchial washing, left upper lobe: Necrotic debris and inflammatory cells. Brief Hospital Course: The patient was admitted [**2162-5-2**]. On HD 2, he had a flexible bronchoscopy was at the bedside in the intensive care unit through an endotracheal tube. There was near complete occlusion of the left main-stem bronchus with extrinsic compression was noted. The bronchoscope could not be advanced past this obstruction. Purulent sputum was seen emanating from the left main-stem bronchus. On the right, severe bronchomalacia was seen in the mainstem bronchus. A small amount of purulent secretions seen in the right upper lobe, bronchus intermedius, right middle and lower lobe segmental bronchi, were all suctioned clean. Vancomycin and Zosyn were started empirically for pneumonia. A BAL was sent. later on HD 2, she was taken to the OR for a rigid bronchoscopy. Please see operative note for full details. A biopsy of the occlusive airway lesion revealed a non small cell lung cancer. Her LMSB was balloon dilated to 12 mm. A 14 x 40 mm covered metal stent was placed. A CT scan was done which showed central left upper lobe Mass contiguous with a mediastinal lymph node conglomeration, most consistent with advanced lung cancer. There is direct contact and mild compression on the aortic arch, encasement and obstruction of the left pulmonary artery, and encasement of the left main stem bronchus with partially obstructing mass distally. Dominant central cavity in left lung is likely related to necrotizing post- obstructive pneumonia, but cavity component of neoplasm is also possible. Multifocal bilateral pneumonia. Multiple left-sided cavities are consistent with necrotizing pneumonia. Diffuse right peribronchial thickening may be due to either neoplastic infiltration or infection. Small bilateral pleural effusions and pericardial effusion. Cirrhosis and small amount of ascites. On HD 2, she was extubated successfully. A flexible bronchoscopy was done at the bedside- the stent was patent and secretions were aspirated. Saline nebs and Mucomyst nebs were started and Mucinex was started. On HD 3, she continued to be stable. A flexible bronch was again performed at the bedside for therapeutic aspiration of secretions. Overnight she had an episode of mania. Psych was consulted (see note)recommended continue Seroquel and Haldol prn for agitation. She was seen by radiation oncology who recommended starting XRT . She received the first of ten 300 cGy treatment today. She tolerated the treatment well but was mildly paranoid. The patient was stable and to [**Location (un) 21541**] Hospital. Medications on Admission: Meds at home: Buspar 15'', Seroquel 300' + 100QHS, Synthroid 0.113' Meds on transfer: Levaquin, Zosyn, Solumedrol 125, Midaz, Propofol, Lovenox Discharge Medications: 1. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection TID (3 times a day). 2. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed. 3. Nicotine 14 mg/24 hr Patch 24 hr Sig: One (1) Patch 24 hr Transdermal DAILY (Daily). 4. Famotidine 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 5. Levothyroxine 112 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Buspirone 10 mg Tablet Sig: 1.5 Tablets PO BID (2 times a day). 7. Quetiapine 100 mg Tablet Sig: One (1) Tablet PO QHS (once a day (at bedtime)). 8. Quetiapine 100 mg Tablet Sig: Three (3) Tablet PO QAM (once a day (in the morning)). 9. Prednisone 20 mg Tablet Sig: Three (3) Tablet PO DAILY (Daily). 10. Lorazepam 2 mg/mL Syringe Sig: Two (2) mg Injection Q6H (every 6 hours) as needed for anxiety. 11. Albuterol Sulfate 2.5 mg/3 mL Solution for Nebulization Sig: 2.5/3ml Inhalation Q4H (every 4 hours) as needed. 12. Ipratropium Bromide 0.02 % Solution Sig: 0.2 ml Inhalation Q6H (every 6 hours). 13. Mucinex 1,200 mg Tab, Multiphasic Release 12 hr Sig: One (1) Tab, Multiphasic Release 12 hr PO BID (2 times a day). 14. Piperacillin-Tazobactam 4.5 gram Recon Soln Sig: One (1) Intravenous every eight (8) hours. 15. Acetylcysteine 20 % (200 mg/mL) Solution Sig: Three (3) ML Miscellaneous TID (3 times a day). 16. Haloperidol 0.5 mg Tablet Sig: 0.5-1 Tablet PO TID (3 times a day) as needed for agitation. 17. Heparin Lock Flush (Porcine) 10 unit/mL Solution Sig: Five (5) ML Intravenous DAILY (Daily) as needed. Discharge Disposition: Extended Care Facility: Cape Code Hospital Discharge Diagnosis: Central airway obstruction s/p metal stent placement COPD - no record of PFT's, no h/o treatments for COPD in past Hypothyroidism Chronic anxiety disorder Bipolar disorder Osteoarthritis Avascular necrosis of right hip Anemia h/o ETOH dependence, sober x2 yrs Discharge Condition: Stable Discharge Instructions: Normal Saline nebs [**Hospital1 **] Mucomyst nebs tid Mucinex 1200 mg [**Hospital1 **] continue zosyn 6 weeks started [**2162-4-29**] TLC flushes Followup Instructions: Follow-up with Dr. [**Last Name (STitle) 7631**] [**Telephone/Fax (1) 77787**] Follow-up with Dr. [**Last Name (STitle) 61800**] [**Telephone/Fax (1) 61801**] Follow-up with your PCP [**Last Name (NamePattern4) **]. [**Last Name (STitle) 4467**] [**Telephone/Fax (1) 77788**] [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 286**] Completed by:[**2162-5-7**] ICD9 Codes: 496, 2449
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5984 }
Medical Text: Admission Date: [**2150-2-3**] Discharge Date: [**2150-2-16**] Date of Birth: [**2065-6-30**] Sex: F Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2777**] Chief Complaint: Speech problems Major Surgical or Invasive Procedure: [**2150-2-6**] Left ICA endarterectomy [**2150-2-6**] Re-exploration of left carotid endarterectomy site, arteriogram. History of Present Illness: [**Known firstname 794**] is an 84year-old right-handed woman with past medical history significant for HTN, type II DM, hyperlipidemia who presented episode of garbled speech and word finding difficulties. Patient stated that she felt the symptoms last night around 8pm but she could not report the event. She described that her comprehension was intact but the words wouldn't come out the way she inteted, and finally she described as gibberish speech. The symptoms seemd improved later that night and this morning she complained right that she was not speaking the way she uses to. Per nurse description, she was able to follow commands. When asked what day is today and other simple questions she kept repeating "ahh, I can't even tell". He reported that her pupils were equally reactive to light and her left hand was weak to grip. BP was 155/75. patient was then transfer to [**Hospital1 18**] and trigger as stroke code. Upon arrival she was still complaining that her speech was not back to her baseline. Patient was admitted had a similar event in [**2149-10-21**] characterized by garbled speech. Her examination was nonfocal during hospitalization. Her workup included an MRI/MRA of the brain, which was overall unrevealing, and telemetry. Workup for toxic metabolic etiologies was unrevealing as well. She also had a normal EEG study. The only abnormalities noted were elevated LDL of 106. ROS: The patient denied headache, loss of vision, blurred vision, diplopia, dysarthria, dysphagia, She had lightheadedness, vertigo, yesterday during OT section. Denied focal weakness, numbness, parasthesiae. The pt denied recent fever or chills. Denied chest pain or tightness, palpitations. Denied nausea, vomiting, diarrhea, constipation or abdominal pain. Denied arthralgias or myalgias. Denied rash. Past Medical History: Essential hypertension Hyperlipidemia Peripheral neuropathy Type II DM Back pain Admission to stroke service with possible diagnosis of TIA. Left hip fracture after a fall with recent discharge on [**2150-1-28**] Social History: Independent in ADLs and IADLs. Widowed. Lives alone in senior housing in [**Location (un) **]. Has a daughter and son, both of whom live nearby and are involved in care. Denies ETOH, Tobacco, IVDU. Family History: M died in her 90s, but had a h/o of "heart disease". Sister had bypass surgery but died several weeks ago from complications of Alzheimer's Physical Exam: Per admitting resident Physical Exam: Vitals: T: afebrile P:83bpm R: 17 BP: 176/65mmHg General: Awake, cooperative, NAD. Neck: Supple, no carotid bruits appreciated. No nuchal rigidity Pulmonary: Lungs CTA bilaterally without R/R/W Cardiac: RRR, nl. S1S2, no M/R/G noted Abdomen: soft, NT/ND, normoactive bowel sounds, no masses or organomegaly noted. Extremities: No C/C/E bilaterally, 2+ radial, DP pulses bilaterally. Skin: no rashes or lesions noted. Neurologic: Patient's neuro exam was not consistent as she fluctuates in some responses. -Mental Status: awake, oriented x 3. Able to relate history with some difficulty. Patient was not able to name [**Doctor Last Name 1841**] backward, but she did forward. Language is fluent with intact repetition and comprehension. Normal prosody. Pt. was able to name high frequency objects but has significant difficulties with low frequency objects. Able to read without difficulty. Speech was not dysarthric. Able to follow both midline and appendicular commands, but she had clear signs of apraxia and somehow perseverating in the tasks. She demonstrated left-right confusion. patient was not able to write. At first she was not able to calculate, but later she answered correctly. CN I: not tested II,III: VFF to confrontation, pupils 3mm->2mm bilaterally, fundi normal III,IV,VI: EOMI, no ptosis. No nystagmus V: sensation intact V1-V3 to LT VII: Facial strength intact/symmetrical, symm forehead wrinkling VIII: hears finger rub bilaterally IX,X: palate elevates symmetrically, uvula midline [**Doctor First Name 81**]: SCM/trapezeii [**3-25**] bilaterally XII: tongue protrudes midline, no dysarthria Motor: Normal bulk and tone; no asterixis or myoclonus. Right pronator drift. Delt [**Hospital1 **] Tri WE FE Grip C5 C6 C7 C6 C7 C8/T1 L 4+ 5 4+ 5- 5- 5- R 5 5 5 5 5 5 IP Quad Hamst DF [**Last Name (un) 938**] PF L2 L3 L4-S1 L4 L5 S1/S2 L not tested hip fract 5 5 5 R 5 5 5 5 5 5 Reflex: No clonus [**Hospital1 **] Tri Bra Pat An Plantar C5 C7 C6 L4 S1 CST L 2 2 2 2 2 Flexor R 2 2 2 2 2 Flexor -Sensory: No obvious deficits to light touch, pinprick. -Coordination: No intention tremor, dysdiadochokinesia noted. No dysmetria on FNF or HKS bilaterally. -Gait: not tested. Exam On discharge: T: 97.8 HR: 70 BP:127/64 RR: 16 Spo2: 97% Gen: NAD, expressive aphasia Cardiac: No carotid bruit Lungs: CTA bilaterally Abd: soft, NT, ND, no rebound, gaurding Left neck incision cdi, no erythema or induration. Healing ridge. Steri strips intact Extremities: Minimal movement of right upper and lower extremity. Able to move right toes on command at times. Pulses: Fem [**Doctor Last Name **] DP PT [**Name (NI) 2325**] palp palp palp palp Right palp palp palp palp Pertinent Results: [**2150-2-4**] 12:14 am URINE Source: CVS. **FINAL REPORT [**2150-2-5**]** URINE CULTURE (Final [**2150-2-5**]): MIXED BACTERIAL FLORA ( >= 3 COLONY TYPES), CONSISTENT WITH SKIN AND/OR GENITAL CONTAMINATION CT head [**2-3**] IMPRESSION: 1. No evidence of intracranial hemorrhage or large [**Month/Year (2) 1106**] territorial infarct. If clinical suspicion is high for ischemic event, MRI is more sensitive if not contraindicated. 2. Stable appearance of small vessel ischemic disease and age-related involutional changes. 3. Patent intracranial vasculature without evidence of focal stenosis, occlusion, large aneurysm, or dissection. Moderate non-occlusive atherosclerotic calcifications within the aortic arch, at the origin of great vessels, and at bilateral common carotid bifurcations, left greater than right. Distal internal carotid arteries measure 4mm bilaterally. 4. Prominent anterior spondylosis and widening of anterior intervertebral disc space at C6-7, probably degenerative in nature. If there is clinical suspicion for ligamentous injury or history of trauma, further evaluation by MRI may be of benefit. The study and the report were reviewed by the staff radiologist. CXR [**2-3**] IMPRESSION: No acute cardiopulmonary process. MRI/A [**2-3**] IMPRESSION: 1. No evidence of an acute infarct, hemorrhage or mass. 2. Stable areas of white matter hyperintensity are a nonspecific finding, but likely represent the sequela of chronic microangiopathy given the patient's age. Dialted ventricles can relate to volume loss; however, to correlate clinically to exclude associated NPH. 3. Stable focus of susceptibility artifact in the right cerebellar hemisphere, likely represents the sequela of prior hemorrhage. No new focus of hemorrhage is identified. 4. No evidence of a hemodynamically significant stenosis, occlusion or aneurysm more than 3mm, within the limitations of the MRA technique. [**2150-2-11**] [**Hospital 93**] MEDICAL CONDITION: 84 year old woman s/p L CEA c/b stroke REASON FOR THIS EXAMINATION: evaluate for swallow Final Report INDICATION: Status post left CEA complicated by stroke, coughing with solid food intake, evaluate for swallow. VIDEO OROPHARYNGEAL SWALLOW: The study was conducted in collaboration with speech pathology. Various consistencies of barium was administered by mouth. There is no significant retention in the valleculae or piriform sinuses. There is a small amount of penetration into the vestibule seen with thin consistency barium. There is no definite aspiration seen into the airway. IMPRESSION: Penetration with thin consistency barium. Please refer to the complete report from speech pathology that is available on CareWeb. The study and the report were reviewed by the staff radiologist. [**2150-2-10**] [**Last Name (LF) **],[**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 147**] VICU [**2150-2-10**] 3:17 PM CT HEAD W/O CONTRAST Clip # [**Clip Number (Radiology) 28615**] Reason: eval for hemorrhagic transformation/interval change [**Hospital 93**] MEDICAL CONDITION: 84 year old woman with s/p large L stroke s/p L CEA REASON FOR THIS EXAMINATION: eval for hemorrhagic transformation/interval change CONTRAINDICATIONS FOR IV CONTRAST: None. Final Report INDICATION: Large left infarction, status post left carotid endarterectomy. COMPARISON: [**2150-2-7**]. TECHNIQUE: Non-contrast head CT. FINDINGS: There is a large evolving watershed infarction in the left cerebral hemisphere, involving both the anterior/middle cerebral arterial watershed territory and the middle/posterior cerebral arterial watershed territory. There is no change in associated edema or mass effect. There is minimal tilt of the septum pellucidum to the right, as before. There are small faint foci of hyperdensity in the infarcted left parietal cortex, (images 2:23, 2:20), which could represent microhemorrhage or mineralization related to pseudolaminar necrosis. There is unchanged effacement of the posterior left lateral ventricle. There are unchanged scattered hypodensities in the right hemispheric white matter, without mass effect, likely related to chronic small vessel ischemic disease. Internal carotid and vertebral arterial calcifications are again noted. The bones are unremarkable. The imaged paranasal sinuses and mastoid air cells are well aerated. IMPRESSION: Evolving large watershed infarction in the left cerebral hemisphere with unchanged mass effect. Scattered small foci of parietal cortical hyperdensity, which could indicate microhemorrhage or pseudolaminar necrosis of the infarcted cortex. No large hemorrhagic transformation. [**2150-2-10**] [**Hospital 93**] MEDICAL CONDITION: 84 year old woman with postoperative stroke s/p L CEA REASON FOR THIS EXAMINATION: eval stroke progression CONTRAINDICATIONS FOR IV CONTRAST: None. Wet Read: ENYa SAT [**2150-2-7**] 12:22 PM Interval progression of hypodensity in the left occipito-parietal region extension superior to the left frontoparietal region in the vertex, compatible with interval increase of cerebral edema and evolution of the known stroke. No acute intracranial hemorrhage. No significant shift of midline structures. Final Report HISTORY: 84-year-old woman, postoperative strokes, status post left CEA. Assess for stroke progression. COMPARISON: CT cerebral perfusion analysis on [**2150-2-6**] at 4:18 p.m. TECHNIQUE: Non-contrast MDCT images were acquired from the brain. FINDINGS: Compared to the study approximately 19 hours ago, there is increased extensive hypodensity spanning in the left occipitoparietal region extending superiorly to the frontoparietal region in the vertex. There is no acute intracranial hemorrhage. The prominent ventricles are grossly unchanged, allowing for mild mass effect from the increased cerebral edema as described before. There is no evidence of developing hydrocephalus. There is minimal shift of midline structures, but no evidence of herniation. Marked periventricular hypodensities are compatible with moderate underlying microvascular ischemic disease. Mild scattered opacification of the ethmoid air cells is noted. The remaining visualized paranasal sinuses and mastoid air cells are clear. There is no acute fracture. IMPRESSION: Interval increase of extensive hypodensity spanning the left occipitoparietal to the frontoparietal region, compatible with evolving watershed infarcts. No acute intracranial hemorrhage. No significant shift of midline structures or developing hydrocephalus. The study and the report were reviewed by the staff radiologist. Hematology COMPLETE BLOOD COUNT WBC RBC Hgb Hct MCV MCH MCHC RDW Plt Ct [**2150-2-12**] 04:12AM 7.1 3.55* 9.8* 29.6* 83 27.6 33.1 17.2* 370 Source: Line-art DIFFERENTIAL Neuts Bands Lymphs Monos Eos Baso Atyps Metas [**2150-2-4**] 05:10AM 69.7 21.8 4.3 3.6 0.6 BASIC COAGULATION (PT, PTT, PLT, INR) PT PTT Plt Ct INR(PT) [**2150-2-12**] 04:12AM 370 Source: Line-art LAB USE ONLY [**2150-2-12**] 04:12AM Source: Line-art Chemistry RENAL & GLUCOSE Glucose UreaN Creat Na K Cl HCO3 AnGap [**2150-2-13**] 05:39AM 0.6 3.6 Source: Line-cvl ESTIMATED GFR (MDRD CALCULATION) estGFR [**2150-2-11**] 02:57AM Using this1 Source: Line-right subclavian CVL Using this patient's age, gender, and serum creatinine value of 0.5, Estimated GFR = >75 if non African-American (mL/min/1.73 m2) Estimated GFR = >75 if African-American (mL/min/1.73 m2) For comparison, mean GFR for age group 70+ is 75 (mL/min/1.73 m2) GFR<60 = Chronic Kidney Disease, GFR<15 = Kidney Failure ENZYMES & BILIRUBIN ALT AST LD(LDH) CK(CPK) AlkPhos Amylase TotBili DirBili [**2150-2-4**] 05:10AM 20 21 223 971 70 0.6 NEW REFERENCE INTERVAL AS OF [**2149-11-24**];UPPER LIMIT (97.5TH %ILE) VARIES WITH ANCESTRY AND GENDER (MALE/FEMALE);WHITES 322/201 BLACKS 801/414 ASIANS 641/313 OTHER ENZYMES & BILIRUBINS Lipase [**2150-2-4**] 05:10AM 26 CPK ISOENZYMES CK-MB cTropnT [**2150-2-4**] 05:10AM <0.011 [**2150-2-4**] 05:10AM NotDone2 <0.01 CTROPNT > 0.10 NG/ML SUGGESTS ACUTE MI NotDone CK-MB NOT PERFORMED, TOTAL CK < 100 CHEMISTRY TotProt Albumin Globuln Calcium Phos Mg UricAcd Iron Cholest [**2150-2-13**] 05:39AM 8.4 2.8 1.9 Source: Line-cvl DIABETES MONITORING %HbA1c eAG [**2150-2-4**] 05:10AM 6.2*1 131*2 [**Doctor First Name **] RECOMMENDATIONS:; <7% GOAL OF THERAPY; >8% WARRANTS THERAPEUTIC ACTION ESTIMATED AVERAGE GLUCOSE, CALCULATED FROM A1C USING ADAG EQUATION. LIPID/CHOLESTEROL Cholest Triglyc HDL CHOL/HD LDLcalc [**2150-2-4**] 05:10AM 165 156*1 45 3.7 89 LDL(CALC) INVALID IF TRIG>400 OR NON-FASTING SAMPLE PITUITARY TSH [**2150-2-4**] 05:10AM 5.5* TOXICOLOGY, SERUM AND OTHER DRUGS ASA Ethanol Acetmnp Bnzodzp Barbitr Tricycl [**2150-2-4**] 05:10AM NEG NEG1 NEG NEG NEG NEG2 NEG 80 (THESE UNITS) = 0.08 (% BY WEIGHT) POSITIVE TRICYCLIC RESULTS REPRESENT POTENTIALLY TOXIC LEVELS;THERAPEUTIC TRICYCLIC LEVELS WILL TYPICALLY HAVE NEGATIVE RESULTS LAB USE ONLY EDTA Ho RedHold [**2150-2-8**] 02:50AM HOLD Blood Gas BLOOD GASES Type Temp Rates Tidal V PEEP FiO2 O2 Flow pO2 pCO2 pH calTCO2 Base XS Intubat Comment [**2150-2-7**] 05:59AM 7.44 GREEN TOP [**2150-2-7**] 01:53AM 7.47* GREEN TOP WHOLE BLOOD, MISCELLANEOUS CHEMISTRY Glucose Lactate Na K Cl [**2150-2-6**] 02:14PM 141* 1.9 138 3.8 107 HEMOGLOBLIN FRACTIONS ( COOXIMETRY) Hgb calcHCT [**2150-2-6**] 02:14PM 9.2* 28 CALCIUM freeCa [**2150-2-7**] 05:59AM 1.20 [**2150-2-7**] 01:53AM 1.06* Brief Hospital Course: Ms. [**Known lastname 28613**] was admitted to neurology service stroke for evaluation of recurrent episodes of speech difficulties. She underwent CT scan of head with CTA head/ neck which did not show any acute infarct , however suggested stenosis at the left internal carotid artery. This was in accordance with the carotid ultrasound few days ago, which showed the stenosis at the level of left ICA as well. It was discussed with the [**Known lastname 1106**] surgery team. The recurrent epsiodes of speech problems are consistent with TIAs originating from the left ICA affecting the language area leading to the clinical presentation. The risk of stroke was considerable and hence after discussion with patient and family, she was scheduled for carotid endarterectomy on [**2150-2-7**]. She underwent the endarterectomy with no intraoperative complications. Postoperatively she was noted to have right upper extremity weakness and recurrent aphasia. A heparin drip was started and she was taken emergently back to the operating room and an angiogram was performed. This showed the endarterectomy site to be widely patent. A cerebral arteriogram was performed which did not show any major vessel cut off. At this point, the decision was made to maintain the patient on heparin perform a CT scan. The neurology stroke team was consulted in the recovery room. The CT showed left watershed infarcts. Supportive care and heparinization were continued. Postoperatively she made a slow recovery however has progressed well. She was seen by speech and swallow and her diet was slowly advanced as she improved. She still has limited use of her RUE but she regained her speech. She has right sided neglect, but is able to overcome this intermittently. She is slowly progressing with physical therapy, occupational therapy and speech. The decision was made to not initiate coumadin anticoagulation and instead the patient was continued on aspirin and double dose Plavix. Patient tolerating diet well with aspiration precautions. CYP2C19 test for plavix resistance sent to outside lab. On [**2150-2-16**] the patient was discharged to Rehab [**Hospital3 2558**]. She will follow-up with [**Hospital3 **] Surgery and Neurology on an outpatient basis. Medications on Admission: 1. Aspirin 81 mg PO DAILY 2. Cholecalciferol (Vitamin D3) 400 unit [**Unit Number **].5 Tablets DAILY 3. Cyanocobalamin 500 mcg Two (2) Tablet PO DAILY 4. Docusate Sodium 100 mg 1 Capsule PO BID 5. Acetaminophen 325 mg 2Tablet PO Q6H PRN for pain 6. Alendronate 70 mg Tablet Sig: One (1) Tablet PO once a week. 7. XIBROM 0.09 % Drops Sig: ASDIR Ophthalmic ASDIR. 8. Glipizide 2.5 mg Tablet Extended Rel 24 hr Sig: One (1) Tablet Extended Rel 24 hr PO once a day. 9. Levothyroxine 75 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 10. Ferrous Sulfate 300 mg (60 mg Iron) Tablet Sig: One (1) Tablet PO DAILY (Daily). 11. Gabapentin 100 mg [**11-22**] Capsules PO HS (at bedtime). 12. Simvastatin 10 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 13. T.E.D. Sequnt Compress Device Misc Sig: ASDIR Miscellaneous once a day. 14. Calcium 600 600 mg (1,500 mg) Tablet Sig: One (1) Tablet PO twice a day. Discharge Medications: 1. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: 2.5 Tablets PO DAILY (Daily). 2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 3. Levothyroxine 75 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Ferrous Sulfate 300 mg (60 mg Iron) Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Clopidogrel 75 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Tablet(s) 7. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 8. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 9. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for constipation. 10. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. 11. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 12. Insulin Regular Human 100 unit/mL Solution Sig: One (1) Injection ASDIR (AS DIRECTED). 13. Oxycodone 5 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for pain. Discharge Disposition: Extended Care Facility: [**Hospital3 2558**] - [**Location (un) **] Discharge Diagnosis: Aphasia Symptomatic Left Carotid Artery Stenosis Postoperative CVA Discharge Condition: Mental Status: Confused - sometimes Level of Consciousness: Lethargic but arousable Activity Status: Out of Bed with assistance to chair or wheelchair Discharge Instructions: . Division of [**Location (un) **] and Endovascular Surgery Carotid Endarterectomy Surgery Discharge Instructions What to expect when you go home: 1. Surgical Incision: ?????? It is normal to have some swelling and feel a firm ridge along the incision ?????? Your incision may be slightly red and raised, it may feel irritated from the staples 2. You may have a sore throat and/or mild hoarseness ?????? Try warm tea, throat lozenges or cool/cold beverages 3. You may have a mild headache, especially on the side of your surgery ?????? Try ibuprofen, acetaminophen, or your discharge pain medication ?????? If headache worsens, is associated with visual changes or lasts longer than 2 hours- call [**Location (un) 1106**] surgeon??????s office 4. It is normal to feel tired, this will last for 4-6 weeks ?????? You should get up out of bed every day and gradually increase your activity each day ?????? You may walk and you may go up and down stairs ?????? Increase your activities as you can tolerate- do not do too much right away! 5. It is normal to have a decreased appetite, your appetite will return with time ?????? You will probably lose your taste for food and lose some weight ?????? Eat small frequent meals ?????? It is important to eat nutritious food options (high fiber, lean meats, vegetables/fruits, low fat, low cholesterol) to maintain your strength and assist in wound healing ?????? To avoid constipation: eat a high fiber diet and use stool softener while taking pain medication What activities you can and cannot do: ?????? No driving until post-op visit and you are no longer taking pain medications ?????? No excessive head turning, lifting, pushing or pulling (greater than 5 lbs) until your post op visit ?????? You may shower (no direct spray on incision, let the soapy water run over incision, rinse and pat dry) ?????? Your incision may be left uncovered, unless you have small amounts of drainage from the wound, then place a dry dressing over the area that is draining, as needed ?????? Take all the medications you were taking before surgery, unless otherwise directed ?????? Take one full strength (325mg) enteric coated aspirin daily, unless otherwise directed ?????? Call and schedule an appointment to be seen in 2 weeks for staple/suture removal What to report to office: ?????? Changes in vision (loss of vision, blurring, double vision, half vision) ?????? Slurring of speech or difficulty finding correct words to use ?????? Severe headache or worsening headache not controlled by pain medication ?????? A sudden change in the ability to move or use your arm or leg or the ability to feel your arm or leg ?????? Trouble swallowing, breathing, or talking ?????? Temperature greater than 101.5F for 24 hours ?????? Bleeding, new or increased drainage from incision or white, yellow or green drainage from incisions We have increased your dose of simvastatin to 40mg day and have added plavix to your medications. Please take your medicines as advised. Please call if you have any concerns. Followup Instructions: Provider: [**Name10 (NameIs) **] [**Name8 (MD) **], MD Phone:[**Telephone/Fax (1) 250**] Date/Time:[**2150-2-24**] 3:00 Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 8708**], M.D. Phone:[**Telephone/Fax (1) 719**] Date/Time:[**2150-3-12**] 2:30 Provider: [**Name10 (NameIs) **] LAB Phone:[**Telephone/Fax (1) 1237**] Date/Time:[**2150-3-19**] 9:00 Provider: [**Name10 (NameIs) 4267**] [**Last Name (NamePattern4) 4268**], MD, PHD[**MD Number(3) 708**]:[**Telephone/Fax (1) 657**] Date/Time:[**2150-3-24**] 3:00 Completed by:[**2150-2-16**] ICD9 Codes: 2449, 2724, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5985 }
Medical Text: Admission Date: [**2194-11-10**] Discharge Date: [**2194-11-17**] Date of Birth: [**2128-8-7**] Sex: F Service: MEDICINE Allergies: Keflex / Bactrim Attending:[**First Name3 (LF) 5119**] Chief Complaint: respiratory distress Major Surgical or Invasive Procedure: Bronchoscopy [**2194-11-11**]- with severe malacia distal to the stent. History of Present Illness: 66 year old female with history of COPD on home O2, CAD, CHF with diastolic dysfunction, tracheomalacia s/p Y stent last in [**7-/2194**], recent RUL MRSA pneumonia; admit on [**11-10**] to thoracics/IP service with multifocal pneumonia. She was admitted to OSH in [**Month (only) 359**] for MRSA pneumonia and treated with IV vancomycin with eventual transition to PO bactrim and discharged to rehab. Discharged home from rehab on [**11-7**]. Doing well at home until [**11-9**], when developed worsening cough, shaking chills, and noted fever to 102. Called EMS; upon arrival temp > 103. Brought to OSH and noted to have multifocal pneumonia on CXR. Transferred to [**Hospital1 18**] for continued care. . Arrived at [**Hospital1 18**] last night. Admitted to IP. Vancomycin given. Flex bronch performed this morning. Bronch showed stent in place (but malacia distal to stent); thick brown secretions. BAL of superior segment of LLL performed. 4 versed and 100 fentanyl given. Following the procedure, she required increasing O2 (6L with transition to NRB). Noted to be wheezy. Nebs and solumedrol given. Admitted to ICU due to increasing O2 requirements. Patient reports a cough with production of white with sometimes tan and sometimes blood streaked mucous. No current/recent CP (does report intermittent chest tightness during rehab stay when breathing more difficult and wheezing). No abdominal pain, nausea. No dysuria. +diarrhea. MICU course: The pt was initially admitted to the IP service two days ago for MRSA multifocal pneumonia as most of her care is here. Got bronched here, got bronchospasm vs sedation from the bronch. With the wheezing she was placed on a non rebreather. She improved to 4L, which is her baseline. She still has diffuse multifocal pneumonia. She is currently on Vancomycin and wsa tapered from IV steroids to PO prednisone. A PICC was placed bedside for a 14 day course of abx. Pending results for bronch results. She will remain on coumadin for mitral valve replacement. Past Medical History: - Tracheomalacia s/p tracheal Y-stenting in [**5-31**] and [**8-1**] - COPD - reported on 3L O2 in the past; most recently on 1 L NC. Prior PFTs also showing restrictive defect ([**8-/2194**]) - CAD, s/p CABG, with LAD and LCx stenting - CHF, diastolic dysfunction - CRI (baseline Cr low-1s): erythropoietin deficiency - AFib - GERD - Gout - Obstructive sleep apnea - on home CPAP (reports setting of 10) - HTN - Hyperlipidemia - Hypothyroidism - Depression - Obesity - Discoid lupus (inactive) - s/p MVR with St. Jude valve ([**2188**]), on coumadin - s/p L parietal CVA ([**2186**]), no residual neurologic deficits - h/o bladder CA - h/o colonic polyps and diverticulosis - s/p cholecystectomy, t&a, tubal ligation, C-section, vocal cord polyp excision Social History: 15 yr hx tobacco, 1pk every 3d, quit [**2186**] Occasional EtOH Disability Lives alone, just moved to new home without stairs Divorced, one daughter [**Name (NI) **] IVDU Family History: Cardiomyopathy AFib Valvular heart disease Older sister - RA [**Name (NI) **] sister - COPD ([**Name2 (NI) 1818**]), GERD Physical Exam: GENERAL: NAD. Oriented x3. Mood, affect appropriate. HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. NECK: Supple with JVP of 5 cm. CARDIAC: RR, ,metallic S1, S2. ii/vi SEM at LLSB No r/g. No thrills, lifts. No S3 or S4. LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp were unlabored, no accessory muscle use. Aeration was diminished throughout, with some end expiratory wheezes at LLB, some crackles at LLB CTAB. No wheezes or rhonchi. ABDOMEN: Soft, NTND. No HSM or tenderness. No abdominial bruits. EXTREMITIES: No c/c/e. No femoral bruits. SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. PULSES: Left/Right: Carotid 2+ Radial 2+ Pertinent Results: [**2194-11-11**] CXR Multifocal bilateral pneumonia. No pneumothorax. No pleural effusion. . ECG: NSR at 92, NANI. Does have S wave in I, Q in III and TWF in III, but all are unchanged from prior dated [**2194-8-12**]. . PFTs Date: [**2194-9-23**] Actual Pred %Pred Actual %Pred TLC 3.37 4.23 80 FRC 1.61 2.41 67 RV 1.60 1.65 97 VC 1.77 2.58 69 IC 1.76 1.82 97 ERV 0.01 0.76 1 RV/TLC 47 39 122 He Mix Time 2.25 FVC Actual: 1.55 % Predicted: 60 FEVI Actual: 1.26 % Predicted: 68 DLCO Actual: 10.24 % Predicted: 59 . Echo [**2194-8-11**]: EF >55%. TR gradient 47-59. Bileaflet MVR with normal motion and gradients. 1+ MR, 1+TR, mod PA HTN. . PA/LAT [**2195-11-11**]: 1. Multifocal bilateral pneumonia. 2. Status post CABG and aortic valve replacement. . PORTABLE CXR [**2194-11-12**]: In comparison with the study of [**11-11**], there is continued diffuse bilateral airspace consolidation representing multifocal bilateral pneumonia. No definite pleural effusion. There is evidence of a prosthetic mitral valve and previous CABG procedure. Broken second metallic suture is also seen. . [**2194-11-12**] PICC placement: 1) Left-sided PICC with tip projecting over the right atrium and will need to be withdrawn approximately 2 cm. 2) Worsening bilateral air space opacities likely representing worsening multifocal pneumonia. 3) No pleural effusion. No pneumothorax. . [**2194-11-13**] Abdominal u/s: 1. Limited evaluation of the liver, but no intrahepatic biliary ductal dilatation. 2. Common hepatic duct is prominent, measuring up to 6 mm, which could be within normal range for patient's age or could be related to prior cholecystectomy; however, choledocholithiasis cannot be excluded, and correlation with MRCP can be performed if clinically indicated. . [**2194-11-14**] PA and lateral: Multifocal pulmonary consolidation which has been present in the past, reappeared on [**11-11**], improved on [**11-12**], and has remained stable subsequently. Although this could be multifocal infection, in the past, abnormalities like this have been due to pulmonary hemorrhage, sometimes due to over anticoagulation. Mild chronic cardiomegaly and pulmonary vascular engorgement suggesting at least borderline cardiac decompensation are also noted. Tracheobronchial stent in place. Status post MVR. Brief Hospital Course: 66 yr old female with severe COPD, tracheomalacia, recurrent MRSA pneumonia presenting with shortness of breath. 1)Respiratory distress. Patient initially presented for bronch. She developed wheezing, dyspnea, and increased O2 requirement following bronch. Treated with nebs and solumedrol. Likely related to airway reactivity. Transitioned to prednisone and needs to complete taper as outlined in medication list. Treatment of pneumonia as below. Follow up with Dr. [**First Name (STitle) **] [**Name (STitle) **] recommended - his secretary will call rehab facility to set up appointment. 2) Pneumonia. Pt presented with multifocal pneumonia, high fevers. Living at home but 3 days PTA was in nursing facility/rehab, so covered broadly. Later Bronchialveonar lavage revealed MRSA and proteus sp which was pansensitive. Initially on Vanco/Zosyn, then changed to Vanco and Ceftriaxone. Needs 14 day total course 3) COPD. On home O2. Likely contributed to Resp distress. S/p Bronch [**11-11**] by Interventional pulmonology. Nebulizers uptitrated and steroid taper in place. 4) s/p MVR. On coumadin, goal 2.5-3.5. Recent echo with valve in good position, 1+MR. ON coumadin, but sub-therapeutic so on heparin gtt to bridge. Once therapeutic after one day will stop heparin. 5) Anemia. Slightly below baseline, likely [**1-25**] anemia of inflammation from acute illness. Continued on Iron supplementation. 6) Congestive heart failure. Preserved EF, ?diastolic dysfunction. MVR in place. Appears slightly hypervolemic currently, but improved compared to baseline.. Continued home bumex dosing. Not on BB likely b/c of COPD, but not on ACEI for unclear reasons. This should be addressed with primary care. 7) Transaminitis. ALT 113 at OSH, AST 45. Mildly elevated ALTs now and in past here. ?NAFLD. Outpatient follow up recommended. 8) Depression. Continued home venlafaxine, benzos, lexapro. 9) CRI. At baseline creatinine of 0.8 at time of discharge to rehab. 10) Afib. Currently in sinus. Continued verapamil, coumadin. Medications on Admission: D51/2 NS with 20 mEq KCl at 50 ml/hr Fluticasone-Salmeterol Diskus (250/50) 1 INH IH [**Hospital1 **] Acetaminophen 650 mg PO Q6H:PRN fever Allopurinol 100 mg PO BID Guaifenesin [**5-3**] mL PO Q6H:PRN Albuterol 0.083% Neb Soln 1 NEB IH Q4H:PRN wheezes Influenza Virus Vaccine 0.5 mL IM ASDIR Aspirin 81 mg PO DAILY Levothyroxine Sodium 50 mcg PO DAILY Atorvastatin 80 mg PO DAILY MethylPREDNISolone Sodium Succ 40 mg IV Q8H Benzonatate 200 mg PO TID Bumetanide 1 mg PO BID Montelukast Sodium 10 mg PO DAILY CloniDINE 0.1 mg PO DAILY Pantoprazole 40 mg PO Q24H Clonazepam 0.5 mg PO BID Tiotropium Bromide 1 CAP IH DAILY Colchicine 0.6 mg PO BID Vancomycin 1000 mg IV Q 24H Escitalopram Oxalate 20 mg PO DAILY Verapamil SR 240 mg PO Q24H Ferrous Sulfate 325 mg PO DAILY Venlafaxine XR 150 mg PO DAILY Zolpidem Tartrate 10 mg PO HS Order date: [**11-10**] @ 2222 . Discharge Medications: 1. Venlafaxine 75 mg Capsule, Sust. Release 24 hr Sig: Two (2) Capsule, Sust. Release 24 hr PO DAILY (Daily). 2. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 3. Gabapentin 300 mg Capsule Sig: One (1) Capsule PO Q12H (every 12 hours). 4. Clonazepam 0.5 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 5. Ferrous Sulfate 325 mg (65 mg Iron) Tablet Sig: One (1) Tablet PO every eight (8) hours. 6. Verapamil 240 mg Tablet Sustained Release Sig: One (1) Tablet Sustained Release PO Q24H (every 24 hours). 7. Zolpidem 5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) as needed for insomnia. 8. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) Inhalation Q4H (every 4 hours) as needed for shortness of breath or wheezing. 9. Tiotropium Bromide 18 mcg Capsule, w/Inhalation Device Sig: One (1) Cap Inhalation DAILY (Daily). 10. Montelukast 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 11. Clonidine 0.1 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 12. Benzonatate 100 mg Capsule Sig: Two (2) Capsule PO TID (3 times a day). 13. Escitalopram 10 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 14. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO BID (2 times a day). 15. Levothyroxine 50 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 16. Bumetanide 0.5 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 17. Insulin Regular Human 100 unit/mL Solution Sig: One (1) Injection ASDIR (AS DIRECTED): as per insulin sliding scale which is attached to DC form. 18. Fluticasone-Salmeterol 500-50 mcg/Dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). 19. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed. 20. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 21. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed. 22. Guaifenesin 600 mg Tablet Sustained Release Sig: One (1) Tablet Sustained Release PO BID (2 times a day). 23. Warfarin 5 mg Tablet Sig: 1.5 Tablets PO HS (at bedtime): will need repeated INR check as on heparin drip and coumadin until in therapeutic range 2.5-3.5. 24. Heparin Flush (10 units/ml) 2 mL IV PRN line flush PICC, heparin dependent: Flush with 10mL Normal Saline followed by Heparin as above daily and PRN per lumen. 25. Vancomycin in Dextrose 1 gram/200 mL Piggyback Sig: One (1) gram Intravenous Q 12H (Every 12 Hours): can check a vanc level in two days and dose for range of 15-20 END [**11-28**] . 26. Ceftriaxone in Dextrose,Iso-os 1 gram/50 mL Piggyback Sig: One (1) gram Intravenous Q24H (every 24 hours): total 14 days. End [**11-28**]. 27. Potassium Chloride 10 mEq Tablet Sustained Release Sig: Four (4) Tablet Sustained Release PO once a day. 28. Prednisone 10 mg Tablet Sig: Three (3) Tablet PO DAILY (Daily) for 4 days: end [**11-20**] to decrease dose per taper. 29. Prednisone 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily) for 4 days: end 12/1 per taper. 30. Prednisone 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily) for 2 days: to end [**11-26**]. 31. Prednisone 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily): to maintain on 5 mg. 32. Heparin (Porcine) in NS 10 unit/mL Kit Sig: Eight Hundred Fifty (850) units Intravenous once a day: ON HEPARIN DRIP. for subtherapeutic INR. 850/HR. TITRATE PER PTT. PLEASE SEE ATTACHED schedule. Discharge Disposition: Extended Care Facility: [**Hospital6 1293**] - [**Location (un) 8957**] Discharge Diagnosis: Multifocal pneumonia with Staph Aureus and Proteus Mirabilis COPD Tracheomalacia Discharge Condition: stable on 2.5L oxygen on IV antibiotics Vancomycin and Ceftriaxone by PICC line and heparin drip for subtherapeutic INR and mechanical valve to rehabilitation facility Discharge Instructions: Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight > 3 lbs. Adhere to 2 gm sodium diet You were admitted with a mutlifocal pneumonia and had bronchoconstriction in the setting of a bronchoscopy. The samples grew out staph aureus and proteus mirabilis. Two organisms that are being treated with Vancomycin and Ceftriaxone for 14 day course via your PICC line. -Please continue to take your antibiotics Vancomycin and Ceftriaxone for fourteen day total course. -Please continue prednisone taper to 5 mg standing dose to be discussed with your PCP [**Name10 (NameIs) 21421**] continue heparin drip for subtherapeutic INR until INR is between 2.5 and 3.5 -Please continue to hold Statin and allopurinol in the setting of elevated liver tests until discussed with PCP. [**Name10 (NameIs) **] should be reassessed and followed as an outpatient with potential MRCP if no resolution. -Your foley is still in but should be removed with voiding trial at the rehab facility. Followup Instructions: You are going to acute rehabilitation. Please call your PCP [**Last Name (NamePattern4) **]. [**First Name4 (NamePattern1) 1692**] [**Last Name (NamePattern1) 42167**] [**Telephone/Fax (1) 54195**] for follow up appt. Please follow up with Interventional Pulmonary. You will need to call Dr. [**First Name (STitle) **] [**Name (STitle) **] at ([**Telephone/Fax (1) 17398**] for an appointment in the next 2 weeks. [**First Name7 (NamePattern1) 1569**] [**Initial (NamePattern1) **] [**Name8 (MD) **] MD [**MD Number(2) 5122**] ICD9 Codes: 4280
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Medical Text: Admission Date: [**2182-10-15**] Discharge Date: [**2182-10-27**] Date of Birth: [**2148-6-12**] Sex: M Service: CSURG Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1283**] Chief Complaint: ascending aortic dissection Major Surgical or Invasive Procedure: sp repair of ascending aorta/hemi arch dissection [**2182-10-15**] History of Present Illness: 34 M w/ hx of chest pain and back pain X 3 days. Hx of hypertension, but poor compliance with medications. ECG diffue ST elevations. CT chest type A aortic dissection Past Medical History: Hypertension Social History: marijuana Qday Family History: ? dissection Physical Exam: moderate distress RRR, holosystolic murmur CTAB soft, NT, ND Pertinent Results: [**2182-10-15**] 09:57PM PT-19.7* PTT-150* INR(PT)-2.5 [**2182-10-15**] 09:57PM PT-19.7* PTT-150* INR(PT)-2.5 [**2182-10-15**] 11:22PM TYPE-ART PO2-467* PCO2-50* PH-7.37 TOTAL CO2-30 BASE XS-2 [**2182-10-15**] 08:49PM PLT COUNT-163 [**2182-10-15**] 08:49PM WBC-9.3 RBC-4.40* HGB-12.6* HCT-35.6* MCV-81* MCH-28.6 MCHC-35.4* RDW-13.0 [**2182-10-15**] 04:40PM GLUCOSE-103 UREA N-13 CREAT-1.3* SODIUM-140 POTASSIUM-3.1* CHLORIDE-97 TOTAL CO2-30* ANION GAP-16 [**2182-10-15**] 06:15PM D-DIMER-3340* [**2182-10-15**] 04:40PM CK-MB-2 cTropnT-<0.01 [**2182-10-15**] 04:40PM WBC-8.5 RBC-4.99 HGB-14.4 HCT-40.6 MCV-82 MCH-28.9 MCHC-35.5* RDW-13.0 [**2182-10-15**] 04:40PM URINE BLOOD-TR NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-0.2 PH-7.0 LEUK-NEG Brief Hospital Course: Hospital course was complicted by acute renal failure. Renal recommended renal US and MRI which were boht WNL. Renal function improved with time. Multiple anti hypertensive medications added (please see medication list). Pt was tolerating a regular diet and pain was well controlled on PO pain medications upon DC. Pt was cleared by pphysical therapy and was DC's to home with VNA on POD 11. Medications on Admission: lisinopril 40 PO QDay, Maxide 75/50, Norvasc 10 PO QDay Discharge Medications: 1. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 2. Amlodipine Besylate 5 mg Tablet Sig: Two (2) Tablet PO QD (once a day). Disp:*60 Tablet(s)* Refills:*2* 3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 4. Aspirin 325 mg Tablet Sig: One (1) Tablet PO QD (once a day). Disp:*30 Tablet(s)* Refills:*2* 5. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. Disp:*75 Tablet(s)* Refills:*0* 6. Clonidine HCl 0.1 mg/24 hr Patch Weekly Sig: One (1) Patch Weekly Transdermal QTHUR (every Thursday). Disp:*30 Patch Weekly(s)* Refills:*2* 7. Hydrochlorothiazide 25 mg Tablet Sig: One (1) Tablet PO QD (once a day). Disp:*30 Tablet(s)* Refills:*2* 8. Ibuprofen 600 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed. 9. Captopril 25 mg Tablet Sig: Six (6) Tablet PO TID (3 times a day). Disp:*540 Tablet(s)* Refills:*2* 10. Labetalol HCl 200 mg Tablet Sig: Four (4) Tablet PO TID (3 times a day). Disp:*360 Tablet(s)* Refills:*2* 11. Hydralazine HCl 50 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours). Disp:*240 Tablet(s)* Refills:*2* 12. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: sp repair of ascending aorta/hemi arch dissection [**2182-10-15**] Discharge Condition: stable Discharge Instructions: Please call physician if experiencing redness/drainage from the wound, chest pain/shortnes of breath, persistent nausea/vomiting. Do not lift > 10 lbs for 6 weeks. Do not swim or bath for 6 weeks. [**Month (only) 116**] shower. Follow cardiac healthy diet. Follow up with PCP regarding new medications (captopril, clonidine patch, HCTZ, hydralazine, labetolol). Followup Instructions: Please follow up with Dr. [**Last Name (STitle) 1290**] in 4 weeks; call the office for an appointment [**Telephone/Fax (1) 170**]. Follow up with PCP [**Last Name (NamePattern4) **] [**1-25**] weeks regarding new anti-hypertensive medications (see above). Completed by:[**2182-10-28**] ICD9 Codes: 5849, 4019
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Medical Text: Admission Date: [**2132-10-18**] Discharge Date: [**2132-10-28**] Service: MEDICINE Allergies: Keflex / Ambien Attending:[**First Name3 (LF) 2901**] Chief Complaint: Chest pain Major Surgical or Invasive Procedure: None History of Present Illness: 83M with PVD s/p balloon angioplasty to both legs presents with increasing shortness of breath, bilateral leg swelling x2 weeks, and substernal chest pain this evening lasting at least 20 minutes. Chest pain occured while he was getting into bed; he thought it was indigestion and took a tylenol for it, with eventual resolution in He recently had a toe amputation 1 week ago [**3-8**] arterial insufficiency and has been relatively less mobile during this time. He developed some dyspnea with the CP today and then presented to [**Hospital3 **]. There, CXR showed pulm edema, also had an elevated BNP and TnI. D-dimer was also elevated at 393. Lidocaine was started for VT and he was transferred to [**Hospital1 18**]. . In the [**Hospital1 18**] ED, afebrile, pulse 80s, BP 100s/60s, RR 28, Sat 80%RA, 100% NRB. Started heparin gtt, ASA, and given lasix 20mg IV. Past Medical History: Hypertension Peripheral Vascular Disease Hip replacement in [**2130**] L toe osteomyelitis leading to partial amputation one week ago Social History: Lives with wife; has two grown children. Prior smoker, quit many years ago. No alcohol. Family History: Son w/ CAD at young age Physical Exam: VS:108/62, 82, 22, 96%RA HEENT: MMM, No appreciable JVD Heart: RRR, III/VI SEM at URSB Lungs: Decreased breath sounds in the bases, mild crackles to midlung, no wheezes, mild rhonchi in L midlung. Abdomen: Soft, NT, ND, BS+, No HSM Ext: Partially amputated L second toe w/ 2 sutures in place. No LE edema. Pedal pulses dopplerable. Radial pulses 2+ and equal. Neuro: A/OX3, CNII-XII grossly intact w/ slight facial droop to R. Pertinent Results: [**2132-10-18**] echo The left atrium is moderately dilated. The right atrium is moderately dilated. No atrial septal defect is seen by 2D or color Doppler. The estimated right atrial pressure is 10-20mmHg. There is mild symmetric left ventricular hypertrophy. The left ventricular cavity size is normal. There is severe global left ventricular hypokinesis (LVEF = 25 -30%). No masses or thrombi are seen in the left ventricle. There is no ventricular septal defect. The right ventricular cavity is markedly dilated with mild global free wall hypokinesis. The ascending aorta is mildly dilated. The aortic arch is mildly dilated. The aortic valve leaflets are moderately thickened. There is moderate aortic valve stenosis (area 1.2cm2). The mitral valve leaflets are mildly thickened. The mitral valve leaflets are elongated. Mild to moderate ([**2-6**]+) mitral regurgitation is seen. [Due to acoustic shadowing, the severity of mitral regurgitation may be significantly UNDERestimated.] The tricuspid valve leaflets are mildly thickened. Moderate to severe [3+] tricuspid regurgitation is seen. There is moderate pulmonary artery systolic hypertension. There is no pericardial effusion. [**2132-10-18**] LE doppler: No e/o DVT [**2132-10-18**] CXR EMI-UPRIGHT VIEWS OF THE CHEST AT 12:10 A.M.: There are moderate bilateral pleural effusions, with associated atelectasis. Pulmonary vasculature appears slightly engorged, and increased opacity at both lung bases likely reflect mild pulmonary edema. The heart is enlarged. There is no hilar or mediastinal enlargement. There is no pneumothorax. Soft tissue and bony structures are notable for convex leftward curvature of the upper spine, but are otherwise unremarkable. IMPRESSION: Moderate bilateral pleural effusions, enlarged heart and mild pulmonary edema. Brief Hospital Course: 83M with PVD, HTN, history of tobacco, presents with CHF and NSTEMI; hihg-risk features in this patient include the presence of chest pain at rest, positive biomarkers, CHF signs/symptoms, and patient already on ASA. . # CAD/Ischemia: NSTEMI in pt with existing CAD-risk equivalent. High risk feature of CHF. Pt. had indigestion on the day after admission which responded to 2 sublingual nitroglycerin was not associated w/ ECG changes and did not return. Pt. was initially scheduled for catheterization, but was unable to lay flat for procedure due to orthopnea. It was decided that pt. would be high risk for cath and may require intubation from which he would be a very difficult wean. It was determined that given his history of severe PVD he likely has 3vd without a single intervenable culprit lesion and that he would be a very poor candidate for CABG given his debilitated state. He will f/u with cardiologist as an outpt. for possible future catheterization when he is more able to lay flat. His medical regimen was optimized w/ ASA, plavix, BB, ACEI and he was diuresed several liters after which his orthopnea significantly improved. CT coronaries was considered but decided against because either result (3vd vs. single lesion) would require a catheterization for confirmation. . # PUMP: LVEF is 25% with moderate AS (1.2cm2), mild-to-moderate MR, and severe TR. Pt. appeared severely volume overloaded on presentation and could not be cathed secondary to orthopnea. He was diuresed several liters with furosemide and acetazolamide and his oxygen requirement and orthopnea decreased progressively with diuresis. . #Hypercarbia: pt. was noted to have a compensated respiratory acidosis in addition to his initial hypoxia. This was not entirely explained by his pulmonary edema as CO2 is soluble in water. His mental status improved with diuresis, and an ABG was not rechecked after he improved but it is likely that his lungs were stiff from edema fluid increasing the difficulty of breathing and thus causing him to hypoventilate. . # Rhythm: afib, new diagnosis, was started on warfarin, metoprolol for rate control. Pt. had no episodes of RVR. . #HTN: Pt. was initiated on several new antihypertensive medications and for most of his admission his BP was normal to low. He had several episodes of SBP in high 70's, usually in the afternoons when sitting up in the chair during which he mentated appropriately and produced significant UOP. He was also noted to be orthostatic by PT. He had been taking midodrine at home but we did not restart this as he has known PVD and now CAD w/ low EF. We decreased his diuresis and encouraged PO intake as he appeared dry on exam. . # elevated D-dimer: PE was not very high on the differential as pt. was short of breath and hypoxic but clearly in florid heart failure. Pt. was r/o for DVT/PE w/ LE dopplers . # Depression: continued home duloxetine 30mg daily and trazodone 50mg QHS. . # Macrocytic anemia: Pt. was on B12, thiamine, folate supplementation. TSH normal. Vitamin B12 and folate studies were pending on d/c. . # Code: full . Medications on Admission: lisinopril 20mg daily ASA 81mg daily lasix 20mg daily duloxetine 30mg daily trazodone 50mg QHS thiamine folic acid MVI Vit C Vit B12 Discharge Medications: 1. Duloxetine 30 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 2. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 6. Senna 8.6 mg Tablet Sig: 1-2 Tablets PO BID (2 times a day) as needed for constipation. 7. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. Nitroglycerin 0.3 mg Tablet, Sublingual Sig: One (1) Tablet, Sublingual Sublingual PRN (as needed) as needed for chest pain. 10. Cyanocobalamin 250 mcg Tablet Sig: Four (4) Tablet PO DAILY (Daily). 11. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal HS (at bedtime) as needed for constipation. 12. Acetaminophen-Codeine 300-30 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. 13. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO QID (4 times a day) as needed. 14. Trazodone 50 mg Tablet Sig: One (1) Tablet PO at bedtime as needed for insomnia. 15. Famotidine 20 mg Tablet Sig: One (1) Tablet PO once a day. 16. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) vial Inhalation Q4H (every 4 hours) as needed for shortness of breath or wheezing. 17. Ipratropium Bromide 0.02 % Solution Sig: One (1) vial Inhalation Q6H (every 6 hours) as needed for shortness of breath or wheezing. 18. Metoprolol Succinate 50 mg Tablet Sustained Release 24 hr Sig: 1.5 Tablet Sustained Release 24 hrs PO DAILY (Daily). 19. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 20. Lisinopril 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 21. Outpatient Lab Work INR on [**2132-10-31**] , results to be sent to Dr. [**Last Name (STitle) **] rehab. 22. Furosemide 20 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). Discharge Disposition: Extended Care Facility: [**Hospital 1263**] Hospital Transitional Care Unit - [**Location (un) 686**] Discharge Diagnosis: Ischemic Coronary Artery Disease s/p Non ST Elevation Myocardial Infarction. Acute Systolic Congestive Heart Failure Atrial Fibrillation Anemia Peripheral Vascular disease s/p PCI x2 Osteomyelitis s/p amputation of left second toe Hypertension Discharge Condition: stable. Discharge Instructions: You were admitted because you had a heart attack and because your body was overloaded with fluid making it difficult for you to breath. We increased your medicines in order to protect your heart. We considered doing a cardiac catheterization to evaluate your cardiac vessels more precisely but because you looked very ill we decided to try and maximize medical therapy first. Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight > 3 lbs. Adhere to 2 gm sodium diet Fluid Restriction: 2 liters Followup Instructions: Cardiology: Provider: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], MD/ Dr. [**First Name8 (NamePattern2) **] [**Name (STitle) **] Phone: [**Telephone/Fax (1) 62**] Date/Time: Tuesday [**11-11**] at 3:20pm. . Vascular Surgery: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 80155**], MD [**Apartment Address(1) 67514**], [**Hospital1 **], [**Numeric Identifier **] Phone: ([**Telephone/Fax (1) 80156**] [**10-30**] at 11:45pm. . Sleep study: Please discuss this with your primary care doctor, Dr. [**Last Name (STitle) **]. . Primary Care: Please make an appt to see Dr. [**Last Name (STitle) **] in your home after you return. Please have your INR drawn on [**2132-10-31**] and results sent to Physician on site at rehabilitation center. . You should have a podiatrist see you at the rehabilitation center [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2908**] MD, [**MD Number(3) 2909**] Completed by:[**2132-10-28**] ICD9 Codes: 2762, 4280, 311, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5988 }
Medical Text: Admission Date: [**2157-9-15**] Discharge Date: [**2157-9-17**] Date of Birth: [**2096-5-22**] Sex: F Service: MEDICINE Allergies: Meperidine / Heparin Agents / Bactrim Attending:[**First Name3 (LF) 330**] Chief Complaint: Fevers Major Surgical or Invasive Procedure: None History of Present Illness: In brief this is a 60 yo female with muliple complications from uterine CA s/p XRT including radiation cystitis/colitis with multiple enteric and vessicular fistulas requiring bowel resections and chronic colostomy and nephrostomy who presents with 2 days of bladder spasm, and fever to 101.5. Most recently admitted in [**Month (only) **] with line infection (MRSA, VRE in urine), treated for 2 weeks with dapto. During that admission she was noted to have EF 20-30% with global hypokinesis. Seen in office yesterday ([**9-13**])with low grade fever, bladder spasm. Urine/blood cultures taken and based on previous cx, vanco/levo started. B/l urine cx from nephrostomys now growing >100,000 GNRs. Tonight she calls and says that she has a fever to 101.8 and also that she had a twinge of chest pain. Referred to ED for eval. She was started on vanco and levo since yesterday. In the ED, initial vital signs were T 101.8, HR 121, BP 123/66, RR16, O2 96%RA. Urine cultures from [**2157-9-13**] came back growing GNR's. Her blood pressure dropped to 83/60 and she received 500cc NS. She received a total of 1.5L NS and her SBP remained in the mid 70's. She refused a central line, but was started on levophed through her central line. She received zosyn 4.5mg IV x 1. Past Medical History: 1. Endometrial/cervical cancer 2. S/p TAH in [**2153**] (due to uterine cancer) 3. Chylous ascites 4. Colectomy, cholecystectomy, and ileostomy ([**11-16**], likely related to radiation bowel damage.) and chronically draining fistula 5. Small bowel removal and ileostomy ([**6-17**]) c/b chronic skin infection 6. S/p ventral hernia w/ repair 7. PE s/p IVC filter 8. Anxiety 9. Nephrostomy tube replacements, multiple 10. Hyperbilirubinemia and hyper alkaline phosphatemia thought to be [**1-14**] TPN induced chronic cholestasis. 11. Anemia of chronic disease 12. VRE 13. Basal cell of face Social History: Lives with her husband and has 2 children. Denies current alcohol use. Had been banking executive prior to development of health issues. Smokes + [**12-14**] PPD for 19 years. Family History: Father 83 (deceased, CVA, MI); Mother (deceased, 92, CVA); Brother (79, esophageal cancer); Sister (60s, colon cancer, lung mass, afib) Physical Exam: Vitals - T99.4, HR94, BP 118/55, RR19, O2 98% Gen - NAD, appears chronically ill, somnolent, but arousable HEENT - PERRL, MMM, no elev JVP Heart - RRR, no murmur appreicates Lungs - clear to [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) **] - soft, mild diffuse discomfort, no rebound/guarding. small amount of discharge from fistula. Extrem - [**1-15**]+ pitting edema bilaterally Neuro - CNII-XII intact, [**4-16**] UE and LE strength Skin - multiple echymosis, no rashes Pertinent Results: [**2157-9-15**] 01:00AM GLUCOSE-94 UREA N-25* CREAT-0.7 SODIUM-138 POTASSIUM-3.2* CHLORIDE-103 TOTAL CO2-26 ANION GAP-12 [**2157-9-15**] 01:00AM WBC-3.3* RBC-2.93* HGB-9.8* HCT-28.9* MCV-99* MCH-33.4* MCHC-33.8 RDW-18.3* [**2157-9-15**] 01:00AM NEUTS-66.6 LYMPHS-23.4 MONOS-8.4 EOS-1.1 BASOS-0.5 [**2157-9-15**] 01:16AM LACTATE-3.1* [**2157-9-15**] 01:30AM URINE BLOOD-LG NITRITE-POS PROTEIN-500 GLUCOSE-NEG KETONE-NEG BILIRUBIN-LG UROBILNGN-12* PH-6.5 LEUK-NEG [**2157-9-15**] 01:30AM URINE RBC-[**11-1**]* WBC-[**11-1**]* BACTERIA-MOD YEAST-NONE EPI-0 [**2157-9-15**] 07:14AM PT-16.5* PTT-37.9* INR(PT)-1.5* [**2157-9-15**] 07:14AM GLUCOSE-107* UREA N-23* CREAT-0.7 SODIUM-138 POTASSIUM-2.9* CHLORIDE-108 TOTAL CO2-25 ANION GAP-8 [**2157-9-15**] 07:14AM CALCIUM-7.3* PHOSPHATE-2.3* MAGNESIUM-1.5* [**2157-9-15**] 07:14AM WBC-3.9* RBC-2.54* HGB-8.3* HCT-24.5* MCV-97 MCH-32.7* MCHC-33.9 RDW-18.4* [**2157-9-15**] 07:30AM LACTATE-2.1* [**2157-9-15**] 11:07AM CORTISOL-19.3 [**2157-9-15**] 11:07AM CORTISOL-24.3* [**2157-9-15**] 03:41PM POTASSIUM-3.6 [**2157-9-15**] 04:04PM LACTATE-1.5 . Micro: Blood culture ([**2157-9-13**], [**2157-9-15**]): No growth to date. Urine ([**2157-9-13**]): Klebsiella pneumoniae, coag positive staph aureus ([**2157-9-15**]): Staph aureus . Imaging: CXR ([**2157-9-15**]): The heart size is moderately enlarged but the precise appreciation of its borders is difficult due to new bilateral moderate pleural effusions accompanied by bibasilar atelectasis. Perihilar haziness has increased in the meantime interval suggesting either volume load or pulmonary edema or combination of both. Central venous line inserted through the left subclavian line terminates at the cavoatrial junction with its tip looped and pointing upward, unchanged since [**2157-8-16**]. Brief Hospital Course: Ms. [**Known lastname 3694**] was admitted with complaints of bladder spasms, fevers and hypotension. There was high concern for sepsis physiology and she was found to have an elevated lactate. The patient was volume resucitated and recieved broad antibiotic therapy with zosyn and daptomycin. Her bp improved and urine cultures grew klebsiella and staph aureus. Her klebsiella was pan sensitive, but because of her history of pan resistent klebsiella we continued to treat with zosyn. Her staph aureus was MRSA and was continued to be treated with daptomycin. She will complete a 10 day course at home. She was discharged home from the ICU. Medications on Admission: Mirtazapine 15 mg Tablet QHS Ativan 0.5 mg Tablet 1-2 Tabs PO Q8hrs Epoetin Alfa 4,000 unit/mL Solution Sig: 20000u qtuesday Loperamide Two Capsule PO QID prn Fludrocortisone 0.1 mg daily Opium Tincture 10 mg/mL Tincture qid Diphenoxylate-Atropine 2.5-0.025 mg q6h Discharge Medications: 1. Piperacillin-Tazobactam-Dextrs 4.5 g/100 mL Piggyback Sig: One (1) dose Intravenous Q8H (every 8 hours) for 7 days. Disp:*21 doses* Refills:*0* 2. Daptomycin 500 mg Recon Soln Sig: Two [**Age over 90 1230**]y (250) mg Intravenous Q24H (every 24 hours) for 7 days. Disp:*1750 mg* Refills:*0* 3. Mirtazapine 15 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 4. Lorazepam 0.5 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed. 5. Epoetin Alfa 4,000 unit/mL Solution Sig: 20,000 units Injection once a week. 6. Fludrocortisone 0.1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. Opium Tincture 10 mg/mL Tincture Sig: One (1) dose PO three times a day. 8. Diphenoxylate-Atropine 2.5-0.025 mg Tablet Sig: One (1) Tablet PO every six (6) hours. Discharge Disposition: Home With Service Facility: [**Location (un) 511**] Home Therapies Discharge Diagnosis: MRSA/Klebsiella Urosepsis Discharge Condition: Stable; normotensive Discharge Instructions: You were admitted to the hospital because of a urinary tract infection and low blood pressue. We are treating your infection with 2 antibiotics. You will need to continue these medications for another 7 days at home. Your new medications: 1. Zosyn - an antibiotic to treat your urinary tract infection 2. Daptomycin - an antibiotic to treat your urinary tract infection Please continue all of your other medications as you were prior to being hospitalized. Please return to the hospital for fevers, chills, worsening pain, difficulty breating. 1. Followup Instructions: -- Please make an appointment to see Dr [**Last Name (STitle) **] in the next 1-2 weeks. ICD9 Codes: 5990, 4254, 2859
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Medical Text: Admission Date: [**2141-5-24**] Discharge Date: [**2141-6-4**] Date of Birth: [**2080-10-2**] Sex: M Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1384**] Chief Complaint: Wound infection Major Surgical or Invasive Procedure: [**2141-5-24**]: - Extensive debridement of complicated wound, including multiple abscesses. - Component separation of the anterior abdominal wall with fascial dissection and reconstruction. - Repair of large incisional hernia with mesh. - Lysis of adhesions [**2141-5-29**] PICC line placement History of Present Illness: 60 y/o male status post liver transplant. Subsequent to his liver transplant, he developed a mycobacterial infection of the skin. Despite aggressive attempts at antibiotics and local debridement, he was not able to clear his mycobacterial infection. After consultation with multiple providers including hernia experts and infectious disease, it was elected to take him back to the operating room to completely clean out his anterior abdominal wound, place a mesh, and close the wound. Past Medical History: PAST MEDICAL HISTORY: - metabolic bone disease - hepatitis C cirrhosis s/p OLT [**2-14**] c/b poor wound healing, as below. - interstitial lung disease - dx 2y ago, no pulmonary follow-up, does not use home inhalers presently. - GERD - chronic pain - abdominal and B LE (neuropathy) - chronic BLE edema - psoriasis - DM2 - dx over past year, on insulin. - h/o B LE burns [**2-7**] trauma in fire. . - denies CVA, CAD, HTN, CKD, PE/DVT, malignancy. . PAST SURGICAL/PROCEDURAL HISTORY [**2138**] RFA of liver lesion [**2132**] lung biopsy [**2131**] Extensive burns&#[**Numeric Identifier 25684**];skin graft surgeries [**2140-2-28**] liver transplant with repair of chronic diaphragmatic hernia. [**2140-3-1**] Exploratory laparotomy, repair of ventral hernia with mesh and liver biopsy. Social History: Currently smoking [**1-7**] ppd, denies etoh, ivdu. History of IVDA and ETOH abuse. He has abstained from both since transplant. Family History: Mother, 85: No known illness Father, dead 76: Liver cancer Twin brother, dead 18: Murdered Brother, 35: No known illness Brother, 46: No known illness Physical Exam: VS: 98.6, 79, 123/65, 24, 98% 5L General: Initially receiving ketamine drip and dilaudid IV for pain management post op Card: Nl S1S2, RRR Lungs: Few crackles bilater bases Abd: Soft, mild distention, initial dressing left on for 5 days to protect initial incision. POst op the incision has remained intact, without erythema or drainage. 1 JP drain with serosanguinous fluid Extr: No edema, venodynes in place Pertinent Results: On Admission: [**2141-5-25**] WBC-23.0*# RBC-3.47* Hgb-10.9* Hct-33.2* MCV-96 MCH-31.4 MCHC-32.8 RDW-15.4 Plt Ct-127*# PT-15.3* PTT-33.0 INR(PT)-1.3* Glucose-197* UreaN-24* Creat-1.0 Na-135 K-5.5* Cl-106 HCO3-24 AnGap-11 ALT-71* AST-78* AlkPhos-127 TotBili-1.7* Albumin-2.8* Calcium-7.6* Phos-2.7 Mg-1.8 At Discharge: [**2141-6-2**] WBC-7.1 RBC-2.96* Hgb-9.2* Hct-28.6* MCV-97 MCH-30.9 MCHC-32.0 RDW-16.5* Plt Ct-123* Glucose-146* UreaN-52* Creat-1.4* Na-130* K-5.9* Cl-101 HCO3-24 AnGap-11 ALT-50* AST-71* AlkPhos-293* TotBili-1.6* Calcium-7.8* Phos-4.5 Mg-1.5* tacroFK-5.8 Brief Hospital Course: 60 y/o male with complicated post liver transplant surgery course. Since last year his course has been complicated by recurrent hernias requiring debridements and infection with Mycobacterium abscesses. (MYCOBACTERIUM ABSCESSUS/MASSILIENSE/BOLLETII GROUP) He was taken to the OR with Dr [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 816**] for Extensive debridement of complicated wound, including multiple abscesses, Component separation of the anterior abdominal wall with fascial dissection and reconstruction, Repair of large incisional hernia with mesh, Lysis of adhesions times 1 hour and Repair of wound more than 30 cm. This was an ext4ensive surgery, which the patient tolerated well. Due to past hsitory of narcotic tolerance, the patient was initially managed on a ketamine drip in addition to dilaudid and his baseline methadone. Over the course of the hospitalization the regimen now includes Home Oxycontin and methadone, breakthrough oxycodone and IV Morphine for breakthrough also. The initial dressing was taken down at 5 days per Dr [**Last Name (STitle) 15283**] instructions, and the incision has remianed intact, with no erythema or drainage noted. The small wound from the previous attempt at debridement has been intact as well. Per ID recommendations, who were following prior to this surgery, initial antibiotics were amikacin, tigecycline and vancomycin. After further consideration, the Vanco was stopped and azithromycin was added. ID continued to follow during this admission, and when the creatinine was noted to be increasing, the amikacin was stopped and Linezolid was added. The patient received 4 days of lasix in an attempt to diurese. He remains about 5 Liters above his admission weight, no further lasix has been attempted, creatinine has leveled at 1.4 (baseline around 1) On POD 8 he had a large amount of ascitic appearing fluid drain Discharge Medications: 1. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) ml Injection TID (3 times a day). 2. Nicotine 21 mg/24 hr Patch 24 hr Sig: One (1) Patch 24 hr Transdermal DAILY (Daily). 3. Methadone 10 mg Tablet Sig: Eleven (11) Tablet PO DAILY (Daily): Home dose. 4. Insulin Regular Human 100 unit/mL Solution Sig: per sliding scale Injection ASDIR (AS DIRECTED). 5. Sulfamethoxazole-Trimethoprim 400-80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Gabapentin 300 mg Capsule Sig: One (1) Capsule PO Q8H (every 8 hours). 7. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) neb Inhalation Q6H (every 6 hours). 8. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 9. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal Once daily PRN constipation as needed for distention. 10. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: Two (2) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 11. Oxycodone 5 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. 12. Tacrolimus 1 mg Capsule Sig: One (1) Capsule PO Q12H (every 12 hours). 13. Oxycodone 40 mg Tablet Sustained Release 12 hr Sig: One (1) Tablet Sustained Release 12 hr PO Q12H (every 12 hours): This is patients home dose. 14. Tigecycline 50 mg Recon Soln Sig: Fifty (50) mg Intravenous Q12H (every 12 hours). 15. Azithromycin 500 mg Recon Soln Sig: Five Hundred (500) mg Intravenous Q24H (every 24 hours). 16. Heparin, Porcine (PF) 10 unit/mL Syringe Sig: Two (2) ML Intravenous PRN (as needed) as needed for line flush. 17. Sodium Chloride 0.9 % 0.9 % Parenteral Solution Sig: Ten (10) ML Intravenous PRN (as needed) as needed for line flush. 18. Morphine Sulfate 1-4 mg IV Q4H:PRN breakthrough pain 19. Linezolid 600 mg/300 mL Parenteral Solution Sig: Six Hundred (600) mg Intravenous Q12H (every 12 hours). 20. Tacrolimus 0.5 mg Capsule Sig: Three (3) Capsule PO Q12H (every 12 hours): needs tacrolimus levels q wk. Disp:*180 Capsule(s)* Refills:*2* Discharge Disposition: Extended Care Facility: [**Hospital **] Hospital - [**Hospital1 8**] Discharge Diagnosis: Complex abdominal wound with multiple abscesses, necrotizing infection, and large hernia Narcotic tolerance Liver transplant [**2-/2140**] Discharge Condition: Stable/Fair A+Ox3 Poor ambulatory state, needs extensive rehabilitation Discharge Instructions: please call the transplant clinic at [**Telephone/Fax (1) 673**] for fever, chills, nausea, vomiting, increased abdominal pain, increased drainage from the JP bulb or area around the JP drain insertion. There is a pouch covering the JP drain insertion site due to some leaking. Drain and record JP drain output twice daily and more often as needed. Please call the transplant clinic if the drainage increases rgeatly, develops a foul odor or becomes bloody in appearance. No heavy lifting Continue labwork q Monday/Thursday with results faxed to transplant clinic. CBC, Chem 10, AST, ALT, Alk Phos, T bili, Trough Prograf Continue antibiotics via PICC line Wear abdominal binder at all times Followup Instructions: [**First Name11 (Name Pattern1) 819**] [**Last Name (NamePattern4) 820**], MD Phone:[**Telephone/Fax (1) 673**] Date/Time:[**2141-6-8**] 10:40 [**Name6 (MD) **] [**Name8 (MD) **], MD Phone:[**Telephone/Fax (1) 673**] Date/Time:[**2141-6-12**] 8:00 [**First Name11 (Name Pattern1) 819**] [**Last Name (NamePattern4) 820**], MD Phone:[**Telephone/Fax (1) 673**] Date/Time:[**2141-6-15**] 8:00 ICD9 Codes: 5849, 496, 3051
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Medical Text: Admission Date: [**2121-11-21**] Discharge Date: [**2122-1-13**] Date of Birth: [**2121-11-21**] Sex: M Service: NB HISTORY OF PRESENT ILLNESS: [**Known lastname 916**] [**Known lastname 467**] is a former 1.36 kilogram product of a 29-1/7 week gestation pregnancy born to a 33 year old G-1, P-0 woman. Prenatal screens - Blood type A positive, antibody negative, Rubella immune, RPR nonreactive, hepatitis B surface antigen negative, group beta Strep status unknown. The pregnancy was uncomplicated until preterm labor on the day of delivery leading to a spontaneous vaginal delivery without anesthesia. There was no intrapartum fever noted. Rupture of membranes occurred at the time of delivery yielding clear fluid. There was intrapartum antibacterial prophylaxis prior to delivery. The infant emerged vigorous at delivery. He required drying, bulb suction and free flow O2. Apgar's were 7 at one minute and 8 at five minutes. He was transported to the Neonatal Intensive Care Unit for management of prematurity. PHYSICAL EXAMINATION: Weight 1.36 kilograms, length 40.5 cm, both 50th percentile. Head circumference 26.5 cm approximately 25th percentile. General - Nondysmorphic preterm male in moderate respiratory distress. HEENT - Palate intact, neck and mouth normal, significant occipital caput without other cranial abnormality, moderate nasal flaring, positive red reflex bilaterally. Chest - Mild to moderate intercostal retractions, good breath sounds bilaterally, few crackles. Cardiovascular - Well perfused, regular rate and rhythm, femoral pulses normal, normal S1 and S2, no murmur. Abdomen - Soft, non-distended, no organomegaly, no masses, bowel sounds active. Anus - Patent. GU - Normal male genitalia, testes palpable bilaterally. Integumentary - Normal. Musculoskeletal - Normal spine, limbs, hips and clavicles. Neurologic - Active, alert and responsive to stimuli. Tone appropriate for gestational age and symmetric, moving all extremities symmetrically, weak suck, gag intact, symmetric grasp. HOSPITAL COURSE: 1. Respiratory. [**Known lastname 916**] was initially placed on continuous positive airway pressure. His respiratory distress persisted and he was electively intubated and given a dose of Surfactin. He was later extubated back to continuous positive airway pressure on day of life one and then weaned to room air. He continued on room air for the rest of his Neonatal Intensive Care Unit admission. He did require treatment for apnea of prematurity with caffeine. The caffeine was continued through day of life number 25. His last episode of spontaneous apnea occurred on [**2121-12-24**]. At the time of discharge, he is breathing comfortably 40- 50 times per minute. 2. Cardiovascular. [**Known lastname 916**] has maintained normal heart rates and blood pressures. An intermittent soft murmur has been noted through the last two weeks of admission. 3. Fluids, electrolytes and nutrition. [**Known lastname 916**] was initially NPO and maintained on intravenous fluids. Enteral feeds were started on day of life number two and gradually advanced to full volume. His maximum caloric intake was 28 calories per ounce with additional protein powder. At the time of discharge he is taking expressed breast milk fortified to 26 calories with Similac powder and 2 calories as corn oil or Similac formula 24 calories with an additional 2 calories of corn oil. Weight on the day of discharge is 2.83 kilograms with a head circumference of 34.5 cm and a length of 47 cm. Serum electrolytes were checked in the first week of life and were within normal limits. 4. Infectious disease. Due to the unknown group beta Strep status of the mother and the preterm labor, [**Name (NI) 916**] was evaluated for sepsis at the time of admission to the Neonatal Intensive Care Unit. A white blood cell count was 7,700 with a normal differential. A blood culture was obtained prior to starting intravenous antibiotics. The blood culture was no growth at 48 hours and the antibiotics were discontinued. On day of life number six with some episodes of hypothermia, he was again evaluated for sepsis. A blood culture was obtained and vancomycin and gentamicin were started. The blood culture was no growth at 48 hours and the antibiotics were discontinued. There have been no other infectious disease issues through the remainder of the Intensive Care Unit admission. 5. Hematological. Hematocrit at birth was 48.9 percent. [**Known lastname 916**] did not receive any transfusions of blood products. The most recent hematocrit on [**2122-1-12**] is 26.5 with reticulocyte count of 6.8. 6. Gastrointestinal. [**Known lastname 916**] required treatment for unconjugated hyperbilirubinemia with phototherapy. Peaks in the bilirubin occurred on day of life two to a total of 8.4/0.4 mg/dl direct. He received phototherapy for ten days. Rebound bilirubin 48 hours after stopping the phototherapy was a total of 4.8/0.2 mg/dl direct. 7. Neurology. [**Known lastname 916**] has maintained a normal neurological exam during admission. He has had two normal head ultrasounds on [**11-28**] and [**2122-12-18**]. 8. Sensory. Audiology - Hearing screening was performed with automated auditory brain stem responses. [**Known lastname 916**] passed in both ears on [**2122-1-12**]. Ophthalmology - [**Known lastname **] eyes were most recently examined for retinopathy of prematurity on [**2122-1-5**]. At that time his retina's were found to be mature. Recommended follow up with pediatric ophthalmology at nine months. 9. Psychosocial. Of note, his father is confined to a wheelchair secondary to hemiplegia from a fall off from a ladder. The father is known MRSA colonized. Both parents have been very involved in [**Known lastname **] care during admission. [**Hospital1 **] social work has been involved with the family. The contact social worker is [**Name (NI) 4457**] [**Name (NI) 36244**]. She can be reached at [**Telephone/Fax (1) 8717**]. CONDITION ON DISCHARGE: Good. DISCHARGE DISPOSITION: Home with the parents. The primary pediatrician is Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], [**Hospital **] Pediatrics, [**Street Address(2) 56673**], [**PO Box 60079**], [**Location (un) **], [**Numeric Identifier 58561**], phone number [**Telephone/Fax (1) 40204**] FAX ([**Telephone/Fax (1) 60080**]. CARE AND RECOMMENDATIONS: 1. Feeding - Breast milk fortified to 26 calories per ounce, 4 calories by Similac powder, 2 calories by corn oil or Similac 26 with 2 calories corn oil. 2. Medications - Ferrous sulfate 0.3 ml PO once daily. 3. Car seat position screening was performed. [**Known lastname 916**] was observed in his car seat for 90 minutes without any episodes of oxygen desaturation or bradycardia. 4. State newborn screens were sent on [**11-24**] and [**2121-12-4**] with all results within normal limits. A third screen was sent on [**2122-1-2**] with no notification of abnormal results to date. 5. Immunizations received - Hepatitis B vaccine was administered on [**2121-12-22**]. Synagis was administered on [**2122-1-5**]. 6. Immunizations recommended: Synagis RSV prophylaxis should be considered from [**Month (only) 359**] through [**Month (only) 547**] for infants who meet any of the following three criteria: First born at less than 32 weeks; second is born between 32 and 35 weeks with two of the following: Day care during RSV season, a smoker in the household, neuromuscular disease, airway abnormalities or school age siblings; or thirdly with chronic lung disease. Influenza immunization is recommended annually in the fall for all infants once they reach six months of age. Before this age and for the first 24 months of the child's life, immunization against influenza is recommended for household contacts and out-of-home care-givers. 1. Follow-up appointments recommended: Appointment with Dr. [**Last Name (STitle) **], primary pediatrician, within three days of discharge and pediatric ophthalmology at nine months of age. DISCHARGE DIAGNOSES: 1. Prematurity at 29-1/7 weeks' gestation. 2. Respiratory distress syndrome. 3. Suspicion for sepsis ruled out. 4. Apnea of prematurity. 5. Unconjugated hyperbilirubinemia. 6. Status post circumcision on [**2122-1-6**]. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 48738**], MD [**MD Number(2) 55708**] Dictated By:[**Last Name (Titles) **] MEDQUIST36 D: [**2122-1-12**] 04:13:05 T: [**2122-1-12**] 06:48:59 Job#: [**Job Number 60081**] ICD9 Codes: 769, 7742, V290, V053
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Medical Text: Admission Date: [**2172-9-28**] Discharge Date: [**2172-10-28**] Date of Birth: [**2131-10-1**] Sex: F Service: NEUROSURGERY Allergies: Sulfa (Sulfonamides) Attending:[**First Name3 (LF) 78**] Chief Complaint: CC: loss of consciousness. Major Surgical or Invasive Procedure: [**9-29**]: Left crani, clipping M1 aneurysm [**10-1**]: External ventricular drain placement [**10-2**]: emergent Lt hemicrani [**10-5**], [**10-7**], [**10-8**]: cerebral angiograms [**10-19**]: VP shunt placement tracheostomy PEG History of Present Illness: HPI: Ms. [**Known lastname **] is a 40 y/o female in previously good health who did not present with predictive symptoms before falling in her bathroom today. The fall was unwitnessed, and the family found her unconscious. She was taken to an OSH where a head CT revealed apparent subarachnoid hemorrhage with blood noted in both sylvian fissures, interhemispheric fissure, and prepontine cisterns. She was transferred to [**Hospital1 18**] ED for higher level of care, and was given propofol, etomidate, succinyl choline, and other sedatives. She was also noted to have possible aspiration. At [**Hospital1 18**] ED, Ct angio showed 8 x 13mm focal region of hemmorhage in high left frontal lobe, also diffuse SAH in sylvian fissures and basilar cisterns (intraventricular bleed noted as well in occiptal horns b/l, 3rd and 4th ventricle). However, no discrete aneursym was appreciated. Past Medical History: GI bleed Social History: Social Hx: lives at home with family Family History: first degree relative died of brain hemorrhage per mother Physical Exam: ***ON ADMISSION*** PHYSICAL EXAM: Gen: WD/WN, comfortable, NAD. HEENT: Pupils: [**3-29**] bilaterally Neck: Supple. Lungs: CTA bilaterally. Cardiac: RRR. S1/S2. Abd: Soft, NT, BS+ Extrem: Warm and well-perfused. Neuro: Mental status: Comatose and intubated. Orientation: none. Recall: none. Language: NO Speech Cranial Nerves: I: Not tested II: Pupils equally round and reactive to light, to mm bilaterally. Visual fields are full to confrontation. Other cranial nerves could not be fully assessed. Motor: Normal bulk and tone bilaterally. No abnormal movements, tremors. Strength could not be adequately assessed. She localizes bilateral upper extremities and withdraws both lower extremities Sensation: could not be assessed. Toes downgoing bilaterally Eyes open to noxious stimuli positive corneals, gag, and cough reflexes ***ON DISCHARGE*** Pertinent Results: CT: Ct angio showed 8 x 13mm focal region of hemmorhage in high left frontal lobe, also diffuse SAH in sylvian fissures and basilar cisterns (intraventricular bleed noted as well in occiptal horns b/l, 3rd and 4th ventricle). However, no discrete aneursym was appreciated. [**2172-9-28**] 04:20PM UREA N-10 CREAT-0.7 [**2172-9-28**] 04:20PM ASA-NEG ETHANOL-NEG ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**2172-9-28**] 04:20PM WBC-36.5* RBC-4.30 HGB-12.7 HCT-37.8 MCV-88 MCH-29.5 MCHC-33.5 RDW-12.9 [**2172-9-28**] 04:20PM NEUTS-91.2* BANDS-0 LYMPHS-7.0* MONOS-1.6* EOS-0.1 BASOS-0.1 [**2172-9-28**] 04:20PM HYPOCHROM-NORMAL ANISOCYT-NORMAL POIKILOCY-NORMAL MACROCYT-NORMAL MICROCYT-NORMAL POLYCHROM-NORMAL [**2172-9-28**] 04:20PM PLT SMR-NORMAL PLT COUNT-304 [**2172-9-28**] 04:20PM PT-13.7* PTT-26.7 INR(PT)-1.2* Brief Hospital Course: This 40 yo F was admitted after being found down and was found to have a SAH. Subsequent studies revealed that she had an M1 aneurysm which she had clipped via an open craniectomy on [**2172-9-29**] with concurrent placement of an EVD. Her neurological exam remained limited, as she did not respond to verbal or tactile stimuli. Her ICP's remained elevated, and she was started on hypertonic saline. Additionally she was placed in a pentobarb coma. On [**10-2**], her serum sodium was elevated to 158 and ICP was still elevated. Her pupils were felt to be somewhat unequal, so she was taken for emergent decompressive craniectomy. On [**10-4**], she experienced fever to 104 F, and at that time, dilantin was switched to keppra, and she was pan-cultured. Sputum was shown to grow MSSA, and she was started on Nafcillin and Zosyn. She underwent trials of ventricular catheter clamping on [**10-6**] and [**10-7**] but ICPs rose requiring unclamping. On [**10-8**] she underwent angiogram which showed increasing size of aneurysm requiring stent placement. Repeat angiogram [**10-9**] showed no spasm but new small L MCA stroke. On [**10-12**] CSF showed high wbc and she was started on antibiotics. She had trials of EVD clamping which she did tolerate in terms of ICPs but CT showed evidence of hydrocephalus and it was opened. She was readied for OR on [**10-19**] for VP shunt placement but had episode of elevated ICP due to EVD line obstruction, subsequent CT showed new bleed into L frontal as well as R sdh. She was brought to angio which showed clot in aneurysm. Her exam continued to be poor with extension of upper extremities and withdrawal of lowers.Dr. [**First Name (STitle) **] had ongoing discussions with family about grave prognosis. On [**10-23**] with family present, it was decided to make the patient comfort measures only. On [**10-26**] Palliative care consulted for assistance with transfer to hospice. Medications on Admission: none Discharge Medications: 1. Morphine Concentrate 5 mg/0.25 mL Solution Sig: One (1) PO Q3H (every 3 hours). 2. Morphine Concentrate 5 mg/0.25 mL Solution Sig: [**1-29**] PO Q1H (every hour) as needed. 3. Lorazepam 2 mg/mL Concentrate Sig: 0.5 - 1 PO Q1H PRN () as needed for agitation. 4. Scopolamine Base 1.5 mg Patch 72 hr Sig: [**1-30**] Transdermal TID (3 times a day) as needed. 5. Acetaminophen 650 mg Suppository Sig: One (1) Rectal Q4H (every 4 hours) as needed. Discharge Disposition: Extended Care Facility: [**Hospital 5503**] [**Hospital **] Hospital Discharge Diagnosis: SAH secondary to aneurysm Large Lt MCA Infarct Discharge Condition: poor neurological exam Discharge Instructions: please titrate medication to comfort Followup Instructions: none Completed by:[**2172-10-28**] ICD9 Codes: 5070, 2760, 496
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Medical Text: Admission Date: [**2148-12-24**] Discharge Date: [**2149-1-6**] Date of Birth: [**2100-1-9**] Sex: M Service: [**Hospital1 212**] HISTORY OF PRESENT ILLNESS: The patient is a 48 year-old man with a past medical history not completely clear, but include apparent developmental delay, living at home with parents who presents with a two to three week history of weakness, mental status changes, decreased po intake, limited ambulation per father who finally called EMS. The patient was found by EMS lying on the couch, surrounded by feces and apparently urinating into bottles. The home environment was reportedly poor with a strong smell of urine and feces. Per father the son was "normal" two to three weeks ago and alert and oriented times three. He has no apparent history of head trauma. He has no recent history of nausea, vomiting, diarrhea, chest pain, or shortness of breath. The patient was initially sent to [**Location (un) 745**] [**Hospital 18896**] Hospital and then transferred to [**Hospital1 69**] for further care. At [**Location (un) 745**] [**Hospital 18896**] Hospital his vital signs were 110/66, 104, 18, 97% on room air, potassium 3.2, sodium 147, BUN 34, creatinine 1.6, white blood cell count 13.2, and a negative urine and serum tox screen. PAST MEDICAL HISTORY: 1. Developmental delay. 2. Rheumatoid arthritis. MEDICATIONS ON ADMISSION: None. ALLERGIES: Aspirin. SOCIAL HISTORY: The patient lives with his parents. He has a 77 year-old mother who is wheel chair bound. PHYSICAL EXAMINATION ON ADMISSION: Temperature 98.5. Heart rate 110. Blood pressure 119/65. Oxygen saturation 98% on room air. General, disheveled, no acute distress, somewhat conversant. HEENT poor hygiene, forehead excoriations, no stiffness of the neck. Lungs clear to auscultation bilaterally. No adventitious sounds. Cardiovascular tachycardic. Regular rate and rhythm. Normal S1 and S2. No murmurs. Abdomen soft, nondistended, slight diffuse tenderness, no rebound or guarding. Extremities right hip decubitus ulcer (stage one) no clubbing, cyanosis or edema. Skin dry, multiple scattered excoriations. Neurological alert and oriented to person only. Cranial nerves II through XII intact. LABORATORIES ON ADMISSION: White blood cell count 15.3, hematocrit 39.6, platelets 547, sodium 154, potassium 3.8, chloride 102, total CO2 22, BUN 38, creatinine 1.5, glucose 96, calcium 9.1, magnesium 3.7, phosphate 2.3. Urinalysis yellow, hazy, positive nitrite, 6 to 10 red blood cells, 6 to 10 white blood cells, many bacteria. Chest x-ray negative for pneumonia, limited secondary to rotation. Head CT negative for bleeding or mass. Electrocardiogram sinus tachycardia, normal axis, normal intervals, ST depressions in V2 through V4. HOSPITAL COURSE: 1. Neurological/psychiatric: The patient was initially admitted to the Medical Intensive Care Unit for presumed urosepsis. Initially the patient was very poorly responsive to verbal and other types of stimulation. A workup for his ulceration and mental status initially included the head CT and a lumbar puncture, which did not reveal abnormalities that would account for a change in mental status. On [**2148-12-24**] the patient was noted to have a sodium of 159. This value was corrected with D5 water infusion, but the patient's apparent encephalopathy persisted even after the sodium was corrected. After transfer to the floor on [**2148-12-25**] the patient had additional studies to workup his delirium, including two MRIs of the head (limited by motion artifact), an electroencephalogram (revealing evidence of metabolic encephalopathy, but no epileptiform activity), and neurology and psychiatry consultations. At the time of this dictation ([**2149-1-5**]) the patient has continued delirium, however, with improvement in his ability to interact and answer questions. It is unclear what the patient's true baseline is. From the father's history the patient is extremely functional and attended [**University/College **]. However, it also appears that the patient has had limited social interactions throughout his whole life not developing a close relationship with his father and per his father never having any friends of either sex. The patient has also been noted by family members to exhibit obsessive compulsive behavior, notably pertaining to obsessions about cleanliness. The patient's current delirium precludes further evaluation of any possible baseline condition the patient might have at this time. 2. Infectious disease: As above, the patient had evidence of a urinary tract infection on his admission urinalysis. His urine culture did not grow any organism. Blood cultures likewise did not grow any organisms. The patient completed a seven day course of Ceftriaxone for this urinary tract infection. At the time of this dictation, the patient has had an increasing white blood cell count to a current value of 19.2 on [**1-5**]. The differential diagnosis for this is felt to include C-difficile colitis, pneumonia, and noninfectious etiology. The patient was started on Levofloxacin for possible pneumonia on this date and a stool study for C-difficile toxin is pending. 3. Hematology: The patient has had anemia of unclear etiology throughout this admission. His initial blood smear demonstrated substantial variation in red cell size, as well as ovalocytes, burr cells, tear drop cells, and bite cells. He has received a total of three units of blood ([**12-26**], [**12-28**] and [**1-2**]) to maintain his hematocrit over 25. He was noted to have a folate deficiency and was placed on folic acid since [**2148-12-30**]. A hemolysis workup (LDH, haptoglobin and bilirubin) was negative and the patient has passed guaiac negative stools. At the time of this dictation a hematology consult is pending for further workup of the patient's anemia. 4. Nutrition: The patient was noted to have approximately two weeks of decreased to absent po intake prior to his admission. In the early portion of this admission when the patient was relatively unresponsive to outside stimuli, he was fed via nasogastric tube and given fluids via intravenous. The patient self discontinued his nasogastric tube and was evaluated by the Swallowing Service and felt to be capable of tolerating a diet of soft solids and thin liquids. As his mental status improved the patient was eating more and more. His diet was supplemented with multivitamin, folate and thiamine. 5. Pulmonary: Prior to admission in the Emergency Department attempts were made to place a right internal jugular venous catheter. This was complicated by a tension pneumothorax for which the patient received needle decompression followed by placement of a chest tube. The patient's pneumothorax resolved and the chest tube was discontinued several days later. Thereafter the patient did not have any problems with oxygenation or ventilation. 6. Electrolytes: As aforementioned the patient had substantial hypernatremia in the initial portion of his hospital stay. This was most likely secondary to dehydration relating to the patient's lack of food and water intake prior to admission. The patient's sodium was corrected via administration of free water. His sodium value remained improved once his po intake improved. 7. Rheum: The patient is noted to have a history of juvenile rheumatoid arthritis. Per his father the patient's baseline is being able to ambulate with the aid of canes. However, prior to admission the patient did not ambulate for four to six weeks, remaining on the couch. At the time of this dictation the patient has remained in bed and has not ambulated. He was noted to have a mildly elevated erythrocyte sedimentation rate at 57. It is felt that further evaluation of the patient's rheumatic disease is appropriate as his mental status improves and his functional status improves. The above is a dictation of the [**Hospital 228**] hospital course through [**2149-1-5**]. Please refer to the discharge addendum for the remainder of the hospital course, as well as discharge information. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 1211**], M.D. [**MD Number(1) 1212**] Dictated By:[**Last Name (NamePattern1) 7561**] MEDQUIST36 D: [**2148-1-6**] 05:23 T: [**2149-1-8**] 10:21 JOB#: [**Job Number 18897**] ICD9 Codes: 5990, 2765, 2760, 5070
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Medical Text: Admission Date: [**2113-5-29**] Discharge Date: [**2113-6-2**] Date of Birth: [**2036-1-4**] Sex: F Service: SURGERY Allergies: Aspirin Attending:[**First Name3 (LF) 695**] Chief Complaint: Subcapsular liver hematoma Major Surgical or Invasive Procedure: None History of Present Illness: 77 year old female two week ago started complaining of abdominal pain, she went to her PCP work up found to have with liver mass 10 cm in size, she was scheduled to see hepatology service on [**2113-6-9**]. However, yesterday at 4pm had acute onset of RUQ pain, the pain was constant, radiating to the back, she went to OSH found to have subcapsular hematoma. then the patient was transferred to [**Hospital1 18**] for further management. The patient denies trauma, no fever, chills, N/V, no chest pain, no shortness of breath. no melena, no hematemesis, no jaundice, the review of system was unremarkable Past Medical History: MI [**2100**] CVA [**2108**] fully recovered DT x 2 last one [**2111**] for which was admitted to the ICU HTN, High cholesterol Osteoarthritis Vit D deficiency PSH: Appendectomy Angioplasty [**2108**] on Plavix no stent per patient son and daughter [**Name (NI) 86228**] removal R eye R CEA [**2108**] complicated by stroke Social History: Smoke: 2 PKT a day 56pkts year history Drink: Glass of wine daily last drink 2-3 days ago Lives with husband Family History: Noncontributory Physical Exam: VS: T 97.2 F P 74 BP 132/64 RR 20 Sat 98 % RA Gen: NAD, A & O x3 C: RRR R: CTAB GI: BS +, Soft, slightly tender RUQ, NR, NG Rectal exam: Spincter normotonic, no hemorrhoid, no fissure, no fistula Pertinent Results: On Admission: [**2113-5-28**] WBC-8.5 RBC-3.67* Hgb-11.4* Hct-34.1* MCV-93 MCH-31.0 MCHC-33.3 RDW-12.2 Plt Ct-379 PT-11.1 PTT-21.5* INR(PT)-0.9 Glucose-116* UreaN-22* Creat-0.9 Na-140 K-4.3 Cl-106 HCO3-24 AnGap-14 ALT-35 AST-35 LD(LDH)-169 AlkPhos-226* TotBili-0.7 Albumin-3.3* Calcium-8.7 Phos-4.2 Mg-2.1 HBsAg-NEGATIVE HBcAb-NEGATIVE HCV Ab-NEGATIVE CEA-6.8* AFP-3.4 CA125-38* At Discharge: [**2113-6-2**] WBC-6.7 RBC-3.48* Hgb-10.9* Hct-32.6* MCV-94 MCH-31.3 MCHC-33.4 RDW-13.1 Plt Ct-284 Glucose-82 UreaN-11 Creat-0.5 Na-143 K-3.1* Cl-109* HCO3-26 AnGap-11 ALT-39 AST-37 AlkPhos-174* TotBili-1.5 Brief Hospital Course: 77 y/o female admitted with abdominal pain. CT of abdomen on admission showed: - Large heterogeneously enhancing mass encompassing almost the entire right lobe of the liver and extending into the main, right, and left portal veins with cavernous transformation. Perihepatic blood could represent a component of subcapsular vs free hemorrhage. There was no evidence of active extravasation. There was also some fluid in the pelvis consistent with a bleed. For the first two days the Hct was monitored q 6 hours and there was no evidence of further bleeding. Her vital signs remained stable and she was afebrile. It was determined that there were not surgical issues at this time. An oncology consult was obtained based upon the CT findings. Assessment and recommendations include: "large right lobe hepatic mass. While this is likely a primary hepatic cancer, it is also possible that this represents a metastasis from somewhere else... A colon primary seems unlikely based on her history and the fact that she has a normal MCV." Dr [**Last Name (STitle) **] recommended waiting at least two weeks to obtain a liver biopsy to allow the liver to heal following the hemorrhage She will be followed up in the oncology clinic for liver biopsy and then discussion of further treatment based on the biopsy results. She was evaluated by physical therapy while in house and was deemed to require a skilled nursing facility for monitoring, (fall risk) and for around the clock care. Medications on Admission: Plavix 75 daily Metoprolol unknown dose Simvastatin 40 ' Lidoderm 5 % 700 mg/patch TP' Alendronate 70mg ' Seroquel 25 " Allergy: ASA Discharge Medications: 1. Quetiapine 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 2. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Hydromorphone 2 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for pain. Disp:*10 Tablet(s)* Refills:*0* 4. Thiamine 100 mg IV DAILY 5. FoLIC Acid 1 mg IV Q24H Discharge Disposition: Extended Care Facility: [**Location (un) 582**] Of [**Location (un) 5176**] Discharge Diagnosis: Liver mass with liver hematoma ETOH abuse Confusion Discharge Condition: Mental Status: Confused - sometimes.Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Level of Consciousness: Alert and interactive. Discharge Instructions: 1) regular diet 2) activity as tolerated 3) you may shower or bathe 4) [**Name8 (MD) **] MD or come to emergency department if you experience dizziness, bright red or dark red blood per rectum, bloody vomit, inability to tolerate liquids, diarrhea/vomiting. Hold Plavix (angioplasty no stent [**2108**]) Followup Instructions: Oncology: Dr [**Last Name (STitle) **] Phone ([**2108**], Date:Time [**6-14**], 2:30. [**Hospital Ward Name 23**] Building, [**Location (un) 24**]. Evaluate and plan for biopsy which should be 2 weeks out from hospitalization [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 707**] MD, [**MD Number(3) 709**] Completed by:[**2113-6-2**] ICD9 Codes: 2851, 3051, 2720, 4019, 412
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Medical Text: Admission Date: [**2197-3-31**] Discharge Date: [**2197-4-5**] Date of Birth: [**2135-1-7**] Sex: M Service: SURGERY Allergies: Demerol / Reglan / Ritalin Attending:[**First Name3 (LF) 1234**] Chief Complaint: Left leg pain, swelling Major Surgical or Invasive Procedure: Procedure [**2197-3-31**]: s/p aborted LLE venous thrombectomy 1. Ultrasound-guided puncture of left posterior tibial vein. 2. Ultrasound-guided puncture of left popliteal vein. 3. Ultrasound-guided puncture of left femoral vein of the thigh. 4. Ultrasound-guided puncture of left common femoral vein. History of Present Illness: The patient is a 62-year-old male with a longstanding history of left lower extremity deep venous thrombosis, with originally identified thrombus approximately 20 years ago complicated by pulmonary embolism and treatment with IVC filter placement. The patient noted increasing swelling at the left lower extremity approximately 3 weeks prior to original presentation and was seen at an outside facility, where CT scan demonstrated significant thrombus along the length of the left lower extremity with evidence of calcification of the pre-existing thrombus along the length of the leg, extending into the inferior vena cava up to the level of the IVC filter. Past Medical History: 1. Barrett esophagitis; Esophageal CA, status post esophagogastrectomy in [**2188-11-16**] ([**Doctor Last Name **]) c/b recurrent post op bleed for esophagitis. Nl sig [**6-19**], Nl colonoscopy, SBFT [**3-19**]. 2. DMII diagnosed in [**2178**]. 3. Deep venous thrombosis; s/p provoked DVT and unprovoked pulmonary embolism. Hypercoagulation work-up negative. IVC filter placed perioperatively for esophagectomy. 4. Bipolar disorder. Depression 5. Sleep apnea (not on CPAP since surgery, followed by Dr. [**Last Name (STitle) **]. [**Doctor Last Name **]). 6. Gastroesophageal reflux disease. 7. Status post cholecystectomy. 8. Asthma (Last Sx in ??????02, moderate reduced FEV1, FVC, mild restrictive disease). 9. Venous insufficiency. 10. Hypercholesterolemia. 11. History of perirectal abscess 12. GI bleeding [**1-18**] esophagitis 14. Dumping syndrome c/b hypoglycemia [**5-20**] Past surgical history: 1) Esophagogastrectomy in [**11/2188**] for esophageal cancer. Social History: Tobacco: smokes 1 ppd, Alcohol: denies any alcohol use Lives with fiance Family History: Father died pancreatic Ca at 85, no history of hypercoagulability or other malignancies Physical Exam: PHYSICAL EXAM Vital Signs: Temp: 96.4 RR: 18 Pulse: 49 BP: 129/52 Neuro/Psych: Oriented x3, Affect Normal, NAD. Neck: No masses, Trachea midline, Thyroid normal size, non-tender, no masses or nodules, No right carotid bruit, No left carotid bruit, abnormal: R IJ CVL. Nodes: No clavicular/cervical adenopathy, No inguinal adenopathy. Skin: No atypical lesions. Heart: Regular rate and rhythm. Lungs: Clear, Normal respiratory effort. Gastrointestinal: Non distended, No masses, Guarding or rebound, No hepatosplenomegally, No hernia, No AAA. Rectal: Not Examined. Extremities: No popiteal aneurysm, No RLE edema, No varicosities, abnormal: LLE swollen, erythematous, diffusely tender. Pulse Exam (P=Palpation, D=Dopplerable, N=None) RLE Femoral: P. Popiteal: P. DP: P. PT: P. LLE Femoral: P. Popiteal: P. DP: D. PT: D. Pertinent Results: [**2197-3-31**] 10:45PM BLOOD WBC-5.4 RBC-3.18* Hgb-9.5* Hct-27.3* MCV-86 MCH-29.7 MCHC-34.7 RDW-15.1 Plt Ct-226 [**2197-4-1**] 04:58AM BLOOD WBC-5.9 RBC-3.28* Hgb-9.8* Hct-28.3* MCV-86 MCH-29.7 MCHC-34.5 RDW-15.3 Plt Ct-214 [**2197-4-2**] 03:00AM BLOOD WBC-4.9 RBC-2.91* Hgb-8.5* Hct-25.3* MCV-87 MCH-29.2 MCHC-33.7 RDW-15.2 Plt Ct-183 [**2197-4-2**] 10:24AM BLOOD Hgb-8.9* Hct-26.8* [**2197-4-3**] 05:30AM BLOOD WBC-4.1 RBC-3.06* Hgb-9.0* Hct-26.1* MCV-86 MCH-29.4 MCHC-34.4 RDW-15.3 Plt Ct-190 [**2197-4-4**] 05:19AM BLOOD WBC-4.7 RBC-3.09* Hgb-9.0* Hct-26.6* MCV-86 MCH-29.2 MCHC-34.0 RDW-15.4 Plt Ct-196 [**2197-3-31**] 10:45PM BLOOD PT-30.9* PTT-150* INR(PT)-3.0* [**2197-3-31**] 10:45PM BLOOD Plt Ct-226 [**2197-4-1**] 04:58AM BLOOD PT-29.2* PTT-150* INR(PT)-2.8* [**2197-4-1**] 04:58AM BLOOD Plt Ct-214 [**2197-4-1**] 11:14AM BLOOD PTT-114.5* [**2197-4-1**] 11:14AM BLOOD Plt Ct-230 [**2197-4-2**] 03:00AM BLOOD PT-21.5* PTT-58.9* INR(PT)-2.0* [**2197-4-2**] 03:00AM BLOOD Plt Ct-183 [**2197-4-2**] 10:24AM BLOOD PT-21.2* PTT-57.4* INR(PT)-2.0* [**2197-4-2**] 04:09PM BLOOD PTT-57.2* [**2197-4-3**] 12:15AM BLOOD PTT-49.1* [**2197-4-3**] 05:30AM BLOOD PT-24.3* PTT-65.1* INR(PT)-2.3* [**2197-4-3**] 05:30AM BLOOD Plt Ct-190 [**2197-4-4**] 05:19AM BLOOD PTT-31.1 [**2197-4-4**] 05:19AM BLOOD Plt Ct-196 [**2197-3-31**] 10:45PM BLOOD Fibrino-525* [**2197-3-31**] 10:45PM BLOOD Glucose-122* UreaN-10 Creat-0.9 Na-137 K-3.8 Cl-105 HCO3-23 AnGap-13 [**2197-4-1**] 04:58AM BLOOD Glucose-203* UreaN-11 Creat-0.9 Na-140 K-4.0 Cl-106 HCO3-26 AnGap-12 [**2197-4-2**] 03:00AM BLOOD Glucose-155* UreaN-10 Creat-0.9 Na-139 K-4.0 Cl-106 HCO3-28 AnGap-9 [**2197-4-3**] 05:30AM BLOOD Glucose-130* UreaN-10 Creat-0.8 Na-140 K-4.1 Cl-106 HCO3-28 AnGap-10 [**2197-3-31**] 10:45PM BLOOD ALT-17 AST-19 CK(CPK)-36* AlkPhos-99 TotBili-0.2 [**2197-4-3**] 05:30AM BLOOD Calcium-8.4 Phos-3.6 Mg-1.8 CT ABD & PELVIS WITH CONTRAST Study Date of [**2197-4-2**] 10:49 AM [**Last Name (LF) **],[**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 147**] VICU [**2197-4-2**] 10:49 AM CT ABD & PELVIS WITH CONTRAST Clip # [**Clip Number (Radiology) 93175**] Reason: Ct venogram of the mid thicgh region tot he diaphragm to [**Doctor First Name **] Contrast: OPTIRAY Amt: 150 [**Hospital 93**] MEDICAL CONDITION: 62 year old man with phlegmalasia and IVC filter REASON FOR THIS EXAMINATION: Ct venogram of the mid thicgh region tot he diaphragm to eval clot burden CONTRAINDICATIONS FOR IV CONTRAST: None. Final Report INDICATION: 62-year-old man with phlegmalasia and IVC filter. Evaluate IVC filter to determine presence of clot burden. COMPARISON: None. TECHNIQUE: Contiguous axial images were obtained through the abdomen and pelvis with the administration of IV contrast. A CTV protocol was used to assess the abdominal veins and extremity veins upto the mid thigh. Multiplanar reformats were generated and reviewed. FINDINGS: There is left lower lobe atelectasis, less likely infectious process. Otherwise, the lungs are clear. No pleural effusion. Large hiatal hernia is noted. The liver shows no focal liver lesions. Minimal intrahepatic biliary dilation is noted. The common bile duct measures 10 mm. These are likely secondary to post-cholecystectomy state. The patient is status post cholecystectomy. The spleen, pancreas, and bilateral adrenal glands are unremarkable. Both kidneys demonstrate mild perinephric stranding which is likely nonspecific. Parapelvic cysts are noted in the left kidney. Bilateral hypodensities, too small to characterize, are noted within both kidneys which likely represent renal cysts. Intra-abdominal loops of large and small bowel are unremarkable. There is some free fluid within the pelvis which may represent postoperative change, correlate clinically. The infrarenal IVC filter appears well seated within the vena cava with clot in the center which extends into bilateral common iliac veins as well as into the left external iliac, left common femoral, left superficial femoral veins. There is a minimal amount of clot noted in the origin of the left profunda femoral vein with reconstitution beyond this point. The right external iliac, common femoral, and superficial femoral veins are patent. There is no free air within the abdomen. The bladder and distal ureters are unremarkable. Visualized osseous structures are grossly unremarkable. There is some surrounding soft tissue subcutaneous stranding within the left thigh. IMPRESSION: 1. Large hiatal hernia. 2. Minimal intrahepatic biliary dilation and dilation of common bile duct to 10 mm, likely post-cholecystectomy. 3. Parapelvic cysts on the left and bilateral hypodensities, too small to characterize, in bilateral kidneys. 4. Small amount of fluid in the pelvis may represent post-surgical changes, correlate with surgical and clinical history. 5. Infrarenal IVC with clot in the center extending into bilateral common iliacs and left external iliac, left common femoral, and left superficial femoral veins. There is some clot burden within the left profunda femoral at its origin, but the left profunda femoral is reconstituted thereafter. The right external iliac, right common femoral, and right superficial femoral veins show no evidence of clot. 6. There is some surrounding soft tissue subcutaneous stranding within the left thigh. Brief Hospital Course: Mr. [**Known lastname 15131**] was transferred to [**Hospital1 18**] from [**Hospital3 **] on [**2197-3-31**] due to concern for phlegmasia and was taken to the OR the same day for attempted thrombectomy. Venous access could not be [**Last Name (LF) 93176**], [**First Name3 (LF) **] he was admitted to the floor for medical management. Heparin drip was resumed and his leg was ACE wrapped and elevated above his heart. A HIT panel was sent which returned negative. Hematology was consulted Medications on Admission: Zegerid 40/1680 Coumadin 5mg po daily Perphenazine 8mg po qHS Trileptal 900mg qHS Percocet PRN Imodium PRN Metamucil 1 pckt daily Discharge Medications: 1. enoxaparin 100 mg/mL Syringe Sig: One (1) Subcutaneous Q12H (every 12 hours). Disp:*30 Syringes* Refills:*2* 2. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. simvastatin 10 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 4. oxycodone-acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for pain for 7 days. 5. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 6. Zegerid 40-1,680 mg Packet Sig: One (1) packet PO twice a day: Per home regimen. 7. nicotine 14 mg/24 hr Patch 24 hr Sig: One (1) Patch 24 hr Transdermal DAILY (Daily). 8. perphenazine 8 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 9. oxcarbazepine 600 mg Tablet Sig: 1.5 Tablets PO HS (at bedtime). 10. bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for constipation. 11. Regular Sliding Scale Q6H Regular Glucose Insulin Dose 0-70 mg/dL Proceed with hypoglycemia protocol 71-119 mg/dL 0 Units 120-159 mg/dL 2 Units 160-199 mg/dL 4 Units 200-239 mg/dL 6 Units 240-279 mg/dL 8 Units 280-319 mg/dL 10 Units > 320 mg/dL Notify M.D. Discharge Disposition: Extended Care Facility: [**Hospital3 7665**] Discharge Diagnosis: Acute-on-chronic deep venous thrombosis of the left lower extremity with associated phlegmasia. Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Followup Instructions: Provider: [**Name10 (NameIs) **] [**Name11 (NameIs) 3628**] (NHB) Phone:[**Telephone/Fax (1) 1237**] Date/Time:[**2197-4-21**] 9:45 Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1244**], MD Phone:[**Telephone/Fax (1) 1237**] Date/Time:[**2197-4-21**] 10:30 Provider: [**Name10 (NameIs) **] [**Last Name (NamePattern4) 15631**], MD Phone:[**Telephone/Fax (1) 1387**] Date/Time:[**2197-5-31**] 11:00 Provider: [**Name6 (MD) 93177**] [**Name11 (NameIs) **], MD(Hematologist) Phone: [**0-0-**] Date/Time: [**2197-4-7**] 9am at [**Hospital6 5016**] Completed by:[**2197-4-5**] ICD9 Codes: 2720, 3051
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5995 }
Medical Text: Admission Date: [**2144-5-25**] Discharge Date: [**2144-6-4**] Date of Birth: [**2087-12-10**] Sex: M Service: MEDICINE Allergies: Tramadol / Hydrocodone Bitartrate/Apap Attending:[**First Name3 (LF) 8790**] Chief Complaint: altered mental status Major Surgical or Invasive Procedure: None History of Present Illness: Mr. [**Known lastname 109738**] is a 56-year old male w/ NSCLC, dementia, residual brain damage from drug OD in [**2118**], known brain tumour from lung CA mets and CVA who presents to the ED with altered mental status and lethargy. . Per pt's wife, he had been more lethargic than usual, refusing to get out of bed, and experiencing urinary incontinence. She states he had been in his USOH (ambulating with a cane, A&Ox3, conversant appropriately) until the day prior to admission when he experienced extreme fatigue and slept all day until noon, when he normally gets up around 7am. Per his wife, pt had been feeling more weak and had been wetting himself while trying to get up to go to the bathroom and urinating on himself in bed several times, more of a function of weakness and inability to reach the bathroom in time rather than incontinence. . He has residual left-sided weakness and numbness at baseline but per wife's report this has been worse lately. Also per wife's report pt had been eating extensively although he is not supposed to given G-tube. He has only been receiving water flushes. . Of note, he was hospitalized on [**4-28**] for changes in mental status, and was treated empirically for meningitis with vancomycin, ceftriaxone, ampicillin and acyclovir. He was discharged on a 14 day course of vancomycin and cetriaxone. LP was not done at the time and BCx showed NGTD. In the [**Name (NI) **], pt refused LP. He presented to [**Hospital 1474**] Hospital with altered mental status on day of admission. In the ED, initial vs were: 98.9 93 19 139/57 SaO2 98% on 4L. Patient was treated w/ CTX, ampicillin, flagyl, azithromycin and zosyn. . He was dx w/ NSCLC (large-cell) in [**7-/2143**] and underwent left upper lobectomy followed by chemo XRT. (Previous notes and D/C summaries document this as Right upper lobectomy; however, [**Year (4 digits) **] data is consistent with Left upper lobectomy). His post-operative courrse was c/b PAC infection requiring removal and vocal cord paralysis. Mr. [**Known lastname 109739**] neurologic problems began in [**2-/2144**] w/ L-sided weakness and difficulty with cognition. MRI at the time showed a large right frontal lobe mass. He is s/p right frontal craniotomy on [**2144-3-1**] and pathology was c/w metastatic lung ca. He subsequently underwent whole-brain XRT from [**Date range (1) 109740**]. ROS: unable to obtain as pt obtunded Past Medical History: 1. Non small cell lung CA s/p radiation, chemo. left upper lobectomy lung lobectomy. 2. Vocal cord paralysis after post lung surgery 3. DM2 4. Dementia for last 2 yrs 5. Residual brain damage from drug overdose [**2118**] 6. Possible NPH seen on MRI [**2133**]? 7. RUE DVT 4/[**2143**]. 8. S/P R subclavian portcath placement [**2143-7-3**] c/b infection removed 1 week later. Now Arteriovenous fistula between the peripheral R subclavian artery and vein 9. cardiac catheterization [**3-/2142**] x2 [**44**]. psych hospitalization x2 for depression several yrs ago 11. MVA 12. hospitalization [**3-/2143**] for "diabetic seizure" 13. s/p head injury [**2118**] PSurgHx: 1. s/p Right frontal craniotomy [**2144-3-1**] 2. s/p PEG [**2144-3-4**] 3. s/p LUL resection 4. s/p tonsilectomy [**2092**] Social History: Lives with his wife [**Name (NI) **], active [**Name (NI) 1818**] trying to quit (was 2 ppd X25 years 10 years ago); no alcohol consumption Family History: DM, Heart Disease Physical Exam: ADMISSION PHYSICAL EXAM: VS: T 101.7, HR 97 BP 152/58 SaO2 97% on 2L NC HT 5'9 Wt 175 lbs GEN: somnolent, lethargic difficult to arouse, falling asleep HEENT: Sclera anicteric, MMM, oropharynx clear PERRLA Neck: supple, JVP not elevated, no LAD CV: Regular rate and rhythm, normal S1 + S2 LUNGS: anteriorly CTAB/L, posterior exam lim by body habitus ABD: +BS soft, NT ND, PEG in place, not erythematous (Guiac negative brown stool in ED) EXT: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema NEURO: somnolent, difficult to arouse, was able to state his name and say he was in a hospital. opens eyes to voice and touch. audibly snoring and falling asleep in conversation. responding very slowly to questions w/ one-word answers. Pertinent Results: [**5-25**]- CT HEAD: post-operative change status post right frontal lesion resection is stable. white matter hypodensity may in part reflect post-treatment change and is also stable from prior studies. no hemorrhage or mass effect. no acute process. . [**5-25**]- CT TORSO: s/p LUL resection. there is extensive new LLL consolidation most c/w PNA. underlying mass not excluded. small adjacent effusion unchnaged from prior study. no PTX. abd/pelvis: no acute pathology, including no free fluid or free air and no evidence of abscess. g-tube in good position. left sided pneumonia, nodular opacities on R that could be additional foci of infection, new from [**Month (only) 958**]. hard to say if there is underlying mass lesion. Likely pulmonary mets. Also colonic wall thickening that could be infectious. . EKG: NSR rate 93, w/ RAD. rSr' in V1. nonspecific septal ST-T changes . DISCHARGE LABS: WBC Hgb Hct MCV Plt Ct [**2144-6-4**] 00:00 12.7* 12.0* 36.2* 93 376 [**2144-6-3**] 00:30 12.6* 12.7* 38.9* 93 441* . Gluc UreaN Creat Na K Cl HCO3 AnGap [**2144-6-4**] 00:00 209*1 26* 0.7 138 4.6 102 27 14 [**2144-6-3**] 00:30 142*1 23* 0.7 141 4.4 104 28 13 . Ca Phos Mg [**2144-6-4**] 00:00 8.9 3.3 1.7 [**2144-6-3**] 00:30 9.2 3.3 1.8 Brief Hospital Course: Mr. [**Known lastname 109738**] is a 56 year-old gentleman with non-small cell lung cancer with known metastatic disease to the brain, s/p R-craniotomy and whole brain radiation, history of dementia and stroke, who presented with altered mental status and increased lethargy. . ICU COURSE: . 1. ALTERED MENTAL STATUS- The differential for Mr. [**Known lastname 109738**] was broad given his immunocompromised state and obtunded presentation. The patient and his wife made it clear that they did not want a lumbar puncture performed and understood the serious risks of turning down the LP including delay in diagnosis or even death. Therefore, the initial differential included bacterial meningitis and HSV encephalitis especially given pt's lethargy and somnolence. He was initially covered with vancomycin, cefepime (due to pseudomonal coverage and good CSF penetration), ampicillin (for listeria coverage) and acyclovir. Also in the differential was worsening of pts malignancy w/ known brain mets, seizure, or other infectious etiology such as PNA. Hyperglycemia could also cause this pt's AMS as FSBS was > 300 on arrival. Toxic-metabolic cause cannot be excluded given waxing and [**Doctor Last Name 688**] mental status. Also, he had colonic wall (ascending colon and cecum) thickening on CT which could represent infectious colitis but is a nonspecific finding; pt's wife did not endorse specific GI complaints but stool studies were sent. Pt's outpatient Neuro-oncologist Dr. [**Last Name (STitle) 724**] was asked to comment on pt's status and he felt the picture was more consistent with encephalitis and agreed with broad antibiotic coverage, but decided to hold off on MRI until later, as pt just had MRI at the end of his radiation treatment which did not show new progression of disease. Dr [**Last Name (STitle) 724**] agreed with bedside EEG to rule out seizure and this was performed on [**5-26**]. . 2. [**Name (NI) **] Pt had evidence of left lower lobe consolidation on chest CT that was likely pneumonia. This underlying infection was most likely the cause of his altered mental status. Initially, broad antibiotic coverage for hospital acquired organisms and aspiration was initiated with vancomycin, cefepime (as above), flagyl for anaerobes and levofloxacin for atypical coverage. Sputum cultures were also sent as well as urine legionella, which later returned negative. The infectious disease service was then consulted and agreed with vancomycin, cefepime and flagyl but suggested discontinuing levofloxacin, acyclovir and ampicillin which was done on [**5-26**]. Since patient had been on long-term steroids, PCP prophylaxis with bactrim was also initiated. Pt's WBC count improved as did his mental status and by the 2nd ICU day he had become more alert and arousable. He was transferred to the general medical service on [**5-27**]. . 3. [**Name (NI) **] pts FSBS > 300 on this admission. Home lantus was initially continued at half pt's normal dose as he had been NPO, but then was increased to his normal dose when tube feeds began. He was also covered with humalog sliding scale, as outpatient metformin was held. . 4. LEUKOCYTOSIS- could be due to infection, inflammation, seizure or steroid use. However, steroids are of chronic duration and leukocytosis is relatively acute. Therefore, infectious etiology is of concern. U/A appeared unremarkable. White count was trending down upon transfer from the ICU. . OMED COURSE: . # Altered Mental Status: Pt was initially on abx for meningitis, which were subsequently stopped. EEG was negative. Blood and urine cx were negative. LLL consolidatio nwas seen on CT chest and pt was treated for a pneumonia with Vanc/Cefepime/Flagyl. Pt was continued on Bactrim for PCP [**Name Initial (PRE) **]. His mental status eventually came back to baseline. Pt was also continued on home Levitiracetam and Dexamethasone taper (2mg daily currently). Per Dr.[**Name (NI) 6767**] rec, start Dexamethasone 1 mg daily on [**6-8**], then start 0.5mg daily on [**6-22**], then start 0.5mg every other day on [**7-6**], and then stop dexamethasone on [**7-20**]. . # Pneumonia: Pt was treated with Vanc/Cefepime/Flagyl. Pt was continued on Bactrim for PCP [**Name9 (PRE) **] since he is on steroids. . # Leukocytosis: Pt remained afebrile. Pt was treated for pneumonia as above. This is likely [**2-4**] steroids. . # NSCLC with brain mets s/p craniotomy: Treatment plan will be per primary oncology team. Pt has a follow-up appointment next week. Pt likely needs reimaging of lungs after resolution of pneumonia to evaluate for underlying cancer. . # DMII: Pt's home Metformin was held during hospital stay but restarted upon discharge. Pt's Lantus was titrated down to 26 units at lunch. Pt's sugars were in reasonably good range (200s) and thus his insluin can be further titrated. Pt was also on insulin sliding scale and fingersticks QID. . # C diff colitis: Pt was found to be c diff positive. Was treated with Flagyl PO, which needs to be continued for 4 more days to complete a 10 day course. Pt's diarrhea is much improved at time of discharge. . # Tobacco abuse: Pt's on Nicotine patch daily. . # Anxiety/Insomnia: Pt was conitnued on home Clonazepam, Zolpidem. . # Pt was on tubefeeds through PEG tube, which he tolerated well. Pt did have occasions when he stated that he wanted to eat, knowing that it will make him at increased risk for aspiration and complications from it. However, after counseling him about it, pt would decide again that he wants to stay NPO and on tubefeeds to reduce risk of aspiration. IF pt and HCP do decide to let him eat, he should be on ground solids and nectar thick liquids. Pt has an outpt S&S eval on [**2144-6-25**] to reassess the situation at that time. Pt was on SC Heparin for DVT ppx. Pt also on PPI. Pt was full code. Medications on Admission: 1. Amantadine 100mg [**Hospital1 **] (0700 and 1200). 2. Ambien CR 12.5g QHS. 3. Clonazepam 1mg PO q8h. 4. Dexamethasone 2mg daily (weaning, changed on [**2144-5-25**] from 2 mg [**Hospital1 **]). 5. Lantus 40u SC at noon. 6. Keppra 500mg PO BID. 7. Nystatin swish TID. 8. Omeprazole 20mg PO Daily. 9. Oxycodone 30mh PO q4h PRN pain. 10. Spiriva 18 mcg 1 puff daily. 11. Metformin HCl 500mg PO BID. 12. MVI 1 cap daily. 13. Lactulose 10 gm/15 mL - 30 mL [**Hospital1 **] prn constipation Discharge Medications: 1. Levetiracetam 100 mg/mL Solution Sig: One (1) PO BID (2 times a day). 2. Tiotropium Bromide 18 mcg Capsule, w/Inhalation Device Sig: One (1) Cap Inhalation DAILY (Daily). 3. Dexamethasone 2 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Docusate Sodium 50 mg/5 mL Liquid Sig: One (1) PO BID (2 times a day). 5. Amantadine 50 mg/5 mL Syrup Sig: One (1) PO BID (2 times a day). 6. Clonazepam 0.5 mg Tablet Sig: Two (2) Tablet PO TID (3 times a day). 7. Nicotine 21 mg/24 hr Patch 24 hr Sig: One (1) Patch 24 hr Transdermal DAILY (Daily). 8. Sulfamethoxazole-Trimethoprim 800-160 mg Tablet Sig: One (1) Tablet PO QMOWEFR (Monday -Wednesday-Friday). 9. Metronidazole 500 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours) for 4 days. 10. Zolpidem 5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) as needed for insomnia. 11. Oxycodone 5 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for pain. 12. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 13. Polyethylene Glycol 3350 17 gram/dose Powder Sig: One (1) PO DAILY (Daily). 14. Lantus 100 unit/mL Solution Sig: Twenty Six (26) units Subcutaneous at lunch. 15. Metformin 500 mg Tablet Sig: One (1) Tablet PO twice a day. 16. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day. Discharge Disposition: Extended Care Facility: [**Hospital1 **] Senior Healthcare of [**Location (un) 1439**] Discharge Diagnosis: penumonia Discharge Condition: Mental Status: Confused - sometimes. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: You were admitted because you had confusion and fatigue. You were initially started on antibiotics for meningitis, but that was stopped once it became clear that you did not have that. You did however have a pneumonia which was treated with appropriate antibiotics. Your confusion resolved and you did very well. You were still weak however so were discharged to a rehab facility where you can regain your strength. We do not expect you to be there greater than 30 days. Your wife, your health care proxy, will be allowed to make decisions for you. Please make the following changes to your medications: START Nicotine 21 mg/24 hr Patch daily START Sulfamethoxazole-Trimethoprim 800-160 mg every Monday-Wednesday-Friday START Metronidazole 500 mg every 8 hours for 4 more days CHANGE Lantus to 26 units Subcutaneous at lunch. Followup Instructions: Please keep your appointment with your oncologist: Provider [**Name9 (PRE) **] [**Name8 (MD) 831**], MD Phone:[**0-0-**] Date/Time:[**2144-6-11**] 10:30 Provider [**First Name8 (NamePattern2) **] [**Name8 (MD) 4322**], MD Phone:[**Telephone/Fax (1) 22**] Date/Time:[**2144-6-11**] 10:30 Please also keep your speech & swallow assessment appointment: Provider [**Name9 (PRE) 326**] UPPER GI (WEST) [**Name9 (PRE) 706**] Phone:[**Telephone/Fax (1) 327**] Date/Time:[**2144-6-25**] 9:45 Completed by:[**2144-6-4**] ICD9 Codes: 5070, 3051
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 5996 }
Medical Text: Unit No: [**Numeric Identifier 56902**] Admission Date: [**2175-12-2**] Discharge Date: [**2175-12-16**] Date of Birth: [**2101-9-15**] Sex: M Service: CSU HISTORY OF PRESENT ILLNESS: This 74-year-old gentleman presented to the Cardiology service with history of intermittent chest pressure and dyspnea on exertion for approximately 4-5 weeks. He had an episode of chest pain on the day of admission. He said it did not radiate, but it is also not associated with any nausea, dizziness, vomiting, palpitations, diaphoresis. He said it usually happens when he is lying down while he is short of breath and is relieved by walking around and it seems to happen frequently to him and it lasts about 25 minutes. Recently he complains of shortness of breath even with minimal walking in his house. PAST MEDICAL HISTORY: Diabetes type 1. Hypertension. Hyperlipidemia. SOCIAL HISTORY: He drinks approximately 1-2 drinks per day and has a 30 pack year history of tobacco. FAMILY HISTORY: Noncontributory. He was admitted to the Cardiology service for workup for his chest pain and was started on Heparin, aspirin, beta-blocker, nitroglycerin. Placed on telemetry to determine whether or not he would rule in or out for myocardial infarction. Lisinopril was held because of his renal function. At the time of admission, over the next 48 hours, he was covered by the Cardiology service in preparation for cardiac catheterization, which was determined when he had elevated troponins and ruled in for non-ST-elevation myocardial infarction. Creatinine preoperatively was 1.5. It is unknown what the patient's baseline creatinine was, but the patient was aware of chronic renal insufficiency and patient received hydration prior to going to cardiac catheterization and was covered by Cardiology service, Dr. [**First Name8 (NamePattern2) **] [**Name (STitle) **]. Cardiac catheterization was performed on the [**8-3**], which revealed severe three-vessel disease with plaquing in the left main, heavily calcified LAD with subtotal occlusions of first septal and diagonal 2. Diagonal 1 had a 70 percent lesion. Circumflex was totally occluded in the A-V groove with moderate plaquing in the OM-3. The right coronary artery had proximal and ostial 80 percent lesions and was totally occluded in the mid portion. Patient also had moderate-to-severe LV diastolic heart failure. His LVEDP was 23 as well as moderate pulmonary artery hypertension and mitral regurgitation. Patient was referred to Dr. [**Last Name (STitle) **]. PAST SURGICAL HISTORY: Also includes appendectomy at age 6. ALLERGIES: He had no known drug allergies. MEDICATIONS AT THE TIME HE WAS SEEN: 1. Glyburide 1.25 mg by mouth daily. 2. Lipitor 10 mg by mouth daily. 3. Hydrochlorothiazide 12.5 mg by mouth daily. 4. Multivitamin by mouth daily. 5. Lisinopril 10 mg by mouth daily. 6. Aspirin 325 mg by mouth daily. PHYSICAL EXAMINATION: On exam, he is 6 feet tall, 109 kg or 240 pounds with a temperature of 96.6, blood pressure 118/62, in sinus rhythm at 76, respiratory rate 20, and saturating 94 percent on room air. He was sitting upright in bed in no distress. He is alert and oriented times three and appropriate. He had no carotid bruits. He had diminished breath sounds at the right base and fine rales at the left base. His heart has regular rate and rhythm with S1, S2 tones and no murmurs, rubs, or gallops. His abdomen is soft, round, nontender, and nondistended with positive bowel sounds. Extremities were warm and well perfused with no peripheral edema. No varicosities noted, but some superficial spider veins. He had 2 plus bilateral radial pulses, 1 plus bilateral dorsalis pedis pulses, 2 plus PT pulse on the right, and a 1 plus PT pulse on the left. PREOPERATIVE LABS: White count is 7.8, hematocrit 29.5, platelet count 261,000. Sodium 139, K 4.3, chloride 105, bicarb 25, BUN 31, creatinine 1.4 with a blood sugar of 137. PT 12.9, PTT 28.7, INR 1.0. ALT 17, AST 17, alkaline phosphatase 38, amylase 36, total bilirubin 0.6. Urinalysis was negative. Preoperative EKG showed sinus rhythm at 71 with PVCs, a left atrial abnormality, and a question of both anteroseptal old myocardial infarction and an old inferior wall myocardial infarction. Additional laboratory work done showed a calcium of 9.0, magnesium 2.0, hemoglobin A1C at 5.8 percent. Preoperative chest x-ray showed background COPD with probable mild CHF and small effusions. Please refer to the x-ray final report dated [**2175-12-2**]. Preoperative CTA of the chest showed no evidence of pulmonary embolism as well as bilateral pleural effusions and increased septal thickening consistent with interstitial edema from mild LV congestive heart failure. It also noted calcified coronaries and aortic atherosclerotic disease. Please refer to the final report dated [**2175-12-2**]. On [**12-6**], the patient underwent coronary artery bypass grafting times four by Dr. [**Last Name (STitle) **] with a LIMA to the LAD, vein graft to the PDA, vein graft to the OM, vein graft to the diagonal. He also underwent mitral valve repair with a 30 mm [**Doctor Last Name 405**] annuloplasty band. He was transferred to Cardiothoracic ICU in stable condition on a propofol drip at 10 mcg/kg/minute, Levophed drip at 0.03 mcg/kg/minute, milrinone drip at 0.1 mcg/kg/minute, and an insulin drip at 2 units/hour. On postoperative day one, he was on a lidocaine drip for premature ventricular contractions. Remained on Levophed, which was weaned during the day, milrinone drip at 0.25, lidocaine drip at 1 mg, and insulin drip at 5 units/hour. Postoperatively, his white count was 11.1, hematocrit 29.4, platelet count 138,000. BUN 34, creatinine 1.6. He remained sedated and intubated on ventilatory support. On postoperative day two, the patient was extubated, remained on milrinone drip, and Natrecor was started at 0.01 for his heart failure. He remained on a lidocaine drip at 1. Aspirin was started and he also began IV Lasix diuresis. He received some Ativan for agitation. His creatinine rose slightly to 1.8. Preoperative echocardiogram estimation of his ejection fraction was 15 percent. Patient was seen by Cardiology everyday for assistance with his congestive heart failure management. He was also seen by the clinical nutrition team. Patient was started on carvedilol beta-blockade, transitioned off his Natrecor. He was weaned off the Levophed and milrinone and remained on the Natrecor drip at 0.01. Diuresis continued. Creatinine decreased slightly to 1.6. He was also seen by Electrophysiology service. At that point, he was off all his drips. The patient was awake and alert on exam, and was also seen by Physical Therapy for initial evaluation, though he remained in the ICU. On postoperative day four, he was hemodynamically stable on no drips. Receiving IV Lasix and carvedilol. Creatinine continued to improve to 1.4. White count dropped to 9.8. Hematocrit was stable at 29. Foley was discontinued. A line was also discontinued. He remained in Cardiothoracic ICU an additional day pending resolution of his ATN and to monitor him closely for ectopy. He was restarted on his lisinopril and seen by Case Management in preparation for moving out to the floor. On the 15th, the patient was transferred out to [**Hospital Ward Name 121**] 2 to begin work with Physical Therapy. He was seen again by the EP fellow to evaluate him for workup for possible ICD in approximately one month postoperatively, also pending whether or not his ejection fraction improved. Patient was also evaluated by the CHF service from Cardiology. On postoperative day six, the patient did have one run of nonsustained V-tach and continued on all of his oral medications. His exam was unremarkable and incisions were clean, dry, and intact. He had positive bowel sounds. Had 1 plus peripheral edema. Decision was made that the patient would follow up with EP postoperatively in one month. Patient was strongly encouraged to work with his incentive spirometer and improve his pulmonary toilet as well as increasing his by mouth intake in all preparation for his probable discharge to home. The following day the patient also had four beats of nonsustained V-tach. He was completely asymptomatic and was waiting clearance so that he can do his physical therapy. His creatinine rose slightly from 1.3 to 1.4. He received additional magnesium repletion. Patient was also seen by Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 284**] of Electrophysiology service and patient went to the EP laboratory on the 18th for a study and received an ICD implant. On postoperative day nine, patient continued to be in sinus rhythm, but had frequent atrial and ventricular ectopic beats status post the ICD being placed. The new pacer site was clean, dry, and intact. His heart rate was irregular. As previously noted, he was saturating 96 percent on 2 liters with a blood pressure of 112/52. His carvedilol was changed to Toprol XL per recommendations of Electrophysiology service with plans to hopefully discharge him if he remains stable for the next 24 hours. His EP device was also interrogated one day prior to discharge. On the 20th, the day of discharge, patient was hemodynamically stable in sinus rhythm at 60, blood pressure 123/61, respiratory rate of 18, and saturating 95 percent on room air. He is alert and oriented. He had a nonfocal neurologic examination. His lungs were clear bilaterally. Incisions were clean, dry, and intact with trace peripheral edema. He was discharged to home with VNA services on [**2175-12-16**]. DISCHARGE DIAGNOSES: Status post coronary artery bypass grafting times four with mitral valve repair. ICD placement. Non-insulin dependent-diabetes mellitus. Hypertension. Hyperlipidemia. DISCHARGE MEDICATIONS: 1. Lisinopril 5 mg by mouth daily. 2. Iron 150 mg by mouth daily. 3. Vitamin C 500 mg by mouth twice a day. 4. Lipitor 10 mg by mouth daily. 5. Amiodarone 400 mg by mouth once a day. 6. Glyburide 1.25 mg by mouth once a day. 7. Lasix 40 mg by mouth once a day times 10 days. 8. Metoprolol 50 mg by mouth daily. 9. Coumadin 5 mg by mouth once a day for two days, then patient is to check with his physician after laboratory draw prior to his next dose. 10. Keflex 500 mg by mouth four times a day for seven days. 11. Potassium chloride 10 mEq by mouth twice a day for 10 days. 12. Percocet 5/325 one tablet by mouth as needed pain every four hours. FOLLOW-UP INSTRUCTIONS: The patient was instructed to followup at the EP Device Clinic on the [**Hospital Ward Name 23**] [**Location (un) 436**] [**Hospital Ward Name 516**] on [**12-26**] at 11:30 a.m. He is also instructed to followup with Dr. [**Last Name (STitle) **], his surgeon for a postoperative surgical visit in one month postoperatively and he was also instructed to followup with Dr. [**Last Name (STitle) 56903**], phone number [**Telephone/Fax (1) 56904**] in [**1-27**] weeks. Patient was instructed to be in contact with his primary care physician, [**Last Name (NamePattern4) **]. [**First Name8 (NamePattern2) 3403**] [**Last Name (NamePattern1) **] [**Telephone/Fax (1) 56905**] for followup of Coumadin dosing with INR blood draws by the VNA service. Again, the patient was discharged home with VNA services on [**2175-12-16**]. [**Name6 (MD) **] [**Name8 (MD) **], M.D. [**MD Number(2) 5897**] Dictated By:[**Last Name (NamePattern1) **] MEDQUIST36 D: [**2176-1-29**] 10:51:01 T: [**2176-1-29**] 11:31:21 Job#: [**Job Number 56906**] ICD9 Codes: 4240, 4111, 9971, 4271, 4280, 4019, 2724, 2859
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Medical Text: Admission Date: [**2129-9-23**] Discharge Date: [**2129-10-3**] Date of Birth: [**2052-5-8**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1505**] Chief Complaint: left arm pain, nausea Major Surgical or Invasive Procedure: [**2129-9-28**] s/p Coronary artery bypass grafting x4: Left internal mammary artery graft to left anterior descending, reverse vein graft to the first marginal, second marginal and third marginal branches of the circumflex History of Present Illness: 77 year old male presented to outside hospital with left arm, axilla, and flank pain, additionally diaphoresis and nausea. He was transferred to [**Hospital1 18**] for cardiac evaluation Past Medical History: coronary artery disease s/p PCI [**2119**] (2 stents to OM1) gout hypertension hypercholesterolemia osteoarthritis skin cancer Social History: Occupation: retired from trucking business Lives with: wife [**Name (NI) 1139**]: denies ETOH: denies Family History: brothers with CAD, s/p CABG Physical Exam: Pulse: 67 Resp: 16 O2 sat: 98% RA B/P Right: 157/81 Left: Height: Weight: 94.9kg General: Skin: Dry [x] intact [x] HEENT: PERRLA [x] EOMI [x] Neck: Supple [x] Full ROM [x] Chest: Lungs clear bilaterally [x] Heart: RRR [x] Irregular [] Murmur Abdomen: Soft [x] non-distended [x] non-tender [x] bowel sounds + [x] Extremities: Warm [x], well-perfused [x] Edema Varicosities: None [x] Neuro: Grossly intact x Pulses: Femoral Right: 1+ Left: 1+ DP Right: 1+ Left: 1+ PT [**Name (NI) 167**]: 1+ Left: 1+ Radial Right: 2+ Left: 2+ Carotid Bruit Right: Left: no bruits Pertinent Results: [**2129-10-3**] 06:25AM BLOOD Hct-26.1* [**2129-10-1**] 06:55AM BLOOD WBC-14.3* RBC-2.53* Hgb-8.6* Hct-25.0* MCV-99* MCH-34.1* MCHC-34.5 RDW-13.3 Plt Ct-159 [**2129-9-24**] 04:40AM BLOOD WBC-10.7 RBC-3.74* Hgb-12.5* Hct-36.3* MCV-97 MCH-33.4* MCHC-34.4 RDW-13.5 Plt Ct-187 [**2129-10-1**] 06:55AM BLOOD Plt Ct-159 [**2129-9-24**] 01:43AM BLOOD Plt Ct-189 [**2129-9-24**] 04:40AM BLOOD PT-12.1 PTT-25.2 INR(PT)-1.0 [**2129-10-3**] 06:25AM BLOOD UreaN-23* Creat-1.0 K-4.8 [**2129-9-24**] 01:43AM BLOOD Glucose-197* UreaN-16 Creat-0.9 Na-136 K-4.3 Cl-103 HCO3-23 AnGap-14 [**2129-9-26**] 05:59AM BLOOD ALT-14 AST-15 LD(LDH)-155 AlkPhos-76 TotBili-0.7 [**2129-9-24**] 04:40AM BLOOD CK-MB-NotDone cTropnT-<0.01 [**2129-9-26**] 05:59AM BLOOD %HbA1c-7.7* PA AND LATERAL CHEST ON [**2129-10-1**] AT 15:39 INDICATION: CABG. COMPARISON: [**2129-9-30**]. FINDINGS: Basilar atelectasis is seen bilaterally with a right effusion. The latter appears a little more prominent than the prior study. There is a patchy opacity in the left lower lobe, which could be atelectasis or pneumonia. Clinical correlation is needed. No definite pneumothorax is seen. Cardiomegaly is stable and the pulmonary vascular markings are within normal limits. IMPRESSION: Slight increase in right pleural fluid. Somewhat improved aeration of the previously seen retrocardiac density, but pneumonia cannot be ruled out. DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 4347**] Approved: SAT [**2129-10-1**] 9:17 PM Cardiology Report ECG Study Date of [**2129-9-28**] 8:48:06 PM Sinus rhythm. Prior inferior myocardial infarction. Incomplete right bundle-branch block. Since the previous tracing of [**2129-9-27**] incomplete right bundle-branch block pattern is now present. Read by: [**Last Name (LF) **],[**First Name3 (LF) 177**] W. Intervals Axes Rate PR QRS QT/QTc P QRS T 92 192 110 382/438 47 -42 66 [**Hospital1 18**] ECHOCARDIOGRAPHY REPORT [**Known lastname 82989**], [**Known firstname **] [**Hospital1 18**] [**Numeric Identifier 82990**] (Complete) Done [**2129-9-28**] at 3:02:23 PM FINAL Referring Physician [**Name9 (PRE) **] Information [**Name9 (PRE) **], [**First Name3 (LF) **] R. [**Hospital1 18**], Division of Cardiothorac [**Hospital Unit Name 4081**] [**Location (un) 86**], [**Numeric Identifier 718**] Status: Inpatient DOB: [**2052-5-8**] Age (years): 77 M Hgt (in): BP (mm Hg): / Wgt (lb): HR (bpm): BSA (m2): Indication: Intraoperative TEE for CABG ICD-9 Codes: 427.89, 440.0, 424.1, 424.0 Test Information Date/Time: [**2129-9-28**] at 15:02 Interpret MD: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 4901**], MD Test Type: TEE (Complete) Son[**Name (NI) 930**]: [**Name Initial (MD) **] [**Name8 (MD) 4901**], MD Doppler: Full Doppler and color Doppler Test Location: Anesthesia West OR cardiac Contrast: None Tech Quality: Suboptimal Tape #: 2009AW4-: Machine: AW2 Echocardiographic Measurements Results Measurements Normal Range Left Atrium - Long Axis Dimension: *4.8 cm <= 4.0 cm Left Ventricle - Diastolic Dimension: 5.5 cm <= 5.6 cm Left Ventricle - Ejection Fraction: 35% to 40% >= 55% Aorta - Ascending: 3.3 cm <= 3.4 cm Aorta - Descending Thoracic: 2.3 cm <= 2.5 cm Aortic Valve - LVOT diam: 2.4 cm Findings LEFT ATRIUM: Mild LA enlargement. No spontaneous echo contrast or thrombus in the LA/LAA or the RA/RAA. Good (>20 cm/s) LAA ejection velocity. All four pulmonary veins identified and enter the left atrium. RIGHT ATRIUM/INTERATRIAL SEPTUM: A catheter or pacing wire is seen in the RA and extending into the RV. No ASD by 2D or color Doppler. LEFT VENTRICLE: Wall thickness and cavity dimensions were obtained from 2D images. Top normal/borderline dilated LV cavity size. Mild-moderate regional LV systolic dysfunction. RIGHT VENTRICLE: Normal RV chamber size and free wall motion. AORTA: Focal calcifications in aortic root. Normal ascending aorta diameter. Focal calcifications in ascending aorta. Normal descending aorta diameter. Simple atheroma in descending aorta. AORTIC VALVE: Mildly thickened aortic valve leaflets (3). No AS. Mild (1+) AR. MITRAL VALVE: Mildly thickened mitral valve leaflets. Mild mitral annular calcification. Mild (1+) MR. TRICUSPID VALVE: Tricuspid valve not well visualized. PULMONIC VALVE/PULMONARY ARTERY: Pulmonic valve not well seen. Physiologic (normal) PR. GENERAL COMMENTS: A TEE was performed in the location listed above. I certify I was present in compliance with HCFA regulations. The patient was under general anesthesia throughout the procedure. No TEE related complications. Suboptimal image quality. The patient appears to be in sinus rhythm. Frequent ventricular premature beats. Results were personally reviewed with the MD caring for the patient. Conclusions PRE BYPASS The left atrium is mildly dilated. No spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. No atrial septal defect is seen by 2D or color Doppler. The left ventricular cavity size is top normal/borderline dilated. There is mild to moderate regional left ventricular systolic dysfunction with severe inferior and inferolateral hypokinesis/akinesis and mild global hypokinesis of the remaining myocardial segments. Right ventricular chamber size and free wall motion are normal. There are simple atheroma in the descending thoracic aorta. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. Mild (1+) aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Mild (1+) mitral regurgitation is seen. Dr. [**Last Name (STitle) **] was notified in person of the results in the operating room at the time of the study. POST BYPASS The patient is receiving epinephrine by infusion. There is normal right ventricular systolic function. The left ventricle displays continued severe inferior and inferolateral wall hypokinesis/akinesis but all other segments now show improved and near normal function. Left ventricular ejection fraction is in the 45% range. Valvular function is unchanged and the thoracic aorta appears intact. I certify that I was present for this procedure in compliance with HCFA regulations. Electronically signed by [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 4901**], MD, Interpreting physician [**Last Name (NamePattern4) **] [**2129-9-28**] 16:25 Brief Hospital Course: Transferred from outside hospital for cardiac evaluation, he was ruled out for myocardial infarction, troponin < 0.01, and underwent cardiac catherization [**2129-9-23**] which revealed coronary artery disease. He was referred for surgical evaluation. He underwent preoperative work up and on [**2129-9-28**] was brought to the operating room and underwent coronary artery bypass graft surgery. See operative report for details. He received vancomycin for perioperative antibiotics as he was in the hospital preoperatively. He was transferred to the intensive care unit for hemodynamic management. In the first twenty four hours he was weaned from sedation, awoke neurologically intact, and was extubated without complications. On post operative day one he was started on beta blockers and diuretics, and transferred to the post operative floor for the remainder of his care. Physical therapy worked with him on strength and mobility. He had issues with back pain that was limiting activity, his medications were adjusted with good response and improved mobility. He was ready for discharge home with services on post operative day five. Medications on Admission: Plavix 75 mg daily Zocor 80 mg daily Allopurinol 300 md daily Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*0* 2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 3. Plavix 75 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*0* 4. Zocor 80 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*0* 5. Allopurinol 300 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 6. Metoprolol Tartrate 25 mg Tablet Sig: 1.5 Tablets PO TID (3 times a day). Disp:*135 Tablet(s)* Refills:*2* 7. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*65 Tablet(s)* Refills:*0* 8. Furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day for 5 days. Disp:*5 Tablet(s)* Refills:*0* 9. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig: One (1) Tab Sust.Rel. Particle/Crystal PO once a day for 5 days. Disp:*5 Tab Sust.Rel. Particle/Crystal(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Company 1519**] Discharge Diagnosis: Coronary artery disease s/p cabg Hypertension hyperlipidemia osteoarthritis skin cancer Discharge Condition: Good Discharge Instructions: Please shower daily including washing incisions, no baths or swimming Monitor wounds for infection - redness, drainage, or increased pain Report any fever greater than 101 Report any weight gain of greater than 2 pounds in 24 hours or 5 pounds in a week No creams, lotions, powders, or ointments to incisions No driving for approximately one month, and while taking narcotics No lifting more than 10 pounds for 10 weeks Please call with any questions or concerns [**Telephone/Fax (1) 170**] Followup Instructions: Please call to schedule appointments Dr. [**Last Name (STitle) **] in 4 weeks ([**Telephone/Fax (1) 170**]) Dr. [**Last Name (STitle) 82991**] in 1 week [**Telephone/Fax (1) 65735**] Dr. [**Last Name (STitle) **] in [**3-15**] weeks Wound check appointment as instructed by [**Hospital Ward Name **] 6 nurse ([**Telephone/Fax (1) 3071**]) Completed by:[**2129-10-3**] ICD9 Codes: 4111, 5859, 2720, 2724, 2749
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Medical Text: Admission Date: [**2201-12-22**] Discharge Date: [**2202-1-9**] Date of Birth: [**2135-12-21**] Sex: M Service: SURGERY Allergies: Sulfa (Sulfonamide Antibiotics) / Penicillins Attending:[**First Name3 (LF) 158**] Chief Complaint: BRBPR Major Surgical or Invasive Procedure: Colonoscopy [**2201-12-23**] by Drs. [**First Name (STitle) 908**] and [**Name5 (PTitle) 23099**] History of Present Illness: 66 y/o male with HIV, HCV, cirrhosis c/b ascites with recurrent varcieal bleeds s/p TIPS c/b encephalopathy, active endocarditis, mycotic aneurysm and AS who presents from [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] with possible GIB. Patient was seen in [**Hospital 702**] [**Hospital **] clinic where he was told that his hematocrit was 21% and he was instructed to present to the hospital for a transfusion. Upon interview by his ID physician he reported that he had noticed blood on his toilet paper for several days. He stated that his stool had been normal color. He denied any melena or frank hematochezia. He denied any associated pain though did report an intermittent LLQ pain that is unrelated to when he notices blood on the toilet paper. He further denied any dizziness, chest pain, or shortness of breath. Of note patient had a recent endoscopy approximately one month ago that did not show any varices. At [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], the patient's hematocrit was noted to be 27%. The patient was started on octreotide and Protonix drips and transferred to [**Hospital1 18**] for further evaluation. Vitals signs prior to transfer were 96.9, 48, 127/52, 97%. Hematocrit at transfer was noted to be 27 and INR was 1.2. . In the ED, initial VS were 97.8, 54, 122/96, 14, 100%. Patient was noted to have guaiac positive brown stool, no external hemorrhoids, and no internal hemorrhoids were visible on anoscopy. His serum potassium was noted to be 6.0. An EKG from [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] revealed sinus rhythm at 56, NA and no STT changes. EKG here revealed sinus bradycardia with peaked T-waves. He was subsequently given an Amp of D50, 10 units of Regular insulin, Calcium gluconate and Kayexalate. Repeat potassium was 5.1. Vitals signs at transfer were 97.8, 50s, 138/55, 22, 98% on RA. . On arrival to the floor, the patient denied any active complaints and reported the history as detaile above. . REVIEW OF SYSTEMS: Positive per HPI. Denies fever, chills, sore throat, cough, shortness of breath, chest pain, abdominal pain, nausea, vomiting, diarrhea, constipation, melena, hematochezia, dysuria, hematuria. Past Medical History: * Cirrhosis c/b ascites and variceal bleeding, no encephalopathy -- cause not yet clearly established -- h/o liver biopsy in [**2186**] showing lobular hepatitis, CMV positive -- EGD [**3-9**] OSH which revealed esophageal varices: 3 columns-2 grade III and 1 grade II esophageal varices with stigmata of bleeding and were banded. Pt was also noted gastric varices. Banded x2 at OSH. -- EGD [**2201-11-25**] without evidence of varices but revealing Barrett's Esophagus * Hepatitis B, but HbSAb positive/HbCAb positive * HIV (CD4 most recent CD4 290 in [**3-/2201**], VL <48 [**2200-3-10**]) on HAART, on dapsone ppx * HTN * Hyperlipidemia * Anemia * GERD * Hemorrhoids * Aortic stenosis - aortic valve area 0.7 Social History: Lives alone in [**Location (un) 20935**] MA and he had been working in carnival business. Divorced with 2 grown sons that live nearby. Has VNA 1x per week. He states he used to smoke 1PPD x40 years and he quit 15 years ago. States does not drink ETOH and only drank rarely in the past. Denies IVDU. Family History: Unavailable as patient states he never knew his family well. Physical Exam: Admission Exam: VS - 97.8, 50s, 138/55, 22, 98% on RA Gen: Elderly male in NAD. Oriented x3. Mood, affect appropriate. HEENT: NCAT. MMM, OP benign. Neck: Supple, full ROM. No JVP distention. No cervical lymphadenopathy. No carotid bruits noted. CV: RRR with normal S1, S2. Systolic murmur [**3-5**] heard throughout the precordium spots. Chest: Respiration unlabored, no accessory muscle use. CTAB without crackles, wheezes or rhonchi. Abd: Normal bowel sounds. Soft, NT, ND. No organomegaly or masses. Ext: No edema. Distal pulses intact radial 2+, DP 2+, PT 2+. Skin: No rashes, ulcers, or other lesions. Neuro: CN II-XII grossly intact. Strength 5/5 in all extremities. No asterixis. On Discharge: VS: T 97.6 HR 67 BP 144/63 RR 16 02Sat 96% on RA GEN: NAD, Comfortable, AOx3, cachectic CV: RRR, nl s1 and s2, systolic murmur unchanged PULM: CTA b/l, no respiratory distress ABD: Soft, BS +, non-distended, minimally tender, incision c/d/i with staple removed and steri-strips in place, JP stitch was removed and JP site was c/d/i without erythema. EXT: No c/c/e, no tremor or asterixis. Pertinent Results: Admission Labs: [**2201-12-22**] 12:00AM WBC-5.5 RBC-2.87* HGB-7.9* HCT-25.1* MCV-88 MCH-27.5 MCHC-31.4 RDW-18.0* [**2201-12-22**] 12:00AM PLT COUNT-198 [**2201-12-22**] 12:00AM GLUCOSE-89 UREA N-31* CREAT-1.4* SODIUM-139 POTASSIUM-6.0* CHLORIDE-109* TOTAL CO2-21* ANION GAP-15 [**2201-12-22**] 12:00AM ALT(SGPT)-13 AST(SGOT)-17 ALK PHOS-106 TOT BILI-0.5 [**2201-12-22**] 12:00AM LIPASE-46 [**2201-12-22**] 05:30AM ALBUMIN-3.5 CALCIUM-9.7 PHOSPHATE-3.9 MAGNESIUM-2.1 IRON-54 [**2201-12-22**] 05:30AM calTIBC-250* FERRITIN-45 TRF-192* Oncologic Labs: [**2201-12-23**] 06:21AM BLOOD CEA-3.1 AFP-1.4 Colonoscopy [**2201-12-23**]: Findings: Protruding Lesions A fungating non-bleeding mass of malignant appearance was found in the distal sigmoid colon. The mass caused a partial obstruction. The scope did NOT traversed the lesion. With a injector needle the area was tattooed. Cold forceps biopsies were performed for histology at the distal sigmoid colon mass. Other Due to the size of the mass, the rest of the colon was NOT evaluated. Impression: Mass in the distal sigmoid colon (biopsy) Due to the size of the mass, the rest of the colon was NOT evaluated. Otherwise normal colonoscopy to sigmoid colon Recommendations: 1. Follow up pathology results 2. Resume diet as tolerated 3. Will discuss with primary hepatolgist 4. Consult colorectal surgery 5. Consider CT abdomen and pelvis with contrast 6. Check a CEA level Sigmoid Mass Pathology: SPECIMEN SUBMITTED: G I BIOPSY (1 JAR). Procedure date Tissue received Report Date Diagnosed by [**2201-12-23**] [**2201-12-23**] [**2201-12-25**] DR. [**Last Name (STitle) **] [**Last Name (NamePattern4) **]/vf Previous biopsies: [**-9/5489**] GI BX (1 JAR) DIAGNOSIS: Colon, 20 cm, biopsy: Colonic adenocarcinoma, low grade. CT CHEST ABDOMEN PELVIS [**2201-12-23**]: LUNGS: Mild apical scarring and centrilobular emphysema is seen. There is no pneumothorax or pleural effusion. The heart size is normal and there is no pericardial effusion. There are no suspicious nodules or masses seen within the lungs. The descending aorta is ectatic with a significant amount of soft plaque. The major airways are patent to their subsegmental levels. ABDOMEN: The liver enhances homogeneously without evidence for masses. There is no biliary ductal dilatation. A TIPS stent is present and patent. Note is made of cholelithiasis, but no cholecystitis. The spleen size is top normal but homogeneous. The pancreas is normal. The kidneys enhance homogeneously without evidence for hydronephrosis. A left renal cyst (3:66) and right renal cyst (3:61) are noted. There is a 1-cm left adrenal mass which is unchanged from prior study and statistically represents an adenoma. The right adrenal gland is normal. The stomach and small bowel are normal. The ascending colon appears collapsed and limits complete evaluation. PELVIS: The bladder, prostate, and seminal vesicles are normal. Within the sigmoid colon is an approximately 5-cm area of thickening concerning for malignancy and corresponding to lesion seen on colonoscopy. There is no pelvic or inguinal lymphadenopathy present. No free fluid is seen. Again noted is a small right side fat-containing inguinal hernia. BONES: There are no suspicious lytic or blastic lesions concerning for metastatic disease. There are stable degenerative changes about the lower lumbar spine with disc space narrowing at L2-L3. IMPRESSION: 1. Approximately 5-cm sigmoid mass concerning for malignancy. There is no evidence for metastatic disease and no lymphadenopathy. 2. Highly ectatic aorta with extensive atherosclerotic calcification and plaque formation. 3. Status post TIPS which is widely patent. 4. Cholelithiasis without cholecystitis. 5. Unchanged 1-cm left adrenal nodule, statistically representing an adenoma. 6. Collapsed ascending colon which cannot be completely evaluated on this study. If clinically indicated, a CT colonoscopy can be performed for better evaluation. TTE [**2201-12-24**]: The left atrium is mildly dilated. No atrial septal defect is seen by 2D or color Doppler. The estimated right atrial pressure is 0-5 mmHg. There is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (LVEF>55%). Doppler parameters are indeterminate for left ventricular diastolic function. Right ventricular chamber size and free wall motion are normal. The ascending aorta is mildly dilated. The descending thoracic aorta is mildly dilated. The abdominal aorta is mildly dilated. There are three aortic valve leaflets. The aortic valve leaflets are moderately thickened. There is critical aortic valve stenosis (valve area <0.8cm2). Trace aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Physiologic mitral regurgitation is seen (within normal limits). The estimated pulmonary artery systolic pressure is normal. There is no pericardial effusion. IMPRESSION: Mild symmetric left ventricular hypertrophy and cavity size with preserved global and regional biventricular systolic function. Mildly dilated ascending aorta, descending thoracic aorta, and abdominal aorta. Critical aortic stenosis by transvalvular velocity and gradients, but visually the aortic valve appears to be more pliable, and likely consistent with moderate to severe aortic stenosis. Normal pulmonary artery systolic pressure. Compared with the prior study (images reviewed) of [**2200-3-11**], the severity of aortic stenosis has increased by transvalvular velocity and gradients from moderate to critical; however, visually the valve appears to be similarly pliable. [**2201-12-26**] KUB: There is residual contrast in the colon with increase in fecal material in the ascending and descending colon. There is no evidence of bowel obstruction. Moderate degenerative changes are in the lumbar spine. A TIPS stent is present. [**2201-12-30**] Pathology: DIAGNOSIS: I. Sigmoid colon, segmental colectomy (A-S, U-AD): 1. Invasive adenocarcinoma; see synoptic report. 2. Sixteen lymph nodes with no carcinoma identified (0/16; additional levels are examined on blocks N and U). II. Anastomotic donuts (T): Colonic fragments with no carcinoma seen. [**2201-12-30**] TEE Intraoperatively: No spontaneous echo contrast is seen in the left atrial appendage. Overall left ventricular systolic function is low normal (LVEF 50-55%). Right ventricular chamber size and free wall motion are normal. The descending thoracic aorta is mildly dilated. There are complex (>4mm) atheroma in the descending thoracic aorta. The aortic valve leaflets are severely thickened/deformed. There is critical aortic valve stenosis (valve area <0.8cm2). Mild (1+) aortic regurgitation is seen. Mild (1+) mitral regurgitation is seen. There is no pericardial effusion. At the end of the operation there were no changes. [**2201-12-30**] CXR: Swan-Ganz catheter is in the main pulmonary artery. There is no pneumothorax or pleural effusion. There is mild cardiomegaly. Aside from atelectasis in the left lower lobe, the lungs are grossly clear. Emphysema and scarring in the right upper lobe are better seen in prior CT from [**12-23**]. There is pneumoperitoneum. There is a TIPS stent. [**2202-1-4**] KUB: IMPRESSION: 1) Findings are consistent with a postoperative small bowel ileus. If concern for mechanical small bowel obstruction persists, a CT would provide better characterization. 2) Intraperitoneal free air compatible with recent surgery. [**2202-1-4**] CXR: FINDINGS: As compared to the previous radiograph, the patient has received a nasogastric tube. The tube shows normal course and the tip projects over the middle parts of the stomach. Normal size of the cardiac silhouette. No pleural effusions. No pneumothorax. The previously placed Swan-Ganz catheter has been removed. The free intraperitoneal air, previously visible in the right upper quadrant, has completely resolved. [**2202-1-5**] CT Abdomen: IMPRESSION: 1. Mildly dilated fluid-filled loops of ascending and descending colon suggestive of focal ileus. Patent distal colon without clear transition point to suggest large bowel obstruction. 2. Minimally prominent loops of small bowel measuring up to 2.5 cm, however, no signs of clear obstruction. Findings may also be secondary to postoperative ileus. 3. Expected moderate pneumoperitoneum due to recent sigmoid colectomy. 4. Normal appearance of the surgical anastomosis. No evidence of extraluminal leak or stenosis. 5. No organized fluid collection in the abdomen or pelvis to suggest abscess. 6. Standard position of TIPS shunt which appears grossly patent. 7. Stable bulky appearance of the bilateral adrenal glands, left greater than right. [**2202-1-6**] KUB: IMPRESSION: Non-obstructive bowel gas pattern. Air seen throughout the non-dilated colon, extending to the rectum, could reflect mild colonic ileus. [**2202-1-4**] 07:24PM BLOOD WBC-5.0 RBC-3.42* Hgb-10.1* Hct-30.1* MCV-88 MCH-29.7 MCHC-33.7 RDW-16.5* Plt Ct-191 [**2201-12-31**] 12:46AM BLOOD WBC-7.6 RBC-3.33* Hgb-9.5* Hct-29.4* MCV-88 MCH-28.7 MCHC-32.5 RDW-16.8* Plt Ct-107* [**2201-12-29**] 05:05AM BLOOD WBC-5.9 RBC-3.64* Hgb-10.5* Hct-31.8* MCV-87 MCH-28.9 MCHC-33.1 RDW-16.8* Plt Ct-155 [**2201-12-30**] 05:38AM BLOOD Neuts-48.4* Lymphs-38.6 Monos-5.3 Eos-6.9* Baso-0.8 [**2201-12-22**] 12:00AM BLOOD Neuts-54.6 Lymphs-35.0 Monos-4.7 Eos-5.2* Baso-0.6 [**2202-1-4**] 07:24PM BLOOD Plt Ct-191 [**2201-12-30**] 02:40PM BLOOD PT-12.3 PTT-30.6 INR(PT)-1.1 [**2201-12-29**] 09:33AM BLOOD PT-12.2 PTT-32.1 INR(PT)-1.1 [**2201-12-22**] 05:30AM BLOOD PT-11.7 PTT-32.5 INR(PT)-1.1 [**2202-1-7**] 05:14AM BLOOD Glucose-100 UreaN-9 Creat-1.0 Na-135 K-3.7 Cl-104 HCO3-25 AnGap-10 [**2202-1-6**] 05:38AM BLOOD Glucose-94 UreaN-11 Creat-1.0 Na-139 K-3.5 Cl-107 HCO3-24 AnGap-12 [**2202-1-3**] 04:58AM BLOOD Glucose-101* UreaN-12 Creat-0.9 Na-139 K-3.6 Cl-106 HCO3-23 AnGap-14 [**2201-12-30**] 02:40PM BLOOD Glucose-102* UreaN-24* Creat-1.0 Na-140 K-4.4 Cl-112* HCO3-21* AnGap-11 [**2202-1-5**] 04:31AM BLOOD ALT-12 AST-24 AlkPhos-104 [**2201-12-22**] 05:30AM BLOOD ALT-12 AST-14 LD(LDH)-124 AlkPhos-99 TotBili-0.5 [**2201-12-22**] 12:00AM BLOOD ALT-13 AST-17 AlkPhos-106 TotBili-0.5 [**2201-12-22**] 12:00AM BLOOD Lipase-46 [**2202-1-7**] 05:14AM BLOOD Calcium-7.9* Phos-3.0 Mg-2.1 [**2202-1-5**] 04:31AM BLOOD Calcium-8.0* Phos-2.4* Mg-1.8 [**2202-1-1**] 04:48AM BLOOD Calcium-7.9* Phos-2.6* Mg-1.8 [**2201-12-30**] 12:27PM BLOOD Glucose-103 Lactate-1.6 Na-139 K-4.0 Cl-113* [**2201-12-30**] 10:09AM BLOOD Glucose-87 Lactate-2.1* Na-139 K-3.8 Cl-113* [**2201-12-30**] 12:27PM BLOOD freeCa-1.09* [**2201-12-30**] 10:09AM BLOOD freeCa-1.13 Brief Hospital Course: Primary Reason for Hospitalization: 66 y/o male with HIV, HCV, cirrhosis c/b ascites with recurrent varcieal bleeds s/p TIPS c/b encephalopathy, active endocarditis, mycotic aneurysm and severe AS who presented from [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] with BRBPR and anemia, and found to be hyperkalemic with EKG changes. Active issues: # Colon adenocarcinoma: Pt presented due to BRBPR and anemia on outpatient labs. It was decided to proceed with inpatient colonoscopy since he continued to have BRBPR and there was concern about monitoring his fluid status during prep for colonoscopy given his comorbidities (particularly severe AS). Unfortunately colonoscopy on [**12-23**] showed a sigmoid mass, and pathology confirmed adenocarcinoma. He was evaluated by the colorectal surgery service, who recommended resection. Due to his severe aortic stenosis, he was also evaluated by the cardiology service, who felt that he could proceed with surgery with intraoperative TEE monitoring and did not require valve replacement prior to surgery. # Acute on chronic anemia: Pt presented with Hct 22, baseline Hct ~28. Likely [**12-31**] colon cancer. He received 1 unit pRBCs and his Hct appropriately increased. On discharge his Hct was 30.1. #. Aortic Stenosis: [**Location (un) 109**] on TTE obtained [**12-24**] 0.7 cm2. He was evaluated by cardiology service pre-operatively, who felt he could proceed with surgery with intraoperative cardiac monitoring. He is being evaluated for possible AVR as outpt. #. Acute on CKD: Creat elevated to 1.4 on admission, thought likely pre-renal. His creatinine returned to his baseline of 1.1 without intervention. #. Hyperkalemia: Potassium was elevated on admission to 6.0 with EKG changes concerning for peaked T waves. He received insulin/glucose/calcium and kayexolate and his potassium returned to [**Location 213**]. Thought likely [**12-31**] high potassium content diet (pt frequently eats bananas, baked potatoes at home) and/or acute on chronic renal failure. Felt unlikely to be related to losartan therapy since he had been on it for 2 years. He was counseled about avoiding high potassium foods. #. S. anginosus Bacteremia: During previous hospitalization, pt had blood cx [**11-17**] and [**11-28**] that grew Strep anginosus in setting of GI bleed. He was initially treated with clindamycin but then switched to IV ceftriaxone after speciation became available. He was continued on his home IV ceftriaxone on admission, and he remained afebrile with nl WBC. He completed his course of ceftriaxone on [**12-26**] (was treated for 4 weeks to empirically treat endocarditis although no vegetation was seen on TTE during previous admission). Blood cultures were repeated on [**2201-12-28**] and were negative. Chronic issues: #. Idiopathic Cirrhosis s/p TIPS: On admission pt's LFTs, T bili, and INR were normal. He has h/o esophageal varices on no varices were visualized on EGD of [**2201-11-25**] during previous hospitalization. He was continued on his home rifaximin, nadolol, sucralfate. #. HIV: Stable. Last CD4 94 on [**2201-11-27**], viral load undectectable. He was continued on his home darunavir, ritonavir, lamivudine, and dapsone. #. Gastric ulcers: Diagnosed on EGD during previous hospitalization in [**11-9**]. He was continued on his home PPI and sucralfate. Transitional issues: - He maintained DNR/DNI code status (reversed for procedures and surgery). The patient was transitioned to the care of the Colon and Rectal Surgery service on [**2201-12-30**]. The patient presented to pre-op on [**2201-12-30**]. Pt was evaluated by anaesthesia and taken to the operating room for open sigmoid colectomy w/primary anastomosis. Please see the operative note for details. Pt was monitored intraoperatively with a TEE and no changes in hemodynamics were noted. Pt was extubated, taken to the TSICU overnight for close cardiopumonary monitoring with arterial line and swanz ganz catheter. Patient recovered well without incident and was transferred to floor on POD 1 after removal of Swanz and Arterial line. Post-operatively: Neuro: The patient was alert and oriented throughout his recovery; pain was initially managed with a diluadid PCA and IV tylenol; he was transitioned to intermittent dilaudid on POD 2. He was transitioned to oral pain medications on POD 5 but was put back on IV tylenol after having to place and NGT for vomiting. He was again put on PO pain meds on POD 8 after diet was advanced and pain was well controlled. CV: The patient was closely monitored from a cardiovascular standpoint with a goal SBP above 120mmHg. Patient recieved fluid boluses PRN as well as albumin to keep pressures in an acceptable range and his beta blocker was held postoperatively until his pressures and HR improved. By POD 3 he had become cardiovacularly stable - vital signs were routinely monitored. Pulmonary: The patient remained stable from a pulmonary standpoint; vital signs were routinely monitored. Good pulmonary toilet, early ambulation and incentive spirometry were encouraged throughout hospitalization. GI/GU/FEN: He was initially kept NPO and he was advanced to sips on POD 1 and clears on POD 2. Patient continued to have problems with nausea and distension and his diet was backed down to NPO and then re-advanced after having several small BM's though no flatus. On POD 5 he vomited 300cc, put back to sips, KUB showed air fluid levels,and an NGT was placed putting out 500cc of bilious fluid. On POD 6 a CT scan that day failed to show leak or ascites and confirmed an ileus. On POD 7 HIV meds were crushed and placed down NGT without issue and clamping trials were started after he began to pass flatus and had low residuals. On POD 8 NGT was d/c and he has advanced to sips without issue and a KUB was obtained after he stopped passing flatus and it showed colonic air - pt was given a suppository and began passing large amounts of flatus and had a BM which continued into POD 9 at which time he was advanced to a regular diet which was well tolerated. A JP drain was discontinued on POD 4 and a stitch was placed which was removed before discharge. C. diff was sent on POD 6 for liquid stools but were all negative. Foley was dicontinued at midnight on POD 3 without incident. PICC line was dinscontinued before discharge. Patient's intake and output were closely monitored and electroyltes repleted as needed. ID: The patient's fever curves were closely watched for signs of infection, of which there were none. Blood, urine, and stool cultures were all negative. HEME: The patient's blood counts were closely watched for signs of bleeding post-operatively, of which there were none. No post-operative transfusions were required and hematocrit was 30 at discharge and stable without signs of GI bleed. Prophylaxis: The patient received subcutaneous heparin and [**Last Name (un) **] dyne boots were used during this stay; he was encouraged to get up and ambulate as early as possible. At the time of discharge, the patient was doing well, afebrile with stable vital signs. The patient was tolerating a regular diet, ambulating, voiding without assistance, and pain was well controlled. The patient received discharge teaching and follow-up instructions with understanding verbalized and agreement with the discharge plan. Medications on Admission: 1. Darunavir 800 mg PO daily 2. Ritonavir 100 mg PO daily 3. Dapsone 50 mg PO daily 4. Rifaximin 550 mg PO BID 5. Lamivudine 150 mg PO daily 6. Pravastatin 10 mg PO daily 7. Polyethylene glycol 3350 17 gram PO daily 8. Lorazepam 0.5 mg PO QHS PRN insomnia 9. Pantoprazole 40 mg PO Q12H 10. Sucralfate 1 gram PO QID 11. Losartan 50 mg PO daily 14. Nadolol 10 mg PO once a day 15. Acetaminophen 500 mg PO Q6H PRN pain 16. Ceftriaxone 2 gm IV daily Discharge Medications: 1. dapsone 25 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 2. darunavir 400 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 3. lamivudine 150 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. ritonavir 100 mg Capsule Sig: One (1) Capsule PO DAILY (Daily). 5. rifaximin 550 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 6. sucralfate 1 gram Tablet Sig: One (1) Tablet PO QID (4 times a day). 7. pravastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. losartan 50 mg Tablet Sig: One (1) Tablet PO once a day. 9. pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). 10. nadolol 20 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 11. polyethylene glycol 3350 17 gram/dose Powder Sig: One (1) packet PO DAILY (Daily). 12. lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) as needed for insomnia. 13. oxycodone 5 mg Tablet Sig: 1-2 Tablets PO every 4-6 hours as needed for pain. Disp:*40 Tablet(s)* Refills:*0* 14. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed for pain. Disp:*60 Tablet(s)* Refills:*0* Discharge Disposition: Home Discharge Diagnosis: Colonic adenocarcinoma Acute blood loss anemia Aortic stenosis HIV Idiopathic cirrhosis Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Dear Mr. [**Known lastname 13099**], You were admitted to [**Hospital1 18**] because you were anemic. You had a colonoscopy, which unfortunately showed a cancer in your colon. You were evaluated by the colorectal surgery service, who recommended surgical removal of the mass. You received 1 unit of blood prior to surgery and your blood counts improved. You were admitted to the hospital after an open Sigmoid Colectomy with Primary Anastamosis for surgical management of the mass obstructing your colon which was revealed to be colonic adenocarcinoma. You have recovered from this procedure well and you are now ready to return home. Samples from your colon were taken and this tissue was sent to the pathology department for analysis. As mentioned during you visit the results were that it was cancerous and you will need to continue to follow up with the Oncologists at [**Hospital1 18**]. You have tolerated a regular diet, passing gas and your pain is controlled with pain medications by mouth. You may return home to finish your recovery. We made no changes to your medications while you were in the hospital but we did add medications for pain and a stool softener. Please continue taking your medications as prescribed by your outpatient providers. Please monitor your bowel function closely. Some loose stool and passing of small amounts of dark, old appearing blood are explected however, if you notice that you are passing bright red blood with bowel movments or having loose stool without improvement please call the office or go to the emergency room if the symptoms are severe. If you are taking narcotic pain medications there is a risk that you will have some constipation. Please take an over the counter stool softener such as Colace, and if the symptoms does not improve call the office. If you have any of the following symptoms please call the office for advice or go to the emergency room if severe: increasing abdominal distension, increasing abdominal pain, nausea, vomiting, inability to tolerate food or liquids, prolonges loose stool, or constipation. You have a long vertical incision on your abdomen that was closed with staples. These have been removed and covered with Steri-strips which should remain in place for 10-14 days. This incision can be left open to air or covered with a dry sterile gauze dressing if the incision become irritated from clothing. Please monitor the incision for signs and symptoms of infection including: increasing redness at the incision, opening of the incision, increased pain at the incision line, draining of white/green/yellow/foul smelling drainage, or if you develop a fever. Please call the office if you develop these symptoms or go to the emergency room if the symptoms are severe. You may shower, let the warm water run over the incision line and pat the area dry with a towel, do not rub. No heavy lifting for at least 6 weeks after surgery unless instructed otherwise by Dr. [**Last Name (STitle) 1120**] or Dr. [**Last Name (STitle) **]. You may gradually increase your activity as tolerated. You will be prescribed a small amount of the pain medication. Please take this medication exactly as prescribed. You may take Tylenol as recommended for pain. Please do not take more than 4000mg of Tylenol daily. Do not drink alcohol while taking narcotic pain medication or Tylenol. Please do not drive a car while taking narcotic pain medication. It has been a pleasure taking care of you at [**Hospital1 18**] and we wish you a speedy recovery. Followup Instructions: Provider: [**Name10 (NameIs) 3150**],[**Name11 (NameIs) **] MD Phone:[**Telephone/Fax (1) 11133**] Date/Time:[**2202-1-15**] 3:30 Department: LIVER CENTER When: FRIDAY [**2202-2-12**] at 1 PM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 8507**], MD [**Telephone/Fax (1) 2422**] Building: LM [**Hospital Unit Name **] [**Location (un) 858**] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage ICD9 Codes: 5789, 7907, 2767, 5715, 4241, 4589, 2724
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Medical Text: Admission Date: [**2201-5-20**] Discharge Date: [**2201-5-25**] Date of Birth: [**2146-7-9**] Sex: M Service: CT SURGERY CHIEF COMPLAINT: Coronary artery disease. HISTORY OF PRESENT ILLNESS: The patient is a 54 year old male with a known history of coronary artery disease, who was transferred her from an outside hospital after a positive stress test which was performed because of chest pain while running. This showed a tight left anterior descending lesion and moderate occlusion of the right coronary artery with a normal ejection fraction. He was admitted for definitive surgery. PAST MEDICAL HISTORY: 1. Hypertension. 2. Benign prostatic hypertrophy. MEDICATIONS ON ADMISSION: 1. Atenolol. 2. Cardura. 3. Prinivil. 4. Zocor. 5. Aspirin. HOSPITAL COURSE: The patient underwent a coronary artery bypass graft times three on [**2201-5-20**]. Apart from a slightly difficult intubation, his surgery was uneventful. He was transferred to the CSRU intubated. He was extubated later the same day. He was transferred out to the regular floor on postoperative day one where he remained stable. His chest tubes were left in because of a small air leak on postoperative day one. His chest tube and pacing wires were discontinued on postoperative day three. His Foley was also discontinued but had to be reinserted, probably likely due to his benign prostatic hypertrophy. On postoperative day five, his Foley was discontinued and he did void after it came out. He is being discharged home today in a stable condition. MEDICATIONS ON DISCHARGE: 1. Lopressor 25 mg p.o. b.i.d. 2. Lasix 20 mg p.o. q.d. for one week. 3. Potassium Chloride 20 meq q.d. for one week. 4. Cardura 8 mg p.o. q.d. 5. Zocor 40 mg p.o. q.h.s. 6. Aspirin 325 mg p.o. q.d. 7. Colace 100 mg b.i.d. 8. Percocet one to two tablets q4-6hours p.r.n. FO[**Last Name (STitle) **]P: With primary care physician, [**Last Name (NamePattern4) **]. [**Last Name (STitle) **], in two weeks, and with Dr. [**Last Name (Prefixes) **] in four weeks. CONDITION ON DISCHARGE: Stable. [**Doctor Last Name 412**] [**Last Name (Prefixes) 413**], M.D. [**MD Number(1) 414**] Dictated By:[**Last Name (NamePattern1) 2209**] MEDQUIST36 D: [**2201-5-25**] 11:24 T: [**2201-5-25**] 20:36 JOB#: [**Job Number 42015**] ICD9 Codes: 4111, 4019, 9971