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{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6000 }
Medical Text: Admission Date: [**2179-11-8**] Discharge Date: [**2179-11-18**] Date of Birth: [**2154-11-12**] Sex: F Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 3223**] Chief Complaint: s/p Motor Vehicle Crash Major Surgical or Invasive Procedure: [**11-7**] IM nail Left Femur [**11-8**] IVC filter placement Exploration/repair of rectal tear History of Present Illness: 24 yo female retrained driver s/p MVC hydroplane and rollover; prolonged extrication (~1 hour). Tachycardic at scene, no hypotension, transferred to [**Hospital1 18**] from referring facility for continued trauma care. Past Medical History: None Social History: Denies tobacco, occas ETOH Teaches Spanish to high school students Lives with roomate Family History: Noncontributory Physical Exam: afebrile hr120 bp148/75 rr18 sats 97 Awake, responsive, gcs 15 op clear ctab rrr soft, ttp b lower quadrants no rebound no midline back tenderness B femorl splinting with good B distal pulses gross blood from vaginal area, known perineal tears, no hematuria Pertinent Results: [**2179-11-8**] 10:40PM HCT-32.7* [**2179-11-8**] 07:53PM TYPE-ART TEMP-37.2 PO2-368* PCO2-39 PH-7.30* TOTAL CO2-20* BASE XS--6 INTUBATED-INTUBATED [**2179-11-8**] 07:37PM GLUCOSE-140* UREA N-10 CREAT-0.7 SODIUM-141 POTASSIUM-4.1 CHLORIDE-108 TOTAL CO2-18* ANION GAP-19 [**2179-11-8**] 07:37PM CALCIUM-9.7 PHOSPHATE-3.7 MAGNESIUM-1.0* [**2179-11-8**] 07:37PM WBC-14.9* RBC-3.86*# HGB-12.5# HCT-34.2*# MCV-89 MCH-32.3* MCHC-36.5* RDW-13.1 [**2179-11-8**] 07:37PM PLT COUNT-117* [**2179-11-8**] 07:37PM PT-13.2 PTT-31.0 INR(PT)-1.2 [**2179-11-8**] 01:40PM ASA-NEG ETHANOL-NEG ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG Brief Hospital Course: Ms [**Known lastname 64708**] was admitted to the trauma/SICU at [**Hospital1 18**] for further assessment and management of her injuries. Prior to arrival, she was intubated. FAST exam in the ED negative. CTA of carotids, CT head and CT C-spine negative in ED. In [**Name (NI) **], pt received ancef, flagyl, clindamycin and levofloxacin. After multiple plain films and CT imaging, the following injuries were discovered: . 1. L femoral fracture 2. R subtrochanteric fracture 3. B inferior pelvic rami fx 4. L superior pelvic ramus fx 5. diastasis of pubic symphasis with presacral hematoma 6. L first rib fracture 7. multiple vaginal and perianal lacerations with associated perianal hematoma. Eventual exam under anesthesia revealed intact rectum, posterior vaginal wall and normal cervix. . Over the subsequent 3 days, pt underwent several orthopedic procedures to repair her femurs, pelvis and perineal injuries. An IVC filter was also placed to prevent migration of any possible clot. Pt did not develop any thrombus during her hospitalization. These procedures are detailed in operative notes on [**11-7**] through [**11-9**], [**2178**]. . Pt was transferred to regular hospital floor on [**2179-11-10**] where she remained hemodynamicaly stable and had stable serial hematocrits. PT and OT were consulted to assist in this patient's recovery. Upon discharge, she will remain NWB LLE, WBAT RLE. Pt completed a 6 day course of the antibiotics started in the ED. . Pain control was an issue throughout this hospitalization, and several different regimens were tried after the patient's PCA was discontinued. Eventually, the acute pain service was consulted for guidance in pain management. Final recommendations were to use a 100 mcg fentanyl patch q 72 hours with 2-6 mg dilaudid q 3-4. At time of discharge, this regimen appeared to control patient's pain. While her injuries are severe, it was explained to her that these medications were being administered at high doses and that she would have to help guide the care team in slow weaning of these medications. . Ms [**Known lastname 64708**] was discharged to rehab in stable condition on Jaunary 5, [**2179**]. Medications on Admission: None. Discharge Medications: 1. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours). 2. Diphenhydramine HCl 25 mg Capsule Sig: One (1) Capsule PO Q6H (every 6 hours) as needed for pruritis. 3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 4. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO Q6H (every 6 hours) as needed for constipation. 5. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for constipation. 6. Ibuprofen 600 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours). 7. Lorazepam 0.5 mg Tablet Sig: 1-2 Tablets PO every 6-8 hours as needed for anxiety. 8. Enoxaparin 40 mg/0.4mL Syringe Sig: One (1) Subcutaneous once a day: Continue for 4 weeks. 9. Fentanyl 100 mcg/hr Patch 72HR Sig: One (1) patch Transdermal every seventy-two (72) hours. 10. Dilaudid 2 mg Tablet Sig: 1-3 Tablets PO q3-4 hours as needed for pain. Discharge Disposition: Extended Care Facility: [**Hospital6 979**] - [**Location (un) 24402**], ME Discharge Diagnosis: s/p Motor Vehicle Crash Inferior/Superior Pubic Rami Fracture Bilateral Femoral Fractures (Right Proximal/Left Distal) Perirectal laceration Vaginal laceration Discharge Condition: Stable Discharge Instructions: 1.Follow up with Orthopedic Surgery and OB/GYN after discharge. 2.Take all of your medications as prescribed. 3. Do not bear any weight on your left lower extremity. Followup Instructions: 1.Call [**Telephone/Fax (1) 1228**] for a follow up appointment with Orthopedic Surgery in [**11-15**] weeks. 2.Followup with your primary OB/GYN for reevaluation/pelvic exam; you will need to call for an appointment. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 520**] MD, [**MD Number(3) 3226**] ICD9 Codes: 2851
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6001 }
Medical Text: Admission Date: [**2170-11-1**] Discharge Date: [**2170-11-3**] Date of Birth: [**2096-8-3**] Sex: M Service: NEUROLOGY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 5018**] Chief Complaint: CODE STROKE Major Surgical or Invasive Procedure: None History of Present Illness: 74 yo M PMH hemorrhagic stroke [**2167**] presents as CODE STROKE. Called at 11:30pm at bedside within seconds. Last seen well @ 6:30pm. Onset of symptoms unknown. History provided by ED resident as wife not present. Wife last saw patient well @6:30pm this evening when he went upstairs to go to the bathroom. She became concerned when he seemed to take longer than usual so went upstairs to find him lying on the floor in BR blocking the door. He was unresponsive but breathing on his own. She called 911, EMS found him without respiratory distress but comatose and took him to OSH. At OSH, noted not to be moving R side of body. Wet read of Head CT showed old R PCA infarct, no change from prior [**2170-3-30**] and no acute process and of CT C-spine showed no fx, extensive degenerative changes. Found to be in atrial fibrillation HR 105 with signs acute ischemia which was thought to be new. He was intubated due to altered mental status (w/etomidate 10mg and succinylcholine 100mg), given propofol after intubation and transferred to [**Hospital1 18**] for neuro eval. (Also, OSH ED note mentioned Versed 2mg IV and Dopamine for pressor support). No IV TPA given h/o hemorrhagic stroke. At [**Hospital1 18**] ED, 99.5 128/74 74 18 100 vent. Head CT performed at showed dense left MCA sign with early loss of insular ribboning, loss of [**Doctor Last Name 352**]-white differentiation and hypoattentuation of the basal ganglia. [**Name (NI) **] PT 10, Cr 3.1 and FS 166. ROS: unable Past Medical History: - CAD, h/o MI, prior CABG multivessel - HTN - Hyperlipid - Gout - Partial nephrectomy for benign renal CA (BUN 37 Cr 1.8 in [**4-4**]) - Prior strokes Social History: Lives with wife Family History: non-contributory Physical Exam: 99.5 128/74 74 18 100 vent Gen: Lying in bed, mildly agitated off propofol HEENT: NC/AT, moist oral mucosa, intubated Neck: supple, no carotid or vertebral bruit CV: irreg irreg, no murmurs/gallops/rubs Lung: Clear to auscultation bilaterally aBd: +BS soft, nontender ext: no edema Neurologic examination: Mental status: Spontaneously opening eyes and grimacing. Not cooperative with exam, does not regard or follow commands. Cranial Nerves: Pupils equally round and reactive to light, 3 to 2 mm bilaterally. Resists passive eye opening with conjugate left eye deviation but able to cross midline with oculocephalic movements. Grimaces to nasal tickle without obvious asymmetry but difficult to assess with ETT tube in place. Positive yawn. Motor/Sensory: Normal bulk bilaterally. Mildly increased tone on the right. No observed myoclonus or tremor. Localizes and very purposeful with left hand, withdraws in legs symmetrically. Right arm extends to noxious stim. Reflexes: +2 brisk symmetric throughout. Right toe upgoing, left down. Coordination/Gait/Romberg: deferred Pertinent Results: [**2170-10-31**] 11:25PM BLOOD WBC-13.1* RBC-4.09* Hgb-13.5* Hct-40.6 MCV-99* MCH-33.0* MCHC-33.2 RDW-13.4 Plt Ct-345 [**2170-11-1**] 03:00AM BLOOD WBC-11.5* RBC-3.67* Hgb-12.1* Hct-36.6* MCV-100* MCH-33.0* MCHC-33.1 RDW-13.5 Plt Ct-302 [**2170-11-2**] 03:05AM BLOOD WBC-9.4 RBC-3.41* Hgb-11.5* Hct-33.3* MCV-98 MCH-33.6* MCHC-34.4 RDW-13.6 Plt Ct-276 [**2170-10-31**] 11:25PM BLOOD PT-11.9 PTT-24.5 INR(PT)-1.0 [**2170-10-31**] 11:25PM BLOOD Glucose-122* UreaN-46* Creat-2.4* Na-143 K-4.0 Cl-105 HCO3-26 AnGap-16 [**2170-11-1**] 03:00AM BLOOD Glucose-129* UreaN-46* Creat-2.2* Na-144 K-4.0 Cl-109* HCO3-24 AnGap-15 [**2170-11-2**] 03:05AM BLOOD Glucose-95 UreaN-30* Creat-1.7* Na-140 K-5.0 Cl-110* HCO3-23 AnGap-12 [**2170-10-31**] 11:25PM BLOOD ALT-16 AST-17 CK(CPK)-85 TotBili-0.6 [**2170-10-31**] 11:25PM BLOOD CK-MB-NotDone cTropnT-<0.01 [**2170-11-1**] 08:57AM BLOOD CK-MB-5 cTropnT-<0.01 [**2170-11-1**] 04:54PM BLOOD CK-MB-4 cTropnT-<0.01 [**2170-11-2**] 03:05AM BLOOD Calcium-9.1 Phos-3.5 Mg-2.3 [**2170-10-31**] 11:25PM BLOOD TSH-2.7 [**2170-10-31**] 11:25PM BLOOD ASA-NEG Ethanol-NEG Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG Head CT ([**10-31**]): Dense left MCA and loss of [**Doctor Last Name 352**]-white matter differentiation in the left MCA territory consistent with acute stroke of the left MCA territory. MRA [**11-1**]: Partial occlusion of the supraclinoid left internal carotid artery with slow flow in the left middle cerebral artery. Non-visualization of distal right vertebral artery. Carotid Dopplers [**11-1**]: There is a less than 40% right ICA stenosis and less than 40% left ICA stenosis with nonvisualized right vertebral artery and antegrade flow in the left vertebral artery. Renal US: No hydronephrosis Brief Hospital Course: Mr. [**Known lastname 74524**] was admitted to the ICU for closer monitoring and evaluation. His hospital course by problem is as follows: Neuro: L MCA infarct Given the finding on OSH EKG of new atrial fibrillation, cardiac source of emboli more likely than artery-artery emboli. Patient has a history of intracranial hemorrhage and presented in ARF. As a result, he was considered not a candidate for IV/IA TPA or clot retrieval. The following day, his PCP was [**Name (NI) 653**] and his history was reviewed. Per these records he had prior infarcts but no history of hemorrhage. He had no history of afib in the past, however had been work-up and found to have an elevated anticardiolipin antibody. When this had been found, he was evaluated for anticoagulation but the decision was made not to start coumadin. In the ICU, he remained unresponsive. He was continued on ASA 325mg QD and his Lipitor was increased from 10 to 40. His LDL was 99. He remained in afib but given the size of the infarct he was not a candidate for anticoagulation given the high risk for spontaneous bleeding. He remained in afib but without tachycardia. His BP was allowed to autoregulate and lopressor was used PRN for SBP>200. He was rulled out for MI with CE. He was gradually restarted on his home regimen of felodine 10 QD and atenolol 25 QD. His Cr improved with gentle IVF resuscitation. A renal US was negative. Given his poor prognosis, his family decided to make him CMO. He was extubated and died shortly there after. Medications on Admission: Home meds: Lyrica 25mg PO TID (not taking it) allopurinol 100mg PO QD Avapro 300mg PO QD HCTZ/triamterene 25/37.5 QD ASA 81 Trental 100mg PO QD Atenolol 25mg PO QD Lipitor 10mg PO QD NG SL Felodipine 10mg PO QD Discharge Medications: NA Discharge Disposition: Expired Discharge Diagnosis: Cerebral Infarction Atrial Fibrillation Discharge Condition: NA Discharge Instructions: NA Followup Instructions: NA [**Name6 (MD) 4267**] [**Last Name (NamePattern4) 4268**] MD, [**MD Number(3) 5023**] ICD9 Codes: 5859, 2749, 2720
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6002 }
Medical Text: Admission Date: [**2103-10-1**] Discharge Date: [**2103-10-21**] Date of Birth: [**2069-7-31**] Sex: Service: Neurosurgery DATE OF DEATH: [**2103-10-21**] HISTORY OF PRESENT ILLNESS: This is a 34-year-old woman who had sudden onset of severe headache accompanied by slurred speech and confusion. She was brought to [**Hospital6 50324**] with a diagnosis of a subarachnoid hemorrhage. She had several episodes of vomiting in [**Hospital1 498**] and was then transferred to [**Hospital1 69**]. PAST MEDICAL HISTORY: Remarkable for diabetes. Hypertension. Breast cancer. CURRENT MEDICATION ON ADMISSION: Meridia 30 mg q.d. ALLERGIES: PENICILLIN. SOCIAL HISTORY: She is legally separated, has 2 children, and was not working. She does not have a history of smoking or drug use. She does drink alcohol occasionally. PHYSICAL EXAMINATION: Vital signs at the time of admission were 195/101, 86, 22, and 10. Head, eyes, ears, nose, and throat, her pupils to be equal, round, and reactive to light and accommodation, 3 mm to 2.5 mm. EOMs were full. Lungs were clear. Heart showed regular rate and rhythm, normal S1 and S2. Abdomen was obese, soft, and nondistended. Extremities showed no edema. Neuro exam, she was awake, alert, and oriented times 3. Did complain of headache. Moving all extremities. Closes eyes at times, but opens to voice. No drift. Cranial nerves II through XII are intact. Strength was [**4-30**] bilaterally in biceps, triceps, iliopsoas, anterior tibialis, and [**Last Name (un) 938**]. Pupils were equal, round, and reactive to light and accommodation. Extraocular movements were full. She had no meningeal signs. Deep tendon reflexes were 1 plus bilaterally at biceps, 2 plus bilaterally at knees. LABORATORY DATA: On admission her sodium was 142, potassium 3.4, chloride 104, bicarb 25, BUN 12, creatinine 0.9, glucose 175, PT was 12, PTT 23.5, and INR 1.0. Her white blood cells were 10.9, hematocrit 40.5, and platelets were 268,000. She did have a CT of the head, which did show a subarachnoid hemorrhage on the left with multiple clot in the suprasellar cistern and Sylvian cistern, left greater than right. She was admitted to the Neurointensive Care Unit with q.1h. neuro checks. She obtained an A-line and the goal was to keep her blood pressure less than 120 with Nipride as needed. She was started on nimodipine 60 mg q.4 h., normal saline, famotidine. She was to have her glucoses checked q.i.d. She was preop for an angiogram in the morning. She was started on Dilantin at 100 mg t.i.d. HOSPITAL COURSE: She did undergo the angiogram and postprocedure she was sleepy, but was easily awakened and followed commands, and moved all extremities; however, was unable to perform complex tasks. Pupils were 3 to 2 bilaterally. She underwent an angiogram, which did show a left internal carotid artery aneurysm and was then brought to the operating room for clipping of her aneurysm. Then early in the morning on [**2103-10-4**], the patient did have an increase in her intracranial pressure. She had a stat head CT at that time, which did show left frontal intraparenchymal hemorrhage at the surgical site. She then underwent an emergency craniectomy with bone flap placement in the abdomen. Postoperatively, she returned to the intensive care unit and was monitored closely. She was kept sedated and was followed with CAT scans of the head. Her serum osmolality was checked every 4 hours. Her INR was followed with the goal of keeping less than 1.3 at all times. She was able to move her left side spontaneously, but moved and localized in the right upper extremity to deep pain only. Her brain flap was tense. She did spike fevers and was pancultured. On [**2103-10-14**], a repeat head CT did show an acute new hemorrhage in the left frontal lobe with surrounding edema and herniation. Ventricles were increased in size slightly. ICPs had been reported as high as 33. A repeat CAT scan again on [**2103-10-15**] showed a large left hemorrhage. Due to the repeat hemorrhage, discussion was held with the patient's cousin and significant other and she was made do not resuscitate. On [**2103-10-21**], she did expire. [**Name6 (MD) **] [**Last Name (NamePattern4) 1359**], [**MD Number(1) 1360**] Dictated By:[**Last Name (NamePattern1) 50325**] MEDQUIST36 D: [**2104-6-16**] 10:41:55 T: [**2104-6-16**] 15:07:29 Job#: [**Job Number 50326**] ICD9 Codes: 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6003 }
Medical Text: Admission Date: [**2168-1-31**] Discharge Date: [**2168-2-8**] Date of Birth: [**2108-6-28**] Sex: F Service: MEDICINE Allergies: Heparin Agents Attending:[**First Name3 (LF) 2610**] Chief Complaint: Mechanical fall at nursing home on [**2168-1-30**], transferred from OSH to [**Hospital1 18**] for orthopedic hemiarthroplasty of displaced left femoral neck fracture, acute on chronic subdural hematoma Major Surgical or Invasive Procedure: Left hemiarthroplasty IVC filter placement Left IJ central venous line placement Hemodialysis History of Present Illness: 59 [**Hospital **] [**Hospital **] nursing home resident with ESRD/HD, seizure disorder, CVA w/ left-sided weakness, recent MRSA endocarditis s/p 6 week course of Vancomycin, SLE, Atrial Fibrillation and antiphospholipid syndrome on coumadin. She was admitted on [**2168-1-31**] (transfer from OSH, where she presented on [**2168-1-30**]) after a mechanical fall resulting in a left femoral neck fracture and acute on chronic SDH in setting of INR 3.4. She is s/p left hemiarthroplasty on [**2168-2-1**], which was uncomplicated. Geriatrics is following the patient and Dr. [**Last Name (STitle) **] will be attending upon transfer. . Overnight from [**2-1**] --> [**2-2**], she had two witnessed tonic-clonic seizures that both self-resolved after 1-3 minutes (note is made in the neurology consult note that she missed her home lamotrigine that morning). After these seizures, she was transferred to the SICU for further monitoring. Neurology following the patient was concerned for lupus cerebritis; they requested a hypercoagulability workup, as well as a TTE given recent endocarditis. She has had continuous EEG to evaluate for non-convulsive status epilepticus given her lethargy and recent seizures. She is currently on keppra and lamotrigine. . Patient was also found to have a right upper extremity DVT and is s/p IVC filter placement on [**2168-2-1**]. As her platelets continued to decrease, patient was found to be HIT antibody positive. Past Medical History: -- IVC filter placed [**2168-2-1**] -- s/p left hemiarthroplasty -- MV MRSA endocarditis [**11-5**]; on vanco from [**11-5**] - [**12-17**] (6 wks) --h/o R CVA w. residual L sided weakness, ESRD on HD M/W/F [**University/College **], hx seizures, lupus, atrial fibrillation, hypercoagulability, anemia -hx of R CVA with residual L sided weakness -Stats she had possibly more than one CVA but unsure, states one in her late 20's and then in her early to mid 30's per her report -ESRD on HD M/W/F -Lupus -Hx of seizures on lamotrigine -Atrial fibrillation -Hypercoagulability -Anemia -Left UE AVG [**12-5**] -[**10-6**]: Fistulogram and balloon angioplasty venous anastomosis and outflow vein stenosis. Social History: Has been living at [**Hospital 599**] Nursing Home in [**Location (un) 55**] since 2/[**2167**]. Denies alcohol and tobacco use. Healthcare proxy is sister, [**Last Name (NamePattern1) 73364**] [**Telephone/Fax (1) 73365**]; guardian [**Name (NI) **] [**Telephone/Fax (1) 73366**] . Functional Baseline: ADLS: mostly dependent IADLS: dependent Services at home: lives at [**Location **] Assistive Device: walker Family History: Father had Parkinson's Physical Exam: VS prior to transfer to floor: T 97.4 (Tmax 99.6); P 94 (70-90); BP 181/74 via right calf (MAP 95); 97% RA GENERAL: frail woman, appears older than stated age, sitting in chair; follows commands but slowed with high speech latency HEENT: PERRL, oral mucosa dry NECK: no LAD, no JVD, right IJ CVL line CV: irregular, II/VI SEM at USB w/o radiation to neck LUNGS: CTA, no wheezes, no crackles ABD: + BS, soft, non-distended, non-tender GU: Foley catheter in place EXT: 2+ RUE edema, no no cyanosis, no clubbing NEURO: AA, Oriented to person & place as hospital (though wrong one); slow somewhat slurred speech though appropriate; slight ptosis of left eye & baseline medial deviation of left eye, also noted in prior neurology note; strength 3/5 in b/l UE, [**5-2**] in lower; no tremor, no rigidity; gait deferred. Able to ambulate to bathroom with 2 assist CAM - A/F: N Inat: Y Disorg: N Consc: N total: [**2-1**] Pertinent Results: MB: 2 Trop-T: 0.02 . PT: 33.3 PTT: 50.1 INR: 3.4 . CBC 13.7 > 13.1 < 193 40.4 N:90.9 L:4.0 M:3.1 E:1.8 Bas:0.2 . Chem 10 135 95 51 97 AGap=20 5.2 25 8.4 &#8710; . Urinalysis: neg leuks, neg nitrites . Imaging: [**1-31**] Left Tib/Fib Xray: No acute fracture to the tibia or fibula [**1-31**] Bil hip Xray: Impacted transcervical fracture of the left hip with medial rotation of the distal femur. [**1-31**] CT head: mixed density L subdural collection consistent w/ acute on chronic hemorrhage [**1-31**] C-spine XRay: 1. No evidence for traumatic injury involving the cervical spine. Significant degenerative change is noted, most severe from C4 through C7; Right thyroid nodule 1/3 L-spine: Mildly limited study of the lumbar spine with no compression fractures identified. . ECHO: Mild symmetric left ventricular hypertrophy with normal global and regional biventricular systolic function. Thickened mitral valve, but no discrete vegetation seen. At least moderate mitral regurgitation. Compared with the prior study (images reviewed) of [**2167-11-9**], mitral valve morphology is similar, but severity of regurgitation has increased. The other findings are similar. . EEG: This is an abnormal noncontinuous extended routine EEG due to slowing and disorganization of the background and intermittent focal left frontotemporal theta/detla slowing. These findings suggest a mild to moderate diffuse encephalopathy, and with a potentially epileptogenic focal structual lesion in the left frontotemporal region. No electrographic seizures were seen during this recording. [**2-1**] Heac Ct : Stable Brief Hospital Course: 59 yoF with multiple medical problems including SLE, ESRD/HD, recent endocarditis, problems with left AV fistula, seizure disorder, CVA with left sided weakness, AFib, hypercoagulopathy who p/w falls resulting in left hip fracture and acute on chronic SDH. Patient is s/p left hip hemiarthoplasty and IVC filter placement. During this hospitalization, had two seizures overnight on POD#1, was transferred to the ICU and also found to have HIT+ antibody. . #. HYPERCOAGULABLE STATE vs. BLEEDING RISK: Very complicated risk-benefit analysis in terms of restarting anticogaulation in patient. She has been on long-term anticoagulation with Coumadin which had to be reversed in the setting of her acute on chronic subdural hematoma and left hip fracture. Reasons to start anticoagulation: HIT +, new right basilic vein DVT, AFib, recent endocarditis, antiphospholipid syndrome in setting of SLE, multiple CVAs with therapeutic INR, recent ortho trauma with relative immobilization. [**Name2 (NI) 73367**] to not anticoagulate: s/p acute on chronic SDH after a fall on [**2167-1-31**], IVC filter. Neurosurgery preferred that patient not be anticoagulated but felt that if absolutely necessary, patient should be anticoagulated with a lower PTT goal of 40-60. In the setting of heparin-induced thrombocytopenia, Hematology recommended anticoagulation with Argatroban. The Primary Geriatric team and patient's primary care doctor, Dr. [**Last Name (STitle) **] also favored anticoagulation. Patient was started on Argatroban gtt and was intially supratherapeutic in the high 60s-70s. Ultimately, patient's PTT was therapeutic at ~60 mcg/kg/minute. Patient had neurological checks every 4 hours without concerns for rebleed into her SDH in setting of resumed anticoagulation. Hematology contact[**Name (NI) **] patient's previous rheumatologist at [**Hospital1 **] who confirmed patient has antiphospholipid, anticardiolipin antibodies since [**2147**], lupus anticoagulant in [**2152**]. Of note, Neurology had wished to start antiplatelet therapy on patient, as well, given her coagulopathies but given patient's low platelet counts during this admission and the fact that she was not on Coumadin during this admission, they held off. This will need to be discussed at her outpatient Neurology appointment. - Continue Argatroban gtt at rate of 0.171 mcg/kg/min given PTT of 45.1 (decreasing) on day of discharge. Patient will get PTT checks at hemodialysis three times weekly. Please titrate Argatroban infusion rate accordingly, for goal PTT of 40-60. When changing rate, should increase/decrease by 0.125-0.25mcg/kg/min. - Start Coumadin once platelets >100 with 5 days of overlap with Argatroban - Please have patient follow-up in [**Hospital 878**] Clinic with Drs. [**First Name4 (NamePattern1) 73368**] [**Last Name (NamePattern1) **] and [**First Name8 (NamePattern2) 1692**] [**Last Name (NamePattern1) 1693**]. She has an appointment for Thursday, [**2-25**] at 10:30am. Location: [**Location (un) **], [**Hospital Ward Name 23**] Bldg [**Location (un) 858**], [**Location (un) 86**], MA Phone number: [**Telephone/Fax (1) 1694**] . # THROMBOCYTOPENIA: Patient was noted to have dropping platelet counts and was diagnosed with HIT antibody positive serology on [**2168-2-3**]. Hematology contact[**Name (NI) **] patient's outpatient nephrologist, Dr. [**Last Name (STitle) 15172**], who confirmed patient has known HIT antibody positive history. She had initially been diagnosed at [**Hospital 794**] Hospital in [**Hospital1 789**], RI and had been evaluated by hematology there. Once care was transferred to Dr. [**Last Name (STitle) 15172**], patient has been receiving altepase instead of heparin during outpatient hemodialysis sessions. Hematology reviewed patient's peripheral smear and felt that microangiopathic hemolytic anemia is unlikely. They felt that the recent decline in platelet count could be attributed to appropriate consumption, given recent hemorrhage and clotting. Drug effect was also considered although which medication causing it could not be pin-pointed. Keppra has not been known to cause thrombocytopenia, nor Argatroban. Lamictal is reported to cause thrombocytopenia but patient has been on that medication long-term. Hematology recommended platelet goal >50 with plans to start Prednisone 1mg/kg daily for ?autoimmune thrombocytopenia (in association with APLAS) should platelet count continue to drop. Patient's platelet count was relatively stable at 65 on day of discharge - Continue to avoid heparin in patient; altepase can be used as an alternative for flushes - Please resume Coumadin once patient's platelet count is above 100. She will need 5 days overlap of Coumadin with Argatroban - Please follow-up in [**Hospital **] Clinic. You have an appointment to see Dr. [**First Name4 (NamePattern1) 3065**] [**Last Name (NamePattern1) 4762**] on [**2-19**] at 10:30am. You can reach his office at: [**Telephone/Fax (1) 22**] . #. SEIZURE DISORDER: Has prior seizure disorder and acute on chronic subdural hematoma. Neurology monitored patient for 24 hours with EEG and she was not having status epilepticus. Immediately after her two seizures, patient was noted to have altered mental status which gradually resolved. By day of discharge, patient was alert and oriented X3. - Continue Lamictal 50mg twice daily with uptitration as follows: Week [**1-30**] 50mg [**Hospital1 **] Week [**3-31**] 50/75mg Week [**6-2**] 75mg [**Hospital1 **] Week [**8-4**] 75/100mg Week [**10-7**] 100mg [**Hospital1 **] Week [**12-9**] 100/125mg Week 13-14 125mg [**Hospital1 **] - Continue Keppra 750mg daily, dosed AFTER hemodialysis on HD days - Please have patient follow-up in [**Hospital 878**] Clinic with Drs. [**First Name4 (NamePattern1) 73368**] [**Last Name (NamePattern1) **] and [**First Name8 (NamePattern2) 1692**] [**Last Name (NamePattern1) 1693**]. She has an appointment for Thursday, [**2-25**] at 10:30am. Location: [**Location (un) **], [**Hospital Ward Name 23**] Bldg [**Location (un) 858**], [**Location (un) 86**], MA Phone number: [**Telephone/Fax (1) 1694**] . #. s/p LEFT HEMIARTHROPLASTY: Patient was briefly on Cefazolin post-operatively. She continued to work with physical therapy and pain was controlled with tylenol 1 gram every 8 hours standing - Continue to have patient work with physical therapy (weight bearing as tolerated) - Continue pain control with Tylenol 1 gram every 8 hours standing --> can decrease and make PRN as needed - Patient needs to follow-up in the [**Hospital **] Clinic within 2 weeks. Please have her call [**Telephone/Fax (1) 1228**] to set up a "Post-Operative Appointment" with [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], the Nurse Practitioner. . #. s/p ACUTE ON CHRONIC SDH: Stable. Neurosurgery felt no surgical intervention was needed. Of note, patient did sustain another unwitnessed fall the day prior to discharge. CT head was negative for any new hemorrhage and the old acute on chronic subdural hematoma was stable. Patient demonstrated no acute mental status changes concerning for worsening of her subdural hematoma. - Patient will need follow-up head CT once anticoagulation is therapeutic - Patient will need head CT if mental status changes (for possible bleeding into subdural hematoma) . #. HYPERTENSION: It was difficult to obtain consistent blood pressure measurements on patient given her left AV fistula and difficulties measuring in right arm. Per neurosurgery, goal was for patient's mean arterial pressures to be <110 to manage her subdural hematoma and subsequent bleeding risk. Patient was continued on home nifedipine 30mg daily and home metoprolol; the latter was increased from 75mg to 125mg twice daily to maintain MAP <110. - Continue Metoprolol 125mg twice daily - DISCONTINUE Nifedipine 30mg daily - START Lisinopril 5mg daily . #. RECENT ENDOCARDITIS: Patient completed 6 week course of Vancomycin in mid-[**Month (only) **] for MRSA endocarditis. Repeat ECHO (TTE) during this admission confirmed residual thickening and fibrous quality to mitral valve that can make patient at increased risk for future embolic events. . #. NONFUNCTIONAL LEFT AV FISTULA: See Letter to Dr. [**Last Name (STitle) **] by Transplant Surgery (Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 816**]) from [**2168-1-3**] in OMR. Patient's left AV fistula is non-salvageable and patient prefers not to have AV fistula placed in right arm. Plan was for leg graft to be placed. - Please have patient follow-up in Transplant Surgery with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 816**] regarding left arm AV fistula, which is no longer working. She can discuss plans for the leg graft. She has an appointment for Thursday, [**2-18**] at 8:00am. Location: [**Last Name (NamePattern1) 439**], [**Hospital Ward Name **] Bldg [**Location (un) **], [**Location (un) 86**], MA Phone number: ([**Telephone/Fax (1) 3618**] . #. ESRD/HD: Likely secondary to lupus and/or hypertension. Patient has some residual urine output - Continue routine hemodialysis schedule, Monday/Wednesday/Friday - Continue neprhocaps and sevelamer . #. ANEMIA: Unclear baseline but stable during this hospitalization - Consider Epo at outpatient dialysis . #. THYROID NODULE: Incidentally noted on admission CT spine. - Patient will need outpatient follow-up with her primary care provider . #. NUTRITION: Speech and Swallow evaluated patient and felt she was appropriate for diet as follows - PO diet of soft solids, pills crushed in applesauce, one-on-one supervision, every 4 hours oral care. . #. ACCESS: Patient has right IJ placed [**2167-2-3**]; right tunneled HD cath. Patient's left IJ entral venous line stopped drawing back blood and could not be flushed. Patient has left AV graft and right upper extremity DVT, making PICC lines in either arm impossible. Left subclavian and repeat left IJ were ultimately not attempted given significant ecchymosis in that region. Labs can be drawn from patient's right tunneled HD catheter. Nothing can be drawn back from the right IJ line. . #. CODE: DNR/DNI Medications on Admission: metoprolol 75 mg po bid, nifedipine 30 mg po every other day, sevelamer 2400 mg po four times daily, wafarin, lamotrigine 25 mg poqam and 50 mg po qhs, omeprazole 20 mg daily, nephrocaps 1 tab daily, percocet prn, trazodone 12.5 mg po bid, docusate prn Discharge Medications: 1. Sevelamer HCl 400 mg Tablet Sig: Two (2) Tablet PO QID (4 times a day). 2. B Complex-Vitamin C-Folic Acid 1 mg Capsule Sig: One (1) Cap PO DAILY (Daily). 3. Simvastatin 10 mg 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. Acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO Q8H (every 8 hours) as needed for pain: This can be changed to PRN (as needed) once left hip heals more. . 6. Metoprolol Tartrate 50 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 7. Levetiracetam 500 mg Tablet Sig: 1.5 Tablets PO DAILY (Daily). 8. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 9. Polyethylene Glycol 3350 17 gram/dose Powder Sig: One (1) PO DAILY (Daily) as needed for constipation. 10. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed for constipation. 11. Lisinopril 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 12. Lamotrigine 25 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day): Weekly uptitration as outpatient. Week [**1-30**] 50mg [**Hospital1 **] Week [**3-31**] 50/75mg Week [**6-2**] 75mg [**Hospital1 **] Week [**8-4**] 75/100mg Week [**10-7**] 100mg [**Hospital1 **] Week [**12-9**] 100/125mg Week 13-14 125mg [**Hospital1 **] . 13. Argatroban 100 mg/mL Solution Sig: 0.171 mcg/kg/min Intravenous INFUSION (continuous infusion): Patient will have PTT labs checked during dialysis. Please titrate Argatroban infusion rate accordingly, for goal PTT of 40-60. When changing rate, should increase/decrease by 0.125-0.25mcg/kg/min. 14. Insulin Regular Human 100 unit/mL Solution Sig: Per insulin sliding scale, which is included Injection ASDIR (AS DIRECTED). Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - MACU Discharge Diagnosis: Primary: Left trochanteric femur fracture, acute on chronic subdural hematoma, heparin-induced thrombocytopenia Secondary: Antiphospholipid syndrome, atrial fibrillation, seizure disorder, anemia, lupus, ESRD on HD, CVA with residual left sided weakness 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: -You were admitted after falling at your nursing home. You were found to have a left hip fracture which was repaired by the Orthopedic Surgeons. You also sustained bleeding into the lining of your brain during the fall. You were followed by Neurosurgery for this and watched closely. You had two seizures shortly after your surgery so your seizure medications have been revised by Neurology. You were also found to have a clot in your right arm and an allergy to heparin (a blood thinner) that depleted your platelets. You were treated with anticoagulation using a medication called Argatroban with plans to eventually resume Coumadin. . -It is important that you continue to take your medications as directed. We made a number of changes to your medications during this admission. Please start taking the medications listed as follows. . -Contact your doctor or come to the Emergency Room should your symptoms return. Also seek medical attention if you develop any new fever, chills, trouble breathing, chest pain, nausea, vomiting or unusual stools. Followup Instructions: Please follow-up in the [**Hospital **] Clinic within 2 weeks. You can call [**Telephone/Fax (1) 1228**] to set up a 'Post-Operative Appointment' with [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], the Nurse Practitioner. . Please follow-up in Transplant Surgery with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 816**] regarding your left arm AV fistula, which is no longer working. You can discuss plans for the leg graft. You have an appointment for Thursday, [**2-18**] at 8:00am. Location: [**Last Name (NamePattern1) 439**], [**Hospital Ward Name **] Bldg [**Location (un) **], [**Location (un) 86**], MA Phone number: ([**Telephone/Fax (1) 3618**] . Please follow-up in [**Hospital **] Clinic. You have an appointment to see Dr. [**First Name4 (NamePattern1) 3065**] [**Last Name (NamePattern1) 4762**] on [**2-19**] at 10:30am. You can reach his office at: [**Telephone/Fax (1) 22**] . Please follow-up in [**Hospital 878**] Clinic with Drs. [**First Name4 (NamePattern1) 73368**] [**Last Name (NamePattern1) **] and [**First Name8 (NamePattern2) 1692**] [**Last Name (NamePattern1) 1693**]. You have an appointment for Thursday, [**2-25**] at 10:30am. Location: [**Location (un) **], [**Hospital Ward Name 23**] Bldg [**Location (un) 858**], [**Location (un) 86**], MA Phone number: [**Telephone/Fax (1) 1694**] . Please follow-up with your primary care doctor, Dr. [**First Name8 (NamePattern2) 622**] [**Last Name (NamePattern1) **] within 2-3 weeks. You can reach her office at: ([**Telephone/Fax (1) 15260**] ICD9 Codes: 5856
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Medical Text: Admission Date: [**2116-2-19**] Discharge Date: [**2116-2-27**] Date of Birth: [**2055-5-29**] Sex: F Service: MEDICINE ICU HISTORY OF PRESENT ILLNESS: This is a 60 year old woman with a history of end stage renal disease secondary to polycystic kidney disease on hemodialysis, also with chronic obstructive pulmonary disease, coronary artery disease, pneumonia, congestive heart failure, atrial fibrillation, and recurrent line sepsis, who was transferred from [**Hospital3 10377**] Hospital to [**Hospital1 69**] for percutaneous endoscopic gastrostomy tube placement. On arrival to the surgery floor, she was found to have a blood pressure of around 60 to 80 over 30 to 50 with an altered mental status. She was then transferred to the Medical Intensive Care Unit for further monitoring and treatment. The patient was initially admitted to [**Hospital3 10377**] Hospital on [**2116-1-24**], from [**Hospital3 **] [**Hospital **] Hospital with suspicion of line sepsis. She had been febrile and had her permacath removed that same day. The catheter was placed in her right groin and then her left groin temporarily. She then had a permacath placed in her left subclavian on [**2116-2-7**]. Culture data showed coagulase negative Staphylococcus in blood cultures from [**2116-1-11**], gram positive cocci in clusters from [**2116-1-21**], in a blood culture, and Serratia marcescens sensitive to Amikacin, Imipenem, Bactrim, and Levofloxacin from a right femoral line on [**2116-2-1**], and finally coagulase negative Staphylococcus on blood cultures from [**2116-2-6**]. She was treated with Amikacin and Linezolid between [**2116-2-2**], and [**2116-2-16**]. She was also seen by neurology for an altered mental status. It was believed that her altered mental status was due to a metabolic encephalopathy. This was determined by an electroencephalogram on [**2116-12-19**], and [**2116-1-24**], as well as a magnetic resonance scan which was reportedly negative. Because she was somnolent and had difficulty eating, it was believed that she may be at serious risk for aspiration. Gastroenterology consultation was obtained for percutaneous endoscopic gastrostomy tube placement as her nutritional status was poor as evidenced by an albumin of 1.8. The outside records document that she is DNI. After being transferred to the [**Hospital1 188**] Medial Intensive Care Unit, a left femoral arterial line and right femoral central venous catheter were placed. She was given approximately three liters of normal saline which did not improve her hypotension or mental status. She was then started on Levophed, which subsequently improved the above. An arterial blood gas was obtained while on ten liters face mask and that revealed the following values: 7.26/56/109. Because she was DNI, a trial of BiPAP was performed and she was not intubated. However, this was discontinued because she could not tolerate BiPAP secondary to discomfort while wearing the mask. PAST MEDICAL HISTORY: 1. End stage renal disease on hemodialysis three times a week secondary to polycystic kidney disease. 2. Chronic obstructive pulmonary disease. 3. Cerebrovascular accident. 4. Pneumonia. 5. Intractable diarrhea history. 6. Status post cholecystectomy. 7. Status post appendectomy. 8. Hypertension. 9. Recurrent sepsis secondary to line infections. 10. Compression fracture of the lumbar spine. 11. Atrial fibrillation with rapid ventricular rate, on Coumadin. 12. Congestive heart failure. 13. Oxacillin resistant Staphylococcus aureus. 14. Coronary artery disease. 15. Anemia. ALLERGIES: 1. Vancomycin causes redman syndrome. 2. Hycodone, unknown allergy. 3. Levofloxacin, unknown allergy. 4. Penicillin causes anaphylaxis. 5. Quinidine, unknown reaction. 6. Sulfa drugs cause anaphylactic reaction. 7. Opiates, unknown reaction. MEDICATIONS AT OUTSIDE HOSPITAL: 1. Digoxin 0.125 mg q.Monday, Wednesday and Friday. 2. Advair Discus 250/50 one puff twice a day. 3. Prevacid. 4. Lactulose. 5. Linezolid. 6. Nephrocaps. 7. Pericolace. 8. Digoxin. 9. Dicacodyl. 10. Epoetin. 11. Amikacin. 12. Coumadin. FAMILY HISTORY: Not obtained. SOCIAL HISTORY: The patient is married and lives with her husband and two daughters. She also has another daughter. She has no alcohol history. She smoked thirty-five plus years but stopped smoking three years ago. PHYSICAL EXAMINATION: Vital signs revealed a temperature 97.0, pulse 89, blood pressure 82/42, oxygen saturation 96% on ten liters cool nebulizer. In general, the patient is oriented times two in moderate respiratory distress. Head, eyes, ears, nose and throat examination - Mucous membranes are dry. No jugular venous distention. Cardiovascular is regular rate and rhythm, no murmurs, rubs or gallops. Distant heart sounds. Respiratory - Decreased breath sounds throughout, crackles at the left lung base greater than right, scattered wheezes. Abdomen reveals mild epigastric tenderness and no rebound, positive bowel sounds. Extremities - no cyanosis, clubbing or edema. LABORATORY DATA AND DIAGNOSTICS: On admission, electrocardiogram showed an atrial fibrillation at a rate of 66 beats per minute and normal axis, Q wave in V1, diffuse T wave flattening and inversions in V4 and V5, but no change compared to that done at outside hospital. Chest x-ray revealed a right lower lobe opacity and a retrocardiac density. White blood cell count was 7.5, hematocrit 29.7, platelet count 162,000. INR 1.6, partial thromboplastin time 36.4. Normal chemistries with the exception of a potassium of 3.5, blood urea nitrogen 8 and creatinine of 3.0. Normal liver function tests. Cardiac enzymes revealed a CPK of 19, CK MB of 3.0 and a troponin of 0.5. The patient's magnesium level was low at 1.5. Her calcium was 7.9, phosphate was 3.5. The patient's blood gases on 100% nonrebreather mask were 7.29/57/113. ASSESSMENT AND PLAN: This is a 60 year old female with a history of end stage renal disease on hemodialysis, also with chronic obstructive pulmonary disease, and recurrent line infections, admitted to the outside hospital for treatment of permacath line infection. She was transferred to [**Hospital1 346**] for percutaneous endoscopic gastrostomy tube. On arrival, the patient was found to be hypertensive along with an arterial blood gas consistent with hypercarbic respiratory failure. She was admitted to the Medical Intensive Care Unit for aggressive treatment of her hypotension with pressor support, management of possible pulmonary edema, management of overwhelming sepsis, and monitoring of her electrolytes and mental status. HOSPITAL COURSE: The following is a summary of the [**Hospital 228**] hospital course by systems: 1. Respiratory - The patient was diagnosed with acute hypercarbic respiratory failure likely triggered by pneumonia, all this on top of a setting of chronic obstructive pulmonary disease. BiPAP was attempted at the time of hospitalization, however, the patient could not tolerate the mask. The patient was maintained on ten liters face mask during which her saturation was satisfactory. The patient remained tachypneic throughout her hospital stay. Serial chest x-rays continued to reveal bilateral pleural effusions and congestive heart failure. The patient continued to receive nebulizer treatments throughout her hospital stay for her chronic obstructive pulmonary disease. She was continued on her face mask for noninvasive ventilation, and towards the end of her hospital stay, she was switched to BiPAP which she, unlike during the beginning of her hospital stay, began to tolerate. She was treated for possible pneumonia, the treatment of which is further delineated under the infectious disease section. She received respiratory therapy in the form of nebulizer treatments and chest physical therapy and suctioning throughout her hospital stay. The patient's wish to remain DNI was honored throughout her hospital stay. When the patient was made comfort measures only, she was taken off her BiPAP and once again placed on a comfortable Venturi mask. Respiratory cultures were obtained in the form of sputum samples and these ended up growing 4+ gram negative rods, which lead to a change in her antibiotic regimen as described in the infectious disease section. 2. Infectious disease - The patient was diagnosed with presumed sepsis, the most likely cause being one of her lines, although a chest x-ray suggesting pneumonia could also point to a culprit. The patient underwent a sepsis workup which included CT and magnetic resonance scan of the lumbar spine to rule out osteomyelitis, CT of the brain to rule out an abscess, serial chest x-rays which showed continued pulmonary processes which may be suggestive of pneumonia, multiple blood cultures including blood cultures positive for gram positive cocci later identified as coagulase negative Staphylococcus, CT of the abdomen to rule out abdominal abscess or colitis. The patient's antibiotic regimen was carefully chosen in light of the patient's multiple drug allergies. At first, she was started on broad spectrum antibiotics consisting of Linezolid, Imipenem, and Flagyl. This was then changed to Amikacin, Vancomycin, and Flagyl. When no gram negative culture data had been obtained after a few days, her Amikacin and Flagyl were discontinued and she was continued on Vancomycin. She had levels of Vancomycin that were therapeutic throughout her hospital stay. When gram negative rods were discovered in her sputum culture towards the end of her hospital stay, the Amikacin was restarted. When the patient was made comfort measures only, the patient was taken off all antibiotics. 3. Cardiovascular - The patient had hypotension for which she required pressor support consisting of Vasopressin and Levophed throughout her hospital stay. With these, we were able to maintain her MAP greater than 70 throughout her hospital stay. The patient was initially started on Digoxin, but this medication was discontinued after an echocardiogram was performed which showed no signs of heart failure. She did, however, have multiple x-rays which revealed pulmonary edema. The patient's Coumadin was held in light of possible need for percutaneous endoscopic gastrostomy in the near future, and she was prophylaxed for deep vein thrombosis with pneumatic boots. However, given concern for her atrial fibrillation and the need for anticoagulation, she was eventually restarted on a Heparin drip in addition to having had subcutaneous Heparin before that. The patient underwent another echocardiogram towards the end of her hospital stay to rule out pulmonary embolism after her tachypnea did not resolve. This echocardiogram did not reveal any new right heart disease, but, as on earlier studies, did indicate that there was mild pulmonary hypertension and right ventricular volume and pressure overload. 4. Renal - The patient had end stage renal disease secondary to polycystic kidney disease. She was continued on her dialysis regimen of three times a week. In addition, the patient required extra dialysis during her hospital stay to either remove volume or provide ultrafiltration. The patient's dialysis catheter which had been placed on [**2116-2-7**], did grow positive blood cultures, but given her poor access issues, this catheter was left in place. An attempt was made to provide the patient with another source of access, but ultrasound of the right neck area revealed a clotted superior vena cava which would preclude any chance for a right IJ or permacath site. The patient was continued on her Nephrocaps. Her electrolyte balance was maintained within normal limits throughout her hospital stay. She remained anuric throughout her hospital stay. 5. Neurology - The patient was admitted with altered mental status most likely secondary to toxic metabolic changes and hypotension. She did improve with respect to her mental status when her pressures were increased by pressors, but her mental status remained subpar throughout her hospital stay. She had had a negative magnetic resonance scan at the outside hospital, and she had a negative CT scan for acute processes such as bleeds or abscesses at this hospital. Her TSH, folate and B12 levels were normal. Towards the end of her hospital stay, the patient developed new mental status changes that were more profound and her neurologic examination revealed left sided weakness and decreased reflexes as well as left sided hemineglect. It was thought that the patient would require new brain imaging, but, given her persisting tachypnea, she was deemed unstable to leave the Medical Intensive Care Unit. When she was made comfort measures only, the patient's mental status worsened to the point that she was no longer responsive. 6. Endocrine - The patient ruled in for adrenal insufficiency with an ACTH stimulation test. It was thought that this could be a potential contributing factors to her hypotension. She was started on Dexamethasone empirically before this test was positive, and afterwards was started on Florinef and Hydrocortisone. However, her pressures did not increase substantially with these alone, and she continued to need pressors. Her TSH was negative which ruled out any potential hypothyroidism. She was placed on a regular insulin sliding scale throughout her hospital stay for coverage since the patient was on steroids. 7. FEN, gastrointestinal - The patient was diagnosed with functional dysphagia secondary to either her mental status changes or a real neuromuscular defect at the outside hospital. A speech and swallow consultation was requested for the purpose of evaluating dysfunctional dysphagia, but give the patient's poor mental status, a video swallowing study was never performed. The patient was made NPO throughout her hospital stay, and a nasogastric tube was placed so that the patient could receive nutrition in the form of tube feeds. The patient tolerated these tube feeds, except for the fact that towards the middle of her hospital stay, she was found to have blood in her residual. As a result, nasogastric tube feeds were discontinued and the tube was used only for medication delivery. The patient then received TPN for the rest of her hospital stay, which she tolerated without any problem. The patient was maintained on aspiration precautions during her hospital stay. She received no extra fluids given chest x-rays revealing pulmonary edema and her end stage renal disease status. It was thought that dialysis would help her volume status, but her hypotension and pulmonary edema persisted regardless. The patient's electrolyte levels were maintained within normal limits throughout her hospital stay. 8. Pain - The patient was admitted with a complaint of pain secondary to compression fractures in her lumbar spine. She was continued on Tylenol PR which she was on at the outside hospital. Given her renal failure, there was concern about giving narcotics, and more so, the patient had a history of opioid allergies as well as hypotension. The decision was made not to treat the patient with narcotics. Instead, the patient was treated at first with Toradol, and then with Tramadol. Her pain was maintained under control throughout her hospital stay. 9. Access - The patient received a femoral arterial line on her left leg, a femoral venous line on her right leg and a nasogastric tube. Arterial lines were attempted in her upper extremities, but these attempts were not successful throughout her hospital stay. The femoral arterial line was discontinued after it grew positive blood cultures. The patient had a permacath on her left upper thorax throughout her hospital stay, but this was not discontinued despite gram positive blood cultures as dialysis access was desperately needed. 10. Prophylaxis - The patient was placed on a H2 blocker at the time of admission and that was later changed to a PPI after blood was found in her residual. The patient was also started on Heparin subcutaneous on her admission. When the blood was found, this was taken off and she was placed on pneumatic boots. When she developed neurological deficit, she was started on a Heparin drip. 11. Code Status - The patient came into the hospital with a DNI status. This status was honored throughout her hospital stay. Towards the end of her hospital stay, numerous family meetings were held, including with the help of the palliative care team and Dr. [**Last Name (STitle) 22926**] [**Name (STitle) **], and the decision was made to change the patient's status to comfort measures only. Previous to this, the family had decided to make her DNR/DNI. When she was made comfort measures only, the patient was discontinued of all her medications. Her nasogastric tube was pulled. She was discontinued of all her medications and she was started on a Morphine drip. She passed away on [**2116-2-27**], at 10:22 a.m. when her breathing stopped. Permission was obtained from the family for an autopsy. [**First Name8 (NamePattern2) **] [**Name8 (MD) **], M.D. [**MD Number(1) 7585**] Dictated By:[**Last Name (NamePattern1) 1595**] MEDQUIST36 D: [**2116-2-27**] 13:48 T: [**2116-3-1**] 12:07 JOB#: [**Job Number 4719**] ICD9 Codes: 4280
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Medical Text: Admission Date: [**2174-4-4**] Discharge Date: [**2174-4-19**] Date of Birth: [**2096-6-1**] Sex: F Service: ORTHOPAEDICS Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 4277**] Chief Complaint: CHF/Sarcoma Major Surgical or Invasive Procedure: Excision of right groin soft tissue sarcoma, gracilis muscle flap coverage: [**4-13**]. History of Present Illness: The patient is a 77 year old female with history of hypertension, hyperlipidemia, and moderate-severe aortic valve stenosis who was recently diagnosed in [**2174-1-6**] with a soft-tissue sarcoma in her right groin after developing right groin pain. She presented on this admission for surgical excision of the right groin mass. Past Medical History: #. Soft tissue right thigh sarcoma - identified [**1-7**] right groin pain [**2174-1-6**] - s/p gamma knife - admitted this admission for wide excisional therapy #. Aortic Stenosis - moderate to severe aortic stenosis, [**Location (un) 109**] 0.8cm2; peak 64mmHg, mean 39mmHg) with mild aortic regurgitation - echocardiogram at OSH revealed mild concentric LVH with normal biventricular function - moderate tricuspid regurgitation and moderate pulmonary artery systolic hypertension (46mmHg #. Post-polio syndrome with fusion of right ankle. #. Hypertension #. Hyperlipidemia #. Chronic backpain spinal stenosis Social History: The patient is married (first husband died at age 28 [**1-7**] Hodgkin's lymphoma). The patient lives in a single family home and was previously a singer. Tobacco: 1-2ppd x 48 years, ETOH: None Illicts: None Family History: Mother - passed in the 80's from "old age," Father - unknown 5 children Physical Exam: Vitals: Afebrile, vital signs stable. General: Alert and oriented. Abdomen: Obese, soft. Non-tender, non-distended. Right Lower Extremity: Incision site clean/dry/intact with some swelling over incision site. She has a drain intact. She is neurovascularly intact distally. Pertinent Results: [**2174-4-4**] 11:30PM WBC-8.3 RBC-4.03* HGB-10.8* HCT-33.4* MCV-83 MCH-26.7* MCHC-32.2 RDW-17.1* CPK: 74, 91, Troponin x 2 sets [**Date range (1) 22743**]: <0.01. [**4-19**]: HCT: 28.9, WBC: 5.6 PLT: 359 Brief Hospital Course: The patient was admitted to the vascular surgery service on [**2174-4-4**] for pre-operative planning. In anticipation of the surgery, the patient underwent diagnostic abdominal aortogram with pelvic arteriogram with pre and post hydration with discontinuation of patient's home lasix. The following morning, on the day of planned surgical resection, the patient was noted to be tachypnic, hypertensive, hypoxic and agitated with rales [**12-7**] way up her lung fields, consistent with pulmonary edema. The surgery was cancelled given decompensated CHF requiring a non-rebreather. The patient received 20mg IV lasix x 2, was transferred to the PACU with improvement in O2 requirements to > 95% on 2L NC. The patient was then transferred to the medical service for management of CHF and medical optimization prior to possible repeat attempt for surgery. Pain service was consulted and a tunneled epidural catheter was placed for pain control. She was optimized medically for one week and on [**4-13**], she underwent resection of her right groin sarcoma without complications. Vascular surgery was not needed as the tumor was resected off the femoral vessels without the need for bypass. Plastic surgery applied a gracilis flap over the femoral vessels. Post-operatively, internal medicine was consulted to help manage her fluid status. She did extremely well post-operatively. Her epidural was discontinued a few days after the procedure and she had good pain control on oral pain medications. Her foley catheter was removed on post-operative day number five. She worked with physical and occupational therapy. She was discharged in stable condition to rehab on post-operative day number six. Due to the drain output of 20 cc over 24 hours, plastic surgery service decided to keep the drain in place at the time of discharge for plan to record drain amounts at rehab then return to plastic surgery (Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **]) in 1 week for removal of the drain. It was also decided by them to keep her on oral keflex to prevent infection while the drain is in place. Medications on Admission: Medications on transfer: ISS Lidocaine 5% Patch 2 PTCH TD Q 24 HRS Atenolol 25 mg PO DAILY Nifedipine CR 30 mg PO DAILY Lorazepam 0.5-1 mg PO Q4-6H:PRN Citalopram Hydrobromide 40 mg PO DAILY Nicotine Patch 14 mg TD DAILY Furosemide 40 mg PO DAILY (holding) OxycoDONE (Immediate Release) 5 mg PO Q4-6H:PRN Oxycodone SR (OxyconTIN) 20 mg PO Q12H Gabapentin 600 mg PO TID Simvastatin 10 mg PO DAILY Haloperidol 2.5 mg IV Q4H:PRN Lasix 20mg IV x 2 . Medications, outpatient Atenolol 25mg daily Nifedipine XL 30mg qd Simvastatin 20mg qd Lasix 40mg qd Neurontin 300mg [**Hospital1 **] Celexa 40mg qd Discharge Medications: 1. Furosemide 40 mg Tablet Sig: One (1) Tablet PO once a day. 2. Simvastatin 20 mg Tablet Sig: One (1) Tablet PO once a day. 3. Gabapentin 300 mg Tablet Sig: One (1) Tablet PO twice a day. 4. Atenolol 25 mg Tablet Sig: One (1) Tablet PO once a day. 5. Lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: One (1) Adhesive Patch, Medicated Topical Q 24 HRS (). 6. Acetaminophen 325 mg Tablet Sig: One (1) Tablet PO Q6-8H (every 6 to 8 hours) as needed. 7. Nicotine 21 mg/24 hr Patch 24 hr Sig: One (1) Patch 24 hr Transdermal DAILY (Daily). 8. Sodium Chloride 0.65 % Aerosol, Spray Sig: [**12-7**] Sprays Nasal TID (3 times a day) as needed. 9. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed. 10. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 11. Enoxaparin 40 mg/0.4 mL Syringe Sig: One (1) Subcutaneous DAILY (Daily). 12. Gabapentin 300 mg Capsule Sig: Two (2) Capsule PO TID (3 times a day). 13. Oxycodone 20 mg Tablet Sustained Release 12 hr Sig: One (1) Tablet Sustained Release 12 hr PO Q12H (every 12 hours). 14. Insulin Regular Human Subcutaneous 15. Oxycodone 5 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed. 16. Lorazepam 1 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) as needed. Tablet(s) 17. Famotidine 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 18. Cephalexin 500 mg Capsule Sig: One (1) Capsule PO Q6H (every 6 hours). 19. Citalopram 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 20. Nifedipine 30 mg Tablet Sustained Release Sig: One (1) Tablet Sustained Release PO DAILY (Daily). Discharge Disposition: Extended Care Facility: [**Hospital6 **] center Discharge Diagnosis: Primary: 1. Congestive heart failure secondary to aortic stenosis and fluid overload 2. Sarcoma, right thigh 3. Delirium secondary to hypoxia and oversedation with underlying dementia. 4. Anxiety 5. Elevated blood sugar 6. Moderate-Severe aortic stenosis 7. Hypertension . Secondary: 1. Hyperlipidemia 2. Post Polio Syndrome Discharge Condition: Good: No shortness of breath, no supplemental oxygen requirement, good pain control. Discharge Instructions: You were admitted for the surgical removal of the soft tissue sarcoma in your right groin. Pre-operatively, you experienced an episode of CHF secondary to fluid overload in the setting of aortic stenosis. You underwent surgical excision of the mass. . Please call your doctor or return to the emergency room if you develop fevers/chills, chest pain, lightheadedness/dizziness, faiting, shortness of breath, worsening back/leg pain, inability to tolerate food/fluid or any other symptoms that concern you. Please record the daily drain output. Continue with oral keflex while the drain is in place. Return in 1 week to see Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] of plastic surgery for removal of the drain. Followup Instructions: Please follow up with your primary care provider within one week of your discharge from rehab. Dr. [**Last Name (STitle) **] at [**Telephone/Fax (1) 71433**]. . Follow-up with Dr. [**First Name11 (Name Pattern1) 4224**] [**Last Name (NamePattern4) 4225**], MD Phone:[**Telephone/Fax (1) 1228**] in 3 weeks. . Follow-up with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] in plastic surgery in 1 week for removal of your drain. Completed by:[**2174-4-19**] ICD9 Codes: 4280, 4241, 2724
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Medical Text: Admission Date: [**2124-10-24**] Discharge Date: [**2124-10-30**] Date of Birth: [**2044-1-3**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 905**] Chief Complaint: PCP: [**Last Name (NamePattern4) **]. [**Last Name (STitle) **] . cc: fatigue and SOB Major Surgical or Invasive Procedure: right IJ central line History of Present Illness: History obtained from patient, wife and family. . 80 yo male w/ recent hospitalizfation for diverticular bleed, h/o stroke, h/o CAD and MI, CRI who p/w few days of malaise and SOB. Pt was feeling reasonably well since his last admission when his wife brought him to [**Name (NI) 2025**] for increasing SOB over last few days. Per pt and family, he has been having progressive fatigue over last months with decrreased interest in activity. He has been feeling lethargic and wife reports increased somnolence. He reports an increase in his thirst but denies polyuria or polydypsia and has no h/o diabetes. He has been feeling light headed and his appetite as been low over past few days. Pt endorses some increase in LE swelling, +orthopnea and occasional PND. He denies chest pain or palipations. He denies any fevers or chills, weight loss or weight gain, abdominal pain, dysuria or hematuria. He has chronic black stools and is on iron but denies any BRBPR. He uses a walker to get around [**1-21**] residual right-sided weakness after sroke. Pt is not on home oxygen and has 25-30 pack year smoking hx, quit 20 years ago. He takes tiotropium daily but denies h/o asthma or COPD. Pt had nml Echo [**2122**] w/ EF >55%. He denies any changes in his medications and denies any new weakness. Wife does report increase in slurred speech over past few weeks. . Pt was transferred from [**Hospital1 2025**] ED where he was noted to be in a-flutter. He received lasix 20mg IV, Metop 25mg PO, atrovent nebs. Head Ct was ordered but results not reported. Past Medical History: - h/o GI bleed, diverticulitis and recent hospitalization - C. Diff colitis - h/o stroke 12 years ago w/ right-sided weakness - h/o nephrolithiasis w/ stent and nephrostomy tube - CAD s/p MI - sleep apnea - h/o supplemental oxygen - thrombocytopenia - h/o klebsiella urosepsis - CRI BL Cr 1.2-1.7, 2.5 last admission w/ GI bleed - sleep apnea - depression . MEDS: metoprolol 25mg [**Hospital1 **] Iron 325mg TID Tiotropium 18mcg daily Social History: Lives with wife [**Name (NI) **], h/o smoking [**12-21**] PPD for 50 years, quit 20 years ago, does not drink alcohol, no drugs. Family History: non-contributory Physical Exam: VS: 96.3 112/68 68 24 97% on 2L Gen'l: obese, sleepy, NAD HEENT: NC/AT, EOMI, MMM, OP clear NECK: IJ in place, site c/d/i, unable to assess JVD CVS: NR/RR, +s1/s2 but distant heart sounds, no murmur appreciated PUL: ([**Last Name (un) **]) ronchorous breathing, difficult to assess, pt too lethargic to sit up [**Last Name (un) **]: obese, +BS, soft, NT/ND, no masses Extrems: no c/c/e Pulses: 2+ radial, 2+ DP Neuro/Psyche: oriented to name, place, year, season, current events; unable to recite days of week backwards Pertinent Results: 12:45pm: Trop-T: 0.04 CK: 33 MB: Notdone . u/a: mod leuks, large bld, neg nit, tr prot, neg glu, neg ket, >50 RBCs, 21-50 WBC, mod bacteria . 03:55am . 140 106 113 --------------< 110 4.6 18 4.3 . CK: 36 MB: Notdone Trop-T: 0.05 . ALT: 34 AP: 194 Tbili: 0.4 AST: 20 LDH: 182 [**Doctor First Name **]: 59 proBNP: 9866 . T4: 7.5 . Lactate:1.0 . 9.0 > 29.5 < 330 D N:85.3 Band:0 L:11.8 M:1.7 E:0.9 Bas:0.2 . PT: 15.1 PTT: 28.3 INR: 1.4 . RENAL U/S: The study is limited by body habitus. The kidneys demonstrate a homogenous echotexture, although are slightly hyperechoic to the liver which may indicate underlying medical renal disease. There is no evidence of hydronephrosis, mass or stone. No definite stent is seen. IMPRESSION: No evidence of hydronephrosis. . CXR: IMPRESSION: Right IJ terminates at the cavoatrial junction. No acute cardiopulmonary disease is identified. Stable cardiomegaly, suggestive of possible cardiomyopathy. . EKG: 4:1<-->2:1 flutter; EKG#2 4:1 flutter w/ LAD and LAFB, no ST segment changes; flutter not noted on prior EKGs . ECHO [**2123-6-16**] The left atrium is mildly dilated. 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%). The right ventricle may be mildly dilated. Right ventricular systolic function is normal. The aortic valve leaflets (3) are mildly thickened. There is no aortic valve stenosis. Mild (1+) aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. The tricuspid valve leaflets are mildly thickened. There is no pericardial effusion. Compared with the prior study (images reviewed) of [**2122-3-24**], estimated pulmonary artery systolic pressure is now higher. . p-mibi [**2121**] negative Brief Hospital Course: 80 yo male w/ h/o diastolic CHF, CAD s/p MI, chronic renal insufficiency (Cr 1.3-1.7), h/o lower GI bleed, diverticulosis, CVA, C.diff, urosepsis who presents to the ED at [**Hospital1 18**] with several days of shortness of breath, gradually worseing fatigue, acute on chronic renal failure and newly diagnosed atrial flutter. . 1. Dyspnea The most likely etiology was CHF exacerbation secondary to new atrial flutter. BNP was elevated to 9866 on admission. Chest x-ray on admission showed possible pleural effusion on left side and stable cardiomegaly. EKG showed new atrial flutter with no evidence of acute myocardial ischemia. Cardiac enzymes x 3 were negative. The patient received Lasix 20 mg IV x 2. He had good urine output and denied any dyspnea during his hospital stay. He was on oxygen 2L nc which was d/c'd on HOD3. . 2. Fatigue His fatigue had started 1-2 months PTA and was most likely secondary to his CHF and recent lower GI bleed/anemia. Other contributing causes were uremia (BUN 113) and atrial flutter. His Hct on admission was 29.3. His Hct in the past have been between 26-35. His guaiac tests were all negative. Another contributing was an UTI and bacteremia. His urine culture and blood culture were positive for E.coli. On HOD3 he felt much better and was not exhausted any mor. . 3. Atrial flutter Possible etilogy was the UTI and bacteremia and CHF exacerbation. Thyrotoxicosis was unlikely as T4 was normal. Electrophysiology was consulted and did not change his metoprolol. He was started on aspirin but no anticoagulation due to his risk for GI bleed. He got an ECHO which showed LVEF > 55%, and minor changes from last ECHO. . 4. Acute renal failure The patient's Cr was 4.3 on admission with baseline Cr 1.3-1.7. The most likely cause was pre-renal, cardiogenic acute renal failure resulting from hypoperfusion of kidneys secondary to CHF and decreased stroke volume. Post-renal cause was unlikely since renal US was negative for any hydronephrosis. Renal cause was unlikely since there are no urine casts, no RBC, no protein. His Cr improved daily and he had good urine output. . 5. UTI Patient had positive UA with urine cx E.coli, sensitive to ceftriaxone and ciprofloxacin. He had no c/o dysuria, hematuria while in the hospital. He was treated with Ceftriaxone 1 grm IV q24h while in the hospital and he will be discharged on cipro to complete a 14 day course. . 6. Bacteremia Blood culture was positive for E.coli, sensitive to ceftriaxone and ciprofloxacin. He had no signs of sepsis. No tachycardia, no fever or hypothermia. WBC decreasing. He was treated with Ceftriaxone 1 grm IV q24h while in the hospital and he will be discharged on cipro to complete a 14 day course. . 7. Hyperkalemia The patient's potassium increased to 5.2 on [**10-26**]. This was most likely related to acute renal insufficiency. EKG showed no peaked T waves. He received Kayexalate and his potssium decreased to 4.7. He was placed on a renal/low K diet. . 8. Gastrointestinal bleed: Patient has history of recurrent bleeds in the past. During this admission, he was noted to have several large bloody bowel movements with blood clots. He was monitored in the intensive care unit where his bleeding resolved and his hematocrit remained stable. He denied any abdominal pain, chest pain, new dyspnea, fevers, chills, night sweats, lightheadedness. GI was consulted while the patient was in the ICU and colonoscopy was not performed during this admission as his bleeding had resolved and his bleed was thought most likely secondary to diverticulosis. He was recommended to follow-up with GI . . . . Of note, he was recently admitted to [**Hospital1 18**] at the end of [**Month (only) 359**] for a GI bleed. He was not scoped during that admission b/c the bleed stopped on its own and his hct was stable. He was scheduled to follow up with GI as an outpatient. This was likely related to his severe diverticulosis, though AVM or other etiology cannot be excluded. He appeared stable and asymptomatic at that time. Medications on Admission: Metoprolol 25mg PO BID Iron 325mg TID Tiotropium 18mcg daily Discharge Medications: 1. Ferrous Sulfate 325 (65) mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 2. Tiotropium Bromide 18 mcg Capsule, w/Inhalation Device Sig: One (1) Cap Inhalation DAILY (Daily). 3. B Complex-Vitamin C-Folic Acid 1 mg Capsule Sig: One (1) Cap PO DAILY (Daily). 4. Ciprofloxacin 500 mg Tablet Sig: One (1) Tablet PO twice a day for 8 days: Take 1 pill TWICE a day till finished. . Disp:*16 Tablet(s)* Refills:*0* 5. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 6. Aspirin 81 mg Tablet Sig: One (1) Tablet PO once a day. 7. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. Discharge Disposition: Extended Care Facility: [**Hospital 12874**] [**Hospital **] Nursing Home Discharge Diagnosis: Primary Diagnoses: - E. coli bacteremia with sepsis - Urinary tract infection - Gastrointestinal bleeding - Atrial flutter - Acute renal failure - Congestive heart failure exacerbation . Secondary Diagnoses: - history of gastrointestinal bleed, diverticulitis - history of stroke 12 years ago with right-sided weakness - history of nephrolithiasis with stent and nephrostomy tube - coronary artery disease - sleep apnea - chronic renal insufficiency Discharge Condition: Stable. Ambulating, talking, returned to baseline. Discharge Instructions: You were admitted with a change in your mental status and shortness of breath and were found to have bacteria (E. coli) in your urine and your blood. You were started on intravenous antibiotics and improved. You also had acute renal failure likely secondary to this infection, in addition to your chronic kidney disease, and were seen by the Kidney Consult service. Your kidney function improved over your stay. You will need to follow-up with the Kidney service. . You will finish a 14-day total course of antibiotics on [**11-5**]. Please take as directed. . You also had a newly diagnosed abnormal heart rhythm called atrial flutter. No medications were started and you will continue to take metoprolol. You will need to follow-up with the electrophysiology clinic to monitor your rhythm. This rhythm may have been caused by your infection. . You had transient increases in your potassium levels and were treated with a bowel medicine and your potassium normalized. You will need to have your blood drawn to monitor this. . You were started on an aspirin daily for the heart and brain protective-effect. You do have a recent history of bleeding from your gastrointestinal tract. . You had gastrointestinal bleeding and you were transferred to the Intensive care unit for close monitoring. You received IV fluids and your hematocrit was stable. . You need to drink a lot of fluids in the next couple days. . If you develop any concerning symptoms such as frequent or prolonged palpitations, chest pain, swelling in your legs, shortness of breath, fevers, dizzyness or notice large blood in your stool, or other concerning symptoms, please call your primary care physician or proceed to the emergency room. Followup Instructions: Renal appointment: Dr. [**Last Name (STitle) 4883**], Monday, [**11-13**], at 3PM. If you have questions, please call [**Telephone/Fax (1) 60**]. Primay care physician: [**Last Name (NamePattern4) **]. [**Last Name (STitle) **], Wednesday, [**11-8**], at 11:50AM. If you have any questions, please call [**Telephone/Fax (1) 1579**]. Electrophysiology: Dr. [**Last Name (STitle) 73**], Monday, [**11-28**], at 11:20AM. If you have questions, please call [**Telephone/Fax (1) 902**]. . Provider [**Name9 (PRE) 1576**],[**First Name8 (NamePattern2) 2352**] [**Doctor Last Name 4694**] APG (SB) Phone:[**Telephone/Fax (1) 1579**] Date/Time:[**2125-1-15**] 1:30 . Please also follow-up with Dr. [**First Name (STitle) **] [**Name (STitle) 9890**] on Friday [**12-8**] at 11am. Her office is located in the [**Hospital Unit Name 1824**] [**Location (un) **]. If you need to reschedule, please call her office at [**Telephone/Fax (1) 463**]. [**Name6 (MD) 251**] [**Name8 (MD) **] MD [**MD Number(1) 910**] Completed by:[**2124-10-30**] ICD9 Codes: 5849, 5990, 4280, 5859, 412
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Medical Text: Admission Date: [**2177-8-16**] Discharge Date: [**2177-8-16**] Date of Birth: [**2097-3-17**] Sex: M Service: Cardiac Surgery HISTORY OF PRESENT ILLNESS: The patient is an 80-year-old man with a long history of coronary artery disease who for the past several weeks has experienced increasing chest pain which in retrospect was angina and has taken increased nitroglycerine. He was taking care of his ill wife and therefore did not want to come to the hospital. The patient has a history of chronic obstructive pulmonary disease, peripheral vascular disease, and shortness of breath. He presented to the hospital and was felt initially to have pneumonia. He was admitted to the medical intensive care unit, however review of the EKG showed severe EKG changes. He was taken for emergent catheterization that showed 90% left main, 90% ostial LAD stenosis, circumflex disease and moderate right coronary artery disease. The patient was hypotensive and hemodynamically unstable. Surgery was consulted because the patient developed cardiogenic shock acidosis and hypotension and intraaortic balloon pump was placed which stabilized his hemodynamics although he continued to be somewhat hypotensive and acidotic. On physical examination, his BP was 90/50 on the intraaortic ballon pump with elevated filling pressures, HR was 90 BPM. He was not intubated. Lung exam showed bilateral rales. Abdomen was soft and nontender. Cardiac exam showed distant heart sounds. The patient had non-papable distal extremity pulses, suggesting peripheral vascular disease. Neurologic exam was grossly normal. He was taken for emergency bypass surgery where coronary artery bypass grafting x3 was performed. The conduits were extremely poor. The LIMA was placed to the OM, veins were placed to the LAD and RCA. Ejection fraction initially was 20-30% with pulmonary hypertension and 1+ mitral regurgitation. His mixed venous oxygen saturation was approximately 48%, suggesting poor peripheral perfusion and shock. His filling pressures were elevated with a CVP of about 25 mmHg. He has rather severe pulmonary hypertension prior to surgery (55/27 mmHg). After surgery initially he did feel well with moderate inotropic support and intraaortic balloon pump support. However his condition gradually and progressively deteriorated. He developed severe episode of ventricular tachycardia prior to chest closure. His chest was reopened but his hemodynamics did not significantly change. The sternum was left open but the skin was closed. His poor hemodynamic condition was felt most likely to be due to poor underlying cardiac function, poor bypass targets and poor vein conduit. His acidosis may be in part been due to the IABP and peripheral vascular disease. He was transported to the cardiac surgical recovery unit. He continues to have low cardiac output syndrome and acidosis despite maximal inotropic support and intraaortic balloon pump support. Consideration for left ventricular assist device was given however because of his advanced age and poor chances for recovery this was not placed. The situation was discussed with the family. The patient's family were at his bedside when he died. FINAL DIAGNOSIS: 1. Acute myocardial infarction. 2. Cardiogenic shock, treated with IABP and emergency CABG x 3. Congestive heart failure, pulmonary edema. 4. Mild renal insufficiency, peripheral vascular disease. 5. Moderate chronic obstructive pulmonary disease. 6. Status post coronary artery bypass grafting. 7. Death following emergent CABG. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 1714**], [**MD Number(1) 1715**] Dictated By:[**Last Name (NamePattern1) 5297**] MEDQUIST36 D: [**2177-8-16**] 22:35:21 T: [**2177-8-17**] 04:35:09 Job#: [**Job Number 74285**] ICD9 Codes: 496, 4280, 2762, 5119, 486, 4240, 4439
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Medical Text: Admission Date: [**2140-7-29**] Discharge Date: [**2140-8-3**] Date of Birth: [**2100-11-24**] Sex: M Service: MEDICINE Allergies: Propoxyphene / Methadone / pseudoephedrine / Peanut / Adhesive Bandage / Banana Attending:[**First Name3 (LF) 2195**] Chief Complaint: fever Major Surgical or Invasive Procedure: IR guided HD line placement History of Present Illness: Mr. [**Known lastname 15532**] is a 39 y.o incarcerated male w/ HIV, ESRD M/W/F HD, last got it Weds, presenting with fevers. On Monday had erythema around his catheter site (in the groin) at HD. He finished HD and got a dose of vanc. On Wed he continued to feel fatigue and had more fevers so go dialyzed completely, got a dose of vanc and then had his catheter pulled. They packed the wound and he went home. He came back today and the site looked much worse after the packing was taken out and the cath site was indurated with concern for an abscess. In addition he was complaining of SOB and couldn't lay flat in HD which they called "respiratory distress". In the ED, VS: 9 98.4 85 173/102 18 87%. he triggered for hypoxia to 87% RA. Responded to upright position and supplemental O2. Also given morphine and 80mg IV lasix. Now sat 94-95 4 L NC In addition he was hypertensive to the 200's and got 10mg IV hydral which dropped the BP to 170s (pt reports this is his baseline). On labs he was noted to have a mild troponin leak. EKG with peaked T waves concerning for hyperkalemia although K 4.7. Got calcium gluconate prior to seeing Ca which was wnl. CXR with diffuse infiltrate suggestive of fluid overload. Exam correlated. Patient had no HD access and a 16 gauge EJ placed and IR was called so patient could get an HD line. Only access site is right groin. Called renal who will evaluate. Also on exam groin site: Erythemaotous, warm, cellulitic, had U/S looks like small ? complex collection--> got IV vanc and pipercillin tazobactam Attempting to obtain more records from federal prison. Contact [**Name (NI) **] at number in RN comments. . On the floor, patient was breathing comfortably. He re-iterated the above story including feeling unwell for the last few days starting Monday. . Review of systems: (+) Per HPI (-) Denies fever, chills, night sweats, recent weight loss or gain. Denies headache, sinus tenderness, rhinorrhea or congestion. Denies cough, shortness of breath, or wheezing. 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: HIV (CD4 308 in [**Month (only) 958**] with undetectable VL) End Stage Renal Disease H/O ESBL sepsis last year AV graft failure complicated by amputation of right forearm and hand HTN DMII Asthma GERD Chronic phantom limb pain Social History: Incarcerated - Tobacco: Denies - Alcohol: Denies - Illicits: Endorses marijuana approximately 7 years ago Family History: Father with ESRD and CAD w/ death of MI at 56. Physical Exam: Vitals: T: 96.9 BP:175/98 P:86 R: 24 O2: 93 on 3L NC 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, 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 GU: no foley Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Discharge exam: GEN: Lying in bed in NAD HEENT: NCAT, EOMI. COR: +S1S2, no m/g/r. PULM: Diminished breath sounds bilaterally secondar to habitus & posture, however CTAB, no c/w/r . [**Last Name (un) **]: +NABS in 4Q. Slight transient tenderness is right lower quadrant, no tenderness to percussion or rebound tenderness. EXT: Left groin site markedly improved, without any surrounding erythema. Area is still firm/scarred. Right tunneled groin catheter tender to palpation over tunneled aspet, but without erythema. NEURO: Awake & alert, MAEE. Pertinent Results: [**2140-7-29**] 09:35PM VANCO-22.5* [**2140-7-29**] 11:54AM COMMENTS-GREEN TOP [**2140-7-29**] 11:54AM LACTATE-0.8 K+-4.7 [**2140-7-29**] 11:50AM GLUCOSE-123* UREA N-89* CREAT-11.2* SODIUM-135 POTASSIUM-4.9 CHLORIDE-91* TOTAL CO2-24 ANION GAP-25* [**2140-7-29**] 11:50AM CK(CPK)-98 [**2140-7-29**] 11:50AM cTropnT-0.09* [**2140-7-29**] 11:50AM CK-MB-2 [**2140-7-29**] 11:50AM CALCIUM-9.8 PHOSPHATE-6.8* MAGNESIUM-2.5 [**2140-7-29**] 11:50AM VANCO-9.0* [**2140-7-29**] 11:50AM WBC-11.6* RBC-4.56* HGB-9.8* HCT-30.7* MCV-67* MCH-21.4* MCHC-31.8 RDW-19.2* [**2140-7-29**] 11:50AM NEUTS-84.0* LYMPHS-9.4* MONOS-3.5 EOS-2.5 BASOS-0.7 [**2140-7-29**] 11:50AM PLT COUNT-310 [**2140-7-29**] 11:50AM PT-13.9* PTT-32.9 INR(PT)-1.2* Micro: Blood Cultures 6/25 NGTD; MRSA Nasal Screen positive . EKG: NSR. Nl Axis, intervals. Peaked Twaves in V2-V4 and TW inversions I, II. LVH. Probably [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) 6192**]. . RADIOLOGY: LENI: 1. No left lower extremity deep venous thrombosis. 2. 1.3 cm complex fluid collection reflects hematoma with or without superinfection or abscess with reactive lymphadenopathy. . CXR: Moderate pulmonary edema with probable small bilateral pleural effusions. No pneumothorax. Brief Hospital Course: Mr. [**Name13 (STitle) **] is a 39 year old gentleman with End Stage Renal Disease on Dialysis admitted with a catheter site infection, transferred to the MICU for volume overload/hypoxia. Dyspnea: The patient was dyspneic and hypoxic on presentation to the MICU. He was treated with several hours of Ultrafiltration and Hemodialysis and his symptoms resolved. Groin/catheter site infection: The patient developed an area of induration and erythema at his groin catheter site. Surgery was consulted and did not intervene. He was started on Vancomycin and Meropenem given a history of Resistant organisms and MRSA. The patient's dialysis catheter was moved under interventional radiology guidance. A PICC was also placed for antibiotic administration. ESRD: The patient was dialyzed while admitted through his newly placed catheter. He did develop asymptomatic hyperkalemia while admitted. He will continue a Monday, Wednesday, Friday scheduled for Dialysis. # HIV: continued home regimen. # Communication: Patient and [**First Name8 (NamePattern2) 8254**] [**Known lastname 15532**] [**Telephone/Fax (1) 87718**] (we cannot contact her she needs to be called by the policemen) # Code: Full (discussed with patient) Transitional issues: Complete Vancomycin/Ertapenem (switched for availability of pharmaceutical [**Doctor Last Name 360**]) until [**2140-8-7**]. Medications on Admission: Nifedipine CR 60 mg PO daily Emtricitabine 200 mg PO 2*/wk (MO, FR) Insulin SC PRN for BG>200 Sevelamer Carbonate 3200 mg PO TID Sertraline 200 mg PO daily Omeprazole 20 mg PO daily Mom[**Name (NI) 6474**] inhaled [**Hospital1 **] Minoxidil 10 mg PO BID Metoprolol Succinate 200 mg PO daily Ferrous gluconate 324 mg PO BID Lisinopril 40 mg PO daily Efavirenz 600 mg PO QHS Docusate 100 mg PO BID Diphenhydramine 25 mg PO Q8hr: PRN itching Amitriptyline 100 mg PO HS Albuterol inhalers Q4hrs Abacavir 600 mg PO daily Discharge Medications: 1. nifedipine 60 mg Tablet Extended Rel 24 hr Sig: One (1) Tablet Extended Rel 24 hr PO once a day. 2. emtricitabine 200 mg Capsule Sig: One (1) Capsule PO 2X/WEEK (MO,FR). 3. sevelamer carbonate 800 mg Tablet Sig: Four (4) Tablet PO TID W/MEALS (3 TIMES A DAY WITH MEALS). 4. sertraline 50 mg Tablet Sig: Four (4) Tablet PO DAILY (Daily). 5. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 6. mom[**Name (NI) 6474**] 110 mcg (30 doses) Aerosol Powdr Breath Activated Sig: One (1) puff Inhalation twice a day. 7. minoxidil 10 mg Tablet Sig: One (1) Tablet PO twice a day. 8. metoprolol succinate 200 mg Tablet Extended Release 24 hr Sig: One (1) Tablet Extended Release 24 hr PO once a day. 9. ferrous gluconate 324 mg (36 mg Iron) Tablet Sig: One (1) Tablet PO twice a day. 10. lisinopril 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 11. efavirenz 600 mg Tablet Sig: One (1) Tablet PO QHS (once a day (at bedtime)). 12. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 13. insulin lispro 100 unit/mL Solution Sig: As directed Subcutaneous three times a day: As directed per attached sliding scale. 14. diphenhydramine HCl 25 mg Capsule Sig: One (1) Capsule PO every eight (8) hours as needed for itching. 15. amitriptyline 100 mg Tablet Sig: One (1) Tablet PO at bedtime. 16. ertapenem 1 gram Recon Soln Sig: Five Hundred (500) mg Intravenous every twenty-four(24) hours for 5 days: To be given after dialysis on dialysis days. Last dose [**8-7**]. Disp:*5 doses* Refills:*0* 17. albuterol sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig: One (1) puff Inhalation every six (6) hours as needed for shortness of breath or wheezing. 18. abacavir 300 mg Tablet Sig: Two (2) Tablet PO once a day. 19. vancomycin 1,000 mg Recon Soln Sig: One (1) gram Intravenous Daily after dialysis for 5 days: To be given on dialysis days only, last dose [**8-9**]. Disp:*3 grams* Refills:*0* 20. oxycodone 5 mg Tablet Sig: One (1) Tablet PO every 4-6 hours as needed for pain for 3 days. Disp:*10 Tablet(s)* Refills:*0* Discharge Disposition: Extended Care Discharge Diagnosis: Primary Diagnoses: - Left groin Cellulitis catheter infection - ESRD Secondary Diagnoses: - HIV infection - Hypertension Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Dear Mr. [**Known lastname 15532**], You have been admitted to the hospital with an infection around your dialysis line. While you were here we replaced a new dialysis line, and treated you with ultrafiltration and hemodialysis to allievate your shortness of breath. You have been evaluated by Surgery and your Kidney team and you are now safe for discharge. New Medications: We have added the following Antibiotics: Ertapenem & Vancomycin for 5 more days. Followup Instructions: Please follow up with your primary care doctor: [**Last Name (LF) **],[**First Name8 (NamePattern2) 3679**] [**Last Name (NamePattern1) **] [**Telephone/Fax (1) 87719**] within 1-2 weeks. ICD9 Codes: 5856, 7907, 4280
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Medical Text: Admission Date: [**2150-2-23**] Discharge Date: [**2150-2-27**] Date of Birth: [**2083-10-11**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1505**] Chief Complaint: Dyspnea on exertion and positive exercise tolerance test Major Surgical or Invasive Procedure: [**2150-2-23**] - CABGx4 (Lima->Lad, SVG->Diagonal, SVG->Obtuse marginal, SVG->Right coronary artery) History of Present Illness: Mr. [**Name13 (STitle) 34062**] is a 66 year-old male with worsening anginal symptoms. A cardiac catheterization showed severe three-vessel disease. He now presents for revascularization. Past Medical History: Coronary artery disease Hypercholesterolemia HTN BPH Colonic polyps Left inguinal hernia Social History: Quit smoking 30 years ago. No alcohol or drug use. He is single and lives in [**Location 86**]. Family History: Brother with CABG at age 74. Physical Exam: Vitals: BP 162/86, HR 46, RR 14, SAT 98% on room air General: well developed male in no acute distress HEENT: oropharynx benign Neck: supple, no JVD Heart: regular rate, normal s1s2 Lungs: clear bilaterally Abdomen: soft, nontender, normoactive bowel sounds Ext: warm, no edema, no varicosities Pulses: 2+ distally Neuro: nonfocal Pertinent Results: [**2150-2-25**] 08:45AM BLOOD WBC-8.8 RBC-2.97* Hgb-9.6* Hct-26.8* MCV-91 MCH-32.5* MCHC-35.9* RDW-13.1 Plt Ct-132* [**2150-2-25**] 08:45AM BLOOD Plt Ct-132* [**2150-1-24**] CXR 1. No evidence of pneumothorax. 2. Worsening left lower lobe atelectasis [**2150-2-23**] ECHO PREBYPASS- A left-to-right shunt across the interatrial septum is seen at rest. A small secundum atrial septal defect is present. Left ventricular wall thicknesses and cavity size are normal. Left ventricular wall thickness, cavity size, and systolic function are normal (LVEF>55%). Regional left ventricular wall motion is normal. Overall left ventricular systolic function is normal (LVEF>55%). Right ventricular chamber size and free wall motion are normal. The descending thoracic aorta is mildly dilated. There are simple atheroma in the descending thoracic aorta. The aortic valve leaflets (3) are mildly thickened. Trace aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Mild (1+) mitral regurgitation is seen. POST BYPASS-Biventricular systolci function remains normal. Remaining study is otherwise unchanged compared to pre-bypass [**2150-2-27**] 06:20AM BLOOD Hct-26.3* [**2150-2-25**] 08:45AM BLOOD Plt Ct-132* [**2150-2-27**] 06:20AM BLOOD UreaN-13 Creat-0.8 Na-143 K-4.6 [**2150-2-26**] CXR There has been interval removal of a right internal jugular vascular catheter. No pneumothorax. Cardiac and mediastinal contours are stable in the postoperative period. There is improving atelectasis in the left lower lobe, and there are small bilateral pleural effusions, left greater than right, which have increased on the left in the interval. Brief Hospital Course: Mr. [**Known lastname 43313**] was admitted to the [**Hospital1 18**] on [**2150-2-23**] for elective surgical management of his coronary artery disease. He was taken directly to the operating room where he underwent coronary artery bypass grafting to four vessels. Postoperatively he was taken to the cardiac surgical intensive care unit for monitoring. On postoperative day one, Mr. [**Known lastname 43313**] [**Last Name (Titles) 5058**] neurologically intact and was extubated. Aspirin and beta blockade were started. He was then transferred to the step down unit for further recovery. Mr. [**Known lastname 43313**] was gently diuresed towards his preoperative weight. The physical therapy service was consulted for assistance with his postoperative strength and mobility. Vitamin C and folic acid were started for postoperative anemia. His wires and drains were removed without complication. Mr. [**Known lastname 43313**] continued to make steady progress and was discharged home on postoperative day four. He will follow-up with Dr. [**Last Name (STitle) **], his cardiologist and his primary care physician as an outpatient. Medications on Admission: Aspirin 81mg QD Atenolol 12.5mg QD Lipitor 20mg QD Discharge Medications: 1. Potassium Chloride 10 mEq Capsule, Sustained Release Sig: Two (2) Capsule, Sustained Release PO once a day for 7 days. Disp:*14 Capsule, Sustained Release(s)* Refills:*0* 2. Furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day for 7 days. Disp:*7 Tablet(s)* Refills:*0* 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. Lisinopril 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 6. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. Disp:*45 Tablet(s)* Refills:*0* 7. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily) for 1 months. Disp:*30 Tablet(s)* Refills:*0* 8. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) for 1 months. Disp:*60 Tablet(s)* Refills:*0* 9. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 10. Ibuprofen 600 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours) as needed. Disp:*100 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: Coronary artery disease Hypercholesterolemia HTN BPH Colonic polyps Left inguinal hernia Discharge Condition: Good Discharge Instructions: 1) Monitor wounds for signs of infection. These included redness, drainage or increased pain. 2) Report any fever greater then 100.5 3) Report any weight gain of greater then 2 pounds in 24 hours or 5 pounds in 1 week. 4) No lifting greater then 10 pounds for 10 weeks 5) No driving for 1 month. Followup Instructions: Follow-up with Dr. [**Last Name (STitle) **] in 1 month. Follow-up with your cardiologist Dr. [**Last Name (STitle) **] in [**1-19**] weeks Follow up with your primary care physician [**Last Name (NamePattern4) **]. [**Last Name (STitle) **] in [**1-19**] weeks. Call all providers for appointments. Completed by:[**2150-2-27**] ICD9 Codes: 2859, 2720, 4019
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Medical Text: Unit No: [**Numeric Identifier 75913**] Admission Date: [**2158-12-24**] Discharge Date: [**2159-1-3**] Date of Birth: [**2158-12-24**] Sex: F Service: NB SERVICE: Neonatology. PATIENT IDENTIFICATION: Baby girl [**Known lastname 75914**] [**Known lastname 75915**] is a former 34 week gestation infant, now 10-days-old, corrected to 35 3/7th week gestation. HISTORY OF PRESENT ILLNESS: This the former 1.915 kilogram product of a 34 week gestation pregnancy, born to 24-year-old G2, P0, now 1 woman. Prenatal screens: Blood type B positive, antibody negative, Rubella immune, RPR nonreactive, hepatitis B surface antigen negative, group beta strep status unknown. The pregnancy was notable for fevers of unknown origin. The mother was initially evaluated on [**2158-12-21**], as a transfer from [**Hospital3 **]. She was given beta Methasone at that time. She was subsequently discharged, but re-admitted on [**2158-12-24**] with a fever of 101.7 and a severe headache. At this time the fetal heart tracing was noted to be 180 to 200 beats per minute and decision was made to proceed with a Cesarean section, due to the non-reassuring fetal heart rate tracing and fetal tachycardia. The infant emerged vigorous, required only crying and bulb suction and brief blow by oxygen. Apgars were 8 at 1 minute and 9 at 5 minutes. She was admitted to the neonatal intensive care unit for treatment of prematurity. Anthropometric measurements at the time of admission, weight 1.915 kg, 25th percentile, length 44.5 cm, 25th percentile, head circumference 32 cm, 50th percentile. PHYSICAL EXAMINATION AT DISCHARGE: Weight 1.875 kg, head circumference 31 cm, length 45 cm. General: Nondysmorphic, nondistressed preterm infant in room air. Skin: Warm and dry, color pink, well-perfused. Head, ears, eyes, nose and throat: Nondysmorphic facies, mucous membranes moist, neck supple, clavicles intact, palate intact. Chest: Lungs clear and equal bilaterally. Cardiovascular: No murmur, normal S1, S2, femoral pulses +2. Abdomen: Soft, nontender, nondistended, no masses. GU: Normal female, patent anus. Musculoskeletal: Moving all extremities equally. Hips stable. Neurologic: Appropriate tone and reflexes. HOSPITAL COURSE BY SYSTEMS INCLUDING PERTINENT LABORATORY DATA SYSTEM: 1. Respiratory: This infant has been in room air since admission to the neonatal intensive care unit. She has not had any episodes of apnea or bradycardia. At the time of discharge she is breathing comfortably with a respiratory rate of 50 to 60 breaths per minute. 2. Cardiovascular: A murmur was noted on day of life #1. This infant has maintained normal heart rates and blood pressures. The murmur resolved by day of life 4. At the time of discharge her baseline heart rate is 141-160 beats per minute with a recent blood pressure of 68 over 41 mmHg, mean arterial pressure 51 mmHg. A recurrent murmur was noted at the time of discharge. A chest xray was normal as was an EKG. 4 ext Bps were normal. RA sats were up to 100%. 3. Fluids, electrolytes, nutrition: This infant was initially NPO and maintained on intravenous fluids. Enteral feeds were started on day of life #1 and gradually advanced to full volume. At the time of discharge she is taking po feeds well with Enfamil 24 calorie per ounce by bottle . Weight on the day of discharge is 2.435 kg. 4. Infectious disease: Due to the mother's history with the fevers, and fetal tachycardia, this event was evaluated for sepsis upon admission to the neonatal intensive care unit. A white blood cell count and differential were within normal limits. A blood culture was obtained prior to starting intravenous ampicillin and gentamicin. The blood culture was no growth at 48 hours and the antibiotics were discontinued. 5. Hematological: Hematocrit at birth was 47.7%. This infant did not receive any transfusions or blood products. 6. Gastrointestinal: This infant required treatment for unconjugated hyperbilirubinemia, with phototherapy. Peak serum bilirubin occurred on day of life #8, with a total of 8.7 mg per dL. The phototherapy had been discontinued on day of life #4 as the infant is feeding and otherwise well. No further treatment was thought indicated. 7. Neurological: This infant has maintained the normal neurological exam during admission and there are no neurological concerns at the time of discharge. 8. Sensory: Audiology, hearing screening was referred bilaterally. Arrangements for post-discharge audiologic testing were made. parents aware of testing results and need for follow-up 9. Psychosocial: This mother moved to the United States from [**Country 11150**] in [**2157-5-16**]. While she was visiting her infant she was noted to have a clonic seizure. She was readmitted to [**Hospital1 69**] and evaluated for her seizure disorder and then started on medication. [**Hospital1 **] Center social work has been involved with this family in the contact social worker is [**Name (NI) 46381**] [**Name (NI) 36527**], and she can be reached at [**Telephone/Fax (1) 8717**]. CONDITION ON DISCHARGE: Stable. DISCHARGE DISPOSITION: To home with parents.The primary pediatrician is Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 73225**], [**Country 75916**], [**Location (un) **], [**Numeric Identifier 75917**], phone number [**Telephone/Fax (1) 73227**]. CARE AND RECOMMENDATIONS AT TIME OF DISCHARGE: 1. Feeding: Ad lib Enfamil 24 calorie per ounce formula, either p.o. by gavage. 2. No medications. 3. Iron and vitamin D supplementation: Iron supplementation is recommendation for preterm and low birth weight infants until 12 months correct age. All infants centered on early breast milk should receive vitamin D supplementation at 200 international units, (provided as a multivitamin preparation) daily until 12 months corrected age. 1. Car seat position screening is recommended prior to discharge. 2. Newborn Screen was sent on [**2158-12-27**] and there has been no notification of abnormal results to date. 3. Immunizations: No immunization administered thus far. 4. Immunizations recommended: Synagis RSV prophylaxis should be considered from [**Month (only) **] through [**Month (only) 958**] for infants who meet and use the following 4 criteria: First born at less than 32 weeks; second born between 32 and 35 and 0/7th weeks with 2 of the following: Daycare during RSV season, a smoker in the household, neuromuscular disease, airway abnormalities, or school age siblings; thirdly chronic lung disease; fourth, hemodynamically significant congenital heart disease. Influenza immunization is recommended 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. This infant has not received rotavirus vaccine. The American Academy of Pediatrics recommend initial vaccination of preterm infants at or following discharge from the hospital if they are clinically stable and at least 6 weeks, but fewer than 12 weeks of age. DISCHARGE DIAGNOSES: 1. Prematurity at 34 weeks gestation. 2. Suspicion for sepsis ruled out. 3. Unconjugated hyperbilirubinemia. 4. Referred hearing screen bilaetrally. [**Doctor Last Name **],[**Doctor Last Name **] 50.470 Dictated By:[**Name8 (MD) 75740**] MEDQUIST36 D: [**2159-1-3**] 02:23:35 T: [**2159-1-3**] 05:46:42 Job#: [**Job Number 75918**] ICD9 Codes: V053, 7742
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Medical Text: Admission Date: [**2102-2-7**] Discharge Date: [**2102-2-14**] Date of Birth: [**2041-3-4**] Sex: M Service: Cardiothoracic Surgery Service HISTORY OF PRESENT ILLNESS: The patient is a 60-year-old gentleman with progressively increasing dyspnea on exertion. His primary care physician recommended an echocardiogram which revealed severe aortic stenosis. The patient was ultimately referred for cardiac catheterization. The cardiac catheterization revealed 50% proximal left anterior descending artery occlusion as well as 20% to 40% other coronary artery disease. He also had an left ventricular ejection fraction of 56% at that time. The patient has subsequently been referred for a coronary artery bypass graft and aortic valve replacement. His aortic valve gradient was 50 mmHg, and his aortic valve area was 0.94 cm2. PAST MEDICAL HISTORY: (Past medical history is significant for) 1. Insulin-dependent diabetes mellitus. 2. Obesity. 3. Hypertension. 4. Parkinson disease. 5. Hypercholesterolemia. 6. Depression. MEDICATIONS ON ADMISSION: (Preoperative medications included) 1. Humalog 75/25 insulin 64 units in the morning and 22 units in the evening. 2. Aspirin 325 mg by mouth once per day. 3. Multivitamin. 4. Lipitor 20 mg by mouth once per day. 5. Atenolol 25 mg by mouth twice per day. 6. Tricor 160 mg by mouth once per day. 7. Prozac 20 mg by mouth once per day. 8. Metformin 500 mg by mouth twice per day. 9. Isosorbide 30 mg by mouth twice per day. 10. Requip 0.5 mg by mouth three times per day. ALLERGIES: The patient states no known drug allergies. SOCIAL HISTORY: The patient is married and lives with his wife. [**Name (NI) **] quit smoking 40 years ago and does not drink alcohol. BRIEF SUMMARY OF HOSPITAL COURSE: The patient was admitted on the day of surgery; which was [**2102-2-7**]. The patient was taken directly to the operating room where he underwent coronary artery bypass graft times one with a left internal mammary artery to the left anterior descending artery as well as an aortic valve replacement 23-mm St. [**Male First Name (un) 923**] mechanical valve. Postoperatively, he was transported in stable condition from the operating room to the Cardiothoracic Surgery Recovery Unit. On the night of surgery, he was weaned from mechanical ventilation and successfully extubated. He remained on amiodarone intravenous drip for some atrial fibrillation intraoperatively as well as Levophed for some hypotension. On postoperative day two, the patient had been weaned off of his Levophed drip. His chest tubes drainage had decreased, and he remained hemodynamically stable. He was transfused for a hematocrit of 23.5 at that time and was transferred from the Cardiothoracic Surgery Recovery Unit to the postoperative telemetry floor in hemodynamically stable condition. On postoperative day three, the patient's chest tubes and epicardial pacing wires were removed. He was started on heparin at 800 units per hour because of his mechanical valve. He was slow to progress with Physical Therapy on ambulation, but this was also initiated at that time. Over the next couple of days, the patient progressed from an ambulation standpoint. The patient was started on Coumadin on postoperative day four. His INR, however, was slow to become therapeutic, and he remained on an intravenous heparin drip over the next few days awaiting his INR to become therapeutic. During this time, he progressed from a cardiac rehabilitation standpoint with Physical Therapy and nurses increasing his level of activity. The patient also had been complaining of insomnia. He had no significant complaints of discomfort. He had remained hemodynamically stable throughout and in a normal sinus rhythm. Today, the patient had an INR of 2. His heparin was discontinued, and he was able to be discharged home today. PHYSICAL EXAMINATION ON DISCHARGE: The patient remained afebrile. Neurologically, he was grossly intact. His pulmonary examination revealed his lungs were clear to auscultation bilaterally; although somewhat diminished at the bilateral bases. Cardiovascular examination revealed a regular rate and rhythm. His abdomen was obese, soft, nontender, and nondistended. There were positive bowel sounds. The patient had trace pedal edema bilaterally. MEDICATIONS ON DISCHARGE: 1. Coumadin 5 mg today ([**2-14**]) and tomorrow ([**2-25**]); then he was to have an INR drawn by the visiting nurses which was to be called to Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] office (telephone number [**Telephone/Fax (1) 3183**]). I have spoken with [**Doctor First Name **] at his office who confirmed that they will dose his Coumadin subsequently, and the visiting nurse was to call with the INR results to get subsequent dosing for Coumadin. 2. Humalog 75/25 insulin 64 units in the morning and 22 units in the evening. 3. Aspirin 325 mg by mouth once per day. 4. Multivitamin. 5. Lipitor 20 mg by mouth once per day. 6. Amiodarone 400 mg p.o. once per day. 7. Dilaudid 2 mg by mouth q.4h. as needed (for pain). 8. Zantac 150 mg by mouth twice per day. 9. Tricor 160 mg by mouth once per day. 10. Requip 0.5 mg by mouth three times per day. 11. Prozac 20 mg by mouth once per day. 12. Metformin 500 mg by mouth twice per day. 13. Lopressor 25 mg by mouth twice per day. 14. Potassium chloride 20 mEq by mouth twice per day (times seven days). 15. Lasix 20 mg by mouth twice per day (times seven days). DISCHARGE DISPOSITION: Of note, the patient had a marginally elevated white blood cell count today ([**2-14**]) of 14.2; up from 11.3 yesterday. The patient had no obvious signs of infection. He had no erythema. His incisions were clean and healing well. The patient had no fevers. DISCHARGE INSTRUCTIONS/FOLLOWUP: 1. The patient has been instructed to call for any temperature of greater than 101, any change in his wound status; to include any drainage or erythema of any of his wounds or any questions concerning his incisions whatsoever. 2. The patient was to be sent home with visiting nurses as well as physical therapist. 3. The patient was instructed to follow up with his primary care physician (Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **]) in two to three weeks. 4. The patient was instructed to follow up with Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 7047**] (his cardiologist) in two to three weeks. 5. The patient was instructed to follow up with Dr. [**First Name (STitle) **] [**Last Name (Prefixes) **] (Cardiac Surgery) in four weeks for a postoperative check. DISCHARGE DIAGNOSES: 1. Aortic stenosis. 2. Coronary artery disease. 3. Insulin-dependent diabetes mellitus. 4. Hypertension. 5. Obesity. 6. Parkinson disease. 7. Depression. 8. Intraoperative atrial fibrillation. [**Doctor Last Name 412**] [**Last Name (Prefixes) 413**], M.D. [**MD Number(1) 414**] Dictated By:[**Name8 (MD) 964**] MEDQUIST36 D: [**2102-2-14**] 13:36 T: [**2102-2-14**] 13:38 JOB#: [**Job Number 33054**] ICD9 Codes: 4241, 9971, 2720
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Medical Text: Admission Date: [**2114-6-13**] Discharge Date: [**2114-6-19**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**Last Name (NamePattern4) 290**] Chief Complaint: melena Major Surgical or Invasive Procedure: endoscopy History of Present Illness: HPI: Briefly, this is an 84yo man with h/o DVT, PAF, gastric ulcer, CAD s/p MI admitted to the [**Hospital Unit Name 153**] with melena. He was residing in a care facility (Coolige House) after total hip arthroplasty. . The patient has a history of DVT and PAF three years ago after right THA and was previously on coumadin but stopped in setting of gastric ulcer bleed (switched to ASA 81mg qday). The patient underwent a THR on [**2114-5-16**] at NEBH and was restarted on Coumadin for DVT prophylaxis. After his THR, he developed an ileus and "small heart attack," likely started on Plavix and was discharged to [**Hospital3 2558**] for rehabilitation. There, he was noted to have brown/black guaiac positive stools for approximately 5 days and on the morning of admission had 4 episodes of melena, became dizzy and presyncopal while shaving. . In the ED, his vitals were: T 98.9, BP 132/63, HR 82, RR 17, Sat 98% on RA. On exam, he was found to be pale with guaiac positive brown stool. His initial labs were notable for a Hct of 23 (unclear baseline) and INR 3.9. He had a NGL that revealed bright red blood, not cleared with 700 cc of sterile water. GI was consulted, recommended ICU admission for close monitoring, FFP for INR reversal, PRBC transfusion, IV Protonix. He received FFP and Protonix in the ED before transfer. He has an 18 Ga PIV and a midline (is on rocephin for possibly infected sacral decubitus ulceration post op). ECG was performed, with no evidence of ischemia. Social History: SH: lived at home alone before recent hospitalizations; widowed 1.5y ago; has a son and dtr who live nearby. Denies tobacco now or in past. Reports rare etoh intake. . Family History: FH: father with MI Physical Exam: Afebrile, vital signs stable on room air. Gen -- pleasant, cooperative HEENT -- sclera anicteric, conjuctiva clear, op without erythema or exudate, neck supple Heart -- regular, no murmur Lungs -- clear Abd -- soft, benign Ext -- no edema rash or lesion Pertinent Results: [**2114-6-13**] 10:25PM WBC-8.2 RBC-2.71* HGB-8.5* HCT-23.6* MCV-87 MCH-31.5 MCHC-36.1* RDW-14.9 Discharge HCT stable >30 for greater than 72 hours. Brief Hospital Course: Mr. [**Known lastname 74188**] was admitted [**2114-6-13**] from his rehab center with melena, lightheadedness and fatigue. His hematocrit was 23%, and INR was supratheraputic. He was taking warfarin post operatively for total hip arthroplasty. He was also taking Aspirin and Plavix because of coronary artery disease. He had been recently treated with antibiotics for Stage II decubitus ulcers as well. He was admitted to the [**Hospital Unit Name 153**] for fluid resucitation, blood products, and gastroenterology consultation. Initial endoscopy showed mild gastritis and several small AVMs. He had a troponin leak and ST depressions with associated shortness of breath during his initial presentation, which resolved with transfusion. Cardiology was consulted and followed during this episode, but recommended against intervention given the acute blood loss anemia as the precursor for NSTEMI. A second endoscopy with small bowel push reveal a large duodenal AVM with evidence of fresh bleeding, and several clips were placed at the site. GI recommended avoiding aspirin, plavix for at least one week, and to reevaluate need for warfarin. On [**2114-6-15**], Mr. [**Known lastname 74188**] was transferred to the general medicine hospitalist team for further evaluation and management. He remained stable, had resolution of melena, and resumed physical therapy. Wound care for his sacral decubiti remained as follows: Commercial wound cleanser to irrigate/cleanse gluteal open wounds. Pat the tissue dry with dry gauze. Apply moisture barrier ointment to the periwound tissue with each drg change. Apply a thin layer of wound gel to the wound bed. Cover with dry gauze, Sofsorb sponge Change dressing daily. Given high risk of venous thromboembolism in a post operative lower extremity joint replacement patient, subcutaneous heparin was initiated after Hct was stable >48 hours. Compression boots were used during his acute bleeding episode. Metoprolol was added in light of his cardiac disease, and aspirin and Plavix will be added back per GI recommendations at one week post bleeding episode ([**2114-6-21**]). Given his previous DVT/PE was provoked (in setting of right total hip arthroplasty), warfarin is not indicated for chronic anticoagulation. However, with his history of paroxysmal atrial fibrillation, warfarin is indicated for stroke prevention. Given his life threatening gastrointestinal bleed, the risks and benefits of anticoagulation for stroke prevention versus recurrent gastrointestinal bleeding were explained to the patient. We will defer the decision making to his primary physician on discharge. He should, however, continue post operative THA DVT prophylaxis for the intended period. Medications on Admission: Ambien 5mg qhs ASA 81mg qday*** Reglan 10mg q4h Coumadin 4mg qhs Rocephin 2gm IV q24h Nifedipine ER 90mg qday*** Zocor 20mg qhs Allopurinol 100mg [**Hospital1 **]*** Senna 2 tabs qhs Tylenol 650mg q4h prn pain Oxycodone 5-15mg q3h prn pain Flomax 0.4mg [**Hospital1 **]*** Lopressor 50mg qday Miralax powder 17gm qday*** MVI qday Nexium 40mg qday Plavix 75mg qday Discharge Medications: 1. Allopurinol 100 mg Tablet Sig: 1.5 Tablets PO BID (2 times a day). Tablet(s) 2. Zolpidem 5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 3. Tamsulosin 0.4 mg Capsule, Sust. Release 24 hr Sig: One (1) Capsule, Sust. Release 24 hr PO BID (2 times a day). 4. Nitroglycerin 0.4 mg Tablet, Sublingual Sig: One (1) Tablet, Sublingual Sublingual PRN (as needed). Disp:*30 Tablet, Sublingual(s)* Refills:*2* 5. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 6. 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* 7. Simvastatin 10 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital 2255**] [**Name (NI) 2256**] Discharge Diagnosis: 1. acute blood loss anemia 2. gastrointestinal bleed, duodenal arteriovenous malformation 3. non ST elevation myocardial infarction in the setting of anemia 4. stage II bilateral sacral decubiti Discharge Condition: stable Discharge Instructions: You have been hospitalized for a gastrointestinal bleed with severe anemia. Please return to the hospital or call your doctor with any lightheadedness, blood in your stool, black or tarry stools, chest pain, or any other concerns. You should restart your baby aspirin on [**6-21**] (one week from latest bleeding episode). Followup Instructions: Follow up with Dr. [**Last Name (STitle) 74189**] on Monday, [**6-25**] at 1:45 pm evaluation of Hematocrit, and discussion of further anticoagulation and care. [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**Name8 (MD) **] MD [**MD Number(1) 292**] ICD9 Codes: 2851
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Medical Text: Admission Date: [**2194-4-18**] Discharge Date: [**2194-4-26**] Date of Birth: [**2139-7-22**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 165**] Chief Complaint: Chest Pain Major Surgical or Invasive Procedure: [**2194-4-20**] Urgent Coronary Artery Bypass Graft x 3 (Left internal mammary artery to left anterior descending artery, Saphenous vein graft to right coronary artery, Saphenous vein graft to posterior lateral branch) History of Present Illness: 54 year old male with history of coronary artery disease with prior stents complaing of increased chest pain on exertion. Had a positive stress test and then underwent a cardiac cath. Cath revealed three vessel coronary disease. Patient was experiencing chest pain during cath and was transferred to [**Hospital3 **] for surgery. Past Medical History: Coronary Artery Disease status post Percutaneous Coronary intervention and stents to left anterior descending and left circumflex Metbolic Syndrome Diabetes Mellitus Obesity Sleep Apnea Social History: Lives alone. Rare alcohol use. Quit smoking in [**2172**] after 2-3ppd x 17 yrs. Family History: non-contributory Physical Exam: Vitals: 69 10 140/75 6' 124kg Skin: Warm, dry and intact HEENT: Unremarkable Neck: Supple, full range of motion Chest: Clear to auscultation bilaterally Heart: Regular rate and rhythm with no murmurs Abd: Soft, non-tender, non-distended, +bowel sounds Ext: Warm, well-perfused Neuro: Grossly intact Pertinent Results: [**4-20**] Echo: PRE-BYPASS: 1. No atrial septal defect is seen by 2D or color Doppler. 2. Left ventricular wall thickness, cavity size, and global systolic function are normal (LVEF>55%). Regional left ventricular wall motion is normal. 3. Right ventricular chamber size and free wall motion are normal. 4. There are simple atheroma in the descending thoracic aorta. 5. There are three aortic valve leaflets. There is no aortic valve stenosis. No aortic regurgitation is seen. 6. Mild (1+) mitral regurgitation is seen. Dr. [**First Name (STitle) **] was notified in person of the results. POST-BYPASS: For the post-bypass study, the patient was receiving vasoactive infusions including phenylephrine. 1. Biventricular function is unchanged 2. Aorta is intact post decannulation. 3. Other findings are unchanged [**2194-4-26**] 07:15AM BLOOD WBC-9.6 RBC-3.39* Hgb-9.6* Hct-29.1* MCV-86 MCH-28.4 MCHC-33.0 RDW-14.7 Plt Ct-408# [**2194-4-18**] 01:40PM BLOOD WBC-8.2 RBC-4.68 Hgb-13.4* Hct-38.7* MCV-83 MCH-28.6 MCHC-34.6 RDW-14.6 Plt Ct-276 [**2194-4-26**] 07:15AM BLOOD Glucose-96 UreaN-35* Creat-1.9* Na-135 K-4.0 Cl-96 HCO3-27 AnGap-16 [**2194-4-25**] 05:50AM BLOOD Glucose-123* UreaN-33* Creat-1.7* Na-135 K-4.3 Cl-99 HCO3-23 AnGap-17 [**2194-4-18**] 01:40PM BLOOD Glucose-238* UreaN-39* Creat-1.5* Na-138 K-3.5 Cl-102 HCO3-26 AnGap-14 [**2194-4-18**] 01:40PM BLOOD %HbA1c-8.2* Brief Hospital Course: As mentioned in the history of present illness, Mr. [**Known lastname **] was transferred from outside hospital after his cardiac cath revealed severe coronary disease. Patient was complaining of chest pain upon admission and was given IV Nitroglycerin until he was pain free. He underwent usual pre-operative cardiac work-up and was planned to have surgery on [**4-22**]. Patient continued to have chest pain on and off despite receiving IV Nitroglycerin and was brought to the operating room on [**4-20**] where he underwent a coronary artery bypass graft x 3. Please see operative report for surgical details. Following surgery he was transferred to the CVICU for invasive monitoring in stable condition. Within 24 hours he was weaned from sedation, awoke neurologically intact and extubated. Chest tubes and epicardial pacing wires were removed per protocol. [**Last Name (un) **] was consulted on post-op day one for improved management of diabetes. On post-op day two he was transferred to the telemetry floor for further care. Patient began to experience some leg pain with movement and at rest. A uric acid was drawn per rheumatology and it was found to be elevated. They suggested 3 days of therapy with colchicine and motrin. He continued to progress and was ready for discharge to home on post-operative day 6. Medications on Admission: At home: Metformin 500mg [**Hospital1 **], Lopressor 100mg TID, Diovan 320mg daily, HCTZ 50mg daily, Isordil 10mg TID, Pravachol 40mg daily, Aspirin 325mg daily, Plavix 75mg daily (last dose 4/17) Discharge Medications: 1. Furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day for 7 days. [**Hospital1 **]:*7 Tablet(s)* Refills:*0* 2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). [**Hospital1 **]:*60 Capsule(s)* Refills:*0* 3. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 4. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). [**Hospital1 **]:*30 Tablet(s)* Refills:*0* 5. Pravastatin 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 6. Metoprolol Tartrate 100 mg Tablet Sig: 1.5 Tablets PO TID (3 times a day). [**Hospital1 **]:*135 Tablet(s)* Refills:*0* 7. Tamsulosin 0.4 mg Capsule, Sust. Release 24 hr Sig: One (1) Capsule, Sust. Release 24 hr PO HS (at bedtime) for 1 months. [**Hospital1 **]:*30 Capsule, Sust. Release 24 hr(s)* Refills:*0* 8. Colchicine 0.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) for 1 days. [**Hospital1 **]:*2 Tablet(s)* Refills:*0* 9. Cephalexin 500 mg Capsule Sig: One (1) Capsule PO Q6H (every 6 hours) as needed for sternal drainage for 3 days. [**Hospital1 **]:*6 Capsule(s)* Refills:*0* 10. Ibuprofen 400 mg Tablet Sig: 1-2 Tablets PO Q8H (every 8 hours) as needed for 1 days. [**Hospital1 **]:*8 Tablet(s)* Refills:*0* 11. Insulin Glargine 100 unit/mL Solution Sig: as directed Subcutaneous twice a day: 50 units in the morning, 20 units in the evening. [**Hospital1 **]:*qs qs* Refills:*0* 12. Humalog 100 unit/mL Solution Sig: as directed Subcutaneous with breakfast, lunch, and dinner: Blood sugar: 0-75: 4oz juice 76-110: no action 111-150: 4 units 151-190: 6 units 191-230: 8 units 231-270: 10 units 271-310: 12 units 311-350: 14 units > 350: [**Name8 (MD) 138**] MD. [**Last Name (Titles) **]:*qs qs* Refills:*2* 13. Hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed. [**Last Name (Titles) **]:*30 Tablet(s)* Refills:*0* 14. Insulin Syringe MicroFine 0.3 mL 28 x [**1-3**] Syringe Sig: as directed Miscellaneous 4-6 times/day. [**Month/Day (2) **]:*qs qs* Refills:*0* Discharge Disposition: Home With Service Facility: VNA Assoc. of [**Hospital3 **] Discharge Diagnosis: Coronary Artery Disease Metbolic Syndrome Diabetes Mellitus Obesity Sleep Apnea status post Percutaneous Coronary intervention and stents to left anterior descending and left circumflex 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: Dr. [**First Name (STitle) **] in 4 weeks Dr. [**Last Name (STitle) 14522**] in [**2-4**] weeks Dr. [**Last Name (STitle) **] in [**1-3**] weeks [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 173**] Completed by:[**2194-4-26**] ICD9 Codes: 4111
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Medical Text: Admission Date: [**2183-8-4**] Discharge Date: [**2183-8-20**] Date of Birth: [**2152-7-2**] Sex: M Service: SURGERY Allergies: peanut / latex Attending:[**First Name3 (LF) 1390**] Chief Complaint: Cellulitis Major Surgical or Invasive Procedure: 1. [**2183-8-7**] left above-the-knee amputation 2. [**2183-8-7**] Debridement of left lower extremity wound and placement of a wound VAC 3. [**2183-8-10**] Revision of left AKA with partial closure and placement of VAC 100 cm2 and debridement of upper sacral wound and back decubitus with placement of wet-to-dry dressings 4. Debridement of presacral ulcer, placement of V.A.C. on left amputation below-knee amputation stump, tracheostomy History of Present Illness: 31 year old male with spina bifida, s/p spinal fusion, hydrocephalus s/p shunt, bilaterally dislocated hips and clubbed feet presented to OSH with chills/night sweats and a known likely infected left foot (has a history of many lower extremity infections in the past). At the OSH, noted to be septic with HR in the 120s, hypotensive to the 70s responsive to IVF, afebrile with source likely cellulitis in his left leg; UA and CXR negative, blood cultures NGTD. Initially was put on vanc/clinda however pt continued to be septic with WBC count trending upwards (17 on [**8-2**] to 33 on [**8-4**], day of transfer) and with spreading of his cellulitis, so his abx were changed to vanc/zosyn. He was seen by surgery at the OSH who felt that he likely did not have nec fasc and recommended adding IV diflucan. Skin/wound cultures reportedly growing group G strep, blood cultures negative. He was transferred for further multidisciplinary workup; normally he is seen at [**Hospital1 2025**] for his lower extremity infections, it is unclear why he was not transferred there. His custom wheelchair recently broke and he has since been in one that is not well fitted to him. He developed lower extremity abrasions and sacral skin breakdown complicated by lower extremity and sacral cellulitis for the past few weeks. On the floor he appears tired and ill but not toxic, intermittently falling asleep. He is oriented to person and time but not place, and exhibits [**Doctor Last Name 688**] concentration. Endorses chills, night sweats, mild shortness of breath. States that he can feel his lower extremities but does not feel pain in them currently. Endorses dysuria. Pt was initially admitted to HMED service. He became increasingly toxic overnight and was transferred to the MICU for dropping pressures in the setting of afib with RVR. On arrival to the MICU, pt was hypotensive to 70s systolic, still in RVR. Past Medical History: PMH: Spina bifida, chronic lymphedema, hydrocephalus s/p shunt, lower extremity paralysis with bilateral clubbed foot deformities PSH: s/p VP shunt placement, s/p spinal fusion Social History: Lives with parents who are caregivers. Worked in the past at kiosk in the mall, but not currently employed. Not married, no children. No tobacco, ethanol, drugs. Family History: Mother with chronic fatigue syndrome and allergies, Dad unknown Physical Exam: 97.2 108/42 110 26 94%2L Admission Exam: GEN Alert, oriented to person/time, states he is at [**Hospital1 2025**], no acute distress HEENT NCAT dry MM, EOMI sclera anicteric, OP clear NECK supple, no JVD, no LAD PULM Only able to auscultate anteriorly due to habitus, good aeration, CTAB no wheezes, rales, ronchi CV regular tachycardia normal S1/S2, no mrg ABD obese soft NT ND normoactive bowel sounds EXT L: massive lymphedema with club foot deformity, capillary refill <2sec distally, over medial thigh and lateral club foot area of skin with cellulitic appearance with skin sloughing and weeping of serous fluid, dermis underneath appears beefy red, nontender to palpation, no area of fluctuance noted. No crepitus. Some areas with dark purple discoloration. Fungal appearing coat over some areas of skin. R: mild lymphedema with club foot deformity, no areas of skin breakdown noted. Sacrum: erythematous non-necrotic ulcer noted without penetration to bone/muscle. Non purulent. NEURO CNs2-12 intact, upper motor function grossly normal GU fungal appearing discharge from meatus Pertinent Results: Admission labs: [**2183-8-5**] 01:55AM BLOOD WBC-41.7* RBC-4.42* Hgb-11.8* Hct-38.2* MCV-86 MCH-26.7* MCHC-30.9* RDW-18.5* Plt Ct-270 [**2183-8-5**] 01:55AM BLOOD Neuts-85* Bands-1 Lymphs-11* Monos-1* Eos-0 Baso-0 Atyps-0 Metas-0 Myelos-2* [**2183-8-5**] 01:55AM BLOOD PT-12.4 PTT-25.2 INR(PT)-1.1 [**2183-8-5**] 01:55AM BLOOD Glucose-118* UreaN-52* Creat-1.6* Na-130* K-4.3 Cl-97 HCO3-22 AnGap-15 [**2183-8-5**] 01:55AM BLOOD ALT-13 AST-37 AlkPhos-207* TotBili-0.8 [**2183-8-5**] 01:55AM BLOOD Albumin-2.0* Calcium-8.4 Phos-4.2 Mg-2.7* [**2183-8-5**] 07:01AM BLOOD Lactate-1.7 [**2183-8-5**] 09:58AM BLOOD Lactate-1.3 [**2183-8-5**] 07:01AM BLOOD Type-ART O2 Flow-4 pO2-137* pCO2-73* pH-7.15* calTCO2-27 Base XS--5 Intubat-NOT INTUBA [**2183-8-5**] 11:04AM BLOOD Type-ART Temp-36.2 Rates-21/ PEEP-5 FiO2-100 pO2-165* pCO2-60* pH-7.14* calTCO2-22 Base XS--9 AADO2-490 REQ O2-83 Intubat-INTUBATED Abscess culture/wound swab [**2183-8-6**] Staph [**Last Name (LF) 61227**], [**First Name3 (LF) **], bacteroides [**2183-8-20**] 12:39AM BLOOD WBC-4.6 RBC-2.78* Hgb-8.2* Hct-27.2* MCV-98 MCH-29.4 MCHC-30.1* RDW-19.5* Plt Ct-212 [**2183-8-20**] 12:39AM BLOOD Plt Ct-212 [**2183-8-20**] 12:39AM BLOOD Glucose-89 UreaN-30* Creat-1.4* Na-141 K-4.4 Cl-112* HCO3-25 AnGap-8 [**2183-8-13**] 01:00AM BLOOD ALT-15 AST-18 AlkPhos-121 TotBili-0.6 [**2183-8-20**] 12:39AM BLOOD Calcium-8.4 Phos-3.0 Mg-2.5 [**2183-8-18**] 04:10AM BLOOD Vanco-15.9 Brief Hospital Course: Mr. [**Name13 (STitle) **] is a 31 yo M w/ PMH of spina bifida with paraplegia and is wheelchair bound at baseline who was transferred from an OSH for concern re: his left leg cellulitis. Upon admission, he was found to be hypotensive despite aggressive fluid resuscitation. He was transferred to the MICU initially, and surgery was consulted for concern regarding necrotizing fasciitis in the face of elevated WBC and signs of sepsis. He was taken urgently to the OR and did require AKA for necrotizing fasciitis; he was transferred to the surgical service postoperatively. His course is summarized by systems below: N: He was initially mentating well. He was sedated while intubated, but remained responsive when sedation was weaned. After sedation was d/c'd, he was A&Ox3. He worked with PT and was out of bed to chair and interacting appropriately. CV: At admission, his pressures did drop and upon transfer to the MICU on [**8-5**] he required three pressors to maintain his BP. His rhythm at this point was afib; he was started on an amiodarone drip. It was at this point that the patient was taken urgently to the OR. He remained on pressors post-operatively, but they were able to be significantly weaned. After the initial operation, he was weaned down to a small dose of levophed, which he continued to require. He was weaned off the amiodarone drip on POD 1 and remained in sinus rhythm. He was weaned off pressors and remained in sinus rhythm. Patient was stable from a cardiovascular standpoint at time of discharge Pulm: He was initially intubated on [**8-5**] after transfer to the MICU due to worsening ventilation and combined respiratory and metabolic acidosis on ABG. He was kept intubated postoperatively initially due to the need to return to the OR for washout. However he did continue to require high PEEP, and attempts to wean off the ventilator were unsuccessful. He was taken to the OR on [**8-13**] for trach placement. At time of discharge patient with stable 02 saturations on trach collar at 40% FiO2 GI: The patient was initially kept NPO with IVF. On [**2183-8-9**] he was started on tube feeds via NGT. These were held as needed for a return trip to the OR on [**8-10**] for washout and partial closure, and then restarted postoperatively. They were titrated up to goal and he tolerated them with low residuals. Patient was tolerating tube feeds at goal at time of discharge and was advanced to a soft solid diet with trach cuff inflated while taking po intake. GU: Urine output was monitored with a foley catheter. His UOP remained good however his creatinine did increase during the course of his ICU stay. This was monitored daily. ID: At initial presentation he was septic [**1-23**] necrotizing fasciitis in his left lower extremity. His preop WBC was 59. He was started on vanc/zosyn/clinda/flagyl for broad spectrum coverage and ID was consulted. ID continued to follow throughout his course. After the initial operation his WBC dropped to 26 on POD1; his hemodynamic status stabilized. His antibiotics were narrowed to vanc/zosyn/clinda. The cultures of his leg returned MRSA. Patient was continued on antibiotics until time of discharge and was discharged without antibiotics, afebrile with stable WBC. Patient was discharged to Rehabilitation facility with trach collar, tolerating tube feeds at goal with a soft diet and vac in place. Vac will be changed every 3 days tube feeds will be managed by the rehab facility pending po intake requirements. Abx were discontinued at time of discharge and patient will call to arrange a follow up appointement with [**Hospital 2536**] clinic in 2 weeks time. Medications on Admission: Medication on transfer from Medical service: metrogel q12h to face tylenol prn albuterol nebs prn oxycodone 5-10mg q3h prn pain zosyn 3.375g q6 vancomycin 2g q12 diflucan 200 qd Discharge Medications: 1. Acetaminophen (Liquid) 650 mg PO Q6H:PRN fever/pain 2. Artificial Tear Ointment 1 Appl BOTH EYES PRN redness/dry eyes 3. Bisacodyl 10 mg PO/PR DAILY 4. BusPIRone 10 mg PO BID anxiety 5. Collagenase Ointment 1 Appl TP DAILY apply to sacral decubitus ulcer daily 6. Docusate Sodium (Liquid) 100 mg PO BID 7. Gabapentin 300 mg PO DAILY 8. Heparin 7500 UNIT SC TID 9. HydrOXYzine 25-50 mg PO Q6H:PRN anxiety/puritus 10. Lactulose 30 mL PO BID 11. OxycoDONE (Immediate Release) 5-10 mg PO Q4H:PRN pain RX *oxycodone [Oxecta] 5 mg [**12-23**] tablet(s) by mouth every four (4) hours Disp #*30 Tablet Refills:*0 12. Sarna Lotion 1 Appl TP TID:PRN itching 13. Senna 1 TAB PO BID *AST Approval Required* 14. Zolpidem Tartrate 10 mg PO HS 15. MetronidAZOLE Topical 1 % Gel 1 Appl TP [**Hospital1 **] Discharge Disposition: Extended Care Facility: [**Hospital **] Hospital for Continuing Medical Care - [**Location (un) 1121**] ([**Hospital3 1122**] Center) Discharge Diagnosis: RLE necrotizing fasciitis Discharge Condition: Stable Discharge Instructions: You were admitted to the General surgery service for Necrotizing fasciitis of the Right lower extremity. Please call your doctor or go to the emergency department if: *You experience new chest pain, pressure, squeezing or tightness. *You develop new or worsening cough, shortness of breath, or wheeze. *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 an unusual discharge. *Your pain is not improving within 12 hours or is not under control within 24 hours. *Your pain worsens or changes location. *You have shaking chills, or fever greater than 101.5 degrees Fahrenheit or 38 degrees Celsius. *You develop any concerning symptoms. General Discharge Instructions: Please resume all regular home medications, unless specifically advised not to take a particular medication. Please take any new medications as prescribed. Please take the prescribed analgesic medications as needed. You may not drive or heavy machinery while taking narcotic analgesic medications. You may also take acetaminophen (Tylenol) as directed, but do not exceed 4000 mg in one day. Please get plenty of rest, continue to walk several times per day, and drink adequate amounts of fluids. Avoid strenuous physical activity and refrain from heavy lifting greater than 20 lbs., until you follow-up with your surgeon, who will instruct you further regarding activity restrictions. Please also follow-up with your primary care physician. The rehabilitation facility will be caring for your wound vac and your wound will be reevaluated at your follow up visit with ACS General Surgery Followup Instructions: Please call the [**Hospital 2536**] clinic to make a follow up appointment in 2 weeks. ICD9 Codes: 0389
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Medical Text: Admission Date: [**2201-1-23**] Discharge Date: [**2201-1-28**] Date of Birth: [**2117-11-27**] Sex: F Service: MEDICINE Allergies: Penicillins Attending:[**Last Name (NamePattern4) 290**] Chief Complaint: transferred from OSH for continued care Major Surgical or Invasive Procedure: None History of Present Illness: Ms. [**Known lastname 25788**] is an 83-year-old woman with a history of peripheral vascular disease, hypertension, osteoporosis, and alcohol abuse with a history of alcohol withdrawal who presented to [**Hospital1 18**] [**Location (un) 620**] on [**2201-1-17**] with 2 days of shortness of breath, malaise, dry cough, chest pain, and myalgia. She had been feeling poorly and had been taking ibuprofen around the clock for 2 days. Per her daughter, the patient was confused the morning of admission and this resolved after oxygen supplementation in the ED. In the ED, she received levofloxacin and then started on ceftriaxone for CAP. . Ms. [**Known lastname 25788**] was Dr. [**Last Name (STitle) **] at [**Hospital1 **]-N and ruled out for MI but was seen by cardiology in consult for atrial tachycardia. She was placed on amiodarone which did not control the pulse initially, so she was placed on digoxin as well. Dig was evenutally held for bradycardia. She also had elevated calcium to 11.4 once corrected for albumin thought [**2-23**] to dehydration. Therefore, calcium and vitamin D were held. Urine electrolytes were monitored, and she had a low FENa of 0.4%, and IV hydration continued and they felt she was clinically dry. Spiked temp to 100.2, blood cultures obtained, repeated CXR. Echocardiogram showed an EF of 30%-35% and, therefore, Zestril was restarted. However, the patient's creatinine bumped up to 2.0 on [**2201-1-23**]. Therefore, the Zestril was held. Patient's daughter requested on [**1-23**] in the am to have patient transferred to [**Hospital1 18**]. . Upon transfer VS: BP 148/67 HR 65 T 97.9 96%on 3L R 20. . Currently, patient feels well. She denied shortness of breath, fever or chills. She denied chest pain but said she had some in a band like pattern when she was first admitted to the hospital that has resolved. She also said she had a cough earlier in admission productive of yellow sputum. Upon further questioning, she had some epigastric abdominal pain and endorsed constipation, not recalling last bowel movement. . ROS:: Denies fever, chills, night sweats, headache, vision changes, rhinorrhea, congestion, sore throat, cough, shortness of breath, chest pain, nausea, vomiting, diarrhea, BRBPR, melena, hematochezia, dysuria, hematuria. Past Medical History: Peripheral vascular disease with bilateral claudication (refusing surgery) Hypertension Depression Osteoporosis with compression fractures Left hip ORIF Polymyalgia rheumatica alcohol abuse with a history of alcohol withdrawal Social History: Lives at home; smokes [**1-23**] pack per day for 15 years; 1 bottle of wine daily; uses a cane to walk. Family History: NC Physical Exam: Vitals - T:96.7 BP:132/66 HR: 103 RR:24 02 sat:94%2L GENERAL: Pleasant but lethargic, increased work of breathing HEENT: Normocephalic, atraumatic. No conjunctival pallor. No scleral icterus. PERRLA/EOMI. dryMM. OP clear. Neck Supple, No LAD, No thyromegaly. CARDIAC: tachy, irreg, irreg. Normal S1, S2. No murmurs, rubs or [**Last Name (un) 549**]. JVP=8cm LUNGS: decreased b/l BS, good air movement biaterally, LLL fine crackles, no accessory muscle use ABDOMEN: Soft, ND, +BS, tender to deep palpation in epigastrium and RLG, No HSM EXTREMITIES: No edema, 1+ dorsalis pedis/ posterior tibial pulses. SKIN: No rashes/lesions, ecchymoses. NEURO: A&Ox1(only to name, close on year [**2200**] but no orientation to place). Appropriate. CN 2-12 grossly intact. Preserved sensation throughout. 4-/5 strength throughout. [**1-23**]+ reflexes, equal BL. Normal coordination. Gait assessment deferred PSYCH: Listens and responds to questions appropriately, pleasant . Pertinent Results: [**2201-1-23**] 05:10PM GLUCOSE-104 UREA N-37* CREAT-2.1* SODIUM-141 POTASSIUM-5.0 CHLORIDE-106 TOTAL CO2-23 ANION GAP-17 [**2201-1-23**] 05:10PM estGFR-Using this [**2201-1-23**] 05:10PM ALT(SGPT)-150* AST(SGOT)-127* LD(LDH)-1426* CK(CPK)-98 ALK PHOS-113 AMYLASE-74 TOT BILI-0.6 [**2201-1-23**] 05:10PM LIPASE-25 [**2201-1-23**] 05:10PM CK-MB-NotDone cTropnT-0.08* [**2201-1-23**] 05:10PM CALCIUM-10.4* PHOSPHATE-3.8 MAGNESIUM-2.0 [**2201-1-23**] 05:10PM WBC-21.0* RBC-4.25 HGB-13.9 HCT-41.3 MCV-97 MCH-32.8* MCHC-33.8 RDW-14.4 [**2201-1-23**] 05:10PM NEUTS-90.3* LYMPHS-5.9* MONOS-3.1 EOS-0.6 BASOS-0.1 [**2201-1-23**] 05:10PM PLT COUNT-318 . [**2201-1-23**] CXR:Evidence of failure and effusions. [**2201-1-23**] LENIs neg for DVT [**2201-1-23**] RUQ US . Normal liver. No evidence of intra- or extra-hepatic biliary dilatation. 2. Right kidney is small with cortical thinning consistent with chronic medical renal disease. 3. Patent main portal and hepatic veins. [**2201-1-24**] CT chest/abd/pelvis1. Bilateral pleural effusions with bilateral lower lobe atelectasis. 2. Mild enlargement of the left kidney with perinephric stranding. Study is limited secondary to lack of IV contrast, however, findings may be secondary to pyelonephritis and correlation with UA is suggested. 3. Bilateral adnexal cysts as described. When patient has improved a pelvic ultrasound can be performed for further evaluation. [**2201-1-26**] Renal U/S Right renal atrophy with prominent cortical thinning and lack of Doppler flow, renal artery stenosis cannot be excluded. Patient could not tolerate Doppler examination. Normal left kidney. [**2201-1-26**] CT head No evidence of hemorrhage or recent infarction. However, MRI with diffusion-weighted imaging is more sensitive in the evaluation for acute infarct. [**2201-1-27**] Echo: The left atrium is mildly dilated. The right atrium is markedly dilated. Left ventricular wall thicknesses are normal. The left ventricular cavity size is normal. There is severe global left ventricular hypokinesis (LVEF = 20-30 %); the anterior septum appears akinetic and somewhat fibrotic. There is no ventricular septal defect. The right ventricular cavity is dilated with depressed free wall contractility. There is abnormal diastolic septal motion/position consistent with right ventricular volume overload. The aortic root is mildly dilated at the sinus level. The ascending aorta is 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 leaflets are mildly thickened. There is no mitral valve prolapse. Moderate to severe (3+) mitral regurgitation is seen. The tricuspid valve leaflets are mildly thickened. Severe [4+] tricuspid regurgitation is seen. The estimated pulmonary artery systolic pressure is normal. There is no pericardial effusion. [**2201-1-27**] CXR: There is stable moderate sized bilateral pleural effusions with mild atelectasis at the left lung base. Overall, there is no change. Brief Hospital Course: 83 yo F with PVD and [**Hospital 4747**] transferred from OSH for continue management of pneumonia. . #Leukocytosis: Patient admitted with cough, SOB, malaise and WBC to 18. WBC initially trended down on ceftriaxone. CXR with B/L pleural effusions. Currently afebrile without cough but tachypnic, but with rise in white count which may represent HAP. Blood cultures, urine cultures negative to date. Urine legionella neg. Started levaquin 500mg PO qday for 5days, white count only trended up with LDH>1000. Never febrile. No source of infx identified. ?pyelo seen on CT. ?Cancer but no clear sight. Trended fever curve, WBCs. BCx negative to date. . #Rhythm: New onset Afib with RVR, pressures stable. Not anticoagulated. Cardiac Enzymes slightly elevated at OSH, was started on amiodarone. Continue to work on rate control metoprolol. Started hep gtt for anticoagulation. Monitored on tele. . #Pump: systolic dysfunction with EF of 35-40% seen on recent echo seemed to be new, BNP elevated to [**Numeric Identifier **] with B/L pleural effusions seen at OSH. No known ischemic disease but focal hypokinesis on echo may suggest it vs. myocarditis in setting of troponin spill. No PND, orthopnea, DOE. No chest pain. Clinically she seem hypovolemic. Held amiodarone started at OSH, started metoprolol 25mg PO BID and titrated up to 50mg [**Hospital1 **]. Cards was consulted and felt she had an AMI about 1 month ago and suggested starting hydralazine, imdur, continue aspirin. . #ARF: Admitted at 2.0. Baseline Cr appears ~0.9-1.1. Patient appears dry. Said she had been eating and drinking prior to admission but her history is not reliable and she seems deconditioned. [**Month (only) 116**] have been taking a lot of NSAIDs prior to admission in combination with ACEI. Continued to hydrated her given 5L of NS overlength of stay, her Cr worsened, renal was consulted and felt she was prerenal. Despite fluids, her Cr bumped to 2.7. No casts were seen in urine, AceI was held. . #Decompensation: on the morning of [**2201-1-27**] patient converted from Afib to bradycardia and then normal sinus brady(betablocker on board), her respiratory status worsened with tachypnea, and hypotension however he oxygen requirement did not change. CXR showed worsening of pleural effusions. ABG performed. ICU was consulted. . #Patient was transferred to the ICU and started on a Dopamine drip for pressure support this was later changed to Dobutamine. Cardiology was consulted but had no further recommendations. Repeat echo showed worsen EF with global hypokinesis. After discussion with the family, the decision was made to make the patient comfortable and withdraw other support. The patient then passed away on the morning of [**2200-1-27**]. Medications on Admission: Ceftriaxone 1 gram IV q24 hours CIWA - no longer needs Wellbutrin SR 150 mg [**Hospital1 **] Amiodarone 400 mg po day Heparin SQ 5000 Units TID Nicotine Patch 21 mg apply Qday Atrovent 1 neb q6 hours prn Toprol XL 12.5 mg/day Discharge Medications: Expired Discharge Disposition: Expired Discharge Diagnosis: expired Discharge Condition: expired Discharge Instructions: expired Followup Instructions: expired [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**Name8 (MD) **] MD [**MD Number(1) 292**] Completed by:[**2201-2-1**] ICD9 Codes: 486, 5849, 4280, 4019, 311, 3051
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Medical Text: Admission Date: [**2147-2-2**] Discharge Date: [**2147-2-15**] Date of Birth: [**2091-11-15**] Sex: F Service: SURGERY Allergies: Amoxicillin / [**Last Name (un) **]-Dur / Lipitor / ketorolac / Sporanox / Latex / Lasix / Amitriptyline / Benadryl / Sulfa (Sulfonamide Antibiotics) / Erythromycin Base / Haldol Attending:[**First Name3 (LF) 17197**] Chief Complaint: acute onset back pain Major Surgical or Invasive Procedure: None History of Present Illness: 55M with chronic abdominal and back pain for over 15 yrs from previous surgeries p/w acute onset of back pain while resting. Pain radiating to abdomen. This was associated with profuse vomiting. She was seen at [**Hospital3 68**] ED where imaging CT showed a Type B aortic dissection. On arrival to ED, SBP > 200 and after nitroprusside and esmolol, her BP did respond. She was still complaining of abdominal and back pain but decreased in severity with narcotics. Past Medical History: PMH: MI, COPD, CVA, [**Doctor Last Name **] disease, prolonged QT, rectocele, HTN, conversion disorder presenting with signs/sx of CVA PSH: CCY, TAH/BSO, appy Social History: Lives at home, continues to smoke. Does not work. Son with schizoaffective disorder, daughter with bipolar disorder. Physical Exam: Gen: Mild distress, in bed, sleepy Lungs: clear Cardio: RRR Abd: soft, dist, obese, tender diffusely but to epigastric region, no palpable masses Ext: scabs t/o lower extremities, no edema or cyanosis Pulses fem [**Doctor Last Name **] DP PT L p/d d p p/d R p/d d p p/d Pertinent Results: 139 103 8 -------------< 150 3.7 25 0.7 estGFR: >75 Ca: 8.1 Mg: 1.8 P: 4.5 15.3> 11.9/34.9< 413 N:86.9 L:9.5 M:2.6 E:0.4 Bas:0.6 PT: 11.8 PTT: 20.0 INR: 1.0 CTA (OSH) - type B dissection starting just past takeoff of L subclavian artery and extending down to above iliac bifurcation. There is some R renal artery as discrepancy in perfusion of kidneys (R<L). CTA ([**2-6**]): Redemonstration of known type B aortic dissection, which extends from the proximal descending thoracic aorta to just above the aortoiliac bifurcation. The compressed true lumen supplies the celiac axis, the SMA, and the left renal artery. The false lumen supplies the right renal artery. Evolution of infarct involving the right kidney, with increasing edematous appearance of the largely nonperfusing kidney. Residual thin cortical perfusion is identified, along with some segmental perfusion of the right lower pole. CTA ([**2-13**]): Redemonstration of type B aortic dissection. No evidence of dissection extension into the proximal ascending thoracic aorta or the aortic arch branch vessels. Stable extension of the dissection into the infrarenal portion of the abdominal aorta. Celiac axis, SMA, left renal artery and inferior mesenteric artery arise from the true lumen. Two right renal arteries are present, with one artery arising from the false and true lumen each. The right renal artery arising from the true lumen is compressed as it passes through the false lumen. Evolving right renal infarct. Brief Hospital Course: Patient was admitted to the Vascular Surgery service with a type B aortic dissection. She was initially admitted to the ICU for monitoring and strict blood pressure control. She was seen by cardiology for recommendations regarding a anti-hypertensive medication regimen that would keep her systolic BP less than 130. She underwent serial exams and demonstrated no signs of mesenteric or peripheral limb ischemia. On hospital day 3 she underwent a repeat CTA abdomen due to continued abdominal and back pain, which showed unchanged aortic dissection. Abdominal pain and back pain improved over the course of her ICU stay and her diet was advanced to regular diet, which she tolerated well. On hospital day 3 she was found to have a UTI and she was started on a 3 days course of ciprofloxacin. On hospital day 5 she was transferred to the VICU. She was evaluated by PT who recommended eventual dispo home. She had been intermittently confused in the ICU and her confusion recurred while in the VICU. She underwent an extensive delerium workup, which was negative and her delerium subsequently resolved. She had one recurrence of abdominal pain and underwent another CTA abdomen which showed unchanged aortic dissection. Her creatinine remained stable throughout her hospital stay despite infarcted right kidney. Her blood pressure was well controlled on the regimen recommended by cardiology. At time of discharge she had no pain, was tolerating a regular diet, was alert and oriented, was able to ambulate independently and was voiding spontaneously. She will be discharged with close follow-up with her PCP, [**Last Name (NamePattern4) **]. [**Last Name (STitle) 32366**], for blood pressure control. Medications on Admission: Lactulose [**1-29**] tsp tid prn, Fosamax qweekly, Caltrat 600, Bentyl 20 QID prn GI spasms, Albuterol prn, Ativan 1''' prn, ASA 81', HCTZ 25', Cyclobenzaprine 10''', prn back spasms, Vicodin 5/500''' prn pain, Cymbalta 60', FioriCET 352/50/40 [**Hospital1 **] prn Discharge Medications: 1. famotidine 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 2. duloxetine 30 mg Capsule, Delayed Release(E.C.) Sig: Two (2) Capsule, Delayed Release(E.C.) PO DAILY (Daily). Disp:*60 Capsule, Delayed Release(E.C.)(s)* Refills:*2* 3. cyclobenzaprine 10 mg Tablet Sig: One (1) Tablet PO TID (3 times a day) as needed for back spasms . 4. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) puff Inhalation Q4H (every 4 hours) as needed for SOB/wheezing. puff 5. dicyclomine 10 mg Capsule Sig: Two (2) Capsule PO QID (4 times a day) as needed for GI spasms . Disp:*60 Capsule(s)* Refills:*0* 6. tramadol 50 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for pain. Disp:*45 Tablet(s)* Refills:*0* 7. hydrochlorothiazide 12.5 mg Capsule Sig: Two (2) Capsule PO DAILY (Daily). Disp:*60 Capsule(s)* Refills:*6* 8. losartan 50 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*6* 9. metoprolol succinate 100 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO DAILY (Daily). Disp:*30 Tablet Sustained Release 24 hr(s)* Refills:*6* Discharge Disposition: Home with Service Discharge Diagnosis: type B aortic dissection Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: *You were admitted for an aortic dissection which was managed conservatively with tight blood pressure control and no surgery. *It is extremely important that you continue to take your blood pressure medications as prescribed! What is aortic dissection? Aortic dissection is a tear or partial tear in the lining of the largest blood vessel in the body, the aorta. This tear allows blood (and the pressure of the blood flow) to penetrate the arterial wall. Over time, this continuous flow can cause the aorta to rupture - a condition that most people do not survive. There are two types of aortic dissections, although sometimes both are required: Type A: A dissection to the ascending aorta is classified as a Type A dissection. These dissections can be treated medically (usually only briefly) or with interventional catheterization or open surgical techniques. Type B: A dissection of the descending aorta is classified as a Type B dissection. These dissections are most often treated medically with routine monitoring and prescribed medications. There is a surgical option, but it carries substantially increased risk of paralysis. What are the warning signs and symptoms of aortic dissection? Aortic dissections are commonly found in people with high blood pressure, arteriosclerotic vascular disease, in individuals with a family history of aortic (or thoracic) dissection and more rarely associated with congenital cardiovascular disorders (Marfan??????s syndrome, Ehlers-Danlos syndrome, and congenital valvular disorders). "Stabbing" pain in the back is a common symptom of an aortic dissection. In some cases, people present with pain in the chest. This pain may be confused with angina (commonly referred to as "chest pain" and a warning sign of a possible heart attack). The main difference between pain resulting from dissection of the aorta, and angina due to lack of blood supply to the heart muscle, is its sudden and intense onset. The pain is characterized as a "ripping" or "tearing" sensation. This sudden pain can be felt in the back, chest, neck, or jaw. These are important differences to understand. Why? Because a common recommendation to those with angina or "chest pain" (that may result in a heart attack) is to chew an aspirin to thin the blood. This is NOT the case if you are experiencing an aortic dissection. Thinning the blood for a person with aortic dissection may cause more blood to leak out of the aorta. This internal bleeding can lead to death. In some cases, people do not experience any pain. Instead, you may experience any of the following symptoms: Distorted mental capacity (due to lack of blood supply to the brain) Numbness or tingling sensation in the arms or legs (due to lack of blood supply to the spinal cord) If you or someone you know is experiencing any of the above symptoms, call 9-1-1 immediately to get to a hospital. The survival rate increases dramatically the sooner a person is treated for an aortic dissection. Followup Instructions: Please follow up with your primary care physician, [**Last Name (NamePattern4) **]. [**Last Name (STitle) 32366**], Monday [**2-27**] at 1230 hrs, Please call ([**Telephone/Fax (1) 32367**], if there is a change You have an appoitment with Dr. [**Last Name (STitle) **], MD on [**2147-4-4**] at 1:00pm. Phone:[**Telephone/Fax (1) 170**], Provider: [**First Name8 (NamePattern2) 177**] [**Last Name (NamePattern1) **], MD Phone:[**Telephone/Fax (1) 170**] Date/Time:[**2147-4-4**] 1:00 Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 20205**], MD Phone:[**Telephone/Fax (1) 20206**] Date/Time:[**2147-3-24**] 12:30, lowey building, [**Location (un) 442**], [**Doctor First Name **] Provider: [**Name10 (NameIs) **] SCAN Phone:[**Telephone/Fax (1) 327**] Date/Time:[**2147-3-24**] 11:30 XCT [**Apartment Address(1) 9394**] [**Hospital Ward Name **] CC CLINICAL CENTER, [**Location (un) **] RADIOLOGY ICD9 Codes: 2930, 5990, 4019, 2768, 412, 496, 3051
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Medical Text: Admission Date: [**2189-11-18**] Discharge Date: [**2189-12-3**] Date of Birth: [**2112-1-2**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 905**] Chief Complaint: Abdominal pain Major Surgical or Invasive Procedure: -Central Line placement (Right internal jugular) in ICU-removed at discharge -[**2189-11-30**] Uncomplicated placement of a percutaneous GJ tube with tip in jejunum. The T-fasteners will fall out on their own in approximately six weeks. The tube should be changed approximately every 3 months. History of Present Illness: Mr. [**Known lastname 42086**] is a 77M with a PMH s/f ogilvies syndrome with frequent admissions for abdominal pain/distention, who was sent to the emergency department when he complained of lower abdominal pain at an outpatient ophthalmology appointment. . The patient is a difficult historian secondary to expressive aphasia, but he is able to tell me that he has right upper quadrant pain with associated nausea, and no vomiting. His last bowel movement was in the emergency department. He also reports three weeks of cough, denies sore throat, but does report chills. Otherwise his review of systems is negative. . In the emergency department presenting vital signs were T=99.4, BP=167/72, HR=93, RR=20, O2sat=99%RA. Per ED resident, his abdominal examination was benign. Laboratory data was wnl, though a lactate was not drawn. A CT of the abdomen showed unchanged sigmoid dilation, consistent with his known Ogilvies syndrome, with moderate fecal loading. A Surgical consultation was obtained, and they assessed him to have no signs of ischemia at this time. They recommended admission to medicine for serial abdominal exams, rectal tube decompression, and GI consultation for possible colonoscopic decompression. Of note, his CT showed "concern for aspiration vs. pneumonia at lung bases". He was given 750mg of levofloxacin. Past Medical History: #. Ogilvies Syndrome- Has frequent admissions for abdominal distention, with dilated colon on imaging, which resolves with rectal tube decompression. #. Chronic aspiration (Per PCP) #. CVA complicated by expressive aphagia, dysphagia #. Coronary artery disease, s/p CABG in [**2154**], mild systolic regional hypokinesis with EF 55% #. HTN #. Hyperlipidemia #. GERD #. History of pancreatitis #. Type 2 diabetes c/b gastroparesis #. Anemia #. Atrial fibrillation on coumadin Social History: Living at [**Hospital3 1186**] nursing home since stroke in [**2183**], wife passed away 5 years ago, no tobacco or ETOH use. Is on aspiration precautions with honey thick liquids. Family History: Non-contributory Physical Exam: Exam on admission [**2189-11-18**]: T=97.6, BP=138/65, HR=89, RR=20, O2=93%RA GENERAL: Elderly male in NAD, non-toxic appearing HEENT: Normocephalic, atraumatic. PERRLA/EOMI. MMM. OP clear. Neck Supple CARDIAC: Irregular rhythm, normal rate, no murmurs LUNGS: Crackles at the right base, overall, good air movement ABDOMEN: On inspection, his abdomen is distended. High pitched bowel sounds. Soft, tympanitic. Tenderness to deep palpation diffusely, no rebound or guarding. EXTREMITIES: No edema or calf pain SKIN: No rashes/lesions, ecchymoses. Exam on discharge [**2189-12-3**]: T 98.5 BP 145/72 HR 78 O2 95-97%RA GENERAL: Elderly male in NAD, lying in bed, alert HEENT: MMM. OP clear. Neck Supple CARDIAC: Irregular rhythm, normal rate, unable to appreciate murmurs due to upper airway sounds LUNGS: Poor effort, difficult to assess given upper airway sounds, clear at apices, coarse breath sounds at bases laterally ABDOMEN: soft, mildly distended, non-tender, +BS, no rebound or guarding. EXTREMITIES: warm, R hand with 1+ edema, R foot with 2+ edema, L foot with trace edema SKIN: Well healed coccyx sore without signs of infection Pertinent Results: Labs on admission [**2189-11-18**]: WBC-7.1 RBC-3.59* Hgb-10.4*# Hct-32.1* MCV-89 MCH-28.8 MCHC-32.3 RDW-16.6* Plt Ct-283 Neuts-77.2* Lymphs-13.9* Monos-5.7 Eos-2.9 Baso-0.3 PT-28.2* INR(PT)-2.8* Glucose-118* UreaN-32* Creat-1.0 Na-142 K-6.5* Cl-115* HCO3-21* AnGap-13 Labs on discharge [**2189-12-3**]: WBC-5.5 RBC-3.23* Hgb-9.2* Hct-28.8* MCV-89 MCH-28.3 MCHC-31.8 RDW-16.9* Plt Ct-254 PT-26.8* PTT-42.2* INR(PT)-2.6* Glucose-92 UreaN-9 Creat-0.6 Na-140 K-3.7 Cl-112* HCO3-26 AnGap-6* Calcium-7.9* Phos-2.3* Mg-1.8 Iron studies: calTIBC-134* VitB12-1305* Folate-16.7 Ferritn-248 TRF-103* Thyroid studies: TSH 6.3 Free T4 0.98 . MICRO: [**2189-11-18**], [**2189-11-22**] Urine culture: negative [**2189-11-19**], [**2189-11-22**] Blood cultures: negative [**11-20**] MRSA screen: negative [**11-20**] and [**11-22**] c diff: negative [**2189-11-22**] sputum culture: STAPH AUREUS COAG +.- MODERATE GROWTH. CLINDAMYCIN----------- =>8 R ERYTHROMYCIN---------- =>8 R GENTAMICIN------------ <=0.5 S LEVOFLOXACIN---------- =>8 R OXACILLIN------------- 0.5 S TRIMETHOPRIM/SULFA---- <=0.5 S IMAGING: [**11-18**] CXR: No acute pneumonia. [**11-18**] CT Abd/pelvis: 1. Unchanged, massively dilated sigmoid colon, with smooth taper and a fluid-filled rectum, compatible with pseudoobstruction ([**Last Name (un) **] syndrome). 2. Unchanged marked fecal loading in the proximal colon. 3. Interval resolution of bilateral pleural effusions. Chronic bibasilar consolidations, suggestive of chronic aspiration. [**11-20**] TTE: The left atrium and right atrium are normal in cavity size. There is mild symmetric left ventricular hypertrophy with normal cavity size. There is mild regional left ventricular systolic dysfunction with mild hypokinesis of the mid to distal anterior septum and distal anterior wall. There is abnormal septal motion/position. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. Trivial mitral regurgitation is seen. The tricuspid valve leaflets are mildly thickened. The estimated pulmonary artery systolic pressure is normal. There is no pericardial effusion. Compared with the prior study (images reviewed) of [**2189-8-17**], the findings are similar. [**11-20**] CT abd/pelvis: 1. Mildly dilated sigmoid and rectum without evidence of obstructions; findings consistent with pseudoobstruction. 2. Stable bilateral consolidation at the lung bases, may represent chronic aspirations [**11-21**] Right UE ultrasound: Right axillary vein could not be assessed due to arm contracture. Right internal jugular, subclavian and brachial veins patent, without evidence of thrombus. [**11-22**] KUB: Interval improvement in gaseous distention of bowel. [**11-22**] CXR: Limited study demonstrating streaky density at the right base most consistent with subsegmental atelectasis. [**2189-11-29**] KUB: In comparison with the study of [**11-22**], there is some increase in the generalized dilatation of the colon with a substantial amount of fecal material within it. The findings are consistent with the clinical impression of colonic ileus. Nasogastric tube extends to the upper stomach. Total hip arthroplasties are again seen. Brief Hospital Course: Mr. [**Known lastname 42086**] is a 77M with a PMH s/f Ogilvies Syndrome, who presents with abdominal pain . #. Abdominal pain/Ogilvies Syndrome: Distention and abdominal pain were consistent with prior episodes of Ogilvies. Initial exam and CT were not concerning for an acute intra-abdominal catastrophe. Rectal tube was placed, and bowel regimen given. He continued to have profuse watery stools. Shortly after admission he had two episodes of vomitting guaic-positive material. He also developed a fever to 100.8. In the context of these changes, abdominal pain worsened over the first hospital day, although abdominal exam remained benign. Repeat KUB demonstrated increased distention and possible volvulus. Immediately after this was discovered he was briefly hypotensive, as below. He was given levofloxacin and metronidazole empirically. Surgery was consulted and recommended serial exams and noncontrast CT abdomen when stable to evaluate further volvulus which was negative. Antibiotics were discontinued, and pt's obstruction improved with rectal tube, which was stopped. Tube feeds were given via NGT until [**2189-11-29**], when he had more distention again attributed to mild obstruction with KUB results as above. His fibersource tube feeds were held. His abdominal distention again improved and no-fiber tube feeds were initiated to decrease work for colon. TSH slightly elevated but Free T4 normal suggesting hypothyroidism not a major etiology in his Ogilvies. . # Hypotension: After blood pressures ranging 130-160 all day morning of admission, patient was found on routine vital signs check to have blood pressure 58/40 several hours after he had complained of worsening abdominal pain. His mental status remained at baseline during the episode, and telemetry demonstrated sinus tachycardia. He was bolused with IVNS, and pressure rebounded to systolic 100 within 30 minutes. This was thought to be secondary to an intra-abdominal process vs a primary cardiac event, as below. . # Demand ischemia: During and immediately after hypotensive episode, Mr. [**Known lastname 42086**] complained of new [**10-3**] substernal chest pain. EKG demonstrated new precordial TWI similar to EKG during recent NSTEMI [**8-2**]. Chest pain responded partially to SL nitro and morphine. Troponin was elevated above recent values, but CK was normal. EKG changes partially normalized with return of blood pressure, and the changes were thought to be most likely representative of demand ischemia. However, he continued to complain of chest pain. He was transferred to the intensive care unit for futher management and improved with sublingual nitroglycerin. As he was therapeutic on Coumadin, a heparin drip was not started. Home CAD regimen including ACEI, beta [**Last Name (LF) 7005**], [**First Name3 (LF) **], Imdur, simvastatin were continued. Chest pain resolved without recurrence during remainder of hospitalization. Echo [**2189-11-20**] unchanged from [**2189-8-17**]. . # Chronic aspiration / nutrition: Pt was evaluated by speech and swallow multiple times. At times, he was able to tolerate some PO and at others, he demonstrated frequent aspiration. With poor nutrition, NGT was placed for tube feeds. After discussion with family, pt had G-J tube placed by IR on [**2189-11-30**] as above. No-fiber tube feeds were initiated, which pt tolerated well. He refused final speech and swallow evaluation prior to discharge and remained NPO at discharge. He should be evaluated by speech and swallow at [**First Name4 (NamePattern1) 2299**] [**Last Name (NamePattern1) **] if he would like to eat for pleasure. If he remains NPO, oral care should be performed every 4 hours. . # Anemia - pt had continued low hematocrit. Iron studies as above. Guaiac negative. He required 2 blood transfusions during his hospitalizations. Hct 28.8 at discharge. continue workup as outpatient. . # Pneumonia: Sputum grew Staph aureus coag positive. Pt started on vancomycin changed to bactrim after sensitivities returned for total 7 day course. . #. Hypertension: For his chronic hypertension, ACEI and BB were initially continued but stopped after episode of hypotension. . #. GERD: Omeprazole changed to lansoprazole after placement of PEG. . #. Type 2 diabetes c/b gastroparesis: Pt developed hypoglycemia on NPH while NPO. His NPH was stopped and he was continued on Humalog ISS. He was discharged on humalog insulin sliding scale. He will need outpatient adjustment of his insulin regimen as nutrition improves with tube feeds. . #. Atrial fibrillation: The patient was in NSR or sinus tachycardia throughout his stay. INR became supratherapeutic with poor nutrition, likely secondary to vitamin K deficiency. His warfarin was held and he was maintained on heparin drip once INR decreased until PEG placement. Home beta [**Last Name (NamePattern1) 7005**] was continued. He was re-initiated on coumadin titrated to INR goal [**1-27**]. . # Communication: [**First Name4 (NamePattern1) 2299**] [**Last Name (NamePattern1) **] SW ([**Doctor First Name **]): [**Telephone/Fax (1) 94608**] Son [**Name (NI) **] (HCP): [**Telephone/Fax (1) 94609**] (work/attorney for Ride); [**Telephone/Fax (1) 94610**] (cell); [**Company 94611**] Medications on Admission: -Aspiration precautions -Honey thick liquids -Prednisolone 1% eye drops 1gtt right eye [**Hospital1 **] -Neomycin/polymyxin ointment to right eye daily -Aspirin 325 mg daily -Multivitamin -Lisinopril 20 mg daily -Omeprazole 20 mg daily -Metoprolol Tartrate 25 mg [**Hospital1 **] -Isosorbide Dinitrate 10 mg TID -Mirtazapine 30 mg qhs -Warfarin 2 mg daily -Furosemide 20 mg daily -KCl 40MEQ daily -Simvastatin 40mg daily -Novolin N 5 Subcutaneous QAM/QHS. -Polyethylene Glycol 3350 17 gram Powder one packet daily -Fleet enema, daily prn if ducolax does not produce bm -Bisacodyl suppository daily as needed for BM/24hrs -MOM, if no BM in 3 days -Calcium/ Vitamin D -Nitro prn Discharge Medications: 1. Aspiration Precautions 2. Prednisolone Acetate 1 % Drops, Suspension [**Hospital1 **]: One (1) Drop Ophthalmic [**Hospital1 **] (2 times a day). 3. Neomycin-Bacitracin-Polymyxin Ointment [**Hospital1 **]: One (1) Appl Ophthalmic DAILY (Daily). 4. Aspirin 325 mg Tablet [**Hospital1 **]: One (1) Tablet PO DAILY (Daily). 5. Multivitamin Tablet [**Hospital1 **]: One (1) Tablet PO once a day. 6. Lisinopril 20 mg Tablet [**Hospital1 **]: One (1) Tablet PO DAILY (Daily): Hold for SBP<100. 7. Lansoprazole 30 mg Tablet,Rapid Dissolve, DR [**Last Name (STitle) **]: One (1) Tablet,Rapid Dissolve, DR [**Last Name (STitle) **] once a day. 8. Metoprolol Tartrate 25 mg Tablet [**Last Name (STitle) **]: One (1) Tablet PO BID (2 times a day): Hold for SPB<100 or HR<60. 9. Isosorbide Dinitrate 10 mg Tablet [**Last Name (STitle) **]: One (1) Tablet PO TID (3 times a day): Hold for SBP<120. 10. Mirtazapine 30 mg Tablet [**Last Name (STitle) **]: One (1) Tablet PO HS (at bedtime). 11. Lasix 20 mg Tablet [**Last Name (STitle) **]: One (1) Tablet PO once a day: Hold for SBP<100. 12. Potassium Chloride 20 mEq Packet [**Last Name (STitle) **]: Two (2) PO once a day. 13. Simvastatin 40 mg Tablet [**Last Name (STitle) **]: One (1) Tablet PO DAILY (Daily). 14. Miralax 17 gram/dose Powder [**Last Name (STitle) **]: One (1) packet PO once a day. 15. Fleet Enema 19-7 gram/118 mL Enema [**Last Name (STitle) **]: One (1) enema Rectal once a day as needed for If Dulcolax does not produce bowel movement: Please give if dulcolax does not produce bowel movement. 16. Bisacodyl 10 mg Suppository [**Last Name (STitle) **]: One (1) suppository Rectal once a day as needed for for 1 BM / 24 hours: Please give as needed for 1 BM / 24 hours. 17. Milk of Magnesia 400 mg/5 mL Suspension [**Last Name (STitle) **]: [**5-3**] mL PO As directed as needed for if not BM in 3 days: Please give if pt has not had Bowel movement in 3 days. 18. Nitroglycerin 0.3 mg Tablet, Sublingual [**Month/Year (2) **]: One (1) tablet Sublingual as directed as needed for chest pain: 1 tablet every 5 minutes x3 tablets as needed for chest pain. 19. Calcium 500 mg Tablet [**Month/Year (2) **]: One (1) Tablet PO three times a day. 20. Vitamin D 400 unit Tablet [**Month/Year (2) **]: One (1) Tablet PO once a day. 21. Warfarin 2 mg Tablet [**Month/Year (2) **]: One (1) Tablet PO once a day. 22. Humalog 100 unit/mL Solution [**Month/Year (2) **]: as directed as directed Subcutaneous As directed: Per Humalog Insulin Sliding Scale. Discharge Disposition: Extended Care Facility: [**Last Name (un) 1188**] house Discharge Diagnosis: PRIMARY: Ogilvies Syndrome Chronic aspiration Staph aureus pneumonia SECONDARY: Hypertension Diabetes Mellitus Discharge Condition: Mental Status: Confused - sometimes Level of Consciousness: Sometimes alert and interactive vs somtimes lethargic but arousable Activity Status:Bedbound vs Out of Bed with assistance to chair or wheelchair SaO2 97% RA, tolerating tube feeds, having bowel movements, PEG site without erythema or induration Discharge Instructions: You were admitted to the hospital with abdominal pain and distention. Your blood pressure dropped and you developed chest pain, which was concerning for a heart attack. You were closely monitored in the intensive care unit, and your pain resolved. Your abdominal fullness improved with decompression. A PEG tube was placed for feeding given your chronic aspiration. You were treated for a pneumonia. The following changes were made to your medications: 1. STOP Omeprazole 2. START Lansoprazole 30mg daily as it can go through the PEG 3. CONTINUE your home bowel regimen 4. CONTINUE Warfarin 2mg daily and it will be titrated to INR goal [**1-27**] 5. STOP Novolin (NPH) 5 units in the morning and at night 6. START finger sticks QID (4 times a day) and use the Humalog sliding scale for insulin. Once you reach a steady state on your tube feeds, your doctor can adjust your insulin regimen. Avoid lactulose or high fiber foods in your diet. Followup Instructions: Please call Dr.[**Name (NI) 51133**] office at [**Telephone/Fax (1) 608**] to be seen within 2 weeks of discharge. [**Name6 (MD) 251**] [**Name8 (MD) **] MD [**MD Number(1) 910**] ICD9 Codes: 5070, 5119, 2760, 4019, 2724, 2859, 4589, 4280
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Medical Text: Admission Date: [**2104-8-7**] Discharge Date: [**2104-8-20**] Date of Birth: [**2032-3-24**] Sex: M Service: Surgery HISTORY OF PRESENT ILLNESS: Mr. [**Known firstname **] [**Known lastname 363**] is a 72-year-old male with a past medical history significant for pancreatic cancer, ulcerative colitis, hypertension, status post endoscopic retrograde cholangiopancreatography, and status post total abdominal colectomy 20 years ago with an end-ileostomy. The patient underwent an endoscopic retrograde cholangiopancreatography recently, but a stent was unable to be placed. A computed tomography was performed which demonstrated a head of the pancreas mass with dilated intrahepatic duct along with vascular involvement of the gastroduodenal artery and superior mesenteric vein. He presented for exploratory laparotomy with possible pancreatic mass resection. PAST MEDICAL HISTORY: 1. Ulcerative colitis. 2. Hypertension. 3. Benign prostatic hypertrophy. PAST SURGICAL HISTORY: 1. Total abdominal colectomy with end-ileostomy. 2. Status post transurethral resection of prostate. MEDICATIONS ON ADMISSION: 1. Moexipril 15 mg by mouth once per day. 2. Aspirin 81 mg by mouth once per day. 3. Atenolol 25 mg by mouth once per day. 4. Allopurinol 300 mg by mouth once per day. 5. Multivitamin. ALLERGIES: The patient has no known drug allergies. PHYSICAL EXAMINATION ON PRESENTATION: The patient is a thin, cachectic Caucasian male who was alert and oriented times three. In no apparent distress. The sclerae were anicteric. The patient was jaundiced. The oropharynx was clear with moist mucous membranes. The neck was supple and without lymphadenopathy. The heart was regular in rate and rhythm. The lungs were clear to auscultation bilaterally. The abdomen was soft, nontender, and nondistended. There was a well-healed midline scar and ileostomy present. The extremities were warm without cyanosis, clubbing, or edema. PERTINENT LABORATORY VALUES ON PRESENTATION: His hematocrit was 43.2. His INR was 1.2. Creatinine was 1.6. Aspartate aminotransferase was 51, his alanine-aminotransferase was 89, his alkaline phosphatase was 395, and his total bilirubin was 12.5. BRIEF SUMMARY OF HOSPITAL COURSE: On the day of admission, the patient was taken to the operating room where an exploratory laparotomy was performed. The patient had evidence of unresectable pancreatic cancer with biliary obstruction seen intraoperatively. Adhesiolysis was therefore performed along with a Roux-en-Y hepaticojejunostomy, and open cholecystectomy, an open pancreatic biopsy, and a gastrojejunostomy. The estimated blood loss for the procedure was 250 cc. The patient was discharged to the regular hospital floor after being extubated in the Postanesthesia Care Unit in good condition. In the evening on postoperative day one, the patient was taken back to the operating room emergently for likely mesenteric bleeding. This was controlled with suture ligation, and the patient was admitted to the Surgical Intensive Care Unit postoperatively for close monitoring. The patient remained intubated in the Intensive Care Unit on pressor support and received total parenteral nutrition until postoperative day seven. At this time, the patient's mental status was extremely labile requiring Haldol for agitation. The patient's hematocrit was stable at 35.8 at this time. Tube feeds were initiated on postoperative day eight. On postoperative day nine, the patient was transferred to the regular hospital floor. At this time, tube feeds were held for elevated residuals and nausea. He was still receiving total parenteral nutrition at this time. The patient's mental status was still not completely improved. A computed tomography scan was performed on postoperative day ten which did not demonstrate any intra-abdominal pathology. The patient was started on sips on postoperative day eleven and was started on his home medications. At this time, he was seen by the Physical Therapy Service and was being screened for rehabilitation placement. However, on the evening on postoperative day twelve the patient spiked a temperature to 101.5 degrees Fahrenheit. A fever workup was done including a chest x-ray and blood cultures. Early the next morning, the patient was found unresponsive without a pulse at approximately 2:45 a.m. At this time, a code blue was called and advanced cardiac life support protocol was initiated. However, the patient was asystolic without any respiratory effort at this time. He did receive multiple rounds of epinephrine along with attempts at ventilation. However, the patient never regained electrical activity and was pronounced deceased at 2:57 a.m. The patient's wife was notified at this time. However, a postmortem examination was declined. CONDITION AT DISCHARGE: The patient expired on [**2105-8-21**]. [**First Name8 (NamePattern2) 251**] [**Name8 (MD) **], M.D. [**MD Number(1) 4984**] Dictated By:[**Last Name (NamePattern1) 26023**] MEDQUIST36 D: [**2105-3-16**] 16:05 T: [**2105-3-16**] 18:33 JOB#: [**Job Number 105917**] ICD9 Codes: 9971, 4275, 4019
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Medical Text: Admission Date: [**2150-3-4**] [**Month/Day/Year **] Date: [**2150-3-9**] Service: MEDICINE Allergies: Sulfa (Sulfonamides) Attending:[**First Name3 (LF) 7455**] Chief Complaint: fever Major Surgical or Invasive Procedure: None History of Present Illness: [**Age over 90 **]F with multiple recent admissions to [**Hospital1 18**] following fall on [**2150-1-19**] with C1 fracture after a mechanical fall down stairs. She was evaluated for surgery but was found to be nonoperable, and was placed in a C-collar at least through [**4-19**] to be followed up with Dr. [**First Name (STitle) 23161**]. She was also noted to have an associated vertebral artery dissection and was treated conservatively with aspirin, and a large retropharyngeal hematoma. She was discharged to [**Hospital1 1501**] on [**1-27**]. . On [**1-29**] she was seen in the ED after sliding out of a chair, but the C1 fracture was stable. She was sent back to rehab, but was noted to not be eating well and have a WBC count of 34k. She was sent to [**Hospital3 **], then transferred to [**Hospital1 18**] on [**2150-2-4**] for white count of 34K, significant dehydration, intraventricular hemorrhage and question of colitis. Her hospital course was complicated by C dif sepsis with hypotension requiring pressors, acute renal failure, subdural hematoma (stable). She was discharged to [**Hospital6 **] on [**2150-2-17**]. . Today she was noted to have fevers to 101-102 and loose slightly bloody stools. She was started on flagyl, then received empiric vancomycin and imipenem and was transferred to the ED. In the ED, she was noted to be tachycardic and febrile, and received about 2 liters of fluids without improvement in her HR. She was never hypotensive. They also gave her some ativan and haldol for agitation. Cultures were drawn and she got additional 500 mg IV flagyl and was admitted to the MICU service. . ROS: denies pain. Other ROS limited by hearing loss and mental status. . Past Medical History: Hypertension Hypothyroidism Osteoarthritis Depression Obesity Urinary Incontinence GERD s/p Total TAH C1 fracture [**12-28**] subdural hematoma ventricular hemorrhage C.difficile colitis ([**1-28**]) Social History: Pt has been widowed for 6 yrs and currently lives alone in her home of 36 yrs. She has one daughter and four sons. Patient's daughter visits daily, and she has two sons near by. Family is close and supportive. Prior to recent trauma, patient was very independent. - EtOH - denies - Tob - denies - IVDU - denies Family History: Noncontributory Physical Exam: V: T99.7 BP 135/35 P108 R26 90% 5L NC Gen: lying in bed, moaning, opens eyes to voice HEENT: pupils 1 mm, min reactive, MM dry Neck: C collar in place, limits JVD assessment Resp: crackles bilateral bases, no wheezes CV: RRR nl s1s2 no MGR Abd: soft NTND +BS Ext: 2+ edema bilaterally Neuro: responds to voice Pertinent Results: Imaging: PORTABLE ABDOMEN [**2150-3-3**] 10:25 PM IMPRESSION: Nonspecific but non-obstructive bowel gas pattern. . CHEST (PORTABLE AP) [**2150-3-3**] 10:21 PM IMPRESSION: Bibasilar atelectasis with left pleural effusion. Retrocardiac opacity likely represents combination of these two processes, although underlying consolidation cannot be excluded. . CHEST (PORTABLE AP) [**2150-3-4**] 5:09 PM IMPRESSION: 1. Moderate sized layering left pleural effusion, and small right pleural effusion, both increased from [**2150-3-3**]. 2. Increase in size and density of retrocardiac opacity, which may be related to technical differences, but this area remains suspicious for underlying consolidation or atelectasis. . CHEST (PORTABLE AP) [**2150-3-5**] 5:50 AM IMPRESSION: Moderate bibasilar pleural effusions with increasing size of the right effusion. Retrocardiac opacity suggests atelectasis or consolidation. . CHEST (PORTABLE AP) [**2150-3-6**] 5:55 PM IMPRESSION: 1. Unsatisfactory placement of Dobbhoff tube which is coiled in the upper mediastinum. Recommend immediate removal. 2. Appearance of cardiomediastinal silhouette and lung fields are not significantly changed compared to an hour prior. These findings were discussed with the SICU nurse at the time of this dictation. . CHEST (PORTABLE AP) [**2150-3-6**] 5:04 PM IMPRESSION: 1. Intrabronchial placement of Dobbhoff tube. These results were immediately called to the SICU. 2. Moderate bibasilar pleural effusions and persistent retrocardiac opacity suggesting atelectasis versus consolidation. . CHEST (PORTABLE AP) [**2150-3-7**] 10:41 AM FINDINGS: The tip of the NGT is well below the diaphragm and seen just to the left of midline by the L4 vertebral body. Perhaps the chest is obscured from view and the lower portions demonstrate some atelectatic features. . CT HEAD W/O CONTRAST [**2150-3-8**] 3:56 PM IMPRESSION: No significant interval change of left frontal cerebral convexity subdural hematoma. Decrease in lateral ventricle hemorrhage and frontal subgaleal hematomas. . PORTABLE ABDOMEN [**2150-3-8**] 11:17 AM Supine views of the abdomen and pelvis demonstrate no evidence of intestinal obstruction. Previously reported distended air-filled loops of bowel have decreased in caliber since the previous study. . CHEST (PORTABLE AP) [**2150-3-8**] 8:28 AM Nasogastric tube remains in place terminating below the diaphragm. Cardiac silhouette is enlarged but stable in size. Bilateral pleural effusions have worsened, moderate on the right and small-to-moderate on the left, with adjacent basilar opacities that likely represent atelectasis. . Micro: *[**2150-3-3**]* Blood Culture: PENDING Stool: C Diff positive *[**2150-3-4**]* Urine Culture: P. aeruginosa & VRE MRSA Screen: negative Stool: C diff positive *[**2150-3-5**]* Stool: C diff positive Blood Culture: NGTD PICC line tip culture: No growth . Labs: [**2150-3-3**] 09:50PM BLOOD WBC-15.0* RBC-3.20* Hgb-9.8* Hct-29.6* MCV-93 MCH-30.8 MCHC-33.3 RDW-18.8* Plt Ct-240# [**2150-3-6**] 03:29AM BLOOD WBC-17.9* RBC-2.81* Hgb-8.6* Hct-26.3* MCV-94 MCH-30.7 MCHC-32.8 RDW-17.5* Plt Ct-264 [**2150-3-9**] 06:10AM BLOOD WBC-20.4* RBC-3.08* Hgb-9.4* Hct-29.4* MCV-95 MCH-30.5 MCHC-32.0 RDW-17.0* Plt Ct-380 [**2150-3-3**] 09:50PM BLOOD PT-12.2 PTT-26.6 INR(PT)-1.0 [**2150-3-6**] 03:29AM BLOOD PT-12.9 PTT-25.6 INR(PT)-1.1 [**2150-3-8**] 07:25AM BLOOD PT-13.2* PTT-24.5 INR(PT)-1.1 [**2150-3-3**] 09:50PM BLOOD Glucose-99 UreaN-28* Creat-0.8 Na-141 K-4.3 Cl-103 HCO3-30 AnGap-12 [**2150-3-5**] 03:27AM BLOOD Glucose-141* UreaN-27* Creat-0.9 Na-141 K-4.1 Cl-103 HCO3-30 AnGap-12 [**2150-3-9**] 06:10AM BLOOD Glucose-106* UreaN-37* Creat-1.2* Na-147* K-4.2 Cl-109* HCO3-31 AnGap-11 [**2150-3-7**] 02:32AM BLOOD CK(CPK)-23* [**2150-3-8**] 07:25AM BLOOD ALT-11 AST-14 LD(LDH)-306* AlkPhos-117 Amylase-32 TotBili-0.3 [**2150-3-8**] 07:25AM BLOOD Lipase-20 [**2150-3-3**] 09:50PM BLOOD Calcium-7.4* Phos-3.2 Mg-2.2 [**2150-3-6**] 03:29AM BLOOD Calcium-7.3* Phos-3.1# Mg-2.3 [**2150-3-9**] 06:10AM BLOOD Calcium-7.7* Phos-3.7 Mg-2.4 [**2150-3-5**] 03:27AM BLOOD Triglyc-157* [**2150-3-8**] 07:25AM BLOOD Osmolal-303 [**2150-3-7**] 02:32AM BLOOD TSH-11* [**2150-3-7**] 02:32AM BLOOD Free T4-0.68* Brief Hospital Course: [**Age over 90 **]F with MMP including C difficle infection, UTI, PICC line infection, PNA. . #) fever, elevated WBC - Patient was on multiple antibiotics to treat C. diff, Pseudomonas/VRE UTI, Coag - staph PICC line associated bacteremia, PNA and these were likely the causes of her fevers and leuckocytosis. After discussion the family, these measures were to be discontinued prior to [**Age over 90 **]. . #) Respiratory distress: Patient with hypercarbic respiratory distress. Patient is DNI and CPAP contraindicated at this time as patient has some respiratory secretions. After discussion with the family, it was determined that the patient definitively not be intubated and she was not transferred to the MICU for respiratory ventilation. RA saturations are 86-88%. . #) Mental status - AAOx3 intermittently in the MICU, although while on the floor the patinet has been slightly responsive to noxious stimulus. Family has been by the bedside and have reassured us that this is not her baseline.. . #) Paroxysmal atrial fibrillation - Likely in setting of numerous infections. Patient was started on IV Lopressor for rate control. This medication was held in the setting of hypotension. . #) h/o C1 fracture - no new trauma since 1/[**2149**]. Patient has been in hard collar and recommendations were to keep patient in hard collar until [**2150-4-19**]. Given goals of comfort, patient will be able to remove the collar. Patient does have scheduled appointments with Neurosurgery in the upcoming months. . #) Hearing loss - appears at baseline. Patient with headphones and microphone for communication. . #) hypothyroid - Synthroid was continued although TFTs were not suggestive of such. This was likely due to decreased PO absorption in the setting of C diff infection. . # Anemia - stable, acute GI bleed resolved at this point, will continue to monitor. . # Depression - on Remeron 15 mg prior to admission but unable to take po's. . # FEN - Family have decided not to undergo PEG placement as this contradicts patient's wishes. Patient initially had an NGT placed although this was removed by the patient on the day of [**Month/Day/Year **]. . . After discussion with the patient's family, HCP, and medical staff, all were in agreement that [**Known firstname **] [**Known lastname 23162**] was a suitable candidate to [**Known lastname **] to hospice. Medications on Admission: imipenem 500 mg x1 vanco 1000 mg x 1 flagyl 500 mg po tid (start [**3-3**] for diarrhea) lorazepam 0.5 mg po qhs, [**Hospital1 **] prn agitiation TPN at 75/hour heparin SQ TID tylenol 1000 mg po q6h calcium carbonate 500 mg po tid hemorrhoidal ointment/hydrocort rectally lansoprazole 30 mg po qd levothyroxine 150 mcg po qd miconazole topically [**Hospital1 **] remeron 30 mg po qhs vitamin d 800 units po qd atrovent nebs Q6H prn [**Hospital1 **] Medications: 1. Acetaminophen 325 mg Tablet [**Hospital1 **]: One (1) Tablet PO Q4-6H (every 4 to 6 hours) as needed. 2. Calcium Carbonate 500 mg Tablet, Chewable [**Hospital1 **]: One (1) Tablet, Chewable PO TID (3 times a day). 3. Cholecalciferol (Vitamin D3) 400 unit Tablet [**Hospital1 **]: Two (2) Tablet PO DAILY (Daily). 4. Ipratropium Bromide 0.02 % Solution [**Hospital1 **]: One (1) Inhalation Q4H (every 4 hours). 5. Ipratropium Bromide 0.02 % Solution [**Hospital1 **]: One (1) Inhalation Q2H (every 2 hours) as needed. 6. Levothyroxine 50 mcg Tablet [**Hospital1 **]: Three (3) Tablet PO DAILY (Daily). 7. Nystatin 100,000 unit/g Cream [**Hospital1 **]: One (1) Appl Topical [**Hospital1 **] (2 times a day). 8. Albuterol Sulfate 0.083 % Solution [**Hospital1 **]: One (1) Inhalation Q6H (every 6 hours) as needed. 9. Lorazepam 0.5 mg IV Q6H:PRN agitation 10. Pantoprazole 40 mg IV Q24H 11. Morphine Sulfate 1 mg IV Q4H:PRN pain 12. Metoprolol 5 mg IV Q6H please hold for SBP<100, HR<60 [**Hospital1 **] Disposition: Extended Care [**Hospital1 **] Diagnosis: Primary Diagnosis: C. diff, Complicated Urinary tract infection, Hypercarbic respiratory failure . Secondary Diagnoses: Hypertension Hypothyroidism Osteoarthritis Depression Obesity Urinary Incontinence GERD s/p Total TAH C1 fracture [**12-28**] subdural hematoma ventricular hemorrhage C.difficile colitis ([**1-28**]) [**Month/Year (2) **] Condition: Afebrile, normotensive, tachycardic, nonambulatory, not tolerating POs, nonresponsive [**Month/Year (2) **] Instructions: You were admitted with an infection and have been treated with antibiotics. Followup Instructions: Provider: [**Name10 (NameIs) **],[**Name11 (NameIs) **] [**Name Initial (NameIs) **]. NEUROSURGERY WEST Date/Time:[**2150-4-21**] 2:00 Provider: [**Name10 (NameIs) **] SCAN Phone:[**Telephone/Fax (1) 327**] Date/Time:[**2150-4-21**] 1:00 Completed by:[**2150-3-10**] ICD9 Codes: 5849, 5990, 486, 2449, 4019, 311, 2859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6020 }
Medical Text: Admission Date: [**2186-3-24**] Discharge Date: [**2186-6-1**] Date of Birth: [**2145-4-18**] Sex: M Service: SURGERY Allergies: Latex Attending:[**First Name3 (LF) 14255**] Chief Complaint: cholangiocarcinoma Major Surgical or Invasive Procedure: 1. R hepatic lobectomy and pancreaticoduodenectomy ([**2186-3-24**]-[**Location (un) **]), 2. ex-lap, drainage of RUQ abscess, and redo pancreaticojejunostomy ([**2186-4-8**]-[**Location (un) **]), 3. ex-lap, washout for bleeding ([**2186-4-14**]-[**Location (un) **]), 4. abd washout, temporary closure ([**2186-4-16**]-[**Location (un) **]), 5. ex-lap, washout, attempted closure ([**2186-4-19**]-[**Location (un) **]), 6. abd washout and closure ([**2186-4-25**]-[**Location (un) **]) Thoracentesis [**2186-4-21**], [**2186-4-28**] Picc placed [**2186-4-4**], removed [**2186-5-30**] History of Present Illness: 40-year-old Italian male who presents with a segment VIII hepatic lesion. [**Known firstname 91899**] was initially diagnosed with his bile duct stricture in [**2183**]. He has undergone multiple brushings and biopsies of this lesion, which were all consistent with a benign stricture. He has had a number of stents placed in the bile duct and eventually these were removed. He was doing well until he was seen at the [**Hospital 8**] Hospital by Dr. [**Last Name (STitle) 2161**] and [**Last Name (STitle) 1834**] a CT scan, which demonstrated what appeared to be metastasis in the right lobe of the liver. He has no significant past medical history. Past Medical History: None Social History: He is currently employed as a construction worker working full time. He divides his time between [**State 108**] and [**Location (un) 86**]. He notes that he has a glass of wine or beer a couple of times a week, approximately 10 cigarettes per day and he has quit approximately three years ago. No drugs, no marijuana. Family History: Non-contributory Physical Exam: discharge PE 98.5 92 100/64 18 A&O, anicteric decreased breath sounds R lower half rrr abd soft/non-tender, capped Roux tube, 2 JP drains with greenish fluid, L side of incision with 2x2 damp to dry NS dressing ext trace edema right ankle roux capped JP #1 15ml/day JP #2 20ml/day BM x2 [**5-31**] Pertinent Results: [**2186-6-1**] 05:55AM BLOOD WBC-9.8 RBC-2.96* Hgb-8.9* Hct-27.4* MCV-92 MCH-30.1 MCHC-32.5 RDW-14.6 Plt Ct-365 [**2186-5-29**] 03:46AM BLOOD PT-13.8* PTT-28.9 INR(PT)-1.3* [**2186-5-29**] 03:46AM BLOOD Glucose-116* UreaN-11 Creat-0.6 Na-132* K-3.9 Cl-98 HCO3-28 AnGap-10 [**2186-6-1**] 05:55AM BLOOD Glucose-116* UreaN-10 Creat-0.6 Na-130* K-4.0 Cl-96 HCO3-29 AnGap-9 [**2186-5-22**] 05:50AM BLOOD ALT-37 AST-36 AlkPhos-215* TotBili-1.1 [**2186-5-29**] 03:46AM BLOOD ALT-30 AST-35 AlkPhos-242* TotBili-0.6 [**2186-6-1**] 05:55AM BLOOD ALT-33 AST-41* AlkPhos-270* TotBili-0.6 [**2186-4-28**] 01:13AM BLOOD Lipase-36 [**2186-6-1**] 05:55AM BLOOD Albumin-2.7* Calcium-8.3* Phos-4.6* Mg-1.8 [**2186-5-9**] 05:32AM BLOOD calTIBC-213* TRF-164* [**2186-5-8**] 05:08AM BLOOD Triglyc-111 [**2186-5-21**] 5:46 pm PLEURAL FLUID PLEURAL FLUID . **FINAL REPORT [**2186-5-27**]** GRAM STAIN (Final [**2186-5-22**]): 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 (Final [**2186-5-24**]): NO GROWTH. ANAEROBIC CULTURE (Final [**2186-5-27**]): NO GROWTH. [**2186-4-7**] 4:20 am BLOOD CULTURE **FINAL REPORT [**2186-4-15**]** Blood Culture, Routine (Final [**2186-4-14**]): PREVOTELLA SPECIES. BETA LACTAMASE NEGATIVE. Anaerobic Bottle Gram Stain (Final [**2186-4-9**]): Reported to and read back by DR. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] @ 1650, [**2186-4-9**]. GRAM NEGATIVE ROD(S). Brief Hospital Course: On [**2186-3-24**], Mr. [**Known lastname 91900**] [**Last Name (Titles) 1834**] right hepatic lobectomy and Whipple procedure for distal cholangiocarcinoma with metastasis to the right lobe of the liver. Surgeon was Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], co-surgeon Dr. [**First Name4 (NamePattern1) 3742**] [**Last Name (NamePattern1) **]. He was intubated and sedated postoperatively for a prolonged period due to revision of pancreaticojejunostomy, drainage of right upper quadrant abscess and redo of pancreaticojejunostomy on [**4-8**] for pancreaticojejunostomy dehiscence. He had open abdomen and need for repeated abdominal washouts. SICU course was prolonged. He was successfully extubated after repeated operations on [**4-22**]. Despite his prolonged intubation, he was oriented to time and place post extubation. Following repeated surgeries, he was persistently tachycardic. CTA was performed on [**2186-3-27**] and was negative for pulmonary embolus, but did show a subdiaphragmatic fluid collection. He remained on pressor support (neo,vasopressin from [**Date range (1) 89937**]). Octreotide was also started due to continued bleeding after initial OR on [**4-8**]. Cardiac echo was performed [**2186-4-10**] which revealed normal biventricular cavity sizes with preserved regional and hyperdynamic global biventricular systolic function. No valvular pathology or pathologic flow identified. On [**4-8**], (postop day 15), he continued to drain bile from his JP drains. He was taken back to the OR for concern of anastomotic leak from his pancreaticojejunostomy. He continued to have a dropping hematocrit on [**4-14**] and returned to to OR on [**4-14**] for abdominal washout, however no source of bleeding was determined. Despite this the patient continued to have a transfusion requirement. had a persistent transfusion requirement and returned again to the OR for abdominal washout later that day. In total, between [**4-8**] and [**4-16**] he received 23 Units of PRBC, 16U of FFP. He again returned to the OR on [**4-14**] for abdominal washout. Abdomen was left open. Following diuresis with a Lasix drip the patient subsequently returned to the OR [**4-25**] for closure. Please refer to operative reports for details. Thoracentesis was done on [**4-21**] and [**4-28**] for 1200 cc and 1000 cc respectively. Respiratory status subsequently improved and patient had decreased oxygen requirement. Thoracentesis was again performed on [**5-16**] for large pleural effusion. Pleural fluid culture isolated pan sensitive E.coli. IV Ciprofloxacin was administered for 15 days. CXR demonstrated apical pneumothorax. Reaccumulation of the pleural effusion occurred necessitating repeat thoracentesis with pigtail drain placement was done on [**5-21**] yielding one liter of exudate. TPA instillation was attempted, however, pigtail catheter became dislodge. Culture of this fluid demonstrated 4+PMN, but was negative for microorganisms. Given concern for empyema, a thoracic consult was obtained on [**5-25**]. After review of CXRs , no further intervention was recommended as the thoracic surgery service thought the effusion was most likely reactive from the subdiaphragmatic collection. Notation of an 8-mm right upper lobe nodule was made and attention on followup scans for surveillance for metastasis was recommended. He was weaned off oxygen and O2 saturations were greater than 93%. CXR on [**5-29**] showed slightly decreased loculated right pleural effusion since the prior study still involving the major fissure and still with multiple air-fluid levels consistent with air loculations. No pneumothorax was noted. There was a small left pleural effusion. He was maintained on total parenteral nutrition throughout most of his hospital course. On postop day 32, a post-pyloric feeding tube was placed and tube feedings were started and successfully advanced to goal rate. Throughout hospital stay, regular insulin was given per sliding scale. From [**Date range (1) 91901**] while critically ill he remained on an insulin gtt which was subsequently weaned off. He passed a bedside swallow and was subsequently advance to clears and then regular diet. Otolaryngology was consulted for weak, hoarse voice. It was felt that prolonged and repeated intubations were likely the cause and that granulomatous changes would resolve over time. PPI therapy was recommended and administered (Protonix [**Hospital1 **]). Hoarseness and projection improved. Creatinine remained stable at ~1.0. He tolerated diuresis with a Lasix drip until successful closure of abdomen on [**4-25**]. While on Lasix drip, urine output remained excellent 100-400 cc/hr with urine output of >4-6L/day. Following abdominal washout on [**2186-4-8**] he was placed on broad spectrum antibiotics including vanc/zosyn and fluconazole. Blood cultures returned on [**4-7**] positive for Prevotella species, but surveillance cultures remained negative since this blood culture. On [**2186-4-20**] his PICC line was removed and his CVL was replaced for concern of rising leukocytosis to 14. PICC line culture was negative. Central line was eventually removed and another PICC line was placed ([**5-6**]/)into left upper arm. This line was used for TPN/antibiotics/blood draws. On [**5-30**], this line was removed as IV antibiotic course (Ciprofloxacin)was stopped on [**5-31**]. Give protracted hospital course, he was very depressed. Social work and pastoral care supported. Remeron was started on [**5-11**] at 7.5mg then increased to 15mg on [**5-25**]. Mood, energy level and sleep pattern improved. LFTs slowly improved with values approaching normal limits with the exception of alk phos which remained in the low to mid 200s. Ursodiol was continued. He continued to have anemia with stable hematocrit of 25. Physical therapy worked with him throughout this hospital stay. He became more independent with ambulation and ADLs as his condition improved. He had been very debilitated, tachycardic and with O2 requirement. Rehab was recommended. Rehab screen was done per case management and [**Hospital3 **] in [**Hospital1 8**] offered a bed on [**6-1**]. He will transfer there today. Medications on Admission: none Discharge Medications: 1. DiphenhydrAMINE 25 mg PO HS:PRN insomnia 2. Docusate Sodium 100 mg PO BID 3. HYDROmorphone (Dilaudid) 2 mg PO Q4H:PRN Pain 4. Mirtazapine 15 mg PO HS 5. Octreotide Acetate 100 mcg SC Q8H 6. Ondansetron 4 mg IV Q8H:PRN nausea 7. Pantoprazole 40 mg PO Q12H 8. Ursodiol 300 mg PO BID Discharge Disposition: Extended Care Facility: [**Hospital **] Hospital - [**Hospital1 8**] Discharge Diagnosis: Cholangiocarcinoma pancreaticojejeunostomy dehiscence right pleural effusion prevotella bacteremia [**2186-4-7**] 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: You will be transferring to [**Hospital3 **] in [**Hospital1 8**]. Please call Drs.[**First Name (STitle) **] and [**Doctor Last Name **] office if you have any of the following: temperature of 101 or greater, chills, nausea, vomiting, jaundice, increased abdominal pain, drain output stops or increases significantly or changes in color/odor, constipation or diarrhea or if feeding tube clogs. You may shower. Followup Instructions: Follow up will be with Dr. [**First Name4 (NamePattern1) 3742**] [**Last Name (NamePattern1) **] on [**2186-6-15**] at 1:15 PM at [**Hospital **] Medical Office Building, [**Location (un) **], [**Last Name (NamePattern1) **]. [**Location (un) 86**], [**Numeric Identifier **] Completed by:[**2186-6-1**] ICD9 Codes: 0389, 7907, 5119, 2767
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6021 }
Medical Text: Admission Date: [**2186-1-25**] Discharge Date: [**2186-2-6**] Date of Birth: [**2142-4-6**] Sex: M Service: SURGERY Allergies: Sulfa (Sulfonamides) / Ampicillin / Levofloxacin Attending:[**First Name3 (LF) 5569**] Chief Complaint: RLE: significant worsening of pain and swelling Major Surgical or Invasive Procedure: [**2186-1-26**] Extensive debridement of right lower extremity. [**2186-1-27**] Exploration, washout and debridement of right lower extremity. History of Present Illness: This 43-year-old male patient with a history of ESLD, cirrhosis secondary to hepatitis C, genotype I, He had been followed in the [**Hospital 1326**] clinic (last visit [**2185-9-21**]). Presented with mildly encephalopathic status and has significantly worsened synthetic function of his liver with low albumin, high INR, and low glucose, MELD 38. Acute on chronic renal failure with uremia in setting of GNR bacteremia. Pt has significant h/o unilateral RLE lymphedema, with progressively worsening pain and tenderness and uncompromised perfusion. Past Medical History: PMH: -Hep C, genotype 1 -Cirrhosis. -MELD 38 -Hx IVDU -Chronic unilateral right leg lymphedema -Chronic renal failure Social History: lives with girlfriend and 3 cats at home + tobacco - [**12-10**] ppd denies etoh + IVDU - He has a history of IV drug use with heroin and cocaine between [**2164**] and [**2174**] but denies any use since then. He repairs computers part time. He was incarcerated between [**2173**] to [**2177**] for possession of drugs with intent, and he does smoke an occasional marijuana, but he reports it is prescribed by doctors [**First Name8 (NamePattern2) **] [**Last Name (Titles) **]. Family History: Non-contributory Physical Exam: VS: 98.2 92/34 106 18 92%RA General: awake orientated, inappropriate responses, anxious. HEENT: Sclera anicteric, dry MM. Neck: supple, JVP not elevated, no LAD Lungs: CTAB, no wheezes, rales, ronchi CV: Regular rate and rhythm, normal S1 + S2, no murmurs Abdomen: soft, mildly hypogastric tender , non-distended, BS+ no rebound tenderness or guarding, no fluid shift,no visceromegaly, no herniation. Ext: Significant RLE 2+, non pitting,very tender tense compartments, with cellulitis, no crepitus. Pain on passive flexion/extension. Uncompromised perfusion, pulses preserved. R inguinal region lymphovarux palpable. L with mild baseline Lymphedema. Neuro: A&O x 3, no focal or global deficits. Pertinent Results: wbc- 3.6, hct 32.1, plt 16.9, plt 19 diff- n- 82, l- 5.7, e-6 Na 135, Cl 96, K 5.6, CO2 24, BUN 47, Cr 3.9, Glucose 59, Ca 8.2, Pr 5.4, Albumin 2.3, T bili 4.2, d bili 2.4, AST 131, Alk Phs 57, ALT 61, CK 115, Mag 1.8 ESR 34 Ammonia 55 INR 2.97 PT 30.5 PTT 47.4 UA- 1.030, ph 5, neg for pro, glu, ketones, RBC [**5-18**], WBC 0-2, granular casts 0-1, hyaline cast [**1-13**] Brief Hospital Course: Patient was admitted with worsening liver disease, acute on chronic renal failure, with encephalopathy/ uremia in the setting of GNR bacteremia/sepsis and worsening swelling/ cellulitis of the RLE. He was admitted to the SICU on [**2186-1-25**]. Comparment syndrome was ruled-out, but he was noted to have increasing erythema, pain and tenderness over the right lower extremity up into the thigh. He became hypotensive requiring volume resuscitation and intermittent vasopressors. Broad-spectrum antibiotics were started. Plans were made to explore the right lower extremity for concern for a deep infection and underwent an extensive debridement of the RLE on [**2186-1-26**]. The patient tolerated the procedure well. He intermittently required Neo-Synephrine for hypotension in the OR. He was transferred back to the ICU. On [**2186-1-27**], he was taken to the OR again for re-exploration of the RLE and to assess the need for further debridement. A washout and further debridement, specially of the anterior incision of the lower leg was made. He was taken intubated on low-dose Neo- Synephrine to the SICU in guarded condition. He was kept intubated, on neo and on CVVHD for his renal failure 2ry to ATN. He was initially treated with Vanc, Cefe, Clinda, flagyl for his GNR on OSH. These actually grew Pasturella, and additionally, his tissue cx grew staph coagulase negative (thought to be likely contaminant). He was continued on Vanco, and started on high dose Cipro, Meropenem and Clinda, following ID recs. From a nutritional standpoint he was started on tube feeds on [**1-27**] via dobhoff catheter. The surgical wounds were managed initially with wet to dry dressing changes but ultimately with VAC dressings applied at the bedside and changed every 3 days. The T.Bili progressively increased from 5.7 preop to 24.6 on [**2-2**]. His transaminases then started to worsen dramatically to [**Telephone/Fax (1) 78539**] (ALT/AST) on [**2-5**] and up to 3640/[**Numeric Identifier 78540**] on [**2-6**]. His renal function also started to get worse on [**2-5**] with serum creatinine higher than 2.0 and up to 3.4 on [**2-6**]. He was evidently coagulopathic due to his liver failure and his INR was notably high during his stay in the ICU, but significantly raisen from 2.1 to 3.6 on [**2-4**] and 7.6 on [**2-5**]. His platelets were also notably low, between 20,000-40,000 and getting down to 12,000 on [**2-2**]. On [**2-3**] his clinical status changed, started again with hypotension requiring pressors, not following commands. Additionally, HIT antibody was found to be positive, thus heparin products were d/c'd and argatroban gtt was started on [**2-4**]. On [**2-5**] patient was complicated with melena - ?GI bleed. Argatroban gtt was held and pRBC/FFP/plt were transfused. NGT lavage was negative. CT head was negative. Patient had progressive deterioration with significant worsening LFTs, liver failure, coagulopathy and renal failure. A duplex U/S of the liver ruled out PVT or HVT. Due to his multiorgan failure and his progressive clinical deterioration despite maximal treatment, poor prognosis was discussed with the family on [**2-6**] and patient was made CMO. Patient expired on [**2186-2-6**] at 7:10 pm. Medications on Admission: Dilaudid 15mg PO PRN, Methadone 64 mg liquid qday, Advil PRN, Lasix 120", aldactone 100', Rifaximin 200mg Q48hours, Testosterone gel unsure dose Discharge Medications: none Discharge Disposition: Expired Discharge Diagnosis: Sepsis by Pasteurella Multocida Multiorgan failure Liver Failure, Encephalopathy, Renal Failure, Coagulopathy HCV cirrhosis RLE cellulits s/p I&D and debridement [**1-26**] and [**1-27**] Heparin Induced Thrombocytopenia Cardiopulmonary Arrest Discharge Condition: Expired Completed by:[**2186-2-24**] ICD9 Codes: 5856, 5849, 2762, 5715, 3051
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6022 }
Medical Text: Admission Date: [**2158-8-7**] Discharge Date: [**2158-8-30**] Date of Birth: [**2096-4-23**] Sex: M Service: [**Doctor First Name 147**] Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 3127**] Chief Complaint: Fevers and decreased O2 sats Major Surgical or Invasive Procedure: Bronchoscopy Tracheostomy [**5-22**] History of Present Illness: 62M w/ h/o OLT [**2158-5-22**] c/b wound infection for which a wound VAC was placed was tranferred from his rehabilitation facility for decreased oxygen saturation. he was seen in clinic that day and had his T-tube clamped. Noted to have lower extremity edema with lethargy. Oxygen saturation was 60-70% on RA with fever to 101.0. In ED was tachycardic to 130 with O2 sats of 91% on 4L nasal canula. Was alert and oriented, but reported upper respiratory congestion and cough. ABG showed hypoxia and hypercarbia: 7.34/67/65, CXR showed LLL consolidation. He recieved levaquin and vancomycin and was admitted to the SICU. Past Medical History: OLT [**2158-5-22**] c/b wound infection HCV DM II Esophageal varices BPH Bipolar d/o Heart Failure Social History: Quit ETOH 17yrs ago Quit tobacco 8yrs ago No illicit drug use Divorced, lives alone Family History: Noncontributory Physical Exam: Admission: T101.2 HR 117 BP128/61 RR22 SAT95/5L GEN:Obese gentleman, NAD HEENT: NCAT, PERRLA, EOMI Neck: supple, no LAD Lungs: diminished BS L base w/ rhonchi CV: tachy, reg rythm ABD: soft NT, distended, VAC in place EXT: LE w/ 2+ edema, warmth, no erythema, cyanosis Pertinent Results: Admission Labs: [**2158-8-7**] WBC-7.1 Hgb-9.6* Hct-29.5* Plt-191 [**2158-8-7**] Glucose-53* UreaN-23* Creat-1.2 Na-142 K-3.7 Cl-101 HCO3-31* AnGap-14 [**2158-8-7**] ALT-11 AST-18 AlkPhos-86 Amylase-50 TotBili-0.3 Albumin-2.9* Calcium-8.6 Phos-3.4 Mg-1.7 Discharge Labs: [**2158-8-29**] WBC-9.9 RBC-3.45* Hgb-9.4* Hct-29.4* MCV-85 MCH-27.4 MCHC-32.1 RDW-16.4* Plt Ct-199 [**2158-8-29**] Glucose-115* UreaN-51* Creat-1.2 Na-145 K-5.0 Cl-105 HCO3-35* AnGap-10 [**2158-8-28**] ALT-9 AST-11 LD(LDH)-203 AlkPhos-93 Amylase-28 TotBili-0.5 [**2158-8-29**] 08:07AM Type-ART pO2-80* pCO2-72* pH-7.33* calHCO3-40* Base XS-8 Cultures: [**8-7**] BCX- neg [**8-7**] UCX- neg [**8-9**] sputum- klebsiella (multi-resistant, [**Last Name (un) 36**] to meropenem) LEGIONELLA CULTURE (Final [**2158-8-19**]): NO LEGIONELLA ISOLATED. IMMUNOFLUORESCENT TEST FOR PNEUMOCYSTIS CARINII (Final [**2158-8-10**]): PNEUMOCYSTIS CARINII NOT SEEN. FUNGAL CULTURE (Final [**2158-8-22**]): NO FUNGUS ISOLATED. ACID FAST SMEAR (Final [**2158-8-11**]): NO ACID FAST BACILLI SEEN ON DIRECT SMEAR. This is only a PRELIMINARY result. If ruling out tuberculosis, you must wait for confirmation by concentrated smear. DUE TO QUANTITY NOT SUFFICIENT CONCENTRATED SMEAR RESULT NOT AVAILABLE. [**2158-8-24**] L SCV CVL- No significant growth. Brief Hospital Course: Mr [**Known lastname 1182**] was admitted to the SICU and placed on BIPAP/mask ventilation to manage his hypoxia/hypercarbia. Zosyn was started, and he was tranfused 1u pRBCs. A CTA of the chest, abdomen and pelvis was obtained that did not show a PE, but a LLL pneumonia and a R posterior perihepatic fluid collection were visualized. He defervesced on HD#4. By systems: Neuro: He was admitted on his outpatient regimen of resperidal for his bipolar disorder. Psychiatry was consulted and had no specific recommendations. They did not think the resperidal was diminishing his respiratory drive. Neurology consult did not think there was a central inhibition of his respiratory drive. Cardiovascular: Given the reported history of CHF, and findings on his CXR an echo was obtained on [**2158-8-15**]. This showed that LV and RV systolic function were normal(LVEF>55%). There were no major valvular abnormalities and moderate pulmonary artery systolic hypertension that had increased from the last study. He was diuresed with lasix, for diastolic dysfunction. PA catheter was placed [**2158-8-19**] with PA 64/32 and PCWP 24-26 and lasix drip was started. His PA numbers improved and his swan was subsequently removed. Pulmonary: Treatment was started for LLL pneumonia with zosyn. He was maintained on BIPAP, however he continued to be somnolent and tachypneic with elevated pCO2. He was electively intubated [**2158-8-11**] and bronchoscopy was performed. This showed mild LMSB deviation c/w LLL collapse and minimal secretions. BAL was performed and subsequently grew multi-resistant klebsiella. He remained a difficult wean with hypercarbia thought to be driven by lasix diuresis with metabolic alkalosis. Pulmonary consult was obtained: thought that pt had pickwickian syndrome with hypoventilation with diastolic dysfunction/CHF and needed more agressive diuresis. His pleural effusions continued to worsen so more lasix and diamox were admininstered. His effusions eventually improved and his oxygenation improved, but he continued to have a poor respiratory drive, requiring high pressure support. Tracheostomy was performed [**2158-8-25**]. Trach collar trials were unsuccessful due to hypercarbia w/ pCO2 in the 70s. GI: He was started on liquids initially. After intubation he was started on tube-feeds. A post-pyloric dobhoff was placed, and TF were advanced to goal of 120cc/h of [**2-9**] strength 1cc/kg formula (currently on impact w/ fibre). Liver Transplant: LFT's and coags were normal on admission. His [**Last Name (un) **] was held because of persistently high levels. He was switched to cyclosporin (neoral) with good levels. His current regimen includes: MMF 1gram [**Hospital1 **], prednisone 10mg qd, and neoral 200mg [**Hospital1 **]. His valcyte and fluconazole were discontinued. He continues on bactrim. He will need full labs, including cyclosporin level twice weekly. The t-tube remained clamped. GU: Given his respiratory failure and CHF, he was diuresed with lasix, with intermittent diamox to manage metabolic alkalosis. His creatinine peaked at 1.8, and subsequently came down to 1.2 and stabilized. HEME: Required blood transfusions initially for a borderline/low HCT of 28. He otherwise stabilized with no major issues. ID: He was started on zosyn emperically, however his BAL grew multiresistant klebsiella, sensitive only to meropenem. He completed a 14 day course on [**2158-8-28**], and remained afebrile with a normal WBC count. END: His insulin regimen was adjusted, and his glargine was incresed to 80u at HS. Wound: His abdominal wound was managed with a VAC dressing, changed every 3 days. The wound was clean and granulating well. Medications on Admission: Lopressor 75 [**Hospital1 **] Bactrim 1 qd fluconazole 200qd valcyte 450 qd cellcept 1gm [**Hospital1 **] hydralazine 75 qid protonix 40qd lantus 58qam riss cardura 2qpm rapamycin 7qd risperidal 4qd lasix 60 [**Hospital1 **] colace 100 [**Hospital1 **] prednisone 10 qd Discharge Medications: 1. Trimethoprim-Sulfamethoxazole 80-400 mg Tablet Sig: One (1) Tablet PO QD (once a day). 2. Mycophenolate Mofetil 200 mg/mL Suspension for Reconstitution Sig: 1000 (1000) mg PO BID (2 times a day). 3. Risperidone 1 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 4. Albuterol Sulfate 0.083 % Solution Sig: One (1) Inhalation Q6H (every 6 hours) as needed. 5. Albuterol 90 mcg/Actuation Aerosol Sig: 1-2 Puffs Inhalation Q4H (every 4 hours). 6. Doxazosin Mesylate 2 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 7. Docusate Sodium 150 mg/15 mL Liquid Sig: One Hundred (100) mg PO BID (2 times a day). 8. Lansoprazole 30 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO QD (once a day). 9. Metoprolol Tartrate 50 mg Tablet Sig: Three (3) Tablet PO BID (2 times a day). 10. Hydralazine HCl 50 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours). 11. Amlodipine Besylate 5 mg Tablet Sig: Two (2) Tablet PO QD (once a day). 12. Heparin Sodium (Porcine) 5,000 unit/mL Solution Sig: One (1) ml Injection [**Hospital1 **] (2 times a day): subcutaneous. 13. Cyclosporine Modified 100 mg/mL Solution Sig: Two Hundred (200) mg PO 6PM AND 6AM (): [**Hospital1 **]. dose may change depending on results of [**Hospital1 **]-weekly levels. MUST CALL TRANSPLANT CENTER AFTER LEVEL SENT. 14. Insulin Glargine 100 unit/mL Solution Sig: Eighty (80) units Subcutaneous at bedtime. 15. Insulin Regular Human 300 unit/3 mL Syringe Sig: sliding scale Subcutaneous four times a day. 16. Prednisone 5 mg Tablet Sig: 1.5 Tablets PO once a day. Discharge Disposition: Extended Care Facility: [**Hospital3 7**] & Rehab Center - [**Hospital1 8**] Discharge Diagnosis: End-stage liver disease Orthotopic liver transplant [**5-22**] Respiratory failure Left lower lobe Pneumonia Hepatitis C Esophageal varices history of encephalopathy diabetes mellitus heart failure benign prostatic hypertrophy Bipolar disorder Discharge Condition: Good Discharge Instructions: [**Hospital1 **]-weekly labs (Monday/Thursday): CBC, chem10, AST, ALT, alk phos, albuimin, T. bili, cyclosporin level 2hours after am dose on the given day. [**Last Name (un) **] lab results to: [**Telephone/Fax (1) 697**] Trach care/vent wean Tubefeeding via dobhoff VAC dressing to abdominal wound, change every 3 days. Followup Instructions: Transplant Center [**Last Name (NamePattern1) 439**], [**Location (un) 436**] [**Telephone/Fax (1) 673**]/ Dr [**Last Name (STitle) **]. Follow-up in [**6-17**] days Completed by:[**0-0-0**] ICD9 Codes: 4280, 2875, 5180, 496
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6023 }
Medical Text: Admission Date: [**2156-6-21**] Discharge Date: [**2156-6-24**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**Known firstname 398**] Chief Complaint: UTI/sepsis Major Surgical or Invasive Procedure: none History of Present Illness: 82M with metastatic esophageal CA managed by watchful waiting, diabetes p/w confusion at [**Hospital 27838**] rehab. He was noted by the staff at the rehab to develop difficulty breathing, decreased oxygen sats requiring supplemental oxygen, and bp to the 80s systolic. Of note, at the rehab he had just completeted a course of levofloxacin for a RLL PNA for which he was treated at [**Hospital **]. He was sent to the ED at [**Hospital1 18**] for further evaluation where he was found to have initial vitals T 99.4 bp 146/72 satting 95 on 3L. He afebrile though found to have a lactate of 5.3 with a wbc of 18.4 from 16.9 a couple of days prior. While his bp and pulse were stable, sepsis protocol was initiated given the elevated lactate and central line was placed in the ED. He was given 3L NS in smaller boluses. CXR showed no infiltrates. UA was positive. Vanc/zosyn were started empirically in the ED. He was admitted to ICU. Past Medical History: 1. Esophageal CA 2. HTN 3. gastric ulcers 4. diabetes, has been diet controlled. Status post left knee replacement x3. Status post right knee replacement x2. Social History: The patient is married and lives with his wife in [**Name (NI) 1474**]. He drives and keeps track of the bills. He is a retired deli store owner, and reports a remote tobacco history, rare alcohol use, and no intravenous drug use. Family History: brother with prostate CA. Physical Exam: VS: Temp: 98.2 BP: 127/56 HR: 71 RR: 25 O2sat: 93% 3L GEN: awake, oriented to self, occasional bursts of agitation HEENT: PERRL, eomi, MM dry NECK: no supraclavicular or cervical lymphadenopathy, no jvd RESP: bibasilar crackles CV: RR, S1 and S2 wnl, IV/VI early systolic murmur ABD: soft, moderately distended, no caput medusae EXT: 1+ edema b/l SKIN: no rashes/no jaundice NEURO: MAEW, CN grossly intact, Pertinent Results: [**2156-6-21**] 09:26PM LACTATE-2.1* [**2156-6-21**] 09:26PM O2 SAT-66 [**2156-6-21**] 09:13PM CORTISOL-27.8* [**2156-6-21**] 08:09PM TYPE-ART O2 FLOW-5 PO2-67* PCO2-42 PH-7.34* TOTAL CO2-24 BASE XS--2 INTUBATED-NOT INTUBA COMMENTS-NASAL [**Last Name (un) 154**] [**2156-6-21**] 07:20PM GLUCOSE-58* UREA N-54* CREAT-1.5* SODIUM-138 POTASSIUM-5.1 CHLORIDE-108 TOTAL CO2-22 ANION GAP-13 [**2156-6-21**] 07:20PM WBC-17.0* RBC-3.09* HGB-9.5* HCT-27.6* MCV-90 MCH-30.6 MCHC-34.2 RDW-13.8 [**2156-6-21**] 07:20PM NEUTS-80* BANDS-11* LYMPHS-7* MONOS-2 EOS-0 BASOS-0 ATYPS-0 METAS-0 MYELOS-0 [**2156-6-21**] 04:20PM URINE BLOOD-NEG NITRITE-NEG PROTEIN-TR GLUCOSE-NEG KETONE-NEG BILIRUBIN-SM UROBILNGN-1 PH-5.0 LEUK-MOD [**2156-6-21**] 04:20PM URINE RBC-0-2 WBC-21-50* BACTERIA-MANY YEAST-NONE EPI-0-2 [**2156-6-21**] 03:42PM LACTATE-5.3* K+-5.3 [**2156-6-21**] 03:40PM ALT(SGPT)-35 AST(SGOT)-54* LD(LDH)-350* CK(CPK)-60 ALK PHOS-303* AMYLASE-22 TOT BILI-0.7 [**2156-6-21**] 03:40PM CK-MB-NotDone cTropnT-0.05* proBNP-2755* [**2156-6-21**] 03:40PM CALCIUM-9.2 PHOSPHATE-4.5 MAGNESIUM-2.3 [**2156-6-21**] 03:40PM HAPTOGLOB-301* [**2156-6-21**] 03:40PM ASA-NEG ETHANOL-NEG ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**2156-6-21**] 02:37PM GLUCOSE-83 UREA N-57* CREAT-1.6* SODIUM-137 POTASSIUM-5.7* CHLORIDE-105 TOTAL CO2-24 ANION GAP-14 [**2156-6-21**] 02:37PM PLT COUNT-316 [**2156-6-24**] 03:25AM BLOOD WBC-19.9* RBC-3.24* Hgb-9.8* Hct-28.9* MCV-89 MCH-30.3 MCHC-34.0 RDW-14.2 Plt Ct-307 [**2156-6-21**] 07:20PM BLOOD Neuts-80* Bands-11* Lymphs-7* Monos-2 Eos-0 Baso-0 Atyps-0 Metas-0 Myelos-0 [**2156-6-24**] 03:25AM BLOOD Plt Ct-307 [**2156-6-21**] 03:40PM BLOOD PT-15.3* PTT-34.3 INR(PT)-1.4* [**2156-6-23**] 04:31AM BLOOD Glucose-90 UreaN-42* Creat-1.1 Na-142 K-4.5 Cl-111* HCO3-25 AnGap-11 [**2156-6-22**] 03:20PM BLOOD Glucose-80 UreaN-44* Creat-1.2 Na-141 K-4.4 Cl-109* HCO3-24 AnGap-12 [**2156-6-21**] 03:40PM BLOOD ALT-35 AST-54* LD(LDH)-350* CK(CPK)-60 AlkPhos-303* Amylase-22 TotBili-0.7 [**2156-6-22**] 04:02AM BLOOD Albumin-2.0* Calcium-7.8* Phos-4.0 Mg-2.0 [**2156-6-21**] 09:13PM BLOOD Cortsol-27.8* [**2156-6-21**] 03:40PM BLOOD ASA-NEG Ethanol-NEG Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG . . Abd US IMPRESSION: 1. Multiple nodules throughout the liver consistent with widespread metastases. 2. Small amount of perihepatic ascites. . KUB: IMPRESSION: No evidence of bowel obstruction or free intra-abdominal air is identified. . CXR: IMPRESSION: Suboptimal study due to markedly reduced lung volumes with no acute consolidation. Right hemidiaphragm elevation. Probable cardiomegaly. This will be better evaluated with PA and lateral views of the chest when the patient could tolerate this. . URINE CULTURE (Final [**2156-6-23**]): ESCHERICHIA COLI. >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------------ <=2 S AMPICILLIN/SULBACTAM-- <=2 S CEFAZOLIN------------- <=4 S CEFEPIME-------------- <=1 S CEFTAZIDIME----------- <=1 S CEFTRIAXONE----------- <=1 S CEFUROXIME------------ 4 S CIPROFLOXACIN--------- =>4 R GENTAMICIN------------ <=1 S IMIPENEM-------------- <=1 S MEROPENEM-------------<=0.25 S NITROFURANTOIN-------- <=16 S PIPERACILLIN---------- <=4 S PIPERACILLIN/TAZO----- <=4 S TOBRAMYCIN------------ <=1 S TRIMETHOPRIM/SULFA---- <=1 S Brief Hospital Course: A/P: 82M with metastatic esophageal CA, diabetes p/w sepsis. . 1. Sepsis/UTI: Pt had lactate to 5.3 on admission, with elevated WBC. The ource was found to be UTI. He was treated initially with vanc and zosyn. he was admitted under sepsis protocol with SvO2 central venous line placed and received multiple fluid boluses in the ED. His pulse and BP remained stable in the ED, although the lactate was indicative of early sepsis. This resolved with treatment. Urine Cx showed E Coli sensitive to bactrim. At rehab, pyridium can be considered for pain if needed, patient's daughter specifically requested this. . 2. Hypoxia: He was noted to have a new oxygen requirement. This was thought to be [**2-6**] hypoventilation and abdominal distension. BNP was 2755 in the ED, although there was no other evidence of CHF. . 3. Metastatic esophageal CA: Liver US showed worsening metastatic disease with minimal ascites, patent portal vein with hepatopetal flow. DNR/DNI discussion was held with the patient and his son and daughter. The patient expressed a clear desire to be DNR/DNI and also a general preference to avoid further tests or procedures. His goals are palliative. . 4. ARF: Cr was elevated 1.5 and had been 1.5 range at rehab for the past week. His baseline was 1.0 on [**2156-4-1**]. This resolved to 1.1 with IV fluids. His ACE inhibitor was held. . # hyperkalemia: potassium was elevated to 5.7 on [**6-20**] at rehab, and was 5.7 again in ED. Pt is now s/p insulin and kayexalate, with k to 4.9. The potassium remained stable during the rest of the admission. . # confusion: This resolved by hospital day #2. It was likely mutlifactorial, [**2-6**] acute illness, infection, oxycodone at rehab. This resolved by the second hospital day. . # dm2: Oral agents were held and he was covered with RISS. . # htn: Lisinopril was held given the ARF. . FEN: cardiac, diabetic diet . Access: RSC central line PPx: Hep SQ, ppi DISPO: ICU care Contact: [**Name (NI) **] [**Name (NI) **] [**Name (NI) 44908**] [**Telephone/Fax (1) 101480**] Medications on Admission: glyburide 1.25 mg p.o. daily metformin 500 mg p.o. daily lisinopril 40 mg p.o. daily, Detrol LA 4 mg p.o. daily, finasteride 5 mg p.o. daily Prevacid 30 mg p.o.daily. megace 400' percocets Discharge Medications: 1. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection TID (3 times a day). 2. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 3. Trazodone 50 mg Tablet Sig: 0.5 Tablet PO HS (at bedtime) as needed. 4. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed. 5. Trimethoprim-Sulfamethoxazole 160-800 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) for 10 days: please continue for 14 day course for UTI, day 1=[**6-21**]. 6. Percocet 5-325 mg Tablet Sig: 1-2 Tablets PO every 4-6 hours. 7. insulin standard regular insulin slliding scale 8. Outpatient Lab Work CBC and chem-7 within 1-2 days of arrival at rehab Discharge Disposition: Extended Care Facility: Baypointe - [**Hospital1 1474**] Discharge Diagnosis: UTI ARF metastatic esophageal CA Discharge Condition: fair, requiring 2L nasal cannula. Discharge Instructions: You were admitted for a urinary infection. You were also found to have worsening metastatic cancer and we had important discussions regarding the goals of your care. . 2. please have lab work drawn at rehab for CBC and electrolytes within 1-2 days. Followup Instructions: Please call your primary oncologist, Dr. [**Last Name (STitle) **] to update him this week. We have been in contact with him as well. Provider [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 593**], MD Phone:[**0-0-**] Date/Time:[**2156-7-1**] 2:00 . Provider [**Name9 (PRE) **] [**Name9 (PRE) 10341**], MD Phone:[**Telephone/Fax (1) 22**] Date/Time:[**2156-7-1**] 2:00 ICD9 Codes: 0389, 5990, 5849, 2767, 496, 5859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6024 }
Medical Text: Admission Date: [**2187-12-17**] Discharge Date: [**2187-12-24**] Date of Birth: [**2112-12-2**] Sex: F Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1505**] Chief Complaint: Dyspnea on exertion Major Surgical or Invasive Procedure: [**2187-12-18**] 1. Mitral valve repair with a 3-D [**Company 1543**] annuloplasty ring, 28 mm and a cleft repair of A2. 2. Tricuspid valve repair with 30 mm MC3 annuloplasty ring. History of Present Illness: 75 year old female c/o dyspnea on exertion since summer [**2186**]. Developed congestive heart failure which required diuresis and multiple thoracentesis for recurrent pleural effusions. Most recent right thoracentesis at [**Hospital3 418**] [**2187-12-14**] for 1 liter. Work-up revealed severe mitral regurgitation and she is admitted for heparinization for MV surgery [**2187-12-18**]. Past Medical History: Mitral Regurgitation Congestive heart failure, recurrent effusions s/p thoracentesis x 4 (most recent was last week, also had PTX after thoracentesis) Moderate pulmonary hypertension Atrial Fibrillation (on Coumadin) Diabetes Mellitus Hypertension Hyperlipidemia Hypothyroidism ?COPD Colon Cancer s/p resection Social History: Race: Caucasian Last Dental Exam: [**2187-11-27**], cleared Lives: alone Occupation: Secretary Tobacco: Quit 50 yrs ago ETOH: Occ. Family History: non-contributory Physical Exam: Physical Exam Pulse: 107- irreg Resp: 20 O2 sat: 88% on RA B/P Right: 107/59 Left: 105/63 Height: 170cm Weight: 72kg General: well-developed female in no acute distress Skin: Dry [X] - dime sized area of blanching erythema on right buttock. HEENT: PERRLA [X] EOMI [X] Neck: Supple [X] Full ROM [X] Chest: Bilateral rales at the bases with right>left Heart: RRR [] Irregular [X] Murmur [**1-19**] holosystolic heard loudest at the apex Abdomen: Soft [X] non-distended [X] non-tender [X] bowel sounds + [X] Extremities: Warm [X], well-perfused [X] Edema: +2 Varicosities: None [X] Neuro: Grossly intact [X] Pulses: Femoral Right: 2+ Left: 2+ DP Right: 1+ Left: 1+ PT [**Name (NI) 167**]: 2+ Left: 1+ Radial Right: 2+ Left: 2+ Carotid Bruit Right/Left: none Pertinent Results: [**2187-12-24**] 05:30AM BLOOD WBC-6.1 RBC-3.13* Hgb-8.8* Hct-28.1* MCV-90 MCH-28.1 MCHC-31.2 RDW-15.6* Plt Ct-301# [**2187-12-21**] 06:05AM BLOOD WBC-9.6 RBC-3.04* Hgb-8.7* Hct-27.2* MCV-89 MCH-28.7 MCHC-32.1 RDW-15.7* Plt Ct-168 [**2187-12-20**] 03:57AM BLOOD WBC-11.1* RBC-3.27* Hgb-9.3* Hct-28.5* MCV-87 MCH-28.5 MCHC-32.8 RDW-15.6* Plt Ct-157 [**2187-12-24**] 05:30AM BLOOD PT-14.1* INR(PT)-1.2* [**2187-12-23**] 06:10AM BLOOD PT-13.4 INR(PT)-1.1 [**2187-12-22**] 07:50AM BLOOD PT-12.8 INR(PT)-1.1 [**2187-12-24**] 05:30AM BLOOD Glucose-103* UreaN-12 Creat-0.6 Na-140 K-4.5 Cl-104 HCO3-33* AnGap-8 [**2187-12-23**] 06:10AM BLOOD Glucose-99 UreaN-12 Creat-0.5 Na-141 K-4.6 Cl-104 HCO3-32 AnGap-10 PREBYPASS The left atrium is elongated. The right atrium is moderately dilated. No atrial septal defect is seen by 2D or color Doppler. The left ventricular cavity size is normal. Regional left ventricular wall motion is normal. Overall left ventricular systolic function is normal (LVEF>55%). [Intrinsic left ventricular systolic function is likely more depressed given the severity of valvular regurgitation.] The right ventricular cavity is moderately dilated with mild global free wall hypokinesis. The aortic valve leaflets (3) are mildly thickened. Trace aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. The mitral valve leaflets do not fully coapt. An eccentric, posteriorly directed jet of Severe (4+) mitral regurgitation is seen. Moderate to severe [3+] tricuspid regurgitation is seen. POSTBYPASS LV systolic function is preserved. The is a ring prosthesis in the mitral position . MR is now mild. RV systolic function remains mildly depressed. There is a ring prosthesis in the tricuspid position. TR is mild. The remaining study is unchanged from the prebypass period. Brief Hospital Course: The patient was admitted one day prior to surgery for pre-admission testing and heparin bridge. She was brought to the operating room on [**2187-12-18**] where she underwent mitral valve repair and tricuspid valve repair with Dr. [**Last Name (STitle) **]. Overall the patient tolerated the procedure well and post-operatively was transferred to the CVICU in stable condition on neo and propofol for recovery and invasive monitoring. POD 1 found the patient extubated, alert and oriented and breathing comfortably. She was neurologically intact and hemodynamically stable on no inotropic or vasopressor support. Chest tubes and pacing wires were discontinued without complication. Coumadin was resumed for atrial fibrillation. She was diuresed toward her preoperative weight and beta-blockade was initiated. She does have a history of chronic pleural effusions, and this was closely followed by CXR following removal of chest tubes. Diuresis was adjusted accordingly for pleural effusions and significant lower extremity edema. She will follow up in one week with a chest x-ray. The patient progressed without complication, and was cleared by Dr. [**Last Name (STitle) **] for discharge to **** on POD ******. Medications on Admission: Cardizem CD 120mg QD Lasix 40mg 5x/day Synthroid 75mcg QD Metformin 500mg qd Metoprolol XL 100mg QD KCl 10mEq QD Simvastatin 20mg qd Diovan 80mg QD Coumadin 2.5mg QD- last dose [**2187-12-12**] levaquin 750mg daily- started at [**Hospital3 **] [**2187-12-14**]- unknown infectious process Discharge Medications: 1. Warfarin 2.5 mg Tablet Sig: One (1) Tablet PO once a day: dose will change daily for goal INR 2-2.5, Dr. [**Last Name (STitle) **] to manage. Disp:*30 Tablet(s)* Refills:*2* 2. Levothyroxine 75 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 3. Simvastatin 10 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 4. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 5. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* 6. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4 hours) as needed for fever, pain. 7. Metoprolol Succinate 100 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO DAILY (Daily). Disp:*30 Tablet Sustained Release 24 hr(s)* Refills:*0* 8. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for pain. Disp:*40 Tablet(s)* Refills:*0* 9. Metformin 500 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*0* 10. Furosemide 40 mg Tablet Sig: One (1) Tablet PO four times a day. Disp:*120 Tablet(s)* Refills:*2* 11. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig: One (1) Tab Sust.Rel. Particle/Crystal PO once a day. Disp:*30 Tab Sust.Rel. Particle/Crystal(s)* Refills:*2* Discharge Disposition: Extended Care Facility: Life Care Center of [**Location 15289**] Discharge Diagnosis: Mitral Regurgitation Congestive heart failure, recurrent effusions s/p thoracentesis x 4 Moderate pulmonary hypertension Atrial Fibrillation (on Coumadin) Diabetes Mellitus Hypertension Hyperlipidemia Hypothyroidism ?COPD Colon Cancer s/p resection Discharge Condition: Alert and oriented x3 nonfocal Ambulating, gait steady Sternal pain managed with percocet prn Discharge Instructions: Please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions Please NO lotions, cream, powder, or ointments to incisions Each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart No driving for approximately one month until follow up with surgeon No lifting more than 10 pounds for 10 weeks Please call with any questions or concerns [**Telephone/Fax (1) 170**] Females: Please wear bra to reduce pulling on incision, avoid rubbing on lower edge Followup Instructions: Please call to schedule appointments Surgeon Dr. [**Last Name (STitle) **] Thursday, [**2188-1-17**] 1:15pm [**Telephone/Fax (1) 170**] Primary Care Dr. [**First Name8 (NamePattern2) 1059**] [**Last Name (NamePattern1) **] [**Telephone/Fax (1) 19470**] in [**11-17**] weeks Cardiologist Dr. [**Last Name (STitle) **] [**Last Name (NamePattern4) **] [**Last Name (NamePattern1) **] [**Telephone/Fax (1) 8725**] in [**11-17**] weeks CXR [**2187-12-31**] to follow up on pleural effusions, with film emailed to [**University/College 86751**], for Dr. [**Last Name (STitle) **] Completed by:[**2187-12-24**] ICD9 Codes: 4240, 4280, 4168, 4019, 2724, 2449
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6025 }
Medical Text: Admission Date: [**2175-6-10**] Discharge Date: [**2175-6-20**] Service: MEDICINE Allergies: Sulfa (Sulfonamides) / Ceftriaxone Attending:[**First Name3 (LF) 3507**] Chief Complaint: SOB Major Surgical or Invasive Procedure: None History of Present Illness: [**Age over 90 **] yo female with hx of HTN, afib, ? PE, multiinfarct dementia and recurrent UTI who presents with lethargy, hypoxia, and LE erythema. Pt is aphasic at baseline. Per notes from ED and PCP coverage, the patient was being treated for recurrent UTI with a course of levofloxacin started on [**6-7**] but was otherwise doing well. Last night she was noted to be more lethargic than normal with increasing SOB. She was noted to be hypoxic with O2 Sats of 80% so was transferred to the ED. In the ED she had a fever to 101.8 with intermittent hypoxia that improved to 98% with 4LNS oxygen . She was given Clindamycin 600mg IV x1 for LE cellulitis and a dose of Levofloxacin 500mg IV for possible UTI. For her hypoxia, she was given 20mg IV Lasix and a combivent neb with significant improvement with CTA neg for PE and LENI neg for DVT. She continued to have intermittent hypoxia of unclear etiology so was transferred to the [**Hospital Unit Name 153**] for closer monitoring. . In the MICU, the patient was treated with CTX and Vanc for UTI/cellulitis. Also diuresed. Patient improved and sent to floor [**6-11**] on 2L NC. Patient noted to have increased Eos in blood and urine so CTX stopped and placed on levo/macrodantin. . [**6-13**] Patient decompenstated on the floor. Patient desatted to 80's on 6L NC. ABG 7.46/52/63 on 6L NC. Patient initially with HR in 80's. Patient given lasix 20mg IV x 1 and an alb neb. Then went into afib with RVR into the 140's maintaining her pressure. Patient given 5mg IV lopressor x 3 with out response in HR. Transferred back unit for further mgt of HR and hypoxia, where she was started on a diltiazem drip; CTA was without evidence of PE. Course complicated by persistent hypotension requiring multiple fluid boluses; this resolved after the discontinuation of the diltiazem drip. She was started on an amiodarone load with conversion into NSR. Her O2 sat improved with diuresis. A picc line was placed and she was started on aztreonam (instead of macrobid) for UTI. She was transferred back to the general medical floor on [**2175-6-16**]. Currently, she has a new rash over her trunk and arms bilaterally--thought to be from Ceftriaxone. Past Medical History: CVA-with multiinfarct dementia-aphasic at baseline Afib UTI Zoster-L thorax Syncope PE Hypothyroidism DJD Social History: Divorced, lived alone in [**Location (un) 7349**] until fall at home with hip fx then moved to NH here in [**Location (un) 86**] because son lives in [**Name (NI) 392**], had CVA at [**Name (NI) **], never smoker, no ETOH, no illicits. Family History: NC Physical Exam: T 98 HR 93 BP 100/37 RR 24 O2Sat 99 (3LNC) Gen: chronically ill, in bed listing to left side, NAD HEENT: R nasolabial flattening, Edentulous, Dry MM, Neck: JVP to mandible Heart: regular with occasional premature beats, no MRG, no heave, not parvus et tardus Lungs: Marked kyphosis, Bilateral crackles throughout, decreased breath sounds at R base- not dull to percussion. Abd: soft, NT, ND, BS+ Extrem: 2+ LLE with erthema to midshin, 1+ RLE, 1+ DP pulses bilaterally. Neuro: expressive aphasia- unintelligable speech, follows verbal commands "close your eyes" "wiggle your toes" Pupils 2-->1cm bilaterally, arcus senilis, moving all 4 extremities. Skin: Large 3x4cm SK's over thorax, crusted raised lesions in T4 distribution on Left back and chest. Pertinent Results: [**2175-6-10**] CT CHEST: 1. No evidence of acute pulmonary embolism, aortic aneurysm, or dissection. 2. No evidence of pneumonia. 3. Midthoracic vertebral body compression fracture likely chronic. 4. Calcified left lung granuloma and mediastinal lymph node consistent with old granulomatous disease, such as tuberculosis. 5. Moderate-sized hiatal hernia. . [**2175-6-10**] BILAT LOWER EXT VEINS: No evidence of DVT. . [**2175-6-10**] CT HEAD: Slightly limited study by patient motion, but no intracranial hemorrhage is identified. . [**2175-6-10**] CXR: No evidence of pneumonia or CHF. . [**2175-6-10**] ECG: Technically difficult study Sinus tachycardia Left ventricular hypertrophy Early R wave progression Lateral ST-T changes are probably due to ventricular hypertrophy Clinical correlation is suggested No previous tracing available for comparison . [**2175-6-13**] CTA CHEST: 1. No pulmonary embolism. 2. Right lower lobe atelectasis/consolidation with tiny bilateral pleural effusions. 3. Moderate hiatal hernia. 4. Unchanged calcified mediastinal lymph node. . [**2175-6-13**] CXR: Small bilateral pleural effusions without overt CHF/pulmonary edema and no evidence for new pneumonia. Calcified granuloma and node on left. Osteoporosis of spine with compression fractures. . [**2175-6-13**] ECG: Sinus rhythm @ 78 with atrial premature beats. Left ventricular hypertrophy. Since the previous tracing of [**2175-6-10**] probably no significant change, although baseline artifact on both tracings makes comparison difficult. TRACING #1 . [**2175-6-13**] ECG: Atrial fibrillation with a rapid ventricular response. Left ventricular hypertrophy. Non-specific ST-T wave changes. Since the previous tracing of [**2175-6-13**] atrial fibrillation and ST-T wave changes are present. TRACING #2 . [**2175-6-14**] FLUORO: Successful repositioning of the right-sided PICC which now terminates in the distal SVC. Line is ready for use. . [**2175-6-14**] ECHO: The left atrium is mildly dilated. The estimated right atrial pressure is 16-20 mmHg. There is mild symmetric left ventricular hypertrophy. The left ventricular cavity size is normal. Left ventricular systolic function is hyperdynamic (EF 70-80%). Right ventricular chamber size and free wall motion are normal. 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. There is no mitral valve prolapse. Trivial mitral regurgitation is seen. There is mild pulmonary artery systolic hypertension. There is no pericardial effusion. Impression: hypertrophic, hyperdynamic left ventricle . [**2175-6-16**] CXR: Lung volumes have improved, borderline interstitial edema decreased, heart size normal, but left atrium likely enlarged. Stable pulmonary vascular congestion. Small right pleural effusion may also have decreased. Leftward tracheal deviation just above the thoracic inlet is due to tortuous head and neck vessels. . [**2175-6-11**] 8:35 am URINE Source: Catheter. URINE CULTURE (Final [**2175-6-12**]): NO GROWTH. . [**2175-6-10**] 03:15AM URINE Color-Yellow Appear-Clear Sp [**Last Name (un) **]-1.014 [**2175-6-10**] 03:15AM URINE Blood-MOD Nitrite-NEG Protein-NEG Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-NEG pH-5.0 Leuks-MOD [**2175-6-10**] 03:15AM URINE RBC-[**7-23**]* WBC->50 Bacteri-RARE Yeast-NONE Epi-[**4-17**] [**2175-6-12**] 06:31PM URINE Eos-POSITIVE [**2175-6-11**] 08:35AM URINE Color-Yellow Appear-Clear Sp [**Last Name (un) **]-1.020 [**2175-6-11**] 08:35AM URINE Blood-LGE Nitrite-NEG Protein-100 Glucose-NEG Ketone-15 Bilirub-NEG Urobiln-NEG pH-6.0 Leuks-NEG [**2175-6-11**] 08:35AM URINE RBC-88* WBC-2 Bacteri-FEW Yeast-NONE Epi-0 [**2175-6-10**] 03:15AM BLOOD WBC-17.6* RBC-3.73* Hgb-11.3* Hct-34.2* MCV-92 MCH-30.4 MCHC-33.1 RDW-13.8 Plt Ct-229 [**2175-6-10**] 03:15AM BLOOD Neuts-84* Bands-9* Lymphs-2* Monos-2 Eos-3 Baso-0 Atyps-0 Metas-0 Myelos-0 [**2175-6-10**] 03:15AM BLOOD Hypochr-1+ Anisocy-1+ Poiklo-1+ Macrocy-1+ Microcy-NORMAL Polychr-1+ Ovalocy-1+ Stipple-OCCASIONAL [**2175-6-10**] 03:15AM BLOOD Plt Ct-229 [**2175-6-10**] 03:15AM BLOOD Glucose-144* UreaN-19 Creat-0.8 Na-138 K-4.5 Cl-99 HCO3-30 AnGap-14 [**2175-6-10**] 03:15AM BLOOD ALT-11 AST-21 AlkPhos-101 Amylase-23 TotBili-0.4 [**2175-6-10**] 03:15AM BLOOD Lipase-17 [**2175-6-10**] 03:15AM BLOOD CK-MB-2 cTropnT-0.03* [**2175-6-10**] 10:30AM BLOOD CK-MB-NotDone proBNP-1148* [**2175-6-10**] 10:30AM BLOOD cTropnT-0.03* [**2175-6-10**] 04:41PM BLOOD CK-MB-2 cTropnT-0.03* proBNP-1259* [**2175-6-10**] 03:15AM BLOOD Albumin-3.6 Phos-3.4 Mg-2.1 [**2175-6-10**] 11:55AM BLOOD Type-ART pO2-101 pCO2-49* pH-7.43 calTCO2-34* Base XS-6 Intubat-NOT INTUBA [**2175-6-10**] 03:34AM BLOOD Lactate-1.9 . [**2175-6-11**] 10:15AM BLOOD WBC-10.2 RBC-3.35* Hgb-10.5* Hct-31.9* MCV-95 MCH-31.2 MCHC-32.8 RDW-13.1 Plt Ct-211 [**2175-6-11**] 10:15AM BLOOD Neuts-73.5* Lymphs-12.2* Monos-1.0* Eos-12.2* Baso-0 Atyps-1.0* [**2175-6-11**] 10:15AM BLOOD Hypochr-NORMAL Anisocy-NORMAL Poiklo-NORMAL Macrocy-NORMAL Microcy-NORMAL Polychr-NORMAL [**2175-6-11**] 10:15AM BLOOD PT-14.3* PTT-32.3 INR(PT)-1.3* [**2175-6-11**] 10:15AM BLOOD Plt Smr-NORMAL Plt Ct-211 [**2175-6-11**] 05:54AM BLOOD Glucose-95 UreaN-15 Creat-0.6 Na-140 K-3.6 Cl-101 HCO3-31 AnGap-12 [**2175-6-11**] 05:54AM BLOOD Calcium-8.6 Phos-2.6* Mg-2.2 . CT Head FINDINGS: There is no intracranial hemorrhage, mass effect, hydrocephalus, or shift of normally midline structures. Ventricular prominence is unchanged, consistent with moderate cortical atrophy. Focal hypodensities in the left parietal lobe, coronal radiata, and frontal lobe are unchanged, representing chronic infarction. More diffuse hypodensities in the periventricular white matter are unchanged, and most consistent with chronic small vessel ischemic disease. Surrounding osseous and soft tissue structures are unremarkable. . IMPRESSION: No significant change since [**2175-6-10**]. Unchanged appearance of several left-sided chronic infarcts, and small vessel ischemic disease. No intracranial hemorrhage. . [**2175-6-20**] 06:10AM 98 13 1.3* 141 4.0 100 36* 9 . CXR [**6-19**]: IMPRESSION: Slight interval improvement in pulmonary vascular congestion, otherwise no significant interval change. Brief Hospital Course: A/P: [**Age over 90 **] yo female with hx of HTN, afib, PE, multinfarct dementia admitted with UTI, left leg cellulitis, and diastolic CHF; course c/b AF with RVR. . #Diastolic CHF: initially due to infection, worsened by AF with RVR and fluid resuscitation, was continued on Lasix with good diuresis. Needs serial assesments of volume status/weights at her nursing home with her lasix titrated accordingly. Low dose ACE was added. No evidence of ACS. Lasix held on day of d/c secondary to bump in Cr (.8-->1.3). Needs serial Chem 7 at her nursing home. Currently has minimal oxygen requirements. . #AF: Now in NSR on amiodarone and Lopressor 12.5 TID. Needs one more week of Amio 200 [**Hospital1 **] then 200 mg daily. Poor anticoagulation candidate given fall risk and advanced age. . #UTI: Pt has received 7 days of treatment (CTX, macrodantin, aztreonam) for E. coli UTI; d/c'd aztreonam/ctx given rash. . #LLE Cellulitis: resolved with 10 days of vancomycin. . #Rash: suspect secondary to ceftriaxone or aztreonam. Resolving. . #Dementia: pt noted to be more somnolent on [**6-19**]; CT head/ABG/toxic-metabolic w/u unrevealing. ?secondary to benadryl (from rash) along with neurontin. Would avoid sedating meds until MS completely back to baseline. No evidence of recurrent infection. Medications on Admission: Ciprofloxacin 250mg [**Hospital1 **] Amoxicillin 500mg PO tid ? d/c'ed Lopressor 25mg tid Lasix 40mg alt 20mg qd held Neurontin 100mg [**Hospital1 **] Levofloxacin 250mg qd-started on Tylenol prn Erythromycin eye ointment Levalbuterol Nebs q6h prn Nortryptilline 25mg qhs MVI Digoxin 0.125mg qd KCl 10 meq qd Celexa 10mg qd Colace Levothyroxine 50mcg qd Macrodantin 50mg qid-completed Discharge Medications: 1. Citalopram 20 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 2. Aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 3. Levothyroxine 50 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Gabapentin 100 mg Tablet Sig: One (1) Tablet PO twice a day: Pleaes hold for somnolence. 5. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 6. Lisinopril 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO every eight (8) hours: hold for SBP <110 or HR <55 . 8. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed. 9. Lasix 40 mg Tablet Sig: One (1) Tablet PO once a day: Please alternate with 20 mg daily to start [**6-21**]. 10. Camphor-Menthol 0.5-0.5 % Lotion Sig: One (1) Appl Topical QID (4 times a day) as needed. 11. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO twice a day for 1 weeks. 12. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO once a day: to begin after one week of [**Hospital1 **]. Discharge Disposition: Extended Care Facility: [**Doctor First Name 391**] Bay Skilled Nursing Facility Discharge Diagnosis: Left Lower Extremity Cellulitis Urinary Tract Infection Diastolic Dysfunction/Congestive Heart Failure Atrial Fibrillation Drug Rash Secondary Diagnoses: CVA-with multiinfarct dementia-aphasic at baseline h/o Zoster-L thorax Hypothyroidism DJD Discharge Condition: Stable Discharge Instructions: Please come back to the emergency room should you develop any fevers, chills, chest pain, shortness of breath, difficulty thinking, or any other complaints. Followup Instructions: Please follow up with Dr. [**Last Name (STitle) **] within the next two weeks. ICD9 Codes: 5119, 5990, 4280, 4589, 4019, 2449
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Medical Text: Admission Date: [**2117-6-18**] Discharge Date: [**2117-6-24**] Date of Birth: [**2051-3-8**] Sex: F Service: MEDICINE Allergies: Cephalosporins / Ace Inhibitors / Penicillins / Benzodiazepines Attending:[**First Name3 (LF) 943**] Chief Complaint: Somnolence Major Surgical or Invasive Procedure: Esophagogastroduodenoscopy x 2 Transthoracic Echocardiography PICC Line Placement Arterial line placement Tracheal Intubation with eventual extubation History of Present Illness: 66 yo F with history of DM2, portal HTN from EtOh cirrhosis, prior right hepatectomy for HCC, and hx of encephalopathy who was admitted to OSH this AM after being more somnolent this AM. On arrival to OSH her vitals were 97.4, HR 68, BP 116/45, RR 12, 100% on RA, GCS 6. She was found to be "gurgling" with breathing and was given etomidate, versed, propofol and intubated for airway protection. Also received IV flagyl and levofloxacin, and lactulose, and 2L NS. Her HCT was 20.3, Na 133, BUN/Cr 45/2.0. Trop was elevated at 2.55 and ECG showing new lateral TWI. Patient was transferred to [**Hospital1 18**] via [**Location (un) **] for management of upper GIB. . Yesterday, per sister patient seemed more tired but went outside in wheelchair and was interactive and oriented. She did not seem confused. She has been unresponsive with encephalopathy in the past in the setting of UTIs. Per the sister she has had chronic "blood in stool" and has been getting "almost weekly" transfusions for past 1 year. . In the emergency department, vitals were: HR 59, BP 104/57, RR 14, O2 100% on vent (AC 500x14+5). She received lactulose, ASA. She got 5L NS, 50mcg fentanyl IV, 1g ceftriaxone and 1U RBCs. HCT was 18.5 and Cr 1.8. NG tube initially did not show any blood or coffee grounds but subsequently returned frank blood. CXR was obtained and showed mild pulmonary edema without consolidations. U/A was positive with 180 WBCs, many bacteria, and large leuk. . Vitals prior to transfer to the floor were: HR 57, BP 105/51, RR 13, O2Sat 100% on PEEP 5 and FiO2 of 40%. . REVIEW OF SYSTEMS: (+)ve: (-)ve: fever, chills, night sweats, loss of appetite, fatigue, chest pain, palpitations, rhinorrhea, nasal congestion, cough, sputum production, hemoptysis, dyspnea, orthopnea, paroxysmal nocturnal dyspnea, nausea, vomiting, diarrhea, constipation, hematochezia, melena, dysuria, urinary frequency, urinary urgency, focal numbness, focal weakness, myalgias, arthralgias Past Medical History: 1. Cirrhosis c/b encephalopathy 2. Hepatocellular CA s/p resection 3. Diabetes 4. Hypertension 5. Congestive heart failure, EF 55% TTE [**2108**] 6. Coronary artery disease 7. Chronic kidney disease stage III baseline creatinine 1.4 8. s/p ORIF L hip 9. History of gluteal muscle bleed secondary to coagulopathy 10.Gastropathy Social History: The patient does not smoke. She did drink alcohol but has not since developing liver disease. According to prior discharge summaries she has not had any illicit drug use. She is a resident of [**Location 582**] [**Location (un) 620**]. Family History: Non-contributory. Physical Exam: On Admission: VS: T 96, HR 65, BP 108/60, RR 8, 99% GEN: intubated, does not open eyes or respond to verbal commands, in no distress HEENT: lateral eye movements, R pupil 4mm and reactive, L pupil 3mm and reactive, dry mucosa NECK: supple, no cervical LAD, R IJ in place PULM: anterior breath sounds symmetrical and clear, no rhonchi or rales CARD: nl S1/S2, no m/r/g ABD: tense, non-distended, obese, no fluid wave appreciated, sluggish BS, no grimace to deep palpation EXT: 2+ pitting edema in upper and lower extremities, 1+ distal pulses SKIN: no rashes NEURO: pupils anisicoric and reactive, patient withdraws to pain On Discharge: VS: T 98.3 HR 62, BP 116/56, RR 18, 99% RA GEN: Anasarcous. Opens eyes spontaneously. No acute distress. HEENT: Dry lips but wet mucuous membranes. PERRLA. No cervical lymphadenopathy. NECK: supple, no cervical LAD PULM: Bilateral crackles up to midlung fields. No wheezes or rhonchi appreciated. CARD: Distant heart sounds. Normal S1/S2. No MRG apprecaited. ABD: Large, soft obese abdomen. No shifting dullness appreciated. NBS. Nontender to palpation EXT: 3+ pitting edema in upper and lower extremities bilaterally. Right PICC line in place. Right UE slightly more swollen than left UE, with tenderness to pressure. No evidence of erythema. 1+ radial/posterior tibial pulses. GU: Foley in place (since admission- discharged on 6 days of foley) SKIN: no rashes noted. NEURO: Alert and oriented to person and time. Confused to place/hospital setting. Cannot do serial sevens or days of the week backwards. No asterixis. Moving all extremities. Pertinent Results: Laboratory Data: Trop/CK/MB: [**2117-6-18**] 01:00PM BLOOD CK-MB-6 cTropnT-2.45* [**2117-6-19**] 11:30AM BLOOD CK-MB-8 cTropnT-1.97* [**2117-6-19**] 06:35PM BLOOD CK-MB-7 cTropnT-2.07* [**2117-6-20**] 05:36AM BLOOD CK-MB-6 cTropnT-1.83* CBC [**2117-6-18**] 01:00PM BLOOD WBC-3.4* RBC-1.83* Hgb-6.3* Hct-18.5* MCV-102* MCH-34.6* MCHC-34.1 RDW-21.8* Plt Ct-100* [**2117-6-24**] 06:08AM BLOOD WBC-4.5 RBC-2.77* Hgb-9.5* Hct-26.7* MCV-97 MCH-34.5* MCHC-35.7* RDW-21.3* Plt Ct-89* COAGS [**2117-6-18**] 01:00PM BLOOD PT-16.0* PTT-32.2 INR(PT)-1.4* [**2117-6-24**] 06:08AM BLOOD PT-17.8* INR(PT)-1.6* METABOLIC PANEL [**2117-6-19**] 11:30AM BLOOD Glucose-256* UreaN-54* Creat-2.0* Na-137 K-5.0 Cl-112* HCO3-14* AnGap-16 [**2117-6-24**] 06:08AM BLOOD UreaN-32* Creat-1.4* Na-134 K-4.3 Cl-109* HCO3-18* AnGap-11 [**2117-6-19**] 11:30AM BLOOD Calcium-7.8* Phos-4.3# Mg-1.9 [**2117-6-24**] 06:08AM BLOOD Phos-3.4 Mg-1.7 [**2117-6-20**] 06:59PM BLOOD freeCa-1.16 LIVER FUNCTION TESTS [**2117-6-19**] 11:30AM BLOOD ALT-26 AST-32 CK(CPK)-108 AlkPhos-104 TotBili-1.8* [**2117-6-24**] 06:08AM BLOOD ALT-22 AST-35 TotBili-1.6* ABG'S [**2117-6-18**] 02:36PM BLOOD Type-ART Rates-14/ Tidal V-500 PEEP-5 FiO2-100 pO2-580* pCO2-19* pH-7.50* calTCO2-15* Base XS--5 AADO2-129 REQ O2-31 -ASSIST/CON Intubat-INTUBATED [**2117-6-21**] 04:39PM BLOOD Type-[**Last Name (un) **] pO2-208* pCO2-34* pH-7.26* calTCO2-16* Base XS--10 URINE TESTS [**2117-6-18**] 01:00PM URINE Color-Yellow Appear-Cloudy Sp [**Last Name (un) **]-1.012 [**2117-6-21**] 10:00AM URINE Color-Yellow Appear-Clear Sp [**Last Name (un) **]-1.013 [**2117-6-18**] 01:00PM URINE Blood-SM Nitrite-NEG Protein-30 Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-NEG pH-5.5 Leuks-LG [**2117-6-21**] 10:00AM URINE Blood-NEG Nitrite-NEG Protein-TR Glucose-TR Ketone-NEG Bilirub-NEG Urobiln-NEG pH-5.0 Leuks-SM [**2117-6-18**] 01:00PM URINE RBC-3* WBC->182* Bacteri-MANY Yeast-NONE Epi-0 [**2117-6-18**] 01:00PM URINE CastHy-6* [**2117-6-18**] 01:00PM URINE WBC Clm-MANY [**2117-6-21**] 10:00AM URINE Hours-RANDOM UreaN-665 Creat-56 Na-51 K-15 Cl-36 HCO3-LESS THAN [**2117-6-21**] 10:00AM URINE Osmolal-451 MICROBIOLOGY URINE ADDED TO 64689E [**2117-6-18**]. **FINAL REPORT [**2117-6-22**]** URINE CULTURE (Final [**2117-6-22**]): PROTEUS MIRABILIS. >100,000 ORGANISMS/ML.. KLEBSIELLA PNEUMONIAE. 10,000-100,000 ORGANISMS/ML.. Piperacillin/tazobactam sensitivity testing available on request. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ PROTEUS MIRABILIS | KLEBSIELLA PNEUMONIAE | | AMPICILLIN------------ =>32 R AMPICILLIN/SULBACTAM-- 16 I 8 S CEFAZOLIN------------- 8 S <=4 S CEFEPIME-------------- <=1 S <=1 S CEFTAZIDIME----------- <=1 S <=1 S CEFTRIAXONE----------- <=1 S <=1 S CIPROFLOXACIN--------- 2 I <=0.25 S GENTAMICIN------------ <=1 S <=1 S MEROPENEM-------------<=0.25 S <=0.25 S NITROFURANTOIN-------- 64 I TOBRAMYCIN------------ <=1 S <=1 S TRIMETHOPRIM/SULFA---- 8 R <=1 S RADIOGRAPHIC/IMAGING DATA Chest X-Ray [**2117-6-18**] IMPRESSION: Mild pulmonary edema with small bilateral pleural effusions. Endotracheal tube and nasogastric tube are in standard positions. Chest X-Ray [**2117-6-20**] Endotracheal tube and nasogastric tube have been removed. Heart is mildly enlarged, and is accompanied by mild pulmonary vascular congestion. Small right pleural effusion is present and has likely decreased in size compared to prior study, although positional differences limit comparisons. Minor areas of atelectasis are present at the lung bases, right greater than left. RUQ ULTRASOUND [**2117-6-19**] RIGHT UPPER QUADRANT ULTRASOUND: Changes of right hepatectomy are present. The liver is coarsened and nodular, consistent with cirrhosis. Again seen is a 2.3 x 1.9 x 1.6 cm hypoechoic mass in segment III, with mild peripheral vascularity. Normal flow and Doppler waveforms are seen in the main and left portal veins, with wall-to-wall hepatopetal flow. Color flow is also noted in the hepatic arteries, hepatic veins, and IVC. There is no intrahepatic or common biliary ductal dilation. The pancreatic head and body are normal, and the tail is not well visualized due to shadowing bowel gas. The spleen is stably enlarged at 14.7 cm. There is mild ascites, concentrated in the right lower quadrant. IMPRESSION: 1. Cirrhosis post right hepatectomy, with patent main and left portal veins. 2. 2.3-cm mass in segment III, concerning for HCC. 3. Splenomegaly. 4. Mild ascites. EKG [**2117-6-21**] Sinus bradycardia. QTc interval prolongation. Loss of R waves in leads I, aVL and V3-V6 consistent with extensive anterolateral myocardial infarction, age undetermined but possibly acute. Compared to the previous tracing of [**2116-6-9**] these changes are present. Intervals Axes Rate PR QRS QT/QTc P QRS T 59 158 84 504/502 4 -138 165 EKG [**2117-6-22**] Sinus bradycardia. Marked right superior axis. Consider a lateral myocardial infarction. Q-T interval prolongation. T wave abnormalities. Since the previous tracing of [**2117-6-21**] probably no significant change from previously noted findings. Intervals Axes Rate PR QRS QT/QTc P QRS T 55 164 84 518/509 50 -157 162 PICC LINE PLACEMENT TECHNIQUE: Using sterile technique and local anesthesia, the right basilic vein was punctured under direct ultrasound guidance using a micropuncture set. Hard copies of ultrasound images were obtained before and immediately after establishing intravenous access are on file. A peel-away sheath was then placed over a guide wire and a double lumen PICC line measuring 43 cm in length was then placed through the peel-away sheath with its tip positioned in the SVC under fluoroscopic guidance. Position of the catheter was confirmed by a fluoroscopic spot film of the chest. The peel-away sheath and guide wire were then removed. The catheter was secured to the skin, flushed, and a sterile dressing applied. The patient tolerated the procedure well. There were no immediate complications. IMPRESSION: Uncomplicated ultrasound and fluoroscopically guided 5 French double lumen PICC line placement via the right basilic venous approach. Final internal length is 43 cm, with the tip positioned in SVC. The line is ready to use. ECHOCARDIOGRAPHY [**2117-6-22**] Echocardiographic Measurements Results Measurements Normal Range Left Atrium - Long Axis Dimension: *4.4 cm <= 4.0 cm Left Atrium - Four Chamber Length: *5.9 cm <= 5.2 cm Left Atrium - Peak Pulm Vein S: 0.3 m/s Left Atrium - Peak Pulm Vein D: 0.6 m/s Right Atrium - Four Chamber Length: *5.5 cm <= 5.0 cm Left Ventricle - Septal Wall Thickness: 0.9 cm 0.6 - 1.1 cm Left Ventricle - Inferolateral Thickness: *1.2 cm 0.6 - 1.1 cm Left Ventricle - Diastolic Dimension: 5.0 cm <= 5.6 cm Left Ventricle - Ejection Fraction: 25% to 30% >= 55% Left Ventricle - Septal Peak E': *0.06 m/s > 0.08 m/s Left Ventricle - Ratio E/E': *18 < 15 Aorta - Sinus Level: 2.7 cm <= 3.6 cm Aorta - Ascending: 2.9 cm <= 3.4 cm Aortic Valve - Peak Velocity: 1.2 m/sec <= 2.0 m/sec Mitral Valve - E Wave: 1.1 m/sec Mitral Valve - A Wave: 0.7 m/sec Mitral Valve - E/A ratio: 1.57 Mitral Valve - E Wave deceleration time: 140 ms 140-250 ms Mitral Valve - [**Last Name (un) **]: 0.20 cm2 Mitral Valve - Regurgitation Volume: 29 ml TR Gradient (+ RA = PASP): *43 mm Hg <= 25 mm Hg Findings LEFT VENTRICLE: Mild symmetric LVH with normal cavity size. Severe regional LV systolic dysfunction. No resting LVOT gradient. RIGHT VENTRICLE: Normal RV chamber size and free wall motion. AORTA: Normal aortic diameter at the sinus level. Normal ascending aorta diameter. AORTIC VALVE: Mildly thickened aortic valve leaflets (3). No AS. No AR. MITRAL VALVE: Mildly thickened mitral valve leaflets. No MVP. Moderate (2+) MR. TRICUSPID VALVE: Mildly thickened tricuspid valve leaflets. Moderate [2+] TR. Mild PA systolic hypertension. PULMONIC VALVE/PULMONARY ARTERY: Normal pulmonic valve leaflet. No PS. Physiologic PR. PERICARDIUM: Trivial/physiologic pericardial effusion. REGIONAL LEFT VENTRICULAR WALL MOTION: Conclusions There is mild symmetric left ventricular hypertrophy with normal cavity size. There is severe regional left ventricular systolic dysfunction with akinesis of the mid- and distal LV segments. This most compatible with either LAD-territory myocardial infarction or Takotsubo cardiomyopathy. The remaining segments contract normally (LVEF = 25-30%). Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No 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 [2+] tricuspid regurgitation is seen. There is mild pulmonary artery systolic hypertension. There is a trivial/physiologic pericardial effusion. IMPRESSION: Severe regional left ventricular systolic dysfunction, c/w LAD-territory infarction or Takotsubo cardiomyopathy. Moderate mitral and tricuspid regurgitation. Mild pulmonary hypertension. Findings discussed with Dr. [**First Name8 (NamePattern2) 7306**] [**Last Name (NamePattern1) 805**] at 1550 hours on the day of the study. EGD [**2117-6-15**] Findings: Esophagus: Normal esophagus. Stomach: Mucosa: Friability, erythema, congestion and mosaic appearance of the mucosa with contact bleeding were noted in the stomach body and antrum. These findings are compatible with hypertensive gastropathy. Duodenum: Mucosa: Erythema and congestion of the mucosa were noted in the second part of the duodenum. Other findings: No varices noted. Impression: Gastritis, Duodenitis (Portal hypertensive gastropathy) No varices noted. Otherwise normal EGD to third part of the duodenum egd [**2117-6-18**] Findings: Esophagus: Contents: Clotted blood was seen in the lower third of the esophagus. Mucosa: Normal mucosa was noted in the whole esophagus. Stomach: Contents: Coffee ground heme was seen in the fundus. Mucosa: Diffuse continuous congestion, erythema and mosaic appearance of the mucosa with spontaneous bleeding were noted in the antrum, stomach body and fundus. These findings are compatible with severe portal hypertensive gastropathy. Duodenum: Mucosa: Normal mucosa was noted in the whole duodenum. Impression: Normal mucosa in the whole esophagus Blood clot in the lower third of the esophagus Old blood in the fundus Congestion, erythema and mosaic appearance in the antrum, stomach body and fundus compatible with severe portal hypertensive gastropathy Normal mucosa in the whole duodenum Otherwise normal EGD to third part of the duodenum Additional notes: specimens: none blood loss: none final diagnosis: severe portal hypertensive gastropathy causing GI bleed The attending was present for the entire procedure Brief Hospital Course: # Upper GI bleed - Presented from OSH with HCT of 18. Required a total of 6 red blood cell transfusion during her stay. EGD was negative for varices, but did show Diffuse continuous congestion, erythema and mosaic appearance of the mucosa with spontaneous bleeding noted in the antrum, stomach body and fundus compatible with severe portal hypertensive gastropathy. Initially maintained on PPI on Octreotide drip. Allergic to cephalosporins, so given ciprofloxacin for SBP prophylaxis in presence of GIB. Outside of hospital, she has been on near weekly blood transfusions for chronic slow GIB. Her baseline HCT is around 30, and is around 26 prior to discharge. Colonoscopy not perfromed in house. No melena, hematachezia, or hematemesis in house. *Follow daily CBC's, decrease frequency if stable *Sufferred NSTEMI (see below). Should keep HCT greater than 25 to optimize coronary oxygen delivery. *Please set up follow up with her [**Hospital1 882**] gastroenterologist, [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 75046**], within 1-2 weeks. Encephalopathy - patient has many previous admissions for hepatic encephalopathy which typically presents as unresponsiveness. Likely precipitated by GI bleed and urinary tract infection (see below). She was intubated for airway protection at OSH prior to arrival at [**Hospital1 18**]. At home patient is on lactulose and rifaximin. Became more alert/oriented after lactulose administration and blood transfusions. Patient was treated with lactulose 30 mg q3h, which was titrated to 3 - 4 bowel movements daily. Continued home dose of rifaximin. Her UTI was treated (see below). RUQ US showed cirrhosis post right hepatectomy, with patent main and left portal veins. Incidenetally, 2.3-cm mass in segment III was seen concerning for HCC (see below). Splenomegaly and mild ascites was also identified. *Continue lactulose administration to titrate to [**4-16**] bowel movements per day. *Continue Rifaxamin dosing *Note, patient had Non-Gap metabolic acidosis after leaving the ICU, probably from fluid boluses with NS and diarrhea from lactulose. Consider non-saline IVF repletion if necessary and having diarrhea. Urinary tract infection- Patient has history of UTIs, no previous culture date available in online medical record. U/A positive on admission. Started on IV ciprofloxacin for SBP ppx as well as UTI treatment. Cultures grew out P.Mirabilis with intermediate sensitivity to ciprofloxacin, and K.Pneumoniae sensitivity to cipro. Please note, has documented cephalosproin allergy. *Please perform UA and UCx prior to cessation of ciprofloxacin (last day [**2117-7-3**]) NSTEMI - Trop elevated to 2.55 at OSH with CK 58, new lateral TWI in V3-6 and AvL with no ST-T changes. Likely in setting of demand from acute GI bleed as well as documented history of coronary artery disease. Troponin trended 2.45 to 1.97 to 2.07, CK and MB remained flat. Patient was not started on antithrombotic therapy due to GI bleed. TTE showed anterior wall akinesis as well as worsening depression in EF to 25-30%. Restarted propanolol for beta blockade/portal hypertension, and started losartan 12.5 mg as well as pravastatin 40 mg qhs. Also on spironolactone for diuresis. *Please continue above medications. Please note patient has a documented allergy history to ACE-I. *Patient has severe anasarca from fluid boluses. Will need daily diuresis and monitoring of Ins/Outs until achieves euvolemia. Also need to monitor renal function and electrolytes. Currently on Furosemide 40 mg po daily as well as spironolactone 25 mg daily. [**Month (only) 116**] want to increase if patient requiring additional diuretic boluses. Was on 50 mg of spironolactone prior to admission. EtOH cirrhosis - history of right hepatectomy for HCC, hepatic encephalopathy and portal hypertension with portal gastropathy. No fluid wave appreciated on exam and encephalopathy as above likely due to acute GI bleed and UTI. Continued thiamine and folic acid. Continued lactulose and rifaxamin for hepatic encephalopathy. Baseline mental status is mild to moderately confused, with occassional visual hallucinations (puppies/putting away jewlry) *Regarding US liver lesion, patient is aware and says it has been biopsied at [**Hospital1 2025**] in [**Location (un) 86**] [**State 350**] and is non cancerous. Please reference [**Hospital1 2025**] hepatologists for further details. *Monitor LFTs Diabetes Mellitus II: Discontinued original NPH insulin and transitioned to Glargine Insulin while in house. Glucoses marginally controlled. Increased Glargine to 20 U qhs and also increased sliding scale (please reference medication list) *Check for appropriate glucose control and increase long acting/SSI prn T12/L1 compression fracture: Seen on radiographic imaging from prior hospitalization. Should wear TLSO brace while ambulating. Goals of care- patient has had progressive decline in function and is not a transplant or TIPS candidate. She has recurrent severe encephalopathy with multiple prior admissions. Per sister they have discussed with patient goals of care. Family meeting occurred prior to discharge resulted in patient requesting to be full code. Should continue to have ongoing discussion as most likely will continue to need frequent hospital readmissions given patient's multiple comorbidities. Given overall poor prognosis and poor functional status, need to discuss limitations of treatments without transplant. *Should attempt to have repeated goals of care discussions with the patient and family as will most likely require frequent repeated hospitalizations based on morbidity of current illness. TRANSITIONAL ISSUES: Please see asterisks with individual issues. PENDING LABS: None Medications on Admission: lactulose 10 gram/15 mL Syrup 30ml QID rifaximin 550 mg [**Hospital1 **] thiamine HCl 100 mg daily folic acid 1 mg daily propranolol 40 mg [**Hospital1 **] venlafaxine 37.5 mg [**Hospital1 **] aripiprazole 5 mg daily omeprazole 40 mg [**Hospital1 **] Lasix 40 mg daily spironolactone 50 mg daily Klonopin 0.5 mg qhs NPH insulin human recomb 100 unit/mL 35 units [**Hospital1 **] insulin lispro 100 unit/mL per sliding scale Iron (ferrous sulfate) 325 mg daily multivitamin ergocalciferol (vitamin D2) 50,000 unit weekly Discharge Medications: 1. rifaximin 550 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 2. thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. folic acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. propranolol 10 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 5. glucagon (human recombinant) 1 mg Recon Soln Sig: One (1) Recon Soln Injection Q15MIN () as needed for hypoglycemia protocol. 6. lactulose 10 gram/15 mL Syrup Sig: Thirty (30) ML PO TID (3 times a day). 7. insulin glargine 100 unit/mL Solution Sig: Twenty (20) Subcutaneous at bedtime. 8. insulin lispro 100 unit/mL Solution Sig: Per sliding scale Subcutaneous qachs: BRKFAST,LNCH,DNER SSI 101-150 3 Units 151-200 5 Units 201-250 7 Units 251-300 9 Units 301-350 11 Units 351-400 13 Units BEDTIME SSI 101-150 0 Units 151-200 2 Units 201-250 3 Units 251-300 4 Units 301-350 5 Units 351-400 6 Units . 9. furosemide 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily): Hold for SBP<100. 10. losartan 25 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily): Hold for SBP<100. 11. ciprofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours): Please continue up to and including [**2117-7-3**] for total 2 week treatment of complicated UTI. Please renally dose with changes in renal function. 12. ferrous sulfate 300 mg (60 mg iron) Tablet Sig: One (1) Tablet PO DAILY (Daily). 13. multivitamin Tablet Sig: One (1) 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. spironolactone 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 16. pravastatin 20 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime). 17. ergocalciferol (vitamin D2) 50,000 unit Capsule Sig: One (1) Capsule PO once a week. Discharge Disposition: Extended Care Facility: [**Hospital1 700**] - [**Location (un) 701**] Discharge Diagnosis: Primary: Hepatic Encephalopathy Non-ST Elevation Myocardial Infarction Urinary Tract Infection Gastrointestinal Bleed . Secondary: 1. Cirrhosis 2. Hepatocellular cancer status post resection 3. Diabetes 4. Hypertension 5. Coronary artery disease 6. Chronic kidney disease stage III baseline creatinine 1.4 7. Gastropathy Discharge Condition: Mental Status: Confused - always. Level of Consciousness: Lethargic but arousable. Activity Status: Out of Bed with assistance to chair or wheelchair. Discharge Instructions: Ms. [**Known lastname 40860**], You presented to the hospital due to being more somnolent. You were found to have multiple issues, including a gastrointestinal bleed, a urinary tract infection, and you also sufferred a heart attack. You were evaluated in the cardiac ICU then transferred to the Liver service. You had an endoscopy performed which did not show any evidence of acute bleeding, but rather slow oozing bleeds in your stomach. Your heart attack was medically managed as best possible, but given your risk for bleeding we do not suggest you take a daily aspirin. Your urinary tract infection was treated with antibiotics. You had imaging of your heart after your heart attack which showed compromised function, giving you a diagnosis of systolic heart failure. You will need to take some new medications to help your heart. You were also found to have compound fractures in your back requiring a brace for you to wear when you walk around. Please work with physical therapy to help gain your strength. Lastly, you were given lots of fluids when you came to the hospital to keep your blood pressure up. You will require medication to help urinate off the extra fluid that has accumulated in your body over the last several days. Some of your medications have changed. 1) We have DECREASED your dosing of Omeprazole 40 mg [**Hospital1 **] to 20 mg [**Hospital1 **]. 2) We have DECREASED you dose of spironolactone from 50 mg daily to 25 mg daily. 3) Please STOP taking your Klonopin 0.5 mg at night 4) We have changed your Insulin. Please STOP taking NPH insulin human recomb 100 unit/mL 35 units twice a day. Please START taking Glargine Insulin 20 U at night with Insulin lispro 100 unit/mL per sliding scale 5) Please DECREASE your propanolol from 40 mg twice a day to 10 mg twice a day 6) Please START taking pravastatin 40 mg at night 7) Please START taking losartan 12.5 mg daily. 8) Please CONTINUE to take your antibiotic ciprofloxacin up to an including [**2117-7-3**] 9) Please STOP taking your venlafaxine 37.5 mg twice a day 10) Please STOP taking aripiprazole 5 mg daily. Please continue to take the rest of your medications as prescribed. . While in the hospital, you had a family meeting with your medical team and your sister. [**Name (NI) **] understand that you are not a surgical candidate for liver transplant. You determined that you would like to continue with medical therapy and physical rehab, and rehospitalizations if necessary. You will be going to physical therapy for strengthening. . It has been a pleasure taking care of you Ms. [**Known lastname 40860**]! this AM. On arrival to OSH her vitals were 97.4, HR 68, BP 116/45, RR 12, 100% on RA, GCS 6. She was found to be "gurgling" with breathing and was given etomidate, versed, propofol and intubated for airway protection. Also received IV flagyl and levofloxacin, and lactulose, and 2L NS. Her HCT was 20.3, Na Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight goes up more than 3 lbs. Followup Instructions: You have the following follow up appointments: Department: ORTHOPEDICS When: FRIDAY [**2117-7-9**] at 9:05 AM With: ORTHO XRAY (SCC 2) [**Telephone/Fax (1) 1228**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 551**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: ORTHOPEDICS When: FRIDAY [**2117-7-9**] at 9:25 AM With: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] [**Telephone/Fax (1) 1228**] Building: [**Hospital6 29**] [**Location (un) 551**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage ICD9 Codes: 5990, 2762, 5849
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Medical Text: Admission Date: [**2151-3-26**] Discharge Date: [**2151-4-13**] Date of Birth: [**2082-11-30**] Sex: F Service: CARDIOTHORACIC Allergies: Penicillins / Sulfa (Sulfonamides) / Keflex / Diovan / Ciprofloxacin / Ace Inhibitors / Quinine / Levaquin / Novocain / Lidocaine Attending:[**First Name3 (LF) 1505**] Chief Complaint: Dsypnea and fatigue Major Surgical or Invasive Procedure: [**2151-4-2**] - 1. Redo sternotomy with aortic valve replacement with a 19-mm St. [**Hospital 923**] Medical Biocor Epic Supra tissue heart valve. 2. Mitral valve replacement, 27-mm St. [**Hospital 923**] Medical Biocor Epic tissue valve. [**2151-3-26**] - Cardiac catheterization History of Present Illness: 68F w/CAD s/p CABG '[**39**](LIMA/LAD, SVG/OM1, SVG/RCA) c/b occlusion of LIMA/LAD graft s/p DES to LAD '[**46**], NSTEMI due to LAD in-stent stenosis [**2-22**] s/p repeat DES, recurrrent NSTEMI during HD run [**2-23**] in context of LGIB & cath demonstrating patent vein grafts & LAD stent and an echo indicating moderate to severe aortic stenosis ([**Location (un) 109**] 0.8-1.0) at that time who is seen today as an inpatient consultation to evaluate her appropriateness for AVR/MVR. Had recent episode of sub-sternal chest pain after HD; responsive to SLNTG. Sent to ED for eval and subsequently to cath lab. Past Medical History: IDDM CAD, s/p CABG CHF ESRD on hemodialysis Tues, Thurs and Sat Anemia PVD, s/p right BKA Irritable bowel syndrome Diverticulitis Social History: Patient lives iwth her daughter and son-in-law as well as granddaughter. She does not work. She reports recent significant stressors as 2 family members have died in the last month and a great-grandaughter was born. Tobacco: smoked as a teenager EtOH: rare glass of wine Drugs: denies Family History: Mother died of colon ca; she also had diabetes. Father died of heart disease. Physical Exam: Pulse: 68 BP: 100/46 Resp: 16 O2 sat: 97/2L Height: Weight: General: NAD Skin: Dry [x] intact [x] HEENT: PERRLA [] EOMI [x] Neck: Supple [] Full ROM [x] Chest: Lungs clear bilaterally [ ] bibasilar crackles Heart: RRR [] Irregular [] Murmur [x] III/VI at base > neck Abdomen: Soft [x] non-distended [x] non-tender [x] Extremities: Warm [x], well-perfused [] R BKA Neuro: Grossly intact Pulses: Femoral Right: nd Left: palp DP Right: na Left: - PT [**Name (NI) 167**]: na Left: - Radial Right: na Left: palp Carotid Bruit obscured by murmur Pertinent Results: [**2151-3-26**] Cardiac Catheterization 1. Two vessel coronary artery disease. 2. Patent native LAD, SVG-OM, and SVG-RCA unchanged from prior. 3. Severe aortic stenosis. 4. Severe mitral regurgitation. 5. Mild systolic ventricular dysfunction. 6. Elevated biventricular filling pressures. 7. Severe pulmonary hypertension. [**2151-4-2**] ECHO PRE-BYPASS: The left atrium is moderately dilated. No spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. No atrial septal defect is seen by 2D or color Doppler. The left ventricular cavity size is normal. There is mild global left ventricular hypokinesis (LVEF = 45 %). The right ventricular cavity is mildly dilated with mild global free wall hypokinesis. The ascending, transverse and descending thoracic aorta are normal in diameter and free of atherosclerotic plaque. There are simple atheroma in the ascending aorta. 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. The mitral valve leaflets are moderately thickened. There is severe mitral annular calcification. There is severe thickening of the mitral valve chordae. Moderate (2+) mitral regurgitation is seen. The tricuspid valve leaflets are mildly thickened. Moderate [2+] tricuspid regurgitation is seen. There is no pericardial effusion. [**2151-3-30**] Carotid duplex ultrasound Impression: Right ICA stenosis <40%. Left ICA stenosis <40%. Pre-op: [**2151-3-26**] 09:49PM GLUCOSE-196* UREA N-55* CREAT-5.7*# SODIUM-135 POTASSIUM-5.0 CHLORIDE-95* TOTAL CO2-22 ANION GAP-23* [**2151-3-26**] 09:49PM CK(CPK)-28* [**2151-3-27**] 06:50AM BLOOD WBC-9.0 RBC-3.25* Hgb-11.0* Hct-33.0* MCV-102* MCH-33.9* MCHC-33.4 RDW-14.5 Plt Ct-213 [**2151-3-27**] 06:50AM BLOOD Plt Ct-213 [**2151-3-26**] 09:49PM BLOOD Glucose-196* UreaN-55* Creat-5.7*# Na-135 K-5.0 Cl-95* HCO3-22 AnGap-23* [**2151-3-27**] 06:50AM BLOOD ALT-5 AST-15 CK(CPK)-22* AlkPhos-99 [**2151-3-27**] 06:50AM BLOOD CK-MB-NotDone cTropnT-0.28* [**2151-3-27**] 06:50AM BLOOD %HbA1c-6.0* eAG-126* [**2151-3-29**] 06:25AM BLOOD PTH-559* Post-op: [**2151-4-13**] 03:51AM BLOOD WBC-11.8* RBC-2.91* Hgb-9.7* Hct-31.0* MCV-107* MCH-33.2* MCHC-31.1 RDW-21.8* Plt Ct-335 [**2151-4-13**] 03:51AM BLOOD Plt Ct-335 [**2151-4-13**] 03:51AM BLOOD Glucose-181* UreaN-43* Creat-5.0* Na-132* K-4.7 Cl-90* HCO3-30 AnGap-17 Radiology Report CHEST (PORTABLE AP) Study Date of [**2151-4-7**] 5:22 PM Final Report CHEST RADIOGRAPH INDICATION: Triple lumen change over wire, evaluation of line placement. COMPARISON: [**2151-4-5**]. FINDINGS: As compared to the previous examination, the right central venous introduction sheath has been removed and exchanged against a central venous access line. The tip of this access line projects over the leads of the pacemaker and is difficult to visualize but appears to be positioned at the inflow tract of the right atrium. No evidence of complications, notably no pneumothorax. Subtle increase of bilateral basal opacities. Unchanged size of the cardiac silhouette. The study and the report were reviewed by the staff radiologist. DR. [**First Name (STitle) **] [**Doctor Last Name 3900**] DR. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 4130**] OROPHARYNGEAL VIDEOFLUOROSCOPIC SWALLOWING EVALUATION EVALUATION: An oral and pharyngeal swallowing videofluoroscopy was performed today in collaboration with Radiology. Thin liquid, Nectar-thick liquid, and pureed consistency barium were administered. Results follow: RECOMMENDATIONS: 1. PO diet: soft solids, thin liquids 2. PO meds whole with thin liquids as tolerated 3. TID oral care 4. Strict aspiration precautions including: a) sit fully upright for all PO intake b) alternate between bites and sips to clear oropharynx c) swallow twice per bite as needed to clear oropharynx d) swallow-cough-swallow with ALL liquids including when taking meds 5. ENT eval in if vocal quality does not continue to improve 6. Swallow follow up in rehab setting to ensure tolerating diet, re-assess need for swallow-cough-swallow maneuver. These recommendations were shared with the patient, the nurse and the medical team. [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) 77062**] M.S., CCC-SLP Brief Hospital Course: Ms. [**Known lastname **] was admitted to the [**Hospital1 18**] on [**2151-3-26**] for work up of her chest pain during hemodialysis. She underwent a cardiac catheterization which revealed two vessel coronary artery disease with patent grafts froom her previous bypass syrgery. Severe aortic stenosis and mitral regurgitation were also noted. Given the severity of her valvular disease, the cardiac surgical service was consulted for evaluation for redo surgery. She was accepted for AVR/MVR and on [**4-2**] she was brought to the operating room for aortic and mitral valve replacement. Please see OR report for details, in summmary she had: 1. Redo sternotomy with aortic valve replacement with a 19-mm St. [**Hospital 923**] Medical Biocor Epic Supra tissue heart valve. 2. Mitral valve replacement, 27-mm St. [**Hospital 923**] Medical Biocor Epic tissue valve. She tolerated the operation well and was transferred from the operating room to the cardiac surgery ICU in stable condition. She was sedated through the night on the surgical day, the following day see awoke and followed commands but remained intubated as she was somewhat lethargic and she needed to have hemodialysis prior to extubation to support her pulmonary status. She was dialyzed on a daily basis and was ultimately extubated on POD3. She remained hemodynamically stable throughout this period. On POD4 she was transferred from the ICU to the stepdown floor for further recovery. She made slow progress in her physical activity and was transferred to rehabilitation at [**Hospital1 2670**] Care and Rehab in [**Location (un) 5871**],MA on POD 11 Medications on Admission: Plavix 375mg today, aspirin 324mg today lopressor 25mg, TUMS, NTP (held), Insulin sliding scale, celexa, Lantus at hs, prilosec, renagel, vitamin C, Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 3. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4 hours) as needed for pain/fever. 4. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO HS (at bedtime) as needed for constipation. 5. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO every six (6) hours as needed for pain. 6. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal DAILY (Daily) as needed for constipation. 7. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. Heparin (Porcine) 5,000 unit/mL Solution Sig: 5000 (5000) units Injection TID (3 times a day). 9. Citalopram 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 10. Insulin Lispro 100 unit/mL Solution Sig: sliding scale Subcutaneous QAC&HS. 11. Cinacalcet 30 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 12. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). Discharge Disposition: Extended Care Facility: SunbridgeCare and Rehab for [**Location (un) 5871**] Discharge Diagnosis: Aortic valve stenosis s/p AVR Mitral valve regurgitation s/p MVR s/p CABG '[**39**](LIMA/LAD, SVG/OM1, SVG/RCA) c/b occlusion of LIMA/LAD graft s/p DES to LAD '[**46**], NSTEMI due to LAD in-stent stenosis [**2-22**] s/p repeat DES, CHF(EF50% 2/09) HTN hyperlipidemia, IDDM2 ESRD on HD(Tu-Th-Sa) Anemia Irritable bowel syndrome Diverticulitis PAD s/p R BKA Discharge Condition: Alert and oriented x3 nonfocal s/p BKA: prostetic device not yet fitting stump, unable to ambulate Sternal pain managed with percocet prn Sternal wound healing well, no erythema or drainage Discharge Instructions: Please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions Please NO lotions, cream, powder, or ointments to incisions Each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart No driving for approximately one month until follow up with surgeon No lifting more than 10 pounds for 10 weeks Please call with any questions or concerns [**Telephone/Fax (1) 170**] Females: Please wear bra to reduce pulling on incision, avoid rubbing on lower edge Followup Instructions: Surgeon Dr. [**Last Name (STitle) **] [**2151-5-13**] @ 1PM [**Telephone/Fax (1) 170**] Wound check appointment - [**Hospital Ward Name 121**] 6 ([**Telephone/Fax (1) 3071**]) - your nurse will schedule Please call to schedule appointments: Primary Care Dr. [**Last Name (STitle) 77063**]([**Telephone/Fax (1) 8539**]) in [**1-16**] weeks OUTPATIENT CARDIOLOGIST: [**Location (un) 24344**] [**Telephone/Fax (1) 77064**] in [**2-17**] weeks Completed by:[**2151-4-13**] ICD9 Codes: 5856, 2762, 4280, 4168, 2724, 4439
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6028 }
Medical Text: Admission Date: [**2164-5-23**] Discharge Date: [**2164-6-20**] Date of Birth: [**2092-5-28**] Sex: F Service: VASCULAR SURGERY CHIEF COMPLAINT: Abdominal aortic aneurysm. HISTORY OF THE PRESENT ILLNESS: The patient is a 71-year-old white female with diabetes, hypertension, chronic low back pain, who was evaluated by her PCP in [**Name9 (PRE) 958**] for her back pain. Plain films showed degenerative arthritis and an abdominal aortic aneurysm. CT scan of the abdomen done at [**Hospital1 **] confirmed a 4.9 cm AAA. The patient was referred to Dr. [**Last Name (STitle) 1391**] for further treatment. The patient's back pain has been controlled with Vicodin but has worsened her preexisting constipation. The patient complained of bilateral band-like upper abdominal pain, worse with movement of her arms. She has also decreased her oral intake due to abdominal discomfort. She was admitted for further treatment. PAST MEDICAL HISTORY: 1. Diabetes. 2. Hypertension. 3. Chronic low back pain. PAST SURGICAL HISTORY: 1. Bilateral carpal tunnel release. 2. Cataract extraction O.U. ALLERGIES: Sulfa causes swelling. ADMISSION MEDICATIONS: 1. Glyburide. 2. Verapamil. 3. Prilosec. 4. Zocor. FAMILY HISTORY: Noncontributory. SOCIAL HISTORY: The patient lives alone. She quit smoking tobacco about 15 years ago. She has approximately six glasses of wine per week. PHYSICAL EXAMINATION ON ADMISSION: Vital signs: Temperature 98.2, pulse 74, respirations 18, blood pressure 174/75 on the right, 171/75 on the left, 02 saturation equals 97% on room air. General: Alert, cooperative white female in no acute distress. HEENT: Sclerae anicteric. Neck: Supple. No lymphadenopathy or thyromegaly. Carotids palpable. No bruits. Chest: Heart revealed a regular rate and rhythm without murmur. Lungs: Clear bilaterally. Abdomen: Soft, distended, mild diffuse tenderness. Palpable aortic aneurysm. Extremities: Feet equally warm. No edema. Pulse examination: Carotid, radial, femoral pulses 2+ bilaterally. Popliteal and dorsalis pedis pulses were 1+ bilaterally. PT pulses have biphasic Doppler signals bilaterally. Neurologic: Nonfocal. LABORATORY/RADIOLOGIC DATA: Admission laboratories revealed a WBC of 7.5, hematocrit 33.8, platelets 318,000, PT 12.6, PTT 23.5, INR 1.0. Sodium 142, potassium 4.2, chloride 106, C02 22, BUN 22, creatinine 1.1, glucose 68. Chest x-ray showed no acute pulmonary disease, compression deformities of the lower thoracic vertebra present. EKG on [**2164-5-22**] showed a normal sinus rhythm at a rate of 77. CT of the abdomen showed a 5 by 5 cm infrarenal AAA with extension into both iliacs, left greater than right. No leaking, no dissection. HOSPITAL COURSE: The patient was initially evaluated in the Emergency Room on [**2164-5-22**]. She was admitted to the Vascular Surgical Service on [**2164-5-23**]. The Cardiology Service was consulted for preoperative clearance. They ordered a Persantine MIBI study which showed a moderate, reversible anterior wall perfusion defect. They cleared the patient for urgent surgery with careful hemodynamic perioperative monitoring. On [**2164-5-26**], the patient underwent abdominal aortic aneurysm repair with Dacron graft. Postoperatively, the patient had equally warm feet with pedal Doppler signals. In the early afternoon of [**2164-5-26**], the patient developed a cold, pulseless right leg with no palpable femoral pulse and no Dopplerable pedal pulses. The patient was taken to the Operating Room several hours later where she underwent thrombectomy of the right aortoiliac limb of her graft and had a right common iliac artery to right common femoral artery bypass graft with Dacron. Postoperatively, the patient had equally warm feet and Doppler signals of the right DP and left DP/PT. The patient was transferred to the SICU. The patient developed significant oozing at her incision site and had required 8 units of packed red blood cells, 4 units of fresh frozen plasma, 2 units of platelets and IV vitamin K for coagulopathy. She received several doses of Kefzol perioperatively. An epidural for pain control was removed on postoperative day number two. The patient was unable to be weaned and extubated. The patient developed a low-grade fever. Blood cultures were drawn. Sputum culture was sent. Stool for Clostridium difficile was negative times three. On [**2164-6-4**], the patient spiked to 103. She was jaundiced. A gallbladder ultrasound was negative. Blood cultures showed gram-negative rods which were later identified as Enterobacter cloacae. Initial sputum culture grew Hemophilus and a repeat sputum culture grew Enterobacter. Urine culture also grew Enterobacter. Zosyn had been started and vancomycin had been added shortly afterwards. The patient completed a two week course of IV vancomycin and subsequently will finish two weeks of oral levofloxacin. Diuresis with Lasix was started in the hopes of removing 1-2 liters of fluid per day. The patient's preoperative weight was 73 kilograms and postoperatively was 90 plus kilograms. The patient responded well to Lasix. She was finally able to be extubated on [**2164-6-15**], postoperative day number 20. The patient was started on TPN during her prolonged intubation. She was then started on Trophik tube feedings via postpyloric Dobbhoff catheter. The patient was started on clear liquids on [**2164-6-17**]. She did extremely well and her feeding catheter was removed the following day. She was able to tolerate a house diet over the next 24 hours without difficulty and was ready for discharge. Staples from surgical incision were removed on [**2164-6-16**]. Physical Therapy evaluated the patient and recommended [**Hospital 3058**] rehabilitation initially. However, the patient was anxious to be discharged to the home of her sister in-law. Physical Therapy reassessed the patient and felt that she would be safe to go home but recommended physical therapy at home. At the time of discharge, the patient's surgical incisions were clean, dry, and intact. She had palpable dorsalis pedis pulses bilaterally. While on tube feedings, the patient had been started on 10 units of NPH insulin b.i.d. in addition to her Glyburide 5 mg p.o. q.d. After resuming a normal diet, the patient had low blood sugars and the NPH insulin was discontinued. The patient was instructed to continue taking her Glyburide 5 mg p.o. q.d. and following up with her primary care physician within [**Name Initial (PRE) **] week after discharge from the hospital to reassess her blood sugar control. The patient was instructed to follow-up with Dr. [**Last Name (STitle) 1391**] in the office in two weeks by calling the office for an appointment. DISCHARGE MEDICATIONS: 1. Levofloxacin 500 mg p.o. q.d. for 11 days to finish a two week course. 2. Glyburide 5 mg p.o. q.d. 3. Lopressor 50 mg p.o. t.i.d. 4. Simvastatin 10 mg p.o. q.d. 5. Timolol 0.25% ophthalmic solution one drop O.U. b.i.d. 6. Tylenol 325-650 mg p.o. q. four to six hours p.r.n. DISPOSITION: Home with home physical therapy. CONDITION ON DISCHARGE: Satisfactory. PRIMARY DIAGNOSIS: 1. Abdominal aortic aneurysm. 2. Abdominal aortic aneurysm resection with aortobi-iliac Dacron graft on [**2164-5-26**]. 3. Thrombectomy, right limb of bypass graft and right iliofemoral Dacron bypass graft on [**2164-5-26**]. SECONDARY DIAGNOSIS: 1. Blood loss anemia, status post transfusion. 2. Postoperative coagulopathy, treated. 3. Respiratory failure with prolonged intubation until postoperative day number 20. 4. Enterobacter urosepsis. 5. Enterobacter pneumonia. 6. Postoperative malnutrition, treated with total parenteral nutrition and tube feedings. 7. Jaundice, resolved. 8. Anasarca, treated. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) **], M.D. [**MD Number(1) 4417**] Dictated By:[**Last Name (NamePattern1) 3954**] MEDQUIST36 D: [**2164-6-22**] 07:24 T: [**2164-6-22**] 18:28 JOB#: [**Job Number 52144**] ICD9 Codes: 5185, 5990, 2851
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Medical Text: Admission Date: [**2145-7-30**] Discharge Date: Date of Birth: [**2145-7-30**] Sex: M Service: NB HISTORY OF PRESENT ILLNESS: Baby [**Name (NI) **] [**Known lastname 953**], twin number 2, is a newborn, born at 31 and 2/7 weeks, admitted to the NICU with respiratory distress and prematurity. He was born at 5:57 a.m. on [**2145-7-30**]. He was a 1520 gram product of a 31 and [**2-16**] week twin gestation. He was born to a 37 year-old, Gravida III, Para 0, now II mother, with estimated date of confinement of [**2145-9-29**]. Prenatal labs included blood type 0 positive, antibody negative, RPR non reactive, Rubella immune, hepatitis B surface antigen negative and GBS unknown. Pregnancy was Clomid induced. It was uncomplicated until early in the morning of [**2145-7-30**] when mother presented with abdominal pain, contractions and bleeding. Variable decelerations were noted and due to persistent abdominal pain, mother was taken for Cesarean section delivery for concern for abruption. She received one dose of betamethasone shortly before delivery. She did not receive intrapartum antibiotics and membranes were intact at delivery. Twin 2 was in breech presentation and emerged with good tone and spontaneous cry. He was resuscitated with stimulation and blow-by oxygen and was brought to the NICU. Apgars were 9 and 9. In the NICU, moderate respiratory distress was noted and he was begun on C-pap. PHYSICAL EXAMINATION: Weight 1520 grams, 50th percentile. Head circumference 29.5 cm, 50th to 75th percentile. Length 41 cm, 50th percentile. Vital signs: Temperature 97.3; heart rate 180; respiratory rate 50; blood pressure 55/27 with a mean of 37. Oxygen saturations 92 to 98% on C-Pap of 6 and FI02 of 25 to 35%. In general, active, vigorous, premature infant, responsive to exam, moderate respiratory distress. Skin: Warm, pale, pink, bruises over right leg and feet, no rash. HEENT: Fontanel soft and flat. Ears: Nares patent. Palate intact. Positive red light reflex bilaterally. Neck supple. Chest: Coarse, moderately aerated, moderate retractions. Cardiac: Regular rate and rhythm, no murmur. Femoral pulses 2+ bilaterally. Abdomen soft, no hepatosplenomegaly, no masses, quiet bowel sounds. Three vessel cord. Genitourinary: Normal male. Testes palpable in inguinal canals bilaterally. Anus patent. Extremities: Hips, back normal. Neuro: Appropriate tone and activity. Intact Moro grasp. HOSPITAL COURSE BY SYSTEMS: Baby [**Name (NI) **] [**Known lastname 953**] was initially admitted to the NICU and placed on C-Pap. He remained on C- Pap for several hours and then was transitioned to conventional ventilator, SIMV where he received Surfactant x2 and was quickly extubated to C-Pap. He remained on C-Pap for another 3 days and then was transitioned to nasal cannula. Nasal cannula was discontinued on day of life #5 at which point the patient was transitioned to room air. He has since been in room air and has been doing well. He has completed a 5 day spell count of no apnea, bradycardia or desaturation. At the time of discharge, his respiratory rate is anywhere from the 30's to the 60's and his oxygen saturation is above 96%. Cardiovascular: This infant does have a history of good blood pressures and good heart rates throughout his hospital stay. His heart rate has ranged anywhere from the 130s to 160s and blood pressure means have been anywhere from 45 to 55. He has not had a murmur and there has been no indication for cardiac evaluation. Fluids, electrolytes and nutrition: Initially, Baby [**Name (NI) **] [**Known lastname 953**] was started on intravenous fluids. He has since transitioned to gavage feeds and now he has full p.o. feeds of breast milk and/or Similac 24 with a minimum of 150 cc per kg per day. He averages anywhere between 160 and 190 cc per kg per day. His discharge weight is 2570 grams. Discharge height is 44.5 cm. Discharge head circumference is 33 cm. Gastrointestinal: This infant was treated for hyperbilirubinemia. His peak bilirubin was noted on day of life #2 and was 6.9 over 0.3. phototherapy was discontinued on day of life #5 with a rebound bilirubin of 5.5 over 0.3. Hyperbilirubinemia now resolved. Hematology: Admission hematocrit was 47.8. Most recent hematocrit was performed on [**8-30**] and was 35.3 with a reticulocyte count of 3.4%. he was not transfused throughout this admission. Infectious disease: Baby [**Known lastname 953**] is status post a sepsis rule out on hospital day number #[**Serial Number **]. He did receive Ampicillin and Gentamycin x 48 hours with all blood cultures negative to date. Neurology: Initial head ultrasound was performed on [**8-5**] on day of life #7. This exam was normal. A subsequent head ultrasound was performed on [**8-31**] and revealed two very small choroid plexus cysts. Neurologic exam is appropriate for gestational age. No further work-up deemed necessary by the NICU team. Sensory: Audiology: Hearing screening was performed with automated auditory brain stem responses. Baby [**Name (NI) **] [**Known lastname 953**] passed his hearing screen on [**2145-9-5**]. Ophthalmology: Mature. Eyes were examined most recently on [**2145-9-7**] revealing mature retinal vessels. A follow- up exam is recommended in 9 months. Infant is recommended to follow-up with Dr. [**Last Name (STitle) 36137**] of [**Hospital3 1810**] in 9 months time. Mother to schedule this appointment. Psychosocial: [**Hospital1 18**] social work is involved with the family. The contact social worker can be reached at [**Telephone/Fax (1) 8717**]. CONDITION ON DISCHARGE: Stable. DISCHARGE DISPOSITION: To home with parents. NAME OF PRIMARY PEDIATRICIAN: Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], telephone number [**Telephone/Fax (1) 69395**]. CARE RECOMMENDATIONS: Baby [**Name (NI) **] [**Known lastname 953**] should continue on his ad lib p.o. feeds of breast milk and/or Similac 24 with a minimum of 150 cc/kg/day. MEDICATIONS: The patient should continue on his Ferrous sulfate 0.4 ml once daily. CAR SEAT POSITION SCREENING: Passed on [**2145-9-7**]. STATE NEWBORN SCREEN STATUS: [**2145-8-5**], normal. [**2145-8-20**], normal. IMMUNIZATIONS RECEIVED: Hepatitis B #1 received on [**2145-8-27**]. IMMUNIZATIONS RECOMMENDED: 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 weeks 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; (3) 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 first 24 months of the child's life, immunization against influenza is recommended for household contacts and out-of-home caregivers. FOLLOW UP: 1. Infant is to follow-up with the primary care physician, [**Last Name (NamePattern4) **]. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] on [**2145-9-9**] at 1:30 p.m. Telephone number [**Telephone/Fax (1) 69395**]. 2. VNA scheduled via Maximum Health Care, 1-[**Telephone/Fax (1) 69396**]. They should be meeting with the family on Friday, [**9-10**] or Saturday, [**9-11**]. 3. Early intervention should be arranged through Minuteman Early Intervention Program of [**Location (un) 14753**]. Telephone number [**Telephone/Fax (1) 43117**]. 4. Ophthalmology: Follow-up is scheduled in 9 months due to the last eye exam on [**2145-9-7**] revealing mature retinal vessels bilaterally. 5. Breech presentation. Should have hip ultrasound at outpt. DISCHARGE DIAGNOSES: 1. Prematurity. 2. Respiratory distress syndrome. 3. Rule out sepsis. 4. Hyperbilirubinemia. 5. Follow-up hip ultrasound due to breech presentation. [**First Name8 (NamePattern2) 1154**] [**Last Name (NamePattern1) **], MD [**MD Number(2) 56585**] Dictated By:[**Last Name (NamePattern1) 62404**] MEDQUIST36 D: [**2145-9-7**] 12:36:49 T: [**2145-9-7**] 13:52:54 Job#: [**Job Number 69397**] ICD9 Codes: 769, 7742, V053, V290
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Medical Text: Admission Date: [**2162-10-26**] Discharge Date: [**2162-11-22**] Date of Birth: [**2122-1-24**] Sex: F Service: MEDICINE Allergies: Codeine Attending:[**First Name3 (LF) 30**] Chief Complaint: Pancreatitis Major Surgical or Invasive Procedure: Central line placement x2, Intubation x3, Arterial line placement x3, Removal of percutaneous gall bladder drain History of Present Illness: Patient is a 40 year old female with history of alcohol use, pancreatitis, and hyperlipidemia who presented to [**Hospital1 3325**] on [**2162-10-25**] with abdominal pain. She reports that she was feeling relatively well until the day prior to presentation, when she developed nausea, vomiting, abdominal pain, and chills. Her last meal prior to onset of the symptoms was spaghetti and meatballs. At [**Hospital3 3583**], she underwent a CT of her abdomen and pelvis, which per report demonstrated findings consistent with mild pancreatitis and a distended gallbladder with mild "prominence" of the extrahepatic duct system. She then underwent a RUQ ultrasound which demonstrated gallbladder wall thickening and edema, with minimally dilated common bile duct, as well as diffuse fatty infiltration of the liver. Per report, no stones were noted, and no intrahepatic ductal dilatation was noted. MRCP demonstrated dilated common duct without obstruction or stone within the common duct. She was hydrated aggressively, but the morning of [**10-26**], several laboratory abnormalities were noted. Her creatinine bumped from 0.2 to 2.1 and her HCT also rose from 40 to 52, and she was noted to be increasingly acidotic. She also had increased amount of pain. She was noted to be mildly hypotensive, and there was concern for cholangitis. A percutaneous gall bladder drain was placed, with drainage of non-purulent bile. Of note, her triglycerides came back at over 6300. Gram stain and culture of the bile drained from the percutaneous tube are pending. Request for transfer was made for further management and evaluation. Patient was Med Flighted over to [**Hospital1 18**]. Upon arrival to the floor, patient states she would like more pain medication, but denied any concerns or complaints. Past Medical History: - Previous episode of pancreatitis, hospitalized at [**Hospital3 **] - GERD - Seasonal allergies - Alcohol use - Developmental disorder of her bones requiring multiple surgeries on her lower extremities to remove bone fragments - Status post Cesarian section - Arthritis Social History: Patient is a single mother, has an 11 year old son who she is very close with. She cites her mother, [**Name (NI) **], as her preferred contact. She reports she enjoys drinking wine and White Russians, and drinks several a week. According to the chart from the outside hospital, it was noted that she drinks daily. She could not further elaborate on the amount she drinks. Her last drinks were the night prior to admission to the OSH (PM of [**10-24**]). She smokes "a few" cigarettes a week (less than a half pack weekly). She was formerly employed at Linen's 'N Things, but lost her job when the branch closed. She is looking for work at present. No illicit drug use. Family History: Her mother has Lupus. Physical Exam: Temperature 98, Heart rate 110, Blood pressure 113/76, Oxygen saturation 95% on 4L nasal cannula General: Slightly diaphoretic and flushed, slightly lethargic but fully arousable and appropriately converses. HEENT: NC/AT. Dry MM, clear oropharynx. No scleral icterus or conjunctival pallor. PERRL, EOMI. Neck: Supple, flat JVP. Cardiac: Tachycardic, regular, no rubs, murmurs, gallops appreciated. Lungs: Slightly decreased BS at bases, otherwise CTAB no w/r/r Abdomen: Distended, tender to palpation without guarding or rebound tenderness. +BS. Extremities: Warm, good capillary refill, no c/c/e Neurologic: A&Ox3, CN symmetric, moving all extremities without difficulty. Skin: No rashes or lesions, slightly flushed. Pertinent Results: LABS ON ADMISSION: [**2162-10-26**] 10:18PM TYPE-ART PO2-84* PCO2-30* PH-7.38 TOTAL CO2-18* BASE XS--5 [**2162-10-26**] 10:18PM GLUCOSE-141* LACTATE-1.5 NA+-137 K+-4.0 CL--111 [**2162-10-26**] 10:18PM freeCa-0.83* [**2162-10-27**] 01:45AM BLOOD WBC-10.1 RBC-4.07* Hgb-14.3 Hct-41.6 MCV-102* MCH-35.0* MCHC-34.3 RDW-14.1 Plt Ct-197 [**2162-10-27**] 01:45AM BLOOD Neuts-88.6* Lymphs-8.0* Monos-2.1 Eos-1.0 Baso-0.2 [**2162-10-27**] 01:45AM BLOOD PT-14.3* PTT-47.6* INR(PT)-1.2* [**2162-10-27**] 01:45AM BLOOD Glucose-124* UreaN-20 Creat-2.0* Na-137 K-4.1 Cl-113* HCO3-19* AnGap-9 [**2162-10-27**] 01:45AM BLOOD ALT-138* AST-219* LD(LDH)-638* AlkPhos-172* Amylase-77 TotBili-1.1 [**2162-10-27**] 01:45AM BLOOD Lipase-112* [**2162-10-27**] 01:45AM BLOOD Albumin-2.4* Calcium-6.6* Phos-2.1* Mg-1.5* [**2162-10-29**] 05:42AM BLOOD calTIBC-114* VitB12-GREATER TH Hapto-380* Ferritn-763* TRF-88* [**2162-10-27**] 01:45AM BLOOD Triglyc-2335* LABS ON DISCHARGE: WBC RBC Hgb Hct MCV MCH MCHC RDW Plt Ct 10.4 2.84* 9.0* 26.4* 93 31.7 34.1 14.3 590* Glucose UreaN Creat Na K Cl HCO3 AnGap 81 7 0.8 133 3.6 97 27 13 Calcium Phos Mg 9.7 5.1* 2.1 MICROBIOLOGY: Blood Culture, Routine (Final [**2162-11-2**]): ENTEROCOCCUS FAECALIS. BETA LACTAMASE NEGATIVE. HIGH LEVEL GENTAMICIN SCREEN: Resistant to 500 mcg/ml of gentamicin. Screen predicts NO synergy with penicillins or vancomycin. Consult ID for treatment options. HIGH LEVEL STREPTOMYCIN SCREEN: Susceptible to 1000mcg/ml of streptomycin. Screen predicts possible synergy with selected penicillins or vancomycin. Consult ID for details.. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ ENTEROCOCCUS FAECALIS | AMPICILLIN------------ <=2 S PENICILLIN G---------- 8 S VANCOMYCIN------------ <=1 S Aerobic Bottle Gram Stain (Final [**2162-10-27**]): REPORTED BY PHONE TO [**First Name8 (NamePattern2) 247**] [**Last Name (NamePattern1) **] @ 2040 ON [**10-27**] - CC7D. GRAM POSITIVE COCCI. IN PAIRS AND CHAINS. ----------- FROM PERCUTANEOUS TUBE BILE TEST. **FINAL REPORT [**2162-10-30**]** GRAM STAIN (Final [**2162-10-27**]): 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.. FLUID CULTURE (Final [**2162-10-30**]): NO GROWTH. ---------- Source: Endotracheal. **FINAL REPORT [**2162-11-7**]** GRAM STAIN (Final [**2162-11-4**]): [**11-27**] PMNs and <10 epithelial cells/100X field. NO MICROORGANISMS SEEN. RESPIRATORY CULTURE (Final [**2162-11-7**]): OROPHARYNGEAL FLORA ABSENT. YEAST. RARE GROWTH. ---------- [**2162-11-7**] 11:49 pm SPUTUM Site: ENDOTRACHEAL **FINAL REPORT [**2162-11-10**]** GRAM STAIN (Final [**2162-11-8**]): >25 PMNs and <10 epithelial cells/100X field. 1+ (<1 per 1000X FIELD): GRAM NEGATIVE ROD(S). RESPIRATORY CULTURE (Final [**2162-11-10**]): OROPHARYNGEAL FLORA ABSENT. KLEBSIELLA PNEUMONIAE. MODERATE GROWTH. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ KLEBSIELLA PNEUMONIAE | AMPICILLIN/SULBACTAM-- =>32 R CEFAZOLIN------------- =>64 R CEFEPIME-------------- <=1 S CEFTAZIDIME----------- <=1 S CEFTRIAXONE----------- <=1 S CEFUROXIME------------ 4 S CIPROFLOXACIN---------<=0.25 S GENTAMICIN------------ <=1 S MEROPENEM-------------<=0.25 S PIPERACILLIN/TAZO----- =>128 R TOBRAMYCIN------------ <=1 S TRIMETHOPRIM/SULFA---- <=1 S ---------- Log-In Date/Time: [**2162-11-8**] 7:51 pm BLOOD CULTURE **FINAL REPORT [**2162-11-19**]** Blood Culture, Routine (Final [**2162-11-19**]): STAPHYLOCOCCUS, COAGULASE NEGATIVE. ISOLATED FROM ONE SET ONLY. SENSITIVITIES REQUESTED BY [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] [**Numeric Identifier 80005**] [**2162-11-17**] 09:00AM. FINAL SENSITIVITIES. COAG NEG STAPH does NOT require contact precautions, regardless of resistance. Oxacillin RESISTANT Staphylococci MUST be reported as also RESISTANT to other penicillins, cephalosporins, carbacephems, carbapenems, and beta-lactamase inhibitor combinations. Rifampin should not be used alone for therapy. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ STAPHYLOCOCCUS, COAGULASE NEGATIVE | CLINDAMYCIN----------- =>8 R ERYTHROMYCIN---------- =>8 R GENTAMICIN------------ 2 S LEVOFLOXACIN---------- =>8 R OXACILLIN------------- =>4 R PENICILLIN G---------- =>0.5 R RIFAMPIN-------------- =>32 R TETRACYCLINE---------- =>16 R VANCOMYCIN------------ 2 S Anaerobic Bottle Gram Stain (Final [**2162-11-10**]): REPORTED BY PHONE TO [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] [**2162-11-10**] 232PM. GRAM POSITIVE COCCI IN CLUSTERS. ----------- Log-In Date/Time: [**2162-11-9**] 5:58 am BLOOD CULTURE ( MYCO/F LYTIC BOTTLE) BLOOD/FUNGAL CULTURE (Preliminary): NO FUNGUS ISOLATED. BLOOD/AFB CULTURE (Preliminary): NO MYCOBACTERIA ISOLATED. ----------- [**2162-11-11**] 2:50 pm CATHETER TIP-IV Source: picc. **FINAL REPORT [**2162-11-13**]** WOUND CULTURE (Final [**2162-11-13**]): No significant growth. IMAGING STUDIES: [**2162-10-26**] Chest X-ray: IMPRESSION: 1. Right IJ central line ending in the right atrium. No pneumothorax. 2. Low lung volumes and bibasilar atelectasis with bilateral small pleural effusions [**2162-10-27**] Abdominal X-ray: IMPRESSION: NG tube with tip in the stomach. [**2162-10-29**]: CT Abdomen and Pelvis: IMPRESSION: 1. New large bilateral pleural effusions with compressive atelectasis. 2. New significant ascites. 3. Peristent pericholecystic fluid and port and cholecystostomy tube with patent appearing CBD. No calcified gall stones. 4. Homogenously enhancing pancreas with fluid and fat stranding about it, consistent with persistent pancreatitis. [**2162-11-2**] Abdominal Ultrasound: INDICATION FOR STUDY: Suspected bile leak in a patient with cholecystostomy tube and pancreatitis. A portable ultrasound examination was performed and compared with the recent CT scan, which demonstrated fluid around the liver. The portable study demonstrates no fluid around the liver or in the right upper quadrant or right lower quadrant. For that reason, a paracentesis was not performed. IMPRESSION: No fluid identified. Therefore, paracentesis not performed [**2162-11-3**]: MRCP IMPRESSION: 1. Markedly thickened gallbladder wall and heterogeneity of the gallbladder wall likely due to inflammation from the patient's acute pancreatitis. There is also pericholecystic blood and blood in the region of the porta hepatis likely due to pancreatitis. 2. Findings of acute pancreatitis without pancreatic necrosis or acute fluid collection. 3. Mildly dilated common bile duct without evidence of stone or stricture. 4. Small amount of ascites increased. New moderate bilateral pleural effusions. [**2162-11-3**]: Transthoracic Echocardiogram The left atrium is normal in size. Left ventricular wall thickness, cavity size and regional/global systolic function are normal (LVEF >55%). Transmitral and tissue Doppler imaging suggests normal diastolic function, and a normal left ventricular filling pressure (PCWP<12mmHg). 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 regurgitation. The mitral valve appears structurally normal with trivial mitral regurgitation. There is no mitral valve prolapse. The estimated pulmonary artery systolic pressure is normal. There is an anterior space which most likely represents a fat pad. IMPRESSION: No echo evidence of vegetation or abscess. Normal global and regional biventricular systolic function. No diastolic dysfunction, pulmonary hypertension or significant valvular disease seen. [**2162-11-8**] CTA and CT Abdomen and Pelvis: IMPRESSION: 1. No evidence of pulmonary embolism. 2. Moderate-sized bilateral pleural effusions, with associated atelectasis of the adjacent lung. However, superimposed pneumonia cannot be excluded. 3. Patchy airspace consolidation within the right lung apex, concerning for a focal area of pneumonia. 4. Continued inflammatory changes surrounding the pancreas, with peripancreatic fluid and phlegmon. However, no drainable fluid collection identified. 5. Markedly abnormal gallbladder, with gallbladder wall irregularity, pericholecystic fluid, and a pigtail catheter in place. These findings likely reflect inflammatory changes secondary to the adjacent pancreatitis. 6. Tiny amount of perihepatic free fluid, with a small amount of free fluid tracking inferiorly into the pelvis. [**2162-11-8**] CT Sinus: IMPRESSION: 1. Fluid in the paranasal sinuses, which may be related to intubation. However, acute sinusitis cannot be excluded. 2. Left middle ear cavity and mastoid air cell opacification without evidence of osseous erosion. Please correlate clinically to exclude mastoiditis. [**2162-11-11**]: CT Abdomen and Pelvis: IMPRESSION: 1. Continued pancreatitis and cholecystitis. The overall appearance of the gallbladder is grossly similar from [**2162-11-8**], with slightly improved stranding surrounding the pancreas. 2. No drainable fluid collection identified. 3. Small amount of ascites, with fluid tracking into the pelvis. 4. Moderate-sized bilateral pleural effusions, with associated atelectasis of the adjacent lung. [**2162-11-17**]: KUB PORTABLE SUPINE ABDOMEN, ONE VIEW: NG tube tip terminates in the stomach. There are no dilated loops of small or large bowel, without evidence of obstruction or ileus. Retained contrast is seen throughout the colon. There is no supine evidence of free intraperitoneal air or pneumatosis. IMPRESSION: No evidence of obstruction or ileus. No supine evidence of free intraperitoneal air. [**2162-11-17**]: CXR INDINGS: There are low lung volumes. There is opacification in the lung bases, likely consistent with minimal basilar atelectasis, unchanged. There is no change in the hilar, mediastinal, and cardiac silhouette. There is no evidence of pneumonia or pleural effusion. IMPRESSION: Low lung volumes. Minimal basilar atelectasis. No obvious evidence of pneumonia. No obvious evidence of pleural effusion. Brief Hospital Course: This is a 40 year old female with history of pancreatitis, alcohol abuse, and hyperlipidemia who was transferred from an outside hospital for further management. #) Pancreatitis: Patient had pancreatitis based on elevated amylase, lipase, high triglycerides, exam, and imaging studies. It was felt that her pancreatitis was secondary to high triglycerides, also possibly related to alcohol use. She may have had a stone as well that passed, given dilated common bile duct noted. Upon arrival to the intensive care unit, a central line was placed for administration of fluids. Patient was aggressively fluid resuscitated with lactated ringers, titrated to improved urine output, heart rate, and normalization of her acute renal failure, hemoconcentrated state, acid-base status, and hypocalcemia. Surgery was consulted and followed along during her stay. During her stay, she had numerous imaging studies done to evaluate for transition of her pancreatitis into a hemorrhagic or infectious process, however none were noted. Initially tube feeds were held and a nasogastric tube was placed for decompression, but after her pancreatitis was stable, they were initiated. She was given TPN while kept NPO. Patient was eventually started on tube feeds which she tolerated well. Her nausea and vomiting significantly improved. Prior to discharge she was started on clears thickened with nectars and her NG tube was removed. Abdominal pain controlled with Fentanyl patches which should continue to be weaned down as pain continues to improve. #) Respiratory failure: On morning of [**2162-10-28**], patient was intubated for increased work of breathing, likely secondary to abdominal distension and pleural effusions. During her stay, it was difficult to wean her from the ventilator due to large amounts of sedation required and agitation when sedation was lifted. During her stay, she managed to self extubate herself twice, both times necessitating immediate re-intubation as she was hypoxic and apneic. She did not tolerate spontaneous breathing trials, as she would become hypoxic and have markedly increased work of breathing. Imaging and culture data suggested that the patient developed a ventilator associated pneumonia, and she received an eight day course of meropenem for klebseilla in her sputum. Thoracentesis was considered a number of times, however she did not have enough fluid to make the procedure possible. Given her slow weaning process from the ventilator, a family meeting was held, and her family decided to pursue tracheostomy, which she underwent on [**2162-11-11**]. Patient's respiratory status has remained very stable on a tracheostomy collar Fi02 of 40%. Would suggest that trach weaning be continued and eventually trach should be removed. #) Fevers, bacteremia: Patient developed fevers on [**9-26**]. She initially had been started on Zosyn at the outside hospital empirically given concern over cholangitis, however repeated imaging of her abdomen was not consistent with an infection. During her stay, given an initial positive blood culture for enterococcous, her work up included a transthoracic echocardiogram which was negative for abscess or vegetation. All of her central lines, arterial lines, and PICC line were removed. Abdominal ultrasound revealed there was not enough fluid for a paracentesis, as did repeated CT scans. There was not enough fluid for a paracentesis either. A CTA was completed to evaluate for a pulmonary embolus, which was negative. A CT of her sinuses was also completed to evaluate for sinus disease. Culture data ultimately revealed Klebseilla in sputum, and gram positive cocci in blood along with bacillus in blood. Drug-related fevers were also a consideration. She was treated with an empiric course of flagyl given improvement in her leukocytosis and bandemia with initiation of that therapy. She completed 14 day course of zosyn ([**Date range (1) 80006**]) to empirically cover potential gastrointestinal pathogens as well as the entercoccous in one blood culture. Blood cultures from [**11-9**] grew coag negative staph and bacillus species (not anthracis) sensitive to Vancomycin. She was started on a 14 day course of Vancomycin that will be completed [**2162-11-24**]. #) Alcohol Use: Patient's last known drink was in the evening of [**10-24**]. Initially she had significant transaminitis (AST much greater than ALT), which was felt to likely be related to alcohol consumption, as her transaminases have returned to [**Location 213**]. She was initially maintained on a CIWA scale prior to intubation. It was felt that her alcohol use was likely contributing to her need for large doses of sedation. She was initially placed on standing diazepam, which was weaned down to 2mg twice daily at the time of discharge. We recommend weaning this to off within two days --> first down to 2mg daily, then off. In addition, she received folate and thiamine supplementation. Social work has followed patient during hospitalization and has provided coping support to patient and her family. Would suggest that patient be connected with social work/substance abuse counseling resources at rehab and in her community. #) Distended, thickened, gallbladder: Initially there was concern for cholangitis at the outside hospital, and a percutaneous drain was placed. Culture data from the outside hospital, as well as repeated cultures here did not demonstrate any growth from her bile. Ultimately, it was felt that her cholecystitis was related to edema from her pancreatitis, as no stones were seen on repeated imaging. During her stay, patient pulled out the percutaneous cholecystostomy tube. Surgery was again consulted, and imaging was completed to ensure that no part of the tube had been retained. Suture material that remained was removed by the surgery team. Surgery has recommended that patient should undergo cholecystectomy in [**5-9**] weeks after she recovers from her acute illness. She has a follow up appointment with Dr. [**Last Name (STitle) 468**] in the department of General Surgery on [**2162-12-18**]. #) Anemia: Patient's hematocrit has trended down during her admission and remained in the mid 20's. This initially was felt to be secondary to fluid resuscitation. Repeated imaging did not reveal any evidence of bleeding. Iron studies, B12, folate, hemolysis, DIC labs all checked, iron studies consistent with anemia of chronic disease. B12 and folate were within normal limits. #) Elevated INR: Patient's INR was initially trending upward, which was felt to be likely secondary to nutritional deficiencies. INR has since normalized likely due to improved nutrition. #) Eosinophilia: Patient developed eosinophilia at the same time she began antibiotoc therapy for her ventilator associated pneumonia and bacteremia. Likely this lab finding is secondary to these medications. Since antibiotic course will be finished by [**11-24**] would suggest continuing to follow this lab value. #) Swallow Evaluation: An oral and pharyngeal swallowing videofluoroscopy was performed. Based on test results it is recommended that patient have nectar thick liquids and regular solids. Pills should be crushed with puree. Patient most comfortable with small bites and sips. #) GERD: Patient has a history of gastric reflux. She was changed from her home medication prilosec to lansoparazole during this hospitalization. Would recommend that she is restarted on prilosec when discharged home. Patient was a FULL code during this admission. Medications on Admission: - Lortadine for allergies - Prilosec daily - Sudaphed PRN Discharge Medications: 1. Heparin (Porcine) 5,000 unit/mL Solution [**Month/Year (2) **]: One (1) Injection TID (3 times a day). 2. Albuterol 90 mcg/Actuation Aerosol [**Month/Year (2) **]: 1-2 Puffs Inhalation Q4H (every 4 hours) as needed. 3. Polyvinyl Alcohol-Povidone 1.4-0.6 % Dropperette [**Month/Year (2) **]: [**2-3**] Drops Ophthalmic PRN (as needed). 4. Acetaminophen 325 mg Tablet [**Month/Day (2) **]: 1-2 Tablets PO Q6H (every 6 hours) as needed. 5. Lansoprazole 30 mg Tablet,Rapid Dissolve, DR [**Last Name (STitle) **]: One (1) Tablet,Rapid Dissolve, DR [**Last Name (STitle) **] DAILY (Daily). 6. Lactulose 10 gram/15 mL Syrup [**Last Name (STitle) **]: Thirty (30) ML PO Q8H (every 8 hours) as needed. 7. Miconazole Nitrate 2 % Powder [**Last Name (STitle) **]: One (1) Appl Topical PRN (as needed). 8. Thiamine HCl 100 mg Tablet [**Last Name (STitle) **]: One (1) Tablet PO DAILY (Daily). 9. Folic Acid 1 mg Tablet [**Last Name (STitle) **]: One (1) Tablet PO DAILY (Daily). 10. Prochlorperazine Maleate 10 mg Tablet [**Last Name (STitle) **]: One (1) Tablet PO Q6H (every 6 hours) as needed for nausea. 11. Fentanyl 100 mcg/hr Patch 72 hr [**Last Name (STitle) **]: One (1) Transdermal Q72H (every 72 hours). 12. Fentanyl 25 mcg/hr Patch 72 hr [**Last Name (STitle) **]: One (1) Transdermal every seventy-two (72) hours. 13. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization [**Last Name (STitle) **]: One (1) Inhalation Q6H (every 6 hours) as needed. 14. Sodium Chloride 0.9% Flush 10 mL IV PRN line flush Temporary Central Access-ICU: Flush with 10mL Normal Saline daily and PRN. 15. Sodium Chloride 0.9% Flush 10 mL IV PRN line flush PICC, non-heparin dependent: Flush with 10 mL Normal Saline daily and PRN per lumen. 16. Ondansetron 8 mg IV Q8H:PRN 17. 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. 18. Diazepam 2 mg Tablet [**Last Name (STitle) **]: One (1) Tablet PO Q 12H (Every 12 Hours). 19. Metoclopramide 5 mg/mL Solution [**Last Name (STitle) **]: One (1) Injection Q6H (every 6 hours) as needed for nausea. 20. Vancomycin in Dextrose 1 gram/200 mL Piggyback [**Last Name (STitle) **]: One (1) Intravenous Q 12H (Every 12 Hours): last doses on [**11-24**] to complete 14 day course. Discharge Disposition: Extended Care Facility: [**Hospital 671**] hospital at [**Hospital6 10353**] Discharge Diagnosis: Primary: Pancreatitis, Ventilator Associated Pneumonia confirmed by sputum as Klebsiella, Bacteremia with Staphylococcus coagulase negative, bacillus and enterococcus Secondary: Anemia, Gastroesophageal reflux disease Discharge Condition: good Discharge Instructions: You were transferred to this hospital for further management of you pancreatitis and inflamed gallbladder. You spent three weeks in the intensive care unit where you received intravenous fluid hydration and your pancreas and gallbladder were monitored closely with multiple imaging studies. You were also followed by our general surgery service. Your pancreatitis has improved clinically. You continue to have abdominal pain that we are managing with pain control medications. The surgeons recommend that you have your gallbladder removed within the next [**5-9**] weeks. During your stay in the ICU you had to be intubated because you were having difficulty breathing on your own. It was very difficulty to get you off the ventilator so you had to have a tracheostomy put in place. Your breathing is now very stable and we feel that you will likely be able to wean from your trach. While on the ventilator you developed a pneumonia that we treated you with antibiotics for. You have completed your antibiotics for this condition. You also developed multiple infections in your blood that we also treated you with antibiotics for. You are nearly done with these antibiotics. You have been continued on your hospital medications. The medications that you will discharged home on are dependent on your course at rehab. If you develop fevers, chills, worsening abdominal pain, chest pain or shortness of breath please contact your primary care physician or go to the emergency department for further evaluation. Followup Instructions: You should follow up with your primary care physician [**Name Initial (PRE) 176**] 1 week of discharge from rehab. You should follow up with Dr. [**First Name8 (NamePattern2) **] [**Name (STitle) 468**] in the department of general surgery to plan your cholecystecomy. Your appointment has been scheduled for [**2162-12-13**] 11:15pm. The office phone number is [**Telephone/Fax (1) 476**]. Completed by:[**2162-11-23**] ICD9 Codes: 5849, 2762, 7907
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Medical Text: Admission Date: [**2119-9-6**] Discharge Date: [**2119-9-10**] Date of Birth: [**2080-6-25**] Sex: M Service: CARDIOTHORACIC Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 165**] Chief Complaint: activity intolerance Major Surgical or Invasive Procedure: [**2119-9-7**] Mini-thoracotomy, atrial septal defect History of Present Illness: This 38 year old male with congential sensorineural hearing loss and a secundum ASD who has been experiencing worsening dyspnea on exertion over the last 6 months. His activity level is quite low. He has been followed by Dr. [**Last Name (STitle) 171**] and has had both an echo and cardiac MRI demonstrating secundum atrial septal defect. The cardiac MRI done [**1-29**] reveals the atrial septal defect's maximal diameter to 2.3cm with a QP/QS to 1.56 and right ventricular enlargement. The patient was then referred for TEE and possibly a percutaneous atrial septal defect closure. Past Medical History: Chronic kidney disease Congenital deafness; uses American sign language (even though understands Spanish; does not speak) Gynecomastia Nephrolithiasis Hypertension Secundum ASD Obesity Asthma as a child Leg surgery as a child for "bowed legs" Social History: Mr. [**Known lastname **] lives with his father and does not work. He denies smoking or drinking alcohol. Family History: Mr. [**Known lastname **] has a sister with an atrial septal defect which was surgically repaired in [**Male First Name (un) 1056**]. Physical Exam: Pulse: 100 Resp: 16 O2 sat: 100% RA B/P Right: 128/86 Left: 119/82 Height: 64 in Weight: 214 lbs General: Skin: Warm [x] Dry [x] intact [x] HEENT: NCAT [] PERRLA [] EOMI [x] Neck: Supple [x] Full ROM [x] Chest: Lungs clear bilaterally [x] Heart: RRR [x] Irregular [] Murmur [] grade ______ Abdomen: Soft [x] non-distended [x] non-tender [x] +BS [x] Extremities: Warm [x], well-perfused [x] Edema [] _____ Varicosities: None [x] Neuro: Grossly intact [] Discharge Exam: VS: T:98.9 HR: 70-80's SR BP: 125-139/70's Sats: 97% RA Wt: 102.3 kg General: 39 year-old male in no apparent distress HEENT: normocephalic mucus membranes moist Card: RRR normal S1,S2 no murmur Resp: clear breath sounds GI: benign Extr: warm no edema Incision: right anterior chest below right breast clean dry intact, no erythema Neuro: awake alert. Sign language intrepreter present Pertinent Results: [**Hospital1 18**] ECHOCARDIOGRAPHY REPORT [**Known lastname **] JR, [**Known firstname **] [**Hospital1 18**] [**Numeric Identifier 81079**] (Complete) Done [**2119-9-6**] at 11:30:42 AM FINAL Conclusions PRE-BYPASS: The left atrium is normal in size. No thrombus is seen in the left atrial appendage. A secundum type atrial septal defect is present measuring 2.2 cm x 1.7cm with left to right flow. No other ASDs or VSDs visualized. Left ventricular wall thicknesses and cavity size are normal. Left ventricular wall thicknesses are normal. The left ventricular cavity size is normal. Overall left ventricular systolic function is normal (LVEF>55%). Right ventricular chamber size and free wall motion are normal. The ascending, transverse and descending thoracic aorta are normal in diameter and free of atherosclerotic plaque. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. The mitral valve appears structurally normal with trivial mitral regurgitation. There is no pericardial effusion. No clot in LAA. Normal appearing coronary sinus. Dr. [**Last Name (STitle) **] was notified in person of the results on[**2119-9-6**] at 1030. POST-BYPASS: There is preserved left ventricular function. There is a patch occluding the ASD with no residual defect. There is no evidence of Aortic dissection. Valvular function is unchanged from prebypass. . CXR [**2119-9-9**] Right internal jugular line tip is at the level of mid SVC. Heart size and mediastinum are unremarkable. Bibasilar atelectasis are present. Small amount of pleural effusion is seen. No overt pneumothorax is demonstrated. [**2119-9-8**] WBC-14.3* RBC-3.64* Hgb-11.2* Hct-32.2* MCV-88 MCH-30.7 MCHC-34.8 RDW-13.0 Plt Ct-207 [**2119-9-7**] WBC-19.8* RBC-4.41* Hgb-13.5* Hct-39.5* MCV-90 MCH-30.7 MCHC-34.3 RDW-13.0 Plt Ct-293 [**2119-9-6**] WBC-22.3*# RBC-4.49* Hgb-13.7* Hct-39.0* MCV-87 MCH-30.5 MCHC-35.1* RDW-12.6 Plt Ct-261 [**2119-9-9**] Glucose-202* UreaN-12 Creat-0.9 Na-135 K-3.9 Cl-101 HCO3-26 [**2119-9-9**] Mg-2.3 [**2119-9-6**] MRSA SCREEN (Final [**2119-9-9**]): No MRSA isolated. Brief Hospital Course: The patient was brought to the Operating Room on [**2119-9-6**] where the patient underwent an atrial septal defect repair via a mini-thoracotomy. Overall the patient tolerated the procedure well and post-operatively was transferred to the CVICU in stable condition for recovery and invasive monitoring. POD 1 found the patient extubated, alert and oriented and breathing comfortably. The patient was neurologically intact and hemodynamically stable, weaned from inotropic and vasopressor support. Beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. The patient was transferred to the telemetry floor for further recovery. Chest tubes and pacing wires were discontinued without complication. The patient was evaluated by the physical therapy service for assistance with strength and mobility. By the time of discharge on POD **** the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. The patient was discharged to home with Multicultural VNA in good condition with appropriate follow up instructions. Medications on Admission: AMLODIPINE 10 mg tablet daily HYDROCHLOROTHIAZIDE 25 mg tablet daily LISINOPRIL 20 mg tablet daily Discharge Medications: 1. Acetaminophen 650 mg PO Q4H:PRN pain 2. Aspirin EC 81 mg PO DAILY 3. Docusate Sodium 100 mg PO BID 4. Ibuprofen 600 mg PO Q8H Duration: 2 Weeks Take with food and water RX *ibuprofen 600 mg 1 tablet(s) by mouth three times a day Disp #*45 Tablet Refills:*0 5. Metoprolol Succinate XL 50 mg PO DAILY RX *metoprolol succinate 50 mg 1 tablet(s) by mouth once a day Disp #*30 Tablet Refills:*0 6. Hydrochlorothiazide 25 mg PO DAILY 7. Lisinopril 5 mg PO DAILY RX *lisinopril 5 mg 1 tablet(s) by mouth once a day Disp #*30 Tablet Refills:*0 8. HYDROmorphone (Dilaudid) 2-4 mg PO Q4H:PRN pain RX *hydromorphone 2 mg [**12-19**] tablet(s) by mouth every six (6) hours Disp #*60 Tablet Refills:*0 Discharge Disposition: Home With Service Facility: Multicultural VNA Discharge Diagnosis: atrial septal defect PMH: Chronic kidney disease Congenital deafness; uses American sign language (even though understands Spanish; does not speak) Gynecomastia Nephrolithiasis Hypertension Secundum ASD Obesity Asthma as a child Past Surgical History: Leg surgery as a child for "bowed legs" Discharge Condition: Alert and oriented x3 nonfocal Ambulating, gait steady Sternal pain managed with oral analgesics Sternal Incision - healing well, no erythema or drainage Discharge Instructions: Shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions NO lotions, cream, powder, or ointments to incisions Daily weights. Keep a log No driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive No lifting more than 10 pounds for 10 weeks 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: Wound Check at Cardiac Surgery Office [**Telephone/Fax (1) 170**], [**2119-9-19**] 12:30 in the [**Hospital **] Medical Building [**Hospital Unit Name **] Surgeon Dr. [**First Name8 (NamePattern2) **] [**Name (STitle) **], MD Phone:[**Telephone/Fax (1) 170**], [**2119-10-10**] 1:15 in the [**Hospital **] Medical Building [**Hospital Unit Name **] Cardiologist Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], MD Phone:[**Telephone/Fax (1) 62**] Date/Time:[**2119-10-18**] 10:20 Please call to schedule the following: Primary Care Dr.[**Last Name (STitle) **],[**First Name3 (LF) **] M. [**Telephone/Fax (1) 3581**] in [**3-23**] 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** [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 173**] Completed by:[**2119-9-10**] ICD9 Codes: 5859
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Medical Text: Admission Date: [**2101-10-1**] Discharge Date: [**2101-10-5**] Date of Birth: [**2046-11-20**] Sex: M Service: Neurosurgery HISTORY OF PRESENT ILLNESS: The patient is a 54-year-old male, who was admitted to [**Hospital **] Hospital on [**9-29**] after being found unresponsive by his girlfriend. [**Name (NI) **] had a five minute long generalized tonoclonic seizure followed by two more generalized tonoclonic seizures in the ED at [**Hospital1 **] lasting approximately 2-5 minutes each. Patient was loaded with Dilantin. Head CT at that time showed diffuse subarachnoid hemorrhage with a large amount of interventricular clot. At [**Hospital **] Hospital, an externalized ventriculostomy drain was placed with good return of CSF. Patient had reflexes in the ED all which were brain stem reflexes only, and an EEG which demonstrated diffuse slowing without focal epileptiform discharges. Initially ICPs were approximately 38-43 cm of water, which decreased to 20-23, 25 grams of mannitol post EVD placement. MRI at [**Hospital **] Hospital demonstrated a 3 mm aneurysm of the ACOM and left A2 segment, as well as dilation of the left lateral ventricle. While at [**Hospital1 **], patient had ICPs rising to approximately 8 cm of water at one point. Because of the inability to treat the aneurysm, the patient was transferred to [**Hospital1 346**] on [**2101-10-1**]. PAST MEDICAL HISTORY: 1. Hypertension. 2. Hepatitis C and B. 3. Oxygenous imperfecta. 4. Depression. 5. Gastritis. MEDICATIONS ON ADMISSION: 1. Cardizem. 2. Protonix. 3. Hydrochlorothiazide. 4. Diovan. 5. Paxil. PAST SURGICAL HISTORY: Patient has no past surgical history. Remote history of trauma. SOCIAL HISTORY: The patient was an IV drug abuser prior to [**2095**]. MEDICATIONS ON TRANSFER: 1. Dilantin 100 mg q.8h. 2. Amlodipine. 3. Vancomycin. 4. Rocephin. 5. Mannitol. 6. Morphine prn. PHYSICAL EXAM ON ADMISSION: Pulse 81, blood pressure 165/89, ICP is 24, CPP 96, respiratory rate 23, sating 98% ventilated and sedated. Patient had EVD in place with straining of bloody fluid. Pupils are 1.5 to 1 mm. There is no eye opening spontaneously. There were brief torsional eye movements as well as some rhythmic oscillations and dysconjugate gaze. There was no doll's eyes. There is a positive gag, and positive corneal reflexes. There is minimal left hand flexion to deep painful stimuli. There is no other movement of the extremities. HOSPITAL COURSE: The patient was admitted to the Neurosurgery service of Dr. [**Last Name (STitle) 1132**] on [**2101-10-1**]. After discussion with the family about the patient's poor prognosis and discussion of possible options, the patient was taken to the Angiography Suite. Prior to the onset of the procedure, the patient's ICP was found to be again elevated to 40 cmH2O. Accordingly a contralateral second ventricular drain was inserted prior to the beginning of the angiogram. The patient's ICP then stabilized to the around 20 cmH2O. The patient then underwent a diagnostic cerebral angiogram as well as coiling of a left pericallosal aneurysm. A small contrast leak was experienced during the deployment of the last coil which was treated with immediate coagulation reversal with protamine. The transient extravasation subsided spontaneously. There was no evidence of intracranial flow decrease and the ICP was noted to increase back to the low 40's. This was then followed by irrigation of the drains with saline and with one dose of tPA which improved CSF flow significantly. Postoperatively, the patient was returned to the Medical Intensive Care Unit. Overnight, both externalized ventriculostomy drains continued to work putting out a moderate amount of CSF overnight from postoperative day 0 to postoperative day one. The patient's intracranial pressures declined from mid-20's into the low teen's progressing further from postoperative day one to postoperative day two into the values of approximately [**5-14**]. Neurologically postprocedure the patient demonstrated minimal improvement compared to his admission. He progressed to a point where he was able to open his eyes, but was not able to attend to examiner, follow commands, or be responsive to deep painful stimuli. Serial CAT scans demonstrated persistent interventricular clot despite multiple attempts to place intrathecal TPA. On [**2101-10-5**] with the patient demonstrating minimal neurologic improvement and after prolonged discussions with the family and Dr. [**Last Name (STitle) 1132**], the family decided to withdraw support for the patient. On [**2101-10-5**], the patient was extubated and his ventricular drains were clamped, and he expired approximately two hours later. The [**Location (un) 511**] Organ Bank was [**Name (NI) 653**], however, the family did not wish to pursue organ donation. On [**2101-10-5**] at approximately 11:58 p.m., the patient was found to have no spontaneous respirations, no pulse is measured either by telemetry or by palpation, and was subsequently pronounced dead. [**Name6 (MD) **] [**Last Name (NamePattern4) **], M.D. [**MD Number(1) 1133**] Dictated By:[**Name8 (MD) 16207**] MEDQUIST36 D: [**2101-10-6**] 00:07 T: [**2101-10-6**] 05:20 JOB#: [**Job Number 50460**] ICD9 Codes: 311, 4019
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Medical Text: Admission Date: [**2129-11-3**] Discharge Date: [**2129-11-12**] Date of Birth: [**2062-6-2**] Sex: F Service: HISTORY OF PRESENT ILLNESS: This is a 66 year old woman who presented to Dr. [**Last Name (STitle) 468**] approximately a year after an episode of acute pancreatitis attributed to alcohol abuse. At the time of that pancreatitis episode, she had a CT scan which revealed a small pseudo cyst. However, on recent CT scan, she was found to still have a small cyst, under the size of one cm, in the head of her pancreas. Clinically, she remained well over the previous year, without fevers, chills, nausea, vomiting or other troubles. In [**2129-9-19**], she developed rapid onset of painless jaundice. CT scan at this time revealed only dilated extra hepatic biliary tract. She had a right upper quadrant ultrasound which showed a dilated common bile duct and gallbladder but no evidence of common bile duct stones. Endoscopic retrograde cholangiopancreatography was performed and a high grade focal stricture of the distal common bile duct was observed. A stent was placed and she was sent to Dr. [**Last Name (STitle) 468**] for evaluation. The patient denies fevers, chills or other symptoms of cholangitis. She also denies weight loss, history of cancer or recent exacerbation of alcohol use. PAST SURGICAL HISTORY: Breast biopsy, appendectomy, a remote laparoscopy. PAST MEDICAL HISTORY: Hypercholesterolemia; paroxysmal atrial fibrillation; mild mitral insufficiency and an alcohol history of four Manhattans a day. MEDICATIONS: Lanoxin, Norvasc, Zestril, Zocor, Allopurinol, Axid, Folic acid and multi-vitamins. ALLERGIES: No known drug allergies. SOCIAL HISTORY: She is a retired teacher. PHYSICAL EXAMINATION: On examination, she has jaundice and has scleral icterus. The rest of her Head, eyes, ears, nose and throat examination was normal. She had normal carotid pulses without bruits and no jugular venous distention. Her chest was clear and her heart was regular rate and rhythm. She did have grade II out of 6 mid systolic ejection murmur, heard best at the apex. Her abdomen was soft, nondistended and nontender. Her gallbladder was not palpable. HOSPITAL COURSE: She underwent a high contrast CT arterial study and was then brought into [**Hospital1 188**], where she underwent on [**2129-11-3**], a Whipple procedure. Postoperatively, she was placed on prophylactic benzodiazepine for possible delirium tremens. She was also placed on subcutaneous heparin, Zantac, Testall and her pain was controlled with an epidural. Initially, she was neo-synephrine dependent and she had very subtle electrocardiogram changes postoperatively. Cardiology was consulted and a myocardial infarction was ruled out with negative enzymes. She remained in the Intensive Care Unit overnight, secondary to the neo drip. However, throughout, she had excellent urine output. The evening of postoperative day one, her epidural was switched to a PCA for better pain control; however, she was found to be over narcotized and required a Narcan drip to alleviate this problem. On postoperative day number two, she was doing well and she was transferred to the floor. Over the next few days, she continued to do well. On postoperative day four, she required some Lasix for mild pulmonary edema on clinical examination. This resolved with upright positioning and the diuresis with the Lasix. On postoperative day number seven, she was noted to have a large amount of wound drainage and her wound was open for copious amounts of somewhat enteric looking drainage. She went for CT scan to rule out fistula or leak. The only finding was a possible SMB clot. Over this time as well, her platelets dropped from 325 to 64 and then by postoperative day number seven, down to nine. Hit antibody was sent. All heparin was removed from her lines and subcutaneous. Zantac was stopped. DIC laboratory studies were sent and found to be unremarkable. We placed Venodynes on her legs for deep vein thrombosis prophylaxis and requested a hematology consult. The hematology consult agreed with our management and furthermore, advised holding any anticoagulation, secondary to a risk of bleed, given that her platelet count was only nine. Her platelet count remained nine over postoperative day eight. Early in the morning on postoperative day number nine, she became anuric, hypotensive and her hematocrit was found to have dropped to 22. She was transferred to the Intensive Care Unit. Swan-Ganz was placed for fluid management. She was actively resuscitated with blood products and fluid. She was taken to the operating room for exploration of possible abdominal bleed. Upon opening the abdomen in the operating room, however, the small bowel was found to be entirely infarcted with catastrophic abdominal findings. She was reclosed without any further intervention and brought back to the Intensive Care Unit. We supported her blood pressure with pressors and fluids until her family could be fully present. At that point, she was made comfort measures only. She expired. [**First Name8 (NamePattern2) 251**] [**Name8 (MD) **], M.D. [**MD Number(1) 4984**] Dictated By:[**Last Name (NamePattern1) 7589**] MEDQUIST36 D: [**2129-11-12**] T: [**2129-11-16**] 05:07 JOB#: [**Job Number **] ICD9 Codes: 2762, 4280
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Medical Text: Admission Date: [**2204-5-8**] Discharge Date: [**2204-5-12**] Date of Birth: [**2152-1-4**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 3705**] Chief Complaint: Dyspnea. Major Surgical or Invasive Procedure: None. History of Present Illness: Mr. [**Known lastname 7086**] is a 52 year old male with past medical history of COPD on home oxygen and type two diabetes mellitus who presented with shortness of breath. . He reported that over the past week to weeks, he has noted some increasing white sputum production, but that was no accompanied by any shortness of breath or fevers. He did note some chills with the clear and white sputum. + Sick contact: nephew. [**Name2 (NI) **] called [**Company 191**] on [**2204-5-7**] to discuss his worsening symptoms. He was instructed to increase his prednisone to 10 mg daily (from qOD) and initiated levofloxacin [**5-7**]. As per usual over the last 2 years (about 4 times), he had a COPD exacerbation that he managed at home with nebulizers. This time, however, the meds "didn't work". Th morning of admission, he woke up acutely short of breath. He took one nebulizer treatment at home, but given the degree of dyspnea and lack of improvement, EMS was called. . Per report from the ED, upon arrival EMS administered another nebulizer treatment, and gave him magnesium en route to [**Hospital1 18**]. It was reported that he was moving "very little air." Upon arrival to the ED, his initial vital signs were: temperature of 97.0, heart rate of 114, blood pressure 107/62, respirations of 24, and oxygen saturation of 100% on 60% face mask. Per discussion with ED, his respiratory rate remained in the low 30's. He received three additional combivent nebulizer treatments back-to-back, as well as 125 mg of methylprednisolone and 500 mg of IV azithromycin. Lorazepam was given to see if there was any improvement in his tachypnea; ED reported this transiently improved his symptoms, but not significantly. At time of sign-out, he was receiving his forth nebulizer treatment. Vitals at time of ICU transfer were reported as heart rate of 119, blood pressure of 132/70, respiratory rate of 29, and oxygen saturaiton of 98% on 50% nebulizer treatment. . In the ICU, he was started on Prednisone 60mg daily, intended for a long taper, received Azithro and plenty of nebs. He required BiPAP at night and was at the mid 90's sats on 6L during the day. He experienced an episode of [**2-1**] CP that radiated down his left arm with flat troponins. On my exam, he feels "100 times better" . Review of systems: (+) Per HPI, + tightness (-) Denies fever, 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: - COPD, on 4 L home oxgyen and 10 mg prednisone every other day, followed by [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **]/[**First Name4 (NamePattern1) 4648**] [**Last Name (NamePattern1) **], no prior intubations - Diabetes Mellitus, type 2 - Obstructive sleep apnea, followed by [**First Name8 (NamePattern2) 450**] [**Last Name (NamePattern1) 437**], in process of starting therapy but not currently on non-invasive - Likely CAD (coronary calcifications on CT) - Depression/Anxiety - Diverticulosis - Scrotal hydrocele - Dupuytren contractures Social History: - Tobacco: Smokes one pack per day ([**11-27**] PPD) since age 13 - Alcohol: Occasional - Illicits: Denies Family History: (per chart) Multiple family members with DM Brother with [**Name2 (NI) 499**] cancer No family history of lung disease Physical Exam: ADMIT Vitals: T: pending BP: 119/59 P: 99-117 R: 25-29 O2: 99% on 50% ACCEPT VS: 98, 148/84, 91, 99on6L General: Resting in bed, tachypneic with pursed lips using accessory muscles, however NAD HEENT: Sclera anicteric, MMM, oropharynx clear, PERRL Neck: supple, JVP not elevated, no LAD, no stridor appreciated, using accessory muscles Lungs: [**Last Name (un) 7016**] chested, Decreased aeration bilaterally, Diffuse wheezes anteriorly and posteriorly, extremely prolonged expiratory phase, no apparent rales. CV: Tachycardic, however regular rate, 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: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Neuro: A&Ox3, speech fluent, following commands appropriately Psych: Appropriate Skin: No lesions Pertinent Results: ADMISSION [**2204-5-8**] 08:28AM BLOOD WBC-13.5*# RBC-4.81 Hgb-13.3* Hct-42.2 MCV-88 MCH-27.6 MCHC-31.5 RDW-13.8 Plt Ct-271 [**2204-5-8**] 08:28AM BLOOD Neuts-79.9* Lymphs-13.4* Monos-4.5 Eos-1.8 Baso-0.5 [**2204-5-8**] 08:28AM BLOOD PT-13.1 PTT-25.0 INR(PT)-1.1 [**2204-5-8**] 08:28AM BLOOD Glucose-167* UreaN-15 Creat-0.8 Na-143 K-4.6 Cl-103 HCO3-32 AnGap-13 [**2204-5-9**] 02:16AM BLOOD Calcium-8.9 Phos-3.4 Mg-2.2 [**2204-5-8**] 11:03AM BLOOD Type-ART pO2-221* pCO2-75* pH-7.18* calTCO2-29 Base XS--2 Intubat-NOT INTUBA Comment-NEBULIZER [**2204-5-8**] 08:34AM BLOOD Lactate-2.1* DISCHARGE [**2204-5-11**] 06:20AM BLOOD WBC-9.1 RBC-4.15* Hgb-11.5* Hct-35.7* MCV-86 MCH-27.6 MCHC-32.2 RDW-13.7 Plt Ct-245 [**2204-5-12**] 07:10AM BLOOD UreaN-16 Creat-0.6 Na-142 K-3.6 Cl-101 HCO3-35* AnGap-10 [**2204-5-11**] 02:26PM BLOOD Type-ART pO2-185* pCO2-56* pH-7.42 calTCO2-38* Base XS-10 CARDIAC [**2204-5-10**] 11:18AM BLOOD CK(CPK)-189 [**2204-5-10**] 03:04AM BLOOD CK(CPK)-189 [**2204-5-9**] 08:27PM BLOOD CK(CPK)-171 [**2204-5-10**] 11:18AM BLOOD CK-MB-8 cTropnT-<0.01 [**2204-5-10**] 03:04AM BLOOD CK-MB-8 cTropnT-LESS THAN [**2204-5-9**] 08:27PM BLOOD CK-MB-8 cTropnT-0.02* [**2204-5-8**] 08:28AM BLOOD cTropnT-<0.01 [**2204-5-10**] 04:03PM BLOOD %HbA1c-6.6* eAG-143* [**2204-5-10**] 11:18AM BLOOD Triglyc-154* HDL-35 CHOL/HD-4.4 LDLcalc-88 LDLmeas-84 CXR 1. No evidence of acute cardiopulmonary process. 2. Severe emphysema. DOBUTAMINE MIBI Normal study without focal defects concerning for ischemia. Left ventricular EF 65%. Brief Hospital Course: Mr. [**Known lastname 7086**] is a 52 year old male with past medical history of COPD on home oxygen, diabetes mellitus, and OSA who presented with respiratory distress. He was found to be in hypercarbic respiratory failure that responded swiftly to IV (and then PO) steroids, nebulized bronchodilators, antibiotics and NIPPV. He had TWI with an episode of chest pain that was evaluated by serial enzymes and a dobutamine-stress MIBI (both negative). He was discharged on a prednisone taper with documentation of nocturnal hypoxia to support a biPap prescription. #) COPD, OSA ?????? Patient was found to by in hypercarbic respiratory failure secondary to COPD exacerbation, improved on bipap in ED. Was given methylprednisolone for 24 hours, changed to prednisone 60mg PO qdaily which was subsequently tapered. continued on azithromycine, iptropium/albuterol nebs standing q4h. Patient did well. Completed abx. Had documented nocturnal desaturation to merit BiPap at home. Bicarb rose on penultimate day with improving ABG, likely related to metabolism of admission hypercarbia. #) chest pain - found to have non-exertional substernal chest pain with radiation to the left shoulder. Had stress test in [**2198**] that was nondiagnostic. ECG with dynamic inferior t wave inversions. TIMI score calculated at 1. Coronary calcifications on chest CT. Stress mibi was negative. Medications on Admission: - Albuterol nebulizer q4H PRN - Citalopram 60 mg - Fluticasone 50 mcg: 2 sprays daily - Fluticasone-Salmeterol 250 mcg/50 mcg [**Hospital1 **] - Metformin 500 mg daily - Prednisone 10 mg every other day - Temazepam 30 mg daily PRN - Tiotropium 18 mcg daily - Loratadine 10 mg Discharge Medications: 1. Ipratropium Bromide 0.02 % Solution Sig: One (1) neb Inhalation Q6H (every 6 hours). Disp:*qs qs* Refills:*2* 2. Nicotine 21 mg/24 hr Patch 24 hr Sig: One (1) Patch 24 hr Transdermal DAILY (Daily). 3. Tiotropium Bromide 18 mcg Capsule, w/Inhalation Device Sig: One (1) Cap Inhalation DAILY (Daily). 4. Citalopram 20 mg Tablet Sig: Three (3) Tablet PO DAILY (Daily). 5. Sulfamethoxazole-Trimethoprim 800-160 mg Tablet Sig: One (1) Tablet PO MWF (Monday-Wednesday-Friday). Disp:*30 Tablet(s)* Refills:*2* 6. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: [**11-26**] neb Inhalation Q2H (every 2 hours) as needed for wheezing. Disp:*qs qs* Refills:*0* 7. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 8. Prednisone 20 mg Tablet Sig: as dir Tablet PO DAILY (Daily): take 60 mg for 3 days. 40 mg for 3 days. 20 mg for 3 days. 10 mg for 3 days and then 10mg qod. Disp:*30 Tablet(s)* Refills:*2* 9. Metformin 500 mg Tablet Sig: One (1) Tablet PO once a day. 10. Fluticasone-Salmeterol 250-50 mcg/Dose Disk with Device Sig: One (1) puff Inhalation [**Hospital1 **] (2 times a day). 11. Calcium 500 + D 500 mg(1,250mg) -400 unit Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* 12. Bipap Sig: One (1) machine at bedtime: Inspiratory pressure: 10 cm/h2o Expiratory pressure: 5 cm/h2o with heated humidification. Disp:*1 machine* Refills:*0* Discharge Disposition: Home With Service Facility: [**Location (un) 86**] VNA Discharge Diagnosis: Primary: Severe COPD, in exacerbation Seconday: T2DM, HTN, Depression, Anxiety Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Mr. [**Known lastname 7086**], You were admitted with shortness of breath and cough. This was likely related to a "COPD Exacerbation" of unknown cause. You responded swiftly to steroids, antibiotics and supplemental oxygen. You spent more time in the ICU because of chest pain that was not associated with heart damage and ultimately evaluated with a stress test. This stress test revealed no areas of low blood flow. You were discharged to follow up outpatient. Please. Please stop smoking . BIPAP machine was delivered to you with instruction at the hospital. Please use this each evening and contact your [**Name2 (NI) 57073**] or primary care physician with questions. . NEW MEDICATION 1. Nicotine - take instead of cigarettes 2. Bactrim - an antibiotic to protect you while on steroids 3. Calcium and Vitamin D - take to prevent bone troubles while on steroids. NEW DOSES 1. Prednisone - taper as directed . Followup Instructions: Department: [**Hospital3 249**] When: TUESDAY [**2204-5-22**] at 4:40 PM With: [**Name6 (MD) **] [**Name8 (MD) **], MD [**Telephone/Fax (1) 250**] Building: [**Hospital6 29**] [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: PULMONARY FUNCTION LAB When: TUESDAY [**2204-5-29**] at 11:25 AM With: PULMONARY FUNCTION LAB [**Telephone/Fax (1) 609**] Building: [**Hospital6 29**] [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: PFT When: TUESDAY [**2204-5-29**] at 11:45 AM PLEASE CALL DR.[**Doctor Last Name **] OFFICE ON MONDAY TO SET UP A SLEEP STUDY. THIS IS VERY IMPORTANT. Completed by:[**2204-5-15**] ICD9 Codes: 4019
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Medical Text: Admission Date: [**2143-3-28**] Discharge Date: [**2143-4-11**] Date of Birth: [**2067-1-25**] Sex: M Service: CARDIOTHORACIC Allergies: Captopril Attending:[**First Name3 (LF) 165**] Chief Complaint: increasing fatigue Major Surgical or Invasive Procedure: [**2143-3-28**] MVRepair(28 CE Band)/AVR(21 mm CE pericardial)/CABG x3(Lima>lad,svg>pda,svg>om) [**2143-4-10**] right hemicolectomy, cholecystectomy, aortagram, SMA bypass graft from right common iliac artery, small bowel resection History of Present Illness: Patient was a 76 male complaining of increasing fatigue who had an echo showing worsening mitral reguritation. Cath showed subtotal occlusion of the LAD, mod-severe MR, EF 30-35%. Past Medical History: HTN, hyperlipidemia CAD with BMS x2 of RCA [**2137**]/instent restenosis [**7-25**] arthritis, anemia Social History: quit smoking 25 years ago, occasional alcohol, retired, lives with wife. Family History: Mother deceased from MI in late 80s. Physical Exam: (at exam [**3-13**]):HR 70 RR 15 157/49 NAD flat after cath skin unremarkable teeth in very poor repair neck supple with full ROM CTAB anteriorly RRR no murmur abd soft, NT, ND +BS extrems warm, well-perfused, no edema or varicosities noted neuro grossly intact no carotid bruits appreciated Pertinent Results: [**2143-4-11**] 03:03AM BLOOD WBC-7.3 RBC-3.07* Hgb-9.2* Hct-26.3* MCV-86 MCH-30.1 MCHC-35.1* RDW-15.4 Plt Ct-78* [**2143-4-10**] 03:57PM BLOOD Neuts-75* Bands-1 Lymphs-18 Monos-3 Eos-0 Baso-0 Atyps-0 Metas-0 Myelos-2* Promyel-1* NRBC-2* [**2143-4-10**] 03:57PM BLOOD Hypochr-3+ Anisocy-1+ Poiklo-1+ Macrocy-NORMAL Microcy-NORMAL Polychr-1+ Ovalocy-1+ Schisto-OCCASIONAL Burr-1+ [**2143-4-11**] 03:03AM BLOOD PT-28.7* PTT-86.1* INR(PT)-2.9* [**2143-4-11**] 03:03AM BLOOD Plt Smr-VERY LOW Plt Ct-78* [**2143-4-11**] 03:03AM BLOOD Glucose-200* UreaN-55* Creat-2.2* Na-159* K-6.4* Cl-99 HCO3-19* AnGap-47* [**2143-4-11**] 03:03AM BLOOD ALT-586* AST-4466* LD(LDH)-4932* AlkPhos-177* Amylase-28 TotBili-2.7* [**2143-4-11**] 03:03AM BLOOD Lipase-36 [**2143-4-11**] 03:03AM BLOOD Albumin-1.6* Calcium-10.5* Phos-12.8* Mg-3.6* [**2143-4-11**] 05:15AM BLOOD Type-ART pO2-68* pCO2-35 pH-7.18* calTCO2-14* Base XS--14 [**2143-4-11**] 05:15AM BLOOD Glucose-234* Lactate-26.4* K-6.6* [**Hospital1 18**] ECHOCARDIOGRAPHY REPORT [**Known lastname **], [**Known firstname **] [**Hospital1 18**] [**Numeric Identifier 73938**] (Complete) Done [**2143-4-10**] at 3:06:05 PM PRELIMINARY 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: [**2067-1-25**] Age (years): 76 M Hgt (in): 63 BP (mm Hg): / Wgt (lb): 135 HR (bpm): BSA (m2): 1.64 m2 Indication: Intraop sternal debridement, ex lap ICD-9 Codes: 440.0, 396.9 Test Information Date/Time: [**2143-4-10**] at 15:06 Interpret MD: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], MD Test Type: TEE (Complete) Son[**Name (NI) 930**]: [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **], MD Doppler: Full Doppler and color Doppler Test Location: Anesthesia West OR cardiac Contrast: None Tech Quality: Adequate Tape #: 2008AW1-: Machine: aw2 Echocardiographic Measurements Results Measurements Normal Range Mitral Valve - Mean Gradient: 3 mm Hg Findings LEFT ATRIUM: Mild LA enlargement. No thrombus in the LAA. RIGHT ATRIUM/INTERATRIAL SEPTUM: Mildly dilated RA. LEFT VENTRICLE: Mild symmetric LVH. Mildly depressed LVEF. RIGHT VENTRICLE: Normal RV chamber size and free wall motion. AORTA: Normal ascending aorta diameter. Simple atheroma in ascending aorta. Normal aortic arch diameter. Complex (>4mm) atheroma in the aortic arch. Normal descending aorta diameter. Complex (>4mm) atheroma in the descending thoracic aorta. AORTIC VALVE: Bioprosthetic aortic valve prosthesis (AVR). AVR well seated, normal leaflet/disc motion and transvalvular gradients. No AS. Trace AR. MITRAL VALVE: Mildly thickened mitral valve leaflets. Mitral valve annuloplasty ring. Trivial MR. TRICUSPID VALVE: Normal tricuspid valve leaflets with trivial TR. PULMONIC VALVE/PULMONARY ARTERY: Pulmonic valve not well seen. Physiologic (normal) 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. No TEE related complications. The patient appears to be in sinus rhythm. Conclusions Pre Bypass: The left atrium is mildly dilated. There is mild symmetric left ventricular hypertrophy. Overall left ventricular systolic function is mildly depressed (LVEF=40%). Septal motion is paradoxical, c/w post CABG. Right ventricular chamber size and free wall motion are normal. There are simple atheroma in the ascending aorta. There are complex (>4mm) atheroma in the aortic arch. There are complex (>4mm) atheroma in the descending thoracic aorta. A bioprosthetic aortic valve prosthesis is present. The aortic valve prosthesis appears well seated, with normal leaflet/disc motion and transvalvular gradients. There is no aortic valve stenosis. Trace aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. A mitral valve annuloplasty ring is present. Trivial mitral regurgitation is seen. There is no pericardial effusion. I certify that I was present for this procedure in compliance with HCFA regulations. Interpretation assigned to [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], MD, Interpreting physician Brief Hospital Course: Mr [**Known lastname 1169**] was admitted on [**3-28**] after he underwent a mitral valve repair, CABG x 3, and aortic valve replacement. For details of the operation please see the operative report. Extubated on POD #1. Postoperatively he was on milrinone, levophed and epinephrine to maintain his cardiac output and blood pressure. He received multiple blood transfusions as well.Amiodarone started for A fib. Pressors/support weaned and then restarted for decreasing C.I. Chest tubes removed. C diff. positive with continuing diarhhea on POD #6 and flagyl started. Beta blockade titrated. Echo showed global hypokinesis. Sub Q heparin started for prophylaxis and mutiple BP agents added for hypertension. Gentle diuresis restarted on POD #7, pacing wires removed, and transferred to the floor to begin increasing his activity level. on POD #11, his WBC rose to 18 and he was pancultured. He c/o LLQ pain on POD #12. Cipro started for UTI. Left pleural effusion tapped on POD #12. At 6:30 AM on POD #13, he acutely decompensated with acute respiratory failure on the floor. He had agonal breathing, was bradycardic and had palpable pulses and was intubated by anesthesia emergently during the code. Transferred back to CVICU for stat TTE and left chest tube placed. Tamponade ruled out by echo. Sternum found to be unstable on exam (no CPR had been performed).Bronchoscopy done to rule out aspiration. Lactate rose to 11 and general surgery was urgently consulted.Creatinine rose to 2.2 and INR was 2.9. New subclavian accesss established.He was taken directly to the OR and Dr. [**First Name (STitle) **] debrided his sternum and re-wired it. The general surgery team then did an exploratory laparotomy to evaluate for acute mesenteric ischemia. He had a right hemicolectomy, cholecystectomy, aortagram with right common iliac artery to SMA bypass graft ( vascular team), and then a small bowel resection by Dr. [**First Name (STitle) **]. He was profoundly acidotic. He was aggressively resuscitated the rest of the night with multiple pressor support to maintain a BP. The family was consulted about his extremely grave prognosis and they agreed to continue the drips but no CPR or additional drug resuscitation. Made CMO by family with increasing pressor requirements and acidosis. Expired at 8:00 AM on [**4-11**]. Family declined autopsy. Medical Examiner elected to review the case. Medications on Admission: coreg 6.25 mg daily zetia 10 mg daily ASA 325 mg daily plavix 75 mg daily lovastatin 80 mg daily lasix 40 mg daily cozaar 50 mg [**Hospital1 **] Discharge Disposition: Extended Care Facility: TBA Discharge Diagnosis: CAd with BMS to RCA x2, [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) **] [**7-25**] and instent restenosis HTN hyperlipidemia anemia arthritis Discharge Condition: Expired Discharge Instructions: patient expired Followup Instructions: expired [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 173**] Completed by:[**2143-4-11**] ICD9 Codes: 4241, 5185, 9971, 5990, 5119, 4240, 4019, 2724, 4280
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Medical Text: Admission Date: [**2190-7-4**] Discharge Date: [**2190-7-13**] Date of Birth: [**2134-1-24**] Sex: M Service: OME HISTORY OF PRESENT ILLNESS: 56-year-old gentleman with a history of myelodysplastic syndrome which has progressed to acute myelogenous leukemia complicated by pancytopenia, absolute neutropenia, and chronic infection involving his lungs (presumptively fungal). The patient was admitted to day with a cough which then progressed to dyspnea and fever. The patient denied any other acute complaints. In the Emergency Department, he was noted to be tachycardic and febrile to 102. He received intravenous fluids, cefepime, and vancomycin and was transferred to the Intensive Care Unit for further evaluation. PAST MEDICAL HISTORY: Myelodysplastic syndrome diagnosed in [**2189-6-21**] which progressed to acute myelogenous leukemia; poor prognosis - cytogenetic was 5q negative and mono filmy 7. Acute myelogenous leukemia diagnosed in [**2189-8-21**]; status post induction with 7+3 which was completed on [**2189-10-21**] with overall poor response complicated by chronic fungal pneumonitis - question Aspergillosis. Negative bronchoalveolar lavage in [**2190-1-21**] and in [**2190-1-21**] for Pneumocystis carinii pneumonia and neuro fungi. [**2190-1-21**] - right palate lesion consistent with chloramine pathology. Hypertension. Type 2 diabetes. Gastroesophageal reflux disease. History of partial small bowel obstruction. History of small-bowel bleed. History of alloimmunization to platelets. Coronary artery disease. History of diabetes insipidus; status post lithium. Chronic hyponatremia felt to be secondary to lithium. Depression. MEDICATIONS ON ADMISSION: 1. Glucotrol 20 mg by mouth once per day. 2. Protonix 40 mg by mouth once per day. 3. [**Doctor First Name **] 60 mg by mouth twice per day. 4. Lopressor 12.5 mg by mouth once per day. 5. Voriconazole 200 mg by mouth twice per day. 6. Caspofungin 50 mg by mouth once per day. 7. Risperidone. 8. Levofloxacin. ALLERGIES: METFORMIN . PHYSICAL EXAMINATION ON PRESENTATION: Temperature maximum was 102.7 degrees Fahrenheit, his blood pressure was 107/55, his heart rate was 93, his respiratory rate was 30, and his oxygen saturation was 100 percent on room air. Generally, a tired ill-appearing diaphoretic male. Head, eyes, ears, nose, and throat examination revealed the oropharynx was dry, poor dentition, white plaque on tongue, with a bruise over right eye and over bridge of nose. Cardiac examination revealed a regular rate. First heart sounds and second heart sounds. No murmurs. Pulmonary examination revealed decreased breath sounds at the bases. No rales or rhonchi. Abdominal examination was benign. Extremity examination revealed the extremities were warm and dry. Right Port-A-Cath with granulation tissue and foul smelling. Neurologic examination revealed affect was flat. Alert and oriented times three. In no apparent distress. Speech was fluent. Cranial nerves were intact. RADIOLOGY: A chest x-ray revealed no focal pneumonia, persistent right-sided effusion. A computed tomography angiogram of the chest revealed no pulmonary emboli, right pleural effusion, multiple nodular densities throughout parenchyma. PERTINENT LABORATORY VALUES ON ADMISSION: White blood cell count was 0.8. His hematocrit was 30.2. Chemistry profile was notable for a blood urea nitrogen of 32, creatinine of 1.4, platelets of 15, D-dimer was 4832, lactate was 2.5, and INR was 1.4. SUMMARY OF HOSPITAL COURSE: 1. ACUTE MYELOGENOUS LEUKEMIA: The patient's treatment has been limited by persistent infection involving old line infections and pulmonary issues. The patient had been on Synercid two weeks prior to admission for persistent line infection and a known history of vancomycin-resistant enterococcus. The [**Hospital 228**] hospital course was notable for an increased level of blasts in circulation. As high as 37 percent blasts were noted on complete blood count from [**2190-7-13**]. The patient was persistently febrile and was treated broadly for his known pulmonary infection as well as other possible sources. The patient was maintained on transfusion parameter scales. He did not have any evidence of disseminated intravascular coagulopathy or tumor lysis during this hospitalization. 1. HISTORY OF VANCOMYCIN-RESISTANT ENTEROCOCCUS STATUS POST LINE REMOVAL: The patient has a history of old line site infection with granulation tissue. Dr. [**Last Name (STitle) **] from Surgery evaluated the site and felt that the line site was not infected, and most likely his fevers were attributed to his known pulmonary infection. The Surgery Service debrided the patient's wound at bedside using silver nitrate. 1. CHRONIC INFECTIOUS PNEUMONITIS: A Pulmonary consultation was obtained. The patient had a bronchoscopy without any evidence of a fungal or Pneumocystis carinii pneumonia or bacterial pneumonia. A video-assisted thoracic surgery was considered versus computed tomography-guided biopsy. The decision regarding this was pending at the time of discharge. However, the patient was persistently febrile despite negative bronchoalveolar lavage. A repeat chest computer tomography revealed slightly worsening bilateral infiltrates, pulmonary edema, and stable left-sided pleural effusion. The patient did not have an oxygen requirement during his hospitalization, and his breathing was stable. He had a nonproductive cough. 1. CORONARY ARTERY DISEASE: The patient was maintained on metoprolol. He had no active issues during his hospital course. 1. TYPE 2 DIABETES: The patient was maintained on twice per day fingerstick glucose checks and a regular insulin sliding scale. 1. INFECTIOUS DISEASE: An Infectious Disease consultation was obtained to assist in the management of the patient's pneumonitis. The patient was treated with Synercid in light of his known history of vancomycin-resistant enterococcus. He was also treated with imipenem after intermittently being on Zosyn. The thought was that imipenem would give no Cardia coverage. However, despite broad coverage for gram-positive and gram-negative rods as well as fungal organisms with both caspofungin and voriconazole, the patient remained febrile. 1. PSYCHIATRY: The patient has a history of depression. The patient is on lithium as an outpatient. He was maintained on this. His lithium level on admission was within normal limits. He was also maintained on Risperdal at bedtime. 1. HYPONATREMIA: There was no evidence of hyponatremia during his hospital course. 1. MYOPATHY: The patient developed right hip flexor weakness on [**7-10**]. A magnetic resonance imaging of his lumbosacral spine revealed a L4-L5 disc herniation as well as a right inferior ramus fracture. It was unclear whether or not this was a new or old fracture. Plain films may help in determining this. The patient was able to ambulate. The Orthopaedic Service was consulted to evaluate the fracture. There was no evidence of cord compression on his magnetic resonance imaging. The Orthopaedic Service felt that the patient was able to weight bear as tolerated with the assistance of physical therapy. The patient denied any hip pain or pelvic pain, and overall right hip flexor strength was [**3-26**]. NOTE: Discharge followup, medications, and Addendum to this Discharge Summary to follow. Dr.[**Last Name (STitle) **],[**First Name3 (LF) 51907**] [**MD Number(4) 51908**] Dictated By:[**Last Name (NamePattern1) 12866**] MEDQUIST36 D: [**2190-7-13**] 14:51:30 T: [**2190-7-15**] 11:42:34 Job#: [**Job Number 51909**] ICD9 Codes: 2875, 5119
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Medical Text: Admission Date: [**2180-2-11**] Discharge Date: [**2180-2-23**] Service: HISTORY OF PRESENT ILLNESS: Ms. [**Known lastname 10269**] is a 79-year-old woman who had intermittent claudication of both legs for many years. The claudication has continued to worsen to the point where she has rest pain in her right foot. Over the several weeks prior to surgery, she had a small ulcer and developed a right fifth toe and heel ulcer of that foot. Her pain is worse at night, and she was referred to Dr. [**Last Name (STitle) **] for possible surgical intervention. PAST MEDICAL HISTORY: (Her past medical history is significant for) 1. Coronary artery disease; status post angioplasty in [**2166**]. 2. She had a carotid endarterectomy in [**2164**]. 3. She had a left lower extremity bypass with a prosthetic graft; she thinks a femoral to anterior tibial graft in [**2170**]. 4. She also had a thyroidectomy. 5. Hysterectomy. 6. Open reduction/internal fixation of a lift hip fracture. MEDICATIONS ON ADMISSION: Inderal, Cardizem, Capoten, Coumadin, nitroglycerin patch, Beconase, [**Doctor First Name **], and Nexium. ALLERGIES: Allergy to PROCARDIA, PERCODAN, and KEFLEX. SOCIAL HISTORY: The patient does not smoke currently. The patient is married and lives with her husband. PHYSICAL EXAMINATION ON PRESENTATION: Physical examination revealed a well-appearing elderly woman. Heart rate was 54, blood pressure was 130/72, respiratory rate was 14. There was a loud right cervical bruit. The chest was clear. The heart was regular in rate and rhythm. The abdomen was soft and nontender. No aneurysm or bruit palpated. Her right femoral pulse was nonpalpable. A very faint palpable pulse in the left groin. All distal pulses were absent. There was a rubor of the right foot with elevational pallor. There was a 3-mm shallow ulcer on the plantar surface of the right heel and an even smaller ulcer in the lateral aspect of her right fifth toe. RADIOLOGY/IMAGING: The patient had an arteriogram done in [**2179-12-5**] which showed extensive aortoiliac atherosclerosis with critical stenosis in the right common iliac and extensive high-grade stenosis throughout both external iliac arteries. The common femoral arteries were somewhat diseased. Both superficial femoral arteries were occluded. There were good-looking profundi bilaterally. There was also significant stenosis in the origin of both renal arteries and possibly an superior mesenteric artery stenosis as well. HOSPITAL COURSE: The patient had a magnetic resonance angiography done that showed similar findings as the angiogram with high-grade left renal artery stenosis, moderate right renal artery stenosis, moderate-to-severe proximal superior mesenteric artery stenosis, diffuse atheromatous plaques in the abdominal aorta, suprarenal, infrarenal aneurysmal dilatation of the abdominal aorta. On the right, severe proximal common iliac artery stenosis with severe distal external iliac artery stenosis on the right. An occluded superficial femoral artery on the right. The profunda femoris artery which supplies collaterals that reconstitute above the knee, the popliteal artery on the right. On the left, there is moderate stenosis of the left common iliac artery, and an occluded superficial femoral artery graft. The profundus femoris artery supplies collaterals. It also reconstitutes the popliteal artery on that side. The patient received cardiac clearance preoperatively, and the surgical options were discussed. It was decided to perform and aortobifemoral profunda bypass graft. The patient agreed and was taken to the operating room on [**2180-2-11**] with aortobifemoral profundus bypass graft was performed by Dr. [**Last Name (STitle) **]. Estimated blood loss was 600 cc. Urine output during the case was 450 cc. The patient received one unit of packed red blood cells and 5.6 liters of crystalloid. The patient was taken to the Postanesthesia Care Unit in stable condition with good affect. Postoperatively, the patient had warm extremities, with a dopplerable dorsalis pedis pulse on the right and a dopplerable posterior tibialis pulse on the left with good capillary refill. Her hematocrit was 27.1 and magnesium was 1.2. The patient was given one unit of blood. Over the first night postoperatively, the patient had an increasing volume requirement and an continued increasing oxygen requirement. Blood gas in the morning was 7.24/59/169/27 and -3 on 70% oxygen. The patient also had increasing complaints of pain overnight. At that time, the patient was also on a fenoldopam drip at 0.15 mcg/kg per minute to 30. At this time, the patient was on vancomycin and Flagyl with no source of infection. The patient was afebrile at that time. On the evening on postoperative day two, the patient had increasing heart rates into the 100s with a narrow complex tachycardia on electrocardiogram. At this time, the patient end-diastolic pressure was around 15, pulmonary artery pressures in the middle 40s, saturating 98% on 3 liters face mask. Cardiology was consulted for the tachycardia. The diltiazem drip was continued with rates in the middle 80s. The tachycardia likely secondary to congestive heart failure. With a rising white blood cell count, ischemia needed to be ruled out, and the General Surgery team was consulted, and a sigmoidoscopy was performed which just showed diverticulosis of the sigmoid colon with normal mucosa up to 30 cm with no evidence of ischemia to this 30-cm point. On postoperative day four, the patient was continued on the diltiazem drip and Lasix for diuresis with a total of four liters out over the past 24 hours. The patient was also continued on beta blockade as well as vancomycin. For pain control, the epidural catheter was discontinued and a Dilaudid patient-controlled analgesia was being used with good affect. On postoperative day five, the tachycardia had improved, with pulses in the 80s with a diltiazem drop and Lopressor. On postoperative day six, the patient's diet was advanced to clear liquids. The patient was also on oral diltiazem and intravenous Lopressor with good rate control in the 70s. The patient was also in good pain control with a Dilaudid patient-controlled analgesia. The patient continued to have intermittent episodes of atrial fibrillation. A few of these episodes of paroxysmal atrial fibrillation, but returned to sinus rhythm in a short time with no specific treatment. The rest of the [**Hospital 228**] hospital course was fairly uneventful, but with a white blood cell count currently at 11. The patient had an ultrasound of the right upper quadrant which showed an enlarged gallbladder with edema with a normal common bile duct and the suggestion of a dilated intrahepatic duct. The patient did have a [**Doctor Last Name **] sign, and General Surgery was asked to evaluate the patient for cholecystitis. The patient's symptoms actually significantly improved. Her abdominal pain completely dissipated. Her liver function tests revealed AST was 16, ALT was 24, alkaline phosphatase was 200, total bilirubin was 0.6, direct bilirubin was 0.5, amylase was 31, and lipase was 56. The patient was seen by Dr. [**Last Name (STitle) 13797**]. At that time, no intervention was deemed necessary considering her remarkable clinical improvement. A HIDA scan had been done on the same day as the ultrasound and was consistent with acute cholecystitis; however, the patient continued to improve with antibiotics. The General Surgery consultation physician (Dr. [**Last Name (STitle) 13797**] felt conservative management at this time was appropriate. No further episodes of abdominal pain. DISCHARGE DISPOSITION/CONDITION: The patient was in stable condition and in sinus rhythm. The incisions were intact. The incision of the left groin continued to drain some serous fluid. There was no erythema, and no evidence of infection. MEDICATIONS ON DISCHARGE: (She was discharged on the following medications) 1. Coumadin 5 mg p.o. q.o.d. and 2.5 mg p.o. q.o.d. 2. Flagyl 500 mg t.i.d. (for a 10-day course). 3. Levofloxacin 500 mg q.d. (for a 10-day course). 4. Lopressor 50 mg p.o. b.i.d. 5. Aspirin 81 mg p.o. q.d. 6. Captopril 25 mg p.o. t.i.d. 7. Diltiazem 60 mg p.o. q.i.d. 8. Ipratropium inhaler. 9. Albuterol inhaler. 10. Nexium. DISCHARGE INSTRUCTIONS/FOLLOWUP: The patient was to follow up with the Dr. [**Last Name (STitle) **] in two weeks. [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern4) 2604**], M.D. [**MD Number(1) 6223**] Dictated By:[**Last Name (NamePattern1) 7241**] MEDQUIST36 D: [**2180-2-23**] 09:59 T: [**2180-2-23**] 10:32 JOB#: [**Job Number 46518**] ICD9 Codes: 9971, 4280, 4019
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Medical Text: Admission Date: [**2132-8-12**] Discharge Date: [**2132-8-22**] Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2534**] Chief Complaint: abdominal distension, discomfort and liquid stool x 2 weeks. Major Surgical or Invasive Procedure: rectal tube placement History of Present Illness: [**Age over 90 **] yo F with [**Hospital 31756**] transfered from [**Hospital 100**] Rehab with abdominal distension, discomfort, and liquid stool for 2 weeks. No nausea, vomiting, fever, or anorexia. History fo fecal impaction. Past Medical History: dementia, depression, COPD, dysphagia, spinal stenosis, legally blind, urinary retention, GERD Social History: Lives at [**Hospital 100**] rehab Family History: Non-contributary Physical Exam: T 98.6 HR 65 BP 158/82 RR 18 SO2: 91% on RA GEN: pt awake and responding appropriately to questions HEENT: PERRLA Resp: CTAB CV: RRR AB: + bs, soft, nt, nd Ext: no edema psych: oriented to person Pertinent Results: KUB [**8-12**] 4:30 pm: IMPRESSION: Massively dilated sigmoid colon gas with a coffee bean appearance in the mid-abdomen, highly suspicious for sigmoid volvulus. KUB [**8-12**] 6:20 pm: IMPRESSION: Interval placement of sigmoid tube with decompression of previously seen sigmoid volvulus. KUB [**2132-8-13**] 8:10 IMPRESSION: Decompression of previously seen sigmoid volvulus. KUB [**2132-8-13**] 4:00 pm IMPRESSION: 1. Status post removal of the rectal tube, no evidence of volvulus recurrence. 2. Interval increase in extent of the right lower lung opacities, a followup with a dedicated chest radiograph is recommended. KUB [**2132-8-14**] 7:22 AM IMPRESSION: Interval recurrence of sigmoid colon dilatation, an asymmetric appearance and absence of dilation of proximal large bowel, may represent pseudovolvulus. KUB [**2132-8-14**] 5:21 PM IMPRESSION: Interval placement of rectal tube into the sigmoid colon with decompression of a previously seen sigmoid distention. KUB [**2132-8-16**] 10:07 AM IMPRESSION: Rectal tube present. No volvulus identified. No obstruction identified. KUB [**2132-8-16**] 10:20 PM The rectal tube has been withdrawn to the level of the rectum. Air is seen throughout the rectum. No findings to suggest obstruction. No grossly dilated small bowel is identified. KUB [**2132-8-17**] 1:36 PM FINDINGS: Rectal tube appears to be placed within the rectosigmoid, which contains air. Bowel loops proximal to this appear to being decompressed. Bowel wall mucosa cannot be well described as the bowel is decompressed. If there is continuing clinical concern for ischemia, CT with intravenous contrast may be helpful. KUB [**2132-8-17**] 6:23 PM The rectal tube has been placed more proximally within the sigmoid. Again noted is one abnormal colonic loop with a thumbprinting pattern. This pattern is nonspecific but can be associated with ischemia. Correlate with clinical findings. The remainder of the bowel is otherwise unremarkable. This finding was discussed by the radiology resident with surgery. KUB [**2132-8-17**] 8:20 AM IMPRESSION: No volvulus identified. One of the colonic air filled loops appears to have a thumb-print pattern, a findings that can be associated with ischemia. Findings transmitted to the nurse caring for the patient at the time of interpretation. COLON (GASTROGRAF) [**2132-8-19**] 11:02 AM GASTROGRAFIN ENEMA: Gastrografin was administered per rectum under constant fluoroscopic guidance. Although there is a capacious sigmoid colon, there is no evidence of sigmoid volvulus. Sacttered sigmoid diverticuli are noted. Contrast passed through to the cecum without evidence of obstruction. Scout image demonstrates diffuse atherosclerotic calcification of the abdominal aorta and iliac system. IMPRESSION: 1. No evidence of obstruction or volvulus. 2. Sigmoid diverticulosis. Cardiology Report ECHO Study Date of [**2132-8-20**] Conclusions: The left atrium is normal in size. 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%). Tissue Doppler imaging suggests an increased left ventricular filling pressure(PCWP>18mmHg). Transmitral Doppler and tissue velocity imaging are consistent with Grade II (moderate) LV diastolic dysfunction. The number of aortic valve leaflets cannot be determined. There is no aortic valve stenosis. Trivial mitral regurgitation is seen. The left ventricular inflow pattern suggests impaired relaxation. The pulmonary artery systolic pressure could not be determined. There is a small pericardial effusion. There are no echocardiographic signs of tamponade. Brief Hospital Course: Pt was admited with abdominal distension and discomfort, with a sigmoid volvulus seen on KUB. A rectal tube was placed in the ED to decompress the air-filled sigmoid colon. Serial abdominal exams showed improvement of tenderness, and the rectal tube was removed on HD2. Serial KUB's showed resolution of volvulus. The pt was initially npo and was advanced to clears on HD2. Bedside swallow eval was performed on HD3 that yielded recommendations to have a diet of p.o. thin liquids and puree-consistently solids and 1:1 supervision at mealtimes. On HD3 the pt's diet was advanced, however the pt became more distended and repeat KUB demonstrated recurrence of her volvulus. Her volvulus was again successfully decompressed with rectal tube placement. On HD5 on transport back from radiology the pt desaturated on room air and was transferred to the trauma-SICU. EKG and cardiac enzymes were found to be negative for acute MI. On HD6 she was started on cipro for a UTI and finished a 3 day course of cipro. On HD8 her diet was advanced. On HD10 she was started on p.o. lopressor for hypertension and given instructions to follow up with her primary care doctor [**First Name (Titles) **] [**Last Name (Titles) **] of this medication and of her hypertension. Her foley was also discharged on HD10. The pt was discharged in stable condition to [**Hospital1 10151**] on HD11. Medications on Admission: ativan, tylenol, [**Last Name (LF) 11346**], [**First Name3 (LF) **], dulcolax, zoloft, lovastatin, senna, selsun Discharge Medications: Resume home meds: ativan, tylenol, [**Last Name (LF) 11346**], [**First Name3 (LF) **], dulcolax, zoloft, lovastatin, senna, selsun 1. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal HS (at bedtime) as needed. Disp:*30 Suppository(s)* Refills:*0* 2. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). Disp:*30 Tablet, Chewable(s)* Refills:*2* 3. Oxycodone 5 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for pain. Disp:*30 Tablet(s)* Refills:*0* 4. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours) as needed for anxiety. Disp:*30 Tablet(s)* Refills:*0* 5. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 6. Ipratropium Bromide 0.02 % Solution Sig: One (1) neb Inhalation Q6H (every 6 hours) as needed for cough, sob. Disp:*30 nebs* Refills:*0* 7. Sertraline 50 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. Dextromethorphan-Guaifenesin 10-100 mg/5 mL Syrup Sig: Five (5) ML PO Q6H (every 6 hours) as needed for cough. 9. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 10. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) injection Injection [**Hospital1 **] (2 times a day). Disp:*60 injection* Refills:*2* 11. Senna 8.6 mg Tablet Sig: One (1) Tablet PO DAILY (Daily): hold for loose stools. Disp:*30 Tablet(s)* Refills:*2* 12. Albuterol Sulfate 0.083 % (0.83 mg/mL) Solution Sig: One (1) Inhalation Q6H (every 6 hours) as needed for cough, sob. Disp:*30 nebs* Refills:*0* 13. Docusate Sodium 50 mg/5 mL Liquid Sig: Ten (10) ml PO BID (2 times a day). Disp:*600 ml* Refills:*2* Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - MACU Discharge Diagnosis: Sigmoid volvulus urinary tract infection Discharge Condition: Stable to rehab facility Discharge Instructions: You came into the hospital with a sigmoid volvulus Treatment: * Drink plenty of liquids (unless your doctor has told you not to.) * A high fiber diet, containing fresh fruits and vegetables, whole grain breads, and cereals, may help prevent constipation and keep your bowel movemnents soft and regular. This diet is recommended unless your doctor recommends otherwise. * Exercising regularly can also help you avoid constipation. Do not over-exert yourself if you have medical conditions for which strenuous exercise could be harmful. * Be sure to continue on a bowel medicine regemin, especially if taking pain medications or other medications that can be constipating. * Be sure to take any prescribed medications as you were instructed. Continue your previously prescribed medications unless you were instructed to do otherwise. Warning Signs: Call your doctor or return to the Emergency Department right away if any of the following problems develop: * [**Name2 (NI) **] are not getting better in 24 hours, or you are getting worse in any way. * New or worsening constipation, decreased or absent bowel movements, pain with bowel movements, or lack of flatus ("passing gas.") * New or worsening abdominal (belly) pain, discomfort, cramping, pressure, or bloating. * New or worsening nausea or vomiting. * Shaking chills, or a fever greater than 102 degrees (F) * Bleeding in your bowel movements, dark, black, tarry bowel movements, or bloody vomiting. * Weakness, numbness, tingling, urinary retention, or incontinence or stool or urine. * Dizziness, confusion or change in behavior. * Any serious change in your symptoms, or any new symptoms that concern you. Followup Instructions: You should follow up with your primary care physician for control of your blood pressure, which has been elevated during this hospital admission. A blood pressure lowering medication has been started and needs to be regulated by your primary care physician. ICD9 Codes: 496, 5990, 4019, 311
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6039 }
Medical Text: Admission Date: [**2133-6-6**] Discharge Date: [**2133-6-19**] Date of Birth: [**2078-2-6**] Sex: F Service: NEUROLOGY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2569**] Chief Complaint: Paraesthesia, right visual impairment and right eye pain Major Surgical or Invasive Procedure: none History of Present Illness: 55 [**Name Initial (MD) **] IV RN who works at the [**Hospital1 2025**] was transfered from the [**Hospital 27217**] Hospital with a right brainstem hemorrhage. Her symptoms started around 19:45 h while she was having dinner with her husband, and she described the following sequence of events: Symptoms started with left face and hand tingling and a right retro-orbital pain. Her husband noted that her speech was slurred and the left side of face was droopy. The paramedics took her BP and the systolic at the scene was greater than 260 mmHg. Past Medical History: She has not seen a PCP in years, and was not aware or any medical problems Social History: Lives with husband. Non-[**Name2 (NI) 1818**], nil alcohol Family History: Mother had HTN controlled on medications. Father died of a stroke in his 50s Physical Exam: Vitals: Apyrexial, BP 182/92, HR 74, RR 20, O2 sats 97% on air General: Sleepy but rousable, high BMI HEENT: no meningismus, moist mucosal membranes CVS: systolic murmur in the aortic area with no radiation to the carotids Resp: Lungs clear to auscultation B/L GI: Soft, non-tender, normal BS Neurological Examination Mental status: Sleepy but cooperative with exam. Oriented to person, place, and date. Able to spell "world" backwards. Speech is fluent with normal comprehension and repetition. Naming intact. Dysarthria. Registers [**1-26**], recalls [**1-26**] in 5 minutes. No right left confusion. No evidence of apraxia or neglect. Cranial Nerves: Pupils equally round and reactive to light, 2 mm bilaterally. Visual fields are full to confrontation. right eye deviated inwards with several beats of lateral nystagmus. Sensation intact V1-V3 diminished to pinprick, cold and soft touch on the left hand side of the face. Facial movement asymmetric, slight left facial droop. Palate elevation symmetric. Trapezius power normal ([**3-30**]) bilaterally. Tongue protrudes to the left due to the weakness of the facial muscles. Upper & Lower limb examination Motor: Normal bulk bilaterally. Tone normal. No observed clonus or tremor No pronator drift [**Doctor First Name **] Tri [**Hospital1 **] WF WE FE FF IP H Q DF PF TE TF R 5 5 5 5 5 5 5 5 5 5 5 5 5 5 L 5 5 5 5 5 5 5 5 5 5 5 5 5 5 Sensation: Intact to light touch, pinprick, vibration and proprioception throughout. No extinction to DSS Reflexes: +2 and symmetric throughout. Plantars equivocal Coordination: finger-nose-finger normal, heel to shin normal Pertinent Results: [**2133-6-14**] 02:08AM BLOOD WBC-9.8 RBC-4.60 Hgb-13.7 Hct-40.7 MCV-89 MCH-29.8 MCHC-33.7 RDW-13.8 Plt Ct-249 [**2133-6-13**] 03:10AM BLOOD WBC-9.6 RBC-4.27 Hgb-12.9 Hct-38.6 MCV-90 MCH-30.2 MCHC-33.5 RDW-13.6 Plt Ct-256 [**2133-6-12**] 01:53AM BLOOD WBC-9.3 RBC-4.00* Hgb-12.5 Hct-36.5 MCV-91 MCH-31.3 MCHC-34.3 RDW-13.8 Plt Ct-253 [**2133-6-11**] 02:05AM BLOOD WBC-9.3 RBC-4.14* Hgb-12.4 Hct-38.4 MCV-93 MCH-29.9 MCHC-32.2 RDW-13.9 Plt Ct-260 [**2133-6-10**] 01:50AM BLOOD WBC-10.0 RBC-4.21 Hgb-12.7 Hct-38.3 MCV-91 MCH-30.2 MCHC-33.2 RDW-14.1 Plt Ct-236 [**2133-6-9**] 02:47AM BLOOD WBC-12.5* RBC-4.62 Hgb-13.9 Hct-41.6 MCV-90 MCH-30.0 MCHC-33.3 RDW-14.1 Plt Ct-214 [**2133-6-8**] 12:22AM BLOOD WBC-16.5*# RBC-4.78 Hgb-14.5 Hct-42.9 MCV-90 MCH-30.3 MCHC-33.7 RDW-14.3 Plt Ct-259 [**2133-6-7**] 01:50AM BLOOD WBC-10.4 RBC-4.66 Hgb-13.8 Hct-42.0 MCV-90 MCH-29.6 MCHC-32.9 RDW-14.2 Plt Ct-235 [**2133-6-6**] 07:00AM BLOOD WBC-8.5 RBC-4.71 Hgb-14.2 Hct-41.0 MCV-87 MCH-30.1 MCHC-34.5 RDW-14.1 Plt Ct-259 [**2133-6-5**] 10:40PM BLOOD WBC-12.0* RBC-4.80 Hgb-14.4 Hct-41.8 MCV-87 MCH-29.9 MCHC-34.4 RDW-14.1 Plt Ct-235 [**2133-6-6**] 07:00AM BLOOD Neuts-89.4* Lymphs-7.0* Monos-3.1 Eos-0.2 Baso-0.4 [**2133-6-5**] 10:40PM BLOOD Neuts-90.5* Lymphs-6.5* Monos-2.2 Eos-0.4 Baso-0.3 [**2133-6-14**] 02:08AM BLOOD Plt Ct-249 [**2133-6-13**] 03:10AM BLOOD Plt Ct-256 [**2133-6-12**] 01:53AM BLOOD Plt Ct-253 [**2133-6-11**] 02:05AM BLOOD Plt Ct-260 [**2133-6-10**] 01:50AM BLOOD Plt Ct-236 [**2133-6-9**] 02:47AM BLOOD Plt Ct-214 [**2133-6-8**] 12:22AM BLOOD Plt Ct-259 [**2133-6-7**] 01:50AM BLOOD Plt Ct-235 [**2133-6-6**] 07:00AM BLOOD Plt Ct-259 [**2133-6-6**] 07:00AM BLOOD PT-13.9* PTT-22.4 INR(PT)-1.2* [**2133-6-5**] 10:40PM BLOOD Plt Ct-235 [**2133-6-5**] 10:40PM BLOOD PT-13.7* PTT-21.9* INR(PT)-1.2* [**2133-6-15**] 09:30AM BLOOD Glucose-170* UreaN-30* Creat-1.3* Na-143 K-3.7 Cl-103 HCO3-30 AnGap-14 [**2133-6-14**] 02:08AM BLOOD Glucose-128* UreaN-30* Creat-1.2* Na-143 K-4.0 Cl-104 HCO3-30 AnGap-13 [**2133-6-13**] 03:10AM BLOOD Glucose-115* UreaN-26* Creat-1.0 Na-144 K-3.4 Cl-106 HCO3-27 AnGap-14 [**2133-6-12**] 01:53AM BLOOD Glucose-128* UreaN-27* Creat-0.9 Na-145 K-4.2 Cl-110* HCO3-27 AnGap-12 [**2133-6-11**] 02:05AM BLOOD Glucose-137* UreaN-26* Creat-1.0 Na-148* K-3.9 Cl-111* HCO3-29 AnGap-12 [**2133-6-10**] 01:50AM BLOOD Glucose-144* UreaN-30* Creat-1.0 Na-150* K-3.5 Cl-111* HCO3-32 AnGap-11 [**2133-6-8**] 12:22AM BLOOD Glucose-143* UreaN-20 Creat-0.9 Na-145 K-3.9 Cl-109* HCO3-28 AnGap-12 [**2133-6-7**] 01:50AM BLOOD Glucose-135* UreaN-23* Creat-1.1 Na-143 K-4.0 Cl-107 HCO3-28 AnGap-12 [**2133-6-6**] 07:00AM BLOOD Glucose-160* UreaN-20 Creat-1.1 Na-144 K-4.1 Cl-104 HCO3-29 AnGap-15 [**2133-6-5**] 10:40PM BLOOD Glucose-185* UreaN-18 Creat-1.0 Na-144 K-3.7 Cl-105 HCO3-29 AnGap-14 [**2133-6-11**] 02:05AM BLOOD ALT-14 AST-15 LD(LDH)-244 AlkPhos-39 TotBili-2.5* [**2133-6-10**] 01:50AM BLOOD ALT-17 AST-18 LD(LDH)-254* AlkPhos-45 TotBili-3.8* [**2133-6-8**] 08:00PM BLOOD ALT-18 AST-16 LD(LDH)-303* AlkPhos-52 Amylase-15 TotBili-4.2* DirBili-0.5* IndBili-3.7 [**2133-6-6**] 05:59PM BLOOD CK(CPK)-134 [**2133-6-6**] 07:00AM BLOOD ALT-32 AST-21 CK(CPK)-176* AlkPhos-60 TotBili-1.6* [**2133-6-5**] 10:40PM BLOOD ALT-37 AST-26 TotBili-1.7* [**2133-6-8**] 08:00PM BLOOD Lipase-16 [**2133-6-6**] 07:00AM BLOOD CK-MB-5 cTropnT-<0.01 [**2133-6-5**] 10:40PM BLOOD cTropnT-0.01 [**2133-6-6**] 05:59PM BLOOD CK-MB-5 [**2133-6-5**] 10:40PM BLOOD CK-MB-6 [**2133-6-15**] 09:30AM BLOOD Calcium-9.5 Phos-3.7 Mg-2.1 [**2133-6-14**] 02:08AM BLOOD Calcium-9.5 Phos-4.6* Mg-2.1 [**2133-6-13**] 03:10AM BLOOD Calcium-9.2 Phos-4.4 Mg-2.1 [**2133-6-12**] 01:53AM BLOOD Calcium-8.7 Phos-4.2 Mg-2.2 [**2133-6-11**] 02:05AM BLOOD Calcium-8.7 Phos-3.6 Mg-2.2 [**2133-6-10**] 01:50AM BLOOD Calcium-9.0 Phos-3.4 Mg-2.3 [**2133-6-9**] 02:47AM BLOOD Calcium-9.7 Phos-3.8 Mg-2.4 [**2133-6-8**] 12:22AM BLOOD Calcium-9.3 Phos-3.2 Mg-2.2 [**2133-6-7**] 01:50AM BLOOD Calcium-9.3 Phos-4.1 Mg-2.2 Cholest-219* [**2133-6-6**] 07:00AM BLOOD Calcium-9.4 Phos-4.8* Mg-2.0 Cholest-225* [**2133-6-5**] 10:40PM BLOOD Calcium-9.3 [**2133-6-7**] 02:25AM BLOOD %HbA1c-5.6 [**2133-6-7**] 01:50AM BLOOD Triglyc-127 HDL-43 CHOL/HD-5.1 LDLcalc-151* [**2133-6-6**] 07:00AM BLOOD Triglyc-75 HDL-53 CHOL/HD-4.2 LDLcalc-157* [**2133-6-8**] 12:22AM BLOOD TSH-0.86 [**2133-6-7**] 01:50AM BLOOD TSH-0.98 [**2133-6-6**] 07:00AM BLOOD TSH-1.3 [**2133-6-11**] 06:28AM BLOOD Vanco-19.9 [**2133-6-10**] 06:19AM BLOOD Vanco-17.0 [**2133-6-6**] 07:00AM BLOOD ASA-NEG Ethanol-NEG Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG [**2133-6-14**] 05:39AM BLOOD Type-ART pO2-114* pCO2-49* pH-7.43 calTCO2-34* Base XS-7 [**2133-6-13**] 03:10AM BLOOD Type-ART pO2-113* pCO2-43 pH-7.46* calTCO2-32* Base XS-6 [**2133-6-12**] 02:38AM BLOOD Type-ART pO2-121* pCO2-44 pH-7.44 calTCO2-31* Base XS-5 [**2133-6-11**] 02:22AM BLOOD Type-ART pO2-98 pCO2-44 pH-7.49* calTCO2-34* Base XS-9 [**2133-6-10**] 02:06AM BLOOD Type-ART pO2-88 pCO2-51* pH-7.43 calTCO2-35* Base XS-7 [**2133-6-9**] 03:10AM BLOOD Type-ART Temp-35.9 PEEP-5 FiO2-40 pO2-91 pCO2-51* pH-7.44 calTCO2-36* Base XS-8 Intubat-INTUBATED Vent-SPONTANEOU [**2133-6-8**] 07:46PM BLOOD Type-ART Temp-38.3 PEEP-5 pO2-105 pCO2-48* pH-7.41 calTCO2-31* Base XS-4 Intubat-INTUBATED Vent-SPONTANEOU [**2133-6-8**] 04:54PM BLOOD Type-ART Temp-38.3 PEEP-5 pO2-99 pCO2-48* pH-7.41 calTCO2-31* Base XS-4 Intubat-INTUBATED Vent-SPONTANEOU [**2133-6-8**] 12:45AM BLOOD Type-ART Temp-37.6 pO2-115* pCO2-46* pH-7.39 calTCO2-29 Base XS-2 [**2133-6-9**] 03:10AM BLOOD Lactate-0.9 K-4.2 [**2133-6-8**] 04:54PM BLOOD Lactate-1.1 K-3.5 [**2133-6-8**] 12:45AM BLOOD Lactate-1.0 [**2133-6-12**] 02:38AM BLOOD O2 Sat-98 [**2133-6-11**] 02:22AM BLOOD O2 Sat-96 [**2133-6-10**] 02:06AM BLOOD O2 Sat-97 [**2133-6-13**] 03:10AM BLOOD freeCa-1.17 [**2133-6-11**] 02:22AM BLOOD freeCa-1.19 [**2133-6-10**] 02:06AM BLOOD freeCa-1.17 [**2133-6-9**] 03:10AM BLOOD freeCa-1.22 [**2133-6-8**] 07:46PM BLOOD freeCa-1.11* [**2133-6-8**] 12:45AM BLOOD freeCa-1.22 Brief Hospital Course: This 55 yo F was admitted with a right brainstem bleed, thought to be secondary to extreme hypertension. No AVM or cavernoma was appreciated on MRI/MRA. Pt was initially treated in the ICU, where she developed a LLL PNA, treated with Augmentin and Flagyl. She also developed jaundice to propofol and was sedated instead with versed. She initally failed swallow eval and had an NG tube which remained until [**2133-6-15**] when she pulled it out, however, susbequent repeat swallow eval suggested she could tolerate oral nutrition. Pt's BP originally controlled with labetalol gtt, but then placed on oral regimen of labetalol, lisinopril, and HCTZ. Systolic BP's are running 130-180, and titration of her BP meds is ongoing. Symptomatically, she showed significant improvement, becoming drowsy with improved HA and nausea. Eye movements continued to improve, although on discharge she still has some dysconjugate gaze, giving her what appears as a partial one-and-a-half syndrome. Her vertigo is also significantly improved, however, she still experiences dizziness on standing and has trouble taking more than a few steps without feeling like she is going to fall. She is continuing to work with PT/OT, and was discharged to rehab facility on [**2133-6-19**] Medications on Admission: ASA prn HA Discharge Medications: 1. Polyvinyl Alcohol-Povidone 1.4-0.6 % Dropperette Sig: [**11-26**] Drops Ophthalmic PRN (as needed). 2. Hydrochlorothiazide 12.5 mg Capsule Sig: One (1) Capsule PO DAILY (Daily). 3. Famotidine 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 4. Amoxicillin-Pot Clavulanate 500-125 mg Tablet Sig: One (1) Tablet PO TID (3 times a day) for 1 weeks: last dose [**2133-6-21**]. 5. Metronidazole 500 mg Tablet Sig: One (1) Tablet PO TID (3 times a day) for 1 weeks: last dose [**2133-6-21**]. 6. Labetalol 100 mg Tablet Sig: 1.5 Tablets PO TID (3 times a day). 7. Ondansetron HCl (PF) 4 mg/2 mL Solution Sig: Four (4) mg Injection Q8H (every 8 hours) as needed. 8. Metoprolol Tartrate 5 mg/5 mL Solution Sig: Ten (10) mg Intravenous Q6H (every 6 hours) as needed for SBP>180. 9. Hydralazine 20 mg/mL Solution Sig: Ten (10) mg Injection Q4H (every 4 hours) as needed for SBP > 160. 10. Atorvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 11. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed: prn pain or fever. 12. Lisinopril 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Discharge Disposition: Extended Care Facility: [**Hospital **] Medical Center - [**Hospital1 3597**] Discharge Diagnosis: pontine hemorrhage hypertension Discharge Condition: stable Discharge Instructions: You have had a stroke in your brainstem. We think that this was most likely secondary to uncontrolled hypertension so controlling your blood pressure is going to be very important. You may also need to have repeat imaging of your brain in the future to ensure that there is not a cavernous angioma underlying the bleed. Follow up with your appointments as below. Followup Instructions: Neurologist: [**Name6 (MD) **] [**Name8 (MD) **], M.D. Phone:[**Telephone/Fax (1) 2574**] Date/Time:[**2133-7-21**] 1:30 [**Hospital1 18**] [**Hospital Ward Name 516**] [**Hospital Ward Name 23**] [**Location (un) **] Please call ([**Telephone/Fax (1) 1300**] to get a PCP at [**Hospital 18**] [**Hospital **], unless you would like to get a PCP [**Name Initial (PRE) 79638**]. This will be extremely important in managing your blood pressure. [**First Name8 (NamePattern2) **] [**Name8 (MD) 162**] MD [**MD Number(2) 2575**] Completed by:[**2133-6-19**] ICD9 Codes: 431, 486, 2760, 5070
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6040 }
Medical Text: Admission Date: [**2152-10-13**] Discharge Date: [**2152-10-22**] Date of Birth: [**2110-1-16**] Sex: M Service: PLASTIC Allergies: Amphotericin B / Ambisome / Campath Attending:[**First Name3 (LF) 5667**] Chief Complaint: Right facial wound and cervicofacial sarcoma. Major Surgical or Invasive Procedure: 1. Right anterolateral free flap to right face using the right facial artery and common facial vein. 2. Repair of orocutaneous fistula. 3. Split thickness skin graft 14 x 20 cm at 0.014 inch. 4. Closure of extensive cervicofacial defect which included exposed zygoma, exposed maxillary bone, exposed lateral portion of the frontal bone. History of Present Illness: The patient is a 42-year-old male who is a patient of Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 1837**] with a history of total body irradiation as well as graft versus host disease following bone marrow transplant several years ago. The patient then had subsequently developed lesion of the right facial region as well as the left cheek area that was biopsied approximately 1 week ago. He was seen in the operating room at [**Location (un) 37217**] originally for assessment of the wound. The lesion was fully excised and margins were sent off and a bolster dressing was placed. He presents to the office for changes of the dressing and removal of the bolster and preoperative planning. Past Medical History: #. MUD allo BMT [**10-8**] for CML, c/b GVHD, chronic thrombocytopenia, anemia, Donor Info: donor #[**Numeric Identifier 37214**] Sex: female, Age: 37, # of pregnancies: 4, ABO donor: Apos, ABO recipient: Apos, CMV donor: (+), CMV recipient:(+) #. GVHD--symptoms have included severe skin findings, thrombocytopenia requiring transfusions, bronchiolitis obliterans and mouth sores. treatment options are limited, since the patient has also had HUS to calcineurin inhibitors such as cyclosporine, FK 506, no response to rapamycin, has had multiple trials of Rituxan as well as trial of endostatin all without signficant improvement. #. BOOP due to GVHD. He unfortunately has had multiple prior therapies including Rituxan, pentostatin, Campath, steroids, and CellCept. He has had a significant issue as in the past with cyclosporin and FK-506. The patient had a repeat chest CT in [**2150-12-8**] to reassess his lung disease. There were no significant changes in the few opacities that may represent underlying BOOP since his last scan several months ago. #. RSV pneumonitis #. HTN #. CRI #. portacath in place #. chronic right extremity edema #. episodic spasm of mouth muscles, unclear etiology. #. Obstructive airways disease, possibly due to GVDH. Social History: no EtOH, tobacco, drugs Family History: Non-contributory Physical Exam: AOx3 Facial wound: The wound measures at least 17 cm in greatest dimension by another 15 cm which includes the entire right side of his face. His zygomatic arch is exposed and the anterior maxillary wall is exposed. There are elements of parotid gland that are also exposed. There is no salivary fistula intraorally that is noted. He has cutaneous changes over his entire body from the graft versus host disease. Pertinent Results: [**2152-10-13**] 01:47PM BLOOD WBC-7.9 RBC-2.48* Hgb-8.7* Hct-25.9* MCV-104* MCH-35.2* MCHC-33.7 RDW-16.0* Plt Ct-378 [**2152-10-18**] 03:12AM BLOOD WBC-7.9 RBC-2.33* Hgb-7.9* Hct-23.6* MCV-101* MCH-33.8* MCHC-33.4 RDW-17.2* Plt Ct-250 [**2152-10-13**] 01:47PM BLOOD Plt Ct-378 [**2152-10-13**] 09:40PM BLOOD PT-11.3 PTT-23.3 INR(PT)-1.0 [**2152-10-17**] 01:46AM BLOOD PT-11.2 PTT-25.4 INR(PT)-0.9 [**2152-10-18**] 03:12AM BLOOD Plt Ct-250 [**2152-10-13**] 09:40PM BLOOD Glucose-114* UreaN-15 Creat-1.0 Na-139 K-4.9 Cl-107 HCO3-27 AnGap-10 [**2152-10-18**] 03:12AM BLOOD Glucose-94 UreaN-20 Creat-1.0 Na-141 K-4.4 Cl-108 HCO3-24 AnGap-13 [**2152-10-13**] 09:40PM BLOOD Calcium-9.0 Phos-3.0 Mg-2.1 [**2152-10-18**] 03:12AM BLOOD Calcium-8.8 Phos-3.8 Mg-2.6 [**2152-10-13**] 06:50PM BLOOD Type-ART Temp-36.6 Rates-/8 Tidal V-600 FiO2-40 pO2-176* pCO2-43 pH-7.44 calTCO2-30 Base XS-5 Intubat-INTUBATED Vent-CONTROLLED [**2152-10-14**] 03:30AM BLOOD Type-ART Tidal V-550 pO2-186* pCO2-45 pH-7.40 calTCO2-29 Base XS-2 -ASSIST/CON Intubat-INTUBATED [**2152-10-16**] 06:05AM BLOOD Type-ART pO2-178* pCO2-40 pH-7.43 calTCO2-27 Base XS-2 [**2152-10-17**] 09:25AM BLOOD Type-ART pO2-86 pCO2-36 pH-7.50* calTCO2-29 Base XS-4 [**2152-10-13**] 06:50PM BLOOD Glucose-81 Na-137 K-4.3 [**2152-10-13**] 06:50PM BLOOD Hgb-10.1* calcHCT-30 [**2152-10-13**] 06:50PM BLOOD freeCa-1.16 [**2152-10-17**] 01:54AM BLOOD freeCa-1.18 Brief Hospital Course: Pt. admitted and operation proceded with. Flap applied to face from R ant. thigh, R ant. thigh covered with STSG from L ant. thigh. Please see detailed Op Note for full details of this operation. Pt. in PACU for frequent flap checks for first 24hr post-procedure. Initial low UOP responded promptly to a 500cc bolus. Pt.'s intubation continued, and pt. remained sedated and ventilated due to tenuous nature of flap and prominent facial edema. Pt. transferred to ICU for further care/ventilation/q2hr flap checks without incident. Pt. remained hemodynamically stable with excellent dop tones in the flap throughout this period. An NG tube was placed and tube feeds were slowly advanced during this time, begining on [**10-15**]. L thigh donor site was open to air beginning on [**10-16**]. Nutrition was consulted and provided excellent assisstance with tube feeding recs. Pt. extubated without incident on [**10-16**]. Tube feeds were slowly increased and eventually moved to bolus feeds. Facial/flap edema slowly decreased and one drain was removed. PT saw the patient and assissted with post-discharge care. Pt. came out to floor on [**10-18**]. The Vac was taken off the R ant. thigh and the STSG was observed to have good take. NGT was removed and the patient advanced to full liquids. At some point the pt. had transient dysuria, a U/A was done and was clean, and his symptoms resolved. When the patient was D/C'd his pain was well controlled, he was tolerating PO well, and was able to ambulate and void on his own. Medications on Admission: acyclovir Prednisone 5 metoprolol Folic Acid Discharge Medications: 1. Acetaminophen 325 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for fever. 2. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 3. Polyvinyl Alcohol-Povidone 1.4-0.6 % Dropperette Sig: [**2-8**] Drops Ophthalmic PRN (as needed). 4. Prednisone 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Bacitracin Zinc 500 unit/g Ointment Sig: One (1) Appl Topical [**Hospital1 **] (2 times a day). 6. Famotidine 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 7. Metoprolol Succinate 25 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO DAILY (Daily). 8. Oxycodone-Acetaminophen 5-325 mg/5 mL Solution Sig: 5-10 MLs PO Q4H (every 4 hours) as needed for pain. Disp:*250 ML(s)* Refills:*1* 9. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO twice a day. Disp:*60 Capsule(s)* Refills:*2* 10. Amoxicillin-Pot Clavulanate 875-125 mg Tablet Sig: One (1) Tablet PO twice a day for 10 days. Disp:*20 Tablet(s)* Refills:*0* 11. Acyclovir 200 mg Capsule Sig: One (1) Capsule PO Q8H (every 8 hours) for 10 days. Disp:*30 Capsule(s)* Refills:*0* 12. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 13. Ferrous Sulfate 325 (65) mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Discharge Disposition: Home Discharge Diagnosis: Cervicofacial sarcoma of the right face. Discharge Condition: good Discharge Instructions: Please return to the hospital if you experience fevers greater then 101.4, chills, or other signs of infection. Also return to the hospital if you experience chest pain, shortness of breath, redness, swelling, or purulent discharge from the incision site. Return if you experience worsening pain or any other concerning symptoms. Certain pain medications may have side effects such as drowsiness. Do not operate heavy machinery while on these medications. Certain pain medications such as percocet or codeine can cause constipation. If needed you can take a stool softner such as Colace (one capsule) or gentle laxative (such as Milk of Magnesia) once per day. Restart taking all your regular medications once you arrive at home. -Please do not shower until your follow-up visit. . Please do not place any pressure on your face, especially the surgical site. Please keep track of JP drain output for your follow-up visit. Please continue to take antibiotics until your drains are out. If you run out of antibiotics before your drains are removed, please call us immediately to get a refill. . Please resume previous medications as prior to your surgery. Please take pain medications and stool softener as prescribed. . Please follow-up as directed. Followup Instructions: F/u with Dr. [**First Name (STitle) **] as directed, please call monday for an appointment. ICD9 Codes: 5859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6041 }
Medical Text: Admission Date: [**2123-5-17**] Discharge Date: [**2123-5-18**] Date of Birth: [**2123-5-11**] Sex: M Service: Neonatology HISTORY: [**Known lastname **] [**Known lastname **] is a former 35-6/7 week male infant who is six days old with hyperbilirubinemia. He was delivered on [**5-11**] by C section with Apgars of 8 and 9. Mother's prenatal course was significant for cerclage at 28 weeks of gestation, history of chronic hypertension, and borderline preeclampsia. Per report, mother's prenatal screens were negative, blood type B+. [**Known lastname 43967**] birth weight was 2705 grams and his newborn nursery course was benign. His bilirubin on [**5-14**] was 12 at which time he was discharged to home on the following day. At home, he has been doing well. Has been receiving breast milk every three hours, taking 2 ounces at each feeding. He has been voiding well and stooling multiple times per day. No change in his activity. [**Known lastname **] was seen in the Pedi office on the day of admission. Given clinical symptoms of jaundice, the bilirubin level was sent revealing a level of 19.2 (by heel stick), and subsequently referred to [**Hospital1 69**] for admission and management of hyperbilirubinemia. PHYSICAL EXAMINATION: Current weight is 2590 grams. Anterior fontanel is open and flat, well appearing. Normal S1, S2, no murmurs. Breath sounds clear. Abdomen was soft, nontender, nondistended. Extremities: Warm and well perfused. Tone appropriate for gestation age. Testes descended bilaterally. Circumcision site healing well. HOSPITAL COURSE BY SYSTEMS: Respiratory: [**Known lastname **] remained on room air with one episode of choking with feeds. No other issues. Cardiovascular: [**Known lastname **] had remained hemodynamically stable during this admission. FEN: [**Known lastname **] has maintained a minimum of 150 cc/kg/day po feeding, tolerating breast milk well. His weight on discharge was 2590 grams. GI: Given the initial bilirubin level in the pediatrician's office was done by heel sticks, a bilirubin level was resent upon admission which was 17.6 by venipuncture. [**Known lastname **] was started on triple phototherapy with subsequent lowering of the bilirubin level to 15.9 at which time phototherapy was decreased to double. The next morning [**Known lastname 43967**] bilirubin level was 13.5 at which time phototherapy was discontinued. Given the resolution of hyperbilirubinemia, [**Known lastname **] is to be discharged home with a followup rebound bilirubin to be drawn in the pediatrician's office the next morning. Hematology: [**Known lastname **] was ruled out for infection with a benign complete blood count with a white count of 11.3 thousand with 33 polys and 0 bands. No antibiotics was started. Baby's admission hematocrit was 58.6% with a retic of 1.5%. Therefore it was felt that it was unlikely that hemolysis was the cause of his hyperbilirubinemia. CONDITION ON DISCHARGE: [**Known lastname 43967**] hyperbilirubinemia has resolved with bilirubin on the morning of discharge of 13.5. He has been taking po well and stooling well. DISCHARGE/DISPOSITION: [**Known lastname **] is to go home with parents. NAME OF PRIMARY PEDIATRICIAN: Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 52069**], telephone #[**Telephone/Fax (1) 37875**]. CARE AND RECOMMENDATIONS: Feeds at discharge breast milk po adlib. MEDICATIONS: None. FOLLOW-UP APPOINTMENT: Dr. [**Last Name (STitle) 52069**] tomorrow morning for a rebound bilirubin level. DISCHARGE DIAGNOSIS: Hyperbilirubinemia. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 37237**], M.D. [**MD Number(1) 37238**] Dictated By:[**Name8 (MD) 47839**] MEDQUIST36 D: [**2123-5-18**] 14:00 T: [**2123-5-18**] 14:13 JOB#: [**Job Number 52070**] ICD9 Codes: 7742
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Medical Text: Admission Date: [**2173-12-15**] Discharge Date: [**2173-12-18**] Date of Birth: [**2111-12-29**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1505**] Chief Complaint: Bilateral shoulder and arm pain Major Surgical or Invasive Procedure: cabg x4 [**2173-12-15**] (LIMA to LAD, SVG to DIAG, SVG to OM, SVG to PDA) History of Present Illness: 61 yo male with recent pain as above and + ETT.Carotid US showed an occluded [**Country **] and 70-79% [**Doctor First Name 3098**] stenosis. Left carotid stent placed [**12-9**]. Cath. revealed severe 3VD. Referred for CABG. Past Medical History: CAD: -BMS to LCx, DES to 1st diagonal in [**12-16**] -3 vessel disease on cath on [**12-6**]--99% mid RCA, 85% prox LAD, 80% OM1 severe carotid disease s/[**Initials (NamePattern4) **] [**Last Name (NamePattern4) 3098**] stent CVA '[**68**] HTN HPLD BPH B/l inguinal herniorraphies Basal Cell Cancer s/p resection Lumbar radiculopathy Social History: Married, 2 children. Works in construction. Denies drugs. Quit smoking 15 years ago Drinks 1 glass of wine per day Family History: CAD-Father, MI [**45**] years old Physical Exam: at discharge: VS:99.4TEMP 140/80BP 88HR SR 20RR Gen: NAD, appears stated age Lungs:CTA B/L CV:RRR, no murmurs, clicks, or rubs Abd:distended, non-tender, decreased bowel sounds, positive bowel movements Ext:trace edema LE Incision:C/D/I, no erythema, sternum stable Pertinent Results: Conclusions The left atrium is normal in size. Left ventricular wall thicknesses and cavity size are normal. Right ventricular chamber size and free wall motion are normal. The ascending, transverse and descending thoracic aorta are normal in diameter and free of atherosclerotic plaque to 22 cm from the incisors. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. The mitral valve leaflets are structurally normal. There is no pericardial effusion. Post Bypass Preserved LV function with EF of 65% I certify that I was present for this procedure in compliance with HCFA regulations. Interpretation assigned to [**Name6 (MD) 15425**] [**Name8 (MD) 15426**], MD, Interpreting physician CXR: [**Known lastname 80109**],[**Known firstname **] J [**Medical Record Number 80110**] M 61 [**2111-12-29**] Radiology Report CHEST (PA & LAT) Study Date of [**2173-12-20**] 8:39 AM [**Last Name (LF) **],[**First Name3 (LF) **] R. CSURG FA6A [**2173-12-20**] SCHED CHEST (PA & LAT) Clip # [**Clip Number (Radiology) 80111**] Reason: f/u atx, effusion [**Hospital 93**] MEDICAL CONDITION: 61 year old man with s/p cabg REASON FOR THIS EXAMINATION: f/u atx, effusion Provisional Findings Impression: JMGw MON [**2173-12-20**] 10:48 AM Small bilateral pleural effusions. Improving bilateral basilar atelectasis. Less bowel dilatation. Final Report PA LATERAL CHEST RADIOGRAPH HISTORY: 61-year-old man status post CABG. Evaluate for pneumothorax or effusion. COMPARISON: Chest radiograph from [**2173-12-17**], [**2173-12-15**] and [**2173-12-6**]. FINDINGS: There is stable cardiomegaly. The aorta is tortuous but stable in appearance and the hilar and mediastinal contours are unchanged in appearance. Patient is status post median sternotomy and CABG. Sternotomy cerclage wires are stable in appearance. There are small bilateral pleural effusions. There is improved bilateral basilar atelectasis. There is less bowel dilatation compared to [**2173-12-17**]. There is no pneumothorax. IMPRESSION: 1. Small bilateral pleural effusions. Improving bilateral basilar atelectasis. 2. No pneumothorax. 3. Less bowel dilatation. The study and the report were reviewed by the staff radiologist. DR. [**First Name (STitle) 13879**] [**Name (STitle) 13880**] DR. [**First Name8 (NamePattern2) 1569**] [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 11006**] Approved: MON [**2173-12-20**] 11:40 AM Imaging Lab [**2173-12-20**] 05:50AM BLOOD Plt Ct-283 [**2173-12-20**] 05:50AM BLOOD Glucose-143* UreaN-35* Creat-0.9 Na-142 K-3.6 Cl-107 HCO3-30 AnGap-9 [**2173-12-18**] 07:05AM BLOOD ALT-15 AST-18 LD(LDH)-312* AlkPhos-82 Amylase-23 TotBili-0.5 [**2173-12-20**] 05:50AM BLOOD Mg-2.3 Brief Hospital Course: Admitted [**12-15**] and underwent coronary artery bypass surgery with Dr. [**Last Name (STitle) **]. Please see operative note for further details. Transferred to the CVICU in stable condition on titrated propofol and phenylephrine drips. Extubated later that day. Transferred to the floor on POD #1 to begin increasin his activity level. Gently diuresed toward his preop weight. Chest tubes and pacing wires were discontinued without complication. On POD 3 the patient was noted to have significant abdominal distention. KUB revealed evidence of colonic ileus, including air-fluid levels. Nasogastric tube was placed in an effort to decompress the GI tract. GI and general surgery services were consulted. C-diff toxin was sent and returned negative. The patient remained afebrile with a normal white blood cell count. Rectal tube was placed, and eventually ileus resolved. Additionally, the patient went into atrial fibrillation, briefly, on POD 4. He received a fluid bolus, amiodarone, and his beta blocker was increased. He returned to sinus rhythm shortly thereafter, and would remain in sinus rhythm throughout the hospital course. The physical therapy service was consulted for assistance with strength and mobility. The patient made excellent progress and was discharged home on POD 6. Medications on Admission: lisinopril 10 mg daily flomax 0.4 mg daily plavix 75 mg daily atenolol 50 mg daily lipitor 80 mg daily isosorbide 60 mg daily finasteride 5 mg daily ASA 81 mg daily loratidine 10 mg 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. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 4. Tamsulosin 0.4 mg Capsule, Sust. Release 24 hr Sig: One (1) Capsule, Sust. Release 24 hr PO HS (at bedtime). Disp:*30 Capsule, Sust. Release 24 hr(s)* Refills:*0* 5. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 6. Tramadol 50 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed. Disp:*60 Tablet(s)* Refills:*0* 7. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4 hours) as needed. Disp:*60 Tablet(s)* Refills:*0* 8. Finasteride 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 9. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* 10. Metoprolol Tartrate 100 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). Disp:*90 Tablet(s)* Refills:*0* 11. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO HS (at bedtime) as needed for constipation. Disp:*10 ML(s)* Refills:*0* 12. Furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day for 5 days. Disp:*5 Tablet(s)* Refills:*0* 13. 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: Community VNA, [**Location (un) 8545**] Discharge Diagnosis: CAD s/p BMS to CX, DES to diag 1 ; s/p cabg x4 HTN carotid stenoses s/p left carotid stent s/p CVA 5 years ago lumbar radiculopathy basal cell CA s/p resection forehead and back BPH Discharge Condition: good Discharge Instructions: no lotions, creams or powders on any incision shower daily and pat incisions dry call for fever greater than 100.5, redness or drainage call for weight gain greater than 2 pounds in one day , or 5 pounds in a week no lifting greater than 10 pounds for 10 weeks no driving for one month and until off all narcotics for pain Followup Instructions: see Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] in [**2-10**] weeks. [**Telephone/Fax (1) 28095**] see Dr. [**Last Name (STitle) **] [**Last Name (STitle) **] [**3-14**] weeks see Dr. [**Last Name (STitle) **] in 4 weeks [**Telephone/Fax (1) 170**] please call for all appts. Completed by:[**2173-12-21**] ICD9 Codes: 4019, 2724, 4439
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Medical Text: Admission Date: [**2178-4-5**] Discharge Date: [**2178-4-7**] Date of Birth: [**2117-12-24**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 30**] Chief Complaint: Melena Major Surgical or Invasive Procedure: EGD History of Present Illness: 60 yo F PMH of DM, HTN, fibroid s/p TAH who p/w symptomatic anemia (weakness, SOB) and black tarry stools since last Wednesday. She was her PCP today for the weakness and hct there was 21 so she was referred to the ED. She has no prior h/o GIB and had a colonoscopy [**2-/2178**] which showed only a polyp, no diverticulosis. She does report that she has intermittently has had dark stools. Never had an EGD. Baseline hct in [**2177-11-11**] was 47. Takes ASA 81mg, no other NSAIDS or anticoac meds. In the ED, initial vs were 98.4 105 144/82 28 98. NG lavage negative for coffee grounds or active bleeding. Patient was given 2L IVF and 2 units RBC and GI was consulted who recommended ICU admission given dramatic drop in hct 47--->21. She remained HD stable. EKG with sinus tach to low 100's without ischemic change. No PPI given. VS prior to transfer: BP 147/65, HR 104, Pox 98RA, RR 16. Past Medical History: DM HTN Obesity Fibroid s/p TAH Social History: Works as SW at the [**Hospital1 **]. Lives with daughter and 2 grandchildren - Tobacco: none - Alcohol: 3 glasses red wine/week - Illicits: none Family History: DM and HTN Physical Exam: Vitals T: 99.3 HR: 100 BP: 128/70 RR: 16 O2: 98%RA General: NAD, sitting comfortably straight up in bed. HEENT: Normocephalic, atraumatic, sclera anicteric, trachea midline and no lymphadenopathy appreciated. Pulm: CTAB CV: RRR, S1S2, no m/r/g Abd: Obese, soft, +BS, NT/ND, no guarding, no rebound Extrem: + DP pulses b/l, no edema Neuro: A+O x 3 Pertinent Results: [**2178-4-5**] 05:00PM BLOOD WBC-11.8* RBC-2.42* Hgb-7.2* Hct-21.6* MCV-89 MCH-29.8 MCHC-33.4 RDW-17.1* Plt Ct-307 [**2178-4-5**] 11:35PM BLOOD Hct-26.0* [**2178-4-6**] 04:16AM BLOOD WBC-9.6 RBC-3.10*# Hgb-9.3*# Hct-27.4* MCV-89 MCH-30.0 MCHC-34.0 RDW-16.3* Plt Ct-256 [**2178-4-6**] 11:19AM BLOOD Hct-30.3* [**2178-4-7**] 06:44AM BLOOD WBC-9.0 RBC-3.70* Hgb-11.1* Hct-33.4* MCV-90 MCH-30.0 MCHC-33.3 RDW-17.4* Plt Ct-269 [**2178-4-6**] 04:16AM BLOOD PT-12.6 PTT-19.4* INR(PT)-1.1 [**2178-4-5**] 05:00PM BLOOD Glucose-194* UreaN-5* Creat-0.5 Na-138 K-3.6 Cl-99 HCO3-29 AnGap-14 [**2178-4-6**] 11:19AM BLOOD Glucose-189* UreaN-4* Creat-0.5 Na-142 K-3.7 Cl-104 HCO3-29 AnGap-13 [**2178-4-5**] 05:00PM BLOOD ALT-24 AST-24 LD(LDH)-167 CK(CPK)-85 AlkPhos-51 TotBili-0.2 EGD: antral gastritis, non-bleeding 0.5cm gastric ulcer, and a 0.5cm duodenal ulcer. Brief Hospital Course: Ms. [**Known lastname 99210**] is a 60 yo F with a PMH of DM, HTN, fibroids s/p TAH who p/w symptomatic anemia (weakness, SOB) and black tarry stools since last Wednesday. She was seen by her PCP today for the weakness and hct there was found to be 21 down from 47 on [**11-19**] so she was referred to the ED. . # GI Bleed: The patient received 3U of PRBCs and was started on IV PPI [**Hospital1 **] in the ED. Despite a negative NG lavage there, the patients bleeding was postulated to be of an upper source given that she had melenic stools and a recent clean colonoscopy. On the morning following admission to the MICU, EGD was performed and two small ulcers one in the gastric antrum and the other in duodenal bulb were found. Neither with active bleeding. Hematocrit was stable post-transfusion. H. pylori serologies were sent and the patient was transitioned to po PPI [**Hospital1 **] prior to transfer to the floor. On the floor, hematocrit remained stable and she had no further episodes of bleeding. Hematocrit was 33 on the day of discharge. Gastroenterology recommended an outpatient capsule study to further evaluate potential other sources of bleeding. The H. Pylori serology was still pending at the time of discharge and will be followed up as an outpatient. Patient will continue on PO BID PPI as outpatient per GI recommendations. . # DM: PO anti-hyperglycemic medications were held and the patient was covered with SSI while in house. Patient will resume PO glycemic medications once discharged. . # HTN: Antihypertensives were held in the hospital and will be re-started upon discharge. Patient instructed to stop aspirin secondary to GI bleed. Medications on Admission: Metformin 1000mg [**Hospital1 **] ASA 81mg qd Glyburide 5mg [**Hospital1 **] Lasix 10mg qd Atenolol 50mg [**Hospital1 **] Enalapril 10mg [**Hospital1 **] Amlodipine 10mg qd MVI 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. Metformin 1,000 mg Tablet Sig: One (1) Tablet PO twice a day. 3. Glyburide 5 mg Tablet Sig: One (1) Tablet PO twice a day. 4. Lasix 20 mg Tablet Sig: [**12-13**] Tablet PO once a day. 5. Atenolol 50 mg Tablet Sig: One (1) Tablet PO twice a day. 6. Enalapril Maleate 10 mg Tablet Sig: One (1) Tablet PO twice a day. 7. Amlodipine 10 mg Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Home Discharge Diagnosis: GI Bleed 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 symptomatic anemia which was felt to be coming from your gastrointestinal tract. Given that you were symptomatic from the anemia, you received a blood transfusion to increase your red blood cell count. You had an upper endoscopy by the Gastroenterologist. They saw two small ulcers, one in the stomach and one in the beginning part of the small intestine. They were not bleeding and no intervention was required. You were started on an antacid and your blood was checked for H. Pylori which is a bacteria which can cause ulcerations. Your blood count was checked and found to be stable and you had no further bleeding. You should continue the antacid twice daily as directed and you should follow-up with your PCP following discharge. The gastroenterologist recommend that you get an outpatient capsule study to get a better look at your entire gastrointestinal tract. Your primary care doctor can also follow-up the H. Pylori study that is still pending. If this is positive then you will be started on an antibiotic. You should return to the ED if you develop: lightheaded, dizziness, fainting, chest pain, shortness of breath, vomiting blood, dark tarry stools or bright red blood from below. You may restart your home medications. This includes your medication for diabetes and high blood pressure. However, you shuld NOT re-start the aspirin. Followup Instructions: Name: [**Last Name (LF) **],[**First Name3 (LF) **] M. Location: [**Hospital1 641**] Address: [**Location (un) **], [**Location (un) **],[**Numeric Identifier 2260**] Phone: [**Telephone/Fax (1) 3530**] Appointment: [**2178-4-16**] 9:20am Outpatient capsule endoscopy. Completed by:[**2178-4-7**] ICD9 Codes: 2851, 4019
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Medical Text: Admission Date: [**2151-10-31**] Discharge Date: [**2151-11-12**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 99**] Chief Complaint: s/p Fall Major Surgical or Invasive Procedure: None History of Present Illness: [**Age over 90 **] y/o f with history of COPD, CAD, Alzheimer's disease transferred from OSH s/p unwitnessed fall down the stairs. According to chart, called out afterwards, so prolonged LOC could not have occurred. Films at the outside hospital showed right radial/ulnar fracture and fracture of C2 through the odontoid process. Transferred for ortho evaluation, to medical service. There is no evidence in OSH documentation that there was a full trauma evaluation. . Pt was a direct transfer to the floor. During the early morning after arrival, pt was found to be in significant respiratory distress. Pt placed on NRB and was sat'ing in mid 80s, tachypneic, and tachycardic to 120s. ABG was 7.36/46/43 with lactate of 2.6. Pt was emergently intubated and transferred to the MICU. CXR on arrival to MICU revealed hyperinflated lungs without any infiltrate or CHF. FiO2 was decreased to 0.5. . Of note, pt was seen by ortho spine consult who recommended full spine precautions with [**Location (un) 2848**] J collar, imaging of TLS spine, and MRI of C-spine. Also recommended reduction/splint of RUE. Past Medical History: Dementia- Alzheimers Disease CAD COPD on Combivent Social History: Tobacco history (quit 15 years ago). No EtOH. 3 children. Lives with daughter at home. Cannot cook, dress, or bath herself. Family History: Non contributory Physical Exam: Vitals: T 98.8, p96, 110/50, rr18, 100% AC 500/16/5 General: Cachectic, bruised, older woman, intubated, NAD HEENT: bilateral peri-orbital ecchymosis Neck: C-spine collar in place CVS: RRR, no m/g/r Lung: diffuse rhonchi Abd: soft, NT, ND, +BS Ext: no edema; ecchymosis on right knee Neuro: moving all 4 ext Pertinent Results: Labs (FROM OSH): WBC 10.3 (Neut 70.4%, Lymph 23.0%, Mono 5.2%, Eos 1.0%, Baso 0.4%) Hgb 11.8 Hct 36.7 Plt 254 MCV 92.3 . Na 147 K 3.0 Cl 108 HCO3 18 BUN 18 Creat 0.7 Gluc 162 Ca 8.5 AST 21 ALT 14 CK 221/656; CKMB 9.8/22.6 Trop I 0.02/0.02 Tot Prot 6.8 Alb 3.7 Alk Phos 70 Amylase 93 Lipase 33 . PT 11.4 / PTT 23.7 / INR 0.9 . ADMISSION LABS: [**2151-11-1**] 06:25AM BLOOD WBC-12.7* RBC-3.42* Hgb-10.3* Hct-30.6* MCV-89 MCH-30.2 MCHC-33.8 RDW-13.4 Plt Ct-201 [**2151-11-1**] 06:25AM BLOOD Neuts-83* Bands-8* Lymphs-4* Monos-5 Eos-0 Baso-0 Atyps-0 Metas-0 Myelos-0 [**2151-11-1**] 06:25AM BLOOD PT-12.3 PTT-23.0 INR(PT)-1.1 [**2151-11-1**] 06:25AM BLOOD Glucose-114* UreaN-16 Creat-0.7 Na-138 K-4.9 Cl-104 HCO3-26 AnGap-13 [**2151-11-1**] 05:13PM BLOOD CK(CPK)-2037* [**2151-11-1**] 11:06PM BLOOD CK(CPK)-2566* [**2151-11-2**] 05:20AM BLOOD CK(CPK)-2539* [**2151-10-31**] 08:40PM BLOOD CK-MB-22* cTropnT-<0.01 [**2151-11-1**] 05:13PM BLOOD CK-MB-23* MB Indx-1.1 cTropnT-0.02* [**2151-11-1**] 11:06PM BLOOD CK-MB-30* MB Indx-1.2 cTropnT-0.04* [**2151-11-2**] 05:20AM BLOOD CK-MB-35* MB Indx-1.4 cTropnT-0.13* [**2151-11-1**] 06:25AM BLOOD Calcium-7.7* Phos-3.0 Mg-1.8 [**2151-11-1**] 04:32AM BLOOD Type-ART pO2-43* pCO2-46* pH-7.36 calTCO2-27 Base XS-0 [**2151-11-1**] 04:32AM BLOOD Lactate-2.6* . CXR (OSH): Increased interstitial markings suggested. Comparison with prior films and clinical correlation is suggested. . CT Head without contrast (OSH): No acute intracranial hemorrhage. Central and cortical atrophy. Low attenuation changes in the periventricular white matter. This is a nonspecific but most likely secondary to chronic microvascular ischemic changes. Clinical correlation suggested. Left frontal scalp hematoma. . CT C-spine without contrast (OSH): Fracture of C2 through the odontoid process. . Cardiology Report ECG Study Date of [**2151-10-31**] 10:39:58 PM Sinus rhythm. Atrial premature beats. Possible left atrial abnormality. Modest non-specific right ventricular conduction delay pattern. Diffuse non-specific ST-T wave abnormalities. No previous tracing available for comparison. . Discharge Labs: [**2151-11-12**] 04:48AM BLOOD WBC-12.8* RBC-3.32* Hgb-9.8* Hct-30.8* MCV-93 MCH-29.7 MCHC-31.9 RDW-15.4 Plt Ct-468* [**2151-11-12**] 04:48AM BLOOD Neuts-89* Bands-0 Lymphs-7* Monos-4 Eos-0 Baso-0 Atyps-0 Metas-0 Myelos-0 [**2151-11-12**] 04:48AM BLOOD Hypochr-1+ Anisocy-1+ Poiklo-OCCASIONAL Macrocy-1+ Microcy-NORMAL Polychr-NORMAL Ovalocy-OCCASIONAL Stipple-OCCASIONAL [**2151-11-11**] 03:53AM BLOOD PT-13.7* PTT-54.7* INR(PT)-1.2* [**2151-11-12**] 04:48AM BLOOD Glucose-139* UreaN-12 Creat-0.7 Na-144 K-3.1* Cl-109* HCO3-27 AnGap-11 [**2151-11-11**] 03:53AM BLOOD Calcium-7.5* Phos-3.0 Mg-1.8 [**2151-11-4**] 03:58AM BLOOD calTIBC-173* VitB12-426 Folate-8.0 Ferritn-144 TRF-133* . RADIOLOGY Final Report C-SPINE TRAUMA W.OBL 4 VIEWS [**2151-10-31**] 10:11 PM C-SPINE TRAUMA W.OBL 4 VIEWS Reason: ? dens fx [**Hospital 93**] MEDICAL CONDITION: [**Age over 90 **] year old woman with pain after fall REASON FOR THIS EXAMINATION: ? dens fx INDICATION: Pain after fall. FINDINGS: On the lateral view, there is a suggestion of a C2 fracture. Some prevertebral soft tissue swelling is evident as well. The spinous process of C4 also appears to have a fracture and small fragment anteriorly off the endplate of C6, may have been avulsed in an extension type injury. At the time of this dictation, I was able to note that a CT had been obtained at 00:25 on [**2151-11-1**]. The findings on that study confirmed the plain film findings. IMPRESSION: Dens fracture, spinous process fracture C4 and inferior endplate avulsion fracture at C6. I conveyed the findings to Dr. [**First Name8 (NamePattern2) 122**] [**Last Name (NamePattern1) 69203**] at 9:51 a.m. on [**2151-11-1**] at the time of interpretation. DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 4347**] Approved: MON [**2151-11-1**] 12:07 PM . RADIOLOGY Final Report WRIST, AP & LAT VIEWS PORT RIGHT [**2151-11-1**] 5:18 AM WRIST, AP & LAT VIEWS PORT RIG Reason: x-rays s/p reduction and splint [**Hospital 93**] MEDICAL CONDITION: [**Age over 90 **] year old woman with pain after fall REASON FOR THIS EXAMINATION: x-rays s/p reduction and splint RIGHT WRIST ON [**2151-11-1**], AT 05:17 INDICATION: Fracture reduction and splint. FINDINGS: Again identified are fractures of the distal radius and ulna. The fragments are in good apposition and near anatomic alignment. A splint is in place. DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 4347**] Approved: MON [**2151-11-1**] 12:08 PM . RADIOLOGY Final Report WRIST(3 + VIEWS) RIGHT [**2151-11-1**] 12:30 AM FOREARM (AP & LAT) RIGHT; WRIST(3 + VIEWS) RIGHT Reason: fx? [**Hospital 93**] MEDICAL CONDITION: [**Age over 90 **] year old woman with pain after fall REASON FOR THIS EXAMINATION: fx? RIGHT FOREARM ON [**2151-11-1**] AT 00:31. INDICATION: Pain after fall. FINDINGS: Transverse fractures of the distal radius and ulna are demonstrated with some dorsal angulation to distal fragments. The radiocarpal and carpometacarpal alignment appear intact. Component of impaction is seen at both fracture sites. Diffuse degenerative changes are evident in MCP and PIP joints with some narrowing and sclerosis. IMPRESSION: Transverse fractures of the distal radius and ulna with an element of impaction and slight dorsal angulation to the distal fragments. DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 4347**] Approved: MON [**2151-11-1**] 12:07 PM . RADIOLOGY Final Report FOREARM (AP & LAT) RIGHT [**2151-11-1**] 12:30 AM FOREARM (AP & LAT) RIGHT; WRIST(3 + VIEWS) RIGHT Reason: fx? [**Hospital 93**] MEDICAL CONDITION: [**Age over 90 **] year old woman with pain after fall REASON FOR THIS EXAMINATION: fx? RIGHT FOREARM ON [**2151-11-1**] AT 00:31. INDICATION: Pain after fall. FINDINGS: Transverse fractures of the distal radius and ulna are demonstrated with some dorsal angulation to distal fragments. The radiocarpal and carpometacarpal alignment appear intact. Component of impaction is seen at both fracture sites. Diffuse degenerative changes are evident in MCP and PIP joints with some narrowing and sclerosis. IMPRESSION: Transverse fractures of the distal radius and ulna with an element of impaction and slight dorsal angulation to the distal fragments. DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 4347**] Approved: MON [**2151-11-1**] 12:07 PM . RADIOLOGY Final Report CT C-SPINE W/O CONTRAST [**2151-11-1**] 12:15 AM CT C-SPINE W/O CONTRAST Reason: ? fx [**Hospital 93**] MEDICAL CONDITION: [**Age over 90 **] year old woman with pain after fall REASON FOR THIS EXAMINATION: ? fx CONTRAINDICATIONS for IV CONTRAST: None. INDICATION: Pain after fall, question fracture. COMPARISON: None. TECHNIQUE: Non-contrast axial CT imaging of the cervical spine with coronal and sagittal reformats. FINDINGS: There is prevertebral soft tissue swelling. There is a nondisplaced fracture through the base of the dens that extends down into the C2 body, thus making the fracture type III dens fracture. There is a small fracture fragment off the anterior inferior aspect of C6 that likely represents an avulsion fracture from flexion or extension injury. There is a minimally displaced fracture through the spinous process of C4. There is a small osseous fragment anterior to the body of left C1 (3:20) that appears well corticated. A donor site cannot be identified and thus this may represent calcification within ligaments. There is some evidence for ligamentous calcification on the right anterior C1 body (3:18). A fracture given the multitude of other fractures cannot entirely be excluded. Evaluation of the spinal canal elements is limited with CT, but there is evidence for some spinal canal narrowing and mild compression of the cord at the C2-C3 to a lesser degree at other levels. This may be chronic. There is no evidence for subluxation. There is scarring and emphysematous changes in the lung apices. Note is made of partial opacification of the nasopharynx and sphenoid sinuses. IMPRESSION: Multiple fractures as described above including a type III dens, C6 vertebral body avulsion fracture and C4 spinous process fracture. Ligamentous injury is suspected given the pattern of fractures, an MR is recommended. The study and the report were reviewed by the staff radiologist. DR. [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) 16277**] DR. [**First Name (STitle) **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] Approved: MON [**2151-11-1**] 10:59 AM . RADIOLOGY Final Report CT T-SPINE W/O CONTRAST [**2151-11-2**] 2:29 PM CT T-SPINE W/O CONTRAST Reason: pls evaluate for fx or cord compression [**Hospital 93**] MEDICAL CONDITION: [**Age over 90 **] year old woman s/p fall with C2 fracture. REASON FOR THIS EXAMINATION: pls evaluate for fx or cord compression CONTRAINDICATIONS for IV CONTRAST: None. INDICATION: [**Age over 90 **]-year-old woman status post fall with cervical spine fractures. COMPARISONS: None. TECHNIQUE: Axial non-contrast CT images of the thoracic spine were obtained and sagittal and coronal reconstructions were also performed. FINDINGS: The patient is intubated. There is a nasogastric tube coursing into the stomach. Coronary artery and aortic calcifications are noted. There is a moderate low-density pleural effusion on the left, and a small one on the right, with adjacent areas of dependent opacity with air bronchograms. These areas could represent atelectasis, pneumonia, or aspiration. There is also moderately severe emphysema. Incidental note is also made of a punctate 3-mm calcification in the right lobe of the thyroid gland. There is no evidence of acute fracture, dislocation, or bony destruction. Multilevel small anterior osteophytes are present in the thoracic spine, as well as degenerative calcifications within the intervertebral disc spaces. There is fragmentation of the tip of the spinous process of T4, with well corticated margins, an appearance likely due to old trauma or congenital in origin. Although CT is not ideal for visualization of the thecal sac, the visualized thecal sac contour is unremarkable. IMPRESSION: 1. No evidence of fracture or dislocation. 2. Non-united appearance of tip of T4 spinous process, probably from old trauma or congenital etiology. 3. Bilateral pleural effusions with adjacent opacities, which may represent atelectasis, aspiration, or pneumonia. Findings discussed [**Last Name (STitle) 17290**] from Medicine service. The study and the report were reviewed by the staff radiologist. DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 1507**] DR. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 9987**] Approved: WED [**2151-11-3**] 7:53 PM . RADIOLOGY Final Report CT L-SPINE W/O CONTRAST [**2151-11-2**] 2:28 PM CT L-SPINE W/O CONTRAST Reason: pls evaluate Lumbar and sacral spine for fx, cord compressio [**Hospital 93**] MEDICAL CONDITION: [**Age over 90 **] year old woman s/p fall with C2 fracture. REASON FOR THIS EXAMINATION: pls evaluate Lumbar and sacral spine for fx, cord compression CONTRAINDICATIONS for IV CONTRAST: None. INDICATION: [**Age over 90 **]-year-old woman with cervical spine fractures. COMPARISONS: None. TECHNIQUE: Axial CT images of the lumbar spine were obtained without intravenous contrast, and sagittal and coronal reconstructions were also performed. FINDINGS: There is no evidence of fracture. There is minimal spondylolisthesis of L4 on L5, which is likely degenerative in origin.. There are mild multilevel degenerative changes with osteophytes, most notably at L2- L3 where there is a mild, likely chronic, compression fracture of L2. Sclerosis and narrowing at the L2-L3 intervertebral disc space are also present. At the same level, there is a small disc bulge with spinal stenosis, and similarly at L3-L4 and L4- L5. There are also proliferative changes of the ligamentum flavum at the same levels, extending from L2-L3 through L4-L5. At these levels, where posterior mild disk herniations are present, there is moderate spinal stenosis. Calcified gallstones and aortic calcifications are noted, as well as moderate left-sided and small right-sided pleural effusions. Bibasilar opacities with air bronchograms may represent either atelectasis, pneumonia or aspiration. IMPRESSION: 1. No evidence of acute fracture or dislocation. 2. Degenerative changes, and a probably old mild compression fracture of L2. 3. Moderate spinal stenosis, associated with small disc bulges and thickening of the ligamentum flavum. 4. Bibasilar pleural effusions and opacities, which may represent atelectasis, aspiration or pneumonia. 5. Aortic calcifications. 6. Cholelithiasis. Major findings including pulmonary effusions and opacities discussed [**Last Name (STitle) 17290**] from Medicine. The study and the report were reviewed by the staff radiologist. DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 1507**] DR. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 9987**] Approved: [**Doctor First Name **] [**2151-11-4**] 12:37 PM . RADIOLOGY Final Report MR CERVICAL SPINE W/O CONTRAST [**2151-11-2**] 12:04 PM MR CERVICAL SPINE W/O CONTRAST Reason: Assess for cord injury, ligamentous injury [**Hospital 93**] MEDICAL CONDITION: [**Age over 90 **] year old woman with C2, C4 and C6 fractures REASON FOR THIS EXAMINATION: Assess for cord injury, ligamentous injury MRI OF THE CERVICAL SPINE ON [**11-2**] CLINICAL HISTORY: C2, C4, and C6 fractures. TECHNIQUE: Sagittal T1-weighted, T2-weighted, STIR, and gradient-echo images, and axial gradient-echo and T2-weighted images were obtained. There is slight limitation by patient motion. FINDINGS: As seen on the CT examination of the preceding day, there is considerable prevertebral soft tissue swelling particularly superiorly. There is an underlying C2 fracture with a horizontally oriented fracture line across the base of the dens which extends inferiorly at the posterior C2 body, most consistent with type III fracture. As expected fluid signal intensity is seen in that fracture. No significant epidural fluid collection is seen and there is no spinal cord compression or abnormal signal intensity in the spinal cord at that level. The abnormalities in the region of the anterior arch of C1 are poorly visualized. There is also edema associated with the fracture through the tip of the C4 spinous process, consistent with acute fracture. There is some increased signal intensity in the C6/7 disc, on the STIR images and the avulsion fracture from the anterior inferior endplate of C6 is to some extent visualized. No clear abnormal signal intensity is seen in the spinal cord nor is there any epidural hematoma. The foramina are grossly well maintained and on the T2-weighted images, normal low-signal intensity is seen in both vertebral arteries. IMPRESSION: 1. No definite spinal cord contusion identified. 2. There are acute fractures across the base of the dens, through the tip of the C4 spinous process and involving the anterior inferior aspect of C6 with apparent disruption of the anterior longitudinal ligament at the C6/7 level. 3. As seen on the CT, there is minimal anterior displacement of the odontoid fragment relative to [**Name (NI) 12952**], but no significant stenosis of the spinal canal at any of the imaged levels. DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] Approved: WED [**2151-11-3**] 7:01 AM . RADIOLOGY Final Report [**Last Name (un) **]-INTESTINAL TUBE PLACEMENT (W/FLUORO) [**2151-11-10**] 10:14 AM [**Last Name (un) **]-INTESTINAL TUBE PLACEMENT Reason: please place post pyloric tube under fluoro guidance as posi [**Hospital 93**] MEDICAL CONDITION: [**Age over 90 **] year old woman with cervical fracture, in [**Location (un) 2848**] J collar, failed speech and swallow. REASON FOR THIS EXAMINATION: please place post pyloric tube under fluoro guidance as positioning an issue INDICATION: [**Age over 90 **]-year-old female with cervical fracture, in [**Location (un) 2848**] J collar, failed speech and swallow. Place post-pyloric tube. TECHNIQUE/FINDINGS: The left naris was anesthetized with 1% lidocaine. An 8 French 120-cm weighted feeding tube was advanced into the third portion of the duodenum under fluoroscopic guidance. Approximately 50 cc of Conray was injected into the nasogastric tube to confirm intended position. No extravasation of contrast was identified. IMPRESSION: Successful nasointestinal tube placement with tip in the third portion of the duodenum. The study and the report were reviewed by the staff radiologist. DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **]. [**Last Name (NamePattern1) **] DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 7832**] Approved: WED [**2151-11-10**] 2:31 PM . [**2151-10-31**] 8:49 pm URINE **FINAL REPORT [**2151-11-3**]** URINE CULTURE (Final [**2151-11-3**]): ESCHERICHIA COLI. >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------------ <=2 S AMPICILLIN/SULBACTAM-- <=2 S CEFAZOLIN------------- <=4 S CEFEPIME-------------- <=1 S CEFTAZIDIME----------- <=1 S CEFTRIAXONE----------- <=1 S CEFUROXIME------------ 4 S CIPROFLOXACIN---------<=0.25 S GENTAMICIN------------ <=1 S IMIPENEM-------------- <=1 S LEVOFLOXACIN----------<=0.25 S MEROPENEM-------------<=0.25 S NITROFURANTOIN-------- <=16 S PIPERACILLIN---------- <=4 S PIPERACILLIN/TAZO----- <=4 S TOBRAMYCIN------------ <=1 S TRIMETHOPRIM/SULFA---- <=1 S . [**2151-11-1**] 8:33 am SPUTUM Site: ENDOTRACHEAL Source: Endotracheal. **FINAL REPORT [**2151-11-4**]** GRAM STAIN (Final [**2151-11-1**]): >25 PMNs and <10 epithelial cells/100X field. 4+ (>10 per 1000X FIELD): GRAM POSITIVE COCCI. IN PAIRS AND CHAINS. 2+ (1-5 per 1000X FIELD): GRAM NEGATIVE ROD(S). 1+ (<1 per 1000X FIELD): GRAM POSITIVE ROD(S). RESPIRATORY CULTURE (Final [**2151-11-4**]): MODERATE GROWTH OROPHARYNGEAL FLORA. STREPTOCOCCUS PNEUMONIAE. MODERATE GROWTH. PRESUMPTIVELY PENICILLIN SENSITIVE BY OXACILLIN SCREEN. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ STREPTOCOCCUS PNEUMONIAE | PENICILLIN------------ S . [**2151-11-1**] 4:27 pm BLOOD CULTURE **FINAL REPORT [**2151-11-7**]** AEROBIC BOTTLE (Final [**2151-11-7**]): NO GROWTH. ANAEROBIC BOTTLE (Final [**2151-11-7**]): NO GROWTH. . [**2151-11-1**] 4:19 pm BLOOD CULTURE **FINAL REPORT [**2151-11-7**]** AEROBIC BOTTLE (Final [**2151-11-7**]): NO GROWTH. ANAEROBIC BOTTLE (Final [**2151-11-7**]): NO GROWTH. . [**2151-11-10**] 5:09 pm STOOL CONSISTENCY: LOOSE Source: Stool. **FINAL REPORT [**2151-11-11**]** CLOSTRIDIUM DIFFICILE TOXIN ASSAY (Final [**2151-11-11**]): FECES NEGATIVE FOR C. DIFFICILE TOXIN BY EIA. Reference Range: Negative. . [**2151-11-10**] 4:28 pm URINE RECEIVED IN LAB AT 6.35PM. **FINAL REPORT [**2151-11-12**]** URINE CULTURE (Final [**2151-11-12**]): NO GROWTH. . Cardiology Report ECHO Study Date of [**2151-11-4**] PATIENT/TEST INFORMATION: Indication: Coronary artery disease. Left ventricular function. Height: (in) 63 Weight (lb): 115 BSA (m2): 1.53 m2 BP (mm Hg): 132/56 HR (bpm): 91 Status: Inpatient Date/Time: [**2151-11-4**] at 14:56 Test: Portable TTE (Complete) Doppler: Full Doppler and color Doppler Contrast: None Tape Number: 2006W046-0:00 Test Location: West Echo Lab Technical Quality: Suboptimal REFERRING DOCTOR: DR. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] MEASUREMENTS: Left Atrium - Long Axis Dimension: *4.1 cm (nl <= 4.0 cm) Left Atrium - Four Chamber Length: 4.7 cm (nl <= 5.2 cm) Right Atrium - Four Chamber Length: 4.4 cm (nl <= 5.0 cm) Left Ventricle - Septal Wall Thickness: *1.2 cm (nl 0.6 - 1.1 cm) Left Ventricle - Inferolateral Thickness: 1.1 cm (nl 0.6 - 1.1 cm) Left Ventricle - Diastolic Dimension: 3.0 cm (nl <= 5.6 cm) Left Ventricle - Systolic Dimension: 1.6 cm Left Ventricle - Fractional Shortening: 0.47 (nl >= 0.29) Left Ventricle - Ejection Fraction: 80% (nl >=55%) Aorta - Valve Level: 2.6 cm (nl <= 3.6 cm) Aorta - Ascending: 2.2 cm (nl <= 3.4 cm) Aortic Valve - Peak Velocity: 1.9 m/sec (nl <= 2.0 m/sec) Mitral Valve - E Wave: 0.7 m/sec Mitral Valve - A Wave: 1.0 m/sec Mitral Valve - E/A Ratio: 0.70 Mitral Valve - E Wave Deceleration Time: 237 msec TR Gradient (+ RA = PASP): *21 to 29 mm Hg (nl <= 25 mm Hg) INTERPRETATION: Findings: LEFT ATRIUM: Mild LA enlargement. RIGHT ATRIUM/INTERATRIAL SEPTUM: Normal RA size. The IVC is normal in diameter with appropriate phasic respirator variation. LEFT VENTRICLE: Mild symmetric LVH. Small LV cavity. Suboptimal technical quality, a focal LV wall motion abnormality cannot be fully excluded. Hyperdynamic LVEF. No resting LVOT gradient. RIGHT VENTRICLE: Normal RV chamber size and free wall motion. AORTA: Normal aortic root diameter. Focal calcifications in aortic root. Normal ascending aorta diameter. Focal calcifications in ascending aorta. AORTIC VALVE: Mildly thickened aortic valve leaflets (3). No AS. No AR. MITRAL VALVE: Moderately thickened mitral valve leaflets. No MVP. Mild mitral annular calcification. Moderate thickening of mitral valve chordae. Calcified tips of papillary muscles. No MS. Trivial MR. Normal LV inflow pattern for age. TRICUSPID VALVE: Mildly thickened tricuspid valve leaflets. Thickened/fibrotic tricuspid valve supporting structures. Mild [1+] TR. Borderline PA systolic hypertension. PULMONIC VALVE/PULMONARY ARTERY: Normal pulmonic valve leaflets with physiologic PR. Normal main PA. No Doppler evidence for PDA PERICARDIUM: No pericardial effusion. GENERAL COMMENTS: Suboptimal image quality - poor echo windows. Suboptimal image quality - poor parasternal views. Suboptimal image quality - poor apical views. Conclusions: The left atrium is mildly dilated. There is mild symmetric left ventricular hypertrophy. The left ventricular cavity is unusually small. Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. Left ventricular systolic function is hyperdynamic (EF 80%). Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No aortic regurgitation is seen. The mitral valve leaflets are moderately thickened. There is no mitral valve prolapse. There is moderate thickening of the mitral valve chordae. Trivial mitral regurgitation is seen. The tricuspid valve leaflets are mildly thickened. The supporting structures of the tricuspid valve are thickened/fibrotic. There is borderline pulmonary artery systolic hypertension. There is no pericardial effusion. Electronically signed by [**First Name11 (Name Pattern1) 449**] [**Last Name (NamePattern4) **], MD on [**2151-11-4**] 15:25. [**Location (un) **] PHYSICIAN: [**Name10 (NameIs) **],[**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 975**] Brief Hospital Course: [**Age over 90 **]yF with history of CAD and COPD s/p fall, transferred for mgmt of Type 3 Dens/C4/C6 fracture and distal radial/ulnar fracture, transferred to ICU for acute hypoxic respiratory failure. . # Hypoxic respiratory failure: CHF, PNA, left pleural effusion, and COPD contributing. Pt s/p intubation [**2151-11-1**], extubated on [**2151-11-3**], reintubated [**2151-11-5**], extubated [**2151-11-7**]. Weaned to NRB, then VM, then O2 by nC. Now on 3L O2 by NC. Saturations in high 90's. s/p nafcillin 10/10 days for pna. Diuresed several days on [**2151-11-6**] and [**2151-11-7**]. Left pleural effusion not tapped as afebrile and likely due to CHF. COPD treated with nebs. Please try to wean O2 as tolerated. . # COPD: Ipratropium/albuterol nebs. No wheezing. Lungs sound clear. . # Afib with RVR: Loaded with Amiodarone(IV) on [**2151-11-2**]. Got one week of 200 mg by NG TID. Now getting 200 mg [**Hospital1 **] for one week (to change to 200 mg QD) on [**2151-11-19**]. Continue amiodarone 200 mg [**Hospital1 **] for one week (until [**2151-11-18**]), then 200 mg QD after that. Will need TFT's, LFT's, and PFT's monitored in the future while on amiodarone. Currently in SInus rhythm on discharge. . # h/o CAD: Unknown history. No evidence of wall motion abnormalities on Echo, though poor windows. No Q waves on EKG. On ASA. . # PNA: Strep pneumo in sputum. Sensitive to penicillin. Treated with nafcillin for 10 days, completed [**2151-11-9**]. . # UTI: E coli grew in culture. Pansensitive. Treated with Levofloxacin for 7 days, completed10/16/06. Repeat U/A had WBC's, but improved after foley change. Urine culture after foley change had no growth. . # Odontoid process fracture: Type 3 dens fracture, c4 fracture, C6 fracture. Needs [**Location (un) 2848**] J collar until; mid [**Month (only) **]. Needs f/u with Dr. [**Last Name (STitle) 1352**] (need to schedule app for mid [**Month (only) 321**]). Orthopedics (Spine) Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 1352**] ([**Telephone/Fax (1) 2007**] . # Right wrist fx: had distal ulnar/radius fracture. Immobilized with splint. Needs f/u with Dr. [**Last Name (STitle) **] [**Location (un) **] (need to schedule for the end of [**Month (only) **]). Orthopedics Dr. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] ([**Telephone/Fax (1) 15940**] . # Dementia: Known Alzheimer's Disease. Currently back to baseline. Not on medications. . # Prophylaxis: Needs Hep SubQ, Colace/Senna, needs frequent turns for decubitus ulcer. . # FEN: Post-pyloric feeding placed by IR, geting tube feeds (surrently at goal of 50). Will need further discussion with family per PEG if she fails future swallowing evaluations. . # code status: DNR/DNI . # Communication: [**Doctor First Name 7798**] [**Telephone/Fax (1) 69204**] Home, [**Telephone/Fax (1) 69205**] Cell # She needs to be seen by her primary care Doctor. Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 2455**]. FINE,[**Doctor Last Name **] H. [**Telephone/Fax (1) 65335**] Medications on Admission: Combivent Discharge Medications: 1. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO BID (2 times a day): can be decreased to 200 mg daily starting [**2151-11-19**]. 2. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 3. Albuterol Sulfate 0.083 % Solution Sig: One (1) neb Inhalation Q6H (every 6 hours). 4. Ferrous Sulfate 325 (65) mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO TID (3 times a day). 7. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: Two (2) Tablet PO DAILY (Daily). 8. Ipratropium Bromide 0.02 % Solution Sig: One (1) neb Inhalation Q6H (every 6 hours). 9. Docusate Sodium 150 mg/15 mL Liquid Sig: Fifteen (15) mL PO BID (2 times a day). 10. Oxycodone 5 mg/5 mL Solution Sig: Five (5) mL PO Q6H (every 6 hours) as needed. 11. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed. Discharge Disposition: Extended Care Facility: [**Hospital3 105**] - [**Location (un) 86**] Discharge Diagnosis: Cervical Fracture Radial/Ulnar Fracture Streptoccoccus pneumoniae Pneumonia E. Coli Urinary Tract Infection Discharge Condition: Cervical Collar in place. Right arm/wrist splint. Non ambulatory. Demented. Not oriented. Foley catheter in place. NG tube (post pyloric) in place. Discharge Instructions: You had fractures to your upper spine. You will need to keep the cervical collar on until the middle of [**2151-11-24**]. You will need to see Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 1352**], ([**Telephone/Fax (1) 2007**], in mid [**Month (only) **] to see how long you will need the cervical collar. You had a fracture of both bones of the lower part of your right arm. You will need to keep the splint on your right arm for the next two weeks, until the end of [**2151-10-24**]. You should see the orthopedic surgeon, Dr. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **],([**Telephone/Fax (1) 2007**], at the end of [**Month (only) 359**]. You had a pneumonia, which was treated with antibiotics for ten days. You had a urinary tract infection which was treated with antibiotics for seven days. You had a tube placed to help feed you because you were unable to swallow. You will need to have your swallowing reevaluated while at rehab to see if you still need the tube. Followup Instructions: Orthopedics Dr. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] ([**Telephone/Fax (1) 2007**] Orthopedics (Spine) Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 1352**] ([**Telephone/Fax (1) 2007**] Primary Care Doctor- Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 2455**] ([**Telephone/Fax (1) 69206**] Completed by:[**2151-11-13**] ICD9 Codes: 496, 4280, 5990, 5070, 2859
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Medical Text: Admission Date: [**2144-3-22**] Discharge Date: [**2144-3-25**] Date of Birth: [**2096-3-2**] Sex: M Service: MEDICINE Allergies: Penicillins Attending:[**First Name3 (LF) 896**] Chief Complaint: Hyperglycemia Major Surgical or Invasive Procedure: none History of Present Illness: 48M with history of HTN and DM2 previously on metformin presents with hyperglycemia to 400-445 at home. Notably the patient hasn't been taking his diabetes medications for 5 months because he started pursuing homeopathy and was told to stop all of his medications. He recently went on a plane ride 5 days prior to admission. He had been sucking candy to help with the air pressure changes. When he returned home, he felt ill with nausea, gassy abdominal pain, polyuria and polydipsia. He also had 1 episode of chest pressure that lasted 1 hour. The night before admission he had chills and sweats, but no diarrhea, vomiting and dysuria. In the ED, T 99.9 HR 116 BP 111/69 RR 16 98% RA. The patient was given 3L IV fluids, and 10 units regular insulin sc. Anion gap was 22. Insulin gtt was started. Prior to transfer, last fingerstick was 424, Vitals were T 99.3 HR 101 BP 124/79 99% on RA. On the floor, the patient is feeling thirsty, with abdominal discomfort. Past Medical History: DM2 -diagnosed several years ago HTN h/o gout Social History: - Tobacco: None - Alcohol: None - Illicits: None Family History: non-contributory Physical Exam: ADMISSION PHYSICAL: Vitals: T: 99.4 BP: 133/74 P: 104 R: 18 O2: 95% on RA General: Alert, oriented, no acute distress HEENT: Sclera anicteric, dry mucous membranes, oropharynx clear Neck: supple, JVP not elevated, no LAD Lungs: Clear to auscultation bilaterally, no wheezes, rales, ronchi CV: Tachycardic, regular 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: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema . DISCHARGE Pertinent Results: ADMISSION LABS: [**2144-3-22**] 09:36PM GLUCOSE-445* UREA N-28* CREAT-1.3* SODIUM-130* POTASSIUM-3.9 CHLORIDE-96 TOTAL CO2-13* ANION GAP-25* [**2144-3-22**] 09:36PM WBC-9.3 RBC-3.76* HGB-11.7* HCT-34.5* MCV-92 MCH-30.8 MCHC-33.8 RDW-14.3 [**2144-3-22**] 09:36PM NEUTS-88.4* LYMPHS-8.2* MONOS-3.1 EOS-0.1 BASOS-0.2 [**2144-3-22**] 09:37PM LACTATE-2.0 [**2144-3-22**] 06:50PM URINE BLOOD-TR NITRITE-NEG PROTEIN-30 GLUCOSE-1000 KETONE-150 BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-NEG [**2144-3-22**] 06:50PM URINE RBC-<1 WBC-1 BACTERIA-FEW YEAST-NONE EPI-<1 DISCHARGE LABS: COMPLETE BLOOD COUNT WBC RBC Hgb Hct MCV MCH MCHC RDW Plt Ct [**2144-3-25**] 06:03 6.8 3.59* 11.8* 32.8* 91 33.0* 36.1* 14.6 270 Chemistry RENAL & GLUCOSE Glucose UreaN Creat Na K Cl HCO3 [**2144-3-25**] 06:03 186 15 0.7 136 4.3 101 27 CHEMISTRY TotProt Calcium Phos Mg [**2144-3-25**] 06:03 8.5 4.3 2.2 MICRO: BCX [**2144-3-23**]: PENDING BCX [**2144-3-25**] x 2: PENDING STUDIES: CXR [**2144-3-22**]: IMPRESSION: No acute cardiopulmonary process. Brief Hospital Course: 48 yo male with HTN, DM 2, with history of medication non-compliance who presented with DKA. Pt initially presented to MICU and was placed on insulin gtt with IVF's. AG closed, and pt was transitioned to SC insulin and discharged on a combination of lantus and oral agents. Active issues: # DKA/Diabetes: The patient had an anion gap of 21, with ketones in his urine on presentation. Underlying etiology likely secondary to medication non-compliance. No focal signs of infection, though did have some chills and sweats. UA negative. Patient did have 1 hour of chest pressure, though no further symptoms. CXR unremarkable. Pt was placed on insulin gtt and lytes were frequently monitored. AG closed. Potassium was repleted agressively with IVF's. A1c was sent and was 13.8. Blood cultures were pending at time of discharge. [**Last Name (un) **] was consulted recommended starting metformin and glipizide as well as continued lantus. He was discharged on all three and will follow up with [**Last Name (un) **] in 1 week. # Chest pain: Brief chest pain, thought unlikely to be cardiac related. CE's were cycled and negative. His pain resolved. # Normocytic anemia: Unclear baseline. Iron studies consistent with anemia of chronic disease or acute illness. His Hct was stable during this hospitalization with no clinical evidence of bleeding. It was recommended that he discuss further workup with his PCP and obtain [**Name Initial (PRE) **] colonscopy. # Acute kidney injury: Likely secondary to profound hypovolemia in the setting of DKA. Cr improved after hydration and was normal upon discharge. # Hypertension: The patient had been on lisinopril, but had stopped it. He was hypertensive here and restarted on lisinopril 10 mg daily. He will need lytes checked in follow up. Transitions of care: - F/u pending blood cultures - Patient requires workup for anemia and Hct trend - Check electrolytes/creatinine on lisinopril Medications on Admission: Metformin Lisinopril (not taking prior to admission) Discharge Medications: 1. Insulin Syringe 1 mL 29 x [**12-8**] Syringe Sig: One (1) syringe Miscellaneous once a day. Disp:*40 syringes* Refills:*2* 2. insulin needles (disposable) 31 Needle Sig: One (1) needle Miscellaneous once a day. Disp:*45 needles* Refills:*2* 3. One Touch Ultra Test Strip Sig: One (1) stip Miscellaneous four times a day. Disp:*120 strips* Refills:*2* 4. lancets Misc Sig: One (1) lancet Miscellaneous four times a day. Disp:*120 lancets* Refills:*2* 5. metformin 1,000 mg Tablet Sig: One (1) Tablet PO twice a day. Disp:*60 Tablet(s)* Refills:*2* 6. glipizide 10 mg Tablet Sig: One (1) Tablet PO twice a day. Disp:*60 Tablet(s)* Refills:*2* 7. lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 8. insulin glargine 100 unit/mL Solution Sig: Sixteen (16) units Subcutaneous at bedtime. Disp:*500 units* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Primary: Diabetic ketoacidosis Hypertension 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 due to very high blood sugars. Your sugars were elevated likely because you had stopped your diabetes medications. No evidence of infection were found. While hospitalized it was noted that your red blood counts were low. You will need to discuss workup and colonscopy with your primary doctor. You were also restarted on lisinopril (a blood pressure medication). You will need labs checked in [**1-9**] weeks to ensure your kidney function and electrolytes are stable on this medication. Please discuss having labs checked at your follow up appointment with [**Last Name (un) **]. Check blood sugars fasting and before meals and at bedtime. If blood sugars are < 90, drop lantus dosing by 2 units. If you feel like your blood sugar is low, check your blood sugar and call your doctor. Medication changes: 1. START lantus 16 units every night. 2. START lisinopril 10 mg every day. 3. START metformin 1000 mg twice daily. 4. START glipizide 10 mg twice daily. It is very important that you take your medications every day and do not miss a dose. Followup Instructions: Department: [**Hospital3 249**] When: TUESDAY [**2144-4-28**] at 1:45 PM With: [**Name6 (MD) 3688**] [**Name8 (MD) **], MD [**Telephone/Fax (1) 250**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 895**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage ***Please be sure and call your insurance company to change your pcp to Dr [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 88708**] works with Dr [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **]. Name: [**Last Name (LF) 15279**], [**Name8 (MD) **] MD Location: [**Last Name (un) **] DIABETES CENTER Address: ONE [**Last Name (un) **] PLACE, [**Location (un) **],[**Numeric Identifier 718**] Phone: [**Telephone/Fax (1) 2384**] Appt: We are working on an appt for you within the next week. The office will call you at home with an appt. If you dont hear from them by tomorrow, please call them directly to book. Completed by:[**2144-3-25**] ICD9 Codes: 5849, 4019, 2859
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Medical Text: Admission Date: [**2166-2-11**] Discharge Date: [**2166-2-12**] Service: NEUROLOGY Allergies: No Drug Allergy Information on File Attending:[**First Name3 (LF) 5868**] Chief Complaint: transfer from OSH for intracerebral hemorrhage Major Surgical or Invasive Procedure: extubation History of Present Illness: This is a 86year old woman with an unknown pmh who was alone at restaurant and appeared suddenly confused and "unresponsive." EMTs arrived, patient was "not answering or even acknowledging anyone." On arrival to OSH ED - patient "awake and alert, but does not respond to questions or commnads." Apparently vomited after head ct and was then intubated. Appeared to be posturing by ED staff at OSH and given mannitol 50gm x1. Transferred here intubated, not following commands and bleed worse on head ct on arrival here. Family contact[**Name (NI) **] and states that patient's wishes would be for extubation and cmo. Past Medical History: essentially unknown, but patient's neice said she had a history of "dementia" for the past year or so, and may have had hypertension because she had decided not to take her BP meds. Social History: lives alone, very independent, never married, no kids, former business woman. HCP is her [**Last Name (LF) 802**], [**Name (NI) 319**] [**Name (NI) 19442**]. Family History: sister died of stomach cancer in her 60's, other sibs are in their 90's and still alive and well. Physical Exam: Physical Exam: afebrile; BP 200s/100s; HR 80s-90s; RR 14; O2 sat 100% on vent gen - intubated heent - mmm. o/p clear. no scleral icterus or injection. neck - supple. no lad or carotid bruits appreciated. lungs - cta bilaterally heart - rrr, nl s1/s2 abd - soft, nt/nd, nabs ext - warm, 2+ peripheral pulses throughout. no edema. neurologic: MS: not following commands or opening eyes. not breathing over the vent. CN: PERRL - pinpoint. intact corneals. intubated, not sure if has facial asymmetry. Motor: not moving RUE. does move LUE to pain, holding LUE flexed. in LLEs, some minimal movement in LLE to pain, and triple flexion on right. Reflexes: hyperreflexic in the right more than the left. toes upgoing. Sensation: withdraws to pain in LUE and minimally in LLE. triple flexion in RLE. Coordination: cannot test Gait: cannot test Pertinent Results: NCHCT: large left temporoparietal occipital bleed with intraventricular extension and shift to the right. also right intraventricular extension. early signs of uncal herniation. more blood since ct at OSH. Brief Hospital Course: This patient was admitted to the Neurology ICU after she suffered a massive intracerebral bleed with early signs of uncal herniation on head CT. Discussions were held with the [**Hospital 228**] health care proxy, [**Name (NI) 319**] [**Name (NI) 19442**] ([**Name (NI) 802**]), and code status was changed to CMO. She was extubated and placed on morphine drip. Time of death: 5:30pm on [**2166-2-12**]. Family denied autopsy. Medical examiner was called as patient died within 24 hrs of admission and they waived the case (per Dr. [**Last Name (STitle) **]. Medications on Admission: none Discharge Medications: none, deceased Discharge Disposition: Expired Discharge Diagnosis: hemorrhagic stroke with herniation Discharge Condition: deceased Discharge Instructions: none Followup Instructions: none ICD9 Codes: 431, 4019
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Medical Text: Admission Date: [**2150-2-27**] Discharge Date: [**2150-3-5**] Date of Birth: [**2084-7-24**] Sex: M Service: CARDIOTHORACIC Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**Known firstname 922**] Chief Complaint: Exertional/rest angina Major Surgical or Invasive Procedure: [**2150-2-27**] emergent coronary artery bypass grafting x4 (LIMA-LAD,SVG-RI,SVG-OM!,SVG-PDA) left heart catheterization, coronary angiogram [**2150-2-27**] History of Present Illness: This 65 year old gentleman with no prior cardiac history describes a 9 month history of episodic exertional chest discomfort and dyspnea. These episodes have occurred while walking 2 or more blocks while carrying books or groceries. He also reports having less frequent chest discomfort occurring at rest but only lasting seconds and resolving spontaneously or with SL nitroglycerin that he was recently prescribed. The patient was seen by Dr. [**First Name (STitle) **] and had an abnormal stress test, as noted below, so has now been referred for catheterization. Cath revealed 90% Left main 100% RCA occulsion. He was referred for urgent operation. Past Medical History: Unstable angina Bicuspid aortic valve. Pectus excavatum. anal cancer [**2125**] (s/p chemo and radiation therapy) iron deficieny anemia hypothyroidism anxiety/depression basal cell cancer of the face gastroesophageal reflux prostate cancer Social History: Lives with: Alone in [**Location (un) **]. Retired. Tobacco: has smoked 45+ years/1ppd since age 17; now trying to quit - down [**12-29**] ciagarettes / day ETOH: socially ~ 5 wines/ week Contact upon discharge: [**First Name4 (NamePattern1) 2048**] [**Last Name (NamePattern1) **]- [**Telephone/Fax (1) 111461**] Family History: non-contributory Physical Exam: Pulse: 75 Resp: 12 O2 sat:94% RA B/P Right: Left: 113/79 Height: 5'8" Weight: 153# General: AAO x 3 in NAD Skin: Dry [x] intact [x] HEENT: PERRLA [x] EOMI [x] Neck: Supple [x] Full ROM [x] Chest: Lungs clear bilaterally [x] Pectis excavatum Heart: RRR [x] Irregular [] Murmur [] grade ______ Abdomen: Soft [x] non-distended [x] non-tender [x] bowel sounds + [x] Extremities: Warm [x, well-perfused [x] Edema none Varicosities: None [x] Neuro: Grossly intact [x] Pulses: Femoral Right:2+ Left:2+ DP Right:2+ Left:2+ PT [**Name (NI) 167**]:2+ Left:2+ Radial Right:cath site Left:2+ Carotid Bruit Right:none Left:none Pertinent Results: [**2150-3-4**] 05:00AM BLOOD WBC-8.9 RBC-4.37* Hgb-12.2* Hct-35.6* MCV-82 MCH-28.0 MCHC-34.4 RDW-15.5 Plt Ct-221 [**2150-3-4**] 05:00AM BLOOD Glucose-103* UreaN-18 Creat-0.7 Na-135 K-4.3 Cl-101 HCO3-24 AnGap-14 [**2150-2-27**] 10:30AM BLOOD Glucose-123* UreaN-21* Creat-1.0 Na-136 K-4.1 Cl-105 HCO3-22 AnGap-13 [**2150-2-27**] 10:30AM BLOOD ALT-14 AST-18 CK(CPK)-168 AlkPhos-62 Amylase-63 TotBili-0.2 DirBili-0.1 IndBili-0.1 [**2150-2-27**] 10:30AM BLOOD %HbA1c-6.0* eAG-126* Findings LEFT ATRIUM: Moderate LA enlargement. Good (>20 cm/s) LAA ejection velocity. No thrombus in the LAA. RIGHT ATRIUM/INTERATRIAL SEPTUM: A catheter or pacing wire is seen in the RA and extending into the RV. Aneurysmal interatrial septum. No ASD by 2D or color Doppler. LEFT VENTRICLE: Normal LV wall thickness. Normal LV cavity size. Overall normal LVEF (>55%). RIGHT VENTRICLE: Normal RV chamber size and free wall motion. AORTA: Mildly dilated ascending aorta. Normal descending aorta diameter. Simple atheroma in descending aorta. No thoracic aortic dissection. AORTIC VALVE: Bicuspid aortic valve. Mild AS (area 1.2-1.9cm2). Trace AR. MITRAL VALVE: Normal mitral valve leaflets. Mild to moderate ([**12-29**]+) MR. TRICUSPID VALVE: Normal tricuspid valve leaflets with trivial TR. PULMONIC VALVE/PULMONARY ARTERY: Normal pulmonic valve leaflets. Physiologic (normal) PR. GENERAL COMMENTS: Written informed consent was obtained from the patient. 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. The TEE probe was passed with assistance from the anesthesioology staff using a laryngoscope. Results were Conclusions PRE-CPB: The left atrium is mildly dilated. No thrombus is seen in the left atrial appendage. No atrial septal defect is seen by 2D or color Doppler. Left ventricular wall thicknesses are normal. The left ventricular cavity size is normal. Overall left ventricular systolic function is normal (LVEF>55%). Right ventricular chamber size and free wall motion are normal. The ascending aorta is mildly dilated. There are simple atheroma in the descending thoracic aorta. No thoracic aortic dissection is seen. The aortic valve is bicuspid. There is mild aortic valve stenosis (valve area 1.2-1.9cm2). Trace aortic regurgitation is seen. The mitral valve leaflets are structurally normal. Mild to moderate ([**12-29**]+) central mitral regurgitation is seen. Dr. [**Last Name (STitle) 914**] was notified in person of the results at time of study. POST-CPB: The patient is on a phenylephrine infusion. The left ventricular systolic function remains normal. Estimated EF>55%. The right ventricular systolic function remains normal. Valvular function remains unchanged. There is no evidence of aortic dissection. Brief Hospital Course: Upon finding the severe left main disease, emergent revascularization was undertaken. He went to the Operating Room where quadruple bypass grafting was performed. He weaned from bypass on Vasopressin, NeoSynephrine and Propofol. He did well, extubating and weaning from Vasopressin the day of surgery. NeoSynephrine weaned over the next 24 hours. A Lasix infusion was begun and he responded with a brisk diuresis. Beta blockade was also started. CTs were removed per protocol as were temporary pacing wires. On POD 4 he transferred to the step down unit, where diuresis was continued and beta blockade titrated as he remained tachycardic. Physical Therapy worked with him for mobility and strength. He did well and on POD 6 was ready for transfer to rehabilitation for further recovery. Arrangements were made for follwo up and medications and restrictions are as noted elsewhere. He was discharged [**Hospital6 1643**] Center. Medications on Admission: CLOPIDOGREL [PLAVIX] - 75 mg Tablet - 1 (One) Tablet(s) by mouth once a day First dose 300 mg then 75 mg daily ISOSORBIDE MONONITRATE - 30 mg Tablet Extended Release 24 hr - 1 (One) Tablet(s) by mouth once a day LEVOTHYROXINE - (Prescribed by Other Provider) - 100 mcg Tablet - 1 (One) Tablet(s) by mouth once a day LORAZEPAM [ATIVAN] - (Prescribed by Other Provider) - 1 mg Tablet - 1 (One) Tablet(s) by mouth as needed METOPROLOL SUCCINATE - 25 mg Tablet Extended Release 24 hr - 1 (One) Tablet(s) by mouth once a day NITROGLYCERIN [NITROSTAT] - 0.3 mg Tablet, Sublingual - 1 (One) Tablet(s) sublingually As needed as needed for chest pain Take one SL NTG for chest pain. [**Month (only) 116**] repeat iafter 5 minutes x2, call 911 if pain persists after 3rd pill TAMSULOSIN [FLOMAX] - (Prescribed by Other Provider) - 0.4 mg Capsule, Ext Release 24 hr - 1 Capsule(s) by mouth daily ZOLPIDEM [AMBIEN] - (Prescribed by Other Provider) - 5 mg Tablet - [**12-29**] Tablet(s) by mouth at bedtime Discharge Medications: 1. flu vaccine [**2148**] (36 mos+)(PF) 45 mcg (15 mcg x 3)/0.5 mL Syringe Sig: One (1) ML Intramuscular NOW X1 (Now Times One Dose). 2. simvastatin 20 mg Tablet Sig: One (1) Tablet PO once a day. 3. tamsulosin 0.4 mg Capsule, Ext Release 24 hr Sig: One (1) Capsule, Ext Release 24 hr PO HS (at bedtime). 4. magnesium hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO HS (at bedtime) as needed for constipation. 5. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4 hours) as needed for pain, fever. 6. levothyroxine 100 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. oxycodone-acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain for 4 weeks. Disp:*50 Tablet(s)* Refills:*0* 8. aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 9. clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 10. lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for anxiety. 11. ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 12. furosemide 40 mg Tablet Sig: One (1) Tablet PO once a day for 4 days. 13. potassium chloride 20 mEq Tablet, ER Particles/Crystals Sig: One (1) Tablet, ER Particles/Crystals PO once a day. 14. metoprolol tartrate 50 mg Tablet Sig: One (1) Tablet PO three times a day. Discharge Disposition: Extended Care Facility: [**Hospital **] Healthcare Center - [**Location (un) **] Discharge Diagnosis: unstable angina Bicuspid aortic valve. s/p emergency coronary artery bypass grafts anxiety/depression prostate cancer gastroesophageal reflux Pectus excavatum. anal cancer [**2125**] (s/p chemo and radiation therapy) iron deficieny anemia hypothyroidism basal cell cancer of the face Discharge Condition: Alert and oriented x3, nonfocal Ambulating, deconditioned Sternal pain managed with oral analgesics Sternal Incision - healing well, no erythema or drainageleg(left) clean and dry. healing well Discharge Instructions: Please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions Please NO lotions, cream, powder, or ointments to incisions Each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart No driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive No lifting more than 10 pounds for 10 weeks 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: Wound Check at Cardiac Surgery Office [**Telephone/Fax (1) 170**] Surgeon Dr. [**Last Name (STitle) 914**]([**Telephone/Fax (1) 170**]) on [**2150-3-30**] at 1:30pm Cardiologist :have Dr [**Last Name (STitle) 6420**] recommend one Please call to schedule the following: Primary Care:Dr.[**First Name8 (NamePattern2) 915**] [**Last Name (NamePattern1) 6420**] ([**Telephone/Fax (1) 5723**]in [**4-2**] 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** Completed by:[**2150-3-5**] ICD9 Codes: 3051, 4111, 2449, 311
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Medical Text: Admission Date: [**2102-4-23**] Discharge Date: [**2102-4-23**] Date of Birth: [**2033-4-8**] Sex: M Service: CHIEF COMPLAINT: Cardiac arrest. HISTORY OF PRESENT ILLNESS: The patient is a 69 year old male with a history of coronary artery disease status post remote myocardial infarction, hypertension, hypercholesterolemia, and chronic obstructive pulmonary disease who presented status post witnessed arrest at home in the presence of his wife. The patient was reported to have fallen backwards without prodrome or complaint, hitting the floor near his bed. EMS was contact[**Name (NI) **] and arrived upon the scene within five minutes. The patient was found to be pulseless and apneic. CPR was started, the patient was intubated and pads were placed revealing ventricular fibrillation. The patient was defibrillated at 200, 300 and 300, with no response. He was given 1 mg of epinephrine which converted him to systole, then given Atropine times two and Epinephrine times three, which converted him to PEA, which transitioned to an idioventricular rhythm at 20 beats per minute. The patient had pacing attempted without success. He reverted to asystole. He was given an ampule of bicarbonate and epinephrine which converted the patient to ventricular fibrillation. He was defibrillated at 03:16, given 300 mg of Amiodarone. He was transferred to [**Hospital3 417**] and then transferred to [**Hospital1 1444**]. His EKG showed inferoposterior injury changes. He arrived on Dobutamine, Neo-Synephrine and Amiodarone. Cardiac catheterization revealed diffuse three-vessel disease. He has elevated left filling pressures. PAST MEDICAL HISTORY: 1. Chronic obstructive pulmonary disease. 2. Coronary artery disease status post remote myocardial infarction. 3. Hypercholesterolemia. 4. Hypertension. ALLERGIES: No known drug allergies. MEDICATIONS: 1. Atenolol. 2. Lipitor. SOCIAL HISTORY: The patient lives with his wife. [**Name (NI) **] has a positive smoking history. FAMILY HISTORY: Noncontributory. PHYSICAL EXAMINATION: The patient's pulse was 83; blood pressure 123/60; respiratory rate of 14 and oxygen saturation of 98%, on mechanical ventilation of AC-800 by 14; respiratory rate of 15. He was on 100% FIO2. On general examination, the patient was an ill appearing intubated man in no apparent distress. HEENT examination reveals scleral edema and moist mucous membranes. Neck examination revealed no lymphadenopathy. Cardiac examination revealed a regular rate and rhythm, normal S1 and S2 that were distant and no murmurs, rubs or gallops. Pulmonary examination revealed diffuse inspiratory and expiratory wheezes. Abdominal examination revealed a belly that was soft, moderately distended, nontender, with no bowel sounds appreciated. Extremities revealed trace edema and no dorsalis pedis pulses. LABORATORY: Pertinent laboratory findings were the patient's white count of 8.0 with a hematocrit of 36.5 and platelets of 188. The patient's creatinine was 1.5. His CK was 138 with an MB of 28.7, a troponin of 1.98. Initial arterial blood gas was 7.19 with pCO2 of 37 and pAO2 of 301. EKG revealed normal sinus rhythm, normal axis and massive ST elevations in II, III and AVF with reciprocal changes in I and L. The patient also had early transition and massive ST depressions in V2 through V5. These findings were consistent with an inferoposterior myocardial infarction. Cardiac catheterization revealed diffusely diseased three vessel coronary system. The mid-left circumflex was totally occluded as was the mid right coronary artery. The left anterior descending was diffusely diseased. The patient had two stents, one to the ostium and one to the mid-portion of the right coronary artery. Pulmonary capillary wedge was 40. SUMMARY OF HOSPITAL COURSE: This 69 year old man with a history of coronary artery disease status post remote myocardial infarction, hypertension, hypercholesterolemia as well as chronic obstructive pulmonary disease, presented with witnessed cardiac arrest and large inferoposterior myocardial infarction. 1. Cardiovascular: The patient presented with ventricular fibrillation arrest at home with prolonged resuscitation in the setting of an inferoposterior myocardial infarction. He had total occlusions of the mid right coronary artery and mid circumflex with a diffusely diseased left anterior descending. He received stents times two to his mid right coronary artery. He was transferred from the Catheterization Laboratory on Dopamine and an intra-aortic balloon pump. The patient had no palpable pulses in his lower extremities, and the move was made to remove the intra-aortic balloon pump. The patient had a worsening lactic acidosis throughout the morning of admission. He remained in normal sinus rhythm on Amiodarone and Lidocaine drips. He required mechanical ventilation for control of his acid-based status as well as for airway protection. Increasing respiratory rate and total volumes were not able to control the patient's overwhelming acidosis. The patient was markedly oliguric and volume control was not able to be obtained. The patient had a markedly distended abdomen and there was concern for ischemic bowel. A KUB showed wall thickening and no free air. The intra-aortic balloon pump was removed and the patient continued to have a worsening acidosis. After discussion with the family, the decision was made to abandon aggressive efforts. The patient experienced at 06:55 p.m. on [**2102-4-23**]. CONDITION AT DISCHARGE: Deceased. DISCHARGE DIAGNOSES: 1. Ventricular fibrillation arrest. 2. Inferoposterior myocardial infarction. 3. Coronary artery disease. 4. Hypercholesterolemia. 5. Chronic obstructive pulmonary disease. 6. Hypertension. 7. Overwhelming lactic acidosis. 8. Acute renal failure. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], M.D. [**MD Number(1) 8227**] Dictated By:[**Last Name (NamePattern1) 5246**] MEDQUIST36 D: [**2102-4-25**] 08:32 T: [**2102-4-26**] 14:57 JOB#: [**Job Number 9742**] ICD9 Codes: 4280, 5849, 496, 4019
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Medical Text: Admission Date: [**2176-6-3**] Discharge Date: [**2176-6-6**] Date of Birth: [**2106-3-30**] Sex: F Service: Neurology DIAGNOSIS: Cerebral Infarction. HISTORY OF PRESENT ILLNESS: Patient is a 70-year-old right-handed woman, who presented to our Emergency Department with right arm and leg weakness with a sudden onset at around 10 a.m. on the day of admission. Patient was working in her work place when she noticed sudden onset of severe dizziness and loss of strength on the right side of the body involving her leg and the arm. She was seen to have fallen on the ground with loss of consciousness. Over the next minutes, she gained consciousness, and was transferred urgently to our hospital. MEDICATIONS ON ADMISSION: 1. Accupril 10 mg b.i.d. 2. Ambien prn. ALLERGIES: None. SOCIAL HISTORY: Patient works in [**University/College 56117**]Laboratory. Lives in studio next door to her daughter. Is an ex-smoker. Denies alcohol or drug abuse. Works three days per week. PAST MEDICAL HISTORY: 1. Miscarriage several times in the past. 2. Hypertension. 3. Anxiety. PHYSICAL EXAM ON ADMISSION: Patient was alert and oriented to person, place, and date. Speech was fluent and comprehension was intact. Patient did not have any apraxia or neglect. Naming and repetition were intact. Visual fields were clear. Cranial nerve exam did not reveal any abnormalities. On motor exam, patient had extensor weakness in the right arm and flexor weakness in the leg. Deep tendon reflexes were 2+ and plantars were upgoing on the right. Sensation was diminished to pinprick, light touch, and cold over the right arm and leg. No truncal ataxia could be seen. Gait was unable to be performed. HOSPITAL COURSE: This lady was admitted to our service and received IV TPA within 3 hours. She was admitted to ICU for frequent neuro checks. Her vitals were checked and no irregularities could be seen. Telemetry recordings from the ICU revealed only infrequent PVCs and sinus tachycardia. Patient was moved towards to the General Service in [**Hospital Ward Name 121**] 5. We detected urinary tract infection and started her on antibiotics for this reason. Twenty-four hours after TPA we initiated aspirin treatments. She received one full dose of aspirin the first day and on the second day the patient received aspirin 81 mg per day and Aggrenox one tablet a day. Blood laboratories indicated no abnormalities except for abnormal homocysteine levels, which were detected on day three of her admission. We initiated treatment with folic acid and multivitamin for this reason. Patient's right elbow was noted to have arthritic changes, and the patient was suffering from pain in this joint. She received six doses of 500 mg naproxen for this, and the arthritic inflammation was found to have subsided on day two of this treatment. Patient received GI prophylaxis with Protonix. Her blood pressure was erratic after she was transferred from the ICU. We could detect systolic pressure in the range of 180-190 at several occasions, which were treated with hydralazine IV and also reinitiation of her preadmission antihypertensive, namely Accupril 10 mg b.i.d. We later changed this medication to 10 mg 3x a day. Upon admission, MRI, angio, and diffusion-weighted images indicated, respectively, poor flow in the branches of the MCA and abnormal diffusion in the parietal region. Repeat MRI including repeat DWI showed she has several lesions in the left hemisphere involving the parietal as well as frontal cortices and some underlying white matter branches of the corona radiata. Patient's neurological status improved especially in the upper extremities, but not in the lower extremities. Her right arm had gained strength in the range of [**5-5**]+ in extensor musculature group, but the right leg had minimal, if any movement in the flexors or extensor musculature. Patient received frequent physical therapy and upon their assessment, she is being transferred to a rehabilitation facility for aggressive exercise. MEDICATIONS ON DISCHARGE: 1. Aspirin 81 mg p.o. q.d. 2. Aggrenox one capsule p.o. q.d. for two more days, and then change to one capsule p.o. b.i.d. Please note if the patient continues with headache after Aggrenox treatment, this needs to be discontinued and then one could start her on Plavix 75 mg p.o. q.d. from there on. If patient's headache subside and she tolerates, please change the dose of Aggrenox to one capsule p.o. b.i.d. as noted. 3. Lipitor 10 mg p.o. q.h.s. This medication was initiated, although her lipid panel did not reveal any gross abnormality. The rationale was to gain preventive effects on future cerebrovascular disease. 4. Folic acid 1 mg p.o. q.d. 5. Levofloxacin 250 mg p.o. q.24h., last dose scheduled for today before the patient leaves. 6. Multivitamin one capsule p.o. q.d. 7. Naproxen 500 mg p.o. q.8h. prn for elbow arthritis. 8. Percocet one tablet p.o. q.4-6h. for headaches associated with Aggrenox treatment. 9. Protonix 40 mg p.o. q.24h. 10. Accupril 10 mg p.o. b.i.d. FOLLOWUP: With Dr. [**First Name8 (NamePattern2) **] [**Name (STitle) **] in [**5-7**] weeks. DIAGNOSES: Left MCA stroke Hyperhomocysteneimia ? Coagulopathy (We are, however, awaiting the coagulopathy workup. This needs to be checked at the follow-up appointment) DISCHARGED TO: Rehabilitation facility. DISCHARGE CONDITION: As described above. [**Name6 (MD) 4267**] [**Last Name (NamePattern4) 4268**], M.D. [**MD Number(1) 4269**] Dictated By:[**Last Name (NamePattern1) 728**] MEDQUIST36 D: [**2176-6-6**] 11:38 T: [**2176-6-6**] 11:39 JOB#: [**Job Number 56118**] ICD9 Codes: 5990, 4019, 3051
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Medical Text: Admission Date: [**2157-3-1**] Discharge Date: [**2157-3-1**] Date of Birth: [**2073-4-5**] Sex: M Service: MEDICINE Allergies: Penicillins / Bactrim Attending:[**Last Name (NamePattern4) 290**] Chief Complaint: Hypoxia Major Surgical or Invasive Procedure: None History of Present Illness: 83 yo male with recent complicated admission significant for: 1. Bladder CA, 7 cm mass, hematuria, with innumberable pulmonary nodules, likely metastases 2. Urosepsis, UCx + pseudomonas, h/o mutliple drug resistant UTIs, treated with 14 days of meropenem 3. Massive DVT, with IVC filter, not on anticoagulation [**1-25**] hematuria During this admission, palliative care was consulted, and significant efforts were made to address goals of care, given his poor prognosis. He was made DNR/DNI. He was discharged to a [**Hospital1 1501**] with the eventual goal of putting him under hospice care. He was then found at his [**Hospital1 1501**] unresponsive. His VS on arrival to the ED were: T 98.0, HR 160s, BP 82/50, SpO2 40% on NRB, with rhonchi on exam. He received Vancomycin 1g IV, Levofloxacin 750mg IV, and Flagyl 500mg IV. On arrival to the floor, patient was unresponsive, was agonal breathing, with an SpO2 in the 60's on a 100% FM with 6L NC. Past Medical History: 1. Pulmonary Embolism ([**2156-12-24**], IVC filter, not on anticoagulation) 2. Pancreatitis 3. Dementia 4. Type 2 Diabetes Mellitus 5. Hypertension, but not on antihypertensives 6. BPH 7. Bladder Cancer - s/p transurethral resection in [**7-31**] - completed [**3-29**] BCG treatment (missed treatment 5 [**1-25**] UTI) 8. s/p Stab Wounds 9. h/o RPR - treated in [**2119**] 10. s/p Penile Implant 11. Osteoarthritis Social History: Per previous records, patient could not complete full history with me due to his delirium and dementia. Home: lives in [**Location 4367**] [**Hospital3 400**] Facility Occupation: retired long-distance truck driver EtOH: remote history of social alcohol use; denies EtOH in > 45 years Tobacco: remote history of 1 PPD smoking history, could not tell me when he quit Drugs: denies Family History: Could not complete due to patient's dementia. Physical Exam: Vitals: BP: 52/31 P: 126 RR: 8 General: Agonal breathing, unresponsive CV: Regular Lungs: Coarse breath sounds bilaterally Ext: warm, well perfused Pertinent Results: [**2157-3-1**] 01:15AM BLOOD WBC-19.4* RBC-4.96 Hgb-11.0* Hct-40.1 MCV-81* MCH-22.2* MCHC-27.4* RDW-18.2* Plt Ct-481* [**2157-3-1**] 01:15AM BLOOD PT-18.2* PTT-34.3 INR(PT)-1.6* [**2157-3-1**] 01:15AM BLOOD Fibrino-821* [**2157-3-1**] 01:15AM BLOOD UreaN-33* Creat-1.9* [**2157-3-1**] 01:15AM BLOOD Lipase-42 [**2157-3-1**] 01:27AM BLOOD Glucose-135* Lactate-11.0* Na-166* K-4.8 Cl-115* calHCO3-23 Brief Hospital Course: 83 year old man with a h/o of metastatic bladder CA, mutliple drug resistant UTIs, & massive DVT s/p IVC filter who presented in respiratory failure likely [**1-25**] pneumonia. On admission, the patient's HCP (his wife) expressed her desire to focus on his comfort. He received supplemental oxygen, antibiotics, and was placed on a morphine gtt and he expired within 2 hours of arriving in the ICU. Medications on Admission: 1. Famotidine 20 mg Tablet Sig: One (1) Tablet PO every twelve (12) hours. Disp:*30 Tablet(s)* Refills:*2* 2. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: Two (2) Tablet PO DAILY (Daily). Tablet(s) 3. Citalopram 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Donepezil 5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 5. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 6. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 7. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for fever or pain. 8. Polyvinyl Alcohol 1.4 % Drops Sig: 1-2 Drops Ophthalmic PRN (as needed) as needed for dryness. Disp:*1 bottle* Refills:*2* 9. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection TID (3 times a day). 10. Nystatin 100,000 unit/mL Suspension Sig: Five (5) ML PO QID (4 times a day). 11. Polyethylene Glycol 3350 17 gram/dose Powder Sig: One (1) packet PO DAILY (Daily) as needed for constipation. 12. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: Two (2) Tablet PO DAILY (Daily). 13. Insulin Sliding scale Discharge Medications: expired Discharge Disposition: Expired Discharge Diagnosis: Respiratory failure Discharge Condition: expired Discharge Instructions: expired Followup Instructions: expired [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**Name8 (MD) **] MD [**MD Number(1) 292**] ICD9 Codes: 0389, 486, 2760, 4019
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Medical Text: Admission Date: [**2181-3-26**] Discharge Date: [**2181-4-3**] Date of Birth: [**2120-5-7**] Sex: F Service: NEUROSURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1854**] Chief Complaint: Right Parietal Brain Mass Major Surgical or Invasive Procedure: [**3-26**]:Right sided craniotomy for mass resection History of Present Illness: Patient is an 60F known to the neurosurgery service, who presents for elective surgery for resection of right sided parietal brain mass on [**3-26**]. Past Medical History: None; however the patient states she has not been to a physician in more than 10 yrs. She does state that she has been smoking for "longer than she can remember" and has had a "benign" mass resected from her left breast "many years" ago. Social History: Married Family History: non-contributory; denies familial history of brain masses/cancer. Physical Exam: On d/c she remains afebrile. She is awake, alert and oriented x3. PRRLA . Rt pupil is 4mm to 3mm and the left remains slightly smaller at 3.5 to 3.0mm. EOM's are full. There is no nystagmus. Tongue is midline with even facial symmetry. She continues to have a left pronator drift. Motor strength 4/5 in the left bicep and tricep only, otherwise she is full in the upper extremities. In the lower extremities she is decreased in the left lower extremity as follows: IP-4+, Quad 5, Ham 4, Gastra 4, AT 4, [**Last Name (un) 938**] 4. Otherwise she is full in the right lower extremity. She has been ambulating in her room and on the nursing unit with staff and Physical therapy. Gait is slow without listing. She is tolerating all p.o. food and fluid well with no nausea or vomiting. She is passing flattus, urine and stool without issues. Her clinical exam has remained stable. Pertinent Results: Anatomical Pathology report DIAGNOSIS: I. Brain, right parietal lesion (A-B): glioblastoma, (WHO IV), see note. Note: Necrosis, mitosis, and vascular proliferation are present. II. Brain, right parietal lesion-research (C-E): Glioblastoma, (WHO IV), see note. Note: MIB-1 immunohistochemistry reveals a focal proliferation index of 80% in a dense small cell focus and 15-20% overall (block D). III. Dural, right parietal (F-G): Leptomeninges focally involved by [**Last Name (un) **]. IV. Brain, white matter (H): White matter is diffusely infiltrated by [**Last Name (un) **] with mild hypercellularity and prominent microvascular proliferation. V. Brain, right parietal lesion (I-K): Diffusely infiltrating [**Last Name (un) **] with areas of solid [**Last Name (un) **] cell nodules. Radiology Report MR HEAD W/CNTRST&[**Last Name (un) **] VOLUMETRIC Study Date of [**2181-3-26**] 6:08 AM [**2181-3-26**] 6:08 AM MR HEAD W/CNTRST&[**Year/Month/Day **] VOLUMET; CT 3D RENDERING W/POST PROCESS Clip # [**Clip Number (Radiology) 82765**] Reason: pre-surgical mapping for craniotomy Contrast: MAGNEVIST Amt: 12 Provisional Findings Impression: RXCg MON [**2181-3-26**] 6:41 PM PFI: Large 4.1 x 3.1 cm heterogeneously enhancing mass in the right parietotemporal region causing mass effect on the ipsilateral lateral ventricle and effacement of the Ambien cistern. Final Report HISTORY: 60-year-old female patient with a right brain mass. TECHNIQUE: Post-gadolinium contrast images were obtained in the axial, coronal, and sagittal planes as per presurgical planning protocol. MR [**First Name (Titles) **] [**Last Name (Titles) 82766**]y was also obtained of the enhancing portion of the [**Last Name (Titles) **]. FINDINGS: There has been slight interval increase in size of the right parietotemporal heterogeneously enhancing mass. The volume of enhancing [**Last Name (Titles) **] measures 18.85 cm3. This mass is closely opposed and appears to involve the overlying dura as indicated by adjacent dural thickening and enhancement. There is surrounding perilesional T1 hypointensity reflecting edema versus [**Last Name (Titles) **] infiltration. There is a mass effect involving the ipsilateral lateral ventricle as well as midline shift of approximately 4.9 mm, not significantly changed when compared to the prior exam. There is effacement of the ipsilateral ambient cistern with no evidence for frank herniation. No other abnormal enhancing lesions are identified. IMPRESSION: Large right parietotemporal heterogeneously enhancing mass. Differential diagnostic considerations include primary CNS malignancy (such as GBM) or solitary metastases. CT brain Wet Read: JXKc TUE [**2181-3-27**] 11:54 PM Post-op changes from right parietal resection with increase in vasogenic edema, and leftward shift of midline and subfalcine herniation of 10 mm (previously, 4mm). New right subdural hypodense collection, measuring 4 mm. Final Report HISTORY: 60-year-old female with recent right craniotomy for a mass, with small bleeding this morning, now increased lethargy and left hemiparesis. Evaluate for increase in hemorrhage. COMPARISON: [**2181-3-26**]. TECHNIQUE: Contiguous axial images of the head were obtained without IV contrast. FINDINS: Changes from a right parietal craniotomy and resection of the mass are again noted, with a small amount of hemorrhage and pneumocephalus seen within the resection bed. There continues to be residual vasogenic edema, which may be slightly increased, particularly near the vertex, compared to prior study. There is, however, a marked increase in associated mass effect and leftward subfalcine herniation, with herniation of approximately 10 mm (previously 4 mm); there is also evidence of early left uncal herniation. There is also mass effect on the ipsilateral lateral ventricle, with an increase in caliber of the contralateral lateral ventricle, with the frontal [**Doctor Last Name 534**] measuring approximately 8 mm (previously approximately 6.5 mm). There is also new dilatation of the left temporal [**Doctor Last Name 534**]. Since the interval study,there is also a new right subdural collection, which is relatively hypodense, could reflect a small subdural hygroma. No new foci of intracranial hemorrhage are identified. Visualized paranasal sinuses and mastoid air cells are normally aerated. Previously noted dilated superior ophthalmic veins are improved. Post-surgical changes are also noted within the soft tissues and scalp overlying the craniotomy site, with soft tissue swelling and air. IMPRESSION: 1. Status post resection of right parietal mass, with increase in vasogenic edema and mass effect, with an increase in leftward subfalcine and early uncal herniation. 2. Increased caliber of the left lateral ventricle, likely "trapped" at the level of the foramen of [**Last Name (un) 2044**], with obliteration of the frontal [**Doctor Last Name 534**] of the right lateral ventricle. 3. Small new right subdural collection, measuring 4 mm in maximal dimension, could reflect a small subdural hygroma. MR HEAD W/O CONTRAST Study Date of [**2181-3-29**] 12:26 PM Final Report COMPARISON: CT [**2181-3-27**]; MR [**2181-3-27**]; [**2181-3-20**]. TECHNIQUE: Diffusion technique images were obtained. FINDINGS: There is no diffusion abnormality. Again seen is a surgical resection site in the right parietal lobe. Signal change due to T2 prolongation in this area and representing edema appears little changed from the prior MR studies. IMPRESSION: 1. No diffusion-weighted abnormalities to suggest infarction. 2. Similar appearance to edema in the right parietal postsurgical area. Radiology Report CT HEAD W/O CONTRAST Study Date of [**2181-3-31**] 12:00 N Provisional Findings Impression: GWp SAT [**2181-3-31**] 2:17 PM PFI: 1. New 3.3 x 1.0 cm focus of hyperdensity within the right parietal resection area consistent with new bleed. 2. Similar leftward subfalcine shift. 3. Persistent right subdural hypodense collection, essentially unchanged from prior. Final Report Right craniotomy, evaluate for reduction of edema. COMPARISON: [**2181-3-27**]; [**2181-3-26**]. TECHNIQUE: Non-contrast head CT. There is a new 3.3 x 1.0 cm focus of hyperdensity within the right parietal resection site, compatible with new bleed. Vasogenic edema persists and the amount of leftward subfalcine herniation is similar to prior at 10 mm. There is evidence of uncal herniation. Again seen is mass effect on the right lateral ventricle with the frontal [**Doctor Last Name 534**] on the left, again mildly dilated. There is a stable appearance to the right subdural collection, which is relatively hypodense. Visualized paranasal sinuses and mastoid air cells are normal. Post-surgical changes are seen in the soft tissues of the scalp overlying the craniotomy site with soft tissue swelling and air. IMPRESSION: 1. Status post resection of right parietal mass with a new hyperdense focus compatible with new bleed. Stable appearance of leftward subfalcine and uncal herniation. 2. Stable appearance of left lateral ventricle likely trapped at the level of foramen of [**Last Name (un) 2044**] with distortion of the frontal [**Doctor Last Name 534**] of the right lateral ventricle. 3. Persistent right subdural collection, unchanged in size, may reflect some small subdural hygroma. Brief Hospital Course: Patient was electively admitted on [**3-26**] for surgical resection of right sided parietal brain mass. Post-operatively she was transferred to the ICU for monitoring overnight. On POD#1 pt was transfered to the floor with left neglect (old) with left drift/ CT stable. On the early evening, pt with lethargy, Ct stable, dilantin changed to Keppra. Later that evening of that same day - pt with increased lethargy. Second stat CT of the day showed increased edema with MLS. She was treated aggressively with mannitol, lasix and decadron and transfered to step down status. MRI completed wihtout signs of stroke. She was seen by Dr. [**Last Name (STitle) 724**] / neuro-onc to formulate a plan as her pathology was finalized as GBM stage IV. The following day she was more awake and passed speech and swallow. Her exam continued to improve. On [**2181-3-31**] a routine CT was done to follow resolution and or improvement of edema. Of note there was a new area of bleeding into the postop bed. A decision was made to follow her clinically as she coninues to do well. Her mannitol was d/c'd after discussion with the attending. On [**2181-4-2**] CT imaging was completed and she was cleared for d/c to home with services by Physical therapy. She has also been seen by Dr. [**Last Name (STitle) 724**] while inpatient and will see him again on [**2181-4-30**] for further management. Medications on Admission: Dilantin Decadron Discharge Medications: 1. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed for Constipation. Disp:*30 Tablet(s)* Refills:*1* 2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 3. Dexamethasone 4 mg Tablet Sig: 1.5 Tablets PO Q8H (every 8 hours). Disp:*135 Tablet(s)* Refills:*1* 4. Levetiracetam 500 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). Disp:*120 Tablet(s)* Refills:*2* 5. Outpatient Physical Therapy For evaluation and continued treatment as needed 6. Protonix 20 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO twice a day. Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 7. Fioricet 50-325-40 mg Tablet Sig: 1-2 Tablets PO every six (6) hours as needed for headache. Disp:*85 Tablet(s)* Refills:*2* Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: Right parietal mass Discharge Condition: Neurologically stable Discharge Instructions: General Instructions/Information ?????? 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. ?????? You may wash your hair only after sutures have been removed. ?????? 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. ?????? You have been prescribed Keppra for seizure control. ?????? You are being sent home on steroid medication, make sure you are taking a medication to protect your stomach (Prilosec, Protonix, or Pepcid), as these medications can cause stomach irritation. Make sure to take your steroid medication with meals, or a glass of milk. ?????? 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. 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: increasing redness, increased swelling, increased tenderness, or drainage. ?????? Fever greater than or equal to 101?????? F. Followup Instructions: Follow-Up Appointment Instructions ??????Please return to the office in [**5-25**] days (from your date of surgery) for removal of your staples/sutures and 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. ??????You have an appointment in the Brain [**Hospital 341**] Clinic on [**2181-4-30**]@ 3:00pm with Dr. [**Last Name (STitle) 724**]. The Brain [**Hospital 341**] Clinic is located on the [**Hospital Ward Name 516**] of [**Hospital1 18**], in the [**Hospital Ward Name 23**] Building. Their phone number is [**Telephone/Fax (1) 1844**]. Please call if you need to change your appointment, or require additional directions. ??????You will not need an MRI of the brain as this was done during your hospitalization. Completed by:[**2181-4-3**] ICD9 Codes: 3051
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Medical Text: Admission Date: [**2193-5-24**] Discharge Date: [**2193-5-29**] Date of Birth: [**2117-8-12**] Sex: M Service: CHIEF COMPLAINT: Increased shortness of breath with exertion and occasional chest discomfort. HISTORY OF PRESENT ILLNESS: The patient is a 75-year-old male with a history of coronary artery disease since [**2184**]. He has been on medical treatment since then. He developed congestive heart failure in the Summer of [**2192**] with increased fatigue and increased shortness of breath on exertion. He also developed atrial fibrillation for which he was cardioverted times two, both of which failed. He was then radioablated with repeat catheterization in [**4-9**]. He also had a positive exercise tolerance test in [**4-9**]. PAST MEDICAL HISTORY: 1) Coronary artery disease. 2) Rheumatic fever at age 12. 3) Paroxysmal atrial fibrillation, status post cardioversion times two, status post ablation. 4) Lower back pain. 5) Osteoarthritis bilateral hips. 6) Emphysema on Theophylline. 7) Congestive heart failure. 8) Hypertension. PAST SURGICAL HISTORY: Status post appendectomy, status post tonsillectomy. MEDICATIONS: On admission, Coumadin discontinued [**5-10**], Zestril 10 mg q d, Atenolol 25 mg q d, Maxzide 37.5 mg q d, ASA 81 mg q d, MVI, Theophylline 300 mg q d. ALLERGIES: None known. HOSPITAL COURSE: The patient underwent an elective coronary artery bypass graft times one on [**2193-5-24**]. His intraoperative course was uneventful and he was transferred to the CSRU. He was extubated on the same day. He recovered well in the CSRU though he needed Neo-Synephrine for blood pressure control on postoperative day #1. On postoperative day #2 he was weaned off the Neo-Synephrine and his chest tubes were discontinued. He was transferred to the regular floor on postoperative day #2 in a stable condition. On postoperative day #3 he developed atrial fibrillation which was treated with IV Lopressor. He reverted back to sinus rhythm with a small dose of IV Lopressor. He was started on po Amiodarone. He remained in sinus rhythm and he is ready for discharge on postoperative day #5. DISCHARGE MEDICATIONS: Lopressor 25 mg [**Hospital1 **], Lasix 20 mg q d times one week, KCL 20 mEq q d times one week, Colace 100 mg [**Hospital1 **], Aspirin enteric coated 325 mg q d, Plavix 75 mg q d, Theodur 300 mg q d, Amiodarone 400 mg q d times one month, Percocet 1-2 tablets q 4-6 hours prn. DISCHARGE STATUS: To home. FO[**Last Name (STitle) **]P: With primary care physician, [**Last Name (NamePattern4) **]. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] in two weeks and with Dr. [**Last Name (Prefixes) **] in four weeks. [**Doctor Last Name 412**] [**Last Name (Prefixes) 413**], M.D. [**MD Number(1) 414**] Dictated By:[**Last Name (NamePattern1) 2209**] MEDQUIST36 D: [**2193-5-28**] 19:54 T: [**2193-5-28**] 20:57 JOB#: [**Job Number 42528**] ICD9 Codes: 4254, 4280, 4019
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Medical Text: Admission Date: [**2143-6-29**] Discharge Date: [**2143-7-31**] Date of Birth: [**2061-12-17**] Sex: M Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 2009**] Chief Complaint: Chest and Abdominal pain Major Surgical or Invasive Procedure: ERCP x2 NJ Tube placement PICC line placement right side, replaced onto left side History of Present Illness: 81M p/w cp/abd pain x 2d. Pt reports nausea with emesis x 3 yesterday. Reports that the pain is over the L side of his chest and abdomen, radiating to his back. In the ED, initial VS were: 10:01 96 102 134/88 20 97%. Given morphine and pressures dropped to the 100s, switched to fentanyl for pain control. A stat CTA was performed which demonstrated no evidence of dissection/ aortic rupture. Lipase 3200 and CT abdomen consistent with pancreatitis. Lactate 3.8, troponin <0.1, BNP 1451. 88 155/84, 16, 100% NC On arrival to the MICU, patient is febrile and rigoring, but comfortable, getting fluids, in no acute distress. Not struggling to breathe, no leg pain. Review of systems: (+) Per HPI (-) Denies fever, chills, night sweats, states that he has gained weight due to a good appetite. Denies headache, sinus tenderness, rhinorrhea or congestion. Denies cough, shortness of breath, or wheezing. Denies chest pain, chest pressure, palpitations, or weakness. No orthopnea, PND, claudication. Denies nausea, vomiting, diarrhea, constipation, or changes in bowel habits. Denies dysuria, frequency, or urgency. Denies arthralgias or myalgias. Denies rashes or skin changes. Past Medical History: PMH per admission note - DM2 - Aortic stenosis (mild per [**9-1**] echo) - HTN - Peripheral artery disease - Myelodysplasia/leukopenia/thrombocytopenia PSH per admission note - [**2141-3-2**] - Open AAA repair with aortobifemoral bypass using Dacro 18x9 bifurcated graft - [**2141-3-9**] - bilateral femoral exploration and iliofemoral embolectomy - [**2141-3-22**] - RP percutaneous drain - [**2141-3-27**] - RLQ perc drain - [**2141-3-28**] - anterior abd drain Social History: The patient immigrated from [**Country 532**] in [**2119**] having previously been a chemist. Lives in [**Location **] with wife who has metastatic cancer, he is the sole caretaker. [**Name (NI) **] is active and walks around. Son is [**Name (NI) **]. The patient reports a remote history of tobacco use. He quit in [**2124**] following many years at one to two packs per day. The patient denies alcohol or illicit drug use. Family History: Family History: 1. CVA - father. 2. Diabetes mellitus - brother. 3. Coronary artery disease - brother. Physical Exam: Admission exam: Physical Exam: General: Alert, oriented, no acute distress HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, PERRL Neck: supple, JVP not elevated, but difficult to tell. No LAD CV: Regular rate and rhythm, normal S1 + S2, 2/6 systolic murmur, radiating to carotids, no rubs, gallops Lungs: Trace crackles at bases Abdomen: soft, tender, non-distended, bowel sounds present, no organomegaly GU: foley Ext: positive cap refill, but somewhat cool, no pain, only doplerable at right DP, no clubbing 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 exam: O: Physical Exam: 98.6 121/63 99 22 96%RA General: Alert, oriented, appears comfortable HEENT: oropharynx clear Neck: supple, JVP not elevated Lungs: CTA CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops Abdomen: mildly distended, nontender to palpation throughout including over drain site, bowel sounds present. Drain with dark brown/green fluid. Ext: PICC site on the Left demonstrates no tenderness to palpation. No streaking or cellulitis present. Temperature in each hand is symmetric. temperature in right foot is cooler then left foot to touch. PT pulses are dopplerable B/L. Lower extremeties demonstrated diffuse extreme pitting edema. Pertinent Results: Admission labs: [**2143-6-29**] 10:30AM GLUCOSE-268* UREA N-26* CREAT-1.3* SODIUM-135 POTASSIUM-8.2* CHLORIDE-102 TOTAL CO2-19* ANION GAP-22* [**2143-6-29**] 10:30AM ALT(SGPT)-65* AST(SGOT)-81* ALK PHOS-78 TOT BILI-1.4 [**2143-6-29**] 10:30AM LIPASE-3200* [**2143-6-29**] 10:30AM cTropnT-<0.01 [**2143-6-29**] 10:30AM proBNP-1451* [**2143-6-29**] 10:30AM ALBUMIN-4.5 [**2143-6-29**] 10:30AM WBC-14.4*# RBC-6.37*# HGB-18.7*# HCT-57.9*# MCV-91 MCH-29.4 MCHC-32.3 RDW-14.0 [**2143-6-29**] 10:30AM TRIGLYCER-124 [**2143-6-29**] 10:30AM NEUTS-79.1* LYMPHS-17.2* MONOS-3.4 EOS-0.1 BASOS-0.3 [**2143-6-29**] 10:30AM PLT COUNT-105* [**2143-6-29**] 10:30AM PT-35.7* PTT-52.3* INR(PT)-3.5* [**2143-6-29**] 05:54PM URINE COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.050* [**2143-6-29**] 05:54PM CALCIUM-8.5 PHOSPHATE-1.7* MAGNESIUM-1.8 [**2143-6-29**] 05:54PM URINE RBC-15* WBC-3 BACTERIA-FEW YEAST-NONE EPI-<1 Discharge labs: [**2143-7-31**] 04:42AM BLOOD WBC-6.5 RBC-2.62* Hgb-7.6* Hct-23.9* MCV-91 MCH-29.1 MCHC-32.0 RDW-20.1* Plt Ct-195 [**2143-7-30**] 06:32AM BLOOD Neuts-58.9 Lymphs-34.8 Monos-5.0 Eos-0.8 Baso-0.6 [**2143-7-31**] 04:42AM BLOOD PT-14.6* PTT-65.3* INR(PT)-1.4* [**2143-7-31**] 04:42AM BLOOD Glucose-139* UreaN-18 Creat-0.7 Na-128* K-4.3 Cl-95* HCO3-27 AnGap-10 [**2143-7-31**] 04:42AM BLOOD ALT-22 AST-28 AlkPhos-89 TotBili-1.3 [**2143-7-31**] 04:42AM BLOOD Lipase-63* [**2143-7-31**] 04:42AM BLOOD Calcium-7.5* Phos-3.6 Mg-2.1 All Blood, urine and wound cultures were negative [**2143-6-29**] 10:08:50 AM Cardiovascular Report ECG Sinus tachycardia. Non-specific ST segment changes in the precordial leads and in the inferior leads. Compared to the previous tracing of [**2141-6-9**] the rate has increased and the non-specific ST segment changes are new. [**2143-6-29**] CHEST (PORTABLE AP)IMPRESSION: No evidence of acute cardiopulmonary process. [**2143-6-29**] 11:00 AM # [**Telephone/Fax (1) 76388**] CTA ABD & PELVIS and CHEST 1. No evidence of acute aortic syndrome, no aortic dissection. 2. Focal area of hypoenhancement and edema centered in the pacreatic head and neck, consistent with acute pancreatitis. Moderate amount of simple free fluid in the abdomen and pelvis is new since [**2142-1-15**] exam and likely relates to underlying panreatitis. No pseudcyst formation or vascular complications at this time. 3. Coarse hepatic calcification is longstanding and likely represents sequela of prior infection or trauma. 4. Emphysema. 5. Severe coronary artery calcifications. 6. Post-surgical changes related to left axillary-bifemoral graft. Femoral arteries appear patent. Persistent thrombosis of the infrarenal aorta. [**2143-6-30**] 9:02 AM # [**Telephone/Fax (1) 76389**] LIVER OR GALLBLADDER US-IMPRESSION: Sludge ball in the gallbladder neck, but no evidence of acute cholecystitis on US. Normal 5-mm CBD without evidence of obstruction. [**2143-6-30**] 3:40 PM # [**Telephone/Fax (1) 76390**] MRCP (MR ABD W&W/OC) MRCP (MR ABD W&W/OC)-IMPRESSION: 1. Diffuse signal abnormality involving the pancreas with hypointensity on the T1 sequences and hyperintensity on the T2 sequences most consistent with diffuse pancreatitis. A more focal region of hypoenhancement involving the pancreatic neck is suspicious for early necrosis. If the clinical situation of the patient worsens over the next few days/weeks, then a followup MRCP examination may be obtained. 2. 1.2 cm pancreatic cyst. A followup MRI may be obtained in six months to ensure stability. 3. Gallstones. 4. No evidence of intra- or extra-hepatic biliary ductal dilatation. [**2143-7-8**] Cardiovascular ECG Sinus rhythm. Borderline prolonged Q-T interval. Compared to the previous tracing of [**2143-6-29**] the T waves in leads V2-V6 are taller. This may represent acute ischemia or, more likely, an electrolyte abnormality. [**2143-7-8**] CT ABD W&W/O C IMPRESSION: 1. New focus of gas within paripancreatic fluid anterior to the pancreatic head is highly concerning for infection. This collection is not yet organized. No drainable collections are present. 2. Markedly increased stranding and neighboring fluid throughout the pancreas, with two evolving foci of necrosis within the pancreatic head. 3. New moderate narrowing of the SMV/portal vein confluence; the vessels remain patent. 4. New moderate right pleural effusion with adjacent compressive atelectasis is new since [**2143-6-29**]. 5. Moderate amount of fluid surrounding the inferior aspect of the liver and along the right paracolic gutter. 6. Chronic occlusion of the infrarenal abdominal aorta. A left axillary-extremity bypass appears patent. [**2143-7-13**] Radiology PORTABLE ABDOMEN There is no interval development of substantial bowel dilatation, neither small nor large. Calcification projecting over the liver is redemonstrated, known. If clinically warranted, correlation with cross-sectional imaging might be considered. [**2143-7-13**] Radiology MRCP (MR ABD W&W/OC) IMPRESSION: 1. Interval increase in size of hemorrhagic peripancreatic collections and increased size of right subhepatic collection. 2. Extrinsic compression of the distal CBD by the enlarged peripancreatic collection at the pancreatic head. The CBD now measures 0.9 cm versus 0.3 cm on the previous MRCP. 3. Severely attenuated portal vein, splenic vein, SMV and splenic artery, again secondary to compression by the peripancreatic collections. No definite evidence of thrombus or pseudoaneurysm formation; focal contour deformity of the main portal vein is unchanged and probably secondary to mass effect from adjacent inflammatory change and collections; nonocclusive thrombus is felt less likely. 4. Decreased amount of free fluid within the peritoneal cavity. 5. Occluded infrarenal abdominal aorta with patent axillary [**Hospital1 **]-fem bypass graft. 6. 3.2 cm calcified lesion within segment [**Doctor First Name 690**]/VIII of the liver - this is unchanged since [**2140**] and could be secondary to previous infection or trauma or calcification of a nonaggressive lesion. [**2143-7-15**] 11:01 AM # [**Telephone/Fax (1) 76391**] CHEST (PORTABLE AP) CHEST (PORTABLE AP) FINDINGS: In comparison with the study of [**7-9**], there is increasing prominence of interstitial markings consistent with elevation of pulmonary venous pressure. Bibasilar opacifications are consistent with pleural effusion and compressive atelectasis. [**2143-7-16**] Radiology CHEST PORT. LINE PLACEM FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. A right-sided PICC line has been placed, seen to terminate overlying the right atrial contours. The tip is located 8 cm below the level of the carina and it is recommended to withdraw the line by 5 cm so to have optimal position in the mid portion of the SVC. In comparison with the next preceding chest examination of [**2139-7-15**], no new pulmonary or cardiovascular abnormalities identified. No pneumothorax is seen. [**Doctor First Name 8513**] was paged at 3:28 p.m. [**2143-7-17**] Radiology GB DRAINAGE,INTRO PERC CONCLUSION: 1. Could not drain the intrahepatic bile ducts directly. While the ducts could be opacified and appeared normal in caliber, they could not be securely accessed for further intervention. 2. Uncomplicated ultrasound-guided placement of a cholecystostomy tube. 3. Unsuccesful attempt to advance dobhoff tube into the duodenum with fluoroscopy. [**2143-7-25**] Radiology UNILAT UP EXT VEINS US IMPRESSION: No evidence of deep vein thrombosis. [**2143-7-26**] Radiology CHEST PORT. LINE PLACEM CONCLUSION: New left-sided PICC line is somewhere in the neck in left jugular vein. IV nurse has been contact[**Name (NI) **] for the results. [**2143-7-26**] Radiology [**Numeric Identifier 76392**] EXCH PERPHERAL W/ IMPRESSION: 1. Successful exchange of a left-sided PICC with tip in the distal SVC. Line is ready for use. Brief Hospital Course: 81M with history of AAA s/p repair presenting with chest/abd pain x 2d with labs and imaging consistent with pancreatitis. Active Diagnoses # Necrotizing Pancreatitis: Patient diagnosed with pancreatitis given classic pain radiating to the back, elevated lipase, and findings on CT c/w pancreatitis. In terms of etiology, gallstone pancreatitis is most likely, given evidence of gallstones on MRCP and mild transaminitis, despite no evidence of ductal dilitation (likely stone passed). Ischemic pancreatitis initially considered due to significant vascular history; however, improved with fluid resuscitatation. Autoimmune pancreatitis ruled out given normal IgG panel. No clear medication or viral cause. BISAP initially 2 but elevated Hct and Cr raised concern for severe pancreatitis. His lactate was initially elevated, but trended down. He was fluid resuscitated in the ICU and by [**2143-7-1**], he was tolerating clears PO. By [**2143-7-2**], he was tolerating a full diet and his pain had resolved. On [**7-8**] he developed fever and CT scanning noted air with an area of pancreatic necrosis concerning for infection; he was started on meropenem/flagyl for infected necrotizing pancreatitis and continued for a full 14 day course. After discontinuation of antibiotics he was never febrile or developed a WBC count. On [**7-13**] he was noted with increasing LFTs and lipase; MRCP was performed which showed worsening pancreatic necrosis and edema as well as worsening hemorrhagic collections around the pancreas (at this time he was coagulopathic with an INR of ~6). The edema was felt to be extrinsically compressing the ductal system causing biliary obstruction. ERCP was performed for stent placement but was unable to access the ampulla due to extensive duodenal edema. Therefore IR was consulted for percutaneous biliary drain placement; they were unable to place this drain and so defaulted to a percutaneous cholecystostomy tube. After tube placement his bili (which peaked at ~12) and LFTs/lipase downtrended back to normal and remained normal after starting oral feeds. The drain initially had ~1L per day output which tapered off to ~100-200cc daily, suggesting (per GI) that his duodenal edema had resolved and the ampulla was no longer extrinsically compressed or obstructed. The drain needs to remain in place until he is evaluated by pancreaticobiliary surgery as an outpatient, who will determine drain removal and cholecystectomy timing. He had a dobhoff tube placed which was advanced endoscopically into the proximal jejunum; tube feeds were started ATC and continued to discharge. His diet was advanced to full liquids and tolerated well; when attempting to advance to a bland solid diet, he experienced GI upset with some abdominal discomfort and a small elevation in his lipase, suggesting that he would require a prolonged course of gradual dietary advancement prior to being able to eat normally. # Volume overload: due to volume resuscitation for severe pancreatitis, patient has developed extensive third spacing of fluid including ascites, pleural effusions (initially had O2 requirement, no longer) and extensive anasarca with pitting edema throughout. He was placed on daily lasix 20mg IV for goal diuresis 1L net negative daily; IV was utilized throughout due to concern of bowel edema and poor PO absorption. He should receive standing lasix IV daily with daily chemistry panels until his edema has improved. # Peripheral vascular disease: noted with complicated history from AAA repair that clotted off requiring conversion to an axillobifemoral bypass graft that is high risk for clot. He was on coumadin which was allowed to downtrend as he remained coagulopathic. As above, when he was noted to have hemorrhagic conversion of his pancreatitis his INR was reversed with IV vitamin K and his anticoagulation was managed with a heparin drip up until the day of discharge. He was given coumadin 2 days prior to discharge (home dose 6mg) and will need to continue heparin bridge with goal PTT 60-90 until his INR is [**1-25**] for 48 hours, at which point he can be maintained on coumadin only. He remained with dopplerable PT/DP pulses bilaterally (PT>DP) and [**1-25**] second capillary refill throughout. # Thrombocytopenia: patient developed in the past in [**2140**]. Negative HIT antibodies and negative serotonin release assay. Perhaps related to his history of MDS compounded by critical illness and marrow suppression. # Elevated INR to 4.7: Possibly due to nutritional changes versus illness. No recent antibiotics. Warfarin was initially held. By [**2143-7-1**], the INR was 2.8, and warfarin was restarted; once again became supratherapeutic and warfarin was held prior to surgery, transition to heparin drip on [**2143-7-7**] when INR was 2.3. This was then turned off when he became coagulopathic again; he was finally reversed with IV vitamin K after hemorrhagic pancreatitis was noted on MRCP on [**7-13**]. # DM: at home on GlipiZIDE 5 mg PO QHS and GlipiZIDE 2.5 mg PO QAM. This was initially held, and paitent was placed on insulin sliding scale. Due to his worsening pancreatic function, he required escalating doses of insulin eventually stabilizing on 34u lantus daily with an aggresive sliding scale. Chronic Diagnoses # HTN: at home, on home Lisinopril 20 mg PO DAILY and Metoprolol Tartrate 12.5 mg PO BID. These were held upon discharge due to him having no issues with blood pressure while in hospital. They should be restarted upon discharge or by his PCP when he is more stable. Metoprolol was restarted prior to discharge. # HL: at home, on Atorvastatin 10 mg PO DAILY. # Constipation: Bowel regimen. Transitional Issues # Communication: Patient, son [**Name (NI) **] [**Telephone/Fax (1) 76393**] # [**Name2 (NI) 7092**]: Full (confirmed) - percutaneous cholecystostomy tube to remain in place and course dictated by pancreaticobiliary surgery - cholecystectomy at some point to be determined by surgery - ongoing heparin bridge to coumadin, goal INR [**1-25**] for bypass graft - ongoing gradual diet advancement with continuation of tube feeds till regular low fat diet is acheived without abdominal symptoms or LFT/lipase elevation - ongoing evaluation for insulin requirement - restarting home blood pressure medications when more medically stable and required - daily diuresis with IV lasix for goal of -1L net negative - pancreatic cyst noted on initial MRCP - will need repeat in 6 months. Medications on Admission: Preadmission medications listed are correct and complete. Information was obtained from webOMR PCP. 1. Lisinopril 20 mg PO DAILY 2. Metoprolol Tartrate 12.5 mg PO BID 3. Senna 5 TAB PO HS 4. Warfarin 10 mg PO DAILY16 5. Atorvastatin 10 mg PO DAILY 6. GlipiZIDE 5 mg PO QHS 7. GlipiZIDE 2.5 mg PO QAM Discharge Medications: 1. Atorvastatin 10 mg PO DAILY 2. Warfarin 6 mg PO DAILY16 3. Acetaminophen 1000 mg PO Q6H:PRN pain, fever 4. Bisacodyl 10 mg PR HS:PRN constipation Patient may refuse. Hold for loose stools. 5. Docusate Sodium 100 mg PO BID 6. 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. 7. Glargine 32 Units Bedtime Insulin SC Sliding Scale using HUM Insulin 8. Pantoprazole 40 mg PO Q24H 9. Polyethylene Glycol 17 g PO DAILY 10. Sodium Chloride 0.9% Flush 10 mL IV PRN line flush PICC, non-heparin dependent: Flush with 10 mL Normal Saline daily and PRN per lumen. 11. Heparin IV per Weight-Based Dosing Guidelines 12. Furosemide 20 mg IV DAILY hold for sbp<100 Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - MACU Discharge Diagnosis: Acute gallstone pancreatitis Pancreatic necrosis with superinfection Hemorrhagic pancreatitis Coagulopathy Peripheral vascular disease with axillobifemoral graft Type 2 Diabetes Hypertension Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Dear Mr. [**Known lastname 76385**], It was a pleasure participating in your care at [**Hospital1 18**]. You were admitted for abdominal pain due to acute pancreatitis. You had a very protracted course with multiple complications from your pancreatitis, including necrosis and hemorrhage. You were treated with IV fluids, antibiotics, anticoagulants and with a feeding tube. You will have this tube removed when you are tolerating a full diet. You will also have your PICC line removed when you do not need heparin any longer. Followup Instructions: Department: DIV. OF GASTROENTEROLOGY When: WEDNESDAY [**2143-8-14**] at 3:00 PM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 6953**], MD [**Telephone/Fax (1) 463**] Building: Ra [**Hospital Unit Name 1825**] ([**Hospital Ward Name 1826**]/[**Hospital Ward Name 1827**] Complex) [**Location (un) **] Campus: EAST Best Parking: Main Garage Department: SURGICAL SPECIALTIES When: FRIDAY [**2143-8-30**] at 9:30 AM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 3000**], MD [**Telephone/Fax (1) 274**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Please discuss with the staff at the facility a follow up appointment with your PCP below when you are ready for discharge. With: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] [**Last Name (NamePattern1) 28089**], MD Location:[**Hospital **]/[**Hospital1 18**] [**Location (un) **]., [**Location (un) 86**], MA [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Phone:[**Telephone/Fax (1) 2010**] ICD9 Codes: 2875, 2761, 4280, 4019, 4241, 4439
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Medical Text: Admission Date: [**2118-5-24**] Discharge Date: [**2118-5-27**] Date of Birth: [**2055-6-3**] Sex: M Service: MEDICINE Allergies: Penicillins / Proton Pump Inhibitors / hayfever Attending:[**First Name3 (LF) 1515**] Chief Complaint: Anterior STEMI Major Surgical or Invasive Procedure: -Cardiac catheterization with bare metal stents x3 to left anterior descending artery -Cystoscopy, bilateral ureteroscopy, bilateral laser lithotripsy, bilateral stent placement. History of Present Illness: Patient is a 62 yo male with history of CAD sp two DES to proximal and mid LAD after positive stress test in [**2109**], anterior STEMI in [**2112**] with late in-stent restenosis sp DES to LAD and ostium of diagnoal, HLD, renal calculi sp bilateral lithotripsy and ureteral stents who presents after this procedure today with anterior STEMI. . Patient was in his normal state of health until he presented for urologic procedure for treatment of bilateral renal calculi. He was instructed to stop Plavix for his urological procedure and has been holding this for 5 days. He did continue aspirin. Procedure included bilateral ureteroscopy, bilateral laser lithotripsy, bilateral ureteral stents. In PACU sp procedure patient developed chest pain and EKG revealed anterior STEMI. He was taken to the for cardiac cath. . In the cath lab, LAD stent was dilated. Procedure complicated by dissection of the LAD. BMS were placed in the mid LAD, distal LAD, and proximal LAD to restablish excellent flow. Patient was hemodynamically stable during the case. Thought of interventional cardiology is that this represents in stent restenosis. Patient to continue on Clopidogrel indefinitely. Given 245 ml of omnipague dye. . In the CCU, patient is pain free and hemodyncamically stable. . 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: 1. CARDIAC RISK FACTORS: + Diabetes, +Dyslipidemia, +Hypertension 2. CARDIAC HISTORY: - PERCUTANEOUS CORONARY INTERVENTIONS: [**2109**]: two drug-eluting stents in the proximal and mid LAD. [**2112**]: presented with an anterior ST elevation infarct and was found to have late stent thrombosis. Treated with two additional drug-eluting stents in the LAD as well as at the ostium of a diagonal branch. Coronary artery disease otherwise consisted of 60% disease in a circumflex marginal and 50% disease in the mid right coronary artery. . 3. OTHER PAST MEDICAL HISTORY: - GERD - Renal Calculi sp lithotripsy Social History: Retired [**Company 2318**] driver. He drives kids for q. day care now. Wife is [**Name (NI) **]. He does the treadmill for exercise. Denies , recreational drugs, or alcohol excess. Family History: Mother died at 85 of colon cancer, MI in her 70s, DM2 Father with prostate cancer at 60, pacemaker, DM2 Brother with prostate cancer at 51 Brother with prostate cancer Sister with DM2 Physical Exam: Admission: 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 *** 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. 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. PULSES: Right: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ Left: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ Discharge: Gen: A/o, NAD HEENT: supple, no JVD CV: RRR, no M/R/G RESP: CTAB post ABD: soft, NT EXTR: no edema NEURO: A/O, no focal defects Extremeties: right radial without bruising or swelling. Pulses: Right: DP 1+ PT 1+ Left: DP 1+ PT 1+ Skin: intact Pertinent Results: COMPLETE BLOOD COUNT WBC RBC Hgb Hct MCV MCH MCHC RDW Plt Ct [**2118-5-27**] 07:00 11.1* 4.97 14.5 40.0 81* 29.3 36.3* 13.9 168 [**2118-5-26**] 07:20 11.6* 5.32 15.7 43.1 81* 29.5 36.4* 13.9 184 [**2118-5-25**] 04:09 12.9* 5.27 15.1 42.2 80* 28.7 35.8* 14.0 196 [**2118-5-24**] 22:34 13.1* 5.11 15.5 41.8 82 30.2 37.0* 13.8 205 [**2118-5-24**] 18:00 14.3* 4.80 14.5 39.1* 82 30.3 37.1* 13.8 195 RENAL & GLUCOSE Glucose UreaN Creat Na K Cl HCO3 AnGap [**2118-5-27**] 07:00 308*1 17 0.6 135 4.1 102 24 13 [**2118-5-26**] 07:20 291*1 15 0.7 135 3.9 98 26 15 [**2118-5-25**] 04:09 296*1 24* 0.8 133 4.1 96 27 14 [**2118-5-24**] 22:34 399*1 26* 1.0 132* 4.6 96 25 16 [**2118-5-24**] 18:00 345*1 27* 0.9 132* 4.1 98 25 13 CKs [**2118-5-25**] 04:09 418*1 [**2118-5-24**] 22:34 453*1 [**2118-5-24**] 18:00 338*1 CPK ISOENZYMES CK-MB MB Indx cTropnT [**2118-5-25**] 04:09 20* 4.8 0.59*1 [**2118-5-24**] 22:34 17* 3.8 0.43*2 [**2118-5-24**] 18:00 0.02*1 CHEMISTRY TotProt Albumin Globuln Calcium Phos Mg UricAcd Iron [**2118-5-27**] 07:00 8.7 1.7* 1.9 [**2118-5-26**] 07:20 9.0 1.7* 1.7 [**2118-5-25**] 04:09 8.9 3.7 1.6 [**2118-5-24**] 22:34 8.8 4.3 1.3* DIABETES MONITORING %HbA1c eAG [**2118-5-26**] 07:20 11.5*1 283*2 Brief Hospital Course: 62 yo male with CAD sp 2 DES to LAD in [**2109**], 2 DES to LAD and Diag in [**2112**] in the setting of late instent restenosis, HLD, Renal Calculi who presents with anterior STEMI sp urological procedure in the setting of holding plavix. . ACTIVE ISSUES: # Anterior LAD In-Stent Thrombosis: Pt was sp 2 DES to LAD in [**2109**], 2 DES to LAD and Diag in [**2112**] in the setting of late instent restenosis, now with instent restensis vs thrombosis while off plavix leading to anterior STEMI now sp 3 BMS to LAD. Procedure complicated by dissection. Pt remained CP free. Continued integrillin for 18 hours and then transitioned to heparin sc. The pt will be on Plavix 75 mg forever, ASA 325mg Daily. Restarted Beta-Blocker, ACE-I. Continue Atorvastatin 80mg Daily. . #. Bilateral Renal Calculi sp B lithotripsy, B ureteral stents. Continued continuous bladder irrigation x 3 days. HCT remained stable. Will follow up with urology s/p hospitalization. . # Type II Diabetes Mellitus: A1C 11.5%. Started on metformin 500mg [**Hospital1 **], diabetic Diet, Insulin Sliding Scale. The pt is to f/u nutritionist and physician at [**Name9 (PRE) **] Clinic in the next month. . CHRONIC ISSUES: # Chronic Diastolic CHF: Post STEMI ECHO ([**5-25**]) showed preserved EF (>55%), mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. Mild resting outflow tract gradient. No signs of heart failure while in house. . # RHYTHM: Sinus. Monitored on Tele. . # HTN: Restarted Beta Blocker and Lisinopril as pressure tolerates. . # HLD: Continue Atorvastatin 80mg Daily. . # Depression: Pt continued on fluoxetine . TRANSITIONAL ISSUES: Full Code. Pt to f/u with [**Last Name (un) **]. Medications on Admission: - atenolol 25 mg q. day - lisinopril 10 - Lipitor 80 - Plavix 75 (holding for procedure) - aspirin 81 mg - Prozac 20 - Zantac/omeprazole 20 mg - Claritin or [**Doctor First Name **] - Flonase - Viagra or [**Doctor First Name **] Discharge Medications: 1. aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 2. clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*11* 3. fluoxetine 20 mg Capsule Sig: One (1) Capsule PO once a day. 4. atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 5. lisinopril 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 6. 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* 7. metformin 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 8. Zantac 75 75 mg Tablet Sig: 1-2 Tablets PO once a day. 9. [**Doctor First Name **] Oral 10. nitroglycerin 0.3 mg Tablet, Sublingual Sig: One (1) tablet Sublingual as directed as needed for chest pain: Interacts wtih [**Last Name (LF) **], [**First Name3 (LF) **] not take within 24 hours. . Disp:*25 tablets* Refills:*0* Discharge Disposition: Home Discharge Diagnosis: Nephrolethiasis ST Elevation myocardial infarction Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: It was a pleasure taking care of you at [**Hospital1 18**]. You had stents placed in your ureters and while you were recovering in the PACU you had a heart attack. You were brought to the cardiac catheterization lab where a three bare metal stents placed in your left anterior descending artery. We believe the stents blocked off because you were not taking Plavix. You will need to take plavix and aspirin every day forever, do not miss [**First Name (Titles) 691**] [**Last Name (Titles) 4319**] or stop taking plavix unless Dr. [**Last Name (STitle) **] tells you to. The foley catheter was removed and we expect that you will have some blood tinged urine for a few days. Please call Dr.[**Name (NI) 825**] office if you notice that your urine is frank blood or if you are having trouble urinating. Your blood sugars have been very high here and your A1C is 11.5 which means that your average blood sugar at home is 280. We have started you on a diabetes medicine and Dr. [**Last Name (STitle) 2472**] can increase this medicine next week. You also have an appt with a nutritionist and physician at [**Name9 (PRE) **] Clinic in the next month. It is crucially important that you control your blood sugars better to protect your kidneys and heart. Please check your blood sugars before breakfast and dinner for a week and record the readings to show to the [**Last Name (un) **] nutritionist and physician. . We made the following changes to your medicines: 1. STOP taking Atenolol 2. Start taking Metoprolol XL to slow your heart rate and help your heart recover from the heart attack 3. Increase the aspirin to 325 mg daily for at least one month and possibly longer 4. Continue to take Plavix every day to prevent the stent from clotting off 5. Decrease Lisinopril to 5 mg daily for now to lower your blood pressure 6. Take the nitroglycerin as needed for chest pain but don't take it within 24 hours of [**Last Name (un) **]. Call 911 if you still have chest pain after taking nitroglycerin. 7. Start Metformin to lower your blood sugars Followup Instructions: Name: [**Last Name (LF) **],[**First Name3 (LF) **] R. Location: [**Hospital1 **] HEALTHCARE - [**Hospital **] MEDICAL GROUP Address: [**Street Address(2) 2687**],8TH FL, [**Location (un) **],[**Numeric Identifier 809**] Phone: [**Telephone/Fax (1) 133**] Appointment: Thursday [**2118-6-2**] 9:45am Department: SURGICAL SPECIALTIES When: THURSDAY [**2118-6-9**] at 3:30 PM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 4653**], MD [**Telephone/Fax (1) 164**] Building: [**Hospital6 29**] [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: CARDIAC SERVICES When: MONDAY [**2118-6-13**] at 1:20 PM With: [**First Name11 (Name Pattern1) 2053**] [**Last Name (NamePattern4) 2761**], MD [**Telephone/Fax (1) 62**] Building: [**Hospital6 29**] [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage . [**Hospital **] Clinic: please go to the [**Location (un) 1773**]. [**6-29**] at 4:00pm with Dr. [**Last Name (STitle) **] for medication adjustment Monday [**5-30**] at 1:00pm with [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], nutritionist. Completed by:[**2118-5-29**] ICD9 Codes: 4280, 9971, 2724, 4019, 311
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6055 }
Medical Text: Admission Date: [**2128-11-26**] Discharge Date: [**2128-12-27**] Date of Birth: [**2100-8-14**] Sex: M Service: NEUROSURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 78**] Chief Complaint: Headache Subarachnoid hemorrhage Major Surgical or Invasive Procedure: [**11-26**] a.m. Ventriculostomy placemtent [**11-26**] A-Comm Aneurysm coiling [**11-26**] Ventriculostomy placement [**12-2**] Cerebral angiogram [**12-8**] IVC filter [**12-8**] Tracheostomy [**12-8**] Peg History of Present Illness: 28y/o male who reportidly had a sudden onset [**10-29**] occipital headache after intercourse. Question of a seizure prior to arrival at outside facility. Patient alert prior to head CT, and then rapidly declined requiring sedation and intubation. CT revealed diffuse SAH with early HCP. Pt. Transferred to [**Hospital1 18**] and arrived at approx. 12:30 am, heavily medicated, proceeded to CT for a CT and CTA which revealed a L MCA aneursym. Past Medical History: Non contributory Social History: Per mother: no Tobacco [**Name (NI) 80077**] use Family History: Non contributory Physical Exam: VSS. Afebrile. Eyes open throughout 90% of evaluation with increased verbal and tactile stimulation to maintain eyes open when in supine position. Eyes track to voice, cross midline. PERRL 4mm to 2mm bilaterally. +Corneal,+Cough. Following approximately 20% of commands with Bilateral upper extremities. Has not been moving the lower extremities to this point. MRI imaging of the spine has not demonstrated pathology to account for this. No seizure activity, pt to continue on Keppra upon discharge. CV: Pt continues to remain hemodynamically stable. Recieving B-blockade to control his episodic tachycardia. Pt remains on coumadin for treatment of his DVT. Coumadin was begun on [**2128-12-19**]. Resp: Pt with Cuffed 8.0mm [**Last Name (un) 295**] tracheostomy. Course breath sounds throughout with copious amouts of thick white secretions. RR 16-40. O2 sat 100% GI/GU: PEG functioning as expected. Estimated nutritional needs based on adjusted weight is 1710-2137 calories (20-25cal/kg) and 103-128 (1.2-1.5G/kG) of protien. Foley draining clear yellow urine. Essentially Euvolemic. No evidence of DI. Code Status: Full Pertinent Results: Radiology Report CTA HEAD W&W/O C & RECONS Study Date of [**2128-11-26**] 12:30 AM Final Report CTA OF THE BRAIN/CIRCLE OF [**Location (un) **] FINDINGS: There is diffuse subarachnoid hemorrhage as well as a small amount of intraventricular hemorrhage in the occipital horns. There is enlargement of ventricles. There is effacement of the basilar cisterns compatible with edema. There is a small amount of mls to the left. There is a 2.5-mm aneurysm at the junction of the AComm and the right A1-A2 junction. No other aneurysms are seen. There is no evidence for vasospasm. There is a hypoplastic left A1 segment. There is a tiny fenestration at the origin of the basilar artery. IMPRESSION: 2.5-mm aneurysm at the junction of the right A1, A2 and ACom segments. The study and the report were reviewed by the staff radiologist. BILATERAL LOWER EXTREMITY VENOUS ULTRASOUND FINDINGS: Grayscale and color Doppler images of the left and right common femoral, superficial femoral, and popliteal veins were obtained. There is non-compressibility and absence of wall-to-wall flow in the proximal superficial left femoral vein, consistent with a non-occlusive deep venous thrombosis. The remainder of the interrogated vessels demonstrate normal flow, compressibility, and augmentation. IMPRESSION: Non-occlusive deep venous thrombosis of the left proximal superficial femoral vein. The findings were conveyed directly to the ICU nurse caring for the patient at the conclusion of the study. [**2128-10-28**]: CT perfusion IMPRESSION: 1. Status post extensive right frontal craniectomy with placement of paired ventricular drains, with persistent herniation of a significant portion of the right frontal lobe through the craniectomy defect. 2. Hemorrhage and edema involving the paramedian frontal lobes, bilaterally, which may represent evolving hemorrhagic transformation of acute infarcts, or, less likely, contusions. 3. Continued blood in the interhemispheric fissure as well as within the ventricular chain, with a very small amount of residual subarachnoid hemorrhage. 4. Perfusion abnormality corresponding to the abnormal portion of both frontal lobes, but, elsewhere, perfusion is normal, and the CTA demonstrates no evidence of vasospasm or flow-limiting stenosis. 5. Chronic inflammatory changes involving the left sphenoidal air cells and bilateral maxillary antra. see attached. Results pending at this time Brief Hospital Course: On [**11-26**] pt was brought to angio to have 5 coils placed into A-comm aneurysm. Later in the day he was emergently brought to the OR for emergent R craniectomy and bilat. EVD's placed. His mental status remained poor and elevated ICP's. Pt was chemically paralyzed, sedated and on Pentobarb in order to decrease ICPs along with HHH therapy for vasospasm. On [**11-28**] the R EVD was not-functioning and CT head showed increasing edema. The pentobarb was weaned and paralytic d/c'd. He also had an angio on [**11-29**] which did not show any vasospasm. Pentobarb was then d/c'd on [**12-2**] and angio on that day showed mild vasospasm. During this time pt was febrile and CSF was sent for culture however pt was found to have LLL PNA which was treated and ID was involved due to gram + cocci in CSF. On [**12-6**] the R EVD was clamped and then removed on [**12-9**]. On [**12-9**] His exam remained poor with only external rotation of BUE and triple flexion of BLE with noxious. He was then found to have a L common fem DVT and an IVC filter was placed. He also had elevated LFTs and abdominal US was negative however an Abd CT was done to confirm these findings. A CTA of the head was done as well to look for vasospasm On [**12-10**], which was positive. he was Trached and Peg'd. On [**12-11**] Patients exam has slowly improved, he is opening his eyes and tracking the examiner and following simple commands with his upper extremities, with minimal to no movement of his lower extremities. During his ICU stay the patient has been bronched multiple times for theraputic lavage and to obtain a BAL. His sputum is positive for Coag negative staph. He is at this time recieving Nafcillin per recommendations made by ID. [**12-13**] Left EVD d/c'ed. [**12-14**] slight development of hydrocephalus. Medications on Admission: None Discharge Medications: 1. White Petrolatum-Mineral Oil 42.5-56.8 % Ointment Sig: One (1) Appl Ophthalmic PRN (as needed). 2. Levetiracetam 500 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 3. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed. 4. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed. 5. Acetaminophen 650 mg Suppository Sig: [**1-21**] Suppositorys Rectal Q6H (every 6 hours) as needed. 6. Ibuprofen 100 mg/5 mL Suspension Sig: One (1) PO Q6H (every 6 hours) as needed for fever >101.5. 7. Nystatin 100,000 unit/mL Suspension Sig: Five (5) ML PO QID (4 times a day) as needed. 8. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection TID (3 times a day). 9. Chlorhexidine Gluconate 0.12 % Mouthwash Sig: One (1) ML Mucous membrane [**Hospital1 **] (2 times a day). 10. Warfarin 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily): Monitor INR weekly once theraputic . 11. Insulin Regular Human 100 unit/mL Solution Sig: One (1) Injection four times a day: Per sliding Scale AC and hs. 12. Metoprolol Tartrate 25 mg Tablet Sig: 1.5 Tablets PO Q6H (every 6 hours). 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. Sodium Chloride 0.9% Flush 10 mL IV PRN line flush Temporary Central Access-ICU: Flush with 10mL Normal Saline daily and PRN. 15. Vancomycin 1000 mg IV Q 8H 16. Piperacillin-Tazobactam Na 4.5 g IV Q8H 17. Med end dates Vancomycin and Zosyn dosing will end [**2128-12-28**] Discharge Disposition: Extended Care Facility: [**Hospital6 85**] - [**Location (un) 86**] Discharge Diagnosis: Aneursymal Subarachnoid Hemorrhage Anterior communicating artery aneurysm Atrial fibrillation L common fem DVT Respiratory failure Cerebral Vasospasm Pneumonia Discharge Condition: Stable Discharge Instructions: General 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. ?????? You may wash your hair only after sutures and/or staples have been removed. ?????? 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. ?????? If you have been prescribed an anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing as ordered. ?????? Clearance to drive and return to work will be addressed at your post-operative office visit. 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. Follow-Up Appointment Instructions ?????? Please return to the office in [**7-29**] days for removal of your staples or sutures. ?????? Please call ([**Telephone/Fax (1) 88**] to schedule an appointment with Dr. [**First Name (STitle) **], to be seen in 2 weeks. ?????? You will / will not need a CT scan of the brain with / without contrast. ?????? You will / will not need an MRI of the brain with/ or without gadolinium contrast. General 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. ?????? You may wash your hair only after sutures and/or staples have been removed. ?????? 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. ?????? If you have been prescribed an anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing as ordered. ?????? Clearance to drive and return to work will be addressed at your post-operative office visit. 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. Follow-Up Appointment Instructions ?????? Please call ([**Telephone/Fax (1) 88**] to schedule an appointment with Dr. [**First Name (STitle) **], to be seen in 4 weeks. ?????? If you brain imaging for this appointment it can be arranged by the office. Followup Instructions: Dr. [**First Name (STitle) **] in 4 weeks please call [**Telephone/Fax (1) 1669**] Completed by:[**2128-12-24**] ICD9 Codes: 4019
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Medical Text: Admission Date: [**2130-8-29**] Discharge Date: [**2130-9-7**] Date of Birth: [**2055-1-25**] Sex: F Service: CARDIOTHORACIC Allergies: Penicillins / Ace Inhibitors / Lidoderm / Codeine Attending:[**First Name3 (LF) 1267**] Chief Complaint: Shortness of breath Major Surgical or Invasive Procedure: [**2130-8-31**] Mitral valve replacement utilizing [**Street Address(2) 11599**]. [**Male First Name (un) 923**] porcine valve. Maze procedure utilizing radio frequency ablation. Ligation of left atrial appendage. History of Present Illness: This is a 75 year old female with history of non-ischemic cardiomyopathy and atrial flutter. She was recently admitted to [**Hospital3 35813**] Center on [**2130-8-14**] with congestive heart failure and hypotension. Workup revealed severe mitral regurgitation and severely depressed left ventricular function with an ejection fraction of 30%. Her coronary arteries were angiographically normal. Based on the above results, she was subsequently transferred to [**Hospital1 18**] for operative care. Past Medical History: Non-ischemic cardiomyopathy, Hypertension, Atrial flutter with history of failed ablation, s/p PPM/AICD placement, Chronic anemia, Osteoporosis with multiple lumbar compression fractures, History of non-Hodgkins lymphoma, Spinal stenosis with chronic low back pain, History of seizures, History of herpetic neuralgia, s/p chole, s/p appendectomy Social History: No history of tobacco or ETOH. Lives with sister-in-law. Family History: Son diagnosed with coronary artery disease in his 40's. Physical Exam: Vitals: Temp 99.2, BP 106/50, HR 65 AV paced, R 18, SAT 99% RA General: Elderly female in no acute distress HEENT: oropharynx benign, PERRL, sclera anicteric Neck: suppple, no JVD, no carotid bruits Chest: lungs clear bilaterally Heart: regular rate, s1s2, [**2-19**] holosystolic murmur Abdomen: benign Ext: warm, no pedal edema Pulses: palpable distal pulses, no femoral bruits Neuro: nonfocal Pertinent Results: [**2130-9-5**] 04:04AM BLOOD WBC-11.8* RBC-3.64*# Hgb-10.6*# Hct-31.5*# MCV-87 MCH-29.2 MCHC-33.7 RDW-16.8* Plt Ct-112* [**2130-9-7**] 04:12AM BLOOD PT-15.8* INR(PT)-1.7 [**2130-9-7**] 04:12AM BLOOD K-4.4 [**2130-9-5**] 04:04AM BLOOD Glucose-83 UreaN-16 Creat-0.5 Na-137 K-4.1 Cl-100 HCO3-28 AnGap-13 Brief Hospital Course: Patient was admitted and underwent further preoperative evaluation which included a repeat echocardiogram. This was notable for 3+ mitral regurgitation with moderate to severe tricuspid regurgitation. The overall left ventricular systolic function was mildly depressed but compared to previous studies, her ejection fraction had improved to 50%. There was moderate pulmonary artery systolic hypertension. Her left atrium was dilated. She had a normal aortic root and her aortic valves were mildly thickened with only 1+ aortic insufficiency. Workup was otherwise unremarkable and she was eventually cleared for surgery. She remained stable on medical therapy. Antibiotics were started for her preoperative urinary tract infection - cutlture grew out E. coli sensitive to Bactrim and Ancef. On [**8-31**], Dr. [**Last Name (STitle) **] performed a mitral valve replacement([**Street Address(2) 11599**]. [**Male First Name (un) 923**] porcine valve) and MAZE procedure. Surgery was uneventful. The intraoperative TEE showed no mitral regurgitation with an ejection fraction around 35-40%. After the operation, she was brought to the CSRU in stable condition. She initially required multiple blood products for an anemia and a postoperative coagulopathy. She concomitantly experienced a transient increasing pressor requirement which prompted a TEE which found no evidence of cardiac tamponade. Over the next 48 hours, she successfully weaned from inotropic support and was extubated without difficulty. Amiodarone was eventually started given her history of atrial fibrillation/flutter as well as Warfarin for her porcine mitral valve replacement. She maintained stable hemodynamcis and adequate urine output. She was intermittently transfused with additional packed red blood cells to maintain hematocrit near 30%. Postop, she continued to experience a persistent leukocystosis. All lines were changed and pan cultures were obtained. Her white count peaked to 25K on POD#3. All cultures remained negative. On POD#4, she transferred to the SDU. There medical therapy was optimized. She required additional diuresis. By discharge, chest x-ray was notable for improving pleural effusions. Amiodarone was titrated and Warfarin was dosed for a goal INR between 2.0 - 2.5. By discharge, her white count improved to 11K. She remained afebrile. At discharge, she was tolerating 1L nasal cannula with oxygen saturations of 95%. Medications on Admission: Warfarin - stopped PTA, ASA 325 qd, Coreg 6.25 [**Hospital1 **], Digoxin 0.125 qd, Cozaar 25 qd, Sotalol 160 [**Hospital1 **], Protonix 40 qd, Spironolactone 12.5 qd, Tegretol 100 [**Hospital1 **], lasix 40 qd, Lexapro 10 qd, Colace, Senna, Oxycodone Discharge Medications: 1. Potassium Chloride 10 mEq Capsule, Sustained Release Sig: Two (2) Capsule, Sustained Release PO DAILY (Daily). 2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 3. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 4. Warfarin 1 mg Tablet Sig: as directed Tablet PO DAILY (Daily): [**9-4**] 2 mg [**9-5**] 3 mg [**9-6**] 3 mg INR 1.2 [**9-7**] INR 1.7 goal INR [**1-19**]. 5. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4 hours) as needed. 6. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 7. Carbamazepine 100 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO BID (2 times a day). 8. Carvedilol 3.125 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 9. Amiodarone 200 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily): 400 mg Qd x 1 week then 200 mg QD. 10. Escitalopram 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 11. Propoxyphene N-Acetaminophen 100-650 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed. 12. Furosemide 20 mg Tablet Sig: Two (2) Tablet PO once a day. Discharge Disposition: Extended Care Facility: [**Doctor Last Name 62491**]Rehabilitation Discharge Diagnosis: Congestive Heart Failure, Mitral regurgitation, Non-ischemic cardiomyopathy - s/p porcine MVR and MAZE, Hypertension, History of Atrial flutter with history of failed ablation, s/p PPM/AICD placement, Chronic anemia, Osteoporosis with multiple lumbar compression fractures, History of non-Hodgkins lymphoma, Spinal stenosis with chronic low back pain, History of seizures, History of herpetic neuralgia, s/p chole, s/p appendectomy, Postoperative leukocytosis, Preoperative UTI, Plueral effusions Discharge Condition: Good Discharge Instructions: Keep wounds clean and dry. OK to shower, no bathing or swimming. Take all medications as prescribed. Call for any fever, redness or drainage from wounds. No lifting more than 10 lbs for at least 10 weeks. Followup Instructions: [**Hospital 409**] clinic in 2 weeks Dr. [**Last Name (STitle) **] in 4 weeks Dr. [**Last Name (STitle) 62492**] on [**2130-9-21**] @ 2PM Local cardiologist in 2 weeks Local PCP [**Last Name (NamePattern4) **] 2 weeks Completed by:[**2130-9-7**] ICD9 Codes: 4280, 4240, 4254, 5990, 5119, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6057 }
Medical Text: Admission Date: [**2154-6-7**] Discharge Date: [**2154-6-14**] Date of Birth: [**2082-7-14**] Sex: F Service: MEDICINE Allergies: Aspirin / Penicillins / Sulfa (Sulfonamide Antibiotics) Attending:[**First Name3 (LF) 3043**] Chief Complaint: dyspnea Major Surgical or Invasive Procedure: none History of Present Illness: 71 yo F with PMH of CAD, CHF, DM, HTN, CVA who developed acute onset SOB the night prior to admission. She additionally had an approximate 5 minute period of chest pain with burning sensation. During the course of the night she noted difficulty lying flat. SOB seemed somewhat positional. The day of presentation, she went to her PCP who then sent her to [**Hospital1 6591**]. There she was found to have elevated Troponin 0.12, 0.13. CXR was not exemplary but CTA with massive pulmonary embolism. Given Lovenox 80 mg SC at [**2154-6-6**] at [**2161**]. Has history of R hemorrhagic CVA in [**2148**] with resultant left hemiparesis. Hemodynamically stable and transferred to [**Hospital1 18**]. . At [**Hospital1 18**], initial VS 97.7, 128/93, 85, 14 and 97 on unknown oxygen. Pulmonary exam noted to be clear to auscultation bilaterally. EKG with SR, multiple PVCs and diffuse new TWI V2-V6 compared to [**2148**]. Labs revealed hypernatremia, low bicarbonate to 20 and UA with pyuria and bacteria. She was not given additional medication but IR was contact[**Name (NI) **] for potential thrombectomy. Past Medical History: Chronic obstructive pulmonary disease. Systolic CHF, Ef 10-15% [**2148**] (Patient unsure) s/p Hemorrhagic CVA (left sided hemiparesis) due to right middle cerebral artery infarction who underwent a craniotomy Hyperlipidemia HTN Diabetes mellitus Constipation UTIs h/o Tracheostomy Social History: Lives with husband with daughter upstairs. Previously smoked (20 years x 1.5 ppWeek) Family History: No family history of thrombus or bleeding disorders. Father with history of MIs. Physical Exam: VS 98, 79, 125/90, 14, 99/2L NC GEN: NAD HEENT: NCAT, PERRL, MMM PULM: CTAB without w/r/r CV: RRR without m/g/r Abd: Soft, NT, active bowel sounds LE: without e/o edema, symmetric Pertinent Results: [**2154-6-7**] 09:25PM HCT-41.5 [**2154-6-7**] 09:25PM PT-14.8* PTT-150.0* INR(PT)-1.3* [**2154-6-7**] 01:17PM CK(CPK)-114 [**2154-6-7**] 01:17PM CK-MB-6 cTropnT-0.07* [**2154-6-7**] 01:17PM PT-15.5* PTT-150* INR(PT)-1.4* [**2154-6-7**] 05:39AM URINE BLOOD-SM NITRITE-NEG PROTEIN-30 GLUCOSE-NEG KETONE-10 BILIRUBIN-NEG UROBILNGN-NEG PH-5.5 LEUK-SM [**2154-6-7**] 12:01AM GLUCOSE-163* UREA N-15 CREAT-0.8 SODIUM-146* POTASSIUM-3.4 CHLORIDE-113* TOTAL CO2-20* ANION GAP-16 [**2154-6-7**] 12:01AM CK(CPK)-88 [**2154-6-7**] 12:01AM cTropnT-0.11* [**2154-6-7**] 12:01AM CK-MB-NotDone [**2154-6-7**] 12:01AM WBC-11.4* RBC-4.91# HGB-15.0# HCT-44.1# MCV-90 MCH-30.5 MCHC-33.9 RDW-14.7 [**2154-6-7**] 12:01AM PLT COUNT-182 [**2154-6-7**] 12:01AM PT-13.2 PTT-36.4* INR(PT)-1.1 EKG [**6-6**]: Normal sinus rhythm with occasional ventricular premature beats. Low voltage in the standard leads and in the precordial leads. Very poor R wave progression. RSR' pattern in lead V1. QRS duration of 90 milliseconds. Non-specific ST-T wave changes throughout the tracing. Compared to the previous tracing of [**2148-4-25**] the patient has gone from atrial fibrillation at a rate of 117 to normal sinus rhythm at 86 beats per minute with occasional atrial premature beats. The T wave inversions in the lateral leads are new. The poor R wave progression out through V6 is new. This may be related to altered lead placement. Consider anterior wall myocardial infarction of undetermined age. ECHO [**6-7**]: Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. Overall left ventricular systolic function is normal (LVEF>55%). The right ventricular cavity is moderately dilated with moderate global free wall hypokinesis. There is abnormal systolic septal motion/position consistent with right ventricular pressure overload. No aortic regurgitation is seen. Mild (1+) mitral regurgitation is seen. There is a very small pericardial effusion. IMPRESSION: Dilated and hypokinetic right ventricle with evidence of pressure overload. Small left ventricle with normal global systolic function. At least mild mitral regurgitation. Suboptimal study. Compared with the report of the prior study (images unavailable for review) of [**2148-4-9**], LV function appears to have improved. At the same time, there is new RV dilation/dysfunction. CXR [**6-7**]: IMPRESSION: 1. No evidence of pneumonia or congestive heart failure. 2. Diminished vascularity in lung, likely due to known large pulmonary embolism. bilateral LE u/s [**6-7**]: IMPRESSION: Partially occlusive DVT of the left common femoral vein extending through the entire left superficial femoral vein where it is nearly completely occlusive and into the left popliteal vein where again it is partially occlusive. Left calf veins cannot be seen. Right lower extremity venous structures do not demonstrate any thrombus. Brief Hospital Course: # Pulmonary embolus: Pt was admitted to MICU and started on heparin gtt. LLE u/s positive for DVT as above. An ECHO showed moderate RV dilation as above. An IVC filter was placed. She continued to have borderline blood pressures which were fluid responsive, likely in part do to her right heart failure, after transition to regular medicine unit, pt remained normotensive. Otherwise, she remained HD stable and did not require significant O2 supplementation. Pt was transitioned to lovenox and then to coumadin. INR WAS 5 ON THE DAY OF DISCHARGE. Pt had previously recieved 5mg coumadin x2 days and was held on the day of discharge. Coumadin was held on the day of discharge. Rehab facility will continue to adjust coumadin dose as needed. Pt has no family history or prolonged recumbency, though clot is in hemiparetic leg. CA screening appears to be mostly uptodate with colonoscopy in [**2152**], mammogram in [**2151**] though she has not had a pap recently. -PT SCHEDULED FOR LOWER EXTREMITY ULTRASOUND ON [**2154-7-8**] FOR CONSIDERATION OF IVC FILTER REMOVAL. -Interventional Radiology (Dr [**Last Name (STitle) **] and [**First Name8 (NamePattern2) 6989**] [**Last Name (NamePattern1) 6745**]) to review LENI and [**First Name8 (NamePattern2) 6989**] [**Last Name (NamePattern1) 6745**] will call pt to arrange for removal of IVC filter at that time. . # UTI: pt was noted to have a +UA and initially started on cipro. However, pt's urine grew esbl e coli s to nitrofurantoin but not cipro and so pt was switched to nitrofurantoin for total course of 7 days. . # History of hemorrhagic stroke: Review of records indicates conversion from ischemic to hemorrhagic stroke. Seemingly minimal risk for recurrent bleeding approximately 6 years post-event. Pt had been on secondary stroke ppx with plavix but this was transitioned to coumadin. . # CAD/?CHF: Pt reports history of EF 10-15%, however, TTE was repeated and showed preserved LV function (no LV systolic or diastolic dysfunction). Metoprolol was initially held for hypotension and then restarted prior to discharge in setting of frequent ectopy (including one 16 beat run of NSVT) and normal blood pressures. Pt is not on aspirin [**2-19**] allergy. Crestor was continued. . # COPD: continued tiotroprium . # HTN: Held BBlocker initially in setting of potential HD instability, restarted prior to discharge. . # Hyperlipidemia: Continued home Crestor . # Low bicarbonate: felt to be compensatory [**2-19**] elevated respiratory rate and low pCO2 as pt's VENOUS pCO2 was only 36. . Family contact: [**Name (NI) **] (daughter) [**Telephone/Fax (1) 54798**] Medications on Admission: Metoprolol Tartrate 25 mg Tab Oral 1 Tablet(s) Twice Daily Plavix 75 mg Tab Oral 1 Tablet(s) Once Daily Tiotropium Bromide 18 mcg Caps w/Inhalation Device(s) Once Daily Crestor 20 mg Tab Oral 1 Tablet(s) Once Daily Glipizide 5 mg Tab Oral 1 Tablet(s) Once Daily Trazodone 50 mg Tab Oral 1 Tablet(s) QHS Topamax 200 mg Tab Oral QPM Topamax 150 mg QAM Allergies: Aspirin / Penicillins / Sulfa Discharge Medications: 1. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). 2. Tiotropium Bromide 18 mcg Capsule, w/Inhalation Device Sig: One (1) Cap Inhalation DAILY (Daily). 3. Rosuvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Glipizide 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Trazodone 50 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) as needed for insomnia. 6. Topiramate 100 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime). 7. Topiramate 100 mg Tablet Sig: 1.5 Tablets PO QAM (once a day (in the morning)). 8. Nitrofurantoin (Macrocryst25%) 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day) for 3 days: last day [**2154-6-16**]. 9. Omeprazole 40 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day. 10. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 11. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed for constipation. 12. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for pain: limit tylenol to less that 4g per day. 13. Nystatin 100,000 unit/g Cream Sig: One (1) Appl Topical [**Hospital1 **] (2 times a day) for 2 weeks: apply to rash underneath right knee and behind right ankle. 14. Clotrimazole 1 % Cream Sig: One (1) Appl Topical [**Hospital1 **] (2 times a day) for 2 weeks: apply to rash in right axilla. 15. Lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: One (1) Adhesive Patch, Medicated Topical DAILY (Daily) as needed for pain: 12 hours on, 12 hours off. apply to sore shoulder as needed. 16. Coumadin 2 mg Tablet Sig: as below Tablet PO once a day: HOLD ALL COUMADIN ON [**6-14**] (INR 5 today). RECHECK INR TOMORROW ([**4-15**]), IF inr 3.5 OR LOWER WOULD GIVE 2MG. NP ON CALL DAILY WITH INR TO HELP WITH COUMADIN ADJUSTMENT UNTIL SHE'S ON A STABLE DOSE OF COUMADIN (JUST STARTED COUMADIN 2D AGO). Discharge Disposition: Extended Care Facility: Cape Code Nursing & Rehabilitation Center - [**Location (un) 10072**] Discharge Diagnosis: primary: pulmonary embolus, UTI 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: You were admitted to the hospital for a large blood clot in the lungs. We started you on a blood thinner called lovenox (which is a shot), but are transitioning you to coumadin (which is a pill). You will need to get your coumadin levels checked very closely for the next few weeks to confirm that your your coumadin levels are not too high (which can cause bleeding) or low (which can lead to clotting). You are going to rehab but when you go home, please weigh yourself every morning, call your primary doctor if your weight goes up more than 3 lbs. We have made several changes to your medications. Please ensure that your rehab gives you a copy of your medicine list when you go. In brief, we STOPPED your plavix, DECREASED your metoprolol tartrate (lopressor), STARTED coumadin, STARTED lidocaine patch Followup Instructions: Please go to the following appointment which we have arranged for you: 1. You need to return to [**Hospital3 **] to see if you still have clot in your leg. It is very important that you go to this appointment. THe radiologists will call you after they see the result of the leg ultrasound and arrange a time to take out the filter they placed in the veins near your heart. ULTRASOUND APPOINTMENT: [**Hospital3 **] Hospital, [**Location (un) 86**] [**Hospital Ward Name **] Monday [**2154-7-8**] at 12:30 pm in the clinical center on the [**Location (un) **] in the radiology suite *** After your ultrasound the radiologists should call you to arrange your next appointment (to get the filter out). If they don't call within 1 week, please call them at [**Telephone/Fax (1) 8243**]. Your appointment should be with Dr [**Last Name (STitle) 9441**]. 2. We also arranged for you to see a dermatologist for the rash on your shoulder and knee. If these rashes have disappeared, you can cancel this appointment. Department: DERMATOLOGY AND LASER When: WEDNESDAY [**2154-7-17**] at 2:15 PM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 8157**], MD [**Telephone/Fax (1) 3965**] Building: [**Location (un) 3966**] ([**Location (un) 55**], MA) [**Location (un) **] Campus: OFF CAMPUS Best Parking: Free Parking on Site Completed by:[**2154-6-15**] ICD9 Codes: 2760, 5990, 2762, 4280, 4019, 496, 2724
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6058 }
Medical Text: Admission Date: [**2144-12-16**] Discharge Date: [**2144-12-18**] Service: MEDICINE Allergies: Penicillins / Ciprocinonide Attending:[**Doctor First Name 1402**] Chief Complaint: lightheadedness Major Surgical or Invasive Procedure: none History of Present Illness: 86f with lingual scc s/p xrt developed lightheadedness on the morning of admission, was transferred by EMS to [**Hospital1 18**] where she was found to be in afib with rvr. She was initially bolused with diltiazem with little response, was moved to a diltiazem gtt with modest response, and per her cardiologist was loaded with digoxin and started on propranolol. Her bp remained 80-90's throughout, and she was given 4L NS as felt to be hypovolemic. Past Medical History: -Lingual SCC s/p xrt (15/25 treatments), no chemo -HTN -Hypercholesterolemia -CAD: IMI in [**12/2141**], cath with 99% rca (cypher stent) and 90% LAD with PCWP 12; cath [**2-/2142**] with stent to LAD lesion -Depressed EF of 45% on [**12/2141**] echo -Tachy-brady -Atrial fibrillation -1+ MR [**First Name (Titles) **] [**Last Name (Titles) **] on [**12/2141**] echo -Lymphoid inflammator infilitrate vs organizing pna on wedge bx [**8-/2141**], done for abnormality seen on cxr -Osteoporosis with left ankle fx, femur fx, knee fx . PSH: -CCY [**1-/2142**] -Wedge resection lung, RML [**8-/2141**] -ORIF [**1-/2143**] of L femur fx -Left hip replacement Social History: Pt is married and lives with her husband. She smoked about 1ppd for about 30 years, quit in the [**2097**]'s. She used to drink 1 vodka drink nightly. Family History: Father had CAD, brother died of unknown malignancy, has one child with breast cancer. Physical Exam: t 98.1, bp 102/68, hr 94, rr 16, spo2 95% 2lNC gen- cachectic, chronically-ill appearing, dehydrated, functions fairly-well, non-tox, nad heent- anicteric, op with erythema and edema of tongue, mucosa slightly dry neck- no jvd, lad, or thyromegaly cv- irreg irreg, [**1-27**] apical holosystol murmur pul- decr throughout, fair air movement, no acc muscle use, no w/r/r abd- soft, nt, nd, nabs extrm- no cyanosis/edema, warm/dry nails- no clubbing, no pitting/color change/indentations neuro- a&ox3, hard of hearing, no other focal cn deficits, no focal motor or sensory deficits Pertinent Results: [**2144-12-16**] 11:40AM WBC-3.1* RBC-4.14* HGB-10.9* HCT-32.4* MCV-78* MCH-26.2* MCHC-33.5 RDW-18.8* [**2144-12-16**] 11:40AM NEUTS-76.5* LYMPHS-15.5* MONOS-7.8 EOS-0.1 BASOS-0.1 [**2144-12-16**] 11:40AM PLT COUNT-326 [**2144-12-16**] 11:40AM PT-14.6* PTT-26.4 INR(PT)-1.3* [**2144-12-16**] 11:40AM GLUCOSE-122* UREA N-31* CREAT-1.0 SODIUM-135 POTASSIUM-3.7 CHLORIDE-93* TOTAL CO2-28 ANION GAP-18 [**2144-12-16**] 11:40AM CALCIUM-9.3 PHOSPHATE-3.4 MAGNESIUM-1.9 [**2144-12-16**] 11:40AM DIGOXIN-0.2* [**2144-12-16**] 11:40AM CK(CPK)-83 [**2144-12-16**] 11:40AM CK-MB-NotDone proBNP-6981* [**2144-12-16**] 11:40AM cTropnT-0.03* . ECG: afib with ventric rate 120's, no q's or st-t changes; prior ecg nsr with lad . CXR: Mild interstitial edema, no effusions or focal infiltrate Brief Hospital Course: . #Afib -- She has had decreased po intake for the last 2 weeks due to mouth pain resulting in severe hypovolemia on presentation. The combination of hypovolemia and medication noncompliance likely led to her atrial fibrillation with rapid ventricular response. She received 4L IVF in the ED and 2 more in the CCU. She was initially maintained on a diltiazem drip. She converted to NSR a few hours after admission so her diltiazem drip was stopped and she was transitioned to metoprolol with her home regimen of digoxin. She remained in NSR with episodes of SVT on metoprolol 25 tid and digoxin 0.125. She was somewhat resistant to care here, refusing medications on occasion. She was opposed to drastic change in her medication regimen as an inpatient. She should likely be considered for amiodarone and ablation but is currently refusing. She was started on Toprol XL in an effort to improve medication compliance with once-daily dosing. She was discharged on her home digoxin as well. The importance of continuing these medications was stressed to the patient and her family. Per her outpatient cardiologist, she is not a candidate for anticoagulation due to risk of bleeding. . #CAD -- No active ischemia. Continued on her outpatient regimen of aspirin, clopidogrel, and atorvastatin. She was started on Toprol XL as above. . #Oral cancer -- Much of patient's problems have come from her inability to take medications secondary to severe oral pain and odynophagia s/p XRT. She was maintained on a Fentanyl patch. The dose was increased to 50mcg but she had mild delirium with this dose, so she was dropped back down to her home regimen. In addition, she was offered lidocaine swish and swallow as well as GelClair and magic mouthwash for symptomatic relief. She was intermittently compliant with these medications. She was discharged with prescriptions for these meds, and is scheduled for Oncology follow up 5 days after discharge. . #Renal insufficiency -- Baseline cr 0.5-0.8, Cr decreased fom 1 to 0.6 with IV hydration initially. It was 1.0 on the day of discharge. The importance of adequate fluid intake was stressed to the patient and her family. . #Anemia -- Microcytic anemia with baseline hematocrit of 26-30. Studies indicate iron deficiency; patient non-compliant with iron at home. She was maintained on iron supplements and further workup was deferred to the outpatient setting. . # Leukopenia: Her WBC count was noted to be 1.7 the day after admission. Her baseline WBC count appears to be 4-7,000. She was not neutropenic by ANC. She was not started on any medications suspicious for causing leukopenia. She has not received any chemotherapy. She had 1 isolated temperature of 100.4, but no infectious symptoms. She was started on ciprofloxacin for a suspected UTI by UA. Her leukopenia in combination with her anemia may be suspicious for MDS. She will be following up with her oncologist in 5 days and should likely have a CBC checked at that time. She was instructed to contact her oncologist should she have a temperature >100.4. . #Code -- FULL CODE, patient refused to discuss code status, states she wants to discuss with her husband and PCP at [**Name Initial (PRE) **] later date . Medications on Admission: -Oxycodone-acetaminophen elixir -Fentanyl 25mcg transdermal -Aspirin 81mg daily -Folic acid 1mg daily -Digoxin 0.125mg daily -Levothyroxine 0.050mg daily -Atorvastatin 10mg daily -Niferex 150mg p.o. daily -Plavix 75mg per day -Propranolol 5mg b.i.d. -Pantoprazole 40mg daily -Vitamin B12 50mg daily. Discharge Medications: 1. Oxycodone-Acetaminophen 5-325 mg/5 mL Solution Sig: Five (5) ML PO Q4-6H (every 4 to 6 hours) as needed. 2. Oral Wound Care Products Packet Sig: One (1) ML Mucous membrane [**Hospital1 **] () as needed for mouth comfort. Disp:*60 packets* Refills:*3* 3. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Digoxin 125 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 6. Ferrous Sulfate 300 mg/5 mL Liquid Sig: 300mg PO twice a day: Please start after you complete ciprofloxacin. Disp:*qs mL* Refills:*2* 7. Toprol XL 50 mg Tablet Sustained Release 24HR Sig: One (1) Tablet Sustained Release 24HR PO once a day. Disp:*30 Tablet Sustained Release 24HR(s)* Refills:*2* 8. Lidocaine HCl 2 % Solution Sig: Twenty (20) ML Mucous membrane QID (4 times a day) as needed for mouth pain: Swish and spit. Disp:*qs ML(s)* Refills:*0* 9. Ciprofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours) for 7 days. Disp:*7 Tablet(s)* Refills:*0* 10. Fentanyl 25 mcg/hr Patch 72HR Sig: One (1) Patch 72HR Transdermal Q72H (every 72 hours). 11. Ferrous Sulfate 325 (65) mg Tablet Sig: One (1) Tablet PO DAILY (Daily): please do not take with ciprofloxacin. 12. magic mouthwash maalox/diphenhydramine/lidocaine 15-30mg po QID prn Discharge Disposition: Home With Service Facility: [**Last Name (un) 2646**] Discharge Diagnosis: Atrial fibrillation with rapid ventricular rate dehydration anemia and leukopenia lingual squamous cell cancer Discharge Condition: fair. AFVSS normal sinus rhythm Discharge Instructions: Please continue to take all of your regular home medications. The most important of these medications is your metoprolol XL; these will help to keep your heart rate in a range that is safe and should keep you out of the hospital. You also need to drink 2 liters of fluids per day and try to eat more. . You should seek medical attention if you have a temperature greater than 100.4, if you have worsening mouth pain, light headedness, dizziness, passing out, palpitations, or for any other concerns. . We have also given you a prescription of gelclaire to help with your mouth pain. . You also have a urinary infection and you should take ciprofloxacin for one week. . Lastly, your blood counts are low; you will need to see Dr. [**First Name (STitle) **] next week (your hematologist/oncologist) for a blood check. . You should call Dr.[**Name (NI) 9920**] office and your oncologist's office for an appointment within the next 1-2 weeks. Followup Instructions: Please call Dr. [**Last Name (STitle) **] at [**Telephone/Fax (1) 10012**] for a follow up appointment within 1-2 weeks. . Provider: [**Name10 (NameIs) **],HEM/ONC HEMATOLOGY/ONCOLOGY-CC9 Phone:[**Telephone/Fax (1) 22**] Date/Time:[**2144-12-24**] 2:30 Completed by:[**2144-12-18**] ICD9 Codes: 2859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6059 }
Medical Text: Admission Date: [**2178-1-26**] Discharge Date: [**2178-1-31**] Date of Birth: [**2111-7-14**] Sex: F Service: UROLOGY Allergies: Sulfa (Sulfonamides) / Zocor Attending:[**First Name3 (LF) 1232**] Chief Complaint: Metastatic renal cancer with primary on left side Major Surgical or Invasive Procedure: Radical nephrectomy with adrenalectomy and multiple nodes. History of Present Illness: This is a 66-year-old female who was detected to have a large renal mass during work up for abdominal pain. She has imaging to confirm that she has a large left renal mass with apparent adrenal metastatic involvement and a small thrombus extending into the left renal vein to the position of the medial aortic side. She presented to the [**Hospital1 18**] for elective resection of the mass. Past Medical History: PMH: anemia (gammaglobulinopathy), OA, hyperlipidemia, chr back spasm PSH: tonsillectomy, appy, TAH-BSO, deviated septum repair Physical Exam: NAD, AAOx3 RRR, S1S2 CTAB, mildly decreased BS on R base Abd: soft, ND, aprop. tender incision c/d/i Ext: no c/c/e Pertinent Results: [**2178-1-30**] 05:55AM BLOOD WBC-6.0 RBC-4.38 Hgb-11.5* Hct-36.0 MCV-82 MCH-26.2* MCHC-31.9 RDW-17.5* Plt Ct-354 [**2178-1-29**] 05:55AM BLOOD WBC-8.6 RBC-4.39 Hgb-11.4* Hct-34.6* MCV-79* MCH-25.9* MCHC-32.8 RDW-17.3* Plt Ct-362 [**2178-1-28**] 04:04AM BLOOD WBC-11.1* RBC-4.35 Hgb-11.4* Hct-35.1* MCV-81* MCH-26.2* MCHC-32.5 RDW-16.9* Plt Ct-351 [**2178-1-27**] 06:44PM BLOOD WBC-10.6 RBC-3.87* Hgb-9.9* Hct-30.0* MCV-78* MCH-25.6* MCHC-33.1 RDW-17.4* Plt Ct-352 [**2178-1-27**] 12:50AM BLOOD WBC-7.7 RBC-4.13* Hgb-10.2* Hct-33.1* MCV-80* MCH-24.8* MCHC-31.0 RDW-17.8* Plt Ct-402 [**2178-1-27**] 06:44PM BLOOD Neuts-79* Bands-2 Lymphs-12* Monos-7 Eos-0 Baso-0 Atyps-0 Metas-0 Myelos-0 [**2178-1-27**] 06:44PM BLOOD Hypochr-2+ Anisocy-1+ Poiklo-1+ Macrocy-NORMAL Microcy-2+ Polychr-NORMAL Ovalocy-1+ Schisto-OCCASIONAL Burr-1+ [**2178-1-30**] 05:55AM BLOOD Plt Ct-354 [**2178-1-29**] 05:55AM BLOOD Plt Ct-362 [**2178-1-29**] 05:55AM BLOOD PT-13.1 PTT-34.0 INR(PT)-1.1 [**2178-1-28**] 04:04AM BLOOD Plt Ct-351 [**2178-1-28**] 04:04AM BLOOD PT-13.4* PTT-29.1 INR(PT)-1.2* [**2178-1-27**] 06:44PM BLOOD Plt Ct-352 [**2178-1-27**] 06:44PM BLOOD PT-14.0* INR(PT)-1.2* [**2178-1-27**] 12:50AM BLOOD Plt Ct-402 [**2178-1-30**] 06:15PM BLOOD Glucose-128* UreaN-14 Creat-0.9 Na-138 K-4.2 Cl-104 HCO3-26 AnGap-12 [**2178-1-30**] 05:55AM BLOOD Glucose-72 UreaN-13 Creat-0.8 Na-140 K-4.0 Cl-106 HCO3-23 AnGap-15 [**2178-1-29**] 04:00PM BLOOD Glucose-86 UreaN-14 Creat-0.8 Na-138 K-4.2 Cl-103 HCO3-23 AnGap-16 [**2178-1-29**] 05:55AM BLOOD Glucose-86 UreaN-14 Creat-0.8 Na-136 K-4.0 Cl-102 HCO3-24 AnGap-14 [**2178-1-28**] 04:04AM BLOOD Glucose-121* UreaN-12 Creat-0.9 Na-138 K-4.3 Cl-107 HCO3-23 AnGap-12 [**2178-1-27**] 06:44PM BLOOD Glucose-142* UreaN-14 Creat-0.7 Na-140 K-4.3 Cl-111* HCO3-20* AnGap-13 [**2178-1-27**] 12:50AM BLOOD Glucose-93 UreaN-12 Creat-0.7 Na-140 K-4.2 Cl-104 HCO3-18* AnGap-22* [**2178-1-30**] 06:15PM BLOOD Calcium-8.6 Phos-1.4* Mg-2.1 [**2178-1-30**] 05:55AM BLOOD Calcium-7.9* Phos-2.0* Mg-2.1 [**2178-1-29**] 05:55AM BLOOD Calcium-8.1* Phos-2.4* Mg-2.3 [**2178-1-28**] 04:04AM BLOOD Calcium-8.1* Phos-3.4 Mg-2.2 [**2178-1-27**] 12:50AM BLOOD Calcium-10.2 Phos-2.9 Mg-2.2 [**2178-1-27**] 06:44PM BLOOD RedHold-HOLD [**2178-1-28**] 04:32AM BLOOD Type-ART pO2-99 pCO2-43 pH-7.37 calTCO2-26 Base XS-0 [**2178-1-28**] 01:01AM BLOOD Type-ART pO2-106* pCO2-43 pH-7.33* calTCO2-24 Base XS--3 [**2178-1-27**] 10:31PM BLOOD Type-ART pO2-115* pCO2-48* pH-7.29* calTCO2-24 Base XS--3 [**2178-1-27**] 06:44PM BLOOD Type-ART pO2-107* pCO2-50* pH-7.26* calTCO2-23 Base XS--4 [**2178-1-27**] 04:26PM BLOOD Type-ART pO2-218* pCO2-38 pH-7.31* calTCO2-20* Base XS--6 Intubat-INTUBATED [**2178-1-27**] 02:29PM BLOOD Type-ART pO2-224* pCO2-35 pH-7.38 calTCO2-22 Base XS--3 Intubat-INTUBATED Vent-CONTROLLED [**2178-1-28**] 04:32AM BLOOD Lactate-0.7 [**2178-1-28**] 01:01AM BLOOD Glucose-140* Lactate-0.6 Na-137 K-4.2 Cl-110 [**2178-1-27**] 10:31PM BLOOD Lactate-0.5 [**2178-1-27**] 04:26PM BLOOD Glucose-143* Lactate-0.5 K-3.9 [**2178-1-27**] 02:29PM BLOOD Glucose-111* Lactate-0.4* Na-138 K-3.7 Cl-112 [**2178-1-27**] 04:26PM BLOOD Hgb-9.9* calcHCT-30 [**2178-1-27**] 02:29PM BLOOD Hgb-9.7* calcHCT-29 [**2178-1-28**] 04:32AM BLOOD freeCa-1.16 [**2178-1-28**] 01:01AM BLOOD freeCa-1.17 [**2178-1-27**] 10:31PM BLOOD freeCa-1.15 [**2178-1-27**] 04:26PM BLOOD freeCa-1.25 [**2178-1-27**] 02:29PM BLOOD freeCa-1.30 Brief Hospital Course: This is a 66-year-old female who was detected to have a large renal mass during work up for abdominal pain. She has imaging to confirm that she has a large left renal mass with apparent adrenal metastatic involvement and a small thrombus extending into the left renal vein to the position of the medial aortic side. She presented to the [**Hospital1 18**] for elective resection of the mass. On [**2178-1-27**] the patient underwent a radical nephrectomy with adrenalectomy and multiple nodes. She tolerated the proceudre well and was transferred to the ICU to monitor here respiratory status for the night. Her chest tube was placed to suction and a CXR obtained overnight revealed no PTX and she had no air leak. She remained stable and her post-op acidosis resolved with pain control and fluid resuscitation. On POD #1 she was transferred to the floor. Her CXR remained stable so her chest tube was D/C'd. Her pain was controlled with IV meds and she was kept NPO/NGT/IVF. Her calcium levels, which were very high pre-op, came down into normal range. Her HCT and other labs remained stable. On POD #2 her NGT was d/c'd. On POD #3 the patient passed gas and her diet was advanced. She was changed to PO pain meds and her calcium values were borderline low so she was started on Ca and Vit D. She was able to ambulate and her foley was d/c'd after which she had not trouble voiding. She was kept in house to further monitor her changing calcium levels. On POD #4 she continued to do well without any issues and was discharged to home in good condition. Medications on Admission: Tussionex prn, FeS 150 mg, Procrit injections, lovastatin 20 mg, Extra Strength Tylenol Discharge Medications: 1. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. Disp:*40 Tablet(s)* Refills:*0* 3. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 4. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO TID (3 times a day) as needed. 5. Famotidine 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Discharge Disposition: Home Discharge Diagnosis: Metastatic renal cancer with primary on left side Discharge Condition: Good Discharge Instructions: [**Name8 (MD) **] M.D. if fever > 101.5, nausea, vomiting, shortness of breath, chest pain, redness or drainage from incision, inability to urinate or any other concerns. You may shower, but do not take a tub bath for 10 days. Do not drive while taking narcotics. Followup Instructions: Please call Dr.[**Doctor Last Name **] office to schedule a followup in 2 weeks. [**Telephone/Fax (1) 25444**]. Completed by:[**2178-2-5**] ICD9 Codes: 2724
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6060 }
Medical Text: Admission Date: [**2129-8-27**] Discharge Date: [**2129-8-28**] Service: HISTORY OF PRESENT ILLNESS: The patient is an 86 year old female with a history of peptic ulcer disease and CVA who presented to an outside hospital the day prior to death with hypotension of 40/palp, unresponsiveness. She rapidly developed respiratory failure and hypotension was refractory to four pressor agents. Over the subsequent six hours patient developed increasing hypoxemia, acidemia, was intubated for airway control and continued on aggressive IV fluids rehydration and multiple pressor agents. She was subsequently transferred to [**Hospital1 188**] for further care for presumed septic shock. PHYSICAL EXAMINATION: The patient was an obese, elderly female, intubated, sedated, unresponsive. Pupils were 5 mm and sluggishly reactive. Neck was supple. Heart sounds were mildly distant, normal S1, S2, no murmurs, gallops or rubs appreciated. Lungs had scattered expiratory wheezes, but no rales or rhonchi. Abdomen was soft and nondistended with decreased bowel sounds. Extremities were cool and mottled. She had a right femoral line. There was 1+ pitting edema throughout. Neurologic the patient was unresponsive, did not withdraw to pain. LABORATORY DATA: The patient had labs that were notable for admission white count of 3.1 with 11 percent polys, 31 percent bands, 39 percent lymphs, 4 percent monos, hematocrit 34.4, platelets 184. Chemistry-7 was sodium 139, potassium 4.3, chloride 112, bicarb 11, BUN 48, creatinine 2.0, glucose 105. Calcium 7.0, magnesium 1.6, phosphate 6.8. CK was initially 247 that rose to 1400. MB was 12 and rose to 55. UA was notable for trace leukocyte esterase, large blood, 21 to 50 red cells, no white cells, no nitrite, trace ketones. ABG on arrival was 6.96, 48, 91; subsequently 7.01, 36, 72. Lactate was 5.4. She had CT of her head which showed no hemorrhage, but chronic microvascular change. CT of the chest showed bilateral infiltrates and small effusion. Chest x-ray was read as anterior consolidation, collapse of the left lower lobe, ill-defined perihilar opacities and possible right pleural effusion. Blood and urine cultures were pending. The latest EKG at 17:30 showed multifocal atrial tachycardia at 120, normal axis, normal QRS, normal QT, decreased voltage in limb leads, [**Street Address(2) 4793**] elevation in leads 2, 3 and aVF. HOSPITAL COURSE: Over the course of hospitalization, the patient developed progressive acidemia with pH dropping to 6.8 with refractory hypoxemia despite aggressive oxygenation with PO2 of 30 and oxygen saturation of 60. Patient's hypotension remained refractory to triple pressors. Hypoxemia was refractory to aggressive oxygenation with 100 percent FIO2 and PEEP as high as 16. Despite these interventions, we could not restore the patient's blood pressure nor her oxygenation level to normal. The family was called and apprised of the critical nature of the situation. They decided to make the patient do not resuscitate. Over the next several hours the patient's blood pressure slowly dropped despite the pressors and she became more acidemic and refractory in terms of her hypoxemia. She eventually passed away at 5:00 a.m. on the morning of [**2129-8-28**]. CONDITION ON DISCHARGE: Dead. FINAL DIAGNOSES: 1. Septic shock. 2. Myocardial infarction. 3. Acidemia. [**First Name11 (Name Pattern1) 4514**] [**Last Name (NamePattern4) 8867**], M.D. [**MD Number(1) 8868**] Dictated By:[**Last Name (NamePattern1) 11801**] MEDQUIST36 D: [**2129-8-28**] 05:19 T: [**2129-8-31**] 11:47 JOB#: [**Job Number 51666**] ICD9 Codes: 0389, 2762, 5849
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6061 }
Medical Text: Admission Date: [**2129-1-17**] Discharge Date: [**2129-1-27**] Date of Birth: [**2052-2-13**] Sex: F Service: CARDIOTHORACIC Allergies: Sulfa (Sulfonamide Antibiotics) / Shellfish Attending:[**First Name3 (LF) 922**] Chief Complaint: Aortic stenosis Major Surgical or Invasive Procedure: [**2129-1-19**] - Core Valve Placement Percutaneous aortic valve replacement with a 26-mm [**Company 1543**] CoreValve device, model #MCS-P3-640, serial #[**Serial Number 71148**]. Balloon aortic valvuloplasty. History of Present Illness: This 76 year old white female with known critical aortic stensis was referred for Corevalve placement as she was deemed a high risk operative candidate due to heavy calcification of the aortic annulus. Core valve data: EXTREME risk cohort STS score 5. % (morbid/mortality 27.7 %) Euroscore 17.6 % Creat 1.3. CrCl 40 Past Medical History: critical aortic stenosis s/p coronary artery bypass s/p aortic valvuloplasty Hypertension Autoimmune Hepatitis with cirrhosis (Child's Class A) Anemia subclavian steal phenomenon Peripheral Vascular Disease Seizure in [**5-5**] 8. L sided subclavian steal h/o paroxysmal atrial fibrillation s/p appendectomy Social History: She is retired, married and lives with her husband and 2 adult children. She formerly worked at [**Company 2892**] as a telephone operator for 20 years. She denies tobacco, illicit drug, or ETOH use. Family History: There is a strong family history of CAD. Five brothers and sisters who are currently in their 60s all with CAD. Many of them have required CABG. Physical Exam: admission: VS: T 97.2 BP 171/66 P 74 RR 16 O2 100 RA Weight 149.3 lbs (prior weight 141 lbs) HEENT: PERRL. No JVD. Carotid bruit vs. radiation of murmur bilaterally Neck: The mucous membranes were moist. Lungs: Clear to auscultation Cardiovascular: There was no jugular venous distension. S1 was normal and S2 was diminished. There was a II/VI late peaking systolic murmur at the left sternal border. Abdomen: Soft without hepatosplenomegaly Neurologic Examination: Alert and Oriented x 3 Skin: No CCE. There were no petechia or purpura. There was no edema. Pulse: Left radial pulse 1+, right radial pulse 2+, DP/PT 1+ bilat Pertinent Results: [**2129-1-25**] 04:14AM BLOOD WBC-6.1 RBC-3.82* Hgb-11.5* Hct-34.6* MCV-91 MCH-30.0 MCHC-33.1 RDW-15.9* Plt Ct-158 [**2129-1-20**] 04:24AM BLOOD WBC-8.8# RBC-2.69* Hgb-8.6* Hct-25.4* MCV-94 MCH-31.9 MCHC-33.8 RDW-13.9 Plt Ct-139* [**2129-1-17**] 06:00PM BLOOD WBC-5.3 RBC-3.23* Hgb-10.7* Hct-30.7* MCV-95 MCH-33.2* MCHC-35.0 RDW-13.7 Plt Ct-162 [**2129-1-26**] 03:24AM BLOOD PT-25.6* INR(PT)-2.5* [**2129-1-25**] 04:14AM BLOOD PT-22.0* INR(PT)-2.1* [**2129-1-24**] 03:58AM BLOOD PT-21.7* PTT-96.6* INR(PT)-2.0* [**2129-1-23**] 05:58AM BLOOD PT-19.2* PTT-71.9* INR(PT)-1.7* [**2129-1-22**] 01:48PM BLOOD PT-16.9* PTT-63.2* INR(PT)-1.5* [**2129-1-22**] 05:09AM BLOOD PT-15.2* PTT-32.0 INR(PT)-1.3* [**2129-1-26**] 03:24AM BLOOD Glucose-96 UreaN-69* Creat-2.4* Na-131* K-4.4 Cl-95* HCO3-26 AnGap-14 [**Hospital1 18**] ECHOCARDIOGRAPHY REPORT [**Known lastname **], [**Known firstname 2671**] [**Hospital1 18**] [**Numeric Identifier 71149**]Portable TTE (Complete) Done [**2129-1-26**] at 12:07:13 PM FINAL Referring Physician [**Name9 (PRE) **] Information [**Name9 (PRE) **], [**First Name3 (LF) 177**] C. [**Hospital Unit Name 927**] [**Location (un) 86**], [**Numeric Identifier 718**] Status: Inpatient DOB: [**2052-2-13**] Age (years): 76 F Hgt (in): 61 BP (mm Hg): 96/61 Wgt (lb): 145 HR (bpm): 59 BSA (m2): 1.65 m2 Indication: Aortic valve disease. Left ventricular function. ICD-9 Codes: 424.1, 424.0, 424.3, 424.2 Test Information Date/Time: [**2129-1-26**] at 12:07 Interpret MD: [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**Last Name (NamePattern1) **], MD Test Type: Portable TTE (Complete) Son[**Name (NI) 930**]: [**First Name4 (NamePattern1) 1022**] [**Last Name (NamePattern1) **], RDCS Doppler: Full Doppler and color Doppler Test Location: [**Location 13333**]/[**Hospital Ward Name 121**] 6 Contrast: None Tech Quality: Adequate Tape #: 2011W000-0:00 Machine: Vivid q-2 Echocardiographic Measurements Results Measurements Normal Range Left Atrium - Long Axis Dimension: *4.2 cm <= 4.0 cm Left Atrium - Four Chamber Length: *5.3 cm <= 5.2 cm Left Atrium - Peak Pulm Vein S: 0.3 m/s Left Atrium - Peak Pulm Vein D: 0.7 m/s Right Atrium - Four Chamber Length: 4.8 cm <= 5.0 cm Left Ventricle - Septal Wall Thickness: *1.5 cm 0.6 - 1.1 cm Left Ventricle - Inferolateral Thickness: *1.4 cm 0.6 - 1.1 cm Left Ventricle - Diastolic Dimension: 3.4 cm <= 5.6 cm Left Ventricle - Systolic Dimension: 2.2 cm Left Ventricle - Fractional Shortening: 0.35 >= 0.29 Left Ventricle - Ejection Fraction: 60% to 65% >= 55% Left Ventricle - Lateral Peak E': *0.07 m/s > 0.08 m/s Left Ventricle - Septal Peak E': *0.05 m/s > 0.08 m/s Left Ventricle - Ratio E/E': *22 < 15 Aorta - Sinus Level: 2.2 cm <= 3.6 cm Aorta - Ascending: 3.1 cm <= 3.4 cm Aortic Valve - Peak Velocity: *2.3 m/sec <= 2.0 m/sec Aortic Valve - Peak Gradient: *20 mm Hg < 20 mm Hg Aortic Valve - Mean Gradient: 8 mm Hg Mitral Valve - E Wave: 1.3 m/sec Mitral Valve - A Wave: 1.0 m/sec Mitral Valve - E/A ratio: 1.30 Mitral Valve - E Wave deceleration time: 164 ms 140-250 ms TR Gradient (+ RA = PASP): *>= 36 mm Hg <= 25 mm Hg Findings This study was compared to the prior study of [**2129-1-20**]. LEFT ATRIUM: Mild LA enlargement. RIGHT ATRIUM/INTERATRIAL SEPTUM: Normal RA size. LEFT VENTRICLE: Moderate symmetric LVH. Normal LV cavity size. Normal regional LV systolic function. Overall normal LVEF (>55%). No resting LVOT gradient. RIGHT VENTRICLE: Normal RV chamber size and free wall motion. AORTA: Normal aortic diameter at the sinus level. Normal ascending aorta diameter. AORTIC VALVE: Aortic CoreValve. Normal AVR gradient. Mild (1+) AR. MITRAL VALVE: Mildly thickened mitral valve leaflets. Mild mitral annular calcification. Mild to moderate ([**11-28**]+) MR. TRICUSPID VALVE: Mildly thickened tricuspid valve leaflets. Moderate [2+] TR. Mild PA systolic hypertension. PULMONIC VALVE/PULMONARY ARTERY: Pulmonic valve not visualized. No PS. Physiologic PR. PERICARDIUM: No pericardial effusion. Conclusions The left atrium is mildly dilated. There is moderate symmetric left ventricular hypertrophy. The left ventricular cavity size is normal. Regional left ventricular wall motion is normal. Overall left ventricular systolic function is normal (LVEF>55%). Right ventricular chamber size and free wall motion are normal. An aortic CoreValve prosthesis is present. The transaortic gradient is normal for this prosthesis. Mild (1+) aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Mild to moderate ([**11-28**]+) 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 [**2129-1-20**], the left ventricular cavity size is now normal. Function is normal rather than hyperdynamic. CoreValve prosthesis is in the appopriate position with normal gradients and mild per-prosthetic regurgitation. Degrees of mitral regurgitation and pulmonary hypertension are similar. Electronically signed by [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**Last Name (NamePattern1) **], MD, Interpreting physician [**Last Name (NamePattern4) **] [**2129-1-26**] 16:28 ?????? [**2120**] CareGroup IS. All rights reserved. [**Known lastname **],[**Known firstname 2671**] R [**Medical Record Number 71150**] F 76 [**2052-2-13**] Radiology Report MR HEAD W/O CONTRAST Study Date of [**2129-1-24**] 3:14 PM [**Last Name (LF) **],[**First Name3 (LF) **] R. CSURG CSRU [**2129-1-24**] 3:14 PM MR HEAD W/O CONTRAST Clip # [**Clip Number (Radiology) 71151**] Reason: ? stroke post [**Hospital **] [**Hospital **] MEDICAL CONDITION: 76 year old woman with s/p corevalve REASON FOR THIS EXAMINATION: ? stroke post corevalve CONTRAINDICATIONS FOR IV CONTRAST: cr 2.5 Final Report HISTORY: S/P core valve ? stroke. TECHNIQUE: MRI brain without contrast, sagittal T1, axial FLAIR, T2, gradient echo, diffusion images with ADC maps. COMPARISON: CT head [**2129-1-20**]. FINDINGS: There are multiple small foci of slow diffusion in the supratentorium and infratentorium consistent with acute embolic infarcts. There is a background of T2 and FLAIR hyperintensity in the cerebral white matter consistent with microangiopathic small vessel disease. An old lacunar infarct is seen in the right [**Last Name (un) **] internal capsule/putamen. There is no mass effect. The ventricles and sulcal configuration are age-appropriate. There is no intracranial hemorrhage. The major vascular flow voids are maintained. IMPRESSION: Multiple small areas of slow diffusion in the supratentorium and infratentorium consistent with acute embolic infarcts. The study and the report were reviewed by the staff radiologist. DR. [**Last Name (STitle) 71152**] [**Name (STitle) 71153**] DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **]. [**Last Name (NamePattern1) 7415**] Approved: TUE [**2129-1-25**] 3:29 PM Imaging Lab Brief Hospital Course: Mrs. [**Known lastname 71146**] was admitted to the [**Hospital1 18**] on [**2128-12-17**] for preoperative work-up for a Core Valve. The Electrophysiology Service was consulted for evaluation of a new right bundle branch block. Although it is possible that she may require a pacemaker following her Core Valve, there was no indication for preoperative placement of a pacemaker. On [**2129-1-19**], Mrs. [**Last Name (STitle) 71154**] was taken to the Operating Room where she underwent placement of percutaneous aortic valve. Please see operative note for details. Postoperatively she was taken to the intensive care unit for monitoring. She later awoke neurologically intact and was extubated. Her medications were resumed including Plavix. She developed AV nodal re-entry tacycardia (AVNRT) which converted with Adenosine. As her transvenous pacer was not capturing, it was readjusted under fluoroscopy. She experienced another burst of AVNRT which responded to Adenosine. She later developed atrial flutter which was rate controlled with diltiazem. The Electrophysiology Service recommended anticoagulation with the possibility of cardioversion and amiodarone at some point. On POD 1 she was briefly apashic and unresponsive. She had some apashia and mild left sided weakness. A neurology consult was obtained and head CT was obtained. This revealed hypodensity of the white matter adjacent to the anterior [**Doctor Last Name 534**] of the rigth lateral ventricle and some reduced density of the right basalk ganglia. A subsequent MRI demonstrated multiple small areas of supratentorial and infratentorial infarcts. She recovered neurologically. EP continued to see her and she had episodic supraventricular arrhythmia and sinus bradycardai with pauses. Medications were adjusted. She was anticoagulated with Coumadin. The remainder of her hospital course was essentially uneventful. Prior to discharge a cardionet was arranged. On POD# 8 Mrs.[**Known lastname 71146**] was cleared for discharge to [**Hospital3 7665**] in [**Hospital1 3597**]. All follow up appointments were advised. Medications on Admission: FUROSEMIDE - 40 mg daily METOPROLOL TARTRATE 50 mg twice daily PRAVASTATIN - 20 mg [**Hospital1 8426**] daily VALSARTAN [DIOVAN] - 160 mg twice daily ASPIRIN 81 mg daily Discharge Medications: 1. valsartan 40 mg [**Hospital1 8426**] Sig: One (1) [**Hospital1 8426**] PO DAILY (Daily). Disp:*60 [**Hospital1 8426**](s)* Refills:*2* 2. tramadol 50 mg [**Hospital1 8426**] Sig: One (1) [**Hospital1 8426**] PO Q4H (every 4 hours) as needed for pain. 3. amiodarone 200 mg [**Hospital1 8426**] Sig: One (1) [**Hospital1 8426**] PO BID (2 times a day). 4. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 5. ranitidine HCl 150 mg [**Hospital1 8426**] Sig: One (1) [**Hospital1 8426**] PO DAILY (Daily). 6. aspirin 81 mg [**Hospital1 8426**], Delayed Release (E.C.) Sig: One (1) [**Hospital1 8426**], Delayed Release (E.C.) PO DAILY (Daily). 7. furosemide 20 mg [**Hospital1 8426**] Sig: One (1) [**Hospital1 8426**] PO BID (2 times a day). 8. potassium chloride 10 mEq [**Hospital1 8426**] Extended Release Sig: Two (2) [**Hospital1 8426**] Extended Release PO BID (2 times a day). 9. insulin regular human 100 unit/mL Solution Sig: One (1) Injection ACHS: per RISS. 10. warfarin 1 mg [**Hospital1 8426**] Sig: [**Name8 (MD) **] MD [**First Name (Titles) 8426**] [**Last Name (Titles) **] DAILY (Daily): INR goal=[**12-30**] for postop AFib. 11. pravastatin 20 mg [**Month/Day (3) 8426**] Sig: One (1) [**Month/Day (3) 8426**] PO HS (at bedtime). 12. metoprolol tartrate 25 mg [**Month/Day (3) 8426**] Sig: One (1) [**Month/Day (3) 8426**] PO BID (2 times a day). 13. hydralazine 25 mg [**Month/Day (3) 8426**] Sig: One (1) [**Month/Day (3) 8426**] PO Q6H (every 6 hours). 14. warfarin 2 mg [**Month/Day (3) 8426**] Sig: One (1) [**Month/Day (3) 8426**] PO once a day. 15. acetaminophen 325 mg [**Month/Day (3) 8426**] Sig: Two (2) [**Month/Day (3) 8426**] PO Q4H (every 4 hours) as needed for pain, fever. Discharge Disposition: Extended Care Facility: [**Hospital3 **] - [**Hospital1 **] Discharge Diagnosis: Aortic stenosis hyperlipidemia s/p Corevalve periprocedural stroke s/p coronary artery bypass s/p appendectomy peripheral vascular disease subclavian steal syndrome autoimmune hepatitis with cirrhosis cerbrovascular disease osteoporosis chronic anemia siezure disorder hypertension Discharge Condition: Good Discharge Instructions: 1) Each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart provided. 2) 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) 914**] ([**Telephone/Fax (1) 170**]) appointment arranged for Fri [**2129-2-4**] at 1pm Cardiologist: Dr. [**Last Name (STitle) **] appointment arranged for Fri [**2129-2-4**] at 1pm Please call to schedule appointments with your Primary Care Dr. [**First Name (STitle) 17859**] ([**Telephone/Fax (1) 40171**]) in [**3-1**] 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 :postop Atrial Fibrillation Goal INR :[**12-30**] First draw:[**2129-1-28**] Completed by:[**2129-1-27**] ICD9 Codes: 4280, 9971, 4241, 5715, 412
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6062 }
Medical Text: Admission Date: [**2151-8-4**] Discharge Date: [**2151-8-9**] Service: MEDICINE Allergies: Sulfa (Sulfonamide Antibiotics) Attending:[**First Name3 (LF) 2712**] Chief Complaint: shortness of breath Major Surgical or Invasive Procedure: none History of Present Illness: Briefly this is a [**Age over 90 **] y.o female w/ pmhx of HTN, parkinson/alzheimer's,on chronic prednisone (10mg daily)started this year ([**1-/2151**]) for temporal arteritis, who initially presented with fatigue and question of aspiration with oxygen saturation of 80% RA at rehab who was admitted [**8-4**]. She was initially doing well on 3L NC,and was found to have lactate 3.0. 500-1000cc fluid given in the ED. Her dyspnea worsened throughout the day [**8-5**], and pulm. edema and questionable right lower lobe infiltrate noted on CXR,however clinically looked dehyrdated. She also had low urine output, been afebrile, with WBC 20, 2% bands,and LDH approx. 5000. She is now being transferred to the MICU for resp. distress. . Of note a [**Month/Day (2) 53767**] in [**Name2 (NI) 73564**] was contact[**Name (NI) **] prior to transfer to the MICU and her DNR/DNI status was confirmed. . On arrival to the MICU, the patient's vitals were: P-92, BP-138/100, 97% venti mask 30%. The patient denies abdominal pain,cough, chest pain, but notes difficulty breathing.She cannot speak in full sentences and is in moderate distress. . Please find the original floor admission HPI below: . [**Age over 90 **] year old woman with dementia and Parkinson's disease who presents with shortness of breath. Over the past two days she has felt weak and unable to walk (usually walks with a walker). She has been having trouble swallowing and has not been eating well. Her aid thought she might have choked after drinking water this morning. Shortly after drinking she developed shortness of breath and cough. EMS was called and the patient was found to have hypoxia with sats low 80s% on RA. In the ED, initial vitals: (unknown temp), HR 83, BP 80/60, RR 16 O2 99% NRB. She subsequently required 3L via NC. Labs notable for lactate 6.0, trop 0.08, creatinine 1.1 (baseline 0.6), WBC 17 with 2% bands, HCT 24 (baseline 31), HCO3 17 with AG 17, pBNP [**Numeric Identifier **]. ECG showed sinus rhythm at 88 bpm, TWI in lead III, no other ST/T changes. She received 500cc IVF in the ED, after which lactate dropped to 3.1. CXR showed pulmonary edema and possible RLL infiltrate. Blood cultures were sent and the patient then received 2g cefepime and 750mg levofloxacin. Vitals prior to transfer: 77 96% 2L 122/43 20 99F. . Upon arrival to the floor, the patient notes malaise, minimal nonproductive cough, dyspnea at rest and a change in her voice. She notes that she has had increasing dyspnea with exertion over the last several months, which has acutely worsened within the last two weeks -- she now becomes very short of breath with 2-3 steps. Her cough and change of voice have accompanied this diminished functional ability. The patient also notes some BRBPR a couple of days ago. Review of systems: Cannot be fully obtained given patient is in resp. distress. (+) Per HPI (-) Denies fever, chills, night sweats, recent weight loss or gain. Denies headache, sinus tenderness, rhinorrhea or congestion. Denies cough, shortness of breath, or wheezing. 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: - HTN - Dementia - Parkinsons - Depression - Osteoarthritis - Dental Disease, now has dentures - Rectal prolapse s/p repair in [**2145**] Social History: Pt. lives in a nursing home. She never married or had children. She has one [**Year (4 digits) **] in the area who is her HCP. Endorses some distant tob use none currently, social EtOH use, no illicit drug use. Family History: CAD in several members of her father's family. Physical Exam: ADMISSION EXAM: Vitals: T:99.0 BP:133/104 P:92 R:18 O2:96% 30% venti mask General: Alert, oriented X 2, mild acute distress, speaking in full sentences, moving extremities spontaneously in rhythmic pattern consistent with parkinson disease HEENT: Sclera anicteric, dry mucous membranes, oropharynx clear, 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:foley with yellow urine Ext: warm, well perfused, 1+ pulses dP b/l, no clubbing, cyanosis or edema Neuro: Does not cooperate but moving all limbs spontaneously skin: 2+ turgor DISCHARGE EXAM: deceased Pertinent Results: ADMISSION LABS: [**2151-8-4**] 11:30AM BLOOD WBC-17.1*# RBC-2.66* Hgb-8.0* Hct-24.2* MCV-91 MCH-30.1 MCHC-33.0 RDW-17.4* Plt Ct-114*# [**2151-8-4**] 11:30AM BLOOD Neuts-90* Bands-2 Lymphs-3* Monos-3 Eos-0 Baso-0 Atyps-0 Metas-1* Myelos-1* NRBC-8* [**2151-8-4**] 11:30AM BLOOD PT-15.6* PTT-20.4* INR(PT)-1.5* [**2151-8-5**] 03:20PM BLOOD Fibrino-466* [**2151-8-5**] 03:20PM BLOOD FDP-40-80* [**2151-8-6**] 04:08AM BLOOD Ret Aut-1.1* [**2151-8-4**] 11:30AM BLOOD Glucose-93 UreaN-48* Creat-1.1 Na-135 K-5.0 Cl-101 HCO3-17* AnGap-22* [**2151-8-4**] 11:30AM BLOOD ALT-58* AST-170* CK(CPK)-259* AlkPhos-217* TotBili-0.4 [**2151-8-4**] 11:30AM BLOOD CK-MB-6 cTropnT-0.08* proBNP-[**Numeric Identifier **]* [**2151-8-5**] 05:55AM BLOOD Calcium-7.2* Phos-3.0 Mg-2.2 [**2151-8-5**] 05:55AM BLOOD Hapto-298* [**2151-8-4**] 11:38AM BLOOD Lactate-6.0* [**2151-8-5**] 04:59PM BLOOD O2 Sat-94 DISCHARGE LABS: [**2151-8-9**] 04:04AM BLOOD WBC-14.6* RBC-2.75* Hgb-7.9* Hct-24.8* MCV-90 MCH-28.8 MCHC-31.9 RDW-18.4* Plt Ct-67* [**2151-8-9**] 04:04AM BLOOD PT-19.9* PTT-32.4 INR(PT)-1.9* [**2151-8-9**] 04:04AM BLOOD Glucose-89 UreaN-38* Creat-0.7 Na-151* K-4.1 Cl-118* HCO3-20* AnGap-17 [**2151-8-7**] 01:58AM BLOOD ALT-22 AST-85* LD(LDH)-3852* AlkPhos-180* TotBili-0.5 [**2151-8-9**] 04:04AM BLOOD Albumin-2.4* Calcium-7.5* Phos-1.5* Mg-2.3 [**2151-8-6**] 04:19AM BLOOD Lactate-2.9* IMAGES: CXR [**8-4**]: There is mild cardiomegaly with increased vascular markings, consistent with mild pulmonary edema. Again noted are extensive tracheal bronchial wall calcifications. Pacemaker battery pack and leads terminate in appropriate positions. Osseous structures are demineralized. No focal opacities concerning for an infectious process. Non-united clavicle racture of uncertain acuity by radiological studies, please correlate with history and physical exam. ECHO [**8-5**]: Normal global and regional biventricular systolic function. Calcific aortic valve disease with mild stenosis and mild regurgitation. Mild pulmonary hypertension. Brief Hospital Course: [**Age over 90 **] y.o female w/ pmhx of HTN, parkinson/alzheimer's,on chronic prednisone (10mg daily)started [**1-/2151**] for temporal arteritis, who initially presented with fatigue and question of aspiration found to have leukocytosis, elevated LDH to 5000, and pulm edema/interstial pattern on [**Hospital **] transferred to MICU with hypoxemia and resp. distress. Pt was covered with broad spec [**Hospital 621**] for PNA, including aspiration and PCP. [**Name10 (NameIs) **] were removed as culture data came back negative. Had a d-dimer of 5000 however in setting of acute illness, no tachycardia, no calf/lower extremity swelling/tenderness on physical with other explanations for hypoxemia suspicion was low for PE and this was not worked up. She was also treated with lasix as needed for pulmonary edema. When pt was initially admitted, she was noted to have transaminitis, coagulopathy, thrombocytopenia, lactic acidosis, and hypoalbuminemia that, all together, were concerning for liver disease, especially since lactate did not compeltely normalize with fluids. Obtained RUQ u/s which showed targetoid lesions concerning for mets of unknown primary (otherwise unremarkable). Decision was made not to pursue diagnostic work up after discussion with patient and family, as work up would be invasive and treatment would not be of benefit. It is possible pt also had lung metastases that were contributing to her hypoxia, but this could not be verified as pt could not tolerate CT scanner without intubation/sedation due to movement disorder. Given the new findings suggestive of cancer, palliative care was consulted to discuss options for her care. She became increasingly SOB throughout her stay and less responsive to nebulizer treatments. She stated that she would prefer to be made comfortable. She was transitioned to a morphine drip on [**2151-8-9**]. On exam at the time of death, she had pacer spikes on telemetry but no heartbeat, no pulse, no breath sounds, pinpoint unreactive pupils, and no dolls eyes. Time of death [**2047**] on [**2151-8-9**]. [**Name (NI) 53767**] [**Name (NI) 382**] [**Name (NI) **] declined autopsy. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 73565**], MD PGY2 Medications on Admission: Preadmission medications listed are correct and complete. Information was obtained from Pharmacy. 1. Aquaphor Ointment 1 Appl TP [**Hospital1 **] 2. Acetaminophen 500 mg PO Q6H:PRN pain 3. traZODONE 25 mg PO HS 4. Donepezil 10 mg PO HS 5. Acetaminophen 500 mg PO HS 6. Polyethylene Glycol 17 g PO DAILY 7. Senna 1 TAB PO HS 8. Loperamide 2 mg PO QID:PRN diarrhea 9. Omeprazole 20 mg PO DAILY 10. Ibuprofen 400 mg PO Q8H:PRN pain 11. Mirtazapine 22.5 mg PO HS 12. Lidocaine 5% Patch 1 PTCH TD DAILY 13. Carbidopa-Levodopa (10-100) 3 TAB PO QID 14. PredniSONE 10 mg PO DAILY Discharge Medications: N/A Discharge Disposition: Expired Discharge Diagnosis: pneumonia Discharge Condition: deceased Discharge Instructions: N/A Followup Instructions: N/A ICD9 Codes: 0389, 5070, 2762, 5849, 2761, 2875, 4019, 4168, 4280
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Medical Text: Admission Date: [**2141-8-7**] Discharge Date: [**2141-8-21**] Date of Birth: [**2094-3-19**] Sex: F Service: [**Doctor First Name 147**] Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 301**] Chief Complaint: obesity/desire for surgical treatment Major Surgical or Invasive Procedure: laparascopic gastric band emergent trachostomy Open reduction, internal fixation of laryngeal fracture with plate History of Present Illness: The patient is a 47 year old who complains of morbid obesity. She has been on multiple supervised diets with an 80 pound weight loss and regain. She is currently at 325 pounds with a BMI of 50 and was deemed a good candidate by the [**Hospital1 **] Bariatric Program for surgical weight loss. The patient was admitted for a laparascopic gastric band procedure Past Medical History: laparascopic cholecystectomy eye surgery anxiety obesity hypertension osteoarthritis Physical Exam: General: no apparent distress Head and neck: neck supple, no lymphadenopathy. pupils equal round and reactive to light Card: regular rate and rhythm Lungs: clear to auscultation abdomen: obese, soft, nontender, nondistended extremities: no clubbing cyanosis or edema On discharge the patients abdominal exam was benign, with a soft, nontender abdomen, and well healing laparascopic port incision sites. She also had a tracheostomy incision that was healing well. Pertinent Results: [**2141-8-9**] Upper GI with small bowel follow through: FINDINGS: Preliminary scout film demonstrates a gastric band around the proximal stomach, in expected location and alignment. Clips are noted within the gallbladder fossa consistent with prior cholecystectomy. There is no evidence of free air under the diaphragms. Water soluble contrast followed by thin barium was administered to the patient in the standing position. Contrast flowed freely from the esophagus into the gastric pouch, through the band and into the distal stomach. There is no evidence of obstruction or leakage. Contrast emptied from the distal stomach into the small bowel after approximately 15 minutes. IMPRESSION: No evidence of obstruction or leakage s/p gastric banding. Brief Hospital Course: The patient had been in the operating room undergoing a surgical procedure and had a successful laparascopic gastric band procedure. At the end of the surgical procedure the patient was extubated, had loss of airway and underwent emergency tracheotomy. After the airway was secured, the throat was examined. It was noted that the tracheotomy was performed at a higher level than normal, and this was moved down to the second and third tracheal ring. ENT was called for evaluation of injury to the larynx. Upon arrival the laryngeal injury appeared to be a vertical incision on the left side of the thyroid cartilage, which extended the length of the thyroid cartilage, through the thyroid cartilage into the larynx. A laryngoscope was passed. There was noted to be mucosal tear around the false cord extending to the retinoid region. The subglottic region was normal. The vocal cords appeared to be both intact without injury. Externally the injury site was examined. There was noted to be a second opening into the trachea between the cricoid thyroid membranes, which appeared to be a clean horizontal incision. The patient had an ORIF of the tracheal injury. Postoperatively, the patient was vented and admitted to the intensive care unit. the patient was weaned off of the vent on postoperative day 2 without difficulty and the patient tolerated CPAP well. on postoperative day 3, the patient had a trach mask trial and she was successfully weaned from the vent by postoperative day 4. ENT continued to evaluate the patient and requested that the patient have antibiotics including ancef and flagyl. an NG tube remained in place. Nutrition services was consulted for TPN initiation. She was transferred to the surgical floor by postoperative day 4. On post operative day 8, the patient returned to the operating room for direct laryngoscopy and a downsizing of her trach. She also recieved 3 doses of IV decadron and transitioned to PO prednisone. The patient was then given a cap trial on Postoperative day [**9-9**], which she tolerated well. At this time the patient was also evaluated by speech and swallow and had an upper GI (which was negative) and she was started on a stage I diet. The trach was removed by postoperative day [**10-11**], and the patient was breathing comfortably. She was advanced to a stage III diet which she was tolerating well. The patient was stable and ready for discharge to home on postoperative days 13/5, with ENT/speech and swallow and general surgery follow up. The patient will remain on voice rest until follow up with ENT. Medications on Admission: xanax prn Discharge Medications: 1. Sertraline HCl 50 mg Tablet Sig: One (1) Tablet PO QD (once a day): crush pill before administering. Disp:*30 Tablet(s)* Refills:*2* 2. Oxycodone-Acetaminophen 5-325 mg/5 mL Solution Sig: 5-10 MLs PO Q4-6H (every 4 to 6 hours) as needed. Disp:*250 ML(s)* Refills:*0* 3. Colace 150 mg/15 mL Liquid Sig: Ten (10) ml PO twice a day. Disp:*600 ml* Refills:*2* 4. Zantac 15 mg/mL Syrup Sig: Ten (10) ml PO twice a day. Disp:*600 ml* Refills:*2* 5. Prednisone 10 mg Tablet Sig: One (1) Tablet PO once a day for 3 days: crush pill before administering. Disp:*3 Tablet(s)* Refills:*0* 6. Prednisone 5 mg Tablet Sig: One (1) Tablet PO once a day for 3 days: crush pill before administering. Disp:*3 Tablet(s)* Refills:*0* 7. Amoxicillin-Pot Clavulanate 250-62.5 mg/5 mL Suspension for Reconstitution Sig: Ten (10) ml PO Q8H (every 8 hours) for 6 doses. Disp:*60 ml* Refills:*0* Discharge Disposition: Home Discharge Diagnosis: Obesity status post laparascopic gastric band Laryngeal injury respiratory distress requiring emergent tracheostomy status post open reduction internal fixation of larynx Discharge Condition: Good Discharge Instructions: You should continue voice rest until you follow up with Dr. [**Last Name (STitle) **] in ENT. Stay on Stage III until follow up. Do not self advance diet Do not drink out of a straw. Do not chew gum You may shower (no bathing or swimming) if no drainage from wound If clear drainage, cover wound with clean dressing, stop showering No heavy (10 pounds or heavier) for 6 weeks If severe pain, persistent nausea, vomiting, fevers >101.5, redness of wound, call surgeon Followup Instructions: You should follow up with Dr. [**Last Name (STitle) **] at [**Telephone/Fax (1) 2349**] in [**12-9**] weeks. You should have a vidoe stroboscopy before your visit and call [**Telephone/Fax (1) 2349**] to schedule this. You will also follow up with Speech and swallow. You should be on voice rest until you follow up with Dr. [**Last Name (STitle) **], [**First Name3 (LF) **] they will send you to speech and swallow after they evaluate you in [**12-9**] weeks. You should follow up in [**Hospital 1560**] clinic [**Telephone/Fax (1) **] at 2 weeks (Do not call surgeons office) ICD9 Codes: 5185, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6064 }
Medical Text: Admission Date: [**2165-11-3**] Discharge Date: [**2165-11-8**] Date of Birth: [**2090-2-13**] Sex: M Service: MEDICINE Allergies: Aspirin / A.C.E Inhibitors Attending:[**First Name3 (LF) 1042**] Chief Complaint: SOB Major Surgical or Invasive Procedure: None History of Present Illness: 75 yo M hx Parkinson's presentes with acute dyspnea following an episode of n/v during dinner, with dyspnea following. He has had a gradual decline from his baseline with Parkinsons but was able to ambulate with assistance and eat dinner that evening. He complained of nausea and vomitted food particles that evening, and later vomitted pills that evening. Then when he was being brought to bed became increasingly dyspneic and EMS was called. . In the ED, 101.1 111 121/53 19 98NRB, cxr unremarkable with only possible ? RML, given levo/flagyl, and in discussion with family would escalate to CPAP as necessary but DNR/DNI. Also received 1.5L NS. . On presentation hear, appears in NAD, family not present, patient nonverbal at this point. . Per Family, has had gradual decline last year with Parkinsons, less movement. Past Medical History: OBESITY CORONARY ARTERY DISEASE s/p 3 stents MI HYPERTENSION DIABETES TYPE II PARKINSON'S DISEASE CIRRHOSIS ANEMIA DEGENERATIVE DISC DISEASE GASTROESOPHAGEAL REFLUX DIABETIC NEPHROPATHY Social History: Lives with wife, no smoking, previous ETOH drinker quit, retired iron worker Family History: NC Physical Exam: VS 97.8 75 118/51 25 100% 15lpm FaceT GEN: NAD, intermittently follows commands HEENT: Eye shut, PERRL, dry MM, tongue out, CV: rrr no mrg CHEST: coarse BS, rhonchi throughout anteriorly ABD:+BS soft, nt/nd, no organomegaly EXT: No c/c/e NEURO: awake, follows commands to squeeze hands. Pertinent Results: Admit Labs: [**2165-11-3**] 02:30AM BLOOD WBC-14.0* RBC-4.33* Hgb-13.5* Hct-39.3* MCV-91 MCH-31.1 MCHC-34.2 RDW-13.7 Plt Ct-236 [**2165-11-3**] 02:30AM BLOOD Neuts-91* Bands-4 Lymphs-3* Monos-2 Eos-0 Baso-0 Atyps-0 Metas-0 Myelos-0 [**2165-11-3**] 02:30AM BLOOD Plt Ct-236 [**2165-11-3**] 02:30AM BLOOD Glucose-167* UreaN-26* Creat-1.1 Na-140 K-3.8 Cl-101 HCO3-26 AnGap-17 [**2165-11-3**] 02:30AM BLOOD CK(CPK)-129 [**2165-11-3**] 02:30AM BLOOD cTropnT-0.01 [**2165-11-3**] 02:30AM BLOOD CK-MB-4 [**2165-11-3**] 02:30AM BLOOD Calcium-9.1 Phos-1.7* Mg-1.8 [**2165-11-3**] 03:10AM BLOOD Lactate-1.8 EKG: Sinus tachy 113bpm, NA, NI, Q II, AVF unchanged from old Studies: SINGLE AP UPRIGHT BEDSIDE CHEST RADIOGRAPH: Fluffy retrocardiac opacity is suspicious for pneumonia. The remainder of the lungs are clear. Cardiomediastinal silhouette is within normal limits. No effusion or pneumothorax. Discoid atelectasis at the left lung base is also noted. Brief Hospital Course: MICU COURSE: 75 M pmhx of parkinson presents with shortness of breath # SOB- acute onset in the setting of vomitting, most likely aspiration PNA. - abx empirically levofloxacin and flayl day 2 - aspiration precautions - supportive o2 - f/u sputum cx . # LEUKOCYTOSIS - Dramatic does not temporally associate with aspiration event, given pyuria, most likely represents a UTI - monitor fever curve - abx levaquin . # CAD: Will cont asprin (even though has questionable history of allergy). Patient has tolerated asa well in the past and post MI with stent placements. . # HYPERTENSION - cont metoprolol . # Hyperlipidemia - cont lovastatin . # DIABETES TYPE II - hold oral meds, cont RISS . # PARKINSON'S DISEASE - Tolerating oral meds. Cont out pt meds. . # PPX - PPI, bowel regiment . # FEN : Could consider speech/swallow. Advance diet. . # CODE: DNR/DNI . # ACCESS: peripheral . Contacts: [**Name (NI) 8214**] Wife [**Telephone/Fax (1) 110335**] [**Doctor First Name 401**] cell [**0-0-**] (Son) Once on the floor, the patient's levofloxacin and metronidazole was continued for his aspiration pneumonia, as well as for his Enterobacter UTI. Over the subsequent two days on the floor, the patient's oxygen requirement improved, his interval CXR improved, and he was discharged home with services. Medications on Admission: Clonazepam 0.5 mg Daily Rasagiline 0.5mg Daily Losartan [Cozaar] 50mg Daily Metformin 500mg Daily LOVASTATIN 40mg Daily CARBIDOPA/LEVODOPA 25/250 QID Entacapone [Comtan] 200mg QID Metoprolol Tartrate 25mg [**Hospital1 **] REQUIP 4mg TID, 6mg 7am, 10pm Glipizide 10mg Daily Vit B12 500mcg Daily Folic Acid 1mg Daily Aspirin 325mg Daily Discharge Medications: 1. Losartan 50 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Carbidopa-Levodopa 25-250 mg Tablet Sig: One (1) Tablet PO QID (4 times a day). 3. Entacapone 200 mg Tablet Sig: One (1) Tablet PO QID (4 times a day). 4. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 5. Ropinirole 1 mg Tablet Sig: Four (4) Tablet PO TID (3 times a day). 6. Ropinirole 1 mg Tablet Sig: Six (6) Tablet PO BID (2 times a day). 7. Cyanocobalamin 500 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. Glipizide 5 mg Tablet Sig: 1-2 Tablets PO twice a day: Take 2 tablets at breakfast and 1 tablet at dinner. Disp:*90 Tablet(s)* Refills:*1* 10. Levofloxacin 750 mg Tablet Sig: One (1) Tablet PO once a day for 7 days. Disp:*7 Tablet(s)* Refills:*0* 11. Flagyl 500 mg Tablet Sig: One (1) Tablet PO three times a day for 7 days. Disp:*21 Tablet(s)* Refills:*0* 12. Bisacodyl 10 mg Suppository Sig: One (1) Rectal once a day as needed for constipation. Disp:*30 suppositories* Refills:*1* Discharge Disposition: Home With Service Facility: VNA of [**Location (un) 270**]-East & Visiting Nurse Hospice Discharge Diagnosis: 1. Aspiration pneumonia 2. Enterobacter urinary tract infection 3. Parkinson's disease 4. Type 2 diabetes mellitus c/b nephropathy 5. Hypertension 6. 3-veseel coronary artery disease s/p stents and h/o myocardial infarction Discharge Condition: Fair, without dyspnea Discharge Instructions: Call your primary care physician or go to the emergency department if you develop fevers or have difficulty breathing. Followup Instructions: Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1143**], MD Phone:[**Telephone/Fax (1) 1144**] Date/Time:[**2165-12-11**] 2:00 Provider: [**Name10 (NameIs) 1037**] [**Name8 (MD) 5647**], MD Phone:[**Telephone/Fax (1) 1971**] Date/Time:[**2166-1-30**] 2:30 Provider: [**First Name8 (NamePattern2) **] [**First Name8 (NamePattern2) 396**] [**Name8 (MD) **], M.D. Phone:[**Telephone/Fax (1) 1040**] Date/Time:[**2166-4-8**] 1:00 ICD9 Codes: 5070, 5990, 2724, 4019, 3572, 5715, 2859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6065 }
Medical Text: Admission Date: [**2121-8-1**] Discharge Date: [**2121-8-9**] Date of Birth: [**2056-10-31**] Sex: M Service: SURGERY Allergies: Atorvastatin / Crestor Attending:[**First Name3 (LF) 6346**] Chief Complaint: 64y M w/prolapsing ostomy, parastomal hernia, ventral hernia, resetting colostomy Major Surgical or Invasive Procedure: Ventral hernia, parastomal hernia repair with mesh History of Present Illness: Pt is a 64y M w/ underwent an [**Month (only) **] for rectal cancer, subsequently had a prolapsing ostomy that was repaired, from repaired and from that operation he developed the parastomal hernia with a ventral hernia. He was offered repair. Past Medical History: Atrial fibrillation, on coumadin CHF, EF of 40% Type 2 Diabetes, poorly controlled on insulin, w/ neuropathy Hypothyroidism Right-sided lung mass that will require bronchoscopy s/p colectomy, colostomy for colon cancer 5 years ago Hernia at site of colostomy Right foot debridement and skin graft 2 years ago Social History: The patient is married, his wife's name is [**Name (NI) **]. [**Name2 (NI) **] has a 40py tobacco history. He used to drink a significant amount of alcohol but quit about two years ago. No illicits. He is a retired master plumber. He has three children. Family History: Mother died suddenly of presumed MI at age 62, father had valvular disease and died of stroke at age 80. 3 children, in good health; 3 siblings, in good health. No family history of DM, cancer. Physical Exam: GEN: AXOx4, NAD, HEENT: Atraumatic, normocephalic, PERRL, RESP: CTAB, no wheezes, crackles, rubs CV: RRR, no murmurs, gallops, rubs ABD: Obese, colostomy on Left, large ventral hernia EXT: no clubbing, cyanosis, [**12-18**]+ LE edema Pertinent Results: [**2121-8-2**] 12:40AM BLOOD Glucose-253* UreaN-37* Creat-2.9*# Na-142 K-4.9 Cl-104 HCO3-26 AnGap-17 [**2121-8-2**] 04:54AM BLOOD Glucose-189* UreaN-39* Creat-3.3* Na-143 K-4.9 Cl-104 HCO3-27 AnGap-17 [**2121-8-3**] 02:34AM BLOOD Glucose-184* UreaN-45* Creat-3.1* Na-143 K-4.3 Cl-106 HCO3-24 AnGap-17 [**2121-8-4**] 03:04AM BLOOD Glucose-69* UreaN-45* Creat-2.6* Na-150* K-3.7 Cl-111* HCO3-31 AnGap-12 [**2121-8-6**] 06:10AM BLOOD Glucose-34* UreaN-39* Creat-2.1* Na-150* K-3.1* Cl-110* HCO3-33* AnGap-10 [**2121-8-8**] 08:29AM BLOOD Glucose-145* UreaN-31* Creat-1.9* Na-142 K-3.3 Cl-104 HCO3-30 AnGap-11 [**2121-8-9**] 04:49AM BLOOD Glucose-67* UreaN-29* Creat-2.0* Na-143 K-3.4 Cl-105 HCO3-30 AnGap-11 [**2121-8-1**] 07:30PM BLOOD CK-MB-7 cTropnT-0.07* [**2121-8-2**] 04:54AM BLOOD CK-MB-10 MB Indx-1.5 cTropnT-0.10* [**2121-8-2**] 01:28PM BLOOD CK-MB-9 cTropnT-0.06* [**2121-8-2**] 12:40AM BLOOD WBC-17.4*# RBC-4.78 Hgb-12.0* Hct-38.8* MCV-81* MCH-25.1* MCHC-30.9* RDW-16.8* Plt Ct-277 [**2121-8-4**] 03:04AM BLOOD WBC-12.8* RBC-4.00* Hgb-9.9* Hct-32.6* MCV-82 MCH-24.7* MCHC-30.3* RDW-16.8* Plt Ct-209 [**2121-8-9**] 04:49AM BLOOD WBC-9.7 RBC-3.95* Hgb-10.3* Hct-30.9* MCV-78* MCH-26.0* MCHC-33.2 RDW-16.4* Plt Ct-358 Brief Hospital Course: Pt admitted for same day procedure noted previously. Case lasting approximately 5 hrs, patient received 1800cc of crystalloid, procedure was without complications. Post-operatively, patient resuscitated in PACU with total of 6L of crystalloid. Epidural was decreased, then held at apporximately 10pm. Pt [**Name (NI) **] responding to resuscitation initially, then decreasing to 6cc/hr at 12am. Fluid bolus of 1500mL given, [**Name (NI) **] did not respond. Echo from [**4-23**] demonstrated evidence of diastolic CHF with EF of 45-60%. POD1 [**8-2**] : Pt admitted to SICU w/oliguria and hypotension, cardiology service was consulted, enzymes were cycled, cardiac echo was obtained, Vanc, Zosyn, Flagyl were continued. BP 90's systolic, CVP was 15-17. Dopamine was initiated. Creatinine 3.3 POD2 [**8-3**] : Dopamine tirated off, urine output improving, O2 sat's stable on 6LNC. BP's systolic 100-140, CVP 15. Creatinine 3.1->2.8 POD3 [**8-4**] : Lasix drip started, goal net neg 1-2L/day. Creatinine-2.6/ Na-150, free water given, await return of bowel function. Rhythum a-fib w/ventricular rate 70-90's controlled with lopressor. SBP 110-130's, CVP 15-17. POD4 [**8-5**] : Lasix drip continued at 1mg/hr, creatinine-2.3/ Na-152. Free water deficit replacement, continued Abx Vanc/Zosyn/Flagyl, plan for transfer to floor. SBP 120-150, CVP 9-11. POD5 [**8-6**] : Transfer to floor, on IV lasix 20mg q6h, NGT out, comfortable with no N/V Cr-2.1/ Na-150. Deit advanced, free water given, lasix held. drain #1 d/c'd, abx continued. POD6 [**8-7**] : Cr 2.0/ Na 143. Tolerating diet, out of bed, refuses rehab, worked with PT. Drain #2 d/c'd. Abx continued. POD7 [**8-8**] : Cr 1.9/ 142. No events, ambulation, CVL d/c'd. Worked with PT, plan for discharge. Abx continued POd8 [**8-9**] : d/c home Medications on Admission: Digoxin 125 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* Carvedilol 12.5 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* Levothyroxine 50 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Hydralazine 50 mg Tablet Sig: Two (2) Tablet PO Q8H (every 8 hours). Clonidine 0.2 mg/24 hr Patch Weekly Sig: One (1) Patch Weekly Transdermal Discharge Medications: 1. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO every 4-6 hours as needed for pain. Disp:*30 Tablet(s)* Refills:*0* 2. Digoxin 125 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 3. Carvedilol 12.5 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 4. Levothyroxine 50 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 5. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Hydralazine 50 mg Tablet Sig: Two (2) Tablet PO Q8H (every 8 hours). 7. Clonidine 0.2 mg/24 hr Patch Weekly Sig: One (1) Patch Weekly Transdermal QTUES (every Tuesday). Discharge Disposition: Home Discharge Diagnosis: Ventral hernia, parastomal hernia Discharge Condition: Improved Discharge Instructions: Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight > 3 lbs. Adhere to 2 gm sodium diet. Return to ED if fever >101.4, Chest pain, shortness of breath, severe pain not relieved by medication, intractable nausea and vomiting, significant discharge or drainage from wound. Call office for other concerns. Followup Instructions: Provider: [**Name10 (NameIs) **],[**Name11 (NameIs) **] [**Name Initial (NameIs) **]. [**Telephone/Fax (1) 2998**] Call to schedule appointment Provider: [**Name10 (NameIs) **] [**Doctor Last Name **], DPM Phone:[**Telephone/Fax (1) 543**] Date/Time:[**2121-9-30**] 8:00 Completed by:[**2121-8-13**] ICD9 Codes: 5849, 4280, 3572, 2449
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Medical Text: Admission Date: [**2117-10-3**] Discharge Date: [**2117-10-7**] Date of Birth: [**2071-3-18**] Sex: F Service: CCU HISTORY OF PRESENT ILLNESS: The patient is a morbidly obese 46 year-old female transferred to the Coronary Care Unit from an outside hospital for management of malignant hypertension. The patient reports a two year history of hypertension with moderate control on Hydrochlorothiazide and propanolol. She has never had a history of coronary artery disease, myocardial infarction or congestive heart failure. She was in her usual state of health until approximately one month ago when she began to have what she describes as a flu like illness. She had severe fatigue, congestion, myalgias and arthralgias. No fevers or chills. She was seen by her primary care physician who diagnosed her with "mono" and sent her home without treatment. She continued to feel poorly staying out of work for the following two weeks and spending much of her time in bed due to severe fatigue. She was finally brought to clinical attention when several days prior to this admission she began to have new pedal edema, which she had never had before. She also reports some paroxysmal nocturnal dyspnea, but no orthopnea. She went to the [**Hospital1 **] Nishoba Emergency Department two days ago when she noted that her lower extremities had become edematous and were weeping fluid and red. She was noted in the Emergency Department to have severely elevated blood pressure at that time to 230/160, which she states is higher then her blood pressure has ever been before. She states it is usually in the 140/90 range. She had an echocardiogram at the outside hospital, which by report showed an EF of 25%. Also by report there was 2+ protein in her urine and her creatinine was elevated to 2.2. At the outside hospital she was started on Norvasc, Labetalol and intravenous nitro for blood pressure control and Ceftriaxone and Clindamycin for lower extremity cellulitis. She reportedly had negative lennies and an intermediate probability VQ scan. She had an abdominal ultrasound also, which reportedly showed normal kidneys. The interventions to control her blood pressure were unsuccessful and she was transferred to [**Hospital3 **] for further evaluation. REVIEW OF SYSTEMS: Negative for headache, changes in vision, neck stiffness, change in mental status, chest pain, shortness of breath, abdominal pain, flank pain and dysuria. PAST MEDICAL HISTORY: Significant for hypertension over the past two years with typical blood pressures less then 140/90. Obesity. MEDICATIONS PRIOR TO ADMISSION: Hydrochlorothiazide 25 mg q.d., Propanolol 80 b.i.d. ALLERGIES: No known drug allergies. SOCIAL HISTORY: The patient smokes one pack per day times twenty years. Rare alcohol. No drugs. She is married with two children. She lives with her family and works in a machine shop out of her house. FAMILY HISTORY: Negative for hypertension, coronary artery disease. PHYSICAL EXAMINATION ON ADMISSION: Blood pressure 194/102. Pulse 98 and regular. Breathing at a rate of 16. Sating 99% on room air. In general, she was well appearing, morbidly obese female. HEENT revealed pupils are equal, round, and reactive to light and accommodation. Anicteric sclera. Oropharynx clear. Mucous membranes are moist. Neck revealed JVP to the angle of the jaw. Respiratory examination was clear to auscultation bilaterally without evidence of rales or rhonchi. Coronary examination was regular rate and rhythm. No murmurs, rubs or gallops. Abdominal examination was benign. Extremities revealed 2+ pounding pulses. 2+ pitting edema to the knee with weeping erythematous lesions over the posterior lower extremities. Electrocardiogram on admission showed normal sinus rhythm at 112 and intraventricular conduction delay, left ventricular hypertrophy, left atrial enlargement and poor R wave progression. HOSPITAL COURSE: 1. Refractory hypertension: The patient was believed to have hypertension refractory to medical treatment up to the point of admission. Initially a central line and arteriole line were inserted without event and the patient was started on intravenous nitroprusside. On this medication she was able to get her blood pressure down to 140 systolic over approximately 80s diastolic. On hospital day two she was titrated off the nitride and onto Labetalol initially at 200 b.i.d. and Captopril initially [**Company 36482**].i.d. Once off the Nipride she continued to have elevated blood pressures as high as the 180s systolic, so her Labetalol dose and Captopril dose were progressively titrated higher. Over the remainder of her hospital course she continued to require greater increasing amounts and number of antihypertensive medications in order to control her blood pressure. Her Labetalol was ultimately increased to 400 b.i.d. Her Captopril was increased to 100 t.i.d. Norvasc was added at 10 q.d. Lasix was added 20 mg b.i.d. and finally Clonidine patch, which is administered once a week and delivers .2 mg per day of medication. Despite these five different antihypertensive medications the patient's blood pressures continued to be in the 180 systolic over 80s diastolic. The patient was ultimately discharged home on these five medications. The patient was ultimately discharged home with instructions to follow up with her primary care physician and have him continue to titrate these medications as needed. However, because the patient was requiring so many medications and because of her high degree of apparently new onset of severe hypertension we were highly suspicious of a secondary form of hypertension. Because of this a workup was begun in house, although it could not be completed as many results are still pending. Her TSH was checked, which was within normal limits essentially ruling out hyperthyroidism as a cause. Prior to her leaving she had a Dexamethasone suppression test to look for a hypercortisol state, which was pending at the time of discharge. She had a 24 hour urine collection to look for evidence of pheochromocytoma. Results of this test are still pending. She also had a random aldosterone level sent off, the results of which are still pending to rule out a hyperaldosterone state. She furthermore made MR angiogram of her renal arteries to rule out renal artery stenosis, which was negative. When the patient follows up with her primary care physician he can review the results of these tests and continue workup. Furthermore on the day of discharge her renal consultation was obtained and they recommended a renal biopsy, although after reviewing her urine sediment they found that it was benign. This additionally can be done as an outpatient basis. Finally, because the patient was obese there were many concerns for diabetes and a fasting blood sugar was obtained on the day of discharge, which was 72 essentially making the patient a nondiabetic. 2. Cardiomyopathy: A repeat echocardiogram was done on approximately hospital day three, which showed an ejection fraction of 30% and global hypokinesis. We were suspicious that this may be related to her hypertension and that if the cause of her hypertension could be determined and her blood pressures got back to normal her cardiomyopathy may resolve. We deferred specific workup for this cardiomyopathy other then treating her hypertension working up causes of her hypertension. We will recommend to her primary care physician that as an outpatient once her hypertension is better controlled she have this further worked up. 3. Cellulitis: The patient presented with evidence of cellulitis already on antibiotics. She was initially started on Ofloxacin intravenous ultimately changed to Dicloxacillin po. Additionally we obtained records from the outside hospital where a culture had been sent, which grew out an organism sensitive to Ciprofloxacin, so because of this Ciprofloxacin was added to regimen. She was discharged home on a ten day course of Dicloxacillin and Ciprofloxacin. Her rash appeared to be marginally improving during the course of her hospital stay. We questioned whether or not this rash could be something other then cellulitis and related to her hypertension. Although we could not ascertain a cause and we had positive skin cultures from the outside hospital. At the present time we will send her home on these antibiotics and she can follow up with her primary care physician who can see if her rash improves on the antibiotics and if not he perhaps will consider obtaining a dermatology consult. 4. Renal function: Again we suspected that any problems with renal function were likely due to the patient's hypertension. The patient's creatinine was followed in house, which fluctuated between 1.2 and 1.4. Again as per the renal team, renal biopsy is likely indicated in this patient and can be done on an outpatient basis. 5. Social Services: The patient was self pay and because of this cost of medications was an issue. We obtained free care for her to get two weeks worth of medications and discharged her with prescriptions for two weeks worth of antihypertensive and antibiotic medications, which she will get for free. An additional issue for this woman will ultimately be paying for this hospital stay. Her Intensive Care Unit stay at the outside hospital and here in addition to the workup of her hypertension will likely be very expensive. This is an additional part of the reason for preferring to continue the workup as an outpatient. The patient actually requested this. It is our hope that she can follow up with Social Services and we offered her to see a Social Services person at the [**Hospital 191**] Clinic, which she declined to help set her up with services to pay for her medical care. I did give her the number of the [**Hospital 191**] Clinic and she can call us if she changes her mind and would like to meet with the Social Services people. However, [**Location (un) 86**] is approximately an hour and a half away from where she lives, so I suspect she may not wish to come all the way back here to further address this issue. CONDITION AT DISCHARGE: Stable and under medical treatment. DISCHARGE STATUS: To home. DISCHARGE DIAGNOSIS: Refractory hypertension. FOLLOW UP: Follow up is with the patient's primary care physician within one to two days for further evaluation of her blood pressure, its treatment and her cellulitis and consideration of further workup of her hypertension. MEDICATIONS ON DISCHARGE: Labetalol 400 b.i.d., Captopril 100 t.i.d., Norvasc 10 q.d., Lasix 20 b.i.d., Clonidine patch one per week delivering 0.2 mg per day. Dicloxacillin 500 mg q.i.d. times ten days. Ciprofloxacin 500 mg b.i.d. times ten days. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], M.D. [**MD Number(1) 2057**] Dictated By:[**Last Name (NamePattern1) 1213**] MEDQUIST36 D: [**2117-10-9**] 10:46 T: [**2117-10-13**] 06:21 JOB#: [**Job Number 36483**] ICD9 Codes: 4254, 2768, 3051
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Medical Text: Admission Date: [**2109-8-20**] Discharge Date: Date of Birth: [**2109-8-20**] Sex: M Service: NEONATOLOGY HISTORY OF PRESENT ILLNESS: Baby boy [**Name2 (NI) 56714**] was the 2.02 g product of a 35 and [**4-26**] week twin gestation born to a 39-year- old, gravida 2, para 0, woman. Pregnancy was complicated by shortened cervix prompting admission at 28 weeks and treated with Betamethasone. PRENATAL SCREENS: Maternal blood type 0 positive, antibody negative, hepatitis surface antigen negative, RPR nonreactive, GBS unknown. The mother was followed closely by Maternal Fetal Medicine. On the day of delivery, she was in Dr.[**Name (NI) 9920**] office with this twin noting to have decelerations prompting admission and cesarean delivery. At delivery, the patient was pink and active, and was given blow-by oxygen and stimulation. Apgar scores were 7 and 8. ADMISSION PHYSICAL EXAMINATION: Birth weight 2.02 g, 25th percentile, length 44 cm, less than 25th percentile, head circumference 30.5 cm, 25th percentile. Examination was notable for pink, active, nondysmorphic infant. Skin was without lesions. Head, ears, nose, and throat notable for flattened top of scalp, most likely due to positioning. Sutures mobile. Cardiovascular normal S1 and S2 without murmurs. Lungs clear. Abdomen benign. Neurologic nonfocal. Spine intact. Hips normal. Anus patent. HOSPITAL COURSE: Respiratory: [**Known lastname **] has been stable in room air throughout his hospital course with mild apnea and bradycardia of prematurity. His most recent episode of apnea and bradycardia was on [**2109-8-31**]. He has not required any Methylxanthine treatments. Cardiovascular: He has been cardiovascularly stable without issue. Fluids and electrolytes: Birth weight was 2.02 g. The infant was initially started on 60 cc/kg/day of D10W. Enteral feedings were initiated on day oflife 1. The infant is currently ad lib feeding breast milk 24 cal concentrated with 4 cal of Similac powder, taking in excess of 150 cc/kg/day. Of note over the past week, the infant has been having guaiac hemoccult positive stools. Rectal fissures were noted at 11 o'clock, 1 o'clock, 5 o'clock, and 7 o'clock. Abdominal examination was reassuring. Gastrointestinal: Peak bilirubin, on day of life 3, was 7.4. He did not require any bilirubin phototherapy. Hematology: Hematocrit on admission was 50.9. The infant has not required any blood transfusions during this hospital course. Infectious disease: The infant received a CBC and blood culture on admission. CBC was benign. Blood culture remained negative at 48 hours at which time Ampicillin and Gentamicin were discontinued. Neurologic: The infant has been appropriate for gestational age. Sensory/audiology: Hearing screen was performed with automated auditory brain stem response. The infant passed in both ears. Psychosocial: [**First Name8 (NamePattern2) 553**] [**Last Name (NamePattern1) **] was the social worker involved with this family and can be contact at [**Telephone/Fax (1) 8717**]. CONDITION ON DISCHARGE: Stable. DISCHARGE DISPOSITION: Home. PRIMARY PEDIATRICIAN: Dr. [**First Name8 (NamePattern2) 56715**] [**Last Name (NamePattern1) 56597**], [**Telephone/Fax (1) 43701**]. CARE RECOMMENDATIONS: Feeds at discharge: Continue ad lib feeding breast milk concentrated to 24 cal. DISCHARGE MEDICATIONS: Nonapplicable. CAR SEAT POSITION SCREENING: Screening has been performed, and the infant passed a 90 min screening. STATE NEWBORN SCREENS: Sent per protocol with the most recent being sent on [**2109-9-3**], and have been within normal limits. IMMUNIZATION RECEIVED: The infant has not received any immunizations during this hospital course. 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: 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 mos of the child's life) immunization against influenza is recommended for household contacts and out-of-home caregivers. DIAGNOSIS: Preterm twin 1. Apnea and bradycardia of prematurity. Rule out sepsis with antibiotics. Mild hyperbilirubinemia. Reviewed By: [**Last Name (LF) **], [**First Name3 (LF) **] A. 50-622 Dictated By:[**Last Name (NamePattern1) **] MEDQUIST36 D: [**2109-9-4**] 17:22:46 T: [**2109-9-4**] 18:26:56 Job#: [**Job Number 56716**] ICD9 Codes: V290, V053
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Medical Text: Admission Date: [**2159-8-24**] Discharge Date: [**2159-8-28**] Service: [**Hospital Unit Name 196**] ADMISSION DIAGNOSIS: Hypertrophic obstructive cardiomyopathy. HISTORY OF PRESENT ILLNESS: Ms. [**Known lastname 108667**] is a 78 year-old woman with a history of HOCM. She was admitted to the hospital on [**2159-8-24**] for elective ETOH ablation. the procedure was performed on the [**8-24**]. This was uncomplicated. Prior to this admission the patient had noticed an increase in shortness of breath on exertion over the past three to four years. This had increased despite medical management with Verapamil and Lasix. PAST MEDICAL HISTORY: 1. HOCM. 2. Hypothyroidism. 3. Hypercholesterolemia. 4. Migraines. 5. Degenerative joint disease. 6. History of colon polyps. 7. Osteoporosis. 8. Appendectomy. 9. Tonsillectomy. 10. Basal cell carcinoma. MEDICATIONS AT HOME: Lasix 160 q.d., Verapamil 80 t.i.d., Synthroid 100 five days of the week and 50 two days of the week. Aldactone 25 b.i.d., Timolol 5 mg q.h.s., Evista 60 mg q.d., Fosamax 60 mg po q Wednesdays. Potassium supplements, vitamin C, vitamin E, B-complex, multivitamin, calcium 600 mg t.i.d., Ultram prn, Tylenol prn. ALLERGIES: No known drug allergies. SOCIAL HISTORY: She is a nonsmoker, nondrinker. PHYSICAL EXAMINATION ON ADMISSION: This is per a note by Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **]. The vital signs were heart rate of 98 and regular. Blood pressure 91/36. Respiratory rate 16. Sating 93% on room air. Afebrile. The head and neck examination was unremarkable. The lungs were clear to auscultation bilaterally. Heart was regular rate and rhythm. S1 and S2 were normal. There was a harsh grade 3 out of 6 systolic ejection murmur heard best at the mid left sternal border. JVP was 4 cm above the sternal angle. The carotids demonstrated a brisk upstroke. The abdomen was benign. The extremities showed no edema. Peripheral pulses palpable. The patient was alert and oriented times three with nothing focal on neurological examination. ADMISSION LABORATORIES: Her CBC and chem 7 were within normal limits. Her electrocardiogram revealed normal sinus rhythm at 98. There was a right bundle branch block. There were Q waves in 2, 3 and AVF and small Q in V4 to V6. HOSPITAL COURSE: The alcohol ablation procedure went smoothly. The patient was transferred to the Coronary Care Unit for observation after her procedure. The pacer wire was removed two days after the procedure. She did well and was transferred to the floor on the [**8-27**]. She continued to do well from a cardiovascular point of view. A routine urinalysis at admission was positive for nitrites and white blood cells. Urine culture showed Pseudomonas. The patient was started on Ciprofloxacin 500 mg b.i.d. She was instructed to continue this for a course of three days. DISCHARGE DIAGNOSES: 1. HOCM status post alcohol ablation. 2. Pseudomonas urinary tract infection. DISCHARGE MEDICATIONS: Ciprofloxacin 500 mg po b.i.d. for three days, Furosemide 20 mg po b.i.d., Timolol 5 mg po q.h.s., Verapamil 80 mg po q 8 h, Diphenhydramine 25 mg po q.6.h. prn, calcium carbonate, aspirin 325 mg po q.d., Levothyroxine 50 mcg q Monday and Thursday, Levothyroxine 100 micrograms Sunday, Tuesday, Wednesday, Friday, Saturday. Alendronate 70 mg po once a week. DISCHARGE FOLLOW UP: The patient has been instructed to see her cardiologist within the next week. [**First Name11 (Name Pattern1) **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **], M.D. [**MD Number(1) 4786**] Dictated By:[**Last Name (NamePattern1) 4066**] MEDQUIST36 D: [**2159-8-28**] 12:33 T: [**2159-9-3**] 10:33 JOB#: [**Job Number **] ICD9 Codes: 5990, 2765, 2449, 2720
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Medical Text: Admission Date: [**2114-3-20**] Discharge Date: [**2114-3-22**] Date of Birth: [**2092-10-1**] Sex: M Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 2758**] Chief Complaint: Abdominal pain, vomiting Major Surgical or Invasive Procedure: None History of Present Illness: This is a 21 yo M with a history of DM1 who had several alcoholic drinks on [**First Name3 (LF) 2974**] night. On Saturday he had 3 episodes of nausea and vomiting. He states that he was afraid to check his blood sugar at home, and has been taking his usual dose of insulin. He woke up on Saturday wtih lightheadedness, polyuria and polydipsia. He thought he had food poisoning and didn't eat yesterday. This morning he came to the ED because he had chest pain, abdominal pain, and severe tachypnea. . . . In the ED, initial vs were: T 96.8 P 125 BP 178/70 R 39 O2 sat 100% on RA. Patient endorsed having abdominal pain, but no other discomfort. Blood sugars were over 500cc. Exam was notable for tachypnea, but no abdominal tenderness. Labs were notable for ABG of 6.93/20/66. K of 5.4, Cr 1.6, WBC of 24.7, HCT of 59.1. Patient was given 2L IV fluids. He was started on an insulin gtt at 9u/hr. Vitals prior to transfer: HR 112 BP 115/84 RR 30, 99% on RA . . On the floor, the patient continues to be short of breath. His chest pain and abdominal pain have resolved. He denies any recent fevers or chills. . Review of systems: (+) Per HPI (-) Denies fever, chills, night sweats, recent weight loss or gain. Denies headache, sinus tenderness, rhinorrhea or congestion. Denies cough, shortness of breath, or wheezing. Denies chest pain, chest pressure, palpitations. Denies nausea, vomiting, diarrhea, constipation, or changes in bowel habits. Denies dysuria, frequency, or urgency. Denies arthralgias or myalgias. Denies rashes or skin changes. Past Medical History: -type one diabetes mellitus -"mild aspergers syndrome" per father Social History: - Tobacco: None - Alcohol: Last drink 3-4 days prior to admission. - Illicits: None Family History: NC Physical Exam: Admission Exam: Vitals: T: 98 BP: 158/87 P: 125 R: 27 O2: 100% on RA General: Alert, oriented, tachypneic. Using accessory muscles to breathe. HEENT: Sclera anicteric, MMM, oropharynx clear Neck: supple, JVP not elevated, no LAD Lungs: Clear to auscultation bilaterally, no wheezes, rales, ronchi CV: Tachycardic. Regular rhythm. No murmurs. Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly GU: no foley Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Pertinent Results: Admission Labs: [**2114-3-20**] 09:10PM GLUCOSE-231* UREA N-11 CREAT-0.9 SODIUM-125* POTASSIUM-3.6 CHLORIDE-102 TOTAL CO2-14* ANION GAP-13 [**2114-3-20**] 09:10PM CALCIUM-8.4 PHOSPHATE-1.1* MAGNESIUM-1.7 [**2114-3-20**] 01:49PM GLUCOSE-150* UREA N-15 CREAT-0.9 SODIUM-131* POTASSIUM-3.4 CHLORIDE-108 TOTAL CO2-9* ANION GAP-17 [**2114-3-20**] 01:49PM ALBUMIN-3.8 CALCIUM-8.2* PHOSPHATE-1.0* MAGNESIUM-1.6 [**2114-3-20**] 10:55AM URINE COLOR-Straw APPEAR-Clear SP [**Last Name (un) 155**]-1.021 [**2114-3-20**] 10:55AM URINE BLOOD-MOD NITRITE-NEG PROTEIN-30 GLUCOSE-1000 KETONE-150 BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-NEG [**2114-3-20**] 10:55AM URINE RBC-<1 WBC-<1 BACTERIA-FEW YEAST-NONE EPI-0 [**2114-3-20**] 10:55AM URINE MUCOUS-RARE [**2114-3-20**] 10:54AM GLUCOSE-257* UREA N-18 CREAT-1.2 SODIUM-129* POTASSIUM-3.7 CHLORIDE-99 TOTAL CO2-8* ANION GAP-26* [**2114-3-20**] 10:54AM ALT(SGPT)-20 AST(SGOT)-12 LD(LDH)-163 ALK PHOS-94 TOT BILI-0.7 [**2114-3-20**] 10:54AM LIPASE-16 [**2114-3-20**] 10:54AM CALCIUM-10.6* PHOSPHATE-1.5* MAGNESIUM-2.0 [**2114-3-20**] 10:54AM WBC-24.2* RBC-5.69 HGB-18.2* HCT-50.9 MCV-89 MCH-31.9 MCHC-35.7* RDW-12.7 [**2114-3-20**] 10:54AM PLT COUNT-362 [**2114-3-20**] 10:54AM PT-11.7 PTT-22.2 INR(PT)-1.0 [**2114-3-20**] 07:59AM PO2-66* PCO2-20* PH-6.93* TOTAL CO2-5* BASE XS--29 COMMENTS-GREEN TOP [**2114-3-20**] 07:59AM LACTATE-5.8* K+-5.0 [**2114-3-20**] 07:57AM GLUCOSE-635* UREA N-21* CREAT-1.6* SODIUM-124* POTASSIUM-5.4* CHLORIDE-94* TOTAL CO2-LESS THAN [**2114-3-20**] 07:57AM estGFR-Using this [**2114-3-20**] 07:57AM ACETONE-SMALL [**2114-3-20**] 07:57AM WBC-24.7* RBC-6.20 HGB-19.8* HCT-59.1* MCV-95 MCH-32.0 MCHC-33.5 RDW-12.7 [**2114-3-20**] 07:57AM NEUTS-92.7* LYMPHS-3.0* MONOS-3.6 EOS-0.2 BASOS-0.5 [**2114-3-20**] 07:57AM PLT COUNT-460* Micro: Blood culture x2 [**2114-3-20**] PENDING Urine culture [**2114-3-20**] PENDING Imaging: CXR [**2114-3-20**]:single view of the chest has been obtained with patient in sitting semi-upright position. The heart size is within normal limits. No typical configurational abnormality is present. Thoracic aorta and mediastinal structures are unremarkable. Pulmonary vasculature is not congested. No signs of acute parenchymal infiltrates are present and the lateral pleural sinuses are free. No pneumothorax in apical area. The frontal view discloses a moderate degree of right-sided convex scoliosis in the mid portion of the thoracic spine. No other gross skeletal abnormalities are seen on this portable chest examination. However, one suspects a skeletal injury in the upper portion of left scapula. Clinical correlation recommended. IMPRESSION: No evidence of acute pneumonia in young male patient with history of leukocytosis. Discharge Labs: [**2114-3-22**] 06:15AM BLOOD WBC-8.5 RBC-4.90 Hgb-15.8 Hct-42.4 MCV-87 MCH-32.3* MCHC-37.3* RDW-12.5 Plt Ct-213 [**2114-3-22**] 06:15AM BLOOD Plt Ct-213 [**2114-3-22**] 03:30PM BLOOD Creat-0.5 Na-130* K-3.1* Cl-97 [**2114-3-22**] 06:15AM BLOOD Amylase-22 [**2114-3-22**] 06:15AM BLOOD Calcium-8.6 Phos-1.3* Mg-2.1 [**2114-3-22**] 06:15AM BLOOD %HbA1c-12.9* eAG-324* Brief Hospital Course: Mr [**Known lastname 73657**] is a 21 year old male with type 1 diabetes mellitus who presents with DKA. ACTIVE PROBLEMS: 1. DIABETIC KETOACIDOSIS: He presented with severe DKA with a sugar of 635, an anion gap of around 25, and a pH of 6.93. This was felt to be due to poor compliance with insulin over the preceding several days, with increased insulin demand based on his nausea/vomiting/and alcohol intake. Per conversations with his parents, his insulin and FSG compliance has been poor throughout his adolescence, and he had a prior episode of DKA 2 years ago of lesser intensity. He was started on an insulin gtt on admission to the ICU, was aggressively rehydrated, and supplemented with both D5 and potassium when necessary. He was extremely hypovolemic based on initial exam, and lab evidence of [**Last Name (un) **] and hemoconcentration (HCT 59). His anion gap closed on the evening of admission and he was placed on his home dose equivalent NPH (42units [**Hospital1 **]). His insulin gtt was stopped, and he was covered with a humalog sliding scale. His FSG and gap remained closed, though persisting abdominal pain prevented good oral intake. He was called out of the ICU on [**2114-3-21**]. On the floor his BS were less than 200. He was tolerating PO with some abdominal pain that was epigastric and associated with food. A [**Last Name (un) **] consult was initiated to help initiate a new sliding scale regiment since he was only taking meal time Humalog coverage in the morning. He remained hypokalemia and required additional IV repletion. He was given a prescription for PO K for three days and encouraged to take PO. 2. ABDOMINAL PAIN: He had diffused abdominal discomfort likely related to DKA. His oral intake slowly improved. He continued to have pain with solid food, but not liquids. The DDX included gastritis, gastropathy or less likely [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**Last Name (NamePattern1) **] tear. Of note, his abdominal pain was only associated with food. Maalox provided minimal relieve, and therefore he was started on a PPI and calcium carbonate. He will need follow up with his [**Last Name (un) **] provider and PCP. Medications on Admission: Insulin 75/25 56units [**Hospital1 **] Discharge Medications: 1. Maalox Maximum Strength 400-400-40 mg/5 mL Suspension Sig: Ten (10) ML PO TID (3 times a day) as needed for indigestion, abd pain. Disp:*250 ML(s)* Refills:*0* 2. calcium carbonate 200 mg (500 mg) Tablet, Chewable Sig: [**12-10**] Tablet, Chewables PO QID (4 times a day) as needed for indigestion. 3. 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* 4. potassium chloride 20 mEq Tablet, ER Particles/Crystals Sig: Two (2) Tablet, ER Particles/Crystals PO once a day for 3 days. Disp:*6 Tablet, ER Particles/Crystals(s)* Refills:*0* 5. NPH insulin human recomb 100 unit/mL (3 mL) Insulin Pen Sig: One (1) 44 Subcutaneous twice a day. 6. Humalog KwikPen 100 unit/mL Insulin Pen Sig: One (1) variable Subcutaneous four times a day: Please see attached sliding scale. Discharge Disposition: Home Discharge Diagnosis: Primary Diagnosis: DKA Secondary Diagnosis: Type I DM Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Dear Mr. [**Known lastname 73657**]- You were diagnosed with DKA after you had alcohol and were unable to take your insulin. You were admitted to the ICU for insulin and intravenous fluids. You were discharged to the floor with stable blood sugars, but your HgBA1C is 12.9. You will need to see your [**Last Name (un) **] provider to help adjust your insulin regiment. The following medications were changed: CHANGED: Humalog SS ADDED: Famotidine, Calcium Carbonate, Maalox Followup Instructions: Name: [**Last Name (LF) 14840**], [**Name8 (MD) **] MD Location: [**Last Name (un) **] DIABETES CENTER Address: ONE [**Last Name (un) **] PLACE, [**Location (un) **],[**Numeric Identifier 718**] Phone: [**Telephone/Fax (1) 2378**] When: Tuesday, [**3-27**], 1PM Name: [**Last Name (LF) **],[**First Name3 (LF) **] A Location: [**Location (un) 2274**]-[**University/College **] Address: [**Hospital1 3470**], [**University/College **],[**Numeric Identifier 3471**] Phone: [**Telephone/Fax (1) 45369**] When: [**Last Name (LF) 2974**], [**4-6**], 3PM Completed by:[**2114-3-22**] ICD9 Codes: 5849
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Medical Text: Admission Date: [**2182-11-23**] Discharge Date: [**2182-11-28**] Service: NEUROSURGERY ADMITTING DIAGNOSIS: Subdural hematoma. CHIEF COMPLAINT: Slurred speech and word finding difficulties transiently since the morning. HISTORY OF THE PRESENT ILLNESS: This is an 83-year-old right-handed white male, retired accountant, with a history of coronary artery disease, status post CABG times six vessels in [**2174**] who presents with a transient episode of slurred speech and word finding difficulties on the morning of admission. The patient came to the Emergency Room for further evaluation. He denied any weakness, numbness, paresthesias, headache, nausea or vomiting. His speech was reportedly garbled and incomprehensible for brief episodes during the course of the morning but the patient denied any comprehension problems. [**Name (NI) **] did note word finding difficulties episodically. The family brought the patient to the Emergency Room in the midafternoon. The Stroke Service was called and stroke protocol was begun with an MRI obtained which was positive for a large subacute left hemisphere subdural hematoma measuring up to 1.5 cm in thickness and moderate midline shift. The patient stated that his word finding difficulty abated since arrival in the Emergency Room. The patient and the family report a fall with an Emergency Room visit approximately three weeks prior to admission at an outside hospital and a one to two day stay for observation at that time. The family is uncertain whether any abnormality was seen on the CT scan at that time. PAST MEDICAL HISTORY: 1. Above mentioned coronary artery disease, status post MI and CABG in [**2174**]. 2. History of hypercholesterol. PAST SURGICAL HISTORY: 1. CABG, as mentioned. 2. Remote herniorrhaphy. ALLERGIES: The patient has no known drug allergies. ADMISSION MEDICATIONS: 1. Atenolol. 2. Aspirin 325 mg q.d. 3. Prinivil. 4. Lipitor. 5. Cardura. REVIEW OF SYSTEMS: History of syncopal episode in [**2181-10-13**] for which an echocardiogram was done and he showed an ejection fraction 60% with 3+ mitral valve regurgitation. There is a history of occasional migraines. PHYSICAL EXAMINATION: On physical examination, the vital signs were within normal limits. He was awake, alert, and oriented times three, in no acute distress. He was conversant without slurring or dysarthria at the time of examination. His short-term memory was intact. He repeated test questions appropriately. He named all common objects appropriately. The pupils were equal, round, and reactive to light and accommodation. The extraocular movements were intact. The neck was supple. There was no jugular venous distention. The chest was clear. The heart rate was regular and rhythmic without murmur, gallop, or rub. The abdominal examination was unremarkable. There was no costovertebral angle tenderness and no suprapubic tenderness or fullness. The extremities were without clubbing, cyanosis or edema. The neurological examination, including strength of the upper and lower extremities, was [**6-16**] throughout. He was moving all extremities spontaneously through a full range. Sensory was intact to light touch throughout. The deep tendon reflexes were essentially within normal limits with the exception of a mildly decreased left knee or patellar reflex and absent bilateral Achilles reflex. The plantar response was downgoing. There was no ankle clonus. Gait and Romberg were not tested. There was no upper extremity drift. The face was symmetric and the tongue was midline. LABORATORIES/OTHER STUDIES: The admission laboratories were all considered to be within normal limits, particularly his coagulation studies with a PT of 12.8, PTT 30.5, and INR 1.1. Review of the MRI did confirm the presence of a large left-sided subdural hematoma. HOSPITAL COURSE: Due to these findings, the patient was admitted to the Neurosurgical Service and to the Neurosurgical Intensive Care Unit for overnight observation. On the morning following admission, the patient underwent a bedside drainage of the subdural hematoma with a subdural drain placed. The patient tolerated the procedure well and remained in the Surgical Intensive Care Unit for approximately 48 hours, at which time he was noted to be doing fine. A follow-up CT scan showed marked decrease in the size of the subdural hematoma. The subdural drain was, therefore, removed and the patient was transferred from the unit to the [**Hospital 16364**] Medical Surgical floor where he remained throughout the remainder of his hospitalization in stable condition. CONDITION ON DISCHARGE: Stable and improved. DISCHARGE MEDICATIONS: The patient was told to resume all preoperative medications with the exception of his aspirin. He was told not to renew his aspirin and to follow-up with his primary care physician within one weeks time and to follow-up with Dr. [**Last Name (STitle) 6910**] at approximately one months time with a follow-up CT scan to be done at that time. [**Name6 (MD) 6911**] [**Name8 (MD) **], MD [**MD Number(1) 6913**] Dictated By:[**Doctor Last Name 7311**] MEDQUIST36 D: [**2182-11-28**] 11:04 T: [**2182-12-1**] 11:48 JOB#: [**Job Number 103499**] ICD9 Codes: 2720
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Medical Text: Admission Date: [**2179-10-9**] Discharge Date: [**2179-10-12**] Date of Birth: [**2094-2-16**] Sex: F Service: MEDICINE Allergies: Niacin / Ultram / Valacyclovir / Neurontin Attending:[**Last Name (NamePattern4) 290**] Chief Complaint: GI bleed Major Surgical or Invasive Procedure: endoscopy History of Present Illness: 85 yo female witih history of GERD who presents from the [**Hospital3 2558**] after nurse [**First Name (Titles) 13431**] [**Last Name (Titles) **] stool in diaper this morning. She also reports 1 episode of coffee ground emesis yesterday and current epigastric pain. She reports intermittent nausea x 1 month, along with recent diarrhea, though she cannot characterize this as she wears a diaper. She uses OTC PPI intermittently and is on SQ heparin, likely secondary to recent hip fracture in [**Month (only) 216**]. She denies any history of alcohol use or NSAID use. On presentation, her vital signs: 96.6, 100, 108/52, 18, 100%. Exam was notable for diffuse abdominal tenderness, worse in epigastric area, and dark maroon stools in rectal vault. She was started on a PPI drip and received zofran 8mg. Her hct has been stable with lactate 1.4. Potassium was markedly elevated though this was a hemolyzed specimen. Repeat K 4.5. Pt is DNR/DNI, however she wishes to reverse this for EGD. She was evaluated by GI in the ED and will have bedside scope on arrival. Review of systems: (+) Per HPI, also endorses multiple months of shortness of breath, also generalized weakness. She has been bed bound since [**Month (only) **] when she had a femur fracture. (-) Denies fever, chills, night sweats, recent weight loss or gain. Denies headache, sinus tenderness, rhinorrhea or congestion. Denies cough or wheezing. Denies chest pain, chest pressure, palpitations, or weakness. Denies dysuria, frequency, or urgency. Denies rashes or skin changes. Past Medical History: herpes zoster R face [**7-22**] polychondritis osteoporosis with compression fracture - not on treatment except ca and vit D bells palsy [**2174**] pancreatic cyst hiatal hernia melanoma Left hip hemiarthroplasty [**7-22**] hysterectomy right THR Social History: lives at [**Hospital3 2558**] since recent hip arthroplasty Family History: Noncontributory Physical Exam: per admitting resident: 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, 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 GU: no foley Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema DISCHARGE EXAM: General: Alert, oriented, flat affect HEENT: Sclera anicteric, MMM 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 Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Pertinent Results: labs on admission: [**2179-10-9**] 12:45PM WBC-9.0 RBC-3.20* HGB-10.2*# HCT-29.8* MCV-93 MCH-32.0 MCHC-34.4 RDW-14.1 [**2179-10-9**] 12:45PM NEUTS-72.2* LYMPHS-21.2 MONOS-5.1 EOS-0.5 BASOS-1.0 [**2179-10-9**] 12:45PM PLT COUNT-418# [**2179-10-9**] 12:45PM PT-14.0* PTT-31.3 INR(PT)-1.2* [**2179-10-9**] 12:45PM GLUCOSE-123* UREA N-43* CREAT-0.7 SODIUM-130* POTASSIUM-7.0* CHLORIDE-97 TOTAL CO2-17* ANION GAP-23* [**2179-10-9**] 03:00PM ALT(SGPT)-11 AST(SGOT)-13 LD(LDH)-118 ALK PHOS-68 TOT BILI-0.2 [**2179-10-9**] 03:00PM LACTATE-1.4 Hct trend: [**2179-10-9**] 12:45PM Hct-29.8 [**2179-10-9**] 07:20PM Hct-25.7 [**2179-10-10**] 03:10AM Hct-20.9 [**2179-10-10**] 10:51AM Hct-30.7 [**2179-10-10**] 02:38PM Hct-34.0 [**2179-10-10**] 10:02PM Hct-30.8 [**2179-10-12**] 04:44AM Hct-34.1 Imaging: CXR: [**10-9**] moderately enlarged heart and large hiatal hernia. The lungs are clear, with limited visualization in the retrocardiac region due to the superimposed hiatal hernia. EGD: [**10-9**] A single cratered non-bleeding 18 mm ulcer was found in the distal bulb. Impression: Medium hiatal hernia Ulcer in the distal bulb Otherwise normal EGD to third part of the duodenum HIP FILMS:Stable-appearing left hip hemiarthroplasty. Brief Hospital Course: 85 y/oF with large hiatal hernia and GERD who was admitted with GI bleed. GI bleed: Patient presented with coffee ground emesis and melanotic stools with Hct near recent baseline of 27- 28. Home heparin SC was discontinued. She was initially started on a protonix gtt and underwent emergent EGD in the ICU which revealed a single nonbleed duondenal ulcer which was thought to be the etiology of her bleed. Following endoscopy, she was monitored with serial Hcts. Hct did drop to 20 on [**10-10**] but this was thought to represent re- equilibration following fluid resuscitation rather than continued active bleeding. She received 2 UpRBC with Hct stabilizing at 30 initially, then up to 34 at discharge. She passed a maroon stool the morning after admission but this was thought to be secondary to old blood and her hematocrit was stable. She did not pass any other [**Month/Year (2) **] stool. Protonix gtt was switched to [**Hospital1 **] dosing and her hct remained stable for remainder of her stay. asymptomatic bacturia: patient was admitted with asymptomatic bacturia with urine cx growing entercoccus sensitive to ampicillin. She was given a prescription for 3d course of ampicillin. metabolic abnormalities: initially presented with hyponatremia, anion gap metabolic acidosis, and hyperkalemia in setting of hemolyzed sample. All normalized with IVF suggesting that she was intravascularly depleted. Anion gap attributed to ketosis and poor nutrition. hip arthroplasty: pt has significant weakness and bilateral LE atrophy. ortho was consulted and recommended plain films of hip which showed no new changes. she was discharged to rehab to improve her LE strength. Medications on Admission: MVI colace 100mg [**Hospital1 **] senna 2 tabs at bedtime vit D3 800 units daily calcium carbonate 500mg QID heparin SQ TID fibercap one tab TID tylenol 500mg PO QID ferrous sulfate 325mg daily tylenol 500 mg QID remeron 15 mg qHS Discharge Medications: 1. multivitamin Tablet Sig: One (1) Tablet PO once a day. 2. docusate sodium 50 mg/5 mL Liquid Sig: One Hundred (100) mg PO BID (2 times a day). 3. senna 8.6 mg Tablet Sig: Two (2) Tablet PO at bedtime. 4. cholecalciferol (vitamin D3) 400 unit Tablet Sig: Two (2) Tablet PO DAILY (Daily). 5. calcium carbonate 200 mg calcium (500 mg) Tablet, Chewable Sig: One (1) Tablet, Chewable PO QID (4 times a day) as needed for indigestion. 6. Fiber-Caps 0.52 g Capsule Sig: One (1) Capsule PO three times a day. 7. acetaminophen 500 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours). 8. ferrous sulfate 325 mg (65 mg iron) Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. mirtazapine 15 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 10. pantoprazole 20 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO twice a day. 11. heparin (porcine) 5,000 unit/mL Solution Sig: 5000 (5000) units Injection TID (3 times a day): inject subcutaneously. 12. ampicillin 500 mg Capsule Sig: One (1) Capsule PO Q6H (every 6 hours) for 3 days. Discharge Disposition: Extended Care Facility: [**Hospital3 2558**] - [**Location (un) **] Discharge Diagnosis: Primary Diagnosis: upper GI bleed from duodenal ulcer (H. pylori negative, likely secondary to hiatal hernia) Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Thank you for letting us take part in your care at [**Hospital1 771**]. You came to the hospital because you had bleeding from your GI tract. You were given a blood transfusion and your red blood cell count stabilized. You had an upper GI scope which showed an ulcer in your duodenum, which is likely what caused your bleeding. You had no further bleeding episodes so you were sent home. You should follow up with a GI doctor in one month. You were found to have a urinary tract infection while you were in the hospital so you should complete a 3 day course of antibiotics for this (prescription below). The following changes were made to your medications: STARTED pantoprazole 20mg by mouth twice a day ampicillin 500mg by mouth every 6 hours for 3 days for urinary tract infection. Followup Instructions: Department: DIV. OF GASTROENTEROLOGY When: TUESDAY [**2179-11-16**] at 1:30 PM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 22337**], MD [**Telephone/Fax (1) 463**] Building: Ra [**Hospital Unit Name 1825**] ([**Hospital Ward Name 1826**]/[**Hospital Ward Name 1827**] Complex) [**Location (un) **] Campus: EAST Best Parking: Main Garage [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**Name8 (MD) **] MD [**MD Number(1) 292**] ICD9 Codes: 2761, 2762, 2851, 2767
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Medical Text: Admission Date: [**2121-5-6**] Discharge Date: [**2121-5-14**] Date of Birth: [**2045-7-26**] Sex: M Service: MEDICINE Allergies: No Allergies/ADRs on File Attending:[**First Name3 (LF) 1185**] Chief Complaint: Urosepsis Major Surgical or Invasive Procedure: Intubation (from OSH) Extubation [**2121-5-6**] History of Present Illness: Mr. [**Known lastname 1313**] is a 75y/o gentleman with a DM2, HTN, and history of nephrolithiasis (no interventions in the past) who is transferred with urosepsis and an obstructing ureteral calculus. . He presented to [**Hospital3 **] on [**5-5**] due to 2 weeks of feeling generally weak and nauseated, with occasional emesis. Of note, he had been started on Cipro 11 days prior for UTI, with no relief, and had been on Nitrofurantoin for the past 4 days. He started feeling more fatigued so he presented to [**Hospital1 **] ER where VS were: T 99.2, HR 112 (but up to 130), BP 97/52, RR 20, POx 100% 2L NC. He was found to be in AFib with RVR to 130 requiring Diltiazem 10mg IV x3 with subsequent drop in BP so was switched to Lopressor IV. 18 Fr foley was placed releasing 4 liters of purulent urine. Was started on Vanc/Zosyn. He was admitted to their ICU where CT showed moderate hydronephrosis and hydroureter on the right secondary to an obstructing calculus just above the UVJ measuring about 4 mm. Urology attempted a right ureteral decompression but was unable to advance past the stone so he was transferred to [**Hospital1 18**] for I.R.-guided urostomy tube placement. Of note, patient was intubated for the procedure and remains so. He reportedly had hypotension in the OR (low blood pressures not documented) so he required Neosynephrine and Levophed. . On arrival to the MICU, he is intubated and sedated. Arrived only on Levophed which was just turned off. Past Medical History: nephrolithiasis class III obesity DM2 HTN gout Social History: retired dry cleaning machine manufacturerer no ETOH no tobacco no illicits Family History: Father lost kidney due to stones Physical Exam: On admission: Vitals: T: 98.5 BP157/90: P:146 Vented: CMV TV 600 PeeP 5 FiO2 50% O2: 98% General: Intubated and sedated HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, PERRL Neck: supple, JVP not elevated, no LAD CV: Irregularly irregular. Distant heart sounds. no murmurs, rubs, gallops Lungs: Coarse breath sounds anterioly. Otherwise no wheezes, rales, ronchi Abdomen: Obese abdomen otherwise soft, non-tender, non-distended, bowel sounds present, no organomegaly GU: foley with dark urine. Ext: cold extremities. Poorly palpable pulses. Trace edema but otherwise no clubbing or cyanosis. Neuro: Pupils reactive. Winces to pain. On discharge: Vitals: 98.2 98.0 112/56 90 20 98% General: Obese, Alert, oriented, no acute distress HEENT: PERRL, EOMI, MMM, sclera anicteric, oropharynx clear Neck: JVP flat, no LAD Lungs: CTA anteriorly, unable to auscultate lung bases due to limited mobility CV: RRR, nl S1 + S2, no m/r/g Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly; nephrostomy tube in place, no tenderness or erythema around site Ext: Warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Pertinent Results: ADMISSION LABS: [**2121-5-6**] 02:04AM BLOOD WBC-16.6* RBC-3.15* Hgb-9.5* Hct-31.5* MCV-100* MCH-30.3 MCHC-30.2* RDW-15.1 Plt Ct-277 [**2121-5-6**] 03:03AM BLOOD PT-14.9* PTT-26.7 INR(PT)-1.4* [**2121-5-6**] 02:04AM BLOOD Glucose-230* UreaN-70* Creat-3.2* Na-137 K-4.4 Cl-110* HCO3-13* AnGap-18 [**2121-5-10**] 12:05AM BLOOD CK-MB-4 cTropnT-0.92* [**2121-5-10**] 02:05AM BLOOD CK-MB-4 cTropnT-1.00* [**2121-5-10**] 06:39AM BLOOD CK-MB-4 cTropnT-1.10* [**2121-5-6**] 02:04AM BLOOD Albumin-3.3* Calcium-7.9* Phos-4.6* Mg-1.6 [**2121-5-6**] 05:00PM BLOOD calTIBC-150* VitB12-397 Ferritn-560* TRF-115* [**2121-5-6**] 02:18AM BLOOD Lactate-1.4 DISCHARGE LABS: [**2121-5-13**] 06:00AM BLOOD WBC-9.8 RBC-2.90* Hgb-8.8* Hct-28.9* MCV-100* MCH-30.3 MCHC-30.3* RDW-15.9* Plt Ct-342 [**2121-5-13**] 06:00AM BLOOD PT-13.8* PTT-56.0* INR(PT)-1.3* [**2121-5-13**] 06:00AM BLOOD Glucose-119* UreaN-21* Creat-1.4* Na-136 K-4.2 Cl-104 HCO3-24 AnGap-12 [**2121-5-10**] 06:39AM BLOOD CK(CPK)-57 [**2121-5-13**] 06:00AM BLOOD Calcium-8.1* Phos-2.6* Mg-1.3* CTA CHEST [**2121-5-10**]: 1. No evidence of acute aortic bony injury or pulmonary embolus. 2. Bronchiectasis and bronchial wall thickening at the lung bases bilaterally with associated minimal central lymphadenopathy. 3. Severe calcified atherosclerotic disease. 4. Trace left pleural effusion. 5. Prominent pumlonary artery suggestive of underlying pulmonary hypertension. TTE: Technically suboptimal image quality. The left atrium is mildly dilated. There is an apical left ventricular aneurysm. Overall left ventricular systolic function is moderately depressed (LVEF = (?) 35 %). Anterior and septal hypokinesis is present, and extensive apical akinesis with focal dyskinesis is present. The right ventricle is not well seen but may also be hypokinetic. The aortic root is mildly dilated at the sinus level. The ascending aorta is mildly dilated. The number of aortic valve leaflets cannot be determined. The aortic valve leaflets are moderately thickened. There is mild aortic valve stenosis. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. Mitral regurgitation is present but cannot be quantified. Tricuspid regurgitation is present but cannot be quantified. There is no pericardial effusion. Brief Hospital Course: Mr. [**Known lastname 1313**] is a 75y/o gentleman with nephrolithiasis, DM2, and HTN presenting with urosepsis, [**Last Name (un) **], and AFib in the setting of obstructive uropathy and urinary retention. . #. Obstructive uropathy with infection: urosepsis. Pt presented from OSH with concerns for urosepsis. CT at OSH showed moderate hydronephrosis and hydroureter on the right secondary to an obstructing calculus just above the UVJ measuring about 4 mm. He was placed initially on broad spectrum antibiotics (vanc/cefepime) initially. This was narrowed to ceftriaxone when urine culture from OSH was reported to be > 100 K E.COLI resistant to Levofloxacin, Bactrim and sensitive to all other agents. Planned for a two week antibiotic course. Percutaneous nephrostomy tube was placed by IR (pt was kept intubated for the procedure) on [**2121-5-6**]. This was complicated by bleeding from nephrostomy tube when pt was started on heparin gtt for afib. IR reassessed the tube and found it to be in calyx instead of kidney; this was replaced ON [**5-9**] and bleeding from nephrostomy tube resolved. Creatinine > 4 on admission from obstructive [**Last Name (un) **], now trending down to 1.4 after nephrostomy tube placement. Patient was discharged on IV ceftriaxone, last day = [**5-18**] for total 2 week course. # [**Last Name (un) **] and urinary retention: Creatinine > 4 on admission, now 1.4 s/p nephrostomy tube placement. Urology was consulted who recommended initiation of tamsulosin and voiding trial in [**2-14**] days. Patient failed subseuqent voiding trial with 750 cc of urine in his bladder. He was intermittently straight - cathed, but it became increasingly difficult likely secondary to his BPH. Thus, a foley was placed prior to discharged. Per urology recommendations, the foley should remain in place until the patient sees his urologist. . #. AFib with RVR: new-onset, in the setting of infection. Per OSH records, pt had no known h/o AFib but was in afib with rvr at OSH. Rate-control was attempted with several different agents including metoprolol, diltiazem, and esmolol drip. However, he became hypotensive on these agents. He was then started on an amiodarone drip. Given his CHADS of 3 and increased risk of stroke with potential cardioversion on amiodarione drip, he was started on heparin gtt. This was complicated by bleeding from foley as well as nephrostomy tube. Cardiology consult was obtained who recommended stopping amiodarone drip and placing pt back on metoprolol. Metoprolol doses were adjusted several times for continued elevated heart rates and low blood pressures, and he was eventually able to be rate controlled on 50 QID metoprolol tartrate, tansitioned to 200 metoprolol succinate on discharge. He was continued on heparin gtt and was initiated on coumadin the day prior to discharge. On discharge, he was well rate controlled in the 90s-110s with bursts into the 130s-140s when eating breakfast or lunch. These rates would only last for several minutes and patient remained stable and asymptomatic until resolution. A TTE was obtained that revealed EF of 35%, left ventricular aneurysm, and possibly hypokinetic right ventricle, mild aortic stenosis. Cardiology recommended that he undergo non urgent cardiac catheterization when stable. He was started on a baby aspirin. # Chest Pain and Increased Troponins: On [**2121-5-9**] pt complained of chest pain radiating to his arm as well as N/V. ECG showed no changes. CTA negative for PE, but did show evidence of pulmonary hypertension. He has no known CAD, but cards recommended a cardiac cath at some point as based on his TTE, likely has 3VD. Trops have increased to 1.10 with flat CKs and MBs. Likely demand ischemia in the setting of sepsis. He was started on aspirin 81 mg and atorvastatin. Cardiology did recommend a non-urgent cardiac cath at some point in the near future. This will be discussed at patient's outpatient cardiology appointment. # Transaminitis: On day of discharge, patient's AST and ALT were mildly elevated to 117 and 80, respectively (had been normal on admission). Possibly secondary to initiation of atorvastatin. Atorvastatin was held on day of discharge. His AST and ALT should be monitored and trended while at the MACU. #. HTN: intermittently hyptonsive off home BP meds. He became hypotensive with IV nodal agents for AFib/RVR in the OSH ED. Again became hypotensive in the OR during attempted ureteral stenting (possibly from vagal response vs. evolving septic shock). He also became hypotensive with several different agents for rate-control for afib. His home BP medications,(Hydrochlorothiazide-Triamterene, Spironolactone, Hydralazine) were held. He was started on metoprolol for rate-control. Given findings of depressed EF on TTE, he was started on an ACE-I, which should be uptitrated as an outpatient. # Loose stools/diarrhea: Patient had frequent loose stool throughout hospital stay, brown but guiac positive. A C diff PCR was negative on [**5-8**], patient's white count remained stable, and patient looked clinically well. Given the small amount of loose stools and his clinical status, the team felt that there was a low pre test probability for C diff on discharge. If patient's loose stools continue at rehab, or if clinical status changes, another C diff PCR test should be sent. . #. DM2: stable. Home oral hypoglycemics were held and he was placed on home lantus and HISS. . #. Anemia: Hct 32 (unclear baseline). He was guaiac positive at OSH. Hct dropped to high 20s but was stable during ICU stay. He initially had bleeding from foley and nephrostomy tube when heparin gtt was started which eventually resolved. He will need outpatient colonoscopy and GI follow-up. # Transitional Issues: - Outpatient cardiac catheterization - Management of INR and coumadin dose - Nephrostomy tube removal to be determined by urology - Trending of AST/ALT and reinitiation of statin - Colonoscopy CODE STATUS: DNR/DNI ** In patient's discharge paperwork, states that ACE/[**Last Name (un) **] not prescribed on discharge because not tolerated. This is a malfunction in the new electronic med reconciliation form. This is to clarify that the patient was in fact discharged on an ACE-I. Medications on Admission: Preadmission medications listed are correct and complete. Information was obtained from Patient Outside hospital records. 1. Metoprolol Tartrate 50 mg PO BID 2. Triamterene-Hydrochlorothiazide 1 CAP PO DAILY 3. Spironolactone 25 mg PO DAILY 4. HydrALAzine 25 mg PO QHS 5. Levemir 15 Units Breakfast 6. Nateglinide 120 mg PO TIDAC 7. Allopurinol 300 mg PO DAILY 8. ibuprofen *NF* 800 mg Oral TID 9. TraMADOL (Ultram) 50 mg PO QID 10. Nitrofurantoin (Macrodantin) 50 mg PO Q6H Discharge Medications: 1. Glargine 10 Units Bedtime Insulin SC Sliding Scale using HUM Insulin 2. TraMADOL (Ultram) 50 mg PO BID:PRN pain 3. Aspirin 81 mg PO DAILY 4. CeftriaXONE 1 gm IV Q24H Day 1= [**5-5**] LAST DAY = [**5-18**] 5. Heparin IV Sliding Scale 6. Metoprolol Succinate XL 200 mg PO DAILY Start: In am Hold for HD <60 or systolic BP <100. 7. Miconazole Powder 2% 1 Appl TP QID:PRN fungal rash 8. Tamsulosin 0.4 mg PO HS 9. Warfarin 2.5 mg PO DAILY16 10. Lisinopril 2.5 mg PO DAILY HOLD FOR SBP < 100 11. Allopurinol 100 mg PO DAILY 12. Simethicone 40-80 mg PO QID:PRN Bloating Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - MACU Discharge Diagnosis: Urosepsis Obstructive uropathy with percutaneous nephrostomy tube placement Atrial Fibrillation Systolic Heart Failure Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Bedbound. Discharge Instructions: You were seen in the hospital because of severe obstruction of your urinary tract which caused an infection in your urine. This obstruction was cleared with a nephrostomy tube and your infection was treated with IV antibiotics. The nephrostomy tubes will stay in place for at least the next several week until you follow-up with a urologist listed below. While in the hospital, you also developed a fast irregular heart rate called atrial fibrillation. We controlle your rate by increasing your metoprolol. Because atrial fibrillation increases your risk of stroke, we also put you on a blood thinner called coumadin. Once you are discharged from the hospital, you will need to have your coumadin levels checked periodically. You also had an echocardiogram, or an ultrasound of your heart, which showed that your heart pumping function has been reduced. You were seen by our cardiology team, who recommended that you eventually have a cardiac catheterization to look to see of there are blockages in your arteries. You will see a cardiologist to discuss this procedure with you, as listed below. It was a pleasure taking care of you during your hospital stay. Followup Instructions: Cardiology: Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 4469**] [**Hospital3 **] [**5-28**] 1:45 PM Urology: Dr. [**Last Name (STitle) 9780**] [**Name (STitle) 5871**] Hospital [**2119-6-5**]:30 AM Once you are discharged from the rehab facility, an appointment will be made for you to see your primary care doctor. [**Name6 (MD) **] [**Name8 (MD) **] MD [**Doctor Last Name 1189**] ICD9 Codes: 0389, 5990, 5849, 4280, 4019, 2749
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Medical Text: Admission Date: [**2111-8-25**] Discharge Date: [**2111-8-31**] Service: MEDICINE Allergies: Epinephrine / Adhesive Tape Attending:[**First Name3 (LF) 3016**] Chief Complaint: hypotension and retroperitoneal bleed Major Surgical or Invasive Procedure: none History of Present Illness: Pt is an 84 y.o male with h.o HTN, s/p CABG, PM/ICD, CMP with EF 35%, PAF, MDS/anemia, hypothyroidism, h.o prostate ca, DVT, with recently diagnosed metastatic adenoca with unknown primary who presented to the ED with symptoms suggestive of presyncope. . Pt had been seen by rad onc for ciber knife eval. Had large dye load for CT scan (then diuresed ~1500cc) and likely became orthostatic. Pt then fell at NH, hit his back, and presented to the ED hypotensive. Pt underwent a FAST exam that looked "positive", underwent CT torso showing large RP bleed. Pt given blood and fluid with good effect. SBP now 120's. U.O good 50-100cc/hr. Pt mentating. . Upon conversation with pt's son with Dr. [**Name (NI) 496**], pt is DNR/DNI and does not want CVL. . Past Medical History: 1. Dyslipidemia. 2. Hypertension. 3. CABG in [**2103**] 4. Pacemaker/ICD due to AV block and tachybrady syndrome 5. Cardiomyopathy with LVEF = 35% in [**10-6**]. 6. PAF 7. TIA in [**2103**]. 8. Macrocytic anemia, attributed to MDS with bone marrow biopsy in [**State 531**]. 9. Spinal stenosis. 10. Hypothyroidism. 11. H/o gastric ulcer; GERD. 12. OSA on nocturnal CPAP. 13. Prostate cancer s/p XRT. 14. Adenocarcinoma of unknown primary metastatic to the left occipitoparietal region s/p resection in [**7-7**] 15. DVT/PE s/p IVC filter on Lovenox [**Hospital1 **] Social History: He lives with his wife in a senior center and is independent in his ADLs. He quit smoking in [**2060**] after 3 ppd for many years. He does not drink EtoOH. Family History: Father died of lung cancer at age 50. Mother had an MI and died at age 86. A brother also had lung cancer. He has two children that are healthy. Physical Exam: Vitals: T 95.4, BP 102/52, HR 73, RR 23, sat 100% on RA General: Alert, oriented, no acute distress, pale. HEENT: Sclera anicteric, MMM, oropharynx clear Neck: supple, JVP not elevated, no LAD Lungs: Clear to auscultation bilaterally anteriorly, no wheezes, rales, rhonchi. CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops chest: [**Doctor Last Name **] chest with pacer/no erythema. Abdomen: soft, TTP R.periumbilical/R.flank. +bs, no guarding/no rebound. Ext: warm, 2+pulses, 1+ pitting edema, +multiple areas of ecchymoses. Pertinent Results: LABS ON ADMISSION: HCT 19 lactate 3.4, WBC 16.1 LABS ON TRANSFER FROM ICU: 135 / 101 / 36 ===============< 134 4.0 / 25 / 0.9 CBC 18.9 > 11.0 / 31.3 < 94 Ca: 7.2 Mg: 2.3 P: 2.7 LABS ON DISCHARGE: EKG: Vpaced @70, STD I, AVF, unchanged from prior on [**2111-8-7**] CXR [**8-26**]: The pacemaker leads terminate in right atrium and right ventricle, unchanged. There is interval decrease in the left pleural effusion with still present area of left basal atelectasis. The left upper lung and the right lung are unremarkable. Cardiomediastinal silhouette is stable. Overall, the lung volumes are lower than on the prior radiograph that might be explained by suboptimal inspiratory effort. CT Torso [**8-25**]: Large right-sided retroperitoneal hematoma, stable bilateral pleural effusions, left greater than right, patient appears anemic and may be hypovolemic as indicated by a spleen, which is smaller than on prior study, and a narrowed IVC. IVC filter in unusual position with the distal aspect at the level of the iliac vein bifurcation. Extensive stool within the colon and fluid within the stomach, but no evidence for bowel obstruction. Stable pulmonary nodule. Stable spine degenerative changes and compression fractures and chronic right posterior rib fracture. CT Head. [**2111-8-25**]. IMPRESSION: Status post left parietooccipital craniotomy with small hyperdense focus at the margin of the resection bed, corresponding to the enhancing focus on the most recent study, which may represent residual tumor, as suggested previously. Otherwise, there is no hemorrhage or other acute process. Brief Hospital Course: 1. Retroperitoneal bleed: Patient was initially hypotensive upon arrival to the hospital shortly after falling at his nursing home and was found on CT to have a large retroperitoneal bleed. Hematocrit on admission was 19.3 and hit a nadir of 18.6 shortly after admission. Patient has MDS with baseline HCT of 30. He was trasnfused a total of 9 units PRBCs in the MICU. He did not require a procedure to stop the bleed. His lovenox and antihypertensives were held. 2. Leukocytosis: He had an elevated WBC reaching 23.0 on the day of admission, likely related to a stress response and ?UTI in the setting of chronic steroid use and malignancy. Initial UA showed > 50 WBCs and positive leukocytes and nitrites. Notably, the patient had been on a suppressive macrodantin which had been stopped a few weeks prior to admission. He had no other clear source of infection. Blood cultures were negative. He was treated with 2 days of Levaquin which was stopped when his urine culture grew out yeast. 3. Acute Renal Failure: Patient was in acute renal failure when admitted with a creatinine at 1.7 from baseline of 1.0. This was most likely due to his pre-renal etiology in the setting of an acute bleed. His creatinine resolved with resolution of his bleed and correction of his volume status. His creatinine on discharge was 0.9. 4. Recent History of DVT: The patient was recently admitted for a DVT and has had an IVC filter placed. In addition he was on Lovenox, which was held on the current admissions. Given his severe risk of internal bleeding, it was decided to permanently discontinue his Lovenox on discharge. 5. Positive U/A: On admission patient was found to have a positive UA showed > 50 WBCs and positive leukocytes and nitrites. Patient was asymptomatic and notably has lived with an indwelling catheter for several months. He was treated with 2 days of Levaquin which was stopped when his urine culture grew out yeast. 5. PICC Line: A PICC line was placed for access and proper placement was confirmed on CXR. 6. Brain Metastesis: Patient known to have a brain metastesis of adenocarcinoma of unknown origin. Patient was undergoing cyberknife evaluation the day he was admitted. During his admission he was continued on dexamethasone and gabapentin 7. CHF and AF: Patient has a history of CHF with EF of 40-45% in [**2108**] and PAF. Patient is s/p AICD. During this admission this patient was monitored for arrythmias, and transufused blood to maintain a goal hematocrit above 30. Patient remained in NSR across his admission. He is currently controlled on amiodarone. 8. HTN: Patient was admitted on daily doses of Carvedilol and Lasix, both of which were initially held in the setting of acute bleed. The carvedilol was initially restarted at half his home dose, with good effect, and then resumed to his normal dose. Lasix was restarted. The patient was discharged on all of his home cardiac medications. 9. Code Status: Per discussions with patient's family, this patient was considered DNR but not DNI. His wishes are only to be intubated only if it is considered likely that his would make a relatively rapid recovery. 10. MRSA Status: MRSA screen on admission was positive. Patient was placed on contact precautions. Specific MRSA treatment was not initiated at this time. 11. Wound Care: Wound care recommendations from this patient's previous admission were followed. No new complications developed. Medications on Admission: 1. IV access: PICC, heparin dependent Location: Right, Date inserted: [**2111-8-27**] Order date: [**8-28**] @ 1300 11. Levothyroxine Sodium 75 mcg PO DAILY Order date: [**8-28**] @ 1300 2. IV access: Peripheral line Order date: [**8-28**] @ 1300 12. Lidocaine 5% Patch 1 PTCH TD DAILY Order date: [**8-28**] @ 1300 3. Acetaminophen 325-650 mg PO Q6H:PRN pain/fever Order date: [**8-28**] @ 1300 13. Omeprazole 40 mg PO DAILY Order date: [**8-28**] @ 1300 4. Amiodarone 200 mg PO DAILY Order date: [**8-28**] @ 1300 14. Ondansetron 4 mg IV Q8H:PRN nausea Order date: [**8-28**] @ 1300 5. Bisacodyl 10 mg PO/PR DAILY:PRN Constipation Order date: [**8-28**] @ 1300 15. Oxycodone-Acetaminophen 1 TAB PO Q6H severe pain pls hold for SBP <100, sedation Order date: [**8-28**] @ 1300 6. Carvedilol 12.5 mg PO BID Hold for HR less than 60 or SBP less than 100mmHg Order date: [**8-28**] @ 1703 16. OxycoDONE (Immediate Release) 5 mg PO Q4H:PRN pain hold for sedation, RR <10 Order date: [**8-28**] @ 1300 7. Dexamethasone 4 mg PO Q12H Order date: [**8-28**] @ 1300 17. Polyethylene Glycol 17 g PO DAILY:PRN constip Order date: [**8-28**] @ 1300 8. Docusate Sodium 100 mg PO BID Order date: [**8-28**] @ 1300 18. Senna 1 TAB PO BID:PRN Constipation Order date: [**8-28**] @ 1300 9. Gabapentin 400 mg PO HS Order date: [**8-28**] @ 1300 19. Simvastatin 10 mg PO DAILY Order date: [**8-28**] @ 1300 10. 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. Order date: [**8-28**] @ 1300 20. 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. 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. Levothyroxine 75 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for severe pain. 4. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed for Constipation. 5. Oxycodone 5 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for pain. 6. Furosemide 20 mg Tablet Sig: 1.5 Tablets PO DAILY (Daily). 7. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: Two (2) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 8. Acetaminophen 325 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for pain/fever. 9. Dexamethasone 4 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours). 10. Simvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 11. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 12. Gabapentin 400 mg Capsule Sig: One (1) Capsule PO HS (at bedtime). 13. Lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: One (1) Adhesive Patch, Medicated Topical DAILY (Daily). 14. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 15. Polyethylene Glycol 3350 100 % Powder Sig: One (1) PO DAILY (Daily) as needed for constip. 16. Carvedilol 12.5 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Discharge Disposition: Extended Care Facility: Commons Residence At Orchard - [**Location (un) 2624**] (a.k.a. [**Location (un) 5481**]) Discharge Diagnosis: PRIMARY: 1. Retroperitoneal hemorrhage 2. Brain metasteses of unknown primary adenocarcinoma 3. Recent history of DVT SECONDARY: 1. Hypertension Discharge Condition: stable, afebrile Discharge Instructions: It was a pleasure to help care for you during your stay at [**Hospital1 1535**]. You were admitted to the hospital with low blood pressure. In our emergency department you were found to have an internal bleed. While you were here you were treated with intravenous fluids and given 9 units of blood. We also continued most of your home medications. You should continue to refraine from taking your Lovenox when you leave the hospital. We have decided to stop this medication. We did not stop any of your other medications while you were here. Please take all of your other medications exactly as prescribed. Please call your physician or return to the emergency department if you experience any of the following: worsening shortness of breath, chest pain, nausea or vomiting, any fevers above 100.4, dizziness or light-headedness, headache, worsening pain, loss of consciousness, or any other concerning signs or symtoms. Followup Instructions: Provider: [**First Name4 (NamePattern1) 3520**] [**Last Name (NamePattern1) 3521**], MD Phone:[**Telephone/Fax (1) 463**] Date/Time:[**2111-9-10**] 10:20 Provider: [**Name10 (NameIs) 706**] MRI Phone:[**Telephone/Fax (1) 327**] Date/Time:[**2111-9-28**] 1:55 Provider: [**First Name11 (Name Pattern1) 640**] [**Last Name (NamePattern4) 4861**], MD Phone:[**Telephone/Fax (1) 1844**] Date/Time:[**2111-9-28**] 4:00 [**Name6 (MD) **] [**Name8 (MD) 831**] MD, [**Doctor First Name 3018**] ICD9 Codes: 5849, 2762, 2851, 4254, 2767, 2449, 4019, 4280
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6074 }
Medical Text: Admission Date: [**2153-5-28**] Discharge Date: [**2153-6-2**] Date of Birth: [**2073-5-16**] Sex: F Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1283**] Chief Complaint: Asymptomatic Major Surgical or Invasive Procedure: [**2153-5-29**] Aortic Valve Replacement utilizing a 21mm Mosaic Porcine Bioprosthesis History of Present Illness: This is a very healthy 79 year old female who was noted to have a heart murmur on routine examination. Serial echocardiograms have shown significant progression of her aortic valve stenosis, most recently [**First Name8 (NamePattern2) **] [**Location (un) 109**] of 0.7cm2, with a peak gradient of 74 mmHg. Subsequent cardiac catheterization showed normal coronary arteries. Based on the above results, she was referred for cardiac surgical intervention. She is asymptomatic and remains very active. Past Medical History: Aortic Valve Stenosis s/p Vein Stripping s/p Benign Breast Mass Removal Social History: Denies history of tobacco. Rare ETOH. She lives alone and still works part-time at an office. Family History: Denies premature coronary disease Physical Exam: Vitals: T afebrile, BP 142/80, HR 88, RR 20 General: pleasant elderly female in no acute distress HEENT: oropharynx benign, Neck: supple, no JVD, Heart: regular rate, normal s1s2, grade 4/6 systolic ejection murmur which radiates to carotids Lungs: clear bilaterally Abdomen: soft, nontender, normoactive bowel sounds Ext: warm, no edema, no varicosities Pulses: 2+ distally Neuro: nonfocal Pertinent Results: [**2153-6-2**] 07:05AM BLOOD WBC-9.2 RBC-3.18* Hgb-10.0* Hct-28.8* MCV-91 MCH-31.4 MCHC-34.7 RDW-14.2 Plt Ct-313# [**2153-5-30**] 02:10AM BLOOD PT-11.6 PTT-27.8 INR(PT)-1.0 [**2153-6-2**] 07:05AM BLOOD Glucose-98 UreaN-10 Creat-0.6 Na-140 K-4.0 Cl-102 HCO3-31 AnGap-11 RADIOLOGY Preliminary Report CHEST (PA & LAT) [**2153-6-1**] 4:38 PM CHEST (PA & LAT) Reason: evaluate for pleural effusions [**Hospital 93**] MEDICAL CONDITION: 80 year old woman s/p AVR REASON FOR THIS EXAMINATION: evaluate for pleural effusions HISTORY: Evaluate pleural effusions in 80-year-old female status post AVR. Comparison is made to prior radiographs dated [**2153-5-30**]. PA AND LATERAL CHEST RADIOGRAPHS: FINDINGS: There has been interval increase in bilateral pleural effusions (right greater than left), both small in size with fluid noted tracking within the major fissure on the left. There is no evidence of new parenchymal consolidation with persistent retrocardiac opacity likely representing atelectasis. No pneumothorax or pulmonary edema. Symmetric biapical pleural thickening is stable. IMPRESSION: Interval increase in small bilateral pleural effusions, right greater than left. DR. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] DR. [**First Name11 (Name Pattern1) 3347**] [**Initial (NamePattern1) **]. [**Last Name (NamePattern1) 5034**] Cardiology Report ECHO Study Date of [**2153-5-29**] PATIENT/TEST INFORMATION: Indication: Intra-op TEE for AVR Height: (in) 64 Weight (lb): 122 BSA (m2): 1.59 m2 Status: Inpatient Date/Time: [**2153-5-29**] at 09:07 Test: TEE (Complete) Doppler: Full Doppler and color Doppler Contrast: None Tape Number: 2007AW06-: Test Location: Anesthesia West OR cardiac Technical Quality: Adequate REFERRING DOCTOR: DR. [**First Name (STitle) 412**] [**Last Name (Prefixes) 413**] MEASUREMENTS: Left Ventricle - Septal Wall Thickness: 0.9 cm (nl 0.6 - 1.1 cm) Left Ventricle - Inferolateral Thickness: 0.9 cm (nl 0.6 - 1.1 cm) Left Ventricle - Diastolic Dimension: 3.9 cm (nl <= 5.6 cm) Left Ventricle - Systolic Dimension: 3.4 cm Left Ventricle - Fractional Shortening: *0.13 (nl >= 0.29) Left Ventricle - Ejection Fraction: 55% (nl >=55%) Aorta - Valve Level: 3.2 cm (nl <= 3.6 cm) Aorta - Ascending: 3.0 cm (nl <= 3.4 cm) Aortic Valve - Peak Velocity: *4.8 m/sec (nl <= 2.0 m/sec) Aortic Valve - Peak Gradient: 90 mm Hg Aortic Valve - Mean Gradient: 60 mm Hg Aortic Valve - LVOT Peak Vel: 1.00 m/sec Aortic Valve - LVOT Diam: 1.9 cm Aortic Valve - Valve Area: *0.6 cm2 (nl >= 3.0 cm2) INTERPRETATION: Findings: RIGHT ATRIUM/INTERATRIAL SEPTUM: Normal interatrial septum. No ASD by 2D or color Doppler. LEFT VENTRICLE: Normal LV wall thicknesses and cavity size. Overall normal LVEF (>55%). RIGHT VENTRICLE: Normal RV chamber size and free wall motion. AORTA: Normal aortic diameter at the sinus level. Focal calcifications in aortic root. Normal ascending aorta diameter. No atheroma in ascending aorta. Normal aortic arch diameter. Simple atheroma in aortic arch. Normal descending aorta diameter. Simple atheroma in descending aorta. AORTIC VALVE: Three aortic valve leaflets. Severely thickened/deformed aortic valve leaflets. Severe AS (AoVA <0.8cm2). Trace AR. MITRAL VALVE: Mildly thickened mitral valve leaflets. Mild mitral annular calcification. No MS. Trivial MR. TRICUSPID VALVE: Physiologic TR. PULMONIC VALVE/PULMONARY ARTERY: Physiologic (normal) PR. GENERAL COMMENTS: A TEE was performed in the location listed above. I certify I was present in compliance with HCFA regulations. No TEE related complications. The patient was under general anesthesia throughout the procedure. The patient appears to be in sinus rhythm. Results were personally post-bypass data Conclusions: PRE-BYPASS: No atrial septal defect is seen by 2D or color Doppler. Left ventricular wall thicknesses and cavity size are normal. Overall left ventricular systolic function is normal (LVEF>55%). Right ventricular chamber size and free wall motion are normal. There are simple atheroma in the aortic arch. There are simple atheroma in the descending thoracic aorta. There are three aortic valve leaflets. The aortic valve leaflets are severely thickened/deformed. There is severe aortic valve stenosis (area <0.8cm2). Trace aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Trivial mitral regurgitation is seen. POST-BYPASS: Well-seated valve. Normal biventricular systolic function. Electronically signed by [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 5209**], MD on [**2153-6-4**] 09:55. Brief Hospital Course: Mrs. [**Known lastname 73317**] was admitted and underwent an aortic valve replacement by Dr. [**Last Name (STitle) 68853**]. For surgical details, please see seperate dictated operative note. Following the operation, she was brought to the CSRU for invasive monitoring. Within several hours, she awoke neurologically intact and was extubated without difficulty. Initially tachycardic with frequent premature atrial contractions, she was started on low dose beta blockade and Amiodarone to prevent atrial fibrillation. She otherwise maintained stable hemodynamics and transferred to the SDU on postoperative day two. Over several days, she continued to make clinical improvements with diuresis. She remained in a normal sinus rhythm as beta blockade was advanced as tolerated. She continued to progress and was discharged to home on POD#4 in stable condition. Medications on Admission: Aspirin 81 qd, Vitamin, Calcium 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. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*100 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 3. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*90 Tablet(s)* Refills:*2* 4. Lopressor 50 mg PO BID. 5. Amiodorone 400 mg PO daily for 7 days, then decrease dose to 200 mg PO daily. 6. Ultram 50 mg PO q 4 hours PRN 7. Lasix 20 mg PO BID x 7 days. 8. Potassium Chloride 20 mg PO BID x 7 days. Discharge Disposition: Home With Service Facility: [**Company 1519**] Discharge Diagnosis: Aortic Valve Stenosis - s/p AVR s/p Vein Stripping s/p Benign Breast Mass Removal Discharge Condition: Good Discharge Instructions: Patient should shower daily, no baths. No creams, lotions or ointments to incisions. No driving for at least one month. No lifting more than 10 lbs for at least 10 weeks from the date of surgery. Monitor wounds for signs of infection. Please call cardiac surgeon if start to experience fevers, sternal drainage and/or wound erythema. Followup Instructions: Cardiac surgeon, Dr. [**Last Name (STitle) 1290**] in [**4-19**] weeks - call for appt. Local PCP, [**Last Name (NamePattern4) **]. [**Last Name (STitle) **] in [**2-17**] weeks - call for appt. Local cardiologist, [**Last Name (un) 32255**] in [**2-17**] weeks - call for appt. Completed by:[**2153-6-4**] ICD9 Codes: 4241, 9971, 5180
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Medical Text: Admission Date: [**2110-5-25**] Discharge Date: [**2110-6-2**] Service: SURGERY Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 6346**] Chief Complaint: Abdominal pain Major Surgical or Invasive Procedure: [**2110-5-25**] Exploratory laparotomy and small-bowel resection,anterior enterostomy History of Present Illness: 92-y.o. male p/w acute onset constant suprapubic abdominal pain since yesterday morning, without radiation, no ameliorating/exacerbating factors. Denies fever, nausea, vomiting, diarrhea, and constipation, though reports dry retching and anorexia. Similar episodes of pain have occurred in the past, and the patient was prescribed medication (which he cannot recall) and the pain resolved. Past Medical History: CHF- EF 30% by report, s/p biventricular ICD in [**2102**] Hypertension Hyperlipidemia Paroxysmal atrial fibrillation, not on coumadin due to risk for fall and history of hematuria CAD, s/p MI in [**2084**], s/p stents to RCA and LAD with the last one placed in ostial RCA in [**10/2106**] Prostate cancer, s/p XRT, now with radiation cystitis Gait instability Presyncope Ulcerative colitis, stable GERD Restless leg syndrome Pernicious anemia Social History: He is married and is primary caretaker for his wife who has Alzheimer??????s. His son [**Name (NI) **] is involved in his care. The patient does not drink or smoke. Family History: N/C Physical Exam: T: 98.2 P: 80 BP: 144/71 RR: 18 O2sat: 99% on RA General: awake, alert, NAD HEENT: NCAT, EOMI, anicteric Heart: RRR Lungs: CTAB, normal excursion, no respiratory distress Back: no vertebral tenderness, no CVAT Abdomen: soft, moderate diffuse tenderness, severe focal tenderness at suprapubis, non-distended, no guarding/rebound, no mass, no hernia, no scars Pelvis: normal rectal tone, enlarged prostate, no occult blood Neuro: strength intact/symmetric, sensation intact/symmetric Extremities: WWP, no CCE, no tenderness, 2+ B radial/DP Pertinent Results: CT A/P [**5-25**] - 1. Marked wall edema of long segment of jejunum consistent with areas of mucosal hyperemia and some smaller areas suggesting relative lack of mucosal enhancement, highly concerning for ischemia. Infectious or inflammatory etiologies are in the differential, but felt less likely. Surrounding perijejunal fat stranding. Complex small amount of perihepatic and pelvic free fluid. 2. Right pleural effusion with mild enhancement of the adjacent parietal pleura may represent a chronic process; however, infection cannot be excluded. Adjacent chronic atelectasis versus infection (aspiration or pneumonia) should be considered. 3. Ectatic abdominal aorta. [**2110-5-30**] KUB : Diffusely dilated loops of large and small bowel likely representing postoperative ileus. No evidence of any intra-abdominal free air. [**2110-5-25**] 04:00PM WBC-16.4*# RBC-4.55* HGB-12.5* HCT-37.2* MCV-82 MCH-27.5 MCHC-33.6 RDW-16.3* [**2110-5-25**] 04:00PM NEUTS-80.5* LYMPHS-14.2* MONOS-4.0 EOS-0.7 BASOS-0.6 [**2110-5-25**] 04:00PM PLT COUNT-335 [**2110-5-25**] 04:00PM PT-139.2* PTT-59.4* INR(PT)-17.6* [**2110-5-25**] 04:00PM ALT(SGPT)-10 AST(SGOT)-55* ALK PHOS-53 TOT BILI-0.5 [**2110-5-25**] 04:00PM LIPASE-181* [**2110-5-25**] 04:05PM GLUCOSE-155* LACTATE-2.1* NA+-136 K+-5.4* CL--101 TCO2-26 [**2110-5-25**] 04:00PM UREA N-26* CREAT-1.7* [**2110-5-25**] 09:09PM PT-26.8* PTT-35.4* INR(PT)-2.6* Brief Hospital Course: Mr. [**Known lastname 24770**] was evaluated by the Acute Care service in the Emergency Room and his Abdominal CT was reviewed showing areas if ischemic bowel along the jejunum. Based on his physical exam, CT scan and elevated WBC of 16K, exploratory laparotomy was recommended. He was transfused with 4 units of FFP as his INR was 17.6 on admission and broad spectrum antibiotics were also initiated. After his INR decreased he was taken to the Operating Room on [**2110-5-25**] and underwent an exploratory laparotomy, small bowel resection and anterior enterostomy for infarcted small bowel. He tolerated the procedure well and returned to the SICU in stable condition. He maintained stable hemodynamics and his pain was well controlled. Following transfer to the Surgical floor his diet was advanced on post op day #2 after his bowel function returned but unfortunately he developed an ileus and returned to NPO. His BUN and creatinine peaked at 56 and 2.3 after receiving Lasix and he required increased IV fluids for 24 hours. He gradually trended down to 27 and 1.4 and maintained adequate hemodynamics. As his bowel function returned, he was restarted on a liquid diet and gradually advanced to regular. His abdomen was soft and his incision was healing well. He was seen by the Physical Therapy service who recommended a short term rehab prior to returning to his [**Hospital3 **]. Of note, his daily lasix was not resumed and his Coumadin for atrial fibrillation may resume on [**2110-6-2**]. Medications on Admission: metoprolol tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). digoxin 125 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). lasix 40 meq daily potassium 20 meq daily Discharge Medications: 1. metoprolol tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day): Hold for SBP < 100, HR < 60. 2. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. digoxin 125 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day. 5. oxycodone 5 mg/5 mL Solution Sig: 0.5 to 1 tab PO Q6H (every 6 hours) as needed for pain. Discharge Disposition: Extended Care Facility: [**Hospital 11790**] Health Center Discharge Diagnosis: Infarcted small bowel Systolic heart failure Acute renal failure 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: * You were admitted to the hospital with abdominal pain due to poor blood supply to your small bowel. * On [**2110-5-25**] you underwent surgery to remove the diseased portion of the small bowel. * You are improving every day and should continue to do so. * Continue to eat a regular diet and restrict your salt intake. Stay well hydrated. * Due to the difficulty of going through such a big operation along with your other medical problems, you will need to spend some time in rehab prior to going home so that you can regain your strength and increase your calories so that you can return home safely. * Your abdominal staples will be removed in rehab. * If you develop any increased incisional pain, abdominal pain or any other symptoms that concern you please call your doctor or return to the Emergency Room. Followup Instructions: Call the Acute Care Clinic at [**Telephone/Fax (1) 600**] for a follow up appointment in [**3-13**] weeks. Call Dr. [**Last Name (STitle) 24717**] for a follow up appointment after your discharge from rehab. Completed by:[**2110-6-2**] ICD9 Codes: 4254, 5849, 4019, 412
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Medical Text: Admission Date: [**2162-1-25**] Discharge Date: [**2162-2-2**] Date of Birth: [**2087-1-28**] Sex: M Service: ADMISSION DIAGNOSIS: Dyspnea on exertion. DISCHARGE DIAGNOSES: 1. Coronary artery disease. 2. Myocardial infarction. 3. Status post coronary artery bypass graft x2. HISTORY OF PRESENT ILLNESS: Patient is a 74-year-old male who is referred by his cardiologist/primary care doctor, Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] for complaints of exertional dyspnea and syncope. The patient had been experiencing shortness of breath and lightheadedness with three presyncopal episodes since [**Month (only) **]. These occurred with exertion such as daily chores like carrying trash to the curb. The patient had a Persantine Myoview test performed on [**2161-10-23**] which revealed a small mild inferobasilar infarct with small anterior adjacent ischemia. The ejection fraction was 57%. Patient denies claudication, orthopnea, PND, or edema. Patient now presents for cardiac catheterization. PAST MEDICAL HISTORY: 1. Hypertension. 2. Hypercholesterolemia. 3. Twenty pack year smoker, quit approximately 30 years ago. 4. Type 2 diabetes mellitus. 5. Family history of coronary artery disease. 6. Hypothyroidism secondary to thyroidectomy for thyroid cancer. 7. Chronic atrial fibrillation. MEDICATIONS: 1. Glucophage 1,000 mg [**Hospital1 **]. 2. Glyburide 2.5 mg q day. 3. Lipitor 20 mg q day. 4. Atenolol 100 mg q day. 5. Imdur 90 mg q day. 6. Diltiazem 120 mg q day. 7. Coumadin 5 mg q day, last dose [**2162-1-22**]. 8. Cozaar 100 mg q day. 9. Protonix 40 mg q day. 10. Levoxyl 0.125 mg q day. 11. Nitroglycerin patch 0.2 mg/hour. 12. Potassium chloride 10 mEq q day. 13. Lasix 20 mg q day. PHYSICAL EXAMINATION: The patient is a pleasant-elderly man in no acute distress. HEENT is atraumatic, normocephalic. Extraocular movements are intact. Pupils are equal, round, and reactive to light. Anicteric. Throat is clear. Neck is supple, midline without masses or lymphadenopathy. Chest was clear to auscultation bilaterally. Cardiovascular is regular, rate, and rhythm without murmurs, rubs, or gallops. Abdomen is soft, nontender, nondistended, obese without masses or organomegaly. Extremities are warm, noncyanotic, nonedematous x4. Neurologic is grossly intact. Height is 5 foot 6 inches, weight 194 pounds. LABORATORIES ON ADMISSION: Complete blood count: 8.3/11.0/32.8/188. Chemistry: 141/4.7/108/27/30/1.4. INR is 1.24. HOSPITAL COURSE: The patient presented for cardiac catheterization secondary to his positive Persantine stress test. Cardiac catheterization revealed mild-to-moderate mitral regurgitation with an ejection fraction of 50%. He had a right dominant coronary artery system with severe three-vessel disease. Recommendation was made for revascularization and the Cardiothoracic Surgery service was consulted. Patient was added on as an urgent coronary artery bypass graft. This was performed on [**2162-1-26**] x2 with LIMA to the left anterior descending artery, saphenous vein graft to the OM. On the postoperative period, the patient was in the Intensive Care Unit for closer monitoring. He was extubated overnight on postoperative day #0. Patient had unremarkable postoperative course and was transferred to the floor on postoperative day #2. Subsequent to this, the patient was cleared by Physical Therapy for home discharge on postoperative day #3. The patient was maintained on therapeutic anticoagulation using a Heparin drip and the Coumadin was restarted. Patient was ultimately discharged after his INR became therapeutic, occurred on postoperative day #7. There were no other complications, and the patient was discharged tolerating regular diet, and in adequate pain control on po pain medications and without any anginal symptoms or dyspnea on exertion. DISCHARGE CONDITION: Good, INR 2.2. DISPOSITION: Home. DIET: Cardiac and diabetic. MEDICATIONS: 1. Aspirin 325 mg q day. 2. Percocet 3/325 [**12-24**] q4h prn. 3. Colace 100 mg [**Hospital1 **]. 4. Glucophage 1,000 mg [**Hospital1 **]. 5. Glyburide 2.5 mg q day. 6. Lipitor 20 mg q day. 7. Levoxyl 125 mcg q day. 8. Lopressor 100 mg [**Hospital1 **]. 9. Lasix 20 mg q day x10 days. 10. Potassium chloride 20 mEq q day x10 days. 11. Coumadin 7.5 mg on Monday, Wednesday, Friday, 5 mg all other days of the week. DISCHARGE INSTRUCTIONS: The patient was to followup with his cardiologist in [**12-24**] weeks time. He should address the need for diuretics as well as adjustment of cardiac medications at that time. The patient should followup with Dr. [**Last Name (STitle) 70**] in six weeks. [**First Name11 (Name Pattern1) **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **], M.D. [**MD Number(1) 75**] Dictated By:[**Last Name (NamePattern1) 5745**] MEDQUIST36 D: [**2162-2-2**] 12:31 T: [**2162-2-2**] 12:44 JOB#: [**Job Number 46560**] ICD9 Codes: 4240, 4019, 412
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Medical Text: Admission Date: [**2116-8-16**] Discharge Date: [**2116-8-19**] Date of Birth: [**2098-2-26**] Sex: M Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 3223**] Chief Complaint: Abdominal pain Major Surgical or Invasive Procedure: None History of Present Illness: 18 yo male reportedly s/p assault to his abdomen, he was taken to an area hospital and was then transferredto [**Hospital1 18**] because of his Grade III splenic laceration. Past Medical History: Denies Family History: Noncontributory Physical Exam: Upon admission: BP 128/palp HR 72 room air sats 100% GCS 15 Airway intact BS equal bilaterally Abdomen soft with guarding FAST positive Rectal tone normal MAE x4 Pertinent Results: [**2116-8-16**] 10:29PM GLUCOSE-88 LACTATE-2.3* NA+-143 K+-3.7 CL--102 TCO2-25 [**2116-8-16**] 10:29PM HGB-14.7 calcHCT-44 O2 SAT-72 CARBOXYHB-1.9 MET HGB-0.1 [**2116-8-16**] 10:25PM URINE bnzodzpn-NEG barbitrt-NEG opiates-POS cocaine-NEG amphetmn-NEG mthdone-NEG [**2116-8-16**] 10:15PM ASA-NEG ETHANOL-48* ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**2116-8-16**] 10:15PM WBC-16.9* RBC-4.31* HGB-13.4* HCT-37.7* MCV-88 MCH-31.0 MCHC-35.4* RDW-13.0 [**2116-8-16**] 10:15PM PLT COUNT-246 [**2116-8-16**] 10:15PM PT-14.3* PTT-26.1 INR(PT)-1.2* [**2116-8-16**] CT ABDOMEN AND PELVIS WITH INTRAVENOUS CONTRAST CT ABDOMEN WITH INTRAVENOUS CONTRAST: With the exception of the mild dependent atelectasis, lung bases are clear. Within the liver, there is a periportal edema, no focal lesion or sign of parenchymal hemorrhage is noted. There is a irregular linear area of low attenuation within the spleen, with a focus of high attenuation superiorly, which does not persist on delayed views, and probably reflect presence of a clot. There is perisplenic hematoma. There is no retroperitoneal hemorrhage. Kidneys enhance equally and excrete contrast normally. No filling defects are noted within the collecting systems. No sign of renal parenchymal injury is noted. The adrenal glands, pancreas, gallbladder are unremarkable. There is a high density free intraperitoneal fluid, mainly in the right paracolic gutter. Non-contrast evaluation of the small bowel is unremarkable in absence of a oral contrast. CT PELVIS WITH INTRAVENOUS CONTRAST: There is a moderate amount of free high- density fluid within the pelvis. Urinary bladder and left distal ureters unremarkable. The right distal ureter is not opacified with contrast. No contrast extravasation seen. The rectum, sigmoid colon, prostate, seminal vesicles are all unremarkable. BONE WINDOWS: No concerning lytic or sclerotic lesions are present. No fracture is appreciated. IMPRESSION: 1. Grade 3 splenic laceration and hematoma. No active arterial extravasation. 2. Moderate-to-large hemoperitoneum, centered in the right paracolic gutter, probably tracking from the splenic injury. Overall the appearance is unchanged from prior outside study of [**2116-8-16**]. Normal appearance of the bowel in absence of oral contrast. 3. No evidence of renal parenchymal injury. Brief Hospital Course: He was admitted to the Trauma service. He was kept NPO, given IV fluids; serial hematocrits and abdominal exams were followed closely. His hematocrits remained stable. He was initially given IV narcotics for pain control and was later changed to oral narcotics. His diet was advanced for which he tolerated. On HD #3 he began to complain of severe abdominal pain; a repeat abdominal CT scan was performed and was unchanged from the previous CT scan. His pain did subside and he was discharged with a prescription for Dilaudid, which he had been taking during his hospital stay. Social work was consulted due to the nature of his trauma and the alcohol associated with the incident. He was provided with explicit instruction on not participating in any contact sports of any kind because of his spleen injury; he acknowledged an understanding of these instructions. He was discharged to home and will follow up in trauma clinic within 1-2 weeks. Medications on Admission: None Discharge Medications: 1. Senna 8.6 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day) as needed for constipation. 2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day) as needed for constipation. 3. Hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*80 Tablet(s)* Refills:*0* 4. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO Q6H (every 6 hours) as needed for constipation. Discharge Disposition: Home Discharge Diagnosis: s/p Blunt trauma to abdomen Grade III splenic laceration Discharge Condition: Hemodynamically stable, tolerating a regular diet, pain controlled adequately. Discharge Instructions: DO NOT participate in any contact sports of any kind or other activities that may cause injury to your abdominal area for the next 6-8 weeks. Go to the nearest Emergecny room immediately if you become dizzy, lightheaded, feeling faint as if you are going to pass out as these may be signs of internal bleeding from your spleen injury. Return to the Emergency room if you develop fevers, chills, shortness of breath, chest pain, abdominal pain, nausea, vomting, diarrhea and/or any other symptoms that are concerning to you. Followup Instructions: Follow up next week with Dr. [**Last Name (STitle) **], Trauma Surgery. Call [**Telephone/Fax (1) 6429**] for an appointment. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 520**] MD, [**MD Number(3) 3226**] Completed by:[**2116-8-27**] ICD9 Codes: 5180
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Medical Text: Admission Date: [**2163-5-15**] Discharge Date: [**2163-5-27**] Service: VASCULAR SURGERY HISTORY OF PRESENT ILLNESS: The patient is a [**Age over 90 **]-year-old female with a one month history of right first toe pain. The patient has been recently treated with antibiotics, but this pain has not improved. She has also developed an area of ulceration on the first toe. She denied any fevers, chills, chest pain, shortness of breath, or nausea and vomiting. She also denied any claudication or rest pain, and has no history of diabetes, hypertension or coronary artery disease. She is admitted for evaluation of right first toe pain. PAST MEDICAL HISTORY: 1) Congestive heart failure, 2) Osteoarthritis, 3) Rheumatoid arthritis. PAST SURGICAL HISTORY: She is status post a right leg fracture in [**2138**] which included rodding of the tibia. ALLERGIES: No known drug allergies. MEDICATIONS: 1) lasix 40 mg po qd, 2) digoxin 0.125 po qd, 3) Aleve for pain prn. SOCIAL HISTORY: She denies tobacco use. No ETOH use. Lives alone and has children in the area. PHYSICAL EXAM: The patient is in no acute distress. Tongue is midline. Neck is supple with palpable carotids and no bruits. Chest is clear to auscultation bilaterally. Heart is regular. Abdomen is soft, nontender, nondistended. On pulse exam, she has palpable pulses bilaterally of her radial artery, femoral artery, popliteal artery. On the left, she has a palpable dorsalis pedis, and she has monophasic Doppler signals of the posterior tibial bilaterally. Her right great toe appears dusky at the tip with dry gangrene at the distal phalanges. There is no erythema or purulence. LABORATORIES ON ADMISSION: White count 8.1, hematocrit 40, BUN 26, creatinine 1.1, INR 1.2. Chest x-ray demonstrates cardiomegaly with no evidence of congestive heart failure or infiltrate. EKG - atrial fibrillation with a left bundle branch block, T waves in V1 and 2, and J-points in V3 through V5. HOSPITAL COURSE: The patient was admitted to the vascular surgery service. She was placed on broad-spectrum antibiotics and was prepared for angiography of the right lower extremity. This was done on hospital day #2 and this demonstrated mild disease of the superficial femoral artery. There was single vessel run-off via the anterior tibial and this occludes at the level of the ankle. The right peroneal occludes at the proximal calf, and the right posterior tibial artery was occluded. There was reconstitution of a markedly diffuse and diseased attenuated plantar branch. There was no dorsalis pedis, and a right tibial intramedullary rod was present during the examination. The patient was prepared for angiography in appropriate fashion with preangio Mucomyst and IV hydration. She tolerated this well. On hospital day #3, the results of this were reviewed, and the decision was made that there would be no possibility of an extra-anatomic bypass to revascularize the foot, and the decision was made that the patient would be best suited to have a below-knee amputation. She underwent a cardiology evaluation which included a Persantine MIBI which showed an ejection fraction of 68% and normal wall motion. On hospital day #5, the patient was taken to the operating room where she underwent a right below-knee amputation. She tolerated this procedure well and postoperatively was returned to the floor. On postoperative day #1, her fluids were Hep-Locked, and her diet was advanced. A physical therapy consult was obtained. On postoperative day #2, the patient was found by staff to be in respiratory distress. She had apparently aspirated during lunch, and due to her failing respiratory status she was intubated on the floor and transferred to the Intensive Care Unit. She underwent an immediate bronchoscopy in the Intensive Care Unit which demonstrated some debris within the larger bronchi and this was suctioned. She also had a bronchoalveolar lavage sent for culture which has shown no growth to date. Over postoperative day # and #4, the patient was awake, following commands, and her ventilator support was weaned. Her chest x-ray showed improvement. She was extubated on postoperative day #4 and was transferred to the VICU in stable condition. She remained hemodynamically stable and underwent a swallow study which demonstrated aspiration with thin liquids. The speech and swallow therapist recommended patient to receive ground solids and honey thickened liquids. She was also placed on aspiration precautions with her head of bed at 90??????, and supervised PO intakes. Physical therapy reassessed the patient, and her below-knee amputation stump has been healing well. She is stable and ready for discharge with aspiration precautions, and to receive physical therapy for her surgery. DISCHARGE DIAGNOSES: 1) Nonhealing right first toe ulcer. 2) Status post below-knee amputation. 3) Aspiration. 4) Emergent intubation for aspiration. 5) History of congestive heart failure. 6) History of osteoarthritis. DISCHARGE MEDICATIONS: 1) digoxin 0.125 mg po qd, 2) Levofloxacin 250 mg po qd x 7 days, 3) Protonix 40 mg po qd, 4) lasix 20 mg po qd, 5) Dulcolax 10 mg PR prn, 6) insulin sliding scale, 7) heparin 5,000 units subcu [**Hospital1 **]. DISCHARGE INSTRUCTIONS TO REHAB: 1) To receive physical therapy. 2) The right BK stump can remain with a dry dressing as needed. 3) The patient will remain in a knee immobilizer at all times until follow-up. 4) The patient may have activity as tolerated. 5) The patient will continue to remain on aspiration precautions, supervised PO intakes, and head of bed elevated at 90??????. 6) Her diet will consist of ground solids and honey thickened nectars. 7) She will follow-up with Dr. [**Last Name (STitle) 1391**] in two weeks. CONDITION ON DISCHARGE: Stable. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) **], M.D. [**MD Number(1) 4417**] Dictated By:[**Last Name (NamePattern1) 3835**] MEDQUIST36 D: [**2163-5-26**] 10:00 T: [**2163-5-26**] 08:59 JOB#: [**Job Number 49245**] ICD9 Codes: 5070, 4280
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Medical Text: Admission Date: [**2151-6-22**] Discharge Date: [**2151-6-25**] Date of Birth: [**2083-5-7**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 613**] Chief Complaint: fever, unresponsivness Major Surgical or Invasive Procedure: none History of Present Illness: This is a 68 yo M with h/o anoxic brain injury s/p cardiac arrest [**2149**], PAF, DM 2, and HTN who presents with fever and intermittent unresponsivness. Per NH notes, pt became unresponsive at 7:45 am while perfomring ADLs. Pt afebrile at the time with BP 150/83, HR 90, O2 sat 95% on RA, FS 471. He was given 10 units of lispro and became more responsive around 8:15 am. The pt also received 6 units of lispro at noon and had KUB checked given complaints of abdominal pain that revealed a distended bladder. He again had an episode of unresponsiveness at 1:30pm after lunch. At that time, he had a temperature of 100.0, HR 62, BP 180/100, RR 20, and O2 sat 93% on RA. At this point, he was transported to the ED for further evaluation. . In the ED, T 104.2 rectally, BP 194/112, HR 170, RR 24, O2 sat 91% RA. EKG revealed afib with RVR with slight ST depressions in the lateral leads. He was given 1 L of NS with improvement in his HR to 94. Foley placed with 1.5 L of urine drained. Port CXR without definitive evidence of consolidations, UA negative, CT abd/pelvis without acute inflammatory processes. Labs significant for WBC 13.9, Na 159, Cr 1.9, trop 0.79, CK 227, lactate 2.7. Given vancomycin 1 gm IV X 1, levoquin 500 mg IV X 1, flagyl 500 mg IV X 1, tylenol 1 gm PR, ASA 325 mg po X 1, metoprolol 50 mg po X 1, and a total of 3L NS and 1 L D5W with HCO3. Cardiology was consulted who felt that ACS was unlikely. As SBPs remained elevated > 180, he was started on a nitro gtt and admitted to the MICU for further care. . The pt cannot say why he was taken to the hospital and does not recall any precipitating factors of his episodes of unresponsiveness earlier today. He does report a new cough with sputum. On ROS, otherwise denies fevers, chills, headache, stiff neck, chest pain or pressure, shortness of breath, abdominal pain, nausea, vomiting, diarrhea, constipation, dysuria, and urinary frequency. No rashes. Per pt's daugther, pt has been intermittently complaining of lower abdominal pain and had an episode of emesis last Friday. He apparently was also complaining of a headache in the ED, which the pt denies. Past Medical History: 1. DM2 2. Hypertension 3. Hyperlipidemia 4. h/o VFIB arrest in [**12-18**] secondary to cocaine/EtOH use, complicated by coma, anoxic brain injury, and evidence if IMI, inferior ischemia with resultant improvement in heart function 5. Paroxysmal AFib: not on anticoagulation due to fall risk 6. Anoxic Brain Injury/Dementia 7. Pulmonary Hypertension 8. BPH with urinary retention 9. GERD Social History: Lives in [**Hospital3 537**] after cardiac arrest and anoxic brain injury. Is ambulatory though with memory delay. Legal guardian is daughter [**Name (NI) 7346**] [**Name (NI) 3924**] who is a nurse. Past h/o cocaine, EtOH use. NO IVDA. Family History: noncontributory Physical Exam: T 98.6 BP 156/90 HR 68 RR 12 O2 sat 100% 4L NC Gen - pleasant male in NAD HEENT - NCAT, sclerae anicteric, PERRL, EOMI, dry MM, OP clear, neck supple, no LAD CV - RRR, nl s1/s2, no m/r/g appreciated Lungs - coarse upper airway breath sounds bilaterally but otherwise CTA b/l Abd - Soft, NT, ND, normoactive BS, no masses or HSM appreciated Ext - no LE edema, WWP Skin - no rashes, no pressure ulcers noted Neuro - AAO X 2 (to person and place "hospital" but unable to name specific hospital, unable to state year or month, unable to say who is running for president), moving all 4 extremities purposefully Pertinent Results: IMPRESSION: No acute intra-abdominal pathology identified Brief Hospital Course: 68 yo M with h/o cardiac arrest with anoxic brain injury, PAF, HTN, and DM 2 who presents with fever, intermittent unresponsiveness, and elevated cardiac enzymes. . # Atrial fibrillation/ elevated troponin On arrival to MICU service, treated AF with RVR with lopressor 5mg IV x 2. Patient reverted to NSR without recurrence of AF. Nitro gtt was quickly weaned off, and BP stabilized with BPs 130s/70s. Covered broadly with vanc/ceftaz/azithro, with no fevers overnight. Satting 98% RA with no complaints. Much more alert, eating well. Cardiology evaluated patient and believes elevated cardiac enzymes likely due to demand ischemia from RVR. . # Aspiration pneumonia Likely aspiration event in setting unresponsiveness. Cover with levofloxacin for 7 days. Urine culture no growth, blood cultures with no growth thus far. Ambulatory saturations were above 94%. . # Urinary retention Failed 2 voiding trials. Likely related to medications, currently not on any medications which would exacerbate the problem. [**Name (NI) **] has follow up scheduled with Urology on [**2151-7-5**] with Dr. [**Last Name (STitle) **]. # Diabetes Placed back on metformin and glipizide. Needs adjustment as indicated. HgBA1c was pending at the time of discharge. . # Altered mental status Poor baseline given anoxic brain injury due to ventricular fibrillatiobn arrest. This acute change was likely related to hypertensive encephalopathy and severe hypernatremia. He was back to baseline per HCP which is the daughter. [**Name (NI) **] has short term memory problems but is easily re-oriented. . # Acute renal failure Resolved with IVF and back to baseline. . # Communication Daughter and HCP is [**Name (NI) 7346**] [**Name (NI) 3924**], [**Telephone/Fax (1) 19907**] Medications on Admission: Lasix 10 mg daily Lipitor 40 mg daily Lisinopril 2.5 mg daily Metformin 1000 mg [**Hospital1 **] Glipizide 5 mg daily Avodart 0.5 mg daily Flomax 0.4 mg qhs Pantoprazole 40 mg daily Trazodone 25 mg q2pm and qhs Metoprolol 50 mg [**Hospital1 **] Aricept 10 mg qhs Prozac 20 mg daily Reglan 5 mg prior to meals Compazine prn Lactulose qid prn Tylenol prn Duoneb prn Discharge Medications: 1. GlipiZIDE 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Finasteride 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Furosemide 20 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 4. Insulin Lispro 100 unit/mL Solution Sig: One (1) Subcutaneous ASDIR (AS DIRECTED). 5. Metformin 500 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 6. Lisinopril 5 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 7. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection TID (3 times a day). 8. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. Atorvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 10. Donepezil 5 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime). 11. Trazodone 50 mg Tablet Sig: 0.5 Tablet PO HS (at bedtime) as needed. 12. Fluoxetine 20 mg Capsule Sig: One (1) Capsule PO DAILY (Daily). 13. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 14. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed. 15. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed. 16. Lactulose 10 gram/15 mL Syrup Sig: Thirty (30) ML PO Q8H (every 8 hours) as needed for constipation. 17. Tamsulosin 0.4 mg Capsule, Sust. Release 24 hr Sig: One (1) Capsule, Sust. Release 24 hr PO HS (at bedtime). 18. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 19. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed. 20. Omeprazole 40 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day. 21. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) Inhalation Q6H (every 6 hours) as needed. 22. Ipratropium Bromide 0.02 % Solution Sig: One (1) Inhalation Q6H (every 6 hours) as needed. 23. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours) for 6 days. Discharge Disposition: Extended Care Facility: [**Hospital3 537**]- [**Location (un) 538**] Discharge Diagnosis: Health care associated pneumonia Urinary retention Diabetes mellitus type II, uncontrolled with complications Hypertension Acute renal failure Discharge Condition: stable Discharge Instructions: You were admitted with fever and abdominal pain. You are being discharged to complete 7 days levofloxacin for a pneumonia. You are leaving with a foley catheter in place given you failed 2 voding trials, you have an appointment with Dr. [**Last Name (STitle) **] [**Last Name (STitle) **] [**7-5**] of Urology to pull the foley catheter. Followup Instructions: Provider: [**First Name8 (NamePattern2) 161**] [**Name11 (NameIs) 162**] [**Name8 (MD) 163**], MD Phone:[**Telephone/Fax (1) 921**] Date/Time:[**2151-7-5**] 3:00 Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 8384**], MD Phone:[**Telephone/Fax (1) 1690**] Date/Time:[**2151-8-25**] 8:30 [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) **] MD [**MD Number(2) 617**] ICD9 Codes: 5070, 5849, 2760, 4019, 4168
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Medical Text: Admission Date: [**2187-7-23**] Discharge Date: [**2187-7-26**] Date of Birth: [**2128-7-12**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 165**] Chief Complaint: Aortic Dissection Major Surgical or Invasive Procedure: None History of Present Illness: 59 year old left handed man with h/o ascending aortic dissection (repaired in [**2182**] at [**Hospital1 2177**]), HTN and CAD s/p CABG p/w aortic dissection. The patient reported falling on [**7-21**], two days prior to presentation. He thinks he tripped on a brick and did not have difficulty getting up afterwards. That night he woke up having found that he wet his bed without tongue or extremity soreness. He does not usually wet his bed. Then on [**7-23**] @6am he was trying to get out of bed for breakfast when he fell towards the right hitting a birdcage and then eventually landed on the floor. No LOC or head trauma. He reportedly had difficulty getting back up and required help from his wife. [**Name (NI) **] figured out that his difficulty picking himself up was due to weakness in his right arm and leg. Weakness lasted approximately 30 minutes so that by the time his wife brought him to the [**Name (NI) **] at an OSH, his symptoms were gone and head CT normal. Workup at OSH, revealed an aortic dissection starting between the left carotid and left sublclavian then extending to the left common iliac artery. Patient was subsequently transferred from OSH to [**Hospital1 18**] on esmolol for further managment of type A+B aortic dissection and recent h/o TIA. Past Medical History: Aortic Aneurysm repair in [**2182**] CABG Hypertension Hyperlipidemia ?TIA Hernia repair Social History: Grew up in [**State 9512**]. Lives in [**Location 686**] but often stays with a friend who lives in [**Name (NI) 8**]. He is married wife [**Telephone/Fax (1) 69605**]. He is on disability for his ht problems. Used to work loading and unloading trucks. No tobacco, 40 oz of beer/day usually on the weekends and +cocaine use, last used [**7-23**]. Family History: Non-contributory Physical Exam: PE: 97.3 106/57 68 15 100RA sitting up in bed, NAD, pleasant NCAT, anicteric sclerae, mmm, OP clear neck supple, no carotid bruits nl S1 S2, RRR, scar from midline sternotomy incision CTAB no wheeze ABD soft +BS nontender ext nonedematous Pertinent Results: [**2187-7-23**] 07:50PM URINE BLOOD-NEG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-1 PH-7.0 LEUK-NEG [**2187-7-23**] 06:45PM GLUCOSE-83 UREA N-11 CREAT-1.0 SODIUM-140 POTASSIUM-3.9 CHLORIDE-103 TOTAL CO2-31 ANION GAP-10 [**2187-7-23**] 06:45PM cTropnT-<0.01 [**2187-7-25**] Carotid Duplex Ultrasound Duplex and color Doppler demonstrate no appreciable plaque or wall thickening involving either carotid system. The peak systolic velocities bilaterally are normal as are the ICA/CCA ratios. There is normal antegrade flow involving both vertebral arteries. [**2187-7-25**] MRA of Head Unremarkable MRA of the circle of [**Location (un) 431**] given the limitations of the exam. A preliminary report was entered into the computer by Dr. [**First Name (STitle) **] at 5:25 p.m. [**2187-7-24**] MRA chest 1. Type B aortic dissection, straddling the takeoff of the left subclavian artery, but not extending into any of the great vessels of the arch. 2. Dissection extends into the left common iliac artery. 3. Right renal artery arises from the false lumen; left renal artery as well as the celiac axis, SMA, and [**Female First Name (un) 899**] arise from the true lumen. 4. Circumaortic renal vein. Brief Hospital Course: Mr. [**Known lastname 14477**] was admitted to the [**Hospital1 18**] on [**2187-7-23**] for evaluation of his aortic dissection. He was admitted to the cardiac surgical intensive care unit and continued on an esmolol drip. The vascular surgery service was consulted for assistance in his care. A chest MRA was performed which revealed a Type B aortic dissection, straddling the takeoff of the left subclavian artery, but not extending into any of the great vessels of the arch extending into the left common iliac. The right renal artery arises from the false lumen and the left renal artery as well as the celiac axis, SMA, and [**Female First Name (un) 899**] arise from the true lumen. When compared to previous films, it was believed that these findings were consistent with an old dissection. As he had some right sided weakness, the neurology service was consulted. A carotid duplex ultrasound was obtained which revealed normal bilateral internal carotid arteries. A brain MRI was also obtained which revealed an unremarkable MRA of the circle of [**Location (un) 431**]. No evidence of stroke was found and Mr. [**Known lastname 69606**] strength and mobility remained stable. Aspirin threapy was recommended. On [**2187-7-25**], Mr. [**Known lastname 14477**] was transferred to the step down unit. His blood pressure was aggressively controlled. He continued to make steady progress and was discharged home on [**2187-7-26**]. He will follow-up with his cardiologist and primary care physician as an outpatient. Medications on Admission: Doxazosin Nifedipine Discharge Medications: 1. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 2. Clonidine 0.1 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). Disp:*90 Tablet(s)* Refills:*0* 3. Doxazosin 1 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). Disp:*30 Tablet(s)* Refills:*0* 4. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* 5. Lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 6. Nifedipine 90 mg Tablet Sustained Release Sig: One (1) Tablet Sustained Release PO DAILY (Daily). Disp:*30 Tablet Sustained Release(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: Type B aortic dissection s/p Ascending Aorta replacement [**2182**] Discharge Condition: Good. Discharge Instructions: Monitor blood pressure. Followup Instructions: Dr. [**First Name (STitle) **] in 3 months with CT Scan. Please call for scheduling: [**Telephone/Fax (1) 170**] Dr. [**Last Name (STitle) **] (Neurology) as soon as possible for additional testing [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 173**] Completed by:[**2187-8-3**] ICD9 Codes: 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6081 }
Medical Text: Admission Date: [**2197-9-17**] Discharge Date: [**2197-9-29**] Date of Birth: [**2155-11-21**] Sex: M Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 4765**] Chief Complaint: CP and SOB Major Surgical or Invasive Procedure: None History of Present Illness: 41yo m w/ hx of dilated cardiomyopathy (EF 30%), HTN, NSTEMI, and EtOH and cocaine abuse presented to OSH on [**9-14**] complaining of worsening CP and SOB over previous 48hrs. Pt first developed [**8-22**] substernal non-radiation CP he desribed as pressure. He developed SOB several hrs after onset of CP. In ED, trop was (+)and ECG notable for no ST changes with prev r-bundle. He was started on a hep ggt and pressure relieved with 1-inch nitro paste. Utox (+) for benzos, cocaine. Pt was admitted and treated for NSTEMI w/ hep drip and acute on chronic CHF exacerbation with IV lasix 40 [**Hospital1 **]. Following admission he beame increasingly confused and diaphoretic with a fever to 103.3 and was started on Zosyn and switched to ceftriaxone/azithro. BC, UC, and legionella ag sent. Legionella urine ag (+) and BG and UC no growth at 48hrs. On [**9-16**] pt noted to be somulent and diaphoretic and thought to be in opioid withdrawl. Given narcan with no response. He developed N/V thought to be [**3-16**] narcain. He was treated with IV lasix as it was believed he was fluid overloaded. He continued to be tachypneic and tachycardic with hr over 200bpm and was cardioverted with 120J. It is uncertain which rhythm he was in at this time (discharge summ says afib w/ rvr but original signout says VT, nursing said SVT, no ECG provided. He was intubated for airway protection and he was sedated with propofol. A CXR showed worsening b/l infiltrates. On transfer, pt continued to be febrile to 103, tachycardic and became hypotensive requiring phenylephrine. Pt given 250cc NS bolus in transit. ABG prior to transfer was 7.32/39.9/141/20. Past Medical History: 1. CARDIAC RISK FACTORS: (-)Diabetes, (-)Dyslipidemia, (+)Hypertension 2. CARDIAC HISTORY: -CABG:n/a -PERCUTANEOUS CORONARY INTERVENTIONS: neg cath [**2190**] -PACING/ICD: N/a 3. OTHER PAST MEDICAL HISTORY: HTN CHF Substance abuse Social History: Pt lives alone in an apt that has been described as cluttered and dirty. He has a history of cocaine and alcohol abuse, has never smoked. See social work note. Pt is presently unemployed and MA Health application is in progress. He has an involved mother and sister. Family History: No family history of early MI, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory Physical Exam: VS: T=102 BP=89/51 HR=117 RR=18 O2 sat= 100% GENERAL: Intubated and sedated HEENT: ET tube in place with visible blood. NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. No xanthalesma. NECK: Supple. Unable to assess JVP. CARDIAC: PMI located in 5th intercostal space, midclavicular line. Tachycardic with (+)s3. No murmurs, rubs. No thrills, lifts. 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: Cold to touch, b/l ecchymosis above ankle SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. . Exam at Discharge: Vitals - Tm/Tc:97.5/97.2 HR:90-100 BP:112-118/71-81 RR:20 02 sat: 96% RA In/Out: Last 24H: 2850/2258 with mult diarrhea Last 8H: 122/700 Weight: 89.7 (91.3) . HEENT: JVD at 12 cm CV: RRR, no M/R/G, distant HS Resp: clear ABD; soft, NT, pos BS Extr: no edema and feet warm, pulses palpable Pertinent Results: Admission Labs: [**2197-9-18**] 12:17AM BLOOD WBC-11.7* RBC-4.11* Hgb-12.4* Hct-36.7* MCV-89 MCH-30.2 MCHC-33.8 RDW-14.2 Plt Ct-294 [**2197-9-18**] 12:17AM BLOOD Neuts-83* Bands-6* Lymphs-8* Monos-3 Eos-0 Baso-0 Atyps-0 Metas-0 Myelos-0 [**2197-9-18**] 12:17AM BLOOD PT-14.2* PTT-60.4* INR(PT)-1.3* [**2197-9-18**] 12:17AM BLOOD Glucose-123* UreaN-49* Creat-4.7* Na-135 K-4.4 Cl-97 HCO3-23 AnGap-19 [**2197-9-18**] 12:17AM BLOOD ALT-43* AST-131* LD(LDH)-580* CK(CPK)-738* AlkPhos-50 TotBili-0.9 [**2197-9-18**] 12:17AM BLOOD CK-MB-12* MB Indx-1.6 cTropnT-0.48* [**2197-9-18**] 12:17AM BLOOD Albumin-3.1* Calcium-8.2* Phos-3.9 Mg-2.3 [**2197-9-18**] 12:32AM BLOOD Lactate-4.0* . Discharged Labs: [**2197-9-29**] 08:00AM BLOOD WBC-8.0 RBC-4.02* Hgb-11.7* Hct-35.4* MCV-88 MCH-29.1 MCHC-33.0 RDW-14.8 Plt Ct-721* [**2197-9-29**] 08:00AM BLOOD PT-30.8* PTT-150* INR(PT)-3.0* [**2197-9-29**] 08:00AM BLOOD UreaN-16 Creat-0.9 Na-140 K-3.9 Cl-109* HCO3-21* AnGap-14 [**2197-9-28**] 05:15AM BLOOD ALT-112* AST-71* AlkPhos-67 TotBili-0.4 [**2197-9-29**] 08:00AM BLOOD Mg-2.1 CXR: [**2197-9-25**]: HISTORY: Pneumonia and dilated cardiomyopathy, to assess for fluid overload. FINDINGS: In comparison with a series of films from [**9-22**] and through [**9-24**], there has been progressive decrease in the bilateral pulmonary opacifications. The right lung is almost clear with only some mild residual medially at the base. There is some more diffuse opacification involving the mid and lower zones on the left. The findings are consistent with the clinical impression of clearing of pneumonia, though there may well have been some associated elevation of pulmonary venous pressure. . ECHO [**9-18**]: The left atrium is moderately dilated. No atrial septal defect is seen by 2D or color Doppler. The estimated right atrial pressure is 0-5 mmHg. Left ventricular wall thicknesses are normal. The left ventricular cavity is severely dilated with severe global hypokinesis (LVEF = 20-25 %). The basal lateral wall contracts best. There is visual dyssnchrony. No masses or thrombi are seen in the left ventricle. The right ventricular cavity is mildly dilated with moderate global free wall hypokinesis. 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 and no aortic stenosis or aortic regurgitation. The mitral valve leaflets are structurally normal. There is no mitral valve prolapse. Mild to moderate ([**2-13**]+) mitral regurgitation is seen. There is mild pulmonary artery systolic hypertension. There is no pericardial effusion. IMPRESSION: Marked left ventricular cavity dilation with severe global hypokinesis c/w diffuse process. Mild-moderate mitral regurgitation. Pulmonary artery hypertension. . ECG [**9-22**]: Sinus rhythm with borderline prolongation of the P-R interval. Right axis deviation. Left bundle-branch block. Compared to the previous tracing of [**2197-9-20**] the heart rate has increased. Other findings are similar. Brief Hospital Course: 41yo m w/ hx of dilated cardiomyopathy (EF 30%), HTN, NSTEMI, and EtOH and cocaine abuse presented to OSH with SOB and CP,found to have legionella PNA and ectopy with an episode of sustained VT and is s/p conversion. Transferred to [**Hospital1 18**] for further EP evaluation. . #Septic Shock: Prior to transfer from OSH, patinet became hypotensive and required phenylephrine on transfer. On arrival to [**Hospital1 18**], it was believed he was most likely in septic shock secondary to legionella PNA. Levophed and vasopressin were started for BP support. Goal was to minimize levophed as pt was having ectopy in the hrs following transfer. He was sedated with Fentenyl/Versed as paramedics noted BP dropped very low with propofol prior to transfer. An IJ central line, a-line and Swan Ganz catheter were placed. Swan confirmed that shock most likely secondary to sepsis with low SVR and normal CO. On [**9-18**], pt received several fluid boluses with target CVP 8-12. BP responded with good urine output. Vasopressin was discontinued and pt kept on levophed. . #Atrial Fibrillation: Developed AF/RVR concurrent with pressor therapy requiring cardioversion to NSR where he has remained. Was initially started on amiodarone IV, then transitioned to 400mg PO TID on [**9-22**] but was eventually discontinued as pt developed a confluent rash on his back thought to be secondary to amio. He was started on warfarin with heparin bridge that was d/c'ed today for INR 3.0. Warfarin dose was cut in half today and should be continued for the next 2-3 weeks depending on cardiology input. # Legionella PNA: On admission to OSH, CXR was unremarkable. On [**9-16**] the patient became febrile to 103 and CXR showed bilateral perihilar infiltrates. ID consulted and recommended treating for CAP with ceftriaxone/Azithro. Legionella urine ag sent and was subsequently (+). BC and UC were no growth at 48hrs. He was not treated for legionella prior to transfer. After transfer to [**Hospital1 **], repeat urine ag confirmed legionella and he was started on Levofloxacin. CXR was notable for b/l perihilar infiltrates. Patient contined to be febrile w/ Tmax of 104 and cooling blanket was used. He was given acetaminophen q8hrs. Repeat CXRs showed worsening b/l infiltrates with no signs of fluid overload or pleural effusion. Blood and urine cx on admission remained negative. # Bacteremia: On [**9-23**], a routine blood culture from pt's L IJ was found to be growing gram positive cocci in clusters and he was started on vancomycin. Thought to secondary to central line infection and IJ was discontinued. He remained normotensive throughout treatment. Speciation and Sensitivity showed coag negative staff sensitive to vancomycin but resistant to several other abx. He will continue a 2 week course of vancomycin, last day to be [**10-7**]. PICC line placed and needs to be removed after ABX are finished. # Acute on Chronic Systolic CHF: Patient was SOB at OSH and was intubated prior to transfer. He remained intubated with heavy sedation due to agitation. He passed an SBT on [**9-22**] and was extubated. However, he became increasingly tachypneic and a ABG showed primary respiratory alkolosis. Pt began to decompensate and was reintubated on the morning of [**9-23**]. Tachypnea was thought to be secondary to PNA and possible fluid overload. He was diuresed with lasix drip. Benzos were weaned in hopes to imoprove AMS. Pt was extubated on [**9-25**] without complication. He saturated well and did not require supplementory 02 for the remained of CCU admission. He was restarted on his home dose of Lasix 60 mg daily and potassium supplementation and appears euvolemic with weight 89.7 kg at discharge. This should be considered his dry weight. He will need extensive teaching regarding low Na foods and medication compliance. #Arrhythmia: Patient was originally transferred to [**Hospital1 18**] following an episode of tachycardia at OSH requiring cardioversion secondary to hemodynamic instability. Folling transfer, the pt had numerous runs of NSVT. This has continued but inpproved with uptitration of metoprolol XL and potassium repletion. # NSTEMI: Patient was found to have elevated troponins (.4)prior to transfer from OSH with no ECG changes and treated for an NSTEMI. At [**Hospital1 **], it was believed the elevated cardiac markers were most likely secondary to demand ischemia in setting of spesis with underlying cardiomyopathy. Pt had reportedly had an unremarkable cath following an NSTEMI 4 years prior. Heparin ggt was stopped and pt remained on ASA. A repeat echo showed dilated cardiomyopathy with an EF of 20-25% with global LV hypokinesis. A BB and [**Last Name (un) **] were held in setting of hemodynamics and restarted when hemodynamics improved. . #Dilated cardiomyopathy: Pt has a hx of dilated cardiomyopathy most likely secondary to EtOH and cocaine abuse. Pt did have an elevated BNP to 7,000 at OSH and was treated for acute on chronic CHF exacerbation prior to transfer. Echo on [**9-18**] notable for left ventricular cavity severely dilated with severe global hypokinesis (LVEF = 20-25 %). He was positive 13L since admission and was diuresed when bp improved with good urine output. He was started back on home dose 60mg of lasix. He will need social work and counseling during his rehab stay and arrangement for addiction services after discharge. #[**Last Name (un) **]: On transfer pt's cr had doubled to 4.7. FeUrea was <35% indicating a pre renal vs intrarenal etiology. Meds were renally dosed. His renal function greatly improved over the next 48hrs with fluid boluses. Pt's renal function normal at discharge. #Transaminitis: Thought to be secondary to either legionella vs. shock liver. LFTs trended down throughout admission. #Substance abuse: Pt has a history of drug and EtOH abuse. U tox at outside hospital was notable for postive benzos, cocaine, and marjiuana. On transfer, pt was very diaphoretic, tachycardic, with liable bp. He displayed seizure like activity (eyes rolled back with flailing of extremities, no ET biting) on several occasions thought to be secondary to EtOH withdrawal. Activity was controlled with versed boluses. He was transitioned to PO valium as versed was weaned. Benzos were stopped on [**9-25**] and pt had no further withdrawal symptoms. . #HTN: BP at goal on metoprolol and [**Last Name (un) **]. Transitions of Care: 2.Patient needs a PCP in the [**Name9 (PRE) 487**] area at discharge to follow INR 3.Full Code Medications on Admission: Preadmission medications listed are correct and complete. Information was obtained from Pharmacy OSH records. 1. Aspirin 162 mg PO DAILY 2. Furosemide 60 mg PO DAILY 3. Metoprolol Tartrate 100 mg PO BID 4. Potassium Chloride 40 mEq PO DAILY Discharge Medications: 1. Furosemide 60 mg PO DAILY 2. Potassium Chloride 40 mEq PO DAILY Duration: 24 Hours Hold for K > 3. Losartan Potassium 50 mg PO DAILY 4. Metoprolol Succinate XL 200 mg PO DAILY Hold SBP < 90, HR < 60 5. Warfarin 2.5 mg PO DAILY16 6. traZODONE 50 mg PO HS:PRN insomnia 7. 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. 8. Diphenoxylate-Atropine 1 TAB PO Q6H:PRN diarrhea 9. FoLIC Acid 1 mg PO DAILY 10. Thiamine 100 mg PO DAILY 11. Vancomycin 1250 mg IV Q 8H 12. Outpatient Lab Work Please check INR at 8am on [**2197-9-30**] and check vanco level before fourth dose, goal level [**12-2**]. Discharge Disposition: Extended Care Facility: [**Hospital6 2222**] - [**Location (un) 538**] Discharge Diagnosis: Non Ischemic Cardiomyopathy Acute on Chronic Systolic congestive heart failure Legionella Pneumonia Septic Shock Coag neg Staph bacteremia Acute on Chronic Kidney Injury Atrial Fibrillation with rapid ventricular response Alcohol Withdrawal 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: You had a pneumonia that may have been caused by mold in your apartment and an infection in your blood. You recieved antibiotics for these infections but will need to receive intravenous antibiotics for the blood infection for the next 9 days. Your heart is weaker now because of your substance abuse and it is very important that you refrain from alcohol or any illegal drugs from now on to let your heart recover. The infections caused an abnormal heart rhythm called atrial fibrillation that increases your risk of stroke. Because of this, we have started you on a blood thinner called warfarin to prevent blood clots. You will need to have your blood levels of warfarin monitored closely by a health care provider. [**Name10 (NameIs) **] had too much fluid in your lungs and needed medicines to remove the extra fluid. Weigh yourself every morning, call [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] NP if weight goes up more than 3 lbs in 1 day or 5 pounds in 3 days. It is very important that you do not eat salt and avoid processed or prepared foods. A list of these foods was provided to you. Followup Instructions: Department: Primary Care Notes: Please discuss with the staff at the facility a follow up appointment with your PCP when you are ready for discharge. Department: CARDIAC SERVICES When: MONDAY [**2197-10-2**] at 10:30 AM With: DR. [**First Name8 (NamePattern2) **] [**Doctor Last Name **] [**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: 0389, 5849, 4254, 2760, 4280, 4019, 412
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Medical Text: Admission Date: [**2106-8-16**] Discharge Date: [**2106-8-18**] Date of Birth: [**2054-6-14**] Sex: M Service: NEUROSURGERY Allergies: No Allergies/ADRs on File Attending:[**First Name3 (LF) 1835**] Chief Complaint: found down Major Surgical or Invasive Procedure: none History of Present Illness: Mr. [**Known lastname 57100**] is a 52 y/o male who resides in prison was transferred to [**Hospital1 18**] from [**Hospital **] Hospital via ambulance with a known subarachnoid hemorrhage. He was reportedly found on the ground unresponsive by prison guards earlier today and at that point taken to [**Hospital **] Hospital. He was reportedly awake and conversant in the ambulance but decompensated at the OSH and was intubated. He underwent a CT of the head which revealed a subarachnoid hemorrhage and temporal hemorrhage. He received Dilantin 1gram IV x1 at [**Hospital **] Hospital. INR was 2.6. He was intubated and transferred to [**Hospital1 18**] for management. He presents intubated. Repeat head CT upon arrival showed worsening bleed. He received Prolifine/Vit K and was started on Mannitol 25mg IV Q6 while in the ED. Past Medical History: HIV positive; Hepatitis C; Mental Illness. liver disease NOS Social History: currently incarcerated Family History: unknown Physical Exam: O: BP: 111/47 HR:115 R 16 O2Sats 100% Gen: Intubated. Skin jaundice. HEENT: NCAT. PERRL 2.5-2. Extrem: Warm and well-perfused. Neuro: Mental status: Sedated and intubated (propofol held for exam). Pupils round and equal in size bilaterally. PERRL 2.5-2. Positive cough/gag and corneal reflexes bilaterally. Withdraws to pain in all four extremities; flexed in the upper extremities bilaterally. Motor: Normal bulk and tone bilaterally. No abnormal movements, tremors. Pertinent Results: [**2106-8-16**] 04:14PM URINE HOURS-RANDOM [**2106-8-16**] 03:30PM PT-24.6* PTT-39.5* INR(PT)-2.4* [**2106-8-16**] 03:30PM FIBRINOGE-125* [**2106-8-16**] 02:56PM TYPE-ART TEMP-36.7 PO2-259* PCO2-42 PH-7.43 TOTAL CO2-29 BASE XS-3 [**2106-8-16**] 02:56PM GLUCOSE-130* LACTATE-4.2* [**2106-8-16**] 02:56PM O2 SAT-99 [**2106-8-16**] 02:56PM freeCa-1.05* [**2106-8-16**] 02:30PM GLUCOSE-128* UREA N-30* CREAT-1.1 SODIUM-123* POTASSIUM-4.9 CHLORIDE-90* TOTAL CO2-26 ANION GAP-12 [**2106-8-16**] 02:30PM ALT(SGPT)-101* AST(SGOT)-288* LD(LDH)-1137* CK(CPK)-236 ALK PHOS-154* TOT BILI-8.6* DIR BILI-5.9* INDIR BIL-2.7 [**2106-8-16**] 02:30PM cTropnT-0.49* [**2106-8-16**] 02:30PM ALBUMIN-2.4* CALCIUM-7.9* PHOSPHATE-4.2 MAGNESIUM-2.6 [**2106-8-16**] 02:30PM WBC-23.5* RBC-2.53* HGB-9.0* HCT-27.4* MCV-108* MCH-35.6* MCHC-33.0 RDW-18.8* [**2106-8-16**] 02:30PM PLT COUNT-46*# [**2106-8-16**] 11:54AM TYPE-ART PO2-71* PCO2-42 PH-7.40 TOTAL CO2-27 BASE XS-0 [**2106-8-16**] 10:20AM UREA N-29* CREAT-1.2 [**2106-8-16**] 10:20AM estGFR-Using this [**2106-8-16**] 10:20AM ALT(SGPT)-122* AST(SGOT)-332* ALK PHOS-162* TOT BILI-8.7* [**2106-8-16**] 10:20AM LIPASE-68* [**2106-8-16**] 10:20AM ASA-NEG ETHANOL-NEG ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**2106-8-16**] 10:20AM WBC-21.0* RBC-3.01* HGB-10.6* HCT-32.9* MCV-109* MCH-35.1* MCHC-32.1 RDW-18.3* [**2106-8-16**] 10:20AM PLT COUNT-19* [**2106-8-16**] CT Head : There is interval increase of the bilateral frontal hemorrhagic contusions. There is interval increase of the subdural hemorrhage along the falx and tentorium. The size of the temporal hematoma on the right is unchanged. Brief Hospital Course: Mr. [**Known lastname 57100**] is a 52 year old male who was found down and unresponsive at the prison. He was transferred to [**Hospital **] Hospital and scans revealed a subarachnoid hemorhage. He was intubated and transferred to [**Hospital1 18**]. Serial CT scans show enlarging intracerebral hemorrhage in the presence of elevated INR and low platelet count. The patient was admitted to the Surgical ICU where his coagulopathy was corrected with FFP, platelets and clotting factors. On [**8-16**], The patient was able to eye open spontaneously,pupils are equal and reactive, +corneals,+cough,+gag. The patient flexes bilaterally upper extremities, the patient withdraws bilaterally in teh lower extremities. The patient did not follow commands. On [**8-17**], The patient was placed on mannitol every six hours with holding parameters for serum osmoality > 320. The patient continued on 3% saline at 30 cc/hr. In the morning the serum sodium was 125 and the goal was 135. renal/hepatology consultations were placed. A NCHCT was performed which was found to be unchanged. The lactate 11.3. Continuous dialysis was initiated per the renal service. The corrected dilantin level was 8.7 and the patient was given a Dilantin bolus of 500 mg IV dilantin. An echocardiogram was performed and was consistent with vegetation on the aortic valve and a cardiology consultation was placed. Infectious disease was consulted for findinh noted on teh echocardiogram. The patient continued vanccomycin/flagyl/micafungin for broad spectrum coverage for pneumonia and aortic vegetation. Over the evening hours the patient's lactate began to elevate to 11 and his renal function deteriotated. He was placed on CVVH. Given the evidence of progressive multiorgan failure the decision was made n conjunction with family to begin withdrawal of care. On [**8-18**] the patient's blood pressure drifted down off pressors and he passed. Medications on Admission: unknown Discharge Medications: n/a Discharge Disposition: Expired Discharge Diagnosis: Right Temporal Intracranial hemorrhage Renal Failure Endocarditis Acute on Chronic Liver Failure Hepatorenal syndrome Discharge Condition: expired Discharge Instructions: n/a n/a Followup Instructions: n/a ICD9 Codes: 0389, 486, 5849, 2875, 2762, 2761, 431, 5715
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6083 }
Medical Text: Admission Date: [**2128-4-3**] Discharge Date: [**2128-4-7**] Date of Birth: [**2071-6-3**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 943**] Chief Complaint: confusion Major Surgical or Invasive Procedure: NGT tube placed - removed [**4-5**] History of Present Illness: HPI: 56 year old male with Hep C cirrhosis transferred from [**Hospital3 3583**] with change in mental status. He was recently admitted to [**Hospital1 18**] [**Date range (1) 46019**] with encephalopathy, which improved with lactulose. 5 BM yesterday. No BRBPR, no melena, no vomiting, no hemetemesis, no abdominal pain, no F/C/R. At 5 a.m. on DAT, wife unable to arouse him from sleep and called 911. He was transported to [**Hospital3 **], where HCT 21.7 (from 32.5 [**2128-3-29**]). NG lavage (-), gauiac (-). He received 1uPRBC, 100 g lactulose down NGT, and levofloxacin 500 mg IV X 1 and transferred to [**Hospital1 18**]. In [**Hospital1 18**] ED, gauiac (-), NG lavage pink-tinged w/o clots or evidence of active bleeding. * Past Medical History: PMHx 1) Cirrhosis [**2-18**] HCV: awaiting liver transplant - [**2127-11-20**] EGD petechiae and erythema in antrup and pyloris c/w hemorrhagic gastritis; portal gastropathy - [**2126-8-20**] cls: wnl - currently enrolled in clinical trial Tolvaptan for chronic hyponatremia 2) Chronic HCV: likely [**2-18**] IVDU - s/p INF/ribavarin [**2126**]; d/c'd [**2-18**] low plt/alb 3) Depression 4) PVD 5) h/o CHF: [**11-19**] TTE: mod LA/RA dilation, mild sym LVH, minimal AS, trivial MR, trivial TR 6) Type II DM 7) HTN 8) s/p cervical spine fusion 9) s/p appendetomy 10) s/p laryngeal polyp removal 11) Arthritis 12) Barrett's esophagus * Social History: The patient actively smokes a pipe/day x 30 yrs, no ETOH, no IVDU for past 30 yrs, lives w/ wife, has 2 grown children (21yo and 25yo), retired rec center worker.Wife: [**Name (NI) **] (?[**Telephone/Fax (1) 46017**] Family History: brother - MI age 45 father - MI age 67 no h/o liver dz or cancers Physical Exam: PE: Temp: 98.3 BP: 100/58 HR: 68 RR; 20 99% on RA gen: awake, able to answer questions, AEO x 2 HEENT: +icteric scleric, NGT tube in place CV: RRR, nl s1, s2, no m/r/g Resp: cta-blt Abd: slightly distended, soft, nt, nabs Ext: no c/c, 1+ edema blt Pertinent Results: Abd CT: bibasilar atelectasis, small amt ascites, gynecomasty, cirrhotic liver, spleen enlarged, splenorenal shung, SC edema. No RP bleed. CXR: no infiltrate effusion, pulmonary edema * [**2128-4-3**] 02:15PM URINE RBC-21-50* WBC-21-50* BACTERIA-MOD YEAST-NONE EPI-0-2 [**2128-4-3**] 02:15PM URINE BLOOD-LG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-SM UROBILNGN-NEG PH-6.5 LEUK-TR [**2128-4-3**] 02:15PM URINE COLOR-LtAmb APPEAR-Hazy SP [**Last Name (un) 155**]-1.020 [**2128-4-3**] 02:15PM FIBRINOGE-96.0* [**2128-4-3**] 02:15PM PT-15.6* PTT-45.2* INR(PT)-1.5 [**2128-4-3**] 02:15PM PLT COUNT-54* [**2128-4-3**] 02:15PM ANISOCYT-2+ POIKILOCY-1+ MACROCYT-3+ [**2128-4-3**] 02:15PM NEUTS-78.0* BANDS-0 LYMPHS-14.1* MONOS-7.1 EOS-0.4 BASOS-0.3 [**2128-4-3**] 02:15PM WBC-6.8 RBC-3.22* HGB-11.1* HCT-32.9* MCV-102* MCH-34.5* MCHC-33.7 RDW-19.1* [**2128-4-3**] 02:15PM AMMONIA-170* [**2128-4-3**] 02:15PM calTIBC-174* HAPTOGLOB-<20* FERRITIN-1167* TRF-134* [**2128-4-3**] 02:15PM TOT PROT-5.3* CALCIUM-8.0* PHOSPHATE-3.0 MAGNESIUM-1.9 IRON-170* [**2128-4-3**] 02:15PM LIPASE-33 [**2128-4-3**] 02:15PM ALT(SGPT)-61* AST(SGOT)-72* LD(LDH)-312* ALK PHOS-110 AMYLASE-31 TOT BILI-10.7* [**2128-4-3**] 02:15PM GLUCOSE-181* UREA N-28* CREAT-1.0 SODIUM-138 POTASSIUM-4.7 CHLORIDE-108 TOTAL CO2-24 ANION GAP-11 [**2128-4-3**] 03:20PM LACTATE-3.5* [**2128-4-3**] 05:30PM HCT-34.6* [**2128-4-3**] 05:49PM HGB-9.2* calcHCT-28 [**2128-4-3**] 05:49PM LACTATE-2.2* [**2128-4-3**] 05:49PM TYPE-ART PO2-97 PCO2-31* PH-7.48* TOTAL CO2-24 BASE XS-0 [**2128-4-3**] 06:07PM URINE RBC-21-50* WBC-21-50* BACTERIA-MANY YEAST-NONE EPI-0-2 [**2128-4-3**] 06:07PM URINE BLOOD-LG NITRITE-NEG PROTEIN-TR GLUCOSE-NEG KETONE-TR BILIRUBIN-MOD UROBILNGN-1 PH-6.5 LEUK-SM [**2128-4-3**] 06:07PM URINE COLOR-Amber APPEAR-Hazy SP [**Last Name (un) 155**]-1.019 [**2128-4-3**] 10:45PM HCT-32.4* Brief Hospital Course: 1) Change in MS:likely hepatic encephalopathy, originally it was thought that this may have been precipitated by UTI. Patient had a dirty UA and was originally treated with levofloxacin, however cultures grew out coag neg staph (likely staph epi), thus levo was stopped after 5 days. CXR (-). Head CT (-) at OSH. Blood cx, ucx, sputum cx showed no growth. Patient had an NGT placed with lactulose q 2hours, with good result. Patient quickly became more oriented and therefore NGT was pulled and patient was allowed to eat. Patient was dc'ed on lactulose QID. * 2) Anemia: HCT stable 32-34 while in ICU, following 1 u PRBC at OSH, HCT 21.7 -> 34.6; it was thought that thet HCt of 21.7 likely represents lab error at OSH While in the hospital, patient was both gauic (-) and w/ (-) NG lavage; benign abd exam (-) abd CT. After being transferred to floor, patient hct was 28, but no signs of bleed. It was attributed to fluid shifts (as patient had received fluids secondary to being dry) and closely monitored. * 3) Cirrhosis: Patient was continued on rifaximin, propranolol, ursodiol (initially held). He was also continued on spironolactone, furosemide. Patient was also continued on the experimental drug, tolvartan. * 4) Type II DM: RISS and with glargine. Medications on Admission: 1. Propranolol HCl 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 2. Ursodiol 300 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 3. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 4. Furosemide 80 mg Tablet Sig: One (1) Tablet PO qd. Disp:*30 Tablet(s)* Refills:*2* 5. Rifaximin 200 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). Disp:*120 Tablet(s)* Refills:*2* 6. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours) for 1 days. Disp:*1 Tablet(s)* Refills:*0* 7. TOLVAPTAN Sig: Sixty (60) QD (). 8. Lactulose 10 g/15 mL Syrup Sig: Thirty (30) ML PO four times a day. Disp:*3600 ML(s)* Refills:*1* 9. medications continue all diabetes meds as previously prescribed 10. Spironolactone 100 mg Tablet Sig: One (1) Tablet PO twice a day. Disp:*60 Tablet(s)* Refills:*2* Discharge Medications: 1. Propranolol HCl 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 2. Ursodiol 300 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 3. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 4. Furosemide 80 mg Tablet Sig: One (1) Tablet PO qd. Disp:*30 Tablet(s)* Refills:*2* 5. Rifaximin 200 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). Disp:*120 Tablet(s)* Refills:*2* 6. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours) for 1 days. Disp:*1 Tablet(s)* Refills:*0* 7. TOLVAPTAN Sig: Sixty (60) QD (). 8. Lactulose 10 g/15 mL Syrup Sig: Thirty (30) ML PO four times a day. Disp:*3600 ML(s)* Refills:*1* 9. medications continue all diabetes meds as previously prescribed 10. Spironolactone 100 mg Tablet Sig: One (1) Tablet PO twice a day. Disp:*60 Tablet(s)* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Hepatic encephalopathy 1) Cirrhosis [**2-18**] HCV: awaiting liver transplant - [**2127-11-20**] EGD petechiae and erythema in antrup and pyloris c/w hemorrhagic gastritis; portal gastropathy - [**2126-8-20**] cls: wnl - currently enrolled in clinical trial Tolvaptan for chronic hyponatremia 2) Chronic HCV: likely [**2-18**] IVDU - s/p INF/ribavarin [**2126**]; d/c'd [**2-18**] low plt/alb 3) Depression 4) PVD 5) h/o CHF: [**11-19**] TTE: mod LA/RA dilation, mild sym LVH, minimal AS, trivial MR, trivial TR 6) Type II DM 7) HTN 8) s/p cervical spine fusion 9) s/p appendetomy 10) s/p laryngeal polyp removal 11) Arthritis 12) Barrett's esophagus Discharge Condition: stable Discharge Instructions: Please call your doctor or come to ED if you develop chest pain, shortness of breath, confusion, nausea, vomiting, fevers, abdominal pain Please call your doctor or come to ED if you develop chest pain, shortness of breath, confusion, nausea, vomiting, fevers, abdominal pain Followup Instructions: Provider: [**Name10 (NameIs) **] [**Name8 (MD) **], MD Where: LM [**Hospital Unit Name 5628**] Phone:[**Telephone/Fax (1) 673**] Date/Time:[**2128-4-22**] 11:00 Follow up with [**First Name8 (NamePattern2) 19313**] [**Last Name (NamePattern1) 11805**] for tolvapatan study in early [**Month (only) 547**] Your labs should be drawn an [**Hospital3 3583**] next Monday, 28th Completed by:[**2128-4-7**] ICD9 Codes: 5715, 4280, 5990, 2761, 2859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6084 }
Medical Text: Admission Date: [**2119-5-1**] Discharge Date: [**2119-5-9**] Date of Birth: [**2059-11-3**] Sex: M Service: Cardiac Surgery CHIEF COMPLAINT: Mitral valve disease. HISTORY OF PRESENT ILLNESS: The patient is a 59-year-old male with a prior cardiac history including ASD repair in [**2099**], mitral valve disease, atrial fibrillation/flutter, status post ablation. He was followed by serial echocardiograms and a recent echocardiogram showed EF greater than 55% with moderate to severe mitral regurgitation. He was schedule for mitral valve replacement. PAST MEDICAL HISTORY: Mitral valve disease, atrial fibrillation, status post ablation. PAST SURGICAL HISTORY: ASD repair in [**2099**]. ALLERGIES: None known. MEDICATIONS: Aspirin 325 mg q d, Zestril 10 mg q d, Amiodarone 200 mg q d. HOSPITAL COURSE: The patient underwent mitral valve replacement with a #27 mosaic valve on [**2119-5-1**]. He was transferred to the CSRU post-operatively. He was A-paced on arrival in the CSRU with intermittent loss of capture, with hypotension. His underlying rhythm was junctional in the 40's. AV pacing was attempted but ventricular ectopic activity occurred. There was loss of both A and V capture with inappropriate sensing despite various measures. He continued to be bradycardic with hypotension. He was started on Dopamine, and emergent pacing Swan was placed with appropriate pacing and sensing. He was also started on Dopamine drip. He was extubated later on in the same day. His hemodynamic status stabilized. He was seen by Dr. [**Last Name (STitle) **] who is his regular electrophysiologist. Subsequently he continued to be V paced with complete heart block. He was continued on his Amiodarone. A tentative decision was made for pacemaker placement because of the complete heart block. On postoperative day #3 he had converted to a junctional rhythm and was maintaining his blood pressure. He was transferred to the regular floor on postoperative day #3 in a junctional rhythm with pacing wires. He was hemodynamically stable at this point. On postoperative day #4 he converted to atrial fibrillation. His Amiodarone dose was increased per EP and he was started on a Heparin infusion. Decision was made for cardioversion on [**2119-5-8**]. The following days he remained hemodynamically stable while awaiting therapeutic PTT with Heparin and he continued to be in atrial fibrillation. On [**2119-5-8**], postoperative day #7, he underwent cardioversion successfully. He converted to a sinus rhythm with a prolonged PR interval. He was stable with this rhythm. He was deemed ready for discharge by both electrophysiology and cardiac surgery on postoperative day #8. He was discharged home on postoperative day #8. DISCHARGE MEDICATIONS: Lasix 20 mg q day times one week, KCL 20 mEq q d times one week, Colace 100 mg [**Hospital1 **], Aspirin, enteric coated, 325 mg q d, Amiodarone 400 mg q d for one day followed by 200 mg q d, duration to be decided by EP, Percocet 1-2 tablets q 4-6 hours prn. CONDITION ON DISCHARGE: Stable. FO[**Last Name (STitle) **]P: His primary care physician in two weeks, Dr. [**Last Name (STitle) **], Dr. [**Last Name (Prefixes) **] in four weeks. [**Doctor Last Name 412**] [**Last Name (Prefixes) 413**], M.D. [**MD Number(1) 414**] Dictated By:[**Last Name (NamePattern1) 2209**] MEDQUIST36 D: [**2119-5-9**] 20:28 T: [**2119-5-9**] 21:19 JOB#: [**Job Number 18071**] ICD9 Codes: 4240, 9971, 4168
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6085 }
Medical Text: Admission Date: [**2166-4-1**] Discharge Date: [**2166-4-5**] Date of Birth: [**2103-9-7**] Sex: F Service: CARDIOTHORACIC Allergies: morphine / Percocet Attending:[**First Name3 (LF) 1505**] Chief Complaint: Shortness of Breath Major Surgical or Invasive Procedure: [**4-1**]: Mitral valve repair with a 26 mm Future CG annuloplasty ring. History of Present Illness: 62 year old female with no significant past medical history who developed palpitations 2 years ago which was initially treated with beta blockade. Over the past year, she has noted progressive dyspnea on exertion and exercise intolerance. She has also noted worsening palpitations which prompted a referral to a cardiologist in [**Month (only) 216**] where her beta blocker was changed. As she continued to not feel well, she was seen by another cardiologist who performed an echocardiogram which revealed moderate to severe mitral regurgitation. Given the findings, her primary care physician has referred her to Dr. [**Last Name (STitle) **] for surgical evaluation. Past Medical History: 1. CARDIAC RISK FACTORS: Dyslipidemia, Hypertension 2. CARDIAC HISTORY: -CABG: no -PERCUTANEOUS CORONARY INTERVENTIONS: no -PACING/ICD: no 3. OTHER PAST MEDICAL HISTORY: Fibromyalgia nephrolithiasis hiatal hernia hypercholesterolemia hypothyroidism headaches Social History: Race: Caucasian Last Dental Exam: Every 6 months Lives with: Husband in [**Name2 (NI) 17927**] Occupation: Teacher Tobacco: Never ETOH: Social Caffeine: One beverage per day Family History: Father with sudden death at 58. Both son's age 28-30 with palps and one apparently need to be "shocked" at a gym Physical Exam: Pulse: 63 Resp: 16 O2 sat: 98% B/P Right: 124/83 Left: 138/77 Height: 63" Weight: 175 lbs General: NAD WDWN Skin: Warm, Dry, intact. No lesions and rashes. HEENT: NCAT, PERRLA, EOMI, sclera anicteric, OP benign, teeth in good repair. Neck: Supple [X] Full ROM [X] No JVD Chest: Lungs clear bilaterally [X] Heart: RRR, Nl S1-Split S2, II/VI late systolic murmur Abdomen: Soft [X] non-distended [X] non-tender [X] bowel sounds + [X] Extremities: Warm [X], well-perfused [X] No Edema Varicosities: None [X] SPider varicosities Neuro: Grossly intact [X] 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: None Left: None Pertinent Results: [**2166-4-1**]: PREBYPASS: 62 year old female for mitral valve repair. Moderate to severe mitral insufficiency is present. Depending on the loading conditions, the degree of MR varied between moderate and severe. Vena contracta in the ME long axis view measured >0.7cm consistent with severe MR, and the left atrium was dilated for this small women (4.6cm). The mechanism of MR was consistent with Type 3b [**Last Name (un) 3843**] leaflet motion with billaterl restriction of the leaflets, and a central MR jet. The other valves were essentially normal. There was normal LV systolic function with an LVEF>55% with no segmental wall motion abnormalities. The RV was mildly dilated, but RV function was preserved. LV diastolic function was preserved with E'>8 cm/sec. E/E' = 10. Normal transmitral inflow velocites with E>A, and Normal pulmonary venous flow. There was mild descending thoracic aortic atherosclerosis, with no significant aortic dilaton and NO dissection seen. The interatrial septum was intact. The coronary sinus was of normal size and should be adequate for antegrade cardioplegia. POSTBYPASS: S/P mitral valve repair with ring. No MR. [**First Name (Titles) **] [**Last Name (Titles) **] with mean gradient of [**3-21**] mmHg. Normal systolic funciton on no inotropes. LVEF>55% No dissection seen following decannulation of the aorta. No significant valvular problems or wall motion changes were observed following chest closure. [**2166-4-3**] 04:55AM BLOOD WBC-11.3* RBC-2.85* Hgb-9.2* Hct-25.8* MCV-90 MCH-32.1* MCHC-35.6* RDW-14.2 Plt Ct-143* [**2166-4-3**] 04:55AM BLOOD Glucose-115* UreaN-15 Creat-0.8 Na-137 K-4.3 Cl-104 HCO3-25 AnGap-12 Brief Hospital Course: The patient was admitted to the hospital and brought to the operating room on [**4-1**] where the patient underwent mitral valve repair with a 26 mm Future CG annuloplasty ring. Overall the patient tolerated the procedure well and post-operatively was transferred to the CVICU in stable condition for recovery and invasive monitoring. POD 1 found the patient extubated, alert and oriented and breathing comfortably. The patient was neurologically intact and hemodynamically stable on no inotropic or vasopressor support. Beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. The patient was transferred to the telemetry floor for further recovery. Chest tubes and pacing wires were discontinued without complication. The patient was evaluated by the physical therapy service for assistance with strength and mobility. By the time of discharge on POD 4 the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. Dilaudid was changed to Ultram and Ibuprofen due to nausea. The patient was discharged home with services in good condition with appropriate follow up instructions and appointments. Medications on Admission: CLONAZEPAM - (Prescribed by Other Provider) - 0.5 mg Tablet - 0.5 (One half) Tablet(s) by mouth once a day EZETIMIBE [ZETIA] - (Prescribed by Other Provider) - 10 mg Tablet - 1 Tablet(s) by mouth once a day LEVOTHYROXINE - (Prescribed by Other Provider) - 75 mcg Tablet - 1 Tablet(s) by mouth once a day NADOLOL - (Prescribed by Other Provider) - 20 mg Tablet - 1 Tablet(s) by mouth twice a day ROSUVASTATIN [CRESTOR] - (Prescribed by Other Provider) - 5 mg Tablet - 1 Tablet(s) by mouth once a day TRIAMTERENE-HYDROCHLOROTHIAZID - (Prescribed by Other Provider) - 75 mg-50 mg Tablet - 1 Tablet(s) by mouth once a day ASPIRIN - (Prescribed by Other Provider) - 325 mg Tablet - 1 Tablet(s) by mouth once a day Discharge Medications: 1. aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*100 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 2. metoprolol tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). Disp:*30 Tablet(s)* Refills:*2* 3. furosemide 40 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* 4. potassium chloride 20 mEq Tablet, ER Particles/Crystals Sig: One (1) Tablet, ER Particles/Crystals PO twice a day. Disp:*60 Tablet, ER Particles/Crystals(s)* Refills:*0* 5. ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* 6. levothyroxine 75 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 7. ezetimibe 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 8. rosuvastatin 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 9. clonazepam 0.5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 10. ferrous sulfate 300 mg (60 mg Iron) Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* 11. senna 8.6 mg Tablet Sig: 1-2 Tablets PO BID (2 times a day) as needed for constipation. Disp:*60 Tablet(s)* Refills:*0* 12. tramadol 50 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for pain. Disp:*30 Tablet(s)* Refills:*0* 13. ibuprofen 600 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours) as needed for pain. Disp:*30 Tablet(s)* Refills:*0* 14. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day) as needed for constipation. Disp:*60 Capsule(s)* Refills:*0* 15. acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed for pain. Discharge Disposition: Home With Service Facility: [**Location (un) 2203**] VNA Discharge Diagnosis: Coronary Artery Disease Discharge Condition: Alert and oriented x3 nonfocal Ambulating with steady gait Incisional pain managed with Ultram, Tylenol, Ibuprofen Incisions: Sternal - healing well, no erythema or drainage 1+ Edema Discharge Instructions: 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 Please NO lotions, cream, powder, or ointments to incisions Each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart No driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive No lifting more than 10 pounds for 10 weeks Please call with any questions or concerns [**Telephone/Fax (1) 170**] Females: Please wear bra to reduce pulling on incision, avoid rubbing on lower edge **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) **] on [**4-24**] at 1:30pm Cardiologist: Dr [**Last Name (STitle) 1923**] on [**4-25**] at 11:10am. Please call to schedule appointments with your Primary Care Dr. [**First Name (STitle) 1356**] in [**4-22**] 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** Completed by:[**2166-4-5**] ICD9 Codes: 4240, 2724, 4019, 2449
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6086 }
Medical Text: Admission Date: [**2184-3-27**] Discharge Date: [**2184-3-28**] Service: NEUROSURGERY Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 1271**] Chief Complaint: unresponsive Major Surgical or Invasive Procedure: none History of Present Illness: 88yo woman with PMH CAD on plavix was found down by her daughter at 7AM today. Initially she was arousable and complained of headache. She was taken to OSH by ambulance where she reportedly decompensated in the ED requiring intubation. BP was recorded as 184/84. Head CT revealed large posterior fossa IPH. She was life flighted to [**Hospital1 18**] and Neurosurgery consultation was requested. Past Medical History: Celiac Disease CAD DM Pacemaker Hysterectomy MI s/p stents and plasty. most recently in [**2179**] @ [**Hospital1 2025**] Social History: married, lives with husband and daughter. no e/t/d Family History: non-contributory Physical Exam: PHYSICAL EXAM: GCS: E-3 V-1 M-6 O: BP: 184/84 HR: 83 R 14 O2Sats 100% Gen: Intubated and sedated (prop held for exam) HEENT: Pupils: 3mm sluggish b/l. + corneals, + gag Neck: hard collar Extrem: Warm and well-perfused Neuro: Mental status: EO to voice Cranial Nerves: II: Pupils equally round and reactive to light 3mm, very sluggish mm bilaterally. Motor: MAE's. B/L UE's antigravity to command On Discharge: No [**Last Name (LF) **], [**First Name3 (LF) 2995**] to noxious Pertinent Results: [**2184-3-27**] 03:00PM PLT COUNT-226 [**2184-3-27**] 03:00PM PT-13.8* PTT-18.8* INR(PT)-1.2* [**2184-3-27**] 03:00PM NEUTS-92.9* LYMPHS-4.2* MONOS-1.9* EOS-0.6 BASOS-0.4 [**2184-3-27**] 03:00PM WBC-10.3 RBC-3.86* HGB-12.2 HCT-35.5* MCV-92 MCH-31.5 MCHC-34.3 RDW-13.6 [**2184-3-27**] 03:00PM CALCIUM-9.6 PHOSPHATE-3.1 MAGNESIUM-1.3* [**2184-3-27**] 03:00PM CK-MB-3 cTropnT-<0.01 [**2184-3-27**] 03:00PM CK(CPK)-48 [**2184-3-27**] 03:00PM estGFR-Using this [**2184-3-27**] 03:00PM GLUCOSE-186* UREA N-20 CREAT-1.0 SODIUM-136 POTASSIUM-4.5 CHLORIDE-102 TOTAL CO2-21* ANION GAP-18 [**2184-3-27**] 03:08PM GLUCOSE-181* LACTATE-3.1* K+-4.7 [**2184-3-27**] 03:45PM TYPE-ART PO2-252* PCO2-38 PH-7.38 TOTAL CO2-23 BASE XS--1 INTUBATED-INTUBATED [**2184-3-27**] 05:40PM URINE MUCOUS-RARE [**2184-3-27**] 05:40PM URINE RBC-1 WBC-125* BACTERIA-FEW YEAST-NONE EPI-<1 RENAL EPI-<1 [**2184-3-27**] 05:40PM URINE BLOOD-NEG NITRITE-POS PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.5 LEUK-LG [**2184-3-27**] 05:40PM URINE COLOR-Straw APPEAR-Hazy SP [**Last Name (un) 155**]-1.026 CHEST (PORTABLE AP) Study Date of [**2184-3-27**] 2:50 PM FINDINGS: Endotracheal tube ends 3.0 cm above the carina. An NG tube passes beyond the GE junction into the antrum of the stomach. There are low lung volumes but no evidence of pleural effusion or pneumothorax. Mild left retrocardiac opacity likely represents atelectasis. IMPRESSION: 1. ET tube ends 3 cm above the carina. 2. Left basilar opacity, likely atelectasis, but aspiration is not excluded. CTA HEAD W&W/O C & RECONS Study Date of [**2184-3-27**] 3:38 PM Preliminary Report !! WET READ !! No evidence of aneuryms. However, reformats which are necessary for interpretation are still pending. CT HEAD W/O CONTRAST Study Date of [**2184-3-27**] 11:12 PM Findings compatible with rapidly-evolving obstructive hydrocephalus due to extensive intraventricular hemorrhage, predominately in the fourth ventricle, with extension into prepontine cisterns and occipital horns. Focal hemorrhage may also be present in the left cerebellum. Left parietal and left supratentorial subdural hemorrhage are not well seen on preceding outside exam. Brief Hospital Course: Pt was admitted to the neurosurgery service for close observation. Upon admission a discussion was held with the daughter (official HCP). She wished to make her mother DNR. She was told the risk of developing hydrocephalus and need for EVD placement. She said she would think about this but was not sure if she would want to proceed with it. Overnight on [**3-27**] - [**3-28**] the patient became less responsive. A head CT was obtained which revealed developing hydrocephalus. The daughter was [**Name (NI) 653**] and said that she did not want to proceed with the EVD. The patient was made CMO at that time and extubated at approximately 6AM. The daughter [**Name (NI) 653**] the ICU later in the morning and requested that the patient be transferred to [**Hospital3 15402**] so that she would be closer to home. The bed facilitator was [**Hospital3 653**] and once transport was arranged she was discharged. Medications on Admission: Medications prior to admission: Nitroglycerine Plavix glucophage metoprolol gemfibrozil alprazolam isosorbide mononitrate flagyl Discharge Medications: 1. morphine (PF) in D5W 100 mg/100 mL (1 mg/mL) Parenteral Solution Sig: 5-20 mg Intravenous TITRATE TO (titrate to desired clinical effect (please specify)). 2. scopolamine base 1.5 mg Patch 72 hr Sig: One (1) Patch 72 hr Transdermal ONCE (Once) for 1 doses. 3. midazolam in 0.9 % NaCl 1 mg/mL Solution Sig: 5-20 mg Intravenous TITRATE TO (titrate to desired clinical effect (please specify)). Discharge Disposition: Extended Care Discharge Diagnosis: cerebellar hemorhage, hydrocephelus Discharge Condition: Activity Status: Bedbound. Level of Consciousness: Lethargic but arousable. Mental Status: Confused - always. Discharge Instructions: Pt is DNR/DNI and CMO. Transfer to [**Hospital3 15402**] per family's request. Followup Instructions: N/A [**Name6 (MD) 742**] [**Name8 (MD) **] MD [**MD Number(2) 1273**] Completed by:[**2184-3-28**] ICD9 Codes: 431
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Medical Text: Admission Date: [**2168-6-23**] Discharge Date: [**2168-6-24**] Date of Birth: [**2131-1-26**] Sex: F Service: MICU DISCHARGE DIAGNOSES: 1. Hypercapnia. 2. Breast biopsies. 3. Status post pneumonectomy. CHIEF COMPLAINT: PCO2 equal to 89 on an arterial blood gas in the operating room. HISTORY OF PRESENT ILLNESS: This is a 37-year-old female admitted for outpatient breast biopsy on the 24th when an arterial blood gas checked at the end of her procedure showed a pCO2 of 89. The total arterial blood gas was 7.18, pCO2 89, pO2 173. Patient was monitored under LMA. Conscious sedation, breathing at her own rate. PAST MEDICAL HISTORY: 1. Tuberculosis at the age of 16, she was treated with 4-5 drugs in [**Country 651**] for 6-9 months. 2. Status post a left pneumonectomy in [**2160**] for a chronically scarred and infected left lung. 3. Pulmonary hypertension, baseline lung values after her pneumonectomy included baseline arterial blood gas of 7.39, 57, 62, and spirometry of a FEV1 of 0.88 liters which is 32% of predicted and a FVC 0.91 which is 26% of predicted. The patient has a baseline bicarb on her Chem-7 approximately 30-35. Based on the elevated pCO2, patient was admitted for close observation to the Intensive Care Unit. MEDICATIONS: Albuterol as needed. ALLERGIES: Tetracycline causes a rash. FAMILY HISTORY: Noncontributory. SOCIAL HISTORY: No tobacco or alcohol, immigrated from [**Country 651**] in [**2155**]. She is a homemaker. She lives with her husband, who is a chef and her son. PHYSICAL EXAMINATION ON ADMISSION: Vital signs: Temperature 96.6, heart rate 92, blood pressure 103/65, respiratory rate 16, oxygen saturation 98-100% on room air. Physical examination was remarkable for a thin Asian woman in no acute distress. Cardiac examination: A 1/6 systolic ejection murmur at the left upper sternal border with a physiologically split S2. Lungs were clear on the right and absent breath sounds on the left. Remainder of examination was normal. RELEVANT LABORATORY DATA: Preoperative complete blood count was normal. Arterial blood gas at 3:30 pm: 7.18/89/173. At 04:02 pm, arterial blood gas: 7.24/78/199. Arterial blood gas was done while the patient was breathing spontaneously. Partial chemistries were all within normal limits. Portable chest x-ray was unchanged from prior. ASSESSMENT ON ADMIT: Patient is status post a pneumonectomy with baseline CO2 retention with a pCO2 approximately 50-55 admitted to the Intensive Care Unit with an elevated pCO2 for close observation of her mental status and respiratory distress. HOSPITAL COURSE: Patient was monitored closely overnight in the Intensive Care Unit with continuous pulse oximetry and close monitoring by the nursing staff. The patient did well without any complaints. She had no respiratory complaints or desaturations or other problems. [**Name (NI) **] further laboratories were checked overnight. In the morning, the patient had no complaints. Was feeling well and looked to be in her usual state of health. The baseline arterial blood gas was performed to establish a baseline for further future reference. This arterial blood gas came back as pH 7.42, pCO2 54, pO2 69, that was done on room air. Patient was discharged in good condition on the 25th. She is to followup with her primary care physician [**Last Name (NamePattern4) **] [**1-5**] weeks, and her pulmonologist, Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 8325**] also in [**1-5**] weeks. Prescriptions for Tylenol #3 for pain as needed, and will continue on her albuterol. DISCHARGE DIAGNOSES: 1. Bilateral breast biopsies. 2. Status post pneumonectomy in [**2160**]. 3. Carbon dioxide retention. DR.[**Last Name (STitle) **],[**First Name3 (LF) **] 02-319 Dictated By:[**Last Name (NamePattern1) 8228**] MEDQUIST36 D: [**2168-6-24**] 10:58 T: [**2168-7-5**] 14:44 JOB#: [**Job Number 8326**] ICD9 Codes: 4168
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6088 }
Medical Text: Admission Date: [**2153-5-23**] Discharge Date: [**2153-5-26**] Date of Birth: [**2092-4-12**] Sex: F Service: MEDICINE Allergies: Compazine / Droperidol / Gadolinium-Containing Agents / Demerol / Morphine / Haldol Attending:[**First Name3 (LF) 1666**] Chief Complaint: Chest pain, shortness of [**First Name3 (LF) 1440**], abdominal pain, nausea, vomiting Major Surgical or Invasive Procedure: None History of Present Illness: Ms. [**Known lastname **] is a 60yo female with PMH significant for Mast Cell Degranulation Syndrome with history of multiple flares who presents with SOB, chest pain, abdominal pain, and flushing. Per patient, these symptoms are consistent with her typical flare. She has an allergist at [**Hospital1 112**]. She was recently discharged from [**Hospital1 18**] on [**5-17**] after presenting with similar symptoms. She came to the hospital because she was extremely nauseous and was not able to take her oral medications. She did inject herself with an EpiPen prior to coming to the emergency room. She has symptoms almost every day but got worse yesterday evening. No recent viral illness. In the ED initial vitals were T 99 BP 191/120 AR 122 RR 30 O2 sat 100% RA. She immediately received Benedryl 50mg, Albuterol neb, Dilaudid 2mg IV, Solumedrol 80mg IV, and Zofran 4mg IV. She received an additional Solumedrol 80mg IV and Dilaudid 6mg IV. She is being transferred to the MICU for further management. Past Medical History: 1)Mast cell degranulation syndrome (MCDS) *** EMERGENCY PLAN *** (as posted in chart) administer: 1. Epinephrine 0.3cc of 1/1000 SC and repeat x3 at 5 min intervals if BP <90 systolic in setting of flare 2. Benadryl 25-50 IV q4 hr for 24-48 hrs 3. Solu-medrol 80mg IV/IM 4. Oxygen by mask or cannula 5. Albuterol nebs q2-4 hr prn 6. Dilaudid 2mg IV q 3hrs or PCA pump 7. Zofran 8mg IV q 12h for 24-48 hrs PRE-MEDICATION for major/minor procedures: 1. Prednisone 50mg po q24 hrs and 1-2 hours prior to surgery 2. Benadryl 25-50mg 1 hour prior to surgery 3. Ranitidine 150mg 1 hour prior to surgery 2)Depression/anxiety 3)Bipolar disorder 4)MI in [**2147**] after receiving cardiac arrest dose epi instead of anaphylactic dose epi 5)HTN 6)Erosive osteoarthritis 7)GERD, gastritis and esophagitis on recent EGD [**2151-1-8**] 8)Paradoxical Vocal Cord Dysfunction viewed on fiberoptic 9)laryngoscopy 9)Anemia, iron studies c/w AOCD 10)Hemorrhoids 11)EGD with vegetable bezoar (?[**12-7**]) 12)Status post hysterectomy and oophorectomy 13)h/o MRSA infection (porthacath associated) 14)portacath placed [**3-8**] - d/c'd [**2-3**] MRSA infection; portacath replaced [**2151-6-9**] Social History: Born and raised in [**State 4260**]. Father is still living. Has 3 sibs. Pt divorced approx 2 [**State 1686**] ago after 37 [**State 1686**] of marriage. Husband was doctor. Pt had worked at magazine and as preschool teacher. Currently works as ED tech at [**Hospital 2436**] Hosp. Denies legal problems, denies h/o abuse. Son is HCP [**Telephone/Fax (1) 21738**]. Family History: Mother died of MI @ 76, Sister w/ breast cancer and bilateral mastectomy. Physical Exam: vitals T 98 BP AR 106 RR 16 O2 sat 97% RA Gen: Patient appears tired, currently in no acute distress HEENT: Dry mucous membranes Heart: RRR, no m,r,g Lungs: Poor air movement posteriorly, scattered wheezes Abdomen: Soft, NT/ND, +BS Extremities: Mild 1+ bilateral LE edema, swelling of PIP/DIP joints consistent with underlying osteoarthritis, multiple areas of ecchymosis on upper extremities Pertinent Results: [**2153-5-23**] 03:45AM WBC-6.4 RBC-3.74* HGB-10.2* HCT-32.8* MCV-88 MCH-27.3 MCHC-31.2 RDW-16.0* [**2153-5-23**] 03:45AM NEUTS-95.0* LYMPHS-3.6* MONOS-1.2* EOS-0.2 BASOS-0.1 [**2153-5-23**] 03:45AM PLT COUNT-255 [**2153-5-23**] 03:45AM CK-MB-NotDone cTropnT-<0.01 [**2153-5-23**] 03:45AM cTropnT-<0.01 [**2153-5-23**] 03:45AM ALT(SGPT)-22 AST(SGOT)-16 CK(CPK)-63 ALK PHOS-96 TOT BILI-0.2 [**2153-5-23**] 03:45AM LIPASE-32 [**2153-5-23**] 03:45AM GLUCOSE-237* UREA N-15 CREAT-0.9 SODIUM-142 POTASSIUM-3.7 CHLORIDE-110* TOTAL CO2-22 ANION GAP-14 [**2153-5-23**] 03:45AM BLOOD cTropnT-<0.01 . CXR [**2153-5-23**] - Right-sided port again seen with tip overlying the cavoatrial junction. Cardiac and mediastinal contours are unchanged. Pulmonary vascularity is within normal limits. There are no focal consolidations or large pleural effusions. Linear opacities at the bases bilaterally suggests atelectasis. IMPRESSION: No evidence of focal consolidation. Brief Hospital Course: Ms. [**Known lastname **] is a 59 y.o. F with h/o Mast Cell Degranulation Syndrome presented with typical MCDS symptoms including SOB, chest, abdominal pain, diarrhea, admitted to MICU for close monitoring. 1)Mast Cell Degranulation Syndrome: The patient presented with nausea/ vomiting, flushing, chest pain, SOB, and diarrhea; these symptoms are consistent with her usual flares. Per protocol she received Zofran, dilaudid, Solu-medrol, Albuterol nebs, O2 by NC, and benadryl. She was continued on these medications on transfer to the ICU. She did not received any additional steroids. The MICU team spoke with Dr. [**Last Name (STitle) **], the allergist here at [**Hospital1 18**] who has seen the patient on prior admissions. He felt that her current medication regimen was reasonable, and he also felt that she there is a major anxiety component. She will need follow-up with her allergist at [**Hospital6 **] who is an expert in this field. The patient continued to have recurrent complaints of dyspnea and headache, responsive to benadryl and dilaudid IV. She also had episoded in which she appeared markedly anxious, with no evidence of flushing, developing tachypnea followed by dyspnea which were resolved with ativan 1mg IV, consistent with panic attack. Prior to discharge, she had another episode of dyspnea and tachypnea, and requested treatment with epinephrine via epipen, IV benadryl, IV dilaudid, IV solumedrol, and albuterol per protocol with resolution of symptoms. She wanted to proceed with her discharge home after this episode which occurred while she was waiting for her discharge paperwork to be competed. 2)Hypertension: Continued on Diltiazem. 3)Anxiety/Depression: Patient has symptoms suggestive of anxiety and/or panic attacks. She has been evaluated by psychiatry in the past and was thought to have bipolar disorder. She was continued on Duloxetine. She was also started on Valium as well. 4)Postmenopausal symptoms: Continued outpatient regimen of Premarin. 5)Osteoarthritis: Patient is followed closely by Dr. [**Name (NI) 9620**] here in rheumatology. She was continued on Plaquenil. Medications on Admission: Diltiazem HCl 180mg PO daily Premarin 0.3mg PO daily Hydroxyzine 25mg PO QID Ranitidine 150mg PO QHS Duloxetine 30mg PO daily Hydroxychloroquine 200mg PO BID Amphetamine-Dextroamphetamine 15mg PO daily Fexofenadine 180mg PO BID Omeprazole 20mg PO BID Zolpidem 10mg PO QHS Zofran 8mg PO TID Asmanex Twisthaler twice a day. Dilaudid 4mg PO every 4-6 hours as needed for pain. Fioricet 50-325-40mg PO Q6H PRN Ativan 0.5mg PO Q4-6 hours PRN Benadryl 25mg PO Q4-6H PRN Albuterol MDI Ferrous Sulfate 325mg PO BID Zyflo 600mg PO QID Discharge Medications: 1. Diltiazem HCl 180 mg Capsule, Sustained Release Sig: One (1) Capsule, Sustained Release PO DAILY (Daily). 2. Conjugated Estrogens 0.3 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Hydroxychloroquine 200 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 4. Duloxetine 30 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 5. Hydroxyzine HCl 25 mg Tablet Sig: One (1) Tablet PO four times a day. 6. Ranitidine HCl 150 mg Capsule Sig: One (1) Capsule PO at bedtime. 7. Fexofenadine 180 mg Tablet Sig: One (1) Tablet PO twice a day. 8. Zolpidem 10 mg Tablet Sig: One (1) Tablet PO at bedtime as needed for insomnia. 9. Zofran 8 mg Tablet Sig: One (1) Tablet PO three times a day. 10. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: One (1) Tablet PO DAILY (Daily). 11. Calcium Carbonate 500 mg Tablet, Chewable Sig: Two (2) Tablet, Chewable PO BID (2 times a day). 12. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours) as needed. 13. Diphenhydramine HCl 25 mg Capsule Sig: One (1) Capsule PO Q4H (every 4 hours) as needed for flare. 14. Albuterol 90 mcg/Actuation Aerosol Sig: One (1) Inhalation every four (4) hours as needed for shortness of [**Name (NI) 1440**] or wheezing. 15. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO twice a day. Amphetamine-Dextroamphetamine 15mg PO daily Zyflo 600mg PO QID Discharge Disposition: Home Discharge Diagnosis: Primary: - Mast Cell Degranulation Syndrome . Secondary: - Hypertension - GERD - Anemia - Bipolar disorder - Depression Discharge Condition: Clinically improved, afebrile, VSS Discharge Instructions: You were admitted with shortness of [**Name (NI) 1440**] and chest pain concerning for a flare of your mast cell degranulation syndrome. Your medications have not changed. Please continue to take your medication as directed. . Please maintain your scheduled follow up listed below. . Please seek medical attention if you experience any fevers > 101, chills, increasing chest pain or shortness of [**Name (NI) 1440**], abdominal pain, flushing, or any other concerning symptoms. Followup Instructions: Please follow up with Dr. [**Last Name (STitle) **] in the Allergy Department of [**Hospital6 1708**] on [**2153-7-19**] at 10:30am in the [**Location (un) 55**] Office. Please call [**Telephone/Fax (1) 21743**] with any questions. . Please maintain your scheduled follow up listed below: Provider: [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) **], MD Phone:[**Telephone/Fax (1) 2226**] Date/Time:[**2153-6-4**] 1:30 Provider: [**Name10 (NameIs) **] [**Name8 (MD) **], MD Phone:[**Telephone/Fax (1) 463**] Date/Time:[**2153-8-22**] 1:20 [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1672**] MD, [**MD Number(3) 1673**] ICD9 Codes: 4019
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Medical Text: Admission Date: [**2124-2-29**] Discharge Date: [**2124-3-29**] Date of Birth: [**2055-8-23**] Sex: M Service: MEDICINE Allergies: Penicillins Attending:[**First Name3 (LF) 9598**] Chief Complaint: hypotension Major Surgical or Invasive Procedure: s/p central line placement x 2 (HD catheter) History of Present Illness: Mr. [**Known lastname 2795**] is a 68 yo with met renal cell carc admitted on [**2124-2-29**] for week 2 of high dose IL-2 therapy. His last dose was complicated by shock requiring dopamine and brief atrial fibrillation, spontaneously reverting back when dopamine was changed to neo. His current course was given from [**2-29**] to [**3-4**] and has been complicated by nausea/vomiting, encephalopathy, diarrhea, rigors, and desquamation, but also by hypotension in the 70s systolic requiring neo for 90 min on [**3-2**] and restarted again on [**3-5**], ARF with decreasing UOP (355 total cc's on [**3-5**], none on [**3-4**], + ~ 14L LOC but without detailed recording of his UOP), and progressive metabolic acidosis despite bicarb infusion. Vancomycin was started empirically in the setting of severe dermatitis, and he has been on prophylactic cipro throughout his stay. His last dose 9am on [**3-4**]. His Cr has risen progressively from 1.9 on admission to 6.6 on the evening of transfer. Because of his progressive renal failure, dopamine was added to improve renal perfusion. He was also transiently in afib. His Tmax during his stay has been 99.5 on [**3-1**] with no other elevated temps, though he has been intermittently around 95F. . REVIEW OF SYSTEMS: (+)ve: as per HPI (-)ve: chest pain, palpitations, rhinorrhea, nasal congestion, cough, sputum production, hemoptysis, dyspnea, orthopnea, paroxysmal nocturnal dyspnea, constipation, hematochezia, melena, dysuria, urinary frequency, urinary urgency, focal numbness, focal weakness Past Medical History: metastatic renal cell carcinoma, s/p nephrectomy. metastatic to lung, adrenal gland, brain. s/p cyberknife [**12-19**]. Bleeding ulcers HTN Hyperlipidemia GERD Diverticulosis Migraines Barrett's esophagus Anemia with folate deficiency Appendectomy in [**2076**] Hemorrhoidectomy [**2094**] Back surgery in [**2113**] Vasectomy Social History: He is a chief of police in [**Location (un) 82875**] Police. He is married and he is seen with his wife today. [**Name2 (NI) **] has two adult children. He does not smoke. He has about five to eight glasses of bourbon weekly. Family History: No history of any kidney cancer, but his mother had ovarian cancer, no obvious signs of Burkitt lymphoma, who is now healthy. Physical Exam: 97.8 119 105/44 16 100%2L . PHYSICAL EXAM GENERAL: dry and desquamated HEENT: Normocephalic, atraumatic. conjunctival erythema. No scleral icterus. PERRLA/EOMI but tracks slowly and incompletely. mucous membranes dry. OP clear. Neck Supple, No LAD, No thyromegaly. CARDIAC: Regular rhythm, tachycardic. Normal S1, S2. 2/6 SEM in RUSB, rubs or [**Last Name (un) 549**]. JVP=flat LUNGS: CTAB, good air movement biaterally anteriorly. ABDOMEN: hypoABS. Soft, NT, ND. No HSM EXTREMITIES: diffuse [**3-15**]+edema, 2+ dorsalis pedis/ posterior tibial pulses. SKIN: diffuse erythema and desquamation. skin breakdown on grown and buttocks. NEURO: A&Ox3 though with difficulty with word finding. Appropriate. CN 2-12 intact. Preserved sensation throughout. [**6-14**] strength throughout. Gait assessment deferred PSYCH: Listens and responds to questions appropriately . Pertinent Results: [**2124-2-29**] 09:49AM PT-13.9* PTT-21.6* INR(PT)-1.2* [**2124-2-29**] 09:49AM PLT COUNT-386# [**2124-2-29**] 09:49AM WBC-8.0 RBC-3.21* HGB-9.5* HCT-29.3* MCV-91 MCH-29.6 MCHC-32.4 RDW-13.9 [**2124-2-29**] 09:49AM ALBUMIN-3.4* CALCIUM-8.1* PHOSPHATE-3.2 MAGNESIUM-2.0 [**2124-2-29**] 09:49AM ALT(SGPT)-19 AST(SGOT)-21 LD(LDH)-169 CK(CPK)-55 TOT BILI-0.6 [**2124-2-29**] 09:49AM estGFR-Using this [**2124-2-29**] 09:49AM GLUCOSE-121* UREA N-17 CREAT-1.6*# SODIUM-144 POTASSIUM-4.1 CHLORIDE-112* TOTAL CO2-25 ANION GAP-11 [**2124-3-24**] hand x-ray No previous images. The distal [**Hospital1 **] and adjacent soft tissues are essentially within normal limits on the images presented. No evidence of erosions or dystrophic calcification. [**2124-3-23**] CT abd/pelvis 1. Small bowel dilation without a clear transition point to suggest mechanical obstruction. A 7 cm segment of small bowel wall thickening may represent ischemia, infection, or inflammation. A repeated CT with i.v. contrast may help evaluate the transit of oral contrast as well as the mesenteric vasculature 2. Nasogastric tube just passed the gastroesophageal junction. Consider reposition of nasogastric tube in the body of the stomach. 3. Metastatic disease, incompletely evaluated on this non-contrast study. 4. Bibasilar consolidative opacity concerning for pneumonia 5. Florid colonic diverticulosis without evidence of diverticulitis. 6. Decrease in size of right adrenal nodule suggestive of response to therapy. 7. Extensive therosclerotis including coronary artery, abdominal aorta and mesenteric vessels. [**2124-3-23**] MRI head 1. Near-complete interval resolution of the enhancing lesion within the left anterior temporal lobe. Only minimal residual enhancement and FLAIR signal hyperintensity persist. No new enhancing lesions are identified. TTE [**2124-3-6**]: The left atrium is elongated. Left ventricular wall thickness, cavity size, and global systolic function are normal (LVEF>55%). Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. There is no ventricular septal defect. Right ventricular chamber size and free wall motion are normal. The ascending aorta is mildly dilated. There is no aortic valve stenosis. No aortic regurgitation is seen. The mitral valve appears structurally normal with trivial mitral regurgitation. The pulmonary artery systolic pressure could not be determined. There is a small pericardial effusion. There are no echocardiographic signs of tamponade. TTE [**2124-3-8**]: IMPRESSION: small pericardial effusion located mostly posterior to the left ventricle. There is minimal fluid anterior to the right ventricle. There is significant, accentuated respiratory variation in mitral/tricuspid valve inflows, which can be consistent with impaired ventricular filling but is more likely due to the irregularity of the heart rate. There is no frank tamponade seen. Normal biventricular function. No evidence of endocarditis although the valves are not well seen. Compared with the prior study (images reviewed) of [**2124-3-6**], this is a limited study. The valves are not well seen. The patient remains tachycardic but is now in atrial fibrillation. The size of the pericardial effusion is similar Renal Ultrasound [**2124-3-6**]: 1. No hydronephrosis of the right kidney. Left kidney is surgically absent. CXR [**2124-3-6**]: Lung volumes are lower, pulmonary vasculature more engorged, and distended mediastinal veins, unchanged, pointing toward volume overload or cardiac decompensation. A more focal opacity at the left lung base laterally would be better evaluated after hemodynamic status is optimized. It could be a small region of infection or infarction, pleural effusion, or transient atelectasis. Heart is top normal size, though increased since yesterday. Right subclavian line ends in the upper SVC. No pneumothorax. CT head/chest non-con [**2124-3-7**]: Slightly decreased vasogenic edema in region of known left temporal lobe metastasis. 1. Extensive new strikingly peripheral/subpleural ground-glass opacities with a slight upper lobe predominance is highly suggestive of drug-induced toxicity (likely IL-2 drug-induced eosinophilic lung disease). The more confluent lower lobe opacities are most suggestive of atelectasis, although infection cannot be excluded by imaging. 2. Persistent findings suggestive of vascular engorgement with mild interstitial edema and small bilateral pleural effusions. 3. No significant interval change to some of the previously noted metastatic lesions with many of the previously noted foci obscured by the new lung parenchymal opacities. Slight enlargement of prevascular lymph nodes can be seen in the setting of underlying pulmonary edema/elevated CVP. CXR [**2124-3-8**]: FINDINGS: As compared to the previous examination, a new central venous access line has been inserted over the left anterior jugular vein. The tip of the line projects over the upper SVC. There is no evidence of complication, notably no pneumothorax. The other monitoring and support devices are in unchanged position. Also unchanged is the size of the cardiac silhouette and the bilateral multifocal parenchymal opacities. The retrocardiac opacity could have minimally increased in the interval. Lower Extremity U/S: IMPRESSION: No evidence of DVT in either lower extremity. Left peroneal vein not well visualized. BAL: Bronchial lavage, right mid lobe: NEGATIVE FOR MALIGNANT CELLS. Bronchial epithelial cells, pulmonary macrophages, and neutrophils; no viral inclusions noted. CXR [**2124-3-11**]: Tip of the endotracheal tube is no less than 48 mm from the carina, standard placement for patient of this size. Diffuse infiltrative pulmonary abnormality, more pronounced in the perihilar right lung has progressed could by virtue of asymmetry be pneumonia rather than pulmonary edema, although pulmonary vascular congestion is present. The heart is moderately enlarged. Moderate right pleural effusion is stable. Right jugular line ends in the low SVC, left jugular line in the mid SVC, nasogastric tube passes below the diaphragm and out of view. Mediastinal widening in the right lower paratracheal station is due to a combination of adenopathy and venous engorgement. Portable Abdomen [**2124-3-10**]: FINDINGS: Supine AP abdomen radiograph demonstrates a nasogastric tube following a normal course and terminating in the distal stomach. There is no evidence of pneumoperitoneum. The bowel gas shadow appears unremarkable [**2124-3-6**] 7:08 am URINE Source: Catheter. **FINAL REPORT [**2124-3-8**]** URINE CULTURE (Final [**2124-3-8**]): ESCHERICHIA COLI. 10,000-100,000 ORGANISMS/ML [**2124-3-7**] 4:21 pm URINE Source: Catheter. **FINAL REPORT [**2124-3-8**]** URINE CULTURE (Final [**2124-3-8**]): NO GROWTH DIRECT INFLUENZA A ANTIGEN TEST (Final [**2124-3-7**]): Negative for Influenza A. DIRECT INFLUENZA B ANTIGEN TEST (Final [**2124-3-7**]): Negative for Influenza B. [**2124-3-8**] 4:22 am STOOL CONSISTENCY: SOFT Source: Stool. **FINAL REPORT [**2124-3-10**]** FECAL CULTURE (Final [**2124-3-9**]): NO SALMONELLA OR SHIGELLA FOUND. CAMPYLOBACTER CULTURE (Final [**2124-3-10**]): NO CAMPYLOBACTER FOUND. CLOSTRIDIUM DIFFICILE TOXIN A & B TEST (Final [**2124-3-8**]): Feces negative for C.difficile toxin A & B by EIA. (Reference Range-Negative). [**2124-3-9**] 10:09 am BRONCHOALVEOLAR LAVAGE GRAM STAIN (Final [**2124-3-9**]): NO POLYMORPHONUCLEAR LEUKOCYTES SEEN. 1+ (<1 per 1000X FIELD): GRAM POSITIVE COCCI. IN PAIRS. RESPIRATORY CULTURE (Final [**2124-3-11**]): ~1000/ML Commensal Respiratory Flora. POTASSIUM HYDROXIDE PREPARATION (Final [**2124-3-9**]): Test cancelled by laboratory. PATIENT CREDITED. This is a low yield procedure based on our in-house studies if pulmonary Histoplasmosis, Coccidioidomycosis, Blastomycosis, Aspergillosis or Mucormycosis is strongly suspected, contact the Microbiology Laboratory (7-2306). Immunoflourescent test for Pneumocystis jirovecii (carinii) (Final [**2124-3-9**]): NEGATIVE for Pneumocystis jirovecii (carinii).. FUNGAL CULTURE (Preliminary): NO FUNGUS ISOLATED. VIRAL CULTURE: R/O CYTOMEGALOVIRUS (Preliminary): No Virus isolated so far. [**2124-3-9**] 10:09 am Rapid Respiratory Viral Screen & Culture **FINAL REPORT [**2124-3-11**]** Respiratory Viral Culture (Final [**2124-3-11**]): 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 [**2124-3-9**]): Negative for Respiratory Viral Antigen. Specimen screened for: Adeno, Parainfluenza 1, 2, 3, Influenza A, B, and RSV by immunofluorescence. Refer to respiratory viral culture for further information. [**2124-3-9**] 12:11 pm SPUTUM Site: ENDOTRACHEAL Source: Endotracheal. GRAM STAIN (Final [**2124-3-9**]): >25 PMNs and <10 epithelial cells/100X field. NO MICROORGANISMS SEEN. RESPIRATORY CULTURE (Final [**2124-3-11**]): NO GROWTH. FUNGAL CULTURE (Preliminary): NO FUNGUS ISOLATED. [**2124-3-6**] 2:29 am BLOOD CULTURE Source: Line-R SCTL -> MSRA (+) [**2124-3-10**]: VRE blood culture from a-line [**2124-3-11**], [**2124-3-12**] blood cultures pending Brief Hospital Course: #. Shock: Felt initially most likely due to sepsis and he was covered broadly with antibiotics. Initially broadened antibiotics to vanc/levo/cefepime to cover above sources. Goal CVP was [**9-21**], MAP > 65. Initial central venous O2 saturation was 91%. Patient was transferred from floor to ICU on dopamine and neo; dopamine was converted to levophed. Pulsus was normal at 5. Echocardiogram as above, largely unremarkable. Hypotension persisted and was thought to be septic in etiology with IL-2 distributive physiology contributing. Shock was refractory to fluid boluses; received normal saline and water with bicarb given renal failure. Blood cultures eventually grew out MRSA, successive cultures negative until [**2124-3-10**], with [**2124-3-10**] culture growing vancomycin-resistant Enterococcus. During this time, patient was actually weaned off pressors. The right subclavian triple lumen was removed and a right internal jugular triple lumen was placed. Goals of care were discussed with family, who requested continued aggressive treatment. Linezolid replaced vancomycin for VRE bacteremia. The patient's pressures stabilized and pressors were discontinued. He did not have further hypotension after transfer to the oncology floor. # MRSA/VRE bacteremia: S/p line removals; Patient completed 15 day course of linezolid. Also added Meropenem on [**3-24**] given MS decline and asterixis. Antibiotics were d/c'd on [**3-25**] and patient has been stable, afebrile without leukocytosis since. Repeat blood and urine cultures have been negative. # partial/early SBO: On [**3-25**] patient developed worsening abdominal distention and confusion. This early SBO was likely due to narcotics though concerning that is ongoing and limiting nutrition. MRI head with improved findings. An NGT was placed for 24 hours and the patient's MS cleared as did his SBO. There was initially some concern for messenteric ischemia given guiaic positive stool, known necrotic fingers and subsequent CT abd findings, so GI and surgery were consulted. Patient however soon improved clinically so further work-up with colonoscopy was not done. He was able to tolerate a regular diet for 48H prior to discharge. A PICC had been placed for access and for ability to start TPN if needed, however TPN was never started. # Anemia: likely multifactorial due to poor nutrition, acute nutrition, and marrow suppression. Patient is also FOB+ s/p 2U PRBC since [**3-17**]. then another 1U [**3-24**]. He was continued on iron, folate and B12 on [**3-27**]. Mr. [**Known lastname 2795**] did have guiaic positive stools during admission which should be followed-up by gastroenterology as an outpatient. # gangrene: [**3-14**] pressors, shock as below. Patient was treated with wound care and transitioned to a fentanyl patch with breakthrough morphine for pain. # thrombocytopenia: Resolved. Likely due to myelosuppression. # coagulopathy: Patient was supplemented with vitamin K X3 days to decrease his INR. # Respiratory failure- Patient was intubated electively in setting of persistent hypervolemia and renal failure. Maintained on minimal ventilatory support during dialysis. Patient received antibiotic coverage for aspiration pneumonia. The patient was extubated on [**2124-3-15**] and continued to improve significantly. The patient was called out to the OMED floor team for further managment. #. ARF: IL-2 mediated ARF most likely, however prerenal or postrenal etiology also possible. K wnl, phos elevated though stable from last draw. Patient likely had IL-2 induced renal injury, with possible ischemic acute tubular necrosis. Despite aggressive fluids, renal function did not improve. Patient was showing signs of uremia and hypervolemia, and continuous [**Last Name (un) **]-venous hemodialysis was started following intubation and placement of HD line. On the last days of admission he did not require diuresis and continued to auto-diurese with a creatinine of 1.1-1.3. He was not continued on his anti-hypertensives as his SBPs were 130-140. Mr. [**Known lastname 2795**] should have his renal function checked as an outpatient in the next 1-2 weeks. If there are concerns with worsening kidney function as an oupatient, he should be followed by renal. # Atrial fibrillation with rapid ventricular response- Occurred on morning of [**2124-3-7**]. Became more hypotensive, received two attempts at DC cardioversion, transient sinus rhythm restored, then converted back into a. fib. Amiodarone load and drip was started. Converted to sinus rhythm day later, maintained on amio drip. Cardiac enzymes were flat, lower extremity ultrasound negative for DVT. Repeat TTE showed no right heart strain. The amiodarone drip was discontinued and the patient remained in normal sinus rhythm. #. HA/MS changes: Known metastatic disease to brain and IL-2 can cause swelling. He is AOx3, though slightly agitated. Clinical picture not c/w meningitis/encephalitis and most likely toxic-metabolic. CT head showed slight improvement in metastatic disease, less vasogenic edema. Lumbar puncture was deferred given intracranial mass. As patient stayed on the oncology floor his mental status gradually returned to [**Location 213**]. He can have a formal neurocognitive outpatient work-up if deemed necessary by his PCP. # skin/eye/mucous membrane breakdown: Patient developed significant skin breakdown, particularly on his fingertips likely due to pressors and IL-2. He was evaluated by plastic surgery and hand x-ray found no need for intervention. He was continued on: nystatin, miconazole, benadryl, sarna, Hydrocerin, HydrOXYzine, eye drops, Gelclair. #. RCC: finished week 2 of IL-2. Maintained contact with outpatient oncologist. CODE STATUS: Full (confirmed) Medications on Admission: MEDICATIONS upon transfer: Hydrocerin 1 Appl TP QID:PRN dry skin 50 mEq Sodium Bicarbonate/1000 ml D5 1/2 NS Continuous at 75 ml/hr HydrOXYzine 25-50 mg PO/NG Q6H:PRN pruritis Lorazepam 0.5-1 mg PO/IV Q4H:PRN Acetaminophen 975 mg PO Q6H prn Meperidine 25-50 mg IV Q2H:PRN Rigors Artificial Tears Preserv. Free 1-2 DROP BOTH EYES PRN Morphine Sulfate 1-2 mg IV Q2H:PRN pain Ciprofloxacin HCl 250 mg PO/NG Q24H Pantoprazole 40 mg PO Q24H DOPamine 4 mcg/kg/min IV DRIP Phenylephrine 1 mcg/kg/min IV DRIP DiphenhydrAMINE 25-50 mg PO/IV Q6H:PRN pruritis Diphenoxylate-Atropine [**2-12**] TAB PO PRN after each loose stool Prochlorperazine 10 mg PO/IV Q6H:PRN nausea/vomiting Erythromycin *NF* 5 mg/g OU TID Sarna Lotion 1 Appl TP QID:PRN pruritus Gabapentin 100 mg PO/NG TID pruritus Gelclair 15 mL ORAL TID:PRN mucositis *Stopped* Aldesleukin 47.4 Million Units IV Q8H on Days 1, 2, 3, 4 and 5. . Home Medications: lipitor 20mg diltiazem 240mg [**Hospital1 **] folate 1mg qday protonix 40mg qday triamterene/hydrochlorothiazide 75/50mg qday valsartan 320mg qday vit C 1g qday citrucel 1g [**Hospital1 **] cyanocobalamin 1g sc monthly Discharge Medications: 1. Lipitor 20 mg Tablet Sig: One (1) Tablet PO once a day. 2. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 4. Cyanocobalamin 1,000 mcg/mL Solution Sig: One (1) Injection once a month: next due [**4-24**]. 5. Vitamin C 1,000 mg Tablet Sig: One (1) Tablet PO once a day. 6. Diphenhydramine HCl 25 mg Capsule Sig: [**2-12**] Capsules PO Q6H (every 6 hours) as needed for pruritis. Disp:*60 Capsule(s)* Refills:*0* 7. Lorazepam 0.5 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for nausea/vomiting, insomnia or anxiety. Disp:*30 Tablet(s)* Refills:*0* 8. White Petrolatum-Mineral Oil Cream Sig: One (1) Appl Topical QID (4 times a day) as needed for dry skin. Disp:*QS 1 month* Refills:*0* 9. Oral Wound Care Products Gel in Packet Sig: Fifteen (15) ML Mucous membrane TID (3 times a day) as needed for mucositis. Disp:*QS 1 month* Refills:*0* 10. Hydroxyzine HCl 25 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for pruritis. Disp:*60 Tablet(s)* Refills:*0* 11. Camphor-Menthol 0.5-0.5 % Lotion Sig: One (1) Appl Topical QID (4 times a day) as needed for pruritus. Disp:*QS 1 month* Refills:*2* 12. Acetaminophen 650 mg Tablet Sig: One (1) Tablet PO every six (6) hours as needed for pain: do note take more than 4 grams per day. Disp:*120 Tablet(s)* Refills:*0* 13. Ferrous Gluconate 325 mg (37.5 mg Iron) Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 14. Fentanyl 25 mcg/hr Patch 72 hr Sig: One (1) Patch 72 hr Transdermal Q72H (every 72 hours): remove previous patch before applying. Do not drive while using this. Disp:*20 Patch 72 hr(s)* Refills:*0* 15. Morphine 15 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*60 Tablet(s)* Refills:*0* 16. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 17. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 18. Polyethylene Glycol 3350 17 gram/dose Powder Sig: One (1) pkt PO DAILY (Daily) as needed for constipation. Disp:*60 pkt* Refills:*2* 19. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for constipation. Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 20. ZOFRAN ODT 8 mg Tablet, Rapid Dissolve Sig: One (1) Tablet, Rapid Dissolve PO every eight (8) hours as needed for nausea. Disp:*30 Tablet, Rapid Dissolve(s)* Refills:*1* Discharge Disposition: Home With Service Facility: [**Hospital **] health care Discharge Diagnosis: Primary: Metastatic RCCA - s/p C1W2 HD IL-2 therapy Secondary: VRE/MRSA sepsis acute renal failure, resolved SBO, resolved peripheral necrosis of digits acute mental status changes, resolved Discharge Condition: Alert, oriented, ambulatory Discharge Instructions: You were admitted to [**Hospital1 69**] for IL-2 therapy for your Renal Cell Carcinoma. While you were here you had a very complicated hospital course. -You developed bacteria in your blood and you were treated with antibiotics for MRSA and VRE. You have finished your courses of antibiotics and your blood cultures have been normal. -You had a UTI with e-coli and you were treated with antibiotics. Your urine cultures have since been normal. -You needed dialysis. Your kidney function has since improved and your creatinine was 1.2 at discharge. This should be monitored closely and you should see a renal doctor if it worsens. -You were in the intensive care unit and you were intubated for confusion. This improved. You should ask Dr. [**Last Name (STitle) **] if neurocognitive evaluation is needed. -You had necrosis (damage) to your fingertips from some of the medications in the ICU. Plastic surgery saw you and your finger tips started to improve. -You also had skin damage to your sacrum (above your buttocks) from the IL-2. The VNA services should help you change these dressings. While you were here some of your medications were changed. You should CONTINUE taking: lipitor 20mg folate 1mg qday protonix 40mg qday vit C 1g qday cyanocobalamin 1g sc monthly (you received this on [**3-27**]) You should STOP taking: citrucel 1g [**Hospital1 **] diltiazem 240mg [**Hospital1 **] triamterene/hydrochlorothiazide 75/50mg qday valsartan 320mg qday You should START taking: Benadryl, hydroxyzine, camphor-methol, petrolatum-mineral oil as needed for itching Lorazepam as needed for nausea, vomiting or anxiety (do not drive or drink alcohol while taking this) oral care and wound care products tylenol as needed for pain ferrous gluconate twice a day fentanyl patch every 72 hours (do not drive or drink alcohol while taking this) morphine as needed for pain (do not drive or drink alcohol while taking this) You should take senna and colace every day to prevent constipation and take miralax and bisacodyl if you become constipated. Notify [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], RN, at ([**Telephone/Fax (1) 82663**] for fever, chills, shortness of breath, or inability to take oral fluids Followup Instructions: You have the following appointment's with Dr. [**Last Name (STitle) 1729**], [**Telephone/Fax (1) 22**]. [**2124-4-25**] 02:00p XCT (TCC) [**Apartment Address(1) **]: Catscan appointment [**Hospital6 29**], [**Location (un) **] [**2124-5-2**] 02:30p [**Doctor Last Name **],TUESDAY BIOLOGICS SC [**Hospital Ward Name **] CLINICAL CTR, [**Location (un) **] Dr. [**Last Name (STitle) 82876**] [**Doctor First Name 82877**] PCP [**Telephone/Fax (1) 82878**] [**4-3**] at 2:15pm We will fax a copy of your discharge paperwork to Dr. [**Last Name (STitle) **]. Visiting Nursing: [**Telephone/Fax (1) 82879**] [**Name6 (MD) **] [**Last Name (NamePattern4) 9601**] MD, [**MD Number(3) 9602**] ICD9 Codes: 5849, 5070, 2762, 5990, 4019, 2724, 2859
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Medical Text: Admission Date: [**2138-4-14**] Discharge Date: [**2138-4-18**] Service: MEDICINE Allergies: Codeine / Benzodiazepines Attending:[**First Name3 (LF) 5893**] Chief Complaint: hematemesis Major Surgical or Invasive Procedure: tracheal intubation, central venous catheter placement, and radial arterial catheter placement History of Present Illness: Ms. [**Known lastname 94926**] is an 87 year old Russian-speaking woman with history of breast cancer, esophageal cancer (requiring esophogeal stent), afib, DMII, apparently went to Pul office to drain pleural effusuion, but was noted to have small episode of hematemesis, Dr. [**Last Name (STitle) **] was called and advised to come to ED for further evaluation. Pt suwsequently had another episode of hematemesis in ED.Claims to have dark stools day pta. Denied CP but have exertional SOB. Denied HA, recent ASA use, denied abd pain. . Last EGD on [**1-10**] demonstrated narrowing in the distal esophagus suggestive of granulation tissue, and a metal stent was successfully deployed distal to the previous stent. Daughter informed us that pt apparently does not know about her diagnosis and prefers not to inform her. Past Medical History: 1. Right breast cancer, status post radiation therapy excision in [**2130-12-4**]. 2. Hypertension. 3. History of exertional angina; negative Persantine thallium in [**2132-4-2**]. 4. Back pain. 5. Carpal tunnel. 6. History of positive PPD. 7. Glaucoma. 8. History of atrial fibrillation with hypokalemia during previous hospitalization. 9. DM diet-controlled Hb A1c 7.1 in [**12-8**] 10. Obesity. 11. Osteopenia. 12. s/p cholecystectomy in [**Country 532**]. 13. Squamous cell esophogeal cancer with esophageal obstruction requiring stent Social History: Lives at elderly home, nurse helps with ADLs. Her daughter is very supportive and active in her care. She denies history of tobacco use. Family History: Esophageal cancer in father - 80s Physical Exam: vital - T 98.6, BP 118/74, HR 94, RR 16, O2 93% on room air. gen -In no distress. heent - Sclera anicteric, moist mucus membranes, OP clear cv: Irregular, S1 S2 present, no murmurs, rubs, gallops pulm - Decreased on right.crackles in bases abd - Soft, non-tender , good BS, rectal- guaiac positive, brown stool ext - Warm. Mild edema. neuro -awake and alert Pertinent Results: [**2138-4-14**] 01:45PM WBC-13.0* RBC-3.65* HGB-10.0* HCT-30.1* MCV-82 MCH-27.4 MCHC-33.2 RDW-14.4 [**2138-4-14**] 01:45PM NEUTS-83.5* LYMPHS-11.8* MONOS-3.8 EOS-0.6 BASOS-0.3 [**2138-4-14**] 01:45PM PLT COUNT-360 [**2138-4-14**] 01:45PM PT-13.7* PTT-23.8 INR(PT)-1.2* [**2138-4-14**] 01:45PM GLUCOSE-155* UREA N-17 CREAT-0.6 SODIUM-139 POTASSIUM-4.5 CHLORIDE-101 TOTAL CO2-29 ANION GAP-14 [**2138-4-14**] 01:45PM ALT(SGPT)-12 AST(SGOT)-34 ALK PHOS-77 TOT BILI-0.4 [**2138-4-14**] 01:45PM LIPASE-11 [**2138-4-14**] 01:45PM ALBUMIN-3.1* SINGLE AP UPRIGHT RADIOGRAPH OF THE CHEST: There are bilateral moderate-sized pleural effusions unchanged. There is also bilateral lower lobe atelectasis also largely unchanged. There is also minimal pleural fluid extending into the right minor fissure. There is no pneumothorax. Cardiomediastinal silhouette is obscured by the left lower lobe atelectasis and effusion. Pulmonary vasculature is within normal limits. There is no evidence of volume overload. Esophageal stent is noted. There is mild dextroconvex thoracic scoliosis. IMPRESSION: Moderate bilateral pleural effusions and lower lobe atelectasis, both of which are unchanged allowing for slight differences in technique. Atrial fibrillation with rapid ventricular response. Non-specific ST-T wave changes. Poor R wave progression. Suspect arm lead reversal. Compared to the previous tracing of [**2138-1-19**] the ventricular rate is faster and the arm leads are reversed. Brief Hospital Course: 87 year old Russian-speaking female with h/o breast cancer, esophageal cancer (requiring esophogeal stent), afib, DMII, s/p EGD with additional stent placement adm with dyspnea and large recurrent right pleural effusion s/p pleurodesis with small volume hematemesis in pulmonary clinic. Hematemesis: Patient was intubated for airway control. Two large bore PIV, active type and cross. Pt was transfused to keep Hct >=30 given coronary disease. She briefly required pressors for hemodynamic support. GI consult team attempted EGD, which revealed large clot adherent to the wall of the esophagus distal to the patent esophageal stent. GI attending recommended to family that any attempt at further intervention would likely result in massive GI bleeding and catastrophic outcome. Extended family flew in from abroad to visit with patient and then the entire family, after reviewing the options for end of life care, decided that she would have wanted to be made comfortable given her pre-terminal condition. Planning for home hospice was offered, but the family was justifiably concerned about the possibility of further hematemesis and therefore asked that she remain intubated while all medications other than analgesics and anxiolytics were stopped. Mechanical ventilation was changed to T-piece oxygen. She subsequently expired with family at her bedside. Medications on Admission: 1. Aspirin 325mg daily 2. Lasix 20mg PO daily 3. Glipizide SR 2.5mg q 24 4. Lisinopril 10mg once daily 5. Metoprolol tartrate 300mg once daily 6. Ranitidine 15mg/mL 7. Valacardine 8. Calcium carbonate 500mg TID Discharge Medications: n/a Discharge Disposition: Expired Discharge Diagnosis: esophageal cancer Discharge Condition: expired Discharge Instructions: n/a Followup Instructions: n/a ICD9 Codes: 5789, 2851, 5119, 4019
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Medical Text: Admission Date: [**2147-1-1**] Discharge Date: [**2147-1-7**] Service: CHIEF COMPLAINT: Fevers, unresponsiveness. HISTORY OF PRESENT ILLNESS: The patient is an 81 year old man with prostate cancer and cerebrovascular accident who was struck by an automobile earlier this year. He has had several admissions to [**Hospital1 69**], the last one culminating in failure to wean from the ventilator, for which he received a tracheostomy and a percutaneous esophagogastrostomy. He was transferred to rehabilitation center in [**2146-11-12**] after a similar presentation, marked by fevers and altered mental status. His work-up at that time was unrevealing (Head computed tomograph and lumbar puncture which were normal). On the day of admission, the patient's percutaneous esophageal gastrostomy tube was flushed. Shortly after the percutaneous esophageal gastrostomy tube was flushed, water was found to be coming out from his tracheostomy site. His heart rate was in the 150's and his temperature was 101.8. The patient was emergently suctioned, bagged and placed on assist control ventilation. Two hours later, his temperature climbed to 105 and his heart rate and systolic blood pressure had dropped to the 80's and he was transferred to [**Hospital1 346**] for further care. PAST MEDICAL HISTORY: 1. Status post motor vehicle accident in [**2146-9-12**], as described in detail in the OMR. 2. Prostate cancer (not active disease). 3. Left frontal cerebrovascular accident. 4. Left lower lobe pneumonia. ALLERGIES: None known. MEDICATIONS ON TRANSFER: Vancomycin 750 mg every 24 hours. Gentamycin 30 mg every 24 hours. Albuterol. Ipratropium. Ranitidine. Aspirin 81 mg. HOSPITAL COURSE: In the Emergency Department, the patient was enrolled in the sepsis protocol. Central venous access was obtained. 2.5 liters of normal saline were infused and his blood pressure climbed to 107 systolic. Copious amounts of sputum were appreciated on transfer to the medical Intensive Care Unit. PHYSICAL EXAMINATION: Temperature 104; heart rate of 125; blood pressure 107/56; respiratory rate of 32. SP02 99% on room air. General: He is cachectic, chronically ill-appearing, minimally responsive elderly man. HEAD, EYES, EARS, NOSE AND THROAT: Anicteric with normal conjunctiva and dry mucous membranes. Neck: The tracheostomy site was clean, dry and intact. Lungs: Crackles at both bases. Heart: Tachycardiac with normal S1 and S2. There is no S3, S4, murmurs, rubs or gallops. The abdomen was scaphoid. Normal bowel sounds. Soft, nontender, nondistended. There was no organomegaly appreciated. Extremities: No rash, clubbing, cyanosis or edema. Vascular: Radial, carotid, dorsalis pedis, posterior tibial pulses were brisk and equal bilaterally. LABORATORY DATA: Arterial blood gases revealed pH of 7.44, PC02 of 35, P02 of 275; lactate 1.6. The remainder of his laboratory evaluation is unremarkable. Chest x-ray showed left retrocardiac opacity. HOSPITAL COURSE: The patient was admitted to the medical Intensive Care Unit and received broad antibiotics initially on hospital day number three. Gentamycin was discontinued. Standard trichomonas was identified in the sputum and Bactrim was added to Vancomycin. The patient continued to produce copious amounts of yellow sputum; however, was relatively easy to ventilate and oxygenate him mechanically. The patient remained minimally responsive for the remainder of his hospital course and he was also hypotensive with a systolic blood pressure below 100. On hospital day number two through five, he was rather agitated and responded only to Haloperidol. After extensive discussions with his wife and his granddaughter, [**Name (NI) **], aggressive care was withdrawn. Antibiotics were discontinued. The patient's tracheostomy tube was disconnected from the ventilator on [**2147-1-7**]. The patient's comfort was ensured with intravenous morphine infusion. The patient was transferred to the medical floor for further management. DISCHARGE DIAGNOSES: 1. Pneumonia. 2. Status post motor vehicle accident. 3. Prostate cancer (not active disease). 4. Left frontal cerebrovascular accident. DISPOSITION: To the medical floor for comfort measures only. [**Name6 (MD) 50136**] [**Last Name (NamePattern4) **], M.D. [**MD Number(1) 3795**] Dictated By:[**Name8 (MD) 7102**] MEDQUIST36 D: [**2147-1-7**] 07:58 T: [**2147-1-7**] 08:04 JOB#: [**Job Number 50137**] ICD9 Codes: 0389, 5070, 2765
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6092 }
Medical Text: Admission Date: [**2143-7-1**] Discharge Date: [**2143-7-22**] Date of Birth: [**2122-1-10**] Sex: F Service: SURGERY Allergies: Bactrim Attending:[**First Name3 (LF) 3223**] Chief Complaint: Trauma s/p MVC Major Surgical or Invasive Procedure: 1. Open tracheostomy 2. Right craniectomy for evacuation of venous epidural hematoma. 3. Dissection of the dura and duraplasty for intracranial hypertension. History of Present Illness: 20yo F s/p rollover MVC. Pt was restrained passenegr but partially ejected by report. Pt was GCS6 at field and was intubated. Past Medical History: none Social History: unknown Family History: unknown Physical Exam: PHYSICAL EXAM: O: T: 99.8 BP:133/67 HR:49-76 O2Sats87-100 Gen: WD/WN, in hard collar on backboard examined in CT scanner. Multiple abrasions on body, blood in nares Neuro/HEENT:intubated, sedated for intubation. Moving bilat legs and left arm spontaneously with good strength, minimal movement right arm- did see fingers move. Toes downgoing right, upgoing left. eyes closed. pupils 3mm equal bilat reactive to light. Cardiovascular: RRR Pulmonary: CTA B/L Equal breath sounds B/L ABD: Soft, Non-distended Rectal Exam: good tone, hemoccult negative. Pertinent Results: [**2143-7-17**] 06:50AM BLOOD WBC-8.3 RBC-2.93* Hgb-8.6* Hct-27.3* MCV-93 MCH-29.4 MCHC-31.6 RDW-16.2* Plt Ct-[**2040**]* [**2143-7-16**] 07:00AM BLOOD WBC-8.1 RBC-2.73* Hgb-8.3* Hct-25.1* MCV-92 MCH-30.5 MCHC-33.1 RDW-16.1* Plt Ct-1827* [**2143-7-15**] 09:30AM BLOOD WBC-10.3 RBC-2.80* Hgb-8.4* Hct-25.5* MCV-91 MCH-30.2 MCHC-33.1 RDW-15.6* Plt Ct-1834* [**2143-7-14**] 02:10PM BLOOD WBC-14.7* RBC-2.91* Hgb-8.8* Hct-26.8* MCV-92 MCH-30.2 MCHC-32.8 RDW-15.3 Plt Ct-[**2095**]* [**2143-7-13**] 06:25AM BLOOD WBC-19.1* RBC-3.28* Hgb-9.7* Hct-30.2* MCV-92 MCH-29.6 MCHC-32.3 RDW-15.0 Plt Ct-2051* [**2143-7-12**] 02:37AM BLOOD WBC-18.8* RBC-3.24* Hgb-9.4* Hct-29.4* MCV-91 MCH-29.1 MCHC-32.1 RDW-14.6 Plt Ct-1689* [**2143-7-11**] 02:24AM BLOOD WBC-20.0* RBC-3.07* Hgb-9.2* Hct-27.7* MCV-90 MCH-29.9 MCHC-33.1 RDW-14.3 Plt Ct-1361* [**2143-7-10**] 03:04AM BLOOD WBC-20.7* RBC-3.07* Hgb-9.3* Hct-27.7* MCV-90 MCH-30.3 MCHC-33.6 RDW-14.1 Plt Ct-1033* [**2143-7-9**] 03:44AM BLOOD WBC-15.4* RBC-3.10* Hgb-9.3* Hct-27.8* MCV-90 MCH-30.1 MCHC-33.6 RDW-14.0 Plt Ct-804* [**2143-7-8**] 03:58AM BLOOD WBC-14.0* RBC-3.19* Hgb-10.0* Hct-28.3* MCV-89 MCH-31.3 MCHC-35.3* RDW-13.8 Plt Ct-599* [**2143-7-7**] 02:32AM BLOOD WBC-11.2* RBC-2.90* Hgb-9.0* Hct-26.6* MCV-92 MCH-31.1 MCHC-34.0 RDW-13.8 Plt Ct-407 [**2143-7-17**] 06:50AM BLOOD Plt Ct-[**2040**]* [**2143-7-16**] 07:00AM BLOOD Plt Ct-1827* [**2143-7-15**] 09:30AM BLOOD Plt Ct-1834* [**2143-7-14**] 02:10PM BLOOD Plt Ct-[**2095**]* [**2143-7-13**] 06:25AM BLOOD Plt Ct-2051* [**2143-7-12**] 02:37AM BLOOD Plt Ct-1689* [**2143-7-11**] 02:24AM BLOOD Plt Ct-1361* [**2143-7-10**] 03:04AM BLOOD Plt Smr-VERY HIGH Plt Ct-1033* [**2143-7-9**] 03:44AM BLOOD Plt Ct-804* [**2143-7-8**] 03:58AM BLOOD Plt Ct-599* [**2143-7-1**] 05:42PM BLOOD Fibrino-140* [**2143-7-1**] 02:15PM BLOOD Fibrino-147* [**2143-7-14**] 02:10PM BLOOD Glucose-97 UreaN-25* Creat-0.6 Na-139 K-5.4* Cl-101 HCO3-26 AnGap-17 [**2143-7-13**] 06:25AM BLOOD Glucose-90 UreaN-27* Creat-0.7 Na-139 K-5.4* Cl-99 HCO3-31 AnGap-14 [**2143-7-12**] 02:37AM BLOOD Glucose-131* UreaN-24* Creat-0.6 Na-138 K-4.8 Cl-101 HCO3-28 AnGap-14 [**2143-7-11**] 02:24AM BLOOD Glucose-158* UreaN-17 Creat-0.6 Na-138 K-4.8 Cl-102 HCO3-26 AnGap-15 [**2143-7-10**] 03:04AM BLOOD Glucose-134* UreaN-16 Creat-0.6 Na-141 K-4.2 Cl-104 HCO3-27 AnGap-14 [**2143-7-4**] 02:05AM BLOOD Glucose-163* UreaN-6 Creat-0.8 Na-142 K-4.2 Cl-110* HCO3-25 AnGap-11 [**2143-7-3**] 12:31AM BLOOD Glucose-139* Na-141 [**2143-7-2**] 08:06PM BLOOD Glucose-56* Na-141 K-4.2 [**2143-7-1**] 11:48PM BLOOD Glucose-200* UreaN-10 Creat-0.8 Na-137 K-4.3 Cl-107 HCO3-18* AnGap-16 [**2143-7-1**] 05:42PM BLOOD Glucose-198* UreaN-12 Creat-0.8 Na-134 K-4.5 Cl-102 HCO3-22 AnGap-15 [**2143-7-1**] 02:15PM BLOOD Glucose-172* UreaN-16 Creat-0.9 Na-138 K-4.2 Cl-106 HCO3-23 AnGap-13 [**2143-7-2**] 12:01PM BLOOD Type-ART pO2-227* pCO2-36 pH-7.41 calTCO2-24 Base XS-0 [**2143-7-2**] 07:05AM BLOOD Type-ART pO2-230* pCO2-32* pH-7.46* calTCO2-23 Base XS-0 [**2143-7-2**] 06:16AM BLOOD Type-ART pO2-234* pCO2-27* pH-7.53* calTCO2-23 Base XS-1 [**2143-7-2**] 03:23AM BLOOD Type-ART pO2-233* pCO2-28* pH-7.50* calTCO2-23 Base XS-0 [**2143-7-2**] 12:42AM BLOOD Type-ART pO2-233* pCO2-33* pH-7.42 calTCO2-22 Base XS--1 [**2143-7-1**] 02:19PM BLOOD pO2-42* pCO2-51* pH-7.31* calTCO2-27 Base XS--1 [**2143-7-1**] 10:09PM BLOOD Glucose-165* Lactate-3.2* Na-134* K-4.4 Cl-106 calHCO3-22 Brief Hospital Course: The patient is a 20-year-old female status post severe motor vehicle accident. She came in our hospital with severe head injury on [**2143-7-1**], and an intracranial pressure monitor showed pressures in the high- 30s despite optimal medical management. Another CT showed an expanding venous epidural hematoma, she was emergently taken to the OR for Craniectomy. Risks and benefits were discussed with her family. The extent of her injuries at the time of her admission to ED was diagnosed as following: 1.Extensive complex comminuted fracture of the calvarium involving both frontal lobes, both parietal lobes, the squamous portion of the left temporal lobe, left greater [**Doctor First Name 362**] of the sphenoid, left lateral aspect of the maxillary sinus, left and possibly right aspect of the sphenoid sinus. 2. Right frontoparietal subdural hematoma and left frontal acute subdural hematomas. The hemorrhage is thicker and more longitudinally extensive on the right side. 3. Blood within the left maxillary, ethmoid, and sphenoid air cells. 4. Fracture of the ring of C1. For additional details refer to the CT of cerevical spine report 5. [**Location (un) 5621**] fracture and mild leftward rotation, possibly a subluxation, of C1 on C2. 6. Anterior flexion teardrop fractures of C5 and C6. Vertically oriented fracture through the C7 vertebral body, all of which likely are unstable. 7. Bilateral hazy opacities within both lung fields may represent pulmonary edema or hemorrhage. Following the procedure she was admitted to the Trauma Intensive Care Unit under the supervision of Dr [**Last Name (STitle) 519**]. She was sedated majority of her time there and lightened for neuro checks. She was started on tube feeds. By HD#10 it was determined that this pt was having respiratory failure although her neuro status was improving. She was taken to the OR on HD#10 for it was felt that she needed to have a tracheostomy. A #7 cuffed tracheostomy tube was placed into the trachea and a tracheostomy collar was put in place. She continued to show improvements in her neurologic status. On HD#12, Pt was transferred to the step down unit and was felt that she did not need to be in an intensive care setting given her improving status. Pt. remained on tube feeds on the step down unit. After evaluation from speech and swallow, she was cleared for oral feeds on [**2143-7-20**] and her tube feed was discontinued. She continues to tolerate oral feeds well. Compalined of some Left sided chest pain on [**2143-7-21**], CXR negative, Likely Musculoskeletal in nature. Pt is D/C to [**Hospital3 **] and will follow up with Neurosurgery in 4 weeks with a repeat Head CT. Pt is to Follow up in Trauma Clinic in [**1-14**] weeks. Medications on Admission: Sodium Chloride 0.9% Flush 3 ml IV DAILY:PRN Acetaminophen 325-650 mg PO Q4-6H:PRN Propofol 5-20 mcg/kg/min IV DRIP TITRATE TO sedation Metoclopramide 10 mg IV Q6H Insulin 100 Units/100 ml NS @ 0.5 UNIT/HR IV DRIP Propofol 20-100 mcg/kg/min IV DRIP TITRATE TO sedation Famotidine 20 mg IV Q12H Phenylephrine HCl 0.5 mcg/kg/min IV DRIP TITRATE TO CPP >60 Labetalol HCl 0.5-2 mg/min IV DRIP TITRATE TO keep CPP<80 Magnesium Sulfate 2 gm / 100 ml NS IV ONCE MED Mannitol 50 gm IV ONCE Mannitol 25 gm IV Q6H Morphine Sulfate 5 mg IV ONCE Duration: 1 Doses Phenytoin 100 mg IV Q8H Cefazolin 1 gm IV Q8H Discharge Medications: 1. Docusate Sodium 100 mg Tablet Sig: 1-2 Tablets PO BID PRN as needed for constipation. Disp:*60 Tablet(s)* Refills:*0* 2. Erythromycin 5 mg/g Ointment Sig: 0.5 in OU Ophthalmic QID (4 times a day) as needed for bil. canthotomies. Disp:*1 tube* Refills:*0* 3. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed. Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 4. Quetiapine 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). Disp:*30 Tablet(s)* Refills:*0* 5. Ibuprofen 600 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed. 6. Phenytoin 50 mg Tablet, Chewable Sig: Two (2) Tablet, Chewable PO TID (3 times a day). Disp:*180 Tablet, Chewable(s)* Refills:*0* 7. Trazodone 50 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). Disp:*30 Tablet(s)* Refills:*0* 8. Albuterol-Ipratropium 103-18 mcg/Actuation Aerosol Sig: [**1-14**] Puffs Inhalation Q6H (every 6 hours) as needed. Disp:*1 Inhaler* Refills:*0* 9. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. Disp:*30 Tablet(s)* Refills:*0* 10. Heparin Flush PICC (100 units/ml) 2 ml IV DAILY:PRN 10 ml NS followed by 2 ml of 100 Units/ml heparin (200 units heparin) each lumen Daily and PRN. Inspect site every shift. 11. Artificial Tears Drops Sig: 1-2 Drops Ophthalmic PRN. Disp:*1 bottle* Refills:*0* Discharge Disposition: Extended Care Facility: [**Hospital6 85**] - [**Location (un) 86**] Discharge Diagnosis: 1.Bilateral Subdural Hematomas 2.Complex Skull Fracture involving Left squamous temporal and greater [**Doctor First Name 362**] sphenoid 3.Cervical Spine Fx: C1 ring, [**Location (un) 5621**] Fracture, anterior flexion teardrop of C5-C6, unstable body fracture of C7. 4.Left sphenoid Sinus/Maxillary Sinus/foramen rotundum Fracture 5.Right Orbitlal Fracture 6.Bilateral Pulmaonry Contusions Discharge Condition: Good Discharge Instructions: Return to the Emergency Room for: Loss of Consciousness Severe Headache Visual Changes Fever >101.5 Severe Nausea/Vomiting Difficulty Breathing Bloody Stools Severe Diarrhea Followup Instructions: Follow up in Trauma Clinic in [**1-14**] weeks. Please call ([**Telephone/Fax (1) 9946**] to schedule an appointment. Follow up with [**Hospital 4695**] Clinic (Dr. [**Last Name (STitle) 26803**] in 4 weeks. Please call ([**Telephone/Fax (1) 11314**] to schedule an appointment and a Head CT without contrast prior to that appointment. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 520**] MD, [**MD Number(3) 3226**] Completed by:[**2143-7-22**] ICD9 Codes: 5185, 5180, 486
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Medical Text: Admission Date: [**2125-4-10**] Discharge Date: [**2125-5-19**] Date of Birth: [**2125-4-10**] Sex: M Service: NB HISTORY: This is a 1785 gram 32-3/7 week male who was admitted to the Neonatal Intensive Care Unit secondary to prematurity. He was born to a 35 year-old gravida IV, para I to II female with the following prenatal screens: Blood type B positive, antibody negative, RPR nonreactive, rubella immune, hepatitis B surface antigen negative, GBS unknown. The pregnancy was complicated by cervical shortening which was treated by cerclage in [**2124-11-9**], preterm labor and premature rupture of membranes 7 hours prior to delivery. There was a question of abruption. The cerclage was removed and labor was allowed to progress. Intrapartum antibiotics were given more than 4 hours prior to delivery. The baby was delivered vaginally. He was depressed initially, floppy with poor respiratory effort treated with positive pressure bag and mask ventilation and then CPAP. Apgars were 2 at one minute, 6 at five minutes and 7 at ten minutes. The patient was transferred to the Neonatal Intensive Care Unit with blow- by oxygen. PHYSICAL EXAMINATION ON ADMISSION: Weight 1785 grams, about 50th percentile. Length 45.5 cm (about 75th percentile). Head circumference 28.5 cm (25 to 50th percentile. Temperature 97.9, pulse 180, respiratory rate 38, blood pressure 53/24 with a mean of 35, O2 saturation 98% in room air. Anterior fontanelle was open and flat, soft, baby was [**Name2 (NI) 43619**] with intact palate, mild retractions, fair aerations, coarse breath sounds, no murmur, normal pulses. Soft abdomen, 3 vessel cord, no hepatosplenomegaly, normal male testes high in the scrotum. Patent anus. Mongolian spot on buttocks. No sacral dimple. No hip click. Decreased tone. Moving all extremities. SUMMARY OF HOSPITAL COURSE BY SYSTEMS: 1. RESPIRATORY: The baby had some initial respiratory distress which required CPAP for 4 days. The baby was on nasal cannula for about 24 hours and has been in room air since day of life 5. He has had some occasional apnea spells with desaturations. His last spell was on [**5-13**]. He has had no apnea and bradycardia since then. 2. CARDIOVASCULAR: The baby has had an intermittent soft murmur. Four extremity blood pressures were reassuring and the hyperoxia test was also reassuring with a PAO2 of greater than 300. The electrocardiogram showed a left axis that was prominent for age but thought to be clinically insignificant. 3. FLUIDS, ELECTROLYTES AND NUTRITION: The baby was started on feeds on day of life 3 and has been working up on calories as well as volume. He is currently meeting a minimum of 130 ml of kilo per day feeding ad lib Similac Special Care 24kcal/oz. His weight the day of discharge was 3015 grams. 4. GASTROINTESTINAL: The baby is currently on iron supplementation. He is voiding and stooling consistently guaiac negative stools. He was on phototherapy for a few days in the first week of life with a maximum bilirubin of 10.6/0.4. The phototherapy was discontinued on [**4-16**]. 5. HEMATOLOGY: As mentioned earlier the baby is on iron supplementation. His last hematocrit was 39.1 at 2 weeks of age. He has never been transfused. 6. INFECTIOUS DISEASE: The baby received ampicillin and gentamicin for 48 hours rule out. Initially at birth the blood culture was negative. He has had no documented infections during this hospitalization. 7. NEUROLOGY: The baby had 2 normal head ultrasounds, 1 on [**4-23**] and 1 on [**5-14**]. 8. SENSORY: Audiology - Hearing screening was performed with automated auditory brain stem responses. The baby was did not pass in both ears and will need follow up. The follow up appointment is scheduled in [**Location (un) 38**] Audiology on [**5-30**] at 2:30 P.M. Ophthalmology - did not meet screening criteria. 9. PSYCHOSOCIAL: No major issues. CONDITION AT DISCHARGE: Baby is stable. Feeding while ad lib with no spells for more than 5 days. DISCHARGE DISPOSITION: Home. NAME OF PRIMARY PEDIATRICIAN: Dr. [**First Name (STitle) **] [**Name (STitle) 40483**], phone #[**Telephone/Fax (1) 66642**]. Fax #[**Telephone/Fax (1) 58781**]. Dr. [**Last Name (STitle) 66643**] was covering for Dr. [**Last Name (STitle) 40483**] the day prior to discharge and he has been given a brief summary regarding the baby. CARE RECOMMENDATIONS: 1. The baby will be feeding Special Care Formula 24 calories at home. 2. Medications: The baby will be on iron supplementation. 3. The baby passed the car seat testing. 4. State Newborn Screening has been sent per routine. 5. The hepatitis B vaccine was given on the 23rd. 6. Recommended immunizations: 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; 2) Born between 32 and 35 weeks with 2 of the following: Day care 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 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. The baby has a follow up appointment with Dr. [**Last Name (STitle) 40483**] on [**5-21**] at 11:10 A.M. As mentioned earlier, the baby also needs a follow up audiology screen in [**Location (un) 38**] on [**5-30**] at 2:30 P.M. DISCHARGE DIAGNOSES: 1. Prematurity. 2. Hyperbilirubinemia. 3. Respiratory distress. 4. Rule out sepsis. 5. Apnea of prematurity. 6. Abnormal newborn hearing screen. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], [**MD Number(1) 55750**] Dictated By:[**Name8 (MD) 66644**] MEDQUIST36 D: [**2125-5-18**] 15:41:24 T: [**2125-5-18**] 16:46:59 Job#: [**Job Number 66645**] ICD9 Codes: 769, 7742, V290, V053
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6094 }
Medical Text: Admission Date: [**2132-11-25**] Discharge Date: [**2132-12-2**] Date of Birth: [**2064-6-20**] Sex: M Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 4095**] Chief Complaint: Fever Major Surgical or Invasive Procedure: TEE History of Present Illness: 68 yo male with history of mental retardation and recurrent UTIs [**2-20**] urethral stricture with chronic Foley admitted from group home for [**10-27**] lower abdominal pain since this AM. His pain was accompained by fever to 104 (decreased to 100.9 with tylenol), chills, nausea and vomiting, also decreased urine output. Patient last had foley changed on [**11-10**]. He has a history of playing with his foley and manipulating the placement. . In the ED inital vitals were 97.6 91 114/60 16 90% RA. His exam in the ED was concerning for a distended lower abdomen/suprapubic area. His foley was replaced with improvement in pain to [**5-27**], and immediate UOP of 1.4L. He received a total of 5L NS with BP remaining 96/53 with HR 61. Since placement of foley, he has had an additional 3L of urine output. Labs were remarkable for WBC 11.8 with left shift and creatinine of 1.6 (baseline 1.1), lactate 1.2. His UA showed positive nitirite, large leuks, >182 WBC, moderate bacteria. He had a CT abdomen without contrast which revealed chronic hydronephrosis (L>R), thickening of the bladder (suggestive of chronic obstruction), could not rule out/in pyelo b/c no IV contrast. He had a chest xray which was not concerning for any acute processes. He was started empirically on vanc/ceftriaxone for history of E. coli and MRSA UTI, and flagyl for possible other intra-abdominal processes. . Of note, pt was recently discharged on [**11-4**] for similar complaints of UTI and urinary retention. Urine cultures at that time revealed E. Coli resistant to cipro and bactrim. He was initially treated with ceftriaxone, and transitioned to PO cefpedoxime to complete a 10 day course. He was seen by urology on [**11-10**] who recommended intermittent catheterization, thought it is unclear if this is a plausible option for this patient given his mental capacity. Per notes, his group home is not equiped to help with intermittent catheterization. On the floor, pt is still complaining of lower abdominal pain. He is complaining of being very hungry. . Review of systems: (+) Per HPI, chronic pelvic pain per previous notes, occasional blood stools, none recently (-) Denies night sweats, recent weight loss or gain. Denies headache, sinus tenderness, rhinorrhea or congestion. Denies cough, shortness of breath, or wheezing. Denies chest pain, chest pressure, palpitations, or weakness. Denies diarrhea, constipation, abdominal pain, or changes in bowel habits. Denies arthralgias or myalgias. Denies rashes or skin changes. Past Medical History: -recurrent urethral stricture: followed by Dr. [**Last Name (STitle) **], s/p cystoscopy, direct-vision internal urethrotomy and fulguration of a bladder lesion on [**2132-10-14**] -Mental Retardation: mild to moderate, independent in ADLs -Traumatic R knee inflamatory arthritis -hx of eczema in the past rx with hydrocortisone cream, -dx with open angle glaucoma R eye [**2121**] -chronic onychomycosis of b/l toe nails -diabetes, based on HbA1c 6.7% -hypertension -elevated PSA -hyperlipidemia: [**3-26**] t chol 192, LDL 118, HDL 64, TG 51 -ECHO [**2130-7-7**] EF 60-70% normal sytolic function -Diverticulosis: [**Last Name (un) **] [**12/2130**] -B 12 Defic Social History: lives in a group home; Bay Cove Human Services. Worked at a Recycling Center few hours daily, retired '[**30**]. Denies tobacco, alcohol or drugs. Family History: Father: unknown Mother: unknown Physical Exam: Physical Exam: Vitals: T: BP: P: R: 18 O2: General: Alert, oriented, no acute distress HEENT: Sclera anicteric, pupils equal and reactive to light, MMM, oropharynx clear 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 with lower abdominal distension, diffusely tender to palpation worse in lower abdomen, bowel sounds present, no rebound tenderness or guarding, no organomegaly, no CVA tenderness though does have diffuse lower back pain, no spinal tenderness GU: foley draining cloudy yellow urine Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema . Discharge Exam: AVSS CV: No M/R/G Abdomen: soft NT ND GU: yellow clear urine. Pertinent Results: [**2132-11-25**] 05:30PM URINE COLOR-Yellow APPEAR-Hazy SP [**Last Name (un) 155**]-1.011 [**2132-11-25**] 05:30PM URINE BLOOD-MOD NITRITE-POS PROTEIN-30 GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.5 LEUK-LG [**2132-11-25**] 05:30PM URINE RBC-16* WBC->182* BACTERIA-MOD YEAST-NONE EPI-0 [**2132-11-25**] 03:13PM UREA N-31* CREAT-1.6* [**2132-11-25**] 03:13PM estGFR-Using this [**2132-11-25**] 03:13PM ALT(SGPT)-18 AST(SGOT)-21 CK(CPK)-31* ALK PHOS-99 TOT BILI-0.5 [**2132-11-25**] 03:13PM LIPASE-22 [**2132-11-25**] 03:13PM CK-MB-2 cTropnT-0.13* [**2132-11-25**] 03:13PM PH-7.51* COMMENTS-GREEN TOP [**2132-11-25**] 03:13PM GLUCOSE-111* LACTATE-1.2 NA+-135 K+-4.4 CL--101 TCO2-23 [**2132-11-25**] 03:13PM freeCa-1.09* [**2132-11-25**] 03:13PM WBC-11.8*# RBC-3.93* HGB-11.3* HCT-33.7* MCV-86 MCH-28.7 MCHC-33.5 RDW-13.5 [**2132-11-25**] 03:13PM NEUTS-93.5* LYMPHS-4.3* MONOS-1.0* EOS-0.9 BASOS-0.2 [**2132-11-25**] 03:13PM PLT COUNT-395 [**2132-11-25**] 03:13PM PT-13.7* PTT-25.0 INR(PT)-1.2* EKG: new TWI in II, III, AVF Blood Culture, Routine (Preliminary): ESCHERICHIA COLI. FINAL SENSITIVITIES. Cefazolin interpretative criteria are based on a dosage regimen of 2g every 8h. Piperacillin/Tazobactam sensitivity testing performed by [**First Name8 (NamePattern2) 3077**] [**Last Name (NamePattern1) 3060**]. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ ESCHERICHIA COLI | AMPICILLIN------------ =>32 R AMPICILLIN/SULBACTAM-- 4 S CEFAZOLIN------------- <=4 S CEFEPIME-------------- <=1 S CEFTAZIDIME----------- <=1 S CEFTRIAXONE----------- <=1 S CIPROFLOXACIN--------- =>4 R GENTAMICIN------------ <=1 S MEROPENEM-------------<=0.25 S PIPERACILLIN/TAZO----- S TOBRAMYCIN------------ <=1 S TRIMETHOPRIM/SULFA---- =>16 R Aerobic Bottle Gram Stain (Final [**2132-11-26**]): Blood Culture, Routine (Final [**2132-11-29**]): ESCHERICHIA COLI. IDENTIFICATION AND SENSITIVITIES PERFORMED ON CULTURE # 334-3294R [**2132-11-25**]. STAPH AUREUS COAG +. Consultations with ID are recommended for all blood cultures positive for Staphylococcus aureus, yeast or other fungi. FINAL SENSITIVITIES. Oxacillin RESISTANT Staphylococci MUST be reported as also RESISTANT to other penicillins, cephalosporins, carbacephems, carbapenems, and beta-lactamase inhibitor combinations. Rifampin should not be used alone for therapy. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ STAPH AUREUS COAG + | CLINDAMYCIN----------- =>8 R ERYTHROMYCIN---------- =>8 R GENTAMICIN------------ <=0.5 S LEVOFLOXACIN---------- =>8 R OXACILLIN------------- =>4 R RIFAMPIN-------------- <=0.5 S TETRACYCLINE---------- <=1 S TRIMETHOPRIM/SULFA---- <=0.5 S VANCOMYCIN------------ <=0.5 S Aerobic Bottle Gram Stain (Final [**2132-11-26**]): GRAM NEGATIVE ROD(S). GRAM POSITIVE COCCI IN CLUSTERS. Reported to and read back by [**First Name8 (NamePattern2) 251**] [**Last Name (un) **] (4I) @ 0956 [**2132-11-26**]. Anaerobic Bottle Gram Stain (Final [**2132-11-26**]): GRAM POSITIVE COCCI IN CLUSTERS. [**2132-11-25**] 5:30 pm URINE Site: CATHETER **FINAL REPORT [**2132-11-26**]** URINE CULTURE (Final [**2132-11-26**]): MIXED BACTERIAL FLORA ( >= 3 COLONY TYPES), CONSISTENT WITH FECAL CONTAMINATION. [**2132-11-26**] 12:05 pm SWAB Source: Urethral. **FINAL REPORT [**2132-11-27**]** Chlamydia trachomatis, Nucleic Acid Probe, with Amplification (Final [**2132-11-27**]): Negative for Chlamydia trachomatis by PCR. NEISSERIA GONORRHOEAE (GC), NUCLEIC ACID PROBE, WITH AMPLIFICATION (Final [**2132-11-27**]): Negative for Neisseria Gonorrhoeae by PCR. [**2132-11-28**] Transthoracic ECHO: IMPRESSION: Normal left ventricular cavity size and regional systolic function. Mild pulmonary artery hypertension. Dilated ascending aorta. No valvular pathology or pathologic flow identified. Compared with the prior study (images reviewed) of [**2130-7-7**], global left ventricular systolic function is less vigorous (and the heart rate is much slower). . [**2132-12-2**] TEE: No spontaneous echo contrast or thrombus is seen in the body of the left or right atrium. No atrial septal defect is seen by 2D or color Doppler. Overall left ventricular systolic function is normal (LVEF>55%). Right ventricular chamber size and free wall motion are normal. There are simple atheroma in the descending thoracic aorta to 40 cm from the incisors. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion. No masses or vegetations are seen on the aortic valve. Trace aortic regurgitation is seen. The mitral valve leaflets are structurally normal. No mass or vegetation is seen on the mitral valve. Trivial mitral regurgitation is seen. No vegetation/mass is seen on the pulmonic valve. There is no pericardial effusion. IMPRESSION: No vegetations or clinically-significant valvular disease seen. Brief Hospital Course: 68M history of mental retardation and recurrent UTI secondary to urethral stricture admitted for recurrent UTI, urinary retention and resulting in urosepsis, fluid responsive hypotension. . ACTIVE ISSUES: # MRSA and E. Coli Septicemia: Pt presented with fever to 104, SBPs to 90s that was responsive to 5L of IVF. Likely due to urinary track infection in etiology. Pt presented in severe sepsis that was responsive to IVF and antibiotics. BCx (last + [**11-27**]) revealed E.Coli and Staph Aureus. TTE and TEE unrevealing for vegetations. I.D. consutled and agreed with CTX and Vancomycin until [**2132-12-11**]. Vanco trough should be rechecked, as well as labs, on [**2132-12-5**]. The I.D. team does not need to follow-up with the patient per team. . # Bacterial UTI: Pt has history of recurrent UTI secondary to urethral stricture. UA had >182 WBC and the source of his sepsis was thought to be likely GU. Pt was maintained with foley in place during admission and will be due to follow-up in Dr. [**Last Name (STitle) **] (urology clinic) on [**2132-12-18**]. . # Hyperglycemia - nor prior diagnosis of DM2: A1c 6.7 in 2/[**2132**]. Not on any medications at home. Repeat check of HbA1c in house was <6.0. . # Positive troponins - thought to be due to demand ischemia in the setting of hypotension. Upon transfer to he floor, routine EKG was obtained that showed new TWI. Cardiac enzymes continue to downtrend. Pt otherwise asymptomatic and recommend outpatient follow-up. - Consider rechecking ECG as outpatient to look for resolution of TWIs in inferior leads. Pt otherwise asymptomatic. . INACTIVE ISSUES: # h/o Hypertension: not on any antihypertensives - confirmed with group home. . # Depression: confirmed with group home, pt is on sertraline. . # Glaucoma: Patient with a known history of open angle glaucoma, - continue eye drops . TRANSTIONAL ISSUES: - Patient will be discharged to [**Hospital 100**] Rehab on [**12-2**]. Accepting physician, [**Last Name (NamePattern4) **]. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] will be emailed the summary above. - Direct verbal signout was provided to pt's PCP via phone on [**12-2**]. PCP recommends [**Name Initial (PRE) **]/u following discharge from [**Hospital 100**] Rehab. - Full Code - Patients Visting Nurse Medications on Admission: colace 100 mg po bid aspirin EC 81 mg po daily zoloft 25 mg po q hs vitamin B12 1000 mcg q day lumigan 0.03% 1 gtt each eye q hs Alphagan 0.2% 1 gtt each eye [**Hospital1 **] Tinactin power q hs to toes robitussin 100 ml/5ml q 4 hrs prn cough Tylenol 325-650 mg po q 6 prn pain, fever, Discharge Medications: 1. vancomycin in D5W 1 gram/200 mL Piggyback Sig: One (1) Intravenous Q 12H (Every 12 Hours): Continue through [**2132-12-11**]. 2. ceftriaxone 1 gram Piggyback Sig: One (1) Intravenous once a day: Continue through [**2132-12-11**]. 3. sertraline 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. latanoprost 0.005 % Drops Sig: One (1) Drop Ophthalmic HS (at bedtime). 5. brimonidine 0.15 % Drops Sig: One (1) Drop Ophthalmic [**Hospital1 **] (2 times a day). 6. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 7. Colace 100 mg Capsule Sig: One (1) Capsule PO twice a day. 8. Outpatient Lab Work Please check Basic Metabolic Panel and Vanco trough Friday [**2132-12-5**] Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - [**Location (un) 550**] Discharge Diagnosis: Primary Diagnosis - E.Coli Septicemia - MRSA Septicemia - Urinary Retention 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 and were found to have a urinary track infection and were found to have a bacterial infection in your blood. . The following changes have been made to your medications: 1) Vancomycin 1gm every 12 hours until [**12-11**] 2) Ceftriaxone 1gm every day until [**12-11**] Followup Instructions: Department: SURGICAL SPECIALTIES When: THURSDAY [**2132-12-18**] at 2:30 PM With: PELVIC FLOOR UNIT [**Telephone/Fax (1) 274**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: WEST [**Hospital 2002**] CLINIC When: MONDAY [**2133-5-18**] at 3:00 PM With: [**Name6 (MD) **] [**Name8 (MD) **], MD [**Telephone/Fax (1) 9420**] Building: De [**Hospital1 **] Building ([**Hospital Ward Name 121**] Complex) [**Location (un) **] Campus: WEST Best Parking: [**Street Address(1) 592**] Garage ICD9 Codes: 5990, 5849, 311
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6095 }
Medical Text: Admission Date: [**2155-12-24**] Discharge Date: [**2156-2-4**] Date of Birth: [**2106-8-13**] Sex: M Service: NEUROLOGY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 618**] Chief Complaint: Headache Major Surgical or Invasive Procedure: None History of Present Illness: 49 year-old man with a history of bipolar/schizoaffective disorder, hypothyroidism, recent admission to OSH with HA who was transferred with recurrent HA, nausea and new left parietal hemorrhage. At admission, patient was found to be a poor historian and much of the history was apparently taken from medical records per OSH and the pt's sister. Per sister, pt first presented to PCP [**Last Name (NamePattern4) **] [**11-29**] with ~8-9 days of nearly daily headache, nausea and vomiting. She was unable to provide details of headache. PCP arranged for head CT which was normal, and pt sent home. Sister accompanied him home, and realized that pt having difficulty with tasks such as dialing phone or using spoon. Normally pt lives alone, and sister felt he was unsafe so brought him to [**Hospital3 1443**] Hospital, where he was admitted from [**Date range (1) 65003**]. While there, he had MRI that per OSH discharge summary showed small bilateral strokes in postrior parietal parasaggital region near the parieto-occipital fissure, thought to be watershed however this was not observed. Also in differential was possible viral meningoencephalitis. Stroke workup with negative carotid US, echo, normal lipids and A1C, no arrythmias. He was started on ASA. On discharge he had full strength, was still having difficulty making phone calls. Headache had improved, though not fully resolved. Sister reports that he was getting percocet in hospital, though he was not discharged with any. Since discharge, sister reports that pt complaining of slowly worsening headache. Also has been complaining of trouble seeing, "I can't see the kitchen sink." He saw his PCP yesterday who thought headaches might be migraines, and gave him Zomig. Today the headache worsened and pt returned to OSH ED. Head CT showed left parieto-occipital bleed and pt transferred for further management. Per sister and brother-in-law, pt "does OK on all your tests, but he still has trouble functioning, such as trouble getting dressed." At baseline (prior to recent headaches) pt did have some cognitive difficulties, and some trouble articulating. He is worse now, but it is not entirely clear the time course of this. The trouble making phone calls is definitely new. Also of note, he has had some recent med changes after psych hospitalization at [**Hospital1 **] ~3 months ago. Also, while at OSH pt refused risperdal and was started on seroquel instead. Currently, pt reports vertex headache, am unable to get any more details. Also reports +nausea, trouble talking and trouble seeing. No chest pain, abdominal pain. Notes some left leg weakness as well. Social History: Lives alone, is own guardian. Sister had been his guardian in the past but apparently a court has determined that she is no longer allowed to hold this position. Family History: Sister with mental illness. Physical Exam: Admission Physical BP 135-152/70s-80s HR 50s-60s RR 18 General: Appears stated age, in no acute distress HEENT: NC/AT Sclera anicteric. OP clear Neck: Supple Lungs: Clear to auscultation anterolaterally CV: Brady, reg rhythm, nl S1, S2, no murmur. No carotid or vertebral bruit Abd: Soft, overweight, nontender, normoactive bowel sounds Extr: No edema, good dorsalis pedis pulses Neurologic Examination: Mental Status: Awake, oriented to person, place and "[**Month (only) 359**], [**2152**]", mostly cooperative with exam though got mildly irritable near end Attention: Can say days of week backward, but slow Language: Fluent, maybe slight dysarthria, no paraphasic errors, repetition intact. Does not name "hand", says "clock" for "watch", does not name "watchband" but does get "pen" Can name my coat color as "white" but does not name "green" or "blue" No apraxia for combing hair, brushing teeth, salute. However, cannot tell me how to make a phone call. No neglect Cranial Nerves: Visual fields with right hemianopsia. Pupils equally round and reactive to light. Extraocular movements intact, no nystagmus. Facial sensation and facial movement normal bilaterally. Hearing intact to finger rub bilaterally. Normal oropharyngeal movement. Tongue midline, no fasciculations. Motor: Normal bulk and tone bilaterally, fasiculations absent in upper and lower extremities. No tremor. No pronator drift. Full strength bilateral deltoid, triceps, finger ext, finger flexion, IP, dorsiflexion Sensation was intact to light touch and temperature (cold). Reflexes: DTRs decreased and symmetric throughout, except absent at knees. Toes were mute bilaterally Coordination is normal on finger-nose-finger Gait deferred. Pertinent Results: MRI/MRA [**12-24**]: 1. MR features of a 43 x 34 mm intracerebral hematoma at the left parietal/occipital region, with surrounding vasogenic edema, and extension of hemorrhage into the adjacent subarachnoid spaces and ventricular system. 2. No obstructive hydrocephalus is seen at present. 3. No pathological enhancement to identify an underlying lesion relating to the left parietal-occipital hematoma. 4. Normal brain MR angiography. . TTE: No valvular vegetations or intracardiac thrombi seen. EF>55%. No PFO/ASD. . CT head [**1-8**]: There has been evolution of the previously noted blood products in the left parieto-occipital region, overall unchanged in extent in the interval. However, new in the interval is hypodensity in the left internal capsule and thalamus, which is exerting slight mass effect on the frontal [**Doctor Last Name 534**] of the left lateral ventricle. This is concerning for acute or subacute infarction. No new intracranial hemorrhage or other new suspicious areas of hypodensity are noted. There is no hydrocephalus. The basilar cisterns are visible. The mastoid air cells are opacified bilaterally. The remainder of the paranasal sinuses and the orbits are unremarkable. . EEG [**1-8**]: IMPRESSION: This is a mildly abnormal EEG due to the presence of a focal area of slowing in the left anterior quadrant suggestive of a subcortical abnormality in this region. Background frequencies were also somewhat slower than normal, suggesting the presence of a mild encephalopathy of toxic, metabolic, or anoxic etiology. . CTA neck [**1-10**]: 1. Left internal jugular vein thrombosis as described. Question of left sigmoid sinus partial thrombosis, versus mixing artifact. 2. Mastoid and partial ethmoid and sphenoid sinus opacification. . CT head [**1-12**]: 1. New hemorrhagic transformation of left caudate nucleus infarction. Blood products within the fourth ventricle. Close clinical followup and followup CT scan recommended. 2. Probable superior sagittal sinus thrombosis and possible thrombosis of the left sigmoid sinus, with continued thrombosis of the left internal jugular vein. . CT head [**1-29**] (compared to [**1-19**]): There has been no significant change from [**2156-1-20**] with a stable appearing left frontal hemorrhage with surrounding edema. There is also a resolving region of hypodensity from hemorrhage in the left temporal lobe. There is stable appearance of the effaced frontal [**Doctor Last Name 534**] of the left lateral ventricle. No new foci of hemorrhage are indicated. There is no shift of normally midline structures. There is some left sphenoid sinus mucosal thickening. IMPRESSION: Multiple stable hemorrhages as described above with no new significant change from [**2156-1-20**]. . [**2155-12-23**] 06:50PM PT-13.3 PTT-20.5* INR(PT)-1.2 [**2155-12-23**] 06:50PM PLT COUNT-170 [**2155-12-23**] 06:50PM NEUTS-80.4* LYMPHS-15.2* MONOS-3.9 EOS-0.4 BASOS-0.1 [**2155-12-23**] 06:50PM WBC-14.8* RBC-4.61 HGB-14.6 HCT-39.9* MCV-87 MCH-31.7 MCHC-36.6* RDW-12.7 [**2155-12-23**] 06:50PM VALPROATE-37* [**2155-12-23**] 06:50PM CALCIUM-9.5 PHOSPHATE-4.6* MAGNESIUM-1.9 [**2155-12-23**] 06:50PM CK-MB-1 cTropnT-<0.01 [**2155-12-24**] 12:00AM URINE BLOOD-TR NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-15 BILIRUBIN-NEG UROBILNGN-NEG PH-6.5 LEUK-NEG [**2155-12-24**] 06:00AM T3-104 FREE T4-1.0 [**2155-12-24**] 06:00AM TSH-5.7* [**2155-12-24**] 06:00AM LIPASE-40 [**2155-12-24**] 06:00AM ALT(SGPT)-10 AST(SGOT)-13 CK(CPK)-31* ALK PHOS-101 AMYLASE-52 TOT BILI-0.3 [**2155-12-24**] 03:13PM ASA-NEG ETHANOL-NEG ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**2155-12-24**] 03:13PM AMMONIA-48* [**2155-12-24**] 03:13PM ALBUMIN-3.9 [**2156-1-12**] 09:45AM BLOOD Fibrino-482* D-Dimer-2839* [**2156-1-11**] 09:36PM BLOOD FDP-10-40 [**2156-1-9**] 12:50PM BLOOD ESR-75* [**2156-1-14**] 01:55PM BLOOD ESR-47* [**2156-1-26**] 01:19PM BLOOD FacVIII-154* [**2156-2-1**] 06:30AM BLOOD LMWH-1.06 [**2156-1-26**] 01:19PM BLOOD ACA IgG-4.6 ACA IgM-7.8 [**2156-1-21**] 11:10AM BLOOD ProtCFn-119 ProtCAg-88 ProtSFn-96 ProtSAg-148* [**2156-1-9**] 07:00PM BLOOD Lupus-NEG AT III-74 [**2156-1-9**] 07:00PM BLOOD ProtCAg-63* ProtSAg-146* [**2156-1-29**] 11:00AM BLOOD TSH-4.1 [**2155-12-24**] 06:00AM BLOOD T3-104 Free T4-1.0 [**2156-1-12**] 11:58AM BLOOD [**Doctor First Name **]-NEGATIVE [**2156-1-14**] 01:55PM BLOOD CRP-11.0* [**2156-1-29**] 11:00AM BLOOD Lithium-0.8 Brief Hospital Course: Mr. [**Known lastname 65004**] is a 49 yo RHM with h/o bipolar/schizoaffective disorder, hypothyroidism, who was transferred with complaints of headache for about a month and nausea. Upon admission he was found to have a large left parietal hemorrhage. The exam upon admission was notable for inattention, anomia, right field cut, mild-moderate R hemiparesis, and perseveration. . Neuro: The patient was transferred to the Neuro/ICU for telemetry and aggressive blood pressure control. Neurosurgery evaluated him and no surgical intervention was necessary. His MRI/MRA scans revealed a large (~40cc) hemorrhage near the [**Doctor Last Name 352**]-white junction in the left parietal lobe. There was no clear underlying mass and there were no underlying vascular abnormalities per MRA (no aneurysms/AVM). An ECHO, to look for a cardio-embolic etiology, was negative (no valvular vegetations or intracardiac thrombi; no PFO/ASD, but not with certainty as the image quality was poor). Mr [**Known lastname 65004**] then developed a L thalamic infarct [**1-8**], and was less alert, with increased R hemiparesis. An EEG ([**1-8**]) showed focal slowing in the L anterior quadrant. A hemorrhagic conversion of the infract was then noted on [**1-12**] with some intraventricular blood (found incidentally when getting CTV). The CTV ([**1-12**]) showed a L superior sagittal sinus thrombosis and ?L sigmoid sinus thrombosis with extension into the internal jugular vein. A repeat head CT [**1-14**], showed no evidence of hydrocephalus, and no further blood in 4th ventricle. Mr. [**Known lastname 65004**] was started on anticoagulation with Lovenox on [**1-13**]. He was also given a short course of Diamox for L hemisphere edema. Neurosurg was re-consulted to monitor the hemorrhage into the 4th ventricle given the risk of hydrocephalus. No intervention was necessary. Follow up CT-head series showed a stable picture. . Psychiatry: The patient was maintained on seroquel. Depakote was discontinued, and lithium was started [**1-6**]. Lithium levels should be monitored closely (every 2 weeks) and the dosing should be adjusted accordingly. The patient has been closely followed by the psychiatry service. Please contact Dr. [**Last Name (STitle) 65005**], [**Numeric Identifier 65006**] if any questions arise. Close follow up will be arranged. Haldol was given on a PRN basis. . Cardiovascular: An Echo showed an EF>55%. The patient was ruled out for an MI [**1-8**]. Goal SBP<160. Lipids profile was within normal limits. EKG should be checked if the patient receives haldol on a regular basis (risk for prolonged QT). . FEN/GI: -cardiac prudent diet . Hematology: The patient was noted to be thrombocytopenic w/nadir in 80s, likely secondary to Depakote. Plt normalized after Depakote was discontinued. As part of a workup related to the sinus thrombosis the following tests were done: -No LE DVT on [**1-11**] U/S. -Hypercoagulable workup: Fibrinogen 482, D-dimer 2938. Homocysteine wnl, [**Doctor First Name **] neg, Lupus anticoagulant neg, ATIII wnl, FVL neg. Prot C slightly low 63, Prot S elevated (?acute phase reactant). Factor VIII and anticardiolipin normal. Prothrombin gene mutation pending. Please resend hypercoag workup again in the future if Pt ever comes off anticoagulation. The patient was started on anticoagulation with lovenox as he is not a coumadin candidate. Lovenox level 2.0 on [**1-26**], after which the dose was decreased; level on [**2-1**]: 1.06; level on [**2-3**]: 0.9 (i.e. within goal range). . Other: The patient has had multiple falls [**12-31**], [**1-5**], [**1-6**] x2, all secondary to orthostasis, a R field cut, and impulsivity. Please check orthostatics in case the patient is unsteady. . Endocrine: -TSH 3.4; Levoxyl was continued. Please continue to monitor. -HbA1C 5.2, no intervention needed. . ID: On Cipro [**Date range (1) 14813**] for E. coli UTI. UA on [**2-2**] was negative. . ENT: Sinus opacification upon admission. This has resolved. If patient becomes symptomatic he will need ENT follow up. . Legal: Mr [**Known lastname 65004**] has a legal guardian since [**1-30**]. [**Name2 (NI) **] is incompetent to sign consent for procedures as he cannot clearly understand its risks and benefits. His sister who had been his previous guardian was legally not permitted to hold this position any longer. Medications on Admission: Depakote 1[**Telephone/Fax (1) 65007**], seroquel 75 hs, cogentin 1 [**Hospital1 **], ASA 325, levoxyl 12.5 Discharge Medications: 1. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 3. Acetaminophen-Codeine 300-30 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed. 4. Quetiapine 100 mg Tablet Sig: 1.5 Tablets PO QAM (once a day (in the morning)). 5. Quetiapine 100 mg Tablet Sig: 2.5 Tablets PO QHS (once a day (at bedtime)). 6. Lithium Carbonate 300 mg Capsule Sig: One (1) Capsule PO QAM (once a day (in the morning)). 7. Haloperidol Lactate 5 mg/mL Solution Sig: Two (2) mL Injection Q4H (every 4 hours) as needed for agitation. 8. Lithium Carbonate 300 mg Capsule Sig: Three (3) Capsule PO QHS (once a day (at bedtime)). 9. Levothyroxine 25 mcg Tablet Sig: 0.75 Tablet PO DAILY (Daily). 10. Enoxaparin 100 mg/mL Syringe Sig: One (1) Subcutaneous Q12H (every 12 hours). 11. Benztropine 1 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Discharge Disposition: Extended Care Facility: Hollywell - [**Location (un) 5110**] Discharge Diagnosis: 1. Intracranial hemorrhage 2. intracranial ischemic stroke 3. venous sinus thrombosis 4. psychosis 5. urinary tract infection 6. hypothyroidism Discharge Condition: Stable Impulsivity, very mild residual hemiparesis and subtle R-upper quadrant field cut; Discharge Instructions: Please take your medications as instructed. . Please check Lithium level every 2 weeks. . Please f/u with Neurology, Psychiatry, and your PCP. Followup Instructions: Please follow up at the Neurology/[**Hospital 4038**] clinic: [**Name6 (MD) 4267**] [**Last Name (NamePattern4) 4268**], MD, [**MD Number(3) 13795**]:[**Telephone/Fax (1) 657**] Date/Time:[**2156-4-6**] 1:00 . The patient will need cery close follow up with Psychiatry. Dr. [**Last Name (STitle) 65005**] [**Numeric Identifier 65006**]) from the Dept. of Psychiatry will leave instructions for follow up. If you do not hear from him within one week, please call his number. . Please follow up with your PCP [**Name Initial (PRE) 176**] 1 week after discharge from rehab. . [**Name6 (MD) **] [**Name8 (MD) **] MD, [**MD Number(3) 632**] Completed by:[**2156-2-4**] ICD9 Codes: 5990, 2449
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6096 }
Medical Text: Admission Date: [**2136-8-31**] Discharge Date: [**2136-9-7**] Date of Birth: [**2064-3-15**] Sex: F Service: MEDICINE Allergies: Penicillins Attending:[**First Name3 (LF) 613**] Chief Complaint: N/V/diarrhea Major Surgical or Invasive Procedure: intubation, placement of femoral line History of Present Illness: 72 yoF with h/o HIV(CD4 312, VL <50 [**2136-8-23**]),CHF(EF 10%), h/o endocarditis, who p/w N/V and diarrhea for two days. Diarrhea is watery, nonbloody. Vomitus is non-bloody. Also reports abdominal pain. In ED, patient reported fevers at home to 103. Denied recent travel, dietary changes, chest pain. Did note mild HA. . In the ED, T 96.7, SBP in 80s. Patient's abdomen diffusely tender and distended. Laboratory studies showed lactate 6.8, transaminitis with INR 9.1, pancreatitis, acute on chronic renal failure with hyperkalemia and hyperphosphatemia. Patient received vancomycin 1 gram, levo 750 mg, and falgyl 500 mg, as well as 10 mg of vitamin K, 15 grams of kayexalate, 1 amp of biarb, and calcium gluconate with insulin. She had a femoral CVL placed and was volume resuscitated but rapidly developed SOB. By report from ED resident, long discussion with patient held and patient voiced desire to be DNR but would like to be intubated and dialyzed. Patient was then intubated and volume resuscitation continued. Was also briefly placed on levophed for hypotension which was quickly weaned off. She received a CT of the abdomen/pelvis which showed some concern for ischemic changes. Surgery evaluated patient and did not feel there was any acute indication for surgery. Renal was also consulted and felt that she did not need emergent dialysis. . Of note, recent admit [**Date range (1) 105349**] after presenting with bradycardia and treated for digoxin and amiodarone toxicity, acute on CRI, and CHF. Amiodarone stopped (had been started during prior hospitalization due to runs of Vtach. Also started on coumadin given severely depressed EF. [**Date range (1) 2775**] therapy was also discontinued which was verified with her PCP. Past Medical History: 1. HIV- Diagnosed in [**2116**], has taken [**Year (4 digits) 2775**] therapy intermittently. Stopped taking her pills three months ago because stated she had foamy vomit every time she took them. CD4 274, VL<50 in [**12-10**] 2. CHF- EF 10% 7/07 followed by Dr. [**First Name (STitle) 437**] 3. HCV- VL >700K in [**12-9**], not a good candidate for interferon therapy or liver biopsy per gi note in 04. 4. mild COPD- PFTs [**7-/2129**] showed a normal study 5. IVDU--last abuse heroin several days ago, skin popping 6. Arthritis 7. chronic pancreatitis 8. ventricular tachycardia Social History: Has 20 grandchildren, tobacco: [**4-8**] cig/day, 40 py Heavy EtOH in past. States that last used heroin in the past few days (skin popping) and also used cocaine in the last month. Family History: NC Physical Exam: PE: T: 96.2 BP: 83/60 HR: 53 Vent: AC 450x12, PEEP 5, FiO2 1 Gen: intubated, sedated HEENT: No icterus. Dry MMs. ET tube in place NECK: Supple, No LAD. JVP ~14 cm H2O. CV: RRR. nl S1, S2. II/VI holosystolic murmur. +S3. LUNGS: crackles at bases ABD: NABS. moderately distended. Soft. Left femoral CVL in place EXT: WWP, NO CCE. 2+ DP pulses BL SKIN: Diffuse scarring from skin popping on lower extremities. Scarring from presumed IVDU in anticubital fossas NEURO: pupils equal, dilated, minimally reactive Pertinent Results: [**2136-8-30**] 05:59PM HGB-9.4* calcHCT-28 [**2136-8-30**] 05:59PM GLUCOSE-37* LACTATE-6.8* NA+-134* K+-6.1* CL--101 TCO2-16* [**2136-8-30**] 06:35PM PT-70.8* PTT-50.9* INR(PT)-9.1* [**2136-8-30**] 06:35PM PLT SMR-NORMAL PLT COUNT-247 [**2136-8-30**] 06:35PM HYPOCHROM-2+ ANISOCYT-NORMAL POIKILOCY-NORMAL MACROCYT-2+ MICROCYT-NORMAL POLYCHROM-1+ OVALOCYT-1+ BURR-1+ [**2136-8-30**] 06:35PM NEUTS-85* BANDS-0 LYMPHS-10* MONOS-5 EOS-0 BASOS-0 ATYPS-0 METAS-0 MYELOS-0 [**2136-8-30**] 06:35PM WBC-7.3 RBC-3.21* HGB-9.4* HCT-29.2* MCV-91 MCH-29.3 MCHC-32.2 RDW-15.4 [**2136-8-30**] 06:35PM CALCIUM-8.8 PHOSPHATE-8.8*# MAGNESIUM-2.9* [**2136-8-30**] 06:35PM CK-MB-NotDone [**2136-8-30**] 06:35PM cTropnT-0.04* [**2136-8-30**] 06:35PM LIPASE-111* [**2136-8-30**] 06:35PM ALT(SGPT)-345* AST(SGOT)-777* CK(CPK)-91 ALK PHOS-123* AMYLASE-173* TOT BILI-1.1 [**2136-8-30**] 06:35PM GLUCOSE-168* UREA N-88* CREAT-5.1*# SODIUM-129* POTASSIUM-6.0* CHLORIDE-92* TOTAL CO2-14* ANION GAP-29* [**2136-8-30**] 06:48PM GLUCOSE-165* LACTATE-5.9* K+-5.9* [**2136-8-30**] 08:19PM PO2-32* PCO2-43 PH-7.30* TOTAL CO2-22 BASE XS--5 INTUBATED-INTUBATED [**2136-8-30**] 09:30PM PT-76.8* PTT-68.8* INR(PT)-10.0* [**2136-8-30**] 09:30PM PLT COUNT-185 [**2136-8-30**] 09:30PM NEUTS-87.1* LYMPHS-8.3* MONOS-4.3 EOS-0.3 BASOS-0 [**2136-8-31**] 03:17AM URINE MUCOUS-FEW [**2136-8-31**] 03:17AM URINE RBC-21-50* WBC-[**7-15**]* BACTERIA-FEW YEAST-NONE EPI-<1 [**2136-8-31**] 03:17AM URINE BLOOD-LG NITRITE-NEG PROTEIN-100 GLUCOSE-NEG KETONE-NEG BILIRUBIN-MOD UROBILNGN-NEG PH-5.0 LEUK-NEG [**2136-8-31**] 03:17AM URINE COLOR-Amber APPEAR-Hazy SP [**Last Name (un) 155**]-1.018 [**2136-8-31**] 03:17AM FIBRINOGE-234 D-DIMER-1335* [**2136-8-31**] 03:17AM FDP-0-10 [**2136-8-31**] 03:17AM PT-84.2* PTT-52.8* INR(PT)-11.2* [**2136-8-31**] 03:17AM PLT COUNT-206 [**2136-8-31**] 03:17AM WBC-8.7 RBC-3.30* HGB-9.3* HCT-29.5* MCV-90 MCH-28.4 MCHC-31.6 RDW-15.1 [**2136-8-31**] 03:17AM URINE bnzodzpn-NEG barbitrt-NEG opiates-POS cocaine-NEG amphetmn-NEG mthdone-POS [**2136-8-31**] 03:17AM URINE HOURS-RANDOM [**2136-8-31**] 03:17AM ASA-NEG ETHANOL-NEG ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**2136-8-31**] 03:17AM CORTISOL-39.6* [**2136-8-31**] 03:17AM HAPTOGLOB-123 [**2136-8-31**] 03:17AM CALCIUM-8.2* PHOSPHATE-8.7* MAGNESIUM-2.7* [**2136-8-31**] 03:17AM CK-MB-6 cTropnT-0.03* [**2136-8-31**] 03:17AM CK(CPK)-68 [**2136-8-31**] 03:17AM GLUCOSE-72 UREA N-84* CREAT-4.9* SODIUM-134 POTASSIUM-6.5* CHLORIDE-99 TOTAL CO2-17* ANION GAP-25* [**2136-8-31**] 04:35AM CORTISOL-42.2* [**2136-8-31**] 04:43AM TYPE-ART TEMP-36.1 RATES-12/ TIDAL VOL-450 PEEP-5 O2-100 PO2-348* PCO2-36 PH-7.25* TOTAL CO2-17* BASE XS--10 AADO2-335 REQ O2-61 -ASSIST/CON INTUBATED-INTUBATED [**2136-8-31**] 05:43AM CORTISOL-38.6* [**2136-8-31**] 05:52AM POTASSIUM-5.3* [**2136-8-31**] 06:06AM O2 SAT-95 [**2136-8-31**] 06:06AM TYPE-[**Last Name (un) **] [**2136-8-31**] 11:38AM PT-36.2* PTT-49.4* INR(PT)-4.0* [**2136-8-31**] 11:38AM DIGOXIN-0.5* [**2136-8-31**] 11:38AM VANCO-<1.7 [**2136-8-31**] 11:38AM POTASSIUM-5.0 [**2136-8-31**] 02:28PM K+-4.1 [**2136-8-31**] 02:28PM TYPE-ART TEMP-35.9 RATES-14/4 TIDAL VOL-450 PEEP-5 O2-50 PO2-91 PCO2-41 PH-7.43 TOTAL CO2-28 BASE XS-2 -ASSIST/CON INTUBATED-INTUBATED [**2136-8-31**] 06:45PM estGFR-Using this [**2136-8-31**] 06:45PM GLUCOSE-88 UREA N-84* CREAT-4.3* SODIUM-137 POTASSIUM-4.0 CHLORIDE-99 TOTAL CO2-25 ANION GAP-17 . CT ABDOMEN W/O CONTRAST [**2136-8-30**] 9:32 PM 1. Linear focus of air within the left renal vein. Approximate volume is 0.7 cubic centimeters. This is of unclear clinical significance, but likely relates to injected air from IV placement or medication administration. 2. Diffuse stranding of the mesentery and abdominal ascites. Please note, lack of intravenous contrast administration limits detailed evaluation of the intra-abdominal and pelvic organs. 3. Non-obstructive left upper pole renal calculus. 4. Nasogastric tube should be advanced at least 5 cm for optimal placement. . CT HEAD W/O CONTRAST [**2136-8-31**] 12:41 AM IMPRESSION: Limited examination secondary to patient motion. No acute intracranial hemorrhage. INTERPRETATION: Findings: This study was compared to the prior study of [**2136-8-3**]. LEFT ATRIUM: Marked LA enlargement. LA volume markedly increased. RIGHT ATRIUM/INTERATRIAL SEPTUM: Markedly dilated RA. The patient is mechanically ventilated. Cannot assess RA pressure. LEFT VENTRICLE: Normal LV wall thickness. Severely dilated LV cavity. Severe global LV hypokinesis. No LV mass/thrombus. No resting LVOT gradient. RIGHT VENTRICLE: Moderately dilated RV cavity. Severe global RV free wall hypokinesis. AORTA: Normal aortic diameter at the sinus level. Focal calcifications in aortic root. AORTIC VALVE: Mildly thickened aortic valve leaflets (3). No AS. No AR. MITRAL VALVE: Mildly thickened mitral valve leaflets. Moderate thickening of mitral valve chordae. Moderate (2+) MR. TRICUSPID VALVE: Mildly thickened tricuspid valve leaflets. Moderate to severe [3+] TR. Moderate PA systolic hypertension. PULMONIC VALVE/PULMONARY ARTERY: Normal pulmonic valve leaflets. Significant PR. PERICARDIUM: No pericardial effusion. GENERAL COMMENTS: Ascites. Conclusions: The left and right atria are markedly dilated. The left atrial volume is markedly increased. Left ventricular wall thicknesses are normal. The left ventricular cavity is severely dilated with severe global hypokinesis (LVEF <20%). No masses or thrombi are seen in the left ventricle. The right ventricular cavity is moderately dilated with severe global free wall hypokinesis. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is moderate thickening of the mitral valve chordae. Moderate (2+) mitral regurgitation is seen. The tricuspid valve leaflets are mildly thickened. Moderate to severe [3+] tricuspid regurgitation is seen. There is moderate pulmonary artery systolic hypertension. Significant pulmonic regurgitation is seen. There is no pericardial effusion. Compared with the prior study (images reviewed) of [**2136-8-3**], the severity of tricuspid regurgitation has progressed. Biventricular systolic function is similar. Brief Hospital Course: Shock: In the MICU, pt had evidence of multisystem organ dysfunction. Ddx included septic vs. cardiogenic. There was initial concern for septic shock given reported high fever, symptoms of GI infection, and hypotension. However, after volume resuscitation, pt was extubated, off all pressors and mounting excellent BP for her EF. It was thought that her hypotension was likely due to cardiogenic shock in the setting of dehydration from diarrhea and preload dependence. No source for infection was isolated during her hospital stay. Mrs [**Known lastname **] was treated with a full 7 day course of levofloxacin and flagyl for presumed gastroenteritis in immunocompromised patient. Stool cultures, blood cultures, urine cx remained negative throughout stay. Was ruled out for MI with serial cardiac enzymes. CHF: An ECHO was completed on [**2136-8-31**] that revealed marked dilatation of the left and right atria, normal left ventricular wall thicknesses. The left ventricular cavity was severely dilated with severe global hypokinesis (LVEF <20%). No masses or thrombi were noted. The right ventricle was moderately dilated with severe hypokinesis. Moderate (2+) mitral regurgitation and moderate to severe [3+] tricuspid regurgitation was seen. There was moderate pulmonary artery systolic hypertension with significant pulmonic regurgitation. Patient has been treated with anticoagulation with goal INR [**3-10**] in setting of her global hypokinesis and poor EF. At the time of discharge her INR was 1.7 on Coumadin 2mg. Throughout her hospital course, Mrs. [**Known lastname **] felt short of breath, was unable to lie flat secondary to orthopnea, and had cough. CXR on [**2136-9-4**] demonstrated small bilateral pleural effusion, left greater than right, and left atelectasis vs. consolidation. She was treated with diuresis, oxygen via nasal cannula and incentive spirometry. It was felt that her symptoms were likely secondary to her severe CHF and pulmonary edema. Patients sats remained good. By the time of discharge she was comfortable, experienced no SOB but remained on 4L via nasal cannula for symptomaitc relief. She would have labored breathing if that aws not administered. Chronic renal failure- Patients baseline Cr is 1.5-2. Her peak cr during hospitalization was 4.3 and had returned to baseline (1.8) by the time of discharge. Renal failure was thought to be prerenal. HIV/AIDS Mrs [**Known lastname **] [**Last Name (NamePattern1) **] most recent labs revealed CD4 count of 312, Viral load less than 50 on [**2136-8-23**]. She was not started on antiretrovirals or during her hospital course. Patient was on PCP prophylaxis with bactrim. # CODE STATUS: lengthy discussion with pt. and grandson by primary and CHF teams and pt. made decision that she would like to seek hospice with focus on comfort and would not want to be intubated or resuscitated in the future and would like to avoid future hospitalizations. Her code status was changed and palliative care consult was called to aid in placement and delineation of goals. She was screened for hospice. Medications on Admission: Methadone 90 mg PO DAILY Lansoprazole 30 mg PO DAILY Trimethoprim-Sulfamethoxazole 160-800 mg PO DAILY Furosemide 100 mg PO BID Digoxin 125 mcg PO every other day Coumadin 5 mg PO once a day Discharge Medications: 1. Warfarin 2 mg Tablet [**Year (4 digits) **]: One (1) Tablet PO DAILY (Daily). 2. Ipratropium Bromide 0.02 % Solution [**Year (4 digits) **]: One (1) Inhalation Q4-6H (every 4 to 6 hours). 3. Digoxin 125 mcg Tablet [**Year (4 digits) **]: Half tablet Tablet PO QMOWEFR (Monday -Wednesday-Friday). 4. Albuterol Sulfate 0.083 % (0.83 mg/mL) Solution [**Year (4 digits) **]: One (1) Inhalation Q4H (every 4 hours). 5. Furosemide 40 mg Tablet [**Year (4 digits) **]: 2.5 Tablets PO BID (2 times a day). 6. Methadone 10 mg/mL Concentrate [**Year (4 digits) **]: Three (3) PO TID (3 times a day). 7. Morphine 10 mg/5 mL Solution [**Year (4 digits) **]: One (1) PO Q3H (every 3 hours) as needed for pain or Shortness of breath. 8. Lorazepam 0.5 mg Tablet [**Year (4 digits) **]: [**2-7**] to 1 tablet Tablet PO Q4H (every 4 hours) as needed for anxiety. 9. Aspirin 325 mg Tablet [**Month/Day (2) **]: One (1) Tablet PO DAILY (Daily). Discharge Disposition: Extended Care Facility: [**Location (un) 11729**] Home - [**Location (un) 686**] Discharge Diagnosis: HIV/AIDS (CD4 312, VL< 50 on [**2136-8-23**]) CHF (EF 10%) Chronic hepatitis C Discharge Condition: Stabe [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) **] MD [**MD Number(2) 617**] ICD9 Codes: 0389, 5849, 5859, 4280, 2767, 496, 4240
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6097 }
Medical Text: Admission Date: [**2149-11-29**] Discharge Date: [**2149-12-3**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 30**] Chief Complaint: black stools and weakness x 7 days. Major Surgical or Invasive Procedure: Esophagogastroduodenoscopy History of Present Illness: 87 yo f w/ h/o CHF, htn, afib, and h/o recent fall resulting in a compression [**Hospital **] transferred from [**Hospital3 **] for c/o black stools w/ hct 16.3 and INR 32.3 due to no available ICU beds at [**Hospital1 392**]. Patient was AF, bp 130/44 and hr 87. She received 2 U PRBC, 40 IV protonix, and 10 mg IV vit K for this. On arrival to [**Hospital1 18**] ER, hct 25.2 and INR 2.1. BP 150/54 and hr 70. Patient received additional 5 mg SQ vit K, in addition to 2 U FFP. NG lavage was done and yielded coffee ground emesis w/ the first 250 cc, followed by a pink-tinged fluid with the second 250 cc. On hx patient reports no po x 2 weeks due to nausea w/o c/o pain w/ eating. She has never had black stools in the past. She is on coumadin and her level was low 3 weeks ago (per her report) and thus her coumadin was increased. Patient denies any diarrhea w/ the black stool. She is N but no V, and she denies abd pain. No h/o NSAIDs and no h/o PUD. No BRBPR or hematemesis. She also denies c/o LH, COP, or SOB. However, she has been completely exhausted for the past week. Past Medical History: ## CHF ## HTN ## afib on coumadin ## h/o compression fx due to fall ## s/p recent fall (2 wks ago) Social History: + h/o tob: [**11-20**] pk yr hx, quit 25 yrs ago. No Etoh x 4 yrs, occasional in the past. Married and has 1 daughter. Contact for emergencies: [**Name (NI) **] [**Name (NI) **] (sister). Family History: NC Physical Exam: T 99.1 hr 71 bp 155/65 rr 18 O2 92% RA (100% on 4L NC) genrl: in nad, pleasant heent: perrla (3->2 mm), MMM, OP clear, NGT in place (120 cc lavage continues to produce coffee grounds) neck: no JVD cv: rrr, no m/r/g pulm: cta bilaterally abd: nabs, soft, nt/nd, no masses/hsm rectal: black, guiac positive stool surrounding anus extr: no [**Location (un) **] neuro: a, o x 3, strength and soft touch sensation [**6-5**] grossly in UE/LE Pertinent Results: [**2149-11-29**] 02:42PM WBC-16.8* RBC-2.81* HGB-9.0* HCT-25.2* MCV-90 MCH-31.9 MCHC-35.6* RDW-16.0* PLT COUNT-281 [**2149-11-29**] 02:42PM NEUTS-82.8* LYMPHS-13.3* MONOS-3.5 EOS-0.3 BASOS-0.2 [**2149-11-29**] 02:42PM PT-17.5* PTT-26.8 INR(PT)-2.1 [**2149-11-29**] 02:42PM GLUCOSE-115* UREA N-45* CREAT-1.0 SODIUM-141 POTASSIUM-3.7 CHLORIDE-101 TOTAL CO2-30 ANION GAP-14 . [**2149-12-3**] 05:03AM BLOOD WBC-11.7* RBC-3.53* Hgb-11.4* Hct-32.7* MCV-93 MCH-32.2* MCHC-34.8 RDW-15.5 Plt Ct-325 [**2149-12-3**] 05:03AM BLOOD Plt Ct-325 [**2149-12-3**] 05:03AM BLOOD Glucose-91 UreaN-21* Creat-1.0 Na-139 K-4.2 Cl-99 HCO3-31 AnGap-13 [**2149-12-3**] 05:03AM BLOOD Mg-1.8 . CXR [**2149-11-29**]: [**Hospital 93**] MEDICAL CONDITION: 87 year old woman with bibasilar crackles w/ h/o chf REASON FOR THIS EXAMINATION: r/o CHF HISTORY: Bibasilar crackles, rule out CHF. CHEST, SINGLE AP VIEW. No previous chest x-rays on PACS record for comparison. The lungs are hyperinflated. There is moderate to moderately severe cardiomegaly. There is subsegmental atelectasis and/or scarring at both bases. There is minimal blunting of both costophrenic angles. There is no CHF or frank consolidation. I doubt the presence of an infectious infiltrate. There is right upper hilar peribronchial cuffing. Linear atelectasis or scarring noted in the right mid zone. An NG tube is present, tip over proximal stomach. There is osteopenia and an old ununited left clavicle fracture. IMPRESSION: Hyperinflation and cardiomegaly. Right upper hilar peribronchial cuffing. No CHF. Doubt acute infectious infiltrate. . CT HEAD W/O CONTRAST [**2149-11-29**] 4:59 PM CT HEAD W/O CONTRAST Reason: r/o ich [**Hospital 93**] MEDICAL CONDITION: 87 year old woman with recent head trauma, INR 35 REASON FOR THIS EXAMINATION: r/o ich CONTRAINDICATIONS for IV CONTRAST: None. CT HEAD INDICATION: Recent head trauma, INR 35. No prior studies are available for comparison. TECHNIQUE: Non-contrast head CT. FINDINGS: There is no intraparenchymal or extra-axial hemorrhage. There is no shift of normally midline structures, mass effect or hydrocephalus. There is mild prominence of the ventricles and sulci consistent with age-related involutional change. Encephalomalacic changes are demonstrated in the anterior and medial portions of the frontal lobes bilaterally. There is also encephalomalacic change demonstrated in the left occipital lobe. Periventricular white matter hypodensities are also noted consistent with chronic small vessel ischemic change. The visualized paranasal sinuses and osseous structures are within normal limits. IMPRESSION: 1. No intracranial hemorrhage or mass effect. 2. Encephalomalacic changes in the bifrontal lobes and left occipital lobe. . CXR [**2149-11-29**]: Atrial fibrillation Modest nonspecific intraventricular conduction delay Modest ST-T wave changes with probable QT interval prolonged although is difficult to measure - are nonspecific but clinical correlation is suggested for possible in part metabolc/drug effect. No previous tracing available for comparison Intervals Axes Rate PR QRS QT/QTc P QRS T 78 0 118 446/479 0 -21 107 . Patient: [**Known firstname 2127**] [**Known lastname 780**] Ref.Phys.: Birth Date: [**2062-8-14**] (87 years) Instrument: GIF XQ140 gastroscope ID#: [**Numeric Identifier 62551**] ASA Class: P2 Medications: Cetacaine topical spray Meperidine 25mg Midazolam 1mg Procedure: The procedure, indications, preparation and potential complications were explained to the patient, who indicated her understanding and signed the corresponding consent forms. A physical exam was performed. The patient was administered Conscious sedation anesthesia. The patient was placed in the left lateral decubitus position and an endoscope was introduced through the mouth and advanced under direct visualization until the second part of the duodenum was reached. Careful visualization of the upper GI tract was performed. The procedure was not difficult. The patient tolerated the procedure well. There were no complications. Findings: Esophagus: Lumen: A small size hiatal hernia was seen. Excavated Lesions A single non-bleeding 6mm ulcer was found in the gastroesophageal junction. Stomach: Contents: Old blood was seen in the stomach. No sites of active bleeding were identified. Duodenum: Normal duodenum. Impression: Blood in the stomach Ulcer in the gastroesophageal junction Small hiatal hernia Brief Hospital Course: 87 yo f w/ h/o CHF, HTN, fib, and h/o recent fall transferred from OSH w/ likely UGI in setting of elevated INRX (on Coumadin). . ## UGI: The patient's HCT was 16.3 with INR 32.3 at OSH. The patient received 2 units of PR BC, Protonix 40 mg iv, and 10 mg IV Vit K at the OSH. Due to no ICU availability, the patient was transferred to [**Hospital1 18**]. On arrival to [**Hospital1 18**], her HCT was 25.2 with INR 2.1. She received additional mg sc Vit K and 2 u FFP. NG lavage showed coffee ground emesis followed by a pink-tinged fluid. CT of head was neg for bleeds. The patient was started on Protonix 40 mg iv bid and observed overnight in the MICU, and GI did not feel that urgent EGD was necessary as the patient was hemodynamically stable with stable HCT after blood transfusion. The patient was transferred to the floor in a hemodynamically stable and hct was stable at 33.2. EGD was performed on [**12-1**] which showed an ulcer at GE junction and old blood in the stomach without signs of active bleeding. The patient was switched to po Protonix [**Hospital1 **] after the procedure and hct continued to remain stable at the time of discharge. The patient is to follow up with Dr. [**First Name (STitle) 1356**], her PCP, [**Name10 (NameIs) **] decide on when to restart coumadin and close monitor of INR when she gets placed on coumadin again. . ## CHF: After a total of 4 units of PRBC transfusion, the patient became hypoxemic and required supplemental O2 to keep O2 sat above 92. Her lung exam was consistent with pulmonary edema. She was given IV lasix and her hypoxemia resolved. Once satting 95-97% on RA, she was restarted on her outpatient po lasix regimen. . ## Afib: Held beta blocker initially given UGIB. Once stable hemodynamically, outpatient atenolol 100mg qday and amlodipine 5mg qday were restarted for rate control. No coumadin was given during this hospitalization. GI felt that she can be restarted on coumadin but with close monitor of INR with goal of [**3-6**]. . ## HTN: No antihypertensives given while in the MICU. Received lasix iv for pulmonary edema and gradually added her outpatient antihypertensives, atenolol, amlodipine, and lasix. . ## S/p recent fall: Head CT w/o bleed or shift. The patient did not have other musculoskeletal pain anywhere. . ## Leukocytosis: No clear sources and the patient remained afebrile. WBC continued to trend down and at the time of discharge, wbc was 11.7. Ua/ucx and bcx and CXR were negative for infection. . ## PPX: pneumoboots, ppi - PT recommended outpatient PT as the patient became deconditioned during this hospitalization. The patient was discharged home with PT services. . ## FEN: Cardiac diet. Repleted 'lytes/prn. . ## Full code (confirmed w/ patient) Medications on Admission: coumadin 1 mg po qd lasix 40 mg po qam, 20 mg po qpm atenolol 100 mg po qd amlodipine 5 mg po qd 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. Furosemide 40 mg Tablet Sig: One (1) Tablet PO qam. Disp:*30 Tablet(s)* Refills:*2* 3. Furosemide 20 mg Tablet Sig: One (1) Tablet PO QPM (once a day (in the evening)). Disp:*30 Tablet(s)* Refills:*2* 4. Amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 5. Atenolol 50 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Disp:*60 Tablet(s)* Refills:*2* 6. Ativan 0.5 mg Tablet Sig: [**2-2**] Tablet PO once a day as needed for anxiety for 10 days. Disp:*5 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital **] Home Health Care Discharge Diagnosis: Principal: 1. Upper GI bleed. 2. Gastric Ulcer. 3. Blood Loss Anemia. Secondary: 1. Atrial Fibrillation. 2. Heart Failure (EF unknown) 3. Hypertension. 4. Vertebral Compression Fracture. Discharge Condition: Stable. Hematocrit stable at 32.7. Discharge Instructions: Return to the emergency department or call your primary care physician if you develop chest pain, shortness of breath, blood in your stools, abdominal pain, nausea, vomiting, bloody sputum, or any other worrisome symptoms. Do not take coumadin until you see you primary care physician tells you so. You may resume all your blood pressure medications as previously prescribed. We've added Protonix 40mg twice a day for your stomach ulcer. You have a follow-up appointment with Dr. [**First Name (STitle) 1356**] on [**2149-12-4**], Thursday at 10:50 am. Discuss with your primary care physician about starting calcium, vitamin D, and possibly bisphophonates for osteoporosis. Followup Instructions: 1. Provider: [**Name10 (NameIs) 1356**], [**Name11 (NameIs) **] [**Name Initial (NameIs) **]. Phone number: [**Telephone/Fax (1) 17465**]. Date/Time: [**2149-12-4**] at 10:50am. 2. Outpatient H. Pylori antibody assay - to be performed by Dr. [**First Name (STitle) 1356**]. 3. Please ask Dr. [**First Name (STitle) 1356**] to start you on calcium and vitamin D supplementation for osteoporosis. She may also add another medication callled a Bisphosphonate for this as well. ICD9 Codes: 4280, 4019, 2851
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Medical Text: Admission Date: [**2126-7-3**] Discharge Date: [**2126-7-12**] Date of Birth: [**2100-9-21**] Sex: F Service: MED Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1055**] Chief Complaint: CC: Increasing lethargy, malaise and chest secretions Major Surgical or Invasive Procedure: Replacement of G-tube on [**2126-7-11**] after it fell out. History of Present Illness: 25 year old female with h/o [**Date Range 14165**] cell anemia, 2 strokes, wheelchair bound, recently had aspiration pneunomia which was treated with ceftriaxone and Unasyn. Patient was sent to rehab after a brief hospitalization and then from rehab to home. Patient had increased secretions from 5 days PTA. From the morning of [**7-2**], patient had increased lethargy and had fevers to 102. Seen at [**Hospital **] Hospital where there was concern for stroke; she was noted also to have guaic positive drainage from J-tube site. CT raised the concern of possible stroke with new bleed in the R external capsule. INR measured there was 3.9, as patient had been on coumadin since stroke in [**2123**]. Patient was transferred here because of concern for intracranial hemorrhage. There is also a history of a bloody stool; it is unclear when that bloody stool happened. [**Name (NI) **] mother reports dark discharge from the J-tube. ER Course: Patient had leukocytosis to 51.7 with 81% neutrophils, 1% bands. Repeat head CT shows R basal ganglia calcification, however bleed could not be excluded; size has not increased from CT at OSH taken 8 hours earlier; multiple old bilateral hemispheric infarcts and likely pontine infarct. MICU Admission for: Initial concern for new intracranial hemorrhage. Past Medical History: PMH: s/p CVA x 2; 1st at age 7 years which left her mildly mentally retarted, 2nd in [**2123**] gave her L foot and R arm plegia, wheelchair bound, aphasic, s/p PEG, s/p J-tube, chronic leukocytosis, urinary tract infections, seizure disorder, chronic aspiration pneumonia, vertigo. Social History: Lives at home; mother is primary caregiver[**Telephone/Fax (3) 58519**]) . Does not smoke, drink alcohol or use illicit drugs. Patient has a 5 year old child. She receives VNA services. Patient at baseline is unable to take care of herself; dependent on assistance for ADLs. Family History: [**Name (NI) **] son has [**Name2 (NI) 14165**] trait vs [**Name2 (NI) 14165**] disease, as does a cousin. Physical Exam: Examination: T:102, HR:110, BP: 112/69, R:13, 93% on RA. Gen: Young AAF, eyes open, responsive through gestures, lying in bed looking fatigued. HEENT: PERRL, EOMI, Anicteric Neck: Supple, NT. Skin: WWP; no rashes. Chest: Crackles at both bases; patient unable to respond to request to cough. CVS: Tachycardia, normal S1/S2. Abd: J-tube and G-tube in place; purulent, greenish drainage surrounding J-tube. Ext: Tender L foot; no obvious swelling or sign of trauma; no warmth. Neuro: Mental status as described above. CNII-XII: Appears to be grossly intact. Motor: R arm 0/5, L arm [**1-10**]; able to grasp with L hand. DTRs: [**Name2 (NI) 35632**], Elbow 2+/2 bilat. Sensory: Hard to examine. Pertinent Results: CXR [**2126-7-2**]: Low lung volumes, no radiographic evidence of pneumonia. CT head w/o contrast [**2126-7-2**]: 1) Amorphous area of increased attenuation in the right basal ganglia/subinsular white matter/periventricular white matter near the atrium of the right lateral ventricle. This has the appearance of calcification, but blood products cannot be excluded. The area has not increased in size since the head CT scan from eight hours earlier. 2) Multiple bilateral hemispheric infarcts and likely pontine infarct as well. 3) Decreased size of brain, with expansion of maxillary sinuses and inner table, consistent with the patient's chronic mental retardation. MR head w/o contrast [**2126-7-3**]: 1) No evidence of acute infarction, although diffusion-weighted imagining would be more sensitive for acute infarction. 2) Evidence of multiple past infarcts, including evidence of past hemorrhage in the right putamen and in a small region of the right parietal lobe. CT head w/o contrast [**2126-7-3**]: 1) Stable appearance of the brain with no interval change noted since the previous exam. Multiple old hemispheric infarcts noted. Diffusion-weighted images are more sensitive to detect acute infarct. 2) A small area of increased attenuation in the right basal ganglia is suggestive of amorphous calcificatinos rather than blood by-products. A followup scan might be helpful based on clinical findings. CXR [**2126-7-4**]: Interval development of bibasilar patchy opacities, which may represent aspiration. MRA brain w/o contrast [**2126-7-5**]: 1) No significant interval change in the brain MR. On this study, however, diffusion weighted images were performed, and these showed no evidence of acute infarction. There is evidence of a chronic resolved slit hemorrhage in the right putamen, likely related to previous ischemic infarction. There are widespread areas of chronic infarction in the subcortical white matter. 2) The MRA shows absent flow signals in multiple major arteries of the circle of [**Location (un) **] with evidence of extensive formation of collaterals. This appearance is consistent with Moyamoya syndrome related to chronic occlusions among the major cerebral arteries. CXR [**2126-7-6**]: 1) Since the previous study there has been some improvement in the degree of right lower lobe partial atelectasis. 2) Areas of patchy infiltration in the right upper lobe and left upper lobe and left lower lobe are unchanged. 3) The tip of the SVP line remains in the right atrium. CT head w/o contrast [**2126-7-6**]: 1) No new intracranial hemorrhage. Appearance of brain unchanged since [**2126-6-3**]. CT abd/pelvis w contrast [**2126-7-6**]: 1) Bilateral lower lobe patchy consolidations consistent with patient's known chronic aspiration. 2) No evidence of acute intraabdominal abnormality. Multiple small mesenteric lymph nodes are present which do not meet CT criteria for pathological enlargement. Spleen small and dense, likely reflecting calcification. Video oropharyngeal swallow study [**2126-7-8**]: Penetration and aspiration with nectar thick and thin liquids secondary to poor bolus control and premature spillover. Aspiration was silent, and cued coughs were inefective for clearing the airway of barium. She showed evidence of phonatory apraxia in her delayed and discoordinated cued coughs. Pureed and honey think liquids (by tsp) were not penetrated or aspirated during this study today. 1) Maintain PEG for primary source of nutrition, hydration, meds. 2) Pureed foods and honey thick liquids by teaspoon for pleasure may be allowed. [**2126-7-2**] 08:50PM PT-19.3* PTT-44.8* INR(PT)-2.5 [**2126-7-2**] 08:50PM PLT COUNT-453* [**2126-7-2**] 08:50PM HYPOCHROM-2+ ANISOCYT-2+ POIKILOCY-3+ MACROCYT-1+ MICROCYT-1+ POLYCHROM-2+ SPHEROCYT-OCCASIONAL [**Month/Day/Year **]-2+ STIPPLED-2+ PAPPENHEI-2+ [**2126-7-2**] 08:50PM NEUTS-81* BANDS-1 LYMPHS-9* MONOS-9 EOS-0 BASOS-0 ATYPS-0 METAS-0 MYELOS-0 NUC RBCS-1* [**2126-7-2**] 08:50PM WBC-51.7* RBC-2.84* HGB-9.1* HCT-26.1* MCV-92 MCH-31.9 MCHC-34.7 RDW-21.7* [**2126-7-2**] 08:50PM CALCIUM-9.3 PHOSPHATE-4.4 MAGNESIUM-2.1 [**2126-7-2**] 08:50PM GLUCOSE-114* UREA N-15 CREAT-0.4 SODIUM-144 POTASSIUM-4.8 CHLORIDE-106 TOTAL CO2-26 ANION GAP-17 [**2126-7-2**] 10:45PM URINE RBC->50 WBC-[**2-8**] BACTERIA-OCC YEAST-NONE EPI-0-2 [**2126-7-2**] 10:45PM URINE BLOOD-LG NITRITE-NEG PROTEIN-TR GLUCOSE-NEG KETONE-NEG BILIRUBIN-SM UROBILNGN-8* PH-7.0 LEUK-SM [**2126-7-2**] 10:45PM URINE COLOR-Amber APPEAR-Hazy SP [**Last Name (un) 155**]-1.014 [**2126-7-3**] 04:15AM WBC-34.9* RBC-2.59* HGB-8.0* HCT-24.2* MCV-93 MCH-30.8 MCHC-33.0 RDW-21.2* [**2126-7-3**] 06:30AM HAPTOGLOB-<20* [**2126-7-3**] 01:33PM HCT-23.1* [**2126-7-3**] 06:30AM TSH-1.2 Brief Hospital Course: MICU course: While in the MICU, the patient was seen by neurology and neurosurgery to further evaluate the possibility of a new intracranial hemorrhage. In light of this, coumadin was discontinued, pending the results of the workup. The patient had multiple head CTs, described in pertinent results section. The conclusion from the scans was that Ms. [**Known lastname **] did not have any new CVA, ischemic or hemorrhagic. Of note, the findings raised a suggestion of Moyamoya disease. Also while in the MICU, the patient was found to have one blood culture bottle positive for enterococcus that was ampicillin sensitive. The change in mental status and elevated wbc count and temperature on admission were thought to be secondary to chronic aspiration, as a CXR on [**7-4**] revealed bilateral opacities consistent with aspiration pneumonia. Also while in the MICU the patient was seen by gastroenterology to investigate the guaiac positive drainage noted from the J-tube site while the patient was at [**Hospital **] hospital, and the report of one episode of bloody stool, as per the mother. They did not feel that the patient was having a GI bleed, as the patient's hematocrit remained stable, and there was noted to be no melanotic drainage from J-tube since arrival in our hospital, nor hematochezia. Stool was found to be negative for salmonella, shigella, campylobacter, C.Difficile. We followed with serial hematocrits, which have been stable between 19 and 22 (unclear baseline), with no further melena/hematochezia noted. The patient was transferred from the MICU to the general floors on [**2126-7-4**]. While on the floors, we addressed the patient's numerous problems, with the common difficulty being uncertainty regarding the rational for medical decisions made for her in the past. 1) Infectious disease: We continued to treat the patient for her presumed aspiration pneumonia with ceftriaxone and flagyl. A TTE was performed to rule out endocarditis in light of the enterococcus cultured from her blood, which was negative. At this time, on [**2126-7-8**], flagyl was discontinued and a two week course of IV ampicillin for treatment of the positive enterococcal blood culture was begun. At the time of this discharge summary ([**2126-7-12**]), the patient is on day [**4-19**] of ampicillin, and has completed a 10 day course of ceftriaxone. 2) Neuro: An extensive effort was made at obtaining CT scan reports from the patient's [**2123**] stroke, which the mother says was managed at [**Name (NI) **] (Medical College of [**State 4260**]), phone number ([**Telephone/Fax (1) 58520**], however they claim that the patient was not there in [**2123**]. After a review of all CT/MRI reports from our hospital, and a thorough investigation of the issue, we have decided to stop this patient's coumadin treatment. The rationale behind this is many-fold. First, we have to assume that the coumadin was initially begun due to concern for strokes that were embolic in nature. However, patients with [**Year (4 digits) 14165**] cell disease are known to develop ischemic strokes, and coumadin has no demonstrated efficacy in these patients (see review in the American Journal of Medicine, [**2125-11-19**]). Additionally, there is still some uncertaintly as to whether or not the patient has had a hemorrhagic stroke in the past, as the MRI of [**7-3**] revealed evidence of past hemorrhage, in which case coumadin would most definitely be contraindicated. Additionally, the finding of changes characteristic of Moyamoya syndrome on MRI also preclude the use of coumadin, as these patients are prone to ischemic strokes as children, followed by hemorrhagic strokes as adults due to the fragility of the collateral vessles that develop in response to the stenotic vessels of the Circle of [**Location (un) 431**]. For all of these reasons, we believe that holding coumadin is the most rational approach to the management of this patient's unfortunate neurologic status. The patient also has a history of seizures, and was maintained on Oxcarbazepine 300 mg PO BID without any seizure activity. 3) Heme: The patient continued to have a chronically low hematocrit, which fluctuated between 19 and 22 without receiving any transfusions. We obtained iron studies, which demonstrated iron overload, which was expected in this patient who has been transfusion dependent, as per mother, and was on deferoxamine therapy 12 mL IV before admission to our hospital. We restarted her deferoxamin at 1g IM per day, however the patient should be switched to IV so that she doesn't have to get painful IM shots everyday in the future. Her reticulocyte count was 10.4, which indicates appropriate marrow response to her severe anemia. A B12 level was within normal limits. We started the patient on Folic Acid 3 mg per day, which should be continued in this patient with chronic hemolysis from [**Location (un) 14165**] cell disease. Additionally, her peripheral smear persistently demonstrates not only sickled cells but also target cells, which is not typical of SSD, therefore a hemoglobin electrophoresis was ordered, and the patient was seen by hematology. She will follow up with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] with whom she has an appointment on [**2126-8-20**] ([**Telephone/Fax (1) 9645**]). [**Known firstname 58521**] should be on iron chelators chronically however it would be safe for her not to be on chelators for a few weeks while at rehab. This would only be acceptable for 2-3 weeks at most. Ms. [**Known lastname **] also appears to have a chronic leukocytosis, usually in the 20,000 range. She is currently at her baseline after being as high as 50,000 on admission. 4) GI: The patient has had a G and a J tube for unknown duration, with multiple adjustments and replacements. There was noted to be scant purulent drainage around both tubes, which surgery evaluated. As per the mother, there is always some drainage around the tubes, however it was noted to have increased. Surgery felt that the drainage was simply the tube feeds, as the areas were not noted to be erythematous, indurated, or tender. A would culture from [**7-3**] revealed sparse growth of MRSA, which was presumed to be colonization rather than infection in this chronically ill and hospitalized patient, without obvious signs of infection around the tube site. The question of the rationale behind the coexistance of a G-tube and a J-tube was discussed. We do not have any records, however it was assumed that the G-tube may have been placed in order to decompress the stomach and prevent aspiration if gastroparesis was present. The patient was also on Reglan, assumedly for the same rationale. The G-tube has not been used while in our hospital, as the J-tube is used for the tube feeds, therefore it is unclear whether or not the patient really needs this additional tube. We are keeping it capped for now, not on continuous suction, and flushing it periodically to maintain patency. This tube should be kept in and flushed periodically for now, but if there continues to be no use for the tube, Dr. [**Last Name (STitle) **] (her new PCP) will consider having the tube removed. Additionally, the patient has not received Reglan for the 3 days prior to discharge, without any problems, therefore we will leave this medication on a PRN basis, and it may be safe to completely discontinue if there continues to be no need. There continued to be no evidence of GI bleed for the remainder of the [**Hospital 228**] hospital course. GI recommended that if there is ever again any suspicion, the patient can at that time have an EGD. 5) FEN - The patient had a video swallow study in light of the suspicion of chronic aspiration, which is detailed in the pertinent results section. The outcome of this was that the patient may try pureed and honey thick foods for pleasure, still maintaining tube feeds as her primary source of nutrition - Probalance Full strength at 55 mL/hour. The patient aspirated with non-thickened fluids. For now, the patient has been taking pureed and honey-thick foods, however if the patient continues to develop aspiration pneumonias, these may have to be discontinued. The patient's aspiration, however, is most likely gastric contents rather than food. 6) Chronic Pain: The patient has a history of chronic pain and came in on a Fentanyl patch, which was continued while in house. In the future it would be useful to clarify the necessity of maintaining this. In light of the chronic opiate use and immobility, Ms. [**Known lastname **] was given a bowel regimen while here, which should be continued. 7) Psych: Ms. [**Known lastname **] was on Lexapro 20 mg PO qd on admission, and was maintained on this. However, the mother reports that the patient has continued to have depressed mood and lack of motivation, with behavior indicating hopelessness since her stroke in [**2123**], and therefore psychiatry was consulted regarding the appropriate medication choice. In patients with multiple medical problems and a clear organic basis for depression, Ritalin can be helpful, and this should be considered in the future. 8) Lines: Ms. [**Known lastname **] has had a portacath for 4 years, as per admission note. For now this should be left in as she is on IV abx and with chronic aspiration is likely to need IV abx in the future, in addition to multiple other IV medications. Also see discussion of G and J tubes above. 9) Prophylaxis: Ms. [**Known lastname **] was given Lansoprazole Oral Suspension 30 mg NG QD while here, which does not need to be continued as there is no clear indication (no high dose steroids, respirator, sepsis, etc.) for a PPI. However, if the G-tube were ever to resume function this might be a good addition, as it could help prevent the development of alkalosis (would be removing a less acidic fluid from the stomach). She was started on prophylactic lovenox 40 mg SQ per day on the day of discharge, as she is largely immobile with multiple medical problems. 10) PT/OT - [**Known firstname 58521**] was seen by PT and OT on [**2126-7-11**], who both felt that the patient could benefit from continued therapy. PT felt the patient has good potential to improve her functioning, and felt she would benefit from a rehab facility to include [**2-8**] hours of combined therapy per day. OT also felt that [**Known firstname 58521**] has good potential for progress given cognitive status, willingness to work with therapy, and AROM of all 4 extremities, and recommended d/c to acute rehab facility with goal of eventually returning home with family once functional status is maximized. Medications on Admission: Coumadin 10 mg po once daily, Deferoxamine, escitalopram 20 mg qpm, miralax, colace 100, reglan 10 mg q6, Xanax 0.125 mg [**Hospital1 **] prn, morphine 20 mg q6, baclofen, fentanyl patch 150 Q72H, Trileptal 300 mg Q6H, Percocet. Discharge Medications: 1. Oxcarbazepine 300 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 2. Fentanyl 75 mcg/hr Patch 72HR Sig: One (1) Patch 72HR Transdermal Q72H (every 72 hours). 3. Docusate Sodium 150 mg/15 mL Liquid Sig: One (1) PO BID (2 times a day). 4. Escitalopram Oxalate 10 mg Tablet Sig: Two (2) Tablet PO QD (once a day). 5. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 6. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO QD (once a day) as needed. 7. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO Q4-6H (every 4 to 6 hours) as needed. 8. Folic Acid 1 mg Tablet Sig: Three (3) Tablet PO QD (once a day). 9. Deferoxamine Mesylate 500 mg Recon Soln Sig: Two (2) Recon Soln Injection Q24H (every 24 hours). 10. Metoclopramide HCl 10 mg Tablet Sig: One (1) Tablet PO QID (4 times a day) as needed. 11. Enoxaparin Sodium 40 mg/0.4mL Syringe Sig: One (1) Subcutaneous Q24H (every 24 hours). 12. Ampicillin Sodium 2 g Recon Soln Sig: One (1) Recon Soln Injection Q6H (every 6 hours). Discharge Disposition: Extended Care Facility: [**Hospital3 1107**] [**Hospital **] Hospital - [**Location (un) 38**] Discharge Diagnosis: [**Location (un) **] Cell Disease, previously transfusion dependent Cerebrovascular accident x 2 with residual aphasia, mild mental retardation, plegia L>R. Chronic pain syndrome Chronic aspiration Aspiration pneumonia Absence seizure disorder Recurrent UTI Chronic leukocytosis Discharge Condition: Stable, at baseline. Discharge Instructions: Please continue medications as directed. Please keep G-tube capped for now, with TID flushes to maintain patency (will consider removal at a later date). Continue IV Ampicillin for 9 more days (pt. on day 5 out of 14 on [**2126-7-12**]). Acute PT/OT. Can wean off O2, keeping sats above 90-93% (currently on NC 1L). Followup Instructions: Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 647**], MD Where: [**Hospital6 29**] HEMATOLOGY/ONCOLOGY Phone:[**Telephone/Fax (1) 22**] Date/Time:[**2126-8-20**] 11:00 -call to confirm appointment Primary Care Provider: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], MD. Call for appointment ([**Telephone/Fax (1) 1921**]. ICD9 Codes: 5070, 7907
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Medical Text: Admission Date: [**2195-4-9**] Discharge Date: [**2195-4-19**] Date of Birth: [**2127-2-15**] Sex: M Service: CARDIOTHORACIC Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 1505**] Chief Complaint: Chest pain s/p hip replacement Major Surgical or Invasive Procedure: Coronary artery bypass grafting x4 urgent with a left internal mammary artery graft to left anterior descending and reverse saphenous vein graft to the marginal branch, diagonal branch and posterior descending artery. History of Present Illness: 68 yo male underwent a R total hip replacement [**4-7**] for osteoarthritis. The procedure was uncomplicated, but the night of POD 0 and early morning on POD 1 he develpoed indigestion, nausea, vomiting with chest pain radiating to both hands with a tingling sensation. He develpoed EKG changes with ST depression in inferior and lateral leads which have resolved. His peak troponin was 22 at 6am on [**4-9**]. He underwent cardiac cath on [**4-9**] which showed elevated LVEDP and severe 3vd. He is transfered to [**Hospital1 18**] for surgical evaluation. Past Medical History: hypertension hyperlipidemia Past Surgical History: s/p R hip replacement [**2195-4-7**] Social History: Lives with:wife Occupation:truck driver for Shaws Tobacco: Nonsmoker ETOH: about 1 beer/day Family History: Positive for father with arthritis and hypertensiion. mother s/p valve replacement x3 Physical Exam: Pulse:84 Resp: 18 O2 sat:96% on 3L NC B/P Right: 144/66 Left: Height:5'[**95**]" Weight:208# General: Skin: Dry [x] intact [x] L leg w/dry skin and mild chronic venous stasis discoloration HEENT: PERRLA [x] EOMI [x] Neck: Supple [x] Full ROM [x] Chest: Lungs clear bilaterally [x] Heart: RRR [x] Irregular [] No Murmur Abdomen: Softly distended [x] non-tender [x] bowel sounds + [x] Extremities: Warm [x], well-perfused [x] Edema none[x] Varicosities: None [x] Neuro: Grossly intact[x] Pulses: Femoral Right: 2+ Left:2+ DP Right: 2+ Left:2+ PT [**Name (NI) 167**]: 2+ Left:2+ Radial Right:post cath TR band in place Left:2+ Carotid Bruit Right:? soft bruit Left:none R hip incision no erythema or obvious bleeding, transparent dressing with small amount of blood. Area edematous, slightly tender, no bruising noted Discharge Physical VS: T: 98.1 HR: 80-90 SR BP: 120-130's/ 60-70 RR 18 Sats: 98 2L Wt: 94.6 ([**2195-4-19**]) General: 68 year-old male in no apparent distress HEENT: normocephalic, mucus membranes moist Neck: supple no lymphadenopathy Card: RRR Resp: decreased breath sounds with crackles 1/4 up bilateral GI: bowel sounds positive, abdomen soft non-tender/on-distended Extr: warm R 3+ edema, L 2+ Incision: sternal clean/dry/intact, stable, Right hip site ecchymotic with 3+ edema Neuro: awake, alert oriented Pertinent Results: [**2195-4-18**] WBC-13.7* RBC-3.75* Hgb-11.6* Hct-32.1* MCV-86 MCH-31.0 MCHC-36.2* RDW-13.9 Plt Ct-301 [**2195-4-9**] WBC-12.4* RBC-3.57* Hgb-11.0* Hct-30.7* MCV-86 MCH-30.8 MCHC-35.8* RDW-13.3 Plt Ct-156 [**2195-4-18**] PT-36.1* INR(PT)-3.6* [**2195-4-17**] PT-17.4* INR(PT)-1.6* [**2195-4-16**] PT-14.5* INR(PT)-1.3* [**2195-4-18**] UreaN-26* Creat-0.9 Na-137 K-4.0 Cl-96 [**2195-4-9**] Glucose-122* UreaN-18 Creat-0.9 Na-140 K-3.9 Cl-104 HCO3-31 [**2195-4-18**] ALT-21 AST-22 LD(LDH)-364* AlkPhos-118 Amylase-126* TotBili-1.9* [**2195-4-16**] ALT-21 AST-21 AlkPhos-74 Amylase-73 TotBili-1.9* [**2195-4-18**] Lipase-249 [**2195-4-16**] Lipase-93* [**2195-4-17**] Abdomen: Persistent bowel dilatation, consistent with ileus. CXR: [**2195-4-15**]: FINDINGS: The patient has been extubated. The left chest tube has been removed without evidence for pneumothorax. The right internal jugular line and intestinal tube have been removed. The stomach is distended. Persistent small left pleural effusion and basilar atelectasis are unchanged. Mild pulmonary vascular congestion persists. Brief Hospital Course: The patient was brought emergently to the operating room on [**2195-4-13**] with a NSTEMI post-operatively from a right total hip replacement on [**2195-4-7**]. The patient underwent a coronary artery bypass grafting x4 with a left internal mammary artery graft to left anterior descending and reverse saphenous vein graft to the marginal branch, diagonal branch and posterior descending artery. Overall the patient tolerated the procedure well and post-operatively was transferred to the CVICU in stable condition for recovery and invasive monitoring. On POD #1 the patient was extubated, alert and oriented and breathing comfortably. The patient was neurologically intact and hemodynamically stable, weaned from inotropic and vasopressor support. Beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. On POD#1 the patient was transferred to the telemetry floor for further recovery. Chest tubes and pacing wires were discontinued without complication on POD #2. Respiratory: Sucessfully extubated POD1. Aggressive pulmonary toilet, nebs, incentive spirometer his oxygen requirements improved to 98% 2L via nasal cannula Cardiac: pacing wires removed [**2195-4-16**]. Beta-blockers were initiated he weaned off NTG. On [**2195-4-15**] he developed atrial fibrillation rate 130-160's converted to sinus rhythm with amiodarone IV load, Dilt drip he converted to sinus rhythm. He continued to have intermittent RAF 130-160's. His was transitioned to PO 30 qid, Beta-block 37.5 mg [**Hospital1 **] and amiodarone PO 400 mg [**Hospital1 **]. Heart rate 80-90's SR. ACE and statins were restarted. He was hypertensive his home meds clonidine, doxazosin were restarted with SBP 120-130's. GI: aggressive bowel regime and PPI were continued. His diet was slowly advanced but was found to an ileus on [**2195-4-17**]. He was kept NPO, KUB showed stool in colon/air in small bowel. Aggressive bowel regime continued with good results on [**2195-4-18**]. His diet was slowly increased which he tolerated. Renal: gently diuresed. Renal function remained within normal limits with good urine output. His electrolytes were repleted as needed. Heme: [**2195-4-14**] he was transfused 2 units PRBC for HCT 23 to Hct of 27. Heparin SQ DVT prophylaxis was transitioned to Lovenox 40 mg [**Hospital1 **] was started [**4-17**], Warfarin 3 mg was given [**4-16**] & [**4-17**], INR [**4-18**] 3.2 warfarin was held. INR [**4-19**] 2.9 0.5 mg ordered. He will follow-up with his PCP [**Last Name (NamePattern4) **]. [**Last Name (STitle) 21448**] for warfarin managment as an outpatient. Endocrine: insulin sliding scale and lantus were given. His blood sugars were less than < 200. Please adjust and titrate off. Pain: IV Dilaudid transitioned to PO Dilaudid which was stopped when his ileus developed. He was given acetaminophen with good pain control. Disposition: he was seen by physical therapy recommended rehab. He was discharged to [**Hospital3 **] TCu on [**2195-4-19**]. He will follow-up as an outpatient with Dr. [**Last Name (STitle) **], his orthopedic surgeon, and PCP for outpatient warfarin follow-up. Medications on Admission: Bisoprolol-HCTZ [**11-24**] daily, Doxazosin 4mg daily, dilt ER 240 daily, lisinopril 40 daily, simvastatin 40 daily, clonidine 0.3 daily, ASA 81, MVI, Vit E Discharge Medications: 1. doxazosin 4 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime). 2. simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 4. aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 5. clonidine 0.1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. furosemide 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours). 9. amiodarone 200 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 10. diltiazem HCl 30 mg Tablet Sig: One (1) Tablet PO QID (4 times a day): hold for HR < 60 SBP < 100. 11. tramadol 50 mg Tablet Sig: One (1) Tablet PO every 4-6 hours as needed for pain. 12. potassium chloride 10 mEq Tablet Extended Release Sig: One (1) Tablet Extended Release PO DAILY (Daily). 13. polyethylene glycol 3350 17 gram Powder in Packet Sig: One (1) PO once a day. 14. Senna-S 8.6-50 mg Tablet Sig: One (1) Tablet PO twice a day. 15. bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal once a day as needed for constipation. 16. warfarin 1 mg Tablet Sig: One (1) Tablet PO as directed to maintain INR 2.0-3.0: dose to maintain INR 2.0-3.0. 17. Insulin sliding scale 71-109 mg/dL 0 Units 0 Units 0 Units 0 Units 110-140 mg/dL 3 Units 3 Units 3 Units 0 Units 141-180 mg/dL 5 Units 5 Units 5 Units 1 Units 181-210 mg/dL 7 Units 7 Units 7 Units 3 Units 211-240 mg/dL 9 Units 9 Units 9 Units 5 Units 241-280 mg/dL 11 Units 11 Units 11 Units 7 Units 18. insulin glargine 100 unit/mL Solution Sig: Ten (10) units Subcutaneous with breakfast. 19. lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours) as needed for anxiety . 20. metoprolol tartrate 25 mg Tablet Sig: 1.5 Tablets PO BID (2 times a day). Discharge Disposition: Extended Care Facility: [**Hospital6 5016**] [**Doctor Last Name 1495**] Raphaels TCU - [**Location (un) 7661**] Discharge Diagnosis: Coronary artery disease with a NSTEMI, and post-operative atrial fibrillation. hypertension hyperlipidemia Past Surgical History: s/p R hip replacement [**2195-4-7**] Discharge Condition: Alert and oriented x3 nonfocal Ambulating, gait steady Sternal pain managed with oral analgesics Sternal Incision - healing well, no erythema or drainage Discharge Instructions: Please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions Please NO lotions, cream, powder, or ointments to incisions Each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart No driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive No lifting more than 10 pounds for 10 weeks 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) **] [**Telephone/Fax (1) 170**] [**5-7**] 1:15 in the [**Last Name (un) 2577**] Building [**Last Name (NamePattern1) **], [**Location (un) 551**]. Cardiologist Dr. [**Last Name (STitle) 5017**], [**First Name3 (LF) 4597**]: follow-up on [**2194-5-14**]:45 Primary Care Dr. [**Last Name (STitle) 21448**] [**Telephone/Fax (1) 69547**] for warfarin follow-up once discharged from rehab Warfarin for atrial fibrillation. INR Goal 2.0-3.0 Last dose of Warfarin [**2195-4-19**], 0.5 mg. INR [**2195-4-19**] 2.9 Follow-up with your orthopedic surgeon Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 89929**] for your right hip surgery. **Please call cardiac surgery office with any questions or concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call person during off hours** Completed by:[**2195-4-19**] ICD9 Codes: 9971, 4019, 2724