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{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6500 }
Medical Text: Admission Date: [**2112-8-9**] Discharge Date: [**2112-8-13**] Date of Birth: [**2041-12-28**] Sex: F Service: Neurosurgery HISTORY OF PRESENT ILLNESS: This is a 70 year old female who was admitted on [**2112-8-9**], with history of arterial venous dural fistula, which had been embolized in [**2112-6-17**]. She presented on [**2112-8-9**], for elective suboccipital craniotomy with bilateral dural arteriovenous fistula cranioplasty. The patient received two units of packed red blood cells intraoperatively, but the Operating Room case was otherwise uncomplicated. Postoperatively, the patient was awake and alert; vital signs were stable. The patient had full motor strength in both upper and lower extremities. The patient was tolerating a regular diet well. The incision was clean and dry, and the patient was out of bed and ambulating postoperative day one. The patient's sodium ppostoperatively was 136 and climbed to 144 postoperative day two. The patient also started putting out large amounts of urine and an Endocrine consultation was called to rule out diabetes insipidus. The patient was ruled out for diabetes insipidus and increased urine output and hypernatremia was considered to be secondary to fluid overload in the setting of surgery. The patient remained afebrile, neurologically unchanged postoperatively. The patient was out of bed with Physical Therapy, who recommended two to three times a week of mobility and gait training. The patient was discharged to rehabilitation on [**2112-8-10**] on the following medications. DISCHARGE MEDICATIONS: 1. Hydralazine 10 mg p.o. q. six hours. 2. Sliding scale insulin. 3. Hydromorphone 2 to 6 mg p.o. q. two hours p.r.n. 4. Famotidine 20 mg p.o. twice a day. 5. Decadron taper. 6. Docusate sodium 100 mg p.o. twice a day. 7. Acetaminophen 325 to 650 mg p.o. q. four to six hours p.r.n. DISCHARGE INSTRUCTIONS: 1. The patient was discharged with instructions to follow-up with Dr. [**Last Name (STitle) 1132**] in one month in the office for a repeat angiogram. [**Name6 (MD) **] [**Last Name (NamePattern4) **], M.D. [**MD Number(1) 1133**] Dictated By:[**Last Name (NamePattern1) 27454**] MEDQUIST36 D: [**2112-8-12**] 22:11 T: [**2112-8-12**] 23:50 JOB#: [**Job Number 51936**] ICD9 Codes: 2760
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6501 }
Medical Text: Admission Date: [**2134-6-12**] [**Month/Day/Year **] Date: [**2134-6-18**] Date of Birth: [**2051-7-10**] Sex: M Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2534**] Chief Complaint: s/p Fall Major Surgical or Invasive Procedure: [**2134-6-12**] Placement of pigtail chest catheter History of Present Illness: 82 yo male s/p fall at home in garage on, no LOC able to recall whole event. He reports that he tripped and thinks he fell and hit his back, he did not hit his head. He went to see his PCP on following day and he was taking tylenol for the pain. He then presented to [**Hospital1 **] [**Location (un) 620**] two days following the fall because he had difficulty sleeping and complaints of left flank/back pain. He was evaluated there, found to have a negative head CT, left rib [**9-30**] fractures and hemothorax with INR 3.2 and was then transferred to [**Hospital1 18**] for further care. Past Medical History: Atrial fibrillation, s/p pacemaker placement, on coumadin Hypertension Prostate cancer status post XRT Benign prostatic hypertrophy Osteoarthritis h/o rectal bleeding in [**2128**] Mild dementia Depression Hypothyroidism Retinitis pigmentosa. Social History: Lives with wife, is a retired computer salesman, denies tobacco, alcohol, or IVDU. normal colonoscopy <10 y ago. Family History: Non-contributory. Physical Exam: Upon admission: Temp (F): 95.9 Heart Rate: 71 Blood Pressure: 142/71 Resp Rate: 15 O2 Sat(%): 99% Room Air/O2: 3L NC Pertinent Results: [**2134-6-12**] 10:39PM PT-18.0* INR(PT)-1.6* [**2134-6-12**] 08:09PM HCT-29.1* [**2134-6-12**] 08:09PM PT-20.9* PTT-31.8 INR(PT)-2.0* [**2134-6-12**] 12:15PM GLUCOSE-95 UREA N-24* CREAT-0.9 SODIUM-137 POTASSIUM-4.1 CHLORIDE-103 TOTAL CO2-29 ANION GAP-9 [**2134-6-12**] 12:15PM WBC-6.7 RBC-3.60* HGB-11.8* HCT-34.6* MCV-96 MCH-32.8* MCHC-34.2 RDW-14.2 [**2134-6-12**] 12:15PM NEUTS-69.2 LYMPHS-25.0 MONOS-4.0 EOS-1.6 BASOS-0.2 [**2134-6-12**] 12:15PM PLT COUNT-130* Reason: reassess Field of view: 36 Final Report (Revised) CT CHEST [**2134-6-12**] FINDINGS: There is a pacemaker with leads in the right atrium and the right ventricle. The heart is enlarged. There is no pericardial effusion. The aorta and pulmonary arteries are normal in caliber. There are multiple small mediastinal lymph nodes that measure less than 1 cm in short axis and do not meet CT criteria for malignancy. The tracheobronchial tree is patent. There is a small left pleural effusion the measures up to 40 [**Doctor Last Name **] in density and is compatible with hemothorax. There is subsegmental atelectasis in the left lower lobe. Otherwise, the lungs are clear. The right pleural effusion that was seen in [**2130**] has resolved. There is no pneumothorax. BONE WINDOWS: The there is an acute nondisplaced fracture of the left 9th rib at midaxillary line. The rest of the fractures seen on an ouside CT are not included on this study. There are multilevel degenerative changes in the thoracic spine. No compression fracutres are identified. Limited images through the abdomen demonstrate a 3 cm cyst in the right kidney. IMPRESSION: 1. Small left hemothorax. No evidence of pneumothorax. 2. Non-displaced fracture of the left 9th rib. CXR [**2134-6-17**] FINDINGS: Portable upright chest radiograph is reviewed and compared to [**2134-6-17**] 8:23. Left pigtail catheter has been removed. There is no pneumothorax. There has been no significant interval change in appearance of the chest, with relatively low lung volumes, elevated hemidiaphragms, and slight apparent widening of the cardiac silhouette. IMPRESSION: No pneumothorax status post pigtail catheter removal. Brief Hospital Course: He was admitted to the Trauma service and transferred to the Trauma SICU for reversal of his INR, pain control and close monitoring. Thoracic surgery was consulted for placement of chest pigtail catheter because of the hemothorax. This remained in place for several days and was eventually removed. Follow up chest film showed no pneumothorax and persistent retrocardiac atelectasis with small bilateral pleural effusions. He was encouraged to use the incentive spirometer and to cough and deep breathe; he was able to do this with lots of encouragement and reinforcement. He was evaluated by Physical and Occupational therapy and they have recommended rehab after acute hospital stay. The screening process was initiated by case management and he was discharged to a rehab facility on [**2134-6-18**]. Medications on Admission: Detrol LA 4', Coumadin 4' (Wed 2), Amiodarone 200', Celexa 40', Synthroid 88', Namenda 10", Toprol 37.5', Exelin 6" [**Date Range **] Medications: 1. Metoprolol Succinate 25 mg Tablet Sustained Release 24 hr Sig: 1.5 Tablet Sustained Release 24 hrs PO DAILY (Daily). 2. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Citalopram 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 4. Levothyroxine 88 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Memantine 5 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 6. Rivastigmine 3 mg Capsule Sig: Two (2) Capsule PO BID (2 times a day). 7. Tolterodine 1 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 8. Famotidine 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 9. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 10. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO every [**4-25**] hours as needed for pain. 11. Milk of Magnesia 800 mg/5 mL Suspension Sig: Thirty (30) ML's PO twice a day as needed for constipation. [**Month/Day (3) **] Disposition: Extended Care Facility: [**Last Name (un) 1687**] - [**Location (un) 745**] [**Location (un) **] Diagnosis: s/p Fall Rib fractures left [**9-30**] Left hemothorax [**Month/Year (2) **] Condition: Good Followup Instructions: Follow up with Dr. [**Last Name (STitle) **] in Clinic in [**2-21**] weeks, call [**Telephone/Fax (1) 600**] for an appointment. Follow up with your primary care doctor [**First Name (Titles) **] [**Last Name (Titles) **] from rehab. Completed by:[**2134-6-23**] ICD9 Codes: 4019, 311, 2449
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6502 }
Medical Text: Admission Date: [**2186-8-7**] Discharge Date: [**2186-8-26**] Date of Birth: [**2120-1-2**] Sex: M Service: SURGERY Allergies: Pneumovax 23 Attending:[**First Name3 (LF) 2836**] Chief Complaint: c diff colitis Major [**First Name3 (LF) 2947**] or Invasive Procedure: none History of Present Illness: HPI: The patient is a 66-year-old male who is known to have C. difficile colitis and was admitted to the Gold surgery service in 3/[**2186**]. He was referred to [**Hospital1 18**] for weakness, rigidity, lethargy, decreased level of interaction, and anorexia. About a week ago, he began having diarrhea. He has been on metronidazole 500mg po BID for several weeks. In the ED, his initial vital signs were 97.3 129 146/93 18 99RA. His heart rate stabilized to 80-90s after 2 liters of IVF. At around 23:30, he became acutely hypotensive to SBP of 80s-90s, maintaining his heart rate in the 90s. ICU bed was arranged for close monitoring. Past Medical History: - Paroxysmal Atrial Fibrillation - History of C diff colitis - Bipolar Affective Disorder - History of resolved hepatitis B - History of rheumatic heart disease - History of right MCA aneurysm clipped in [**2167**] at [**Hospital1 112**] - History of pernicious anemia - Gastroesophageal reflux disease Social History: He lives with his wife. Questionable history of alcohol abuse (did abuse alcohol >20 years ago). He has not smoked for one month but previously has a 40 pack year history. Previously on 2L O2 at home but not prior to this hospitalization. Family History: His father had lung cancer and his mother had congestive heart failure. Physical Exam: PHYSICAL EXAM on admission: 97.3 129->90 146/93->80/50 18 99RA Gen: thin male, NAD, no icterus, expressive aphasia, but A&0 x 3 HEENT: NC/AT, EOMI, PERRLA bilat., dry MM, without cervical LAD on my exam Cor: RRR without m/g/r, no JVD, no bruits Lungs: CTA bilat. [**Last Name (un) **]: +BS, soft, distended with tympany, NT, no masses, no hernias Ext: cold hands and feet, no edema, palpable pulses PE: at discharge Gen: grey, pale, mask faces, tremmer (pin wheel), expressive aphasia, but AOx3 HEENT: PERRL, EMOI COr: RRR Lungs: CTA Abd: +BS, still distended but improved, not "soft" skin: calor and rubo s/p cellulitis from back spreading around to front bilaterally, improved with antibiotics. decubitus ulcer stage 3 maybe 4. ext: cold, no edema Pertinent Results: [**2186-8-7**] 02:41PM WBC-14.6*# RBC-4.20*# HGB-13.6*# HCT-41.2# MCV-98 MCH-32.4* MCHC-33.0 RDW-15.9* [**2186-8-7**] 02:41PM NEUTS-66 BANDS-10* LYMPHS-14* MONOS-7 EOS-0 BASOS-0 ATYPS-2* METAS-0 MYELOS-1* [**2186-8-7**] 02:41PM LIPASE-21 [**2186-8-7**] 02:41PM ALT(SGPT)-9 AST(SGOT)-30 ALK PHOS-201* TOT BILI-1.3 [**2186-8-7**] 02:41PM GLUCOSE-138* UREA N-22* CREAT-0.9 SODIUM-137 POTASSIUM-3.6 CHLORIDE-98 TOTAL CO2-27 ANION GAP-16 [**2186-8-7**] Abdominal CT:IMPRESSION: Wall thickening in the descending and sigmoid colon, including the rectum with mesenteric stranding consistent with colitis. Interval increase in large amount of free intra- abdominal and mesenteric fluid. [**2186-8-10**] Renal Ultrasound : CONCLUSION: No evidence of renal abnormalities. Large volume of ascites noted. [**2186-8-17**] Abdominal CT: IMPRESSION: 1. Increased size of bilateral simple pleural effusions with increased bibasilar dependent atelectatic changes. 2. Large volume abdominal pelvic ascites which appears grossly stable. 3. Evaluation of bowel loops is limited by lack of IV and oral contrast. Given this limitation, there is no evidence for obstruction or bowel perforation. 4. Shrunken liver with nodular contour. Status post cholecystectomy. 5. 4mm left pulmonary nodule. Per Fleichner society guidelines, recommend [**7-28**] month follow up chest CT if patient has risk factors for pulmonary malignancy. [**2186-8-23**] Abdominal CT: IMPRESSION: 1. Unchanged bilateral pleural effusions with associated atelectasis. 2. Nodular, cirrhotic liver with no focal lesions on this single-phase study. There is again moderate ascites, with large gastric varices. 3. Normal appearance of intra-abdominal loops of small and large bowel. No evidence for colitis or enteritis. 4. Diffuse superficial soft tissue induration, consistent with cellulitis. There is no air in the soft tissues to suggest a more aggressive process such as necrotizing fasciitis, although this cannot be excluded by imaging. Brief Hospital Course: Mr. [**Known lastname 2933**] was admitted to the intensive care unit and underwent vigorous fluid resuscitation and maintained on IV Flagyl and PO Vancomycin. He was seen by the infectious disease service for further input in the treatment of his prolonged C Diff colitis and they recommended continued treatment with Flagyl and Vancomycin plus stopping any narcotics as he was at a high risk of developing toxic megacolon. His initial blood and urine cultures were negative and stool for C Diff was positive. His blood pressure improved with fluids and he did not require any pressor support. Vancomycin retention enemas were added for persistent diarrhea and he underwent serial abdominal CT's to assess any colonic changes. His abdominal exam over 3-4 days showed mild lower abdominal tenderness and mild distention therefore continued conservative non operative treatment with antibiotics was planned. Due to his prolonged period of poor nutrition/NPO, hyperalimentation was started on [**2186-8-10**] and eventually he had a PICC line placed in the left antecubital on [**2186-8-21**] for TPN and antibiotics. Of note, Mr. [**Known lastname 2948**] platelet count gradually decreased since his admission from 130K to a low of 49K. His HIT was negative and SRA is still pending. The hematology service was consulted and felt that it was multifactorial including secondary to cirrhosis, sepsis and anemia of chronic disease. Heparin was not contraindicated and over the course of his hospitalization his platelet count gradually increased to the 90K range. Transfer to the [**Known lastname **] floor occured on [**2186-8-12**] and Lasix was started to try to help with fluid mobilization. His PE showed [**4-19**]+ peripheral edema as well as scrotal edema and some ascites. He was treated with Lasix on a prn basis and his BUN/Cr remained stable (22/0.5). A superficial abdominal cellulitis was noted on [**2186-8-21**] beginning on both flank areas and extending to the lower abdomen with no connection to his sacral decubitus. He was started on broad coverage antibiotics including Vancomycin and Zosyn without improvement. He was subsequently changed to Daptomycin, Ciprofloxicin and Flagyl with some improvement. Due to the addition of broad spectrum antibiotics his oral Vancomycin was increased to QID. He had no evidence of diarrhea and no change in his abdominal exam. Recommendations from the infectious disease service recommends cipro/flagyl/ dapto until [**8-31**] (10 days total). Pt c diff colitis has responded well to PO vanco. Pt will continue on 125 [**Hospital1 **] until [**8-31**] when [**Doctor Last Name 2949**] 125 TIDx7d, 125 BIDx7d, 125 qdx7d, 125 qodx7d, 125 q3dx14d. The Neurology service was consulted during this admission for evaluation of his bilateral hand tremors which seemed a bit worse. Although Parkinson's disease could not be ruled out his current situation precluded a definite assessment and they recommended an out patient follow up with Dr.[**First Name (STitle) 951**]. His Depakote continues at his home dose with a level of 53. A speech and swallow evaluation was also done to assess the ongoing question od possible aspiration. His baseline diet was ground solids however over the last week he was tolerating nectar thick liquids and pureed with no evidense of aspirating. He remains on TPN while his diet is being slowly advanced. Continue on nector thickness liquids and TPN until cleared to advance, with one to one supervision. Mr [**Name13 (STitle) 2950**] also impaired skin integrity on his R buttocks first seen [**2186-8-22**] [**Month/Day/Year 409**] Assessment by [**Month/Day/Year **] nurse [**2186-8-22**]: Sacral/coccygeal unstageable pressure ulcer that is a DTI. Ulcer has evidence of healing with necrotic area measuring 2 cm x 1 cm but affected area measures 5 x 2 with ulcer on (R) buttock of 1 cm and more linear ulcers on (L).Drainage is sero sang moderate amount. ALSO there are superficial erosions on soft tissue of buttocks that are caused by moisture and fungal rash.The area causes pain. ID recommended Cipro/flagyl / Dapso treatment and standard [**Month/Day/Year **] care. Medications on Admission: Zantac 150 mg po qd Seroquel 25 mg po qhs Heparin 5000u sc bid Flagyl 500 mg po bid Nystatin i po qid Depakote 1000 mg po qhs Albuterol neb inh q6h prn MVI qd digoxin 0.125mg po qd flecainide 50mg po q12h ASA 325mg po qd Discharge Medications: 1. Quetiapine 25 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 2. Ipratropium Bromide 0.02 % Solution Sig: One (1) neb Inhalation Q6H (every 6 hours) as needed for SOB/wheeze/cough. 3. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) neb Inhalation Q6H (every 6 hours) as needed for SOB/wheeze/cough. 4. Divalproex 500 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO QHS (once a day (at bedtime)). 5. Digoxin 125 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Flecainide 50 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours). 7. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. Miconazole Nitrate 2 % Powder Sig: One (1) Appl Topical [**Hospital1 **] (2 times a day) as needed for rash. 9. Nystatin 100,000 unit/mL Suspension Sig: Five (5) ML PO QID (4 times a day) as needed for oral thrush. 10. Vancomycin 125 mg Capsule Sig: One (1) liquid PO QID (4 times a day) for 2 months: Pt should be on 125 QID until [**8-31**], then taper to 125 qdx7d, 125 qodx7d, 125 q3dx14d. Disp:*240 liquid* Refills:*0* 11. Metoprolol Tartrate 5 mg/5 mL Solution Sig: One (1) Intravenous Q6H (every 6 hours). 12. Metronidazole in NaCl (Iso-os) 500 mg/100 mL Piggyback Sig: One (1) Intravenous Q8H (every 8 hours): Continue till [**8-31**]. 13. Ciprofloxacin in D5W 400 mg/200 mL Piggyback Sig: One (1) Intravenous Q12H (every 12 hours): Continue till [**8-31**]. 14. Daptomycin 500 mg Recon Soln Sig: One (1) Recon Soln Intravenous Q24H (every 24 hours): Continue until [**8-31**]. 15. Hydromorphone 2 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for pain. 16. Insulin Regular Human 100 unit/mL Solution Sig: One (1) Injection ASDIR. 17. Heparin, Porcine (PF) 10 unit/mL Syringe Sig: One (1) ML Intravenous PRN (as needed) as needed for line flush. Discharge Disposition: Extended Care Facility: [**Hospital3 7**] & Rehab Center - [**Hospital1 8**] Discharge Diagnosis: c diff colitis. Please continue on antibiotics: continute PO vanco 125 four times a day until [**8-31**] when [**Doctor Last Name 2949**] 125 three times a day x7days, 125 twice a day x7days, 125 per day x7days, 125 every other day x7days, 125 every third day x14days. Cellulitis ciprofloxacin / flagyl/ dapto until [**8-31**] Nutrician, 1 to 1 feeding to prevent aspiration on nectar thickened liquids. Please continue TPN until safe to advance diet Continue on nector thickness liquids and TPN until cleared to advance Discharge Condition: improving Discharge Instructions: c diff colitis. Please continue on antibiotics: continute PO vanco 125 four times a day until [**8-31**] when [**Doctor Last Name 2949**] 125 three times a day x7days, 125 twice a day x7days, 125 per day x7days, 125 every other day x7days, 125 every third day x14days. Cellulitis ciprofloxacin / flagyl/ dapto until [**8-31**] Nutrician, 1 to 1 feeding to prevent aspiration on nectar thickened liquids. Please continue TPN until safe to advance diet Ulcer: Continue pressure relief measures per pressure ulcer guidelines. Patient is on a 1st Step mattress Continue with current [**Month/Year (2) **] care as per previous note. Commercial [**Month/Year (2) **] cleanser cleanse all open wounds. Pat the tissue dry. Apply moisture barrier antifungal ointment Apply a piece of Aquacel AG to ulcer Apply 1 pack of 4 x 4 gauze. Secure with 1 piece of pink hytape across the center. Do not cover the superficial areas on lower buttocks with gauze. Treat with Miconazole powder and Criticaid clear anti fungal 3 x a day. Suspend heels off the bed with pillows under his calf.If these do not stay in place then order Waffle boots from distribution. Notify MD [**First Name (Titles) **] [**Last Name (Titles) **] care nurse [**First Name (Titles) **] [**Last Name (Titles) **] or skin deteriorates. You have had c diff colitis. Please continue on antibiotics, cipro/flagyl/ dapto until [**8-31**] continute PO vanco 125 [**Hospital1 **] until [**8-31**] when [**Doctor Last Name 2949**] 125 TIDx7d, 125 BIDx7d, 125 qdx7d, 125 qodx7d, 125 q3dx14d. Continue on nector thickness liquids and TPN until cleared to advance Please call your doctor or nurse practitioner or return to the Emergency Department for any of the following: *You experience new chest pain, pressure, squeezing or tightness. *New or worsening cough, shortness of breath, or wheeze. *If you are vomiting and cannot keep down fluids or your medications. *You are getting dehydrated due to continued vomiting, diarrhea, or other reasons. Signs of dehydration include dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. *You see blood or dark/black material when you vomit or have a bowel movement. *You experience burning when you urinate, have blood in your urine, or experience a discharge. *Your pain in not improving within 8-12 hours or is not gone within 24 hours. Call or return immediately if your pain is getting worse or changes location or moving to your chest or back. *You have shaking chills, or fever greater than 101.5 degrees Fahrenheit or 38 degrees Celsius. *Any change in your symptoms, or any new symptoms that concern you. Followup Instructions: Provider: [**Name10 (NameIs) **],[**First Name7 (NamePattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] SPECIALTIES CC-3 (NHB) Phone:[**Telephone/Fax (1) 274**] Date/Time:[**2186-9-20**] 3:45 Provider: [**Name Initial (NameIs) 1220**]. [**Name5 (PTitle) **] & [**Doctor Last Name **] Phone:[**Telephone/Fax (1) 44**] Date/Time:[**2186-9-26**] 1:00 Provider: [**Name10 (NameIs) 251**] [**Last Name (NamePattern4) 677**], M.D. Phone:[**Telephone/Fax (1) 62**] Date/Time:[**2187-2-7**] 2:40 ICD9 Codes: 0389, 5119, 5180, 5715
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6503 }
Medical Text: Admission Date: [**2178-2-22**] Discharge Date: [**2178-3-4**] Date of Birth: [**2127-4-26**] Sex: M Service: SURGERY Allergies: Sulfa (Sulfonamides) Attending:[**First Name3 (LF) 148**] Chief Complaint: Abdominal pain Major Surgical or Invasive Procedure: Cystgastrostomy History of Present Illness: the patient is a 50 year old male presented to [**Hospital3 3765**] with acute onset of left sided abdominal pain. He reports that he had 3 "attacks" of sharp pain on Friday night [**2-20**] which subsided and on Saturday morning had an attack which did not resolve. There was no nausea or vomiting associated with the pain. The pain is constant and radiates to his back and at times to his left shoulder. He reports that it is similar to previous attacks, although the pain in the past was more right sided. He reports that he first had gallstone pancreatitis in [**7-2**] and his gallbladder was removed. In [**2177-10-25**], he had another attack of pancreatitis which he was hospitalized for. A CT was done at this time, which showed a pancreatic pseudocyst. He had similar pain in [**2177-12-26**] which resolved and did not require hospitalization. On admission to [**Hospital1 **] on [**2-21**], his amylase was 288 and lipase was 324, WBC was 11.9, Hct 39.3. Repeat labs done at [**Hospital1 **] on [**2-22**] showed an amylase of 174 and lipase of 136, WBC 9.0 and Hct 36.4. Denies any chest pain, shortness of breath, fevers or chills. Last bowel movement was yesterday, no melena or BRBPR. No emesis and some mild nausea associated with dilaudid. Past Medical History: HTN Recurrent pancreatitis Social History: Denies tobacco use or current EtOH use, past hx of social EtOH use on business trips, which he stopped [**7-2**]. Family History: Non-contributory Physical Exam: (On presentation) Vitals: T 98.9 HR 83 BP 135/91 RR 18 94%RA NAD, A+O x 3 PERRLA, EOMI, Anicteric RRR, no m/r/g, No JVD CTA B, no r/r/c ABD +BS, soft, voluntary guarding, mild tenderness to palpation RLQ and LUQ EXT warm, well perfused, dp palp Pertinent Results: [**2178-2-24**] INTRAOP U/S: High-resolution linear array scans over the pancreas region were obtained demonstrating a large complex cystic collection measuring at least 5-6 cm in diameter and containing two components which are joined by a wide 5-mm neck. There was extensive echogenic material within the fluid including some floating debris. After surveying several sites, the best most proximate approach to the pseudocyst was through the stomach with the cyst approximately 3-5 mm deep to the stomach wall. After opening the anterior wall further, repeat ultrasound through the posterior wall of the stomach was performed, again to identify the closest site and this was confirmed by placement of a needle under direct ultrasound guidance into the cyst. Following visual confirmation of needle placement into the cyst, the ultrasound scan was ended and surgical cyst-gastrostomy was undertaken. . [**2178-2-23**] CTA ABD: IMPRESSION: 1. Necrotizing/hemorrhagic pancreatitis with pseudocyst formation. The extent of surrounding inflammatory change and size of the pseudocysts have increased since [**2178-2-22**]. There is no evidence for pdeudoaneurysm. The splenic vein is thrombosed. 2. Wall thickening involving the stomach, first/second portion of the duodenum and splenic flexure likely related to adjacent inflammatory change. 3. Rounded hypodense lesion within the interpolar region of the right kidney most consistent with cyst. 4. Multiple sub-cm hypodense lesions within the liver, incompletely characterized. . [**2178-2-22**] 08:58PM HCT-36.7* [**2178-2-22**] 02:29PM GLUCOSE-154* UREA N-9 CREAT-0.8 SODIUM-138 POTASSIUM-4.1 CHLORIDE-103 TOTAL CO2-28 ANION GAP-11 [**2178-2-22**] 02:29PM estGFR-Using this [**2178-2-22**] 02:29PM ALT(SGPT)-13 AST(SGOT)-13 ALK PHOS-64 AMYLASE-153* TOT BILI-1.3 [**2178-2-22**] 02:29PM LIPASE-106* [**2178-2-22**] 02:29PM ALBUMIN-3.7 CALCIUM-8.4 PHOSPHATE-2.6* MAGNESIUM-1.8 IRON-17* [**2178-2-22**] 02:29PM calTIBC-298 FERRITIN-242 TRF-229 [**2178-2-22**] 02:29PM TRIGLYCER-77 [**2178-2-22**] 02:29PM WBC-10.0 RBC-4.23* HGB-12.6* HCT-36.6* MCV-86 MCH-29.9 MCHC-34.6 RDW-13.0 [**2178-2-22**] 02:29PM PLT COUNT-294 [**2178-2-22**] 02:29PM PT-14.6* PTT-25.4 INR(PT)-1.3* Brief Hospital Course: [**2178-2-22**] Patient evaluated in the [**Hospital1 18**] Emergency Department on transfer from [**Hospital3 **] with primary complaint of abdominal pain as detailed above. Patient was admitted to the SICU for monitoring, serial HCT's, made NPO, and given IV hydration and pain control. No acute events overnight. . [**2178-2-23**] Patient transferred from SICU to floor following stable exams and HCT's. CTA Abdomen performed to rule out bleeding into pseudocyst with results as detailed above. Pain control adequate with PCA. . [**2178-2-24**] Patient underwent open cystgastrostomy with Dr. [**Last Name (STitle) **] with intraop ultrasound as detailed above. There were no complications during the procedure. The patient was extubated in the OR and transferred to the PACU and ultimately [**Hospital Ward Name 121**] 9 for recovery. No acute events overnight. . [**2178-2-25**] POD1 Patient sat up in bed for 6 hours. Pain well controlled. NGT in place with PCA for pain control. No acute events. . [**2178-2-26**] POD2 Patient with difficulty with pain control, PCA dosing increased. Urine output stable. Patient OOB to chair. Remains NPO with NGT per plan. No acute events. . [**2178-2-27**] POD3 Patient OOB to hallway without assistance. Pain well controlled. NGT in place and good urine output overnight. No acute events. . [**2178-2-28**] POD4 PCA discontinued. Patient with good pain control with PO medication. NGT removed. Patient given sips and tolerating it well. Ambulating in halls without assistance. No acute events. . [**2178-3-1**] POD5 Patient given clear liquid diet and tolerating it well. Given Dulcolax PR x 1 for constipation with good result. All blood cultures from admission with NGTD. No acute events. . [**2178-3-2**] POD6 Patient given a regular diet. Excellent PO pain control. . [**2178-3-4**] POD7 At the time of discharge patient was afebrile with all vital signs within normal limits, tolerating a regular diet, with good pain control with PO medication, and ambulating without assistance. He was ruled out for C.diff after having some loose stool. He was discharged to home to follow up with Dr. [**Last Name (STitle) **] in 2 weeks. Medications on Admission: Amlodopine 5mg qd Quinapril 40mg qd Discharge Medications: 1. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO every 4-6 hours as needed: Do not consume alcohol, drive, or operate machinery while taking this. Disp:*30 Tablet(s)* Refills:*0* 2. Colace 100 mg Capsule Sig: One (1) Capsule PO twice a day for 1 months: Take this stool softener as long as you are taking narcotics. Disp:*60 Capsule(s)* Refills:*0* Discharge Disposition: Home Discharge Diagnosis: Pancreatic Pseudocyst Discharge Condition: Good Discharge Instructions: Please call your doctor or return to the ER for any of the following: * You experience new chest pain, pressure, squeezing or tightness. * New or worsening cough or wheezing. * If you are vomiting and cannot keep in fluids or your medications. * You are getting dehydrated due to continued vomiting, diarrhea or other reasons. * Signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * You see blood or dark/black material when you vomit or have a bowel movement. * Your skin, or the whites of your eyes become yellow. * Your pain is not improving within 8-12 hours or not gone within 24 hours. Call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. * You have shaking chills, or a fever greater than 101.5 (F) degrees or 38(C) degrees. * Any serious change in your symptoms, or any new symptoms that concern you. . * Please resume all regular home medications and take any new meds as ordered. * Do not drive or operate heavy machinery while taking any narcotic pain medication. You may have constipation when taking narcotic pain medications (oxycodone, percocet, vicodin, hydrocodone, dilaudid, etc.); you should continue drinking fluids, you may take stool softeners, and should eat foods that are high in fiber. * Continue to increase activity daily * No heavy lifting (>[**9-9**] lbs) for 6 weeks. * Continue with drain care and flushing of the left sided drain. * Monitor your incision for sign of infection (redness or increased drainage). * Keep incision clean and dry. Followup Instructions: Please follow-up with Dr. [**Last Name (STitle) **] in 3 weeks. Please call [**Telephone/Fax (1) 1231**] to schedule an appointment. ICD9 Codes: 4019
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Medical Text: Admission Date: [**2107-5-19**] Discharge Date: [**2107-5-25**] Date of Birth: [**2027-6-12**] Sex: F Service: MEDICINE Allergies: Codeine / Zocor Attending:[**Last Name (NamePattern1) 1167**] Chief Complaint: Shortness of breath and cough Major Surgical or Invasive Procedure: Cardiac catheterization with no intervention History of Present Illness: 79-year-old with a history of CAD, with 2VD not candidate for CABG s/p PCI with stent to ostial LAD [**1-/2107**] with residual known proximal 80% Lcx in addition to a history of systolic CHF, COPD and OSA who was transferred from the OSH after admission for NSTEMI complicated by VT/VF which resolved with shock on the day of transfer. . Mrs. [**Known lastname 40800**] presented to OSH yesterday ([**5-18**]) due to worsening SOB, cough productive of whote phlegm and parasternal chest pain which was related to cough and deep breathing but not to exertion or rest without coughing. The cough had troubled her for the preceeding two weeks. This was also associated with some fatigue and chills but not with fever or night sweats. She denied nasal congestion, sinus pain, ear pain, throat pain, heartburn, diarrhea or urinary symptoms. . She reported orthopnea X 2 pillows, paroxysmal nocturnal dyspnea, nocturia X [**1-5**]. These have been stable in recent days prior to admission. She denied any lower extremity swelling. . On review of systems, she complained of chronic arthritic pains. Otherwise, she denied any nausea or vomiting, diaphoresis, fevers, prior history of stroke, TIA, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, hemoptysis, bloody stools and fevers. All of the other review of systems were negative. . Cardiac review of systems was notable for absence of ankle edema, palpitations, syncope or presyncope. . At the OSH, her admission vitals were as follows: BP 116/60 HR 79 RR 29 SaO2 89% on 2L. She exhibited signs of florid heart failure (CXR findings and a BNP 1300) and had positive cardiac enzymes (Trop 4.96). Impression was a NSTEMI. She got 2 units of blood as her Hct was 26. She was also diuresed overnight with Lasix 80mg [**Hospital1 **]. As there was suspicion of a GI bleed (Blood on per-rectal examination, guaiac positive), all anticoagulants and antiplatelets were stopped and she was admitted to the ICU. Today ([**5-19**]) In the early PM, after eating lunch she was found to be unresponsive and in VTach/VFib. She was given CPR and then defibrillated x1 into normal sinus rhythm. The downtime was <1 minute. She was then put on a 50% venti mask and she remained hemodynamically stable. An amiodarone gtt was started. She was transferred to [**Hospital1 18**] for consideration of catheterisation. Past Medical History: 1. CARDIAC RISK FACTORS: +Diabetes, +Dyslipidemia, +Hypertension 2. CARDIAC HISTORY: - Coronary Artery Disease with previous NSTEMI - Mitral valve prolapse with trace mitral regurgitation - Congestive Heart Failure - CABG: Evaluated for surgery but not a suitable candidate. - PERCUTANEOUS CORONARY INTERVENTIONS: [**2107-1-1**]: 2VD in ostial LAD and proximal circ s/p ostial LAD stent with DES. No intervention to proximal circ. Procedure complicated by femoral AV fistula that resolved. - PACING/ICD: None 3. OTHER PAST MEDICAL HISTORY: - Peripheral Vascular Disease - Carotid Disease s/p bilateral carotid endarterectomy (f/u Dr [**Last Name (STitle) 26438**] - Chronic Obstructive Pulmonary Disease on home oxygen therapy (2L/min) and chronic respiratory failure: Last PFT's Moderate restrictive ventilatory defect with a marked gas exchange defect. The DLCO is reduced out of proportion to the reduction in TLC which suggests an interstitial process. per pulmonary note: has severe COPD with superimposed restriction, severe emphysema by CT scan, obesity, probably OSA. - Chronic Kidney Disease (Stage III) with atrophic right kidney and episodes of acute renal insufficiency - Gastroesophageal Reflux Disease - Fatty liver and ?liver cirrhosis - Gout - Rheumatoid Arthritis - Thrombocytopenia ?ITP - Anemia of chronic disease - Rhabdomyolysis - Diverticulosis of urinary bladder - Bladder polyp s/p removal - Morbid obesity - Obstructive Sleep Apnea (Clinically Suspected) - History of Bone marrow suppression to methotrexate - History of shingles - Small left adrenal nodule Social History: - Family: Lives alone. Widowed as husband recently died from leukemia. Has a supportive family. - Occupation: Used to work in a variety of jobs but now retired on disability. - ADLs: Could walk a block before she got breathless. Can dress herself but with much difficulty. - Tobacco history: Ex-smoker, quit 20 years ago. - ETOH: Denied. - Illicit drugs: Denied. Family History: - She has 3 sibilings who died of MIs. A brother passed away at 59 suddenly due to MI. Another brother has had multiple MIs s/p CABG but passed away after the surgery. Her sister had double bypass CABG but also passed away after the surgery. - Otherwise, no family history of arrhythmia, cardiomyopathies, or sudden cardiac death. Physical Exam: On Admission: GENERAL: NAD. HEENT: Normocephalic. No trauma to head. Sclera anicteric. PERRL. No change in oropharynx. NECK: Supple, no JVD. Thyroid gland not enlarged. CARDIAC: Normal S1, S2. No S3 or S4. No carotid bruits. LUNGS: Symmetric. [**Hospital1 **]-basilar crackles. Few expiratory wheezes. ABDOMEN: Soft, mild tenderness in left lower quadrant but no rebound tenderness, no palpable masses. No bruits. EXTREMITIES: 1+ pitting pre-tibial edema. No cyanosis / clubbing. SKIN: No rash or eruptions. PULSES: Diminished pulses over posterior tibial and dorsal pedal arteries bilaterally. NEURO: No focal deficits. . On Discharge GENERAL: NAD. HEENT: Normocephalic. No trauma to head. Sclera anicteric. PERRL. No change in oropharynx. NECK: Supple, no JVD. Thyroid gland not enlarged. CARDIAC: Normal S1, S2. No S3 or S4. No carotid bruits. LUNGS: Symmetric. CTA with scant bibasilar crackles. ABDOMEN: Soft, nontender, nondistended no palpable masses. No bruits. EXTREMITIES: 1+ pitting pre-tibial edema. No cyanosis / clubbing. SKIN: No rash or eruptions. PULSES: Diminished pulses over posterior tibial and dorsal pedal arteries bilaterally. NEURO: No focal deficits. Pertinent Results: CBC Trend: [**2107-5-19**] 06:20PM BLOOD WBC-12.5* RBC-3.11*# Hgb-10.4*# Hct-31.4*# MCV-101* MCH-33.6* MCHC-33.3 RDW-19.5* Plt Ct-219# [**2107-5-20**] 06:33AM BLOOD WBC-11.0 RBC-3.06* Hgb-10.0* Hct-31.4* MCV-103* MCH-32.8* MCHC-32.0 RDW-19.2* Plt Ct-199 [**2107-5-21**] 03:27AM BLOOD WBC-9.7 RBC-2.93* Hgb-10.1* Hct-29.8* MCV-102* MCH-34.4* MCHC-33.7 RDW-18.7* Plt Ct-194 [**2107-5-22**] 08:50AM BLOOD WBC-10.3 RBC-3.13* Hgb-10.3* Hct-32.9* MCV-105* MCH-32.8* MCHC-31.2 RDW-18.3* Plt Ct-177 [**2107-5-23**] 07:45AM BLOOD WBC-9.7 RBC-3.16* Hgb-10.4* Hct-33.1* MCV-105* MCH-32.8* MCHC-31.2 RDW-17.8* Plt Ct-195 [**2107-5-24**] 07:15AM BLOOD WBC-11.6* RBC-3.09* Hgb-10.2* Hct-31.8* MCV-103* MCH-33.1* MCHC-32.1 RDW-17.5* Plt Ct-167 [**2107-5-25**] 05:45AM BLOOD WBC-8.7 RBC 2.90* Hgb-9.5* Hct-29.6* MCV 102* MCH 32.7* MCHC 32.1 RDW-17.4* Plt Ct-193 . Chemistry Trend: [**2107-5-19**] 06:20PM BLOOD Glucose-112* UreaN-51* Creat-2.0* Na-142 K-4.0 Cl-101 HCO3-30 AnGap-15 [**2107-5-20**] 12:01AM BLOOD Glucose-119* UreaN-54* Creat-2.2* Na-141 K-3.7 Cl-100 HCO3-29 AnGap-16 [**2107-5-20**] 06:33AM BLOOD Glucose-125* UreaN-59* Creat-2.3* Na-140 K-4.1 Cl-99 HCO3-31 AnGap-14 [**2107-5-21**] 03:27AM BLOOD Glucose-195* UreaN-63* Creat-2.1* Na-140 K-4.0 Cl-102 HCO3-28 AnGap-14 [**2107-5-22**] 04:25AM BLOOD Glucose-154* UreaN-61* Creat-1.7* Na-141 K-4.4 Cl-103 HCO3-26 AnGap-16 [**2107-5-23**] 07:45AM BLOOD Glucose-127* UreaN-73* Creat-2.5* Na-139 K-4.7 Cl-101 HCO3-30 AnGap-13 [**2107-5-24**] 07:15AM BLOOD Glucose-117* UreaN-81* Creat-2.6* Na-137 K-4.5 Cl-99 HCO3-28 AnGap-15 [**2107-5-25**] 05:45AM BLOOD Glucose-135* UreaN-81* Creat-2.2* Na-135 K-4.2 Cl-98 HCO3-28 AnGap-13 . Coags: [**2107-5-19**] 06:20PM BLOOD PT-14.8* PTT-22.4 INR(PT)-1.3* [**2107-5-22**] 08:50AM BLOOD PT-13.8* INR(PT)-1.2* . LFTs [**2107-5-19**] 06:20PM BLOOD ALT-23 AST-47* LD(LDH)-337* CK(CPK)-94 AlkPhos-64 TotBili-0.7 [**2107-5-24**] 07:15AM BLOOD CK(CPK)-347* . Biomarkers Trend: [**2107-5-19**] 06:20PM BLOOD CK-MB-10 MB Indx-10.6* cTropnT-0.88* proBNP-[**Numeric Identifier 40801**]* [**2107-5-20**] 12:01AM BLOOD CK-MB-6 cTropnT-0.89* [**2107-5-20**] 06:33AM BLOOD CK-MB-6 cTropnT-0.93* [**2107-5-21**] 03:27AM BLOOD cTropnT-1.41* [**2107-5-22**] 04:25AM BLOOD CK-MB-4 cTropnT-1.50* [**2107-5-23**] 07:45AM BLOOD CK-MB-7 cTropnT-1.41* [**2107-5-24**] 07:15AM BLOOD CK-MB-5 . HgA1c: [**2107-5-19**] 06:20PM BLOOD %HbA1c-5.2 eAG-103 . Cholesterol Panel [**2107-5-19**] 06:20PM BLOOD Triglyc-74 HDL-57 CHOL/HD-2.0 LDLcalc-44 . TSH [**2107-5-19**] 06:20PM BLOOD TSH-2.4 . ECG ([**2107-5-19**] 5:37:24 PM) Sinus rhythm with atrial premature beats. ST-T wave abnormalities. Since the previous tracing of [**2107-1-16**] atrial premature beats are new. ST-T wave abnormalities are more marked. Clinical correlation is suggested. TRACING #1 . ECG ([**2107-5-20**] 8:23:28 AM) Sinus rhythm. ST-T wave abnormalities. Since the previous tracing atrial premature beats are no longer seen. Rate is decreased. ST-T wave abnormalities persist. TRACING #2 . ECG ([**2107-5-22**] 3:24:00 AM) Sinus rhythm. Prolonged Q-T interval. Anteroapical T wave inversions suggestive of myocardial ischemia. Clinical correlation is suggested. Compared to the previous tracing of [**2107-5-20**] precordial T wave inversions are less pronounced. . ECG ([**2107-5-23**] 9:07:36 AM) Sinus rhythm with an atrial premature beat. Low lateral precordial T wave amplitudes and minor ST-T wave abnormalities in the lateral limb leads. Since the previous tracing of [**2107-5-22**] ST-T wave abnormalities are now less prominent in the lateral precordial leads and more prominent in the lateral limb leads at a faster rate. The atrial premature beat is new. . IMAGING: CHEST (PORTABLE AP) ([**2107-5-19**] 6:11 PM) FINDINGS: In comparison with study of [**1-16**], there is enlargement of the cardiac silhouette with pulmonary vascular congestion. Retrocardiac opacification most likely represents atelectasis with small effusion, though the possibility of supervening pneumonia would have to be considered in the appropriate clinical setting. . CHEST (PORTABLE AP) ([**2107-5-23**] 8:37 AM) The cardiac silhouette remains enlarged, similar from prior study. There is pulmonary vascular congestion and bilateral diffuse opacifications, which likely represents a combination of pulmonary edema and pleural effusion, but infectious process cannot be excluded in the appropriate clinical setting. No pneumothorax is noted. The mediastinal and hilar silhouettes are stable. IMPRESSION: 1. Unchanged pulmonary vascular congestion and pulmonary edema, but pneumonia cannot be excluded in the appropriate clinical setting. 2. Bilateral pleural effusion is unchanged from prior study. . Portable TTE (Complete) ([**2107-5-21**] 10:21:55 AM) The left atrium is elongated. Left ventricular wall thicknesses are normal. The left ventricular cavity is mildly dilated. Overall left ventricular systolic function is low normal (LVEF 50%) secondary to mild hypokinesis of the inferior, posterior, and lateral walls (the anterior septum and anterior free wall are hyeprdynamic). Right ventricular chamber size and free wall motion are normal. There are three aortic valve leaflets. The aortic valve leaflets are moderately thickened. There is mild aortic valve stenosis (valve area 1.9cm2). No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. The estimated pulmonary artery systolic pressure is normal. There is no pericardial effusion. Compared with the findings of the prior report (images unavailable for review) of [**2107-1-7**], mild posterior and lateral hypokinesis is now present. . Cardiac Cath ([**2107-5-20**]) Coronary angiography showed right dominant system. LMCA- Short, normal LAD- Stent widely patent, no significant disease LCX- Mild proximal disease, no significant other disease on limited views. RCA- Mild diffuse disease only. FINAL DIAGNOSIS: 1. Widely patent LAD stent 2. Mild non-significant CAD/ no culprit for NSTEMI. Brief Hospital Course: Ms [**Known lastname 40800**], a 79-year-old with a history of CAD, with 2VD not candidate for CABG, s/p PCI with stent to ostial LAD ([**1-/2107**]) with residual known proximal 80% Lcx in addition to a history of systolic CHF, COPD and OSA who was transferred from an OSH after admission for NSTEMI + CHF exacerbation complicated by VT/VF which resolved with shock on the day of transfer. . # NSTEMI. Patient has a history of CAD with 2VD per cath in [**2107-1-1**]; patient is not a candidate for CABG due to high surgical risk in the setting of severe COPD. Patient underwent an elective PCI at that time with stent to ostial LAD [**1-/2107**] with residual known proximal 80% Lcx. Patient presented to OSH [**5-18**] with lateral and inferior EKG changes and raised troponins suggestive of a new NSTEMI compatible with LCx distribution. She was transferred to [**Hospital1 18**] for cardiac catheterization. She was continued on an IV Heparin gtt and started ASA 325 mg PO, clopidogrel 75 mg PO daily, atorvastatin 80mg daily. Patient underwent cardiac cath on [**5-23**] which demonstrated widely patent LAD stent, mild non-significant CAD and no culprit for NSTEMI. TTE demonstrated normal left ventricular wall thicknesses are normal. The left ventricular cavity is mildly dilated. Overall left ventricular systolic function is low normal (LVEF 50%) secondary to mild hypokinesis of the inferior, posterior, and lateral walls (the anterior septum and anterior free wall are hyperdynamic). Patient remained chest pain free throughout remainder of her stay. . # Acute decompensated sytolic CHF (NYHA Class III): On presentation to OSH CXR showed florid pulmonary congestion. Patient was diuresed in OSH with IV lasix. BNP = 1300. Likely decompensated due to ischemia. On arrival patient with above baseline O2 requirement (nasal canula at 5L; 2L at home). Patient intermittently diuresised with Furosemide 20 mg IV. On HD3 patient creatinine elevated and decision made to hold to diuresis. Patient was started on ACEi and continued on beta blocker. . # RHYTHM. She developed an episode of VTach/VFib possibly as a complication of her recent NSTEMI. The downtime was <1 minute. This required CPR and defibrillation x1 which subsequently converted her to normal sinus rhythm. She was monitored on telemetry without further event. . # COPD: Chronic Obstructive Pulmonary Disease on home oxygen therapy (2L/min) and chronic respiratory failure. Last PFT's Moderate restrictive ventilatory defect with a marked gas exchange defect. FEV1/FVC actual = predicted = 0.65. Per pulmonary note: has severe COPD with superimposed restriction, severe emphysema by CT scan, obesity, probably OSA. Now presenting with worsening cough of 14 days productive of sputum. No fever. Has leukocytosis to 12.5. Dif is pending. No clear infiltrates on CXR except possible small infiltrate at left heart border. Given her prolonged cough with increased sputum in the setting of risk factors including chronic prednison, severe underlyting lung disease, diabetes, CHF and her age would tend to cover her with Abx for CAP organisms. She was started on PO Levofloxacin for likely 5day treatment course. She was continued on home Advair (500/50), ipratropium nebs as well as standing, chronic prednisone 5mg . # Anemia: Has baseline macrocytic anemia, with Hct ~ 30-31. In OSH noted to have PR bleeding per-rectal examination and was guiaic positive. Hct was 26 and she received PRBC X2, now Hct 31. B12, Folate were normal in [**Month (only) 404**]. Patient continued on Pantoprazole 40 mg PO Q24H in the setting of Plavix + Asprin. HCT stable in house. . # Chronic Kidney Disease (Stage III). Creatinine in [**2107-1-1**] was 2.1. Creatinine did uptrend in setting of diuresis as well as contrast load during catheterization. Patient continued to make urine thoughout hospitalization. Creatinine at time of discharge was 2.2. . # Question of cirrhosis. Patient has history of fatty liver with recent CT demonstrating nodular liver. Has chronic macrocytosis, low albumin, borderline elevated INR and mild chronic thrombocytopenia. All suggesting chronic liver disease. Of note current elevated AST is likely of cardiac origin. - Out-patient hepatlogy f/u. . # HTN: Converted to Metoprolol succinate from tartrate and started on Lisinopril for her CHF instead of felodipine. Her blood pressure was well controlled during her hospital stay. Lisinopril should be uptitrated as creatinine allows. . # HLD. Patient was started on Atorvastatin 80mg daily for treatment of CAD. Her lipid panel was normal. . OUTPATIENT ISSUES: - Continue Atorvastatin 80mg daily . # DM. Her HbA1c was 5.2%. Her glypizide was held and she as put on an insulin sliding scale and a low carbohydrate diet. . OUTPATIENT ISSUES: - Restart glypizide . # Gout: She has some minor joint pain that was treated with Tramadol prn, No evidence of acute flare. - Continue Febuxostat 40 mg PO DAILY . # Rheumatoid Arthritis. Hydroxychloroquine was held in the context of recent arrythmias as well as ABx treatment with levofloxacin to avoid excess QT prolongation. This should be restarted as an outpt. . #Urinary Tract Infection. A UA was positive on [**5-25**], but she was asymptomatic. She was treated with PO levofloxacin for 5 days for her pneumonia, course was finished at the time of the postivie U/A. Urine cultures were sent. Rehab will be called if the results are positive. . OUTPATIENT ISSUES: - Urine culture results will need to be followed-up as an outpatient Medications on Admission: HOME MEDICATIONS: - Advair Diskus 500/50 mcg one inhalation [**Hospital1 **] - Uloric one pill qd - Aspirin 162mg qd - Iron sulfate 325mg qd - Folic acid 1mg qd - Lasix 20mg qd - Felodipine 5mg daily - Glipizide 5mg qd - Glucosamine and chondriotin [**Hospital1 **] - Lopressor 50mg po bid - Lovaza 2g [**Hospital1 **] - Plavix 75mg qd - Pravastatin 10mg po at bedtime - ReQuip 1mg po at bedtime - Prednisone 5mg qd - Plaquenil 200mg po qd - Spiriva 18mcg inhalation qd Discharge Medications: 1. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 2. fluticasone-salmeterol 500-50 mcg/dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). 3. folic acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. febuxostat 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. metoprolol succinate 100 mg Tablet Extended Release 24 hr Sig: One (1) Tablet Extended Release 24 hr PO once a day. Disp:*30 Tablet Extended Release 24 hr(s)* Refills:*0* 7. atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 8. ropinirole 1 mg Tablet Sig: One (1) Tablet PO QHS (once a day (at bedtime)). 9. prednisone 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 10. Spiriva with HandiHaler 18 mcg Capsule, w/Inhalation Device Sig: One (1) Inhalation once a day. 11. 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:*0* 12. lisinopril 5 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 13. glipizide 5 mg Tablet Sig: One (1) Tablet PO once a day. 14. Lovaza 1 gram Capsule Sig: Two (2) Capsule PO twice a day. 15. Lasix 20 mg Tablet Sig: One (1) Tablet PO once a day. 16. lactulose 10 gram/15 mL Syrup Sig: Thirty (30) ML PO TID (3 times a day) as needed for constipation: hold for diarrhea. 17. calcium carbonate 200 mg calcium (500 mg) Tablet, Chewable Sig: One (1) Tablet, Chewable PO QID (4 times a day) as needed for heartburn. 18. ferrous sulfate 324 mg (65 mg Iron) Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. 19. Spiriva with HandiHaler 18 mcg Capsule, w/Inhalation Device Sig: One (1) capsulr Inhalation once a day. 20. tramadol 50 mg Tablet Sig: One (1) Tablet PO every six (6) hours as needed for pain. Discharge Disposition: Extended Care Facility: [**Hospital6 1293**] - [**Location (un) 8957**] Discharge Diagnosis: Non ST elevation myocardial infarction Acute on Chronic Systolic congestive heart failure Ventricular tachycardia Acute on chronic kidney disease Community aquired pneumonia Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: Dear Mrs [**Known lastname 40800**], . you were transferred to our hospital after suffering a myocardial infarction ("heart attack") which was complicated by heart failure and heart rythm disturbances. You underwent coronary catheterization which did not show any lesions that require intervention. Your kidneys worsened temporarily because of the catheterization dye, they are improving today. . The following changes were made to your medications: . - Felodipine was stopped - Plaquenil was stopped - Pravastatin was stopped - Lopressor 50mg tablet was changed to a long acting formulation at 100 mg daily - Omeprazole was changed to pantoprazole to protect your stomach from the medicines. Please do not resume these medications without consulting your doctor. . - Aspirin tablet was increased to Aspirin 325mg tablet: please take one tablet once daily. . - Lisinopril 2.5mg tablet was started for blood pressure. Please take one tablet once daily. . - metoprolol succinate 100 mg Tablet Extended Release 24 hr was started to help your heart beat more efficiently. Please take one tablet once daily. . - Atorvastatin 80mg was started. Please take one tablet once daily. . - Laxtulose was started as needed for constipation . - STart Tramadol to treat the pain in your knee and chest wall area. . Daily weights every morning, please notify Dr. [**Last Name (STitle) 5017**] if weight increases more than 3 pounds in 1 day or 5 pounds in 3 days Followup Instructions: Name: [**Last Name (LF) **],[**First Name7 (NamePattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] Location: [**Location (un) **] CARDIOLOGY Address: [**Street Address(2) **], [**Apartment Address(1) **], [**Location (un) **],[**Numeric Identifier 39854**] Phone: [**Telephone/Fax (1) 5424**] Appointment: Monday [**2107-6-6**] 2:15pm Completed by:[**2107-5-26**] ICD9 Codes: 5849, 486, 4280, 496, 5715, 5990, 2749
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6505 }
Medical Text: Admission Date: [**2174-5-7**] Discharge Date: [**2174-5-11**] Date of Birth: [**2121-5-9**] Sex: F Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 3223**] Chief Complaint: Dyspnea Major Surgical or Invasive Procedure: [**2174-5-7**] Thoracentesis History of Present Illness: 53 yo female who six weeks ago was a pedestrian struck by a truck on the left side resulting in multiple fractures including clavicle and 13 ribs. She was left with a pleural effusion on the left which was documented during an emergency room visit on [**4-25**] at [**Hospital1 **]. She has been using an incentive spirometer at home reportedly faithfully. Over the past 2-3 days she has noticed dramatically increased orthopnea such that she is now sleeping sitting up but no significant increase in dyspnea on exertion, fever, sputum production. Physical exam: Looks relatively Past Medical History: Osteopenia OCD Anxiety Social History: Married Works as a social worker Family History: Non contributory Pertinent Results: Upon admission: [**2174-5-7**] 11:49PM GLUCOSE-166* UREA N-10 CREAT-0.6 SODIUM-135 POTASSIUM-3.9 CHLORIDE-100 TOTAL CO2-25 ANION GAP-14 [**2174-5-7**] 11:49PM CALCIUM-8.5 PHOSPHATE-3.5 MAGNESIUM-1.9 [**2174-5-7**] 11:49PM WBC-13.2*# RBC-3.64* HGB-10.2* HCT-31.1* MCV-85 MCH-28.1 MCHC-32.9 RDW-13.8 [**2174-5-7**] 11:49PM PLT SMR-HIGH PLT COUNT-536* [**2174-5-7**] 11:49PM PT-14.2* PTT-33.5 INR(PT)-1.2* CHEST (PORTABLE AP) [**2174-5-7**] 8:57 PM IMPRESSION: AP chest compared to [**5-7**], 6:57 p.m.: There has been no increase in left pleural effusion but consolidation in the left mid and lower lung has increased substantially, an unusual pattern for first reexpansion pulmonary edema suggesting instead pulmonary hemorrhage. There is no pneumothorax. Right lung is clear and heart size is normal. Minimally displaced fracture of the left seventh rib is unchanged and may be a second fracture, of the left tenth rib laterally, chronicity indeterminate. Cytology Report PLEURAL FLUID Procedure Date of [**2174-5-7**] REPORT APPROVED DATE: [**2174-5-10**] SPECIMEN RECEIVED: [**2174-5-9**] [**-7/1936**] PLEURAL FLUID SPECIMEN DESCRIPTION: Received 5ml bloody fluid. Prepared 1 ThinPrep slide. CLINICAL DATA: Undiagnosed effusion. PREVIOUS BIOPSIES: [**2173-11-19**] [**-6/4622**] THIN LAYER PREP PAP SMEAR WITH IMAGING [**2172-8-18**] [**-5/3366**] THIN LAYER PREP PAP SMEAR WITH IMAGING [**2171-3-28**] 05-[**Numeric Identifier 10694**] THIN LAYER PREP PAP SMEAR [**2162-11-26**] 96-[**Numeric Identifier 10695**] PAP 95-[**Numeric Identifier 10696**] PAP DIAGNOSIS: NEGATIVE FOR MALIGNANT CELLS. CHEST (PA & LAT) [**2174-5-10**] 10:36 AM IMPRESSION: PA and lateral chest compared to [**2174-5-9**]: Previously severe left lung consolidation has improved. A smaller volume of consolidation remains in the right apex and perihilar right mid lung. Small bilateral pleural effusions are probably unchanged over the past several days. Heart size is normal. There is no pneumothorax. Brief Hospital Course: She was admitted to the Trauma Service. She underwent chest xray which revealed no increase in left pleural effusion but consolidation in the left mid and lower lung which had increased substantially since last chest radiograph in early [**Month (only) 116**] but no pneumothorax. She was transferred to the ICU where she was monitored closely; she was placed on supplemental oxygen. Serial chest xrays were followed. Interventional Pulmonology was consulted for Thoracentesis; 2.5 liters was drained from the left chest. A bronchoscopy was done 2 days later which revealed patent airways with minimal to no secretions. She was started on Levaquin for presumed pneumonia. She is being discharged to home with skilled nursing from visiting nurses. She will follow up in Surgery clinic in 1 week; an xray will be [**Month (only) 1988**] prior to this appointment. Medications on Admission: MS Contin 30bid, Klonopin 0.25"', Prozac 60' Discharge Medications: 1. Morphine 15 mg Tablet Sustained Release Sig: Two (2) Tablet Sustained Release PO every twelve (12) hours. Disp:*120 Tablet Sustained Release(s)* Refills:*0* 2. Oxycodone 5 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for breakthrough pain. Disp:*60 Tablet(s)* Refills:*0* 3. Clonazepam 0.5 mg Tablet Sig: One (1) Tablet PO QHS (once a day (at bedtime)) as needed for insomnia. Disp:*30 Tablet(s)* Refills:*0* 4. Levofloxacin 250 mg Tablet Sig: Three (3) Tablet PO DAILY (Daily) for 10 days. Disp:*30 Tablet(s)* Refills:*0* 5. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 6. Lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: One (1) Adhesive Patch, Medicated Topical every twenty-four(24) hours: Apply to affected area. Disp:*30 Adhesive Patch, Medicated(s)* Refills:*0* Discharge Disposition: Home With Service Facility: VISITING NURSE AND COMMUNITY HEALTH Discharge Diagnosis: Left pleural effusion Pneumonia Discharge Condition: Good Discharge Instructions: Return to the Emergency room if you develop any fevers, chills, headache, dizziness, chest pain, shortness of breath, nausea, vomiting, diarrhea and/or any other symptoms that are concerning to you. Continue with the antibiotics for another 10 days. You may resume your usual home medications as prescribed. Followup Instructions: Follow up next week with Dr. [**Last Name (STitle) **] in Surgery Clinic, call [**Telephone/Fax (1) 6429**] for an appointment. You will need to have an xray prior to this appointment. You also have an appointment with Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1984**], MD Phone:[**Telephone/Fax (1) 1228**] Date/Time:[**2174-6-16**] 8:30 you will need to have an xray prior to this appointment on Date/Time:[**2174-6-16**] 8:10 [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 520**] MD, [**MD Number(3) 3226**] Completed by:[**2174-5-11**] ICD9 Codes: 5119, 486
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6506 }
Medical Text: Admission Date: [**2180-4-9**] Discharge Date: [**2180-4-13**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 317**] Chief Complaint: diaphoresis, black bowel movement Major Surgical or Invasive Procedure: Endoscopy History of Present Illness: 87yoW with history of CAD s/p PCI to LAD [**2177**], CHF with EF 47%, breast cancer, colitis NOS presenting with melana. Patient was in her normal state of health until [**2180-4-8**] when she felt sweats at night. She awoke on the morning of [**2180-4-9**] again diaphoretic with palpitations and lightheadedness. She called for help and went to the bathroom where she passed a large black bowel movement. She noted mid-epigastric pain that has been ongoing for several weeks. She denied any abdominal cramping, nausea, or vomiting. . In the ED, initial Hct 26.5. She received one unit PRBC and was admitted to MICU. EGD showed a single non-bleeding ulcer at the GE junction, blood in the body and fundus of the stomach. She received an additional three units PRBC overnight and was ruled out for acute coronary syndrome by three negative sets of cardiac enzymes. She denied chest pain or shortness of breath. . On ROS she denies fevers, chills, headache, cough, dysuria, hematuria, new skin changes or rashes. She does note some RLE muscle cramps for the past few days. All other systems per HPI. Past Medical History: 1. 2-v Coronary artery disease s/p MI [**1-/2178**]; Cath with PCI to LCx, LAD; reversible defect IL pMIBI [**1-/2180**], EF 47% 2. Breast cancer s/p B mastectomy 3. Colitis NOS 4. Secundum ASD (L -> R), 2+AR, [**11-21**]+MR 5. Squamous cell cancer 6. Hypothyroid 7. Hypercholesterolemia 8. Depression 9. s/p Appendectomy 10. s/p TAH Social History: lives alone with [**Hospital 2241**] home health aides present at baseline, she dresses herself, walks without assistance, and prepares meals widowed two months ago previously worked in development office at [**Hospital **] Hosp for 47yrs denies tob, EtOH . Contact: daughters [**Name (NI) **] [**Telephone/Fax (1) 94693**] (HCP) [**Name (NI) **] [**Telephone/Fax (1) 94694**] Family History: non-contributory Physical Exam: On admission: 98.0 94 104/41 14 98%RA Gen: elderly woman, comfortable, NAD HEENT: PERRL, anicteric, conjunctiva pale, OP clear with modestly dry MM HEENT: supple, no LAD, no JVD CV: RRR, III/VI pansystolic murmur, no s3s4, 2+radial and DP pulses Resp: CTAB Chest: mastectomy scars, sternal wound 1.5cm diameter, dressed with cream and dry gauze Back: winged scapula, nontender Abd: +BS, soft, ttp mid-epigastric, no rebounding or guarding, no HSM Ext: no edema, mildly ttp right calf Skin: diffuse nevi on neck, chest, abdomen, B arms, large nevi on abdomen, echymoses on right knee, left arm Pertinent Results: [**2180-4-9**] 11:40AM PT-13.5* PTT-19.6* INR(PT)-1.2 [**2180-4-9**] 11:40AM PLT SMR-NORMAL PLT COUNT-250 [**2180-4-9**] 11:40AM NEUTS-88.3* BANDS-0 LYMPHS-9.5* MONOS-2.1 EOS-0.1 BASOS-0.1 [**2180-4-9**] 11:40AM WBC-9.4 RBC-3.05* HGB-8.8* HCT-26.5* MCV-87 MCH-28.7 MCHC-33.0 RDW-13.1 [**2180-4-9**] 11:40AM DIGOXIN-1.1 [**2180-4-9**] 11:40AM CK(CPK)-63 [**2180-4-9**] 11:40AM GLUCOSE-165* UREA N-92* CREAT-1.2* SODIUM-141 POTASSIUM-5.2* CHLORIDE-106 TOTAL CO2-24 ANION GAP-16 [**2180-4-9**] 12:44PM URINE BLOOD-SM NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-TR [**2180-4-9**] 12:44PM URINE COLOR-Straw APPEAR-Clear SP [**Last Name (un) 155**]-1.013 [**2180-4-9**] 08:10PM HCT-26.9* [**2180-4-9**] 08:10PM CK(CPK)-62 EGD Report: Impression: Angioectasia in the stomach body Ulcers in the distal esophagus Recommendations: EGD in 2 months: Scheduled with Dr. [**Last Name (STitle) **] and Dr. [**Last Name (STitle) 7307**] for [**6-8**] (thursday) at 10:30 am. Pt to be on [**Hospital Ward Name 121**] 8 at 9:30 am. Please hold asa and plavix for 1 week if ok with primary team. High dose (double dose) PPI Additional notes: The attending physician was present for the entire procedure. Biopsies of esophagus not performed due to recent bleeding and recent ASA and plavix use. Will bring back after therapy for reassessment. Brief Hospital Course: 87yo woman with history of coronary artery disease, congestive heart failure, presenting with diaphoresis, melana, and found to have upper GI bleed. During her hospitalization, the following problems were addressed:. #. GI bleed: Patient was initially admitted to the ICU and transfused three units PRBC. Emergent EGD was done in the MICU showing an ulcer at the GE junction, but it was too obscured by blood for further investigation. She was monitored overnight in the MICU and then transferred to the floor. She underwent repeat EGD which showed two distal esophageal ulcers. It was later noted that the patient had been taking only a minimal amount of water with her weekly Fosamax, and this was thought to be the cause. Fosamax was held until further discussion with the patient's primary care physician, [**Last Name (NamePattern4) **]. [**First Name (STitle) **], can be had. Aspirin and Plavis were also held, and she was treated with big iv Protonix. Hct stabilized, and her diet was advanced. She was discharged to home on Prevacid 30mg [**Hospital1 **], liquid formula. She will resume taking Plavix 75mg daily on [**2180-4-19**]. She was instructed to resume Aspirin 81mg daily 4 weeks after discharge. She will follow-up with Dr. [**First Name (STitle) **] to review her hospital course On [**2180-4-18**]. She will follow-up with Dr. [**Last Name (STitle) **] for repeat endoscopy [**2180-6-8**], 8 weeks after initial evaluation. #. Leg twitching: On day two of her hospitalization the patient began complaining of bilateral leg twitching. A neurology consult was called and found her exam to be consistent with myoclonus due to metabolic insult. Specifically they felt the elevated urea level after her GI bleed likely resulted in the muscle spasms. Other sources of metabolic insult were evaluated including tests for thyroid function, and were nondiagnostic. The neurology services believed it would resolve spontaneously with clearance of the urea. The remainder of her neurologic exam was within normal limits. #. CAD: There were no acute issues. She was ruled out for acute MI and continued on her outpatient regimen of captopril, carvedilol, and statin for secondary prevention. Plavix will be restarted [**2180-4-19**], aspirin 4weeks after discharge.. #. CRI: Baseline creatinine 1.0-1.1, and was elevated as high as 1.3 during her hospitalization. It was thought to be prerenal in etiology and treated with gentle iv fluids. #. Hypothyroid: continued Synthroid per outpatient regimen. A TSH was checked and was mildly elevated at 4.4; however, free T4 was within normal limits at 1.6. #. Psych: continued citalopram, trazadone per outpatient regimen #. Osteoporosis: We discontinued weekly Fosamax out of concern that this was related to the developed of GE ulcers. The patient was instructed to discuss resuming Fosamax with her primary care physician. #. Dispo: The patient was discharged to home. She has full time home health aides. Health care proxy is her daughter [**Name (NI) **] [**Telephone/Fax (1) 94693**]. She will follow-up with Dr. [**First Name (STitle) **] [**2180-4-18**]. Medications on Admission: Captopril 25mg [**Hospital1 **] Citalopram 60mg daily Coreg 6.25mg [**Hospital1 **] Digoxin 0.125mg daily Folate 4mg daily Trazodone 50mg qHS Fosamax 70mg qweek Lasix 40mg daily Levothyroxine 75mg daily Plavis 75mg daily Zocor 20mg daily Discharge Medications: 1. Captopril 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 2. Citalopram Hydrobromide 20 mg Tablet Sig: Three (3) Tablet PO DAILY (Daily). 3. Carvedilol 3.125 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 4. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Levothyroxine Sodium 50 mcg Tablet Sig: One (1) Tablet PO QOD (). 6. Levothyroxine Sodium 50 mcg Tablet Sig: 0.5 Tablet PO QOD (). 7. Silver Sulfadiazine 1 % Cream Sig: One (1) Appl Topical DAILY (Daily) as needed. 8. Digoxin 125 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) as needed for anxiety, sleeplessness. 10. Trazodone HCl 50 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) as needed for sleeplessness. 11. Furosemide 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 12. Simvastatin 10 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 13. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 14. Plavix 75 mg Tablet Sig: One (1) Tablet PO once a day: Please do not start taking this medication until [**2180-4-19**]. 15. Prevacid 30 mg Susp,Delayed Release for Recon Sig: Thirty (30) mg PO twice a day. Disp:*qs mg* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Primary: Upper GI bleed . Secondary: Coronary artery disease Congestive heart failure Discharge Condition: stable Discharge Instructions: If you develop any further episodes of bleeding, or if you develop dizziness, lightheadedness, chest pain, shortness of breath, abdominal cramps, fever, or any other concerning symptom, please contact your primary care physician [**Name Initial (PRE) **]/or return to the emergency department. . Please follow-up for a repeat endoscopy on [**2180-6-8**]. . Please do not restart your Plavix until next Wednesday [**2180-4-19**]. Please resume taking aspirin in 4 weeks. Please do not take Fosamax again until you discuss this further with Dr. [**First Name (STitle) **]. Taking Fosamax without sufficient water may have been related to development of the ulcers. Followup Instructions: Provider: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 1982**], MD Where: [**Hospital Ward Name **] BUILDING ([**Hospital Ward Name **] COMPLEX) Phone:[**Telephone/Fax (1) 1983**] Date/Time:[**2180-6-8**] 8:30 Provider: [**Name10 (NameIs) **] WEST,ROOM ONE GI ROOMS Where: GI ROOMS Date/Time:[**2180-6-8**] 8:30 . Please follow-up with Dr. [**First Name (STitle) **] Tuesday [**2180-4-18**] at 3:00pm. You can call [**Telephone/Fax (1) 40745**] with any questions or concerns. ICD9 Codes: 2851, 2449, 2720
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6507 }
Medical Text: Admission Date: [**2143-7-14**] Discharge Date: [**2143-8-2**] Service: MEDICINE Allergies: Dilacor XR / Codeine / Rosuvastatin / lisinopril / Levofloxacin Attending:[**Doctor First Name 3298**] Chief Complaint: fall with head strike Major Surgical or Invasive Procedure: None History of Present Illness: Mrs. [**Known lastname 4401**] is a [**Age over 90 **]y/o F h/o dCHF, CAD (CABGx2), HTN. She was found in bed by her husband with a head laceration, amnestic to event. Per Husband, they were getting ready for dinner with family when the pt stated she was going to lie down for a bit. The husband checked on her 15-30min later and he noticed blood on her scalp and pillow. Pt did not recall falling. EMS was initiated at that point and pt brought to ED. Her only complaint in the ED was back pain, which she attributed to the stretcher. On imaging, it was found that she had an intracranial hemorrhage and SAH, for which she was originally admitted to the neurosurgery service. Pt denies any numbness, weakness, tingling. Denies HA, nausea, vomiting. Denies neck pain. Denies CP, SOB. There was no bowel or bladder incontinence, or tongue biting associated with the event. She has no hx of seizures. She has no hx of syncope. Pt was transferred to the MICU in the setting of respiratory distress and intubated on [**7-16**]. Pt was extubated on [**7-25**] and called out to the medicine floor on [**7-28**] (more details in hospital course). Past Medical History: HTN NIDDM hypercholesterolemia CAD CABG x2 ([**2115**], [**2128**]) dCHF Social History: Previously independent in ADLs. Lives with husband. Denies smoking, EtOH use and drug use. Family History: Her children are healthy. Physical Exam: On Admission: O: BP: 159/89 HR: 60 R 18 O2Sats 98% Gen: WD/WN, uncomfortable on stretcher. Cervical collar in place, NAD. HEENT: Pupils: equal and brisk EOMs full Neck: Supple, no midline tenderness. Abd: Soft, NT, BS+ Extrem: Warm and well-perfused. Neuro: Mental status: Awake and alert, cooperative with exam, normal affect. Orientation: Oriented to person, re-oriented to place and date. Language: Speech fluent with good comprehension and repetition. Naming intact. No dysarthria or paraphasic errors. Cranial Nerves: I: Not tested II: Pupils equally round and reactive to light, 3 to 2 mm bilaterally. decreased vision in left eye, cannot count fingers (reported as baseline). III, IV, VI: Extraocular movements intact bilaterally without nystagmus. V, VII: Facial strength and sensation intact and symmetric. VIII: Hearing intact to voice. IX, X: Palatal elevation symmetrical. [**Doctor First Name 81**]: Sternocleidomastoid and trapezius normal bilaterally. XII: Tongue midline without fasciculations. Motor: decreased bulk with normal tone bilaterally. No abnormal movements, tremors. Strength full power [**5-16**] throughout. No pronator drift Sensation: Intact to light touch bilaterally. Toes downgoing bilaterally No midline spine tenderness to palpation. . . ON DISCHARGE: General: Pt sitting in chair in NAD. HEENT: MMM, no lymphadenopathy, no defects in the scalp or cranium appreciated, oropharynx clear Lungs: very mild stridor on inhalation, scattered mild crackles bilaterally in lower lung fields Cardiovascular: RRR, nl S1/S2, no m/r/g Abdomen: soft, BS+, no organomegaly appreciated, no tenderness to palpation Extremities: warm, well perfused, no cyanosis, edema Neuro: PERRL, alert, oriented to person, place and month. CN II-XII intact w/out deficit. Strength 4/5 b/l in lower extremities. No sign of Babinski b/l. Sensation intact bilateral. One error on days of week backward. Pertinent Results: Labs on Admission ([**7-14**]): WBC-14.7* RBC-3.79* Hgb-11.5* Hct-33.5* MCV-89 MCH-30.4 MCHC-34.4 RDW-16.0* Plt Ct-273 Glucose-131* UreaN-25* Creat-1.0 Na-143 K-4.7 Cl-108 HCO3-23 AnGap-17 ALT-13 AST-25 LD(LDH)-306* CK(CPK)-139 AlkPhos-62 TotBili-0.4 04:42PM BLOOD cTropnT-<0.01 01:48AM BLOOD CK-MB-5 cTropnT-0.01 08:06AM BLOOD CK-MB-4 cTropnT-0.01 . ([**7-15**]) Calcium-8.0* Phos-3.7 Mg-1.6 Lactate-4.0* Arterial Blood Gas: pO2-70* pCO2-74* pH-7.11* calTCO2-25 Base XS--7 . Labs on Discarge: WBC-14.4* RBC-2.98* Hgb-9.0* Hct-26.2* MCV-88 MCH-30.2 MCHC-34.4 RDW-17.1* Plt Ct-293 Glucose-108* UreaN-49* Creat-0.9 Na-129* K-4.2 Cl-101 HCO3-25 AnGap-7* Calcium-6.3* Phos-2.8 Mg-2.2 . URINE CULTURE (Final [**2143-7-18**]): KLEBSIELLA PNEUMONIAE. >100,000 ORGANISMS/ML.. Piperacillin/tazobactam sensitivity testing available on request. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ KLEBSIELLA PNEUMONIAE | AMPICILLIN/SULBACTAM-- 4 S CEFAZOLIN------------- <=4 S CEFEPIME-------------- <=1 S CEFTAZIDIME----------- <=1 S CEFTRIAXONE----------- <=1 S CIPROFLOXACIN---------<=0.25 S GENTAMICIN------------ <=1 S MEROPENEM-------------<=0.25 S NITROFURANTOIN-------- 64 I TOBRAMYCIN------------ <=1 S TRIMETHOPRIM/SULFA---- <=1 S . [**2143-7-17**] 11:15 am SPUTUM **FINAL REPORT [**2143-7-20**]** GRAM STAIN (Final [**2143-7-17**]): >25 PMNs and <10 epithelial cells/100X field. 3+ (5-10 per 1000X FIELD): MULTIPLE ORGANISMS CONSISTENT WITH OROPHARYNGEAL FLORA. RESPIRATORY CULTURE (Final [**2143-7-20**]): MODERATE GROWTH Commensal Respiratory Flora. . Blood cultures on [**7-17**],9,10,11 all were no growth. . URINE CULTURE (Final [**2143-7-24**]): KLEBSIELLA PNEUMONIAE. 10,000-100,000 ORGANISMS/ML.. Piperacillin/tazobactam sensitivity testing available on request. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ KLEBSIELLA PNEUMONIAE | AMPICILLIN/SULBACTAM-- 4 S CEFAZOLIN------------- <=4 S CEFEPIME-------------- <=1 S CEFTAZIDIME----------- <=1 S CEFTRIAXONE----------- <=1 S CIPROFLOXACIN---------<=0.25 S GENTAMICIN------------ <=1 S MEROPENEM-------------<=0.25 S NITROFURANTOIN-------- 64 I TOBRAMYCIN------------ <=1 S TRIMETHOPRIM/SULFA---- <=1 S . GRAM STAIN (Final [**2143-7-22**]): NO POLYMORPHONUCLEAR LEUKOCYTES SEEN. NO MICROORGANISMS SEEN. RESPIRATORY CULTURE (Final [**2143-7-24**]): NO GROWTH, <1000 CFU/ml. . [**2143-7-22**] 6:39 pm STOOL CONSISTENCY: NOT APPLICABLE Source: Stool. **FINAL REPORT [**2143-7-23**]** CLOSTRIDIUM DIFFICILE TOXIN A & B TEST (Final [**2143-7-23**]): Feces negative for C.difficile toxin A & B by EIA. (Reference Range-Negative). . [**2143-8-1**] 12:35 pm STOOL CONSISTENCY: NOT APPLICABLE Source: Stool. **FINAL REPORT [**2143-8-1**]** CLOSTRIDIUM DIFFICILE TOXIN A & B TEST (Final [**2143-8-1**]): Feces negative for C.difficile toxin A & B by EIA. (Reference Range-Negative). . [**2143-8-1**] 6:48 pm URINE Source: CVS. **FINAL REPORT [**2143-8-2**]** URINE CULTURE (Final [**2143-8-2**]): <10,000 organisms/ml. . CT C Spine [**7-14**] 1. no acute fracture or malalignment 2. multilevel DJD 3. right thyroid nodules can be evaluted by non-emergent ultrasound if clinically indicated. . CT Head [**7-14**] Small intraparenchymal hemorrhage with SAH extension in the right frontal and left parieto-occipital lobes. No midline shift. No fracture. . CT Head [**7-15**] 1. Overall expected evolution of right frontal and left occipital subcentimeter hemorrhagic contusions with associated subarachnoid hemorrhage. Less conspicuous parafalcine and left tentorial subdural hemorrhage, with redistribution of blood products into the occipital horns, also compatible with expected evolution. No new focal hemorrhage. 2. Underlying small vessel ischemic disease and probable left frontal lacune. Focal hypodensity in the mid brain could also represent additional lacune. Once acute issues resolve, MRI could be considered for further evaluation if not contraindicated. . CT Chest ([**7-14**]) Negative for fracture or malalignment of thoraco-lumbar spine . CT ABD/PELVIS ([**2143-7-14**]) 1. No acute intra-thoracic or intra-abdominal injury. 2. Small subcutaneous contusion at the level of the right greater trochanter. 3. Indeterminant renal lesion is probably a hyperdense cyst but can be further evaluated by non-emergent renal ultrasound, if clinically indicated. 4. Moderate hiatal hernia. . L Hand Xray ([**7-14**]) No fracture or dislocation. Diffuse demineralization with osteoarthritic change as detailed. . ECG ([**7-14**]): Sinus rhythm, rate of 94. Left ventricular hypertrophy with secondary repolarization abnormalities. No previous tracing available for comparison. . ECHO ([**7-16**]): The left atrium is mildly dilated. There is mild 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%). [Intrinsic left ventricular systolic function is likely more depressed given the severity of valvular regurgitation.] Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets (3) are mildly thickened. There is no aortic valve stenosis. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Moderate to severe (3+) mitral regurgitation is seen. The left ventricular inflow pattern suggests impaired relaxation. There is mild pulmonary artery systolic hypertension. There is no pericardial effusion. . CXR ([**8-1**]): No pulmonary congestion or new pulmonary infiltrates. Brief Hospital Course: ========================== HOSPITAL SUMMARY ========================== Patient is a [**Age over 90 **] year old woman with history of CHF, CAD (CABG x2) who was admitted to the ICU and the neurosurgery team after CT head showed frontal contusions as well as a small ICH and SDH on the right. She was transfered to the MICU for actue respiratory failure requiring intubation and had protracted course due to traumatic self-extubation. . On [**7-16**], the patient was found to be in respiratory distress, with oxygen saturations in the 70s/80s%. A code was called and she was intubated, then transferred to the MICU. CXR noted pulmonary congestion. There was low suspicion of PE, as CT on the day prior w/ contrast showed no evidence of PE. She was treated w/ IV lasix, with good diuresis. . On [**7-18**], she was mildly agitated and self-extubated with resultant desaturation to the low 80s. The patient was reintubated and EKG changes slight showed T wave inversions in the lateral leads. Following, she had normal Troponin Ts. After intubation, CXR showed a potential new RLL infiltrate, ? PNA. She received vanc/tobra/cefepime for potential VAP, for a total of 2 days. Also of note, prior to transfer to the MICU, she was treated for a UTI (received ceftriaxone), which she ended [**7-26**] (7d course). . On [**7-25**] interventional pulmonology extubated the patient. She had stridors following extubation. She was placed on racemic epinephrine and Heliox. She was kept on Heliox overnight w/out desats/hypoxemia. . On [**7-26**], a laryngoscopy was performed by ENT, which demonstrated laryngeal edema, and no other structural abnl. She was placed on Decadron 10ml q8hrs. ========================== ACTIVE ISSUES ========================== ICH and SDH: Patient was admitted after sustaining head truama secondary to an unwitnessed, ?syncopal episode. Echo and telemetry revealed no e/o cardiac reason for ?syncope. Likely vasovagal and hypovolemic. CT head on admission ([**7-14**]) showed a small IPH with SAH extension in the R frontal and L parieto-occipital lobes without midline shift. The pt was admitted to the SICU for close monitoring. In the SICU, repeat head CT showed expected evolution the IPH and given her stability she was transferred to the neurology floor under the neurosurgery team. Afterwards, patient was subsequently transferred to the MICU for respiratory distress and required no intervention for ICH/SDH and had no interval change in neuro exam triggering reassessment. Pt to follow with neurosurgery as outpt in [**4-17**] weeks. . RESPIRATORY FAILURE: On [**7-16**] pt began to desat into the 70's and was put on a nonrebreather, but she continued to desat into the 80's. A code was called and she was ultimately sedated and intubated. Pt was transferred to the MICU. On the floor, her lasix had been held and she was receiving 1L of maintenance fluids. She was given 40mg of Lasix during her code, and 40mg more on the MICU. CXR showed findings of pulmonary edema that were not present on study from admission. Respiratory failure was attributed to pulmonary edema in setting of dCHF exacerbation. On [**7-18**] pt self-extubated in the setting of delirium in AM, desatted into 80's and was reintubated. On [**7-21**], pt was started on dexamethasone for laryngeal edema. On [**7-22**] developed a question of new RLL opacification and was treated with antibiotics for 2 days for presumed VAP. Over the next few days, spontaneous breathing trials failed, and she developed laryngeal edema. On [**7-24**] was extubated by interventional pulmonology and was markedly stridorous without hypoxia post-extubation, was given racemic epinephrine and heliox with improvement in symptoms. ON [**7-26**] had laryngoscopy by ENT which showed larygeal edema without other findings and increased to 10 mg dexamethasone Q8h for 3 days. Pt was called out to the medicine floor on [**7-28**]. Her breathing was mildly stridorous, but 96% on 3L on transfer. Pt was weaned off of O2, breathing 96% on RA by evening of [**7-31**]. Pt required no more O2 support throughout hospitalization. Dexamethasone was weaned down starting on [**7-29**], with final dose of dexamethasone given on [**7-31**]. In setting of very minor stridor (no work of breathing, no O2 requirement), ENT re-evaluated, with no new recommendations and instructions for ENT follow-up. . HYPERNATREMIA/Hyponatremia: In MICU, patient's Na was noted to trend up to 148 in the setting of ARF, diuresis with lasix, hypovolemia and inability to take POs. Patient was treated with 500 cc boluses of D5W as needed. When transferred to floor, pt's Na was 148. Free water deficit was calculated to be approximately 1L. When NPO, pt was placed on D5 1/2 NS maintenance fluid and lasix held. When pt initiated PO intake ([**7-30**]), Na corrected into normal range. On day of discharge, Na was 129, likely due to liberal PO fluid intake (was being encouraged by family at bedside). Pt's Na will be followed at rehab. . ARF: Creatinine rose to 1.2 on [**7-27**] from a baseline of 0.8, thought to be prerenal in the setting of diuresis and NPO status. When admitted to the floor on [**7-28**], home lasix was held and patient recieved D5 1/2 NS maintenance for correction of hypernatremia. Diovan was stopped from [**Date range (1) 40891**], with restarting at half dose with resolution of ARF. Lasix was restarted on day of discharge. Cr 0.9 on day of discharge. . HYPERTENSION: Pt was normotensive while in the MICU. WHile on the floor, pt was intermittentely hypertensive to 150s-180s, in the setting of lasix and diovan being held, there was never signs of end organ damage or hypertensive urgency. Throughtou her hospitalization,she was maintained on 25 mg Metoprolol [**Hospital1 **] PO. After her diovan was started half dose (160mg) on [**7-30**], HTN improved to 130s-150s. Pt was normotensive in two days prior to discharge. . LEUKOCYTOSIS: Patient developed a leukocytosis to 23.5 ([**7-25**]) in the setting of dexamethasone administration. No evidence of infection was appreciated (CXR no changes, no pyuria or pos urine cxs). In setting of one day of loose stools ([**8-1**]), C. diff was negative, and no repeat loose stools. No interventions were taken aside from planned dex taper, and leukocytosis resolving, to 14.4 on discharge. . DIABETES: Patient had been receiving metformin as an outpatient and was switched to an insulin sliding scale while in the intensive care unit. She developed worsening hyperglycemia in response to steroids and was managed with an increased sliding scale. Pt transiently hyperglycemic (FSs 300s-400s) during dex taper, but hyperglycemia gradually resolved with end of dexamethasone (FSs 120s-250 on day of discharge). Pt was restarted on metformin at discharge. . CAD and DIASTOLIC CHF: Enzymes were negative on admission. Echo on admission showed preserved ejection fraction and no wall motion abnormalities (see full results in the RESULTS section of this discharge [**Last Name (un) 17576**]). While in the MICU, on [**7-24**] ECG showed increased T wave inversions in lateral leads (old) and anterior leads (newer). Enzymes were negative and patient received TTE which showed 3+ MR and an EF of >55%. She was restarted on metoporol and valsartan when tolerating POs and received home lasix once pulmonary edema had resolved. . #UTI: Klebsiella UTI while in MICU resolved, finished 7 days of ceftriaxone [**2143-7-26**]. No growth on urine cx from [**7-28**]. . #Nutrition: Speech and swallow evaluation on [**7-30**] = regular diet, thin liquids. Pt took POs easily after [**7-30**] (more fluids than solids). . #Anemia: Hct 33.7 on day of admission. Was 27.9 on transfer to MICU, in the setting of lasix being held and IVF administered. On transfer to floor, Hct was 25.6. Hct was 22.5 on [**7-31**], with no source of bleeding (no pain, stools guaiac negative), likely [**2-13**] marrow suppression in the setting of prolonged and complicated hospital course. Pt received 1 unit pRBCs on [**7-31**], Hct bumped to 27.9 on [**8-1**]. . ============================ INACTIVE ISSUES ============================ DEPRESSION: Patient continued to recieve her home Paxil 20 mg. . ============================ TRANSITIONAL ISSUES ============================ 1.) R thyroid nodule and L renal cyst identified on extensive CT imaging during this hospitalization should be followed up on an outpatient basis. 2.) Pt should receive intensive PT, due to deconditioning from prolonged acute-care hospitalization. 3.) Pt was evaluated by specialists in speech and swallowing during the hospitalization. Regular food and thin liquids, and oral medications, are appropriate for this pt. She should be encouraged to eat and drink (DMII, low salt, heart healthy diet) liberally to discourage malnutrition. 4.) Pt has an appt with Dr. [**Last Name (STitle) **] (ENT) on [**8-13**]. 5.) Pt needs to f/u with neurosurgery in [**4-17**] weeks, with a CT scan before her appt. The patient has been given instructions. 6.) Pt is discharged to acute rehab ([**Hospital1 **] [**Hospital1 8**]). Letter has been sent to PCP. [**Name10 (NameIs) **] to follow-up with PCP. 7.) Pt mildly hyponatremic on discharge (129), likely from liberal PO fluid intake. Rehab to follow Na. Pt's leukocytosis resolving, by time of discharge, in setting of stopping steroids. Rehab to follow WBC. Medications on Admission: ASA 81 carteolol 1% on drop HS paroxetine 20mg qd nifedipine 60mg ER qd atenolol 100mg qd valsartan 320mg qd atorvastatin 80mg qd pantoprazole 40mg qd lasix 40mg [**Hospital1 **] Isosorbide Mononitrate 30mg twice per day fluticasone 50mcg 2 sprays qd metformin 1000 PO BID, with meals glucosamine 1g qd zetia 10mg qd Discharge Medications: 1. docusate sodium 50 mg/5 mL Liquid Sig: One (1) packet PO BID (2 times a day). Disp:*60 packet* Refills:*0* 2. senna 8.6 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). Disp:*30 Tablet(s)* Refills:*0* 3. carteolol 1 % Drops Sig: One (1) Drop Ophthalmic HS (at bedtime). 4. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed for fever. 5. paroxetine HCl 10 mg/5 mL Suspension Sig: Two (2) doses PO DAILY (Daily). 6. nifedipine 60 mg Tablet Extended Release Sig: One (1) Tablet Extended Release PO DAILY (Daily). 7. metoprolol tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* 8. psyllium Packet Sig: One (1) Packet PO DAILY (Daily). Disp:*30 Packet(s)* Refills:*0* 9. valsartan 160 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 10. atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 11. pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 12. Lasix 40 mg Tablet Sig: One (1) Tablet PO once a day. 13. Aspirin Low Dose 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. 14. fluticasone 50 mcg/Actuation Spray, Suspension Sig: Two (2) spray Nasal once a day as needed for rhinitis: each nostril, as needed. 15. metformin 1,000 mg Tablet Sig: One (1) Tablet PO twice a day: one pill with breakfast, one pill with supper. 16. Glucosamine 750 mg Tablet Sig: One (1) Tablet PO once a day. 17. Zetia 10 mg Tablet Sig: One (1) Tablet PO once a day. 18. Outpatient Lab Work Please collect CBC, electrolytes (chem 10, with particular Discharge Disposition: Extended Care Facility: [**Hospital **] Hospital - [**Hospital1 8**] Discharge Diagnosis: Primary Diagnosis: Subarachnoid hemorrhage Secondary Diagnoses: respiratory failure Acute kidney injury hypertension diabetes mellitus II Discharge Condition: Mental Status: Confused - sometimes. Level of Consciousness: Alert and interactive. Activity Status: Out of Bed with assistance to chair or wheelchair. Discharge Instructions: Dear Ms. [**Known lastname 4401**], . It was a pleasure taking care of you. . You were admitted to the hospital because you fell, hit your head and had a bleed within your head. Your hospital course was complicated by respiratory failure in the setting of pulmonary edema (fluid in your lungs). You had a prolonged stay in the MICU, where you were intubated. You had some laryngeal edema (swelling in your throat) from irritation from the breathing tube. You made progress while in the hospital, changing from the MICU to the general medicine floor. By the time of discharge to your rehab facility, you were breathing fine on your own, without the aid of oxygen; you were taking food and fluid down; you were exercising with the aid of the physical therapists. . You had a bit of diarrhea yesterday, which has resolved. Stool tests were reassuring. In the rehab facility they will check the sodium in your blood (was slightly low on discharge) and also your white blood count (WBC) to monitor for infection. They will also work on strengthening your body, and to get you eating a good diet again. . We made the following changes to your medications: CHANGES: From Atenolol to METOPROLOL TARTRATE 25mg by mouth twice per day From Valsartan 320mg to Valsartan 160mg per day From Lasix (furosemide) 40mg twice per day to 40mg once per day . STOPPED MEDS: Stop Isosorbide Mononitrate 30mg twice per day OTHERWISE, YOU SHOULD CONTINUE YOUR HOME MEDICATIONS AS YOU HAD TAKEN THEM BEFORE. . General Instructions ?????? Take your pain medicine as prescribed. ?????? Exercise should be limited to walking; no lifting, straining, or excessive bending. ?????? 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, or Ibuprofen etc. Please follow up with your primary care physician regarding follow up for CT findings including a renal lesion/cyst but can be further evaluated by non-emergent renal ultrasound,Moderate hiatal hernia and right thyroid nodules can be evaluted by non-emergent ultrasound. CALL YOUR SURGEON IMMEDIATELY IF YOU EXPERIENCE ANY OF THE FOLLOWING ?????? New onset of tremors or seizures. ?????? Any confusion, lethargy 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. ?????? New onset of the loss of function, or decrease of function on one whole side of your body. Followup Instructions: Follow-Up Appointment Instructions ?????? Please call ([**Telephone/Fax (1) 88**] to schedule an appointment with Dr. [**First Name (STitle) **] to be seen in 6 weeks. ?????? You will need a CT scan of the brain without contrast prior to your appointment. This can be scheduled when you call to make your office visit appointment. . Please follow up with your primary care physician regarding follow up for CT findings including a renal lesion/cyst but can be further evaluated by non-emergent renal ultrasound,Moderate hiatal hernia and right thyroid nodules can be evaluted by non-emergent ultrasound. . Location: [**Hospital1 69**] Specialty: Neurosurgery Address: [**Location (un) **] [**Location (un) 86**] [**Numeric Identifier 718**] Phone: [**Telephone/Fax (1) 1669**] **We are working on a follow up appointment with the Neurosurgery department within 2-4 weeks. You will be called with the appointment. If you have not heard from the office within 2 days or have any questions, please call the number above.** . Department: OTOLARYNGOLOGY (ENT) When: TUESDAY [**2143-8-13**] at 2:15 PM With: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 39**], M.D. [**Telephone/Fax (1) 41**] Building: LM [**Hospital Unit Name **] [**Location (un) 895**] Campus: WEST Best Parking: [**Doctor First Name **]. GARAGE ICD9 Codes: 5990, 2761, 2760, 5849, 4019, 2720, 4280, 2859, 4240
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Medical Text: Unit No: [**Numeric Identifier 76435**] Admission Date: [**2186-1-25**] Discharge Date: [**2186-2-12**] Date of Birth: [**2186-1-21**] Sex: F Service: NBB PATIENT IDENTIFICATION: The patient's post-discharge name is [**Name (NI) **] [**Name (NI) 40558**]. HISTORY OF PRESENT ILLNESS: This is the former 1.14 kilogram product of a 29 and 1/7 weeks gestation pregnancy born to a 28-year-old G2, P1, now P2 woman. Prenatal screens: Blood type O positive, antibody negative, hepatitis B surface antigen negative, rubella equivocal, RPR nonreactive, group beta strep status unknown. The mother's medical history is notable for asthma which is treated with an inhaler. She also had a chronic pain syndrome and abused the drug OxyContin. She was treated at a rehabilitation center and was transitioned to methadone. During this pregnancy she developed pneumonia which was complicated by adult respiratory distress syndrome. She required intubation and was transferred from [**Hospital3 **] to the Intensive Care Unit at [**Hospital1 69**]. On the day of delivery the mother became encephalopathic and had a generalized seizure. She was diagnosed with eclampsia. She had received betamethasone. The mother was delivered by emergent cesarean section for the worsening eclampsia. The infant emerged vigorous with Apgars of 8 at 1 minute and 8 at 5 minutes. She was admitted to the neonatal intensive care unit for treatment of prematurity. At that time due to census issues she was transferred to [**Hospital3 1810**]. She returned on day of life number 4, [**2185-1-25**]. Anthropometric measurements at the time of delivery: Weight 1.140 kilograms, 25th to 50th percentile, length 37.5 cm, 25th to 50th percentile, head circumference 26 cm, 25th to 50th percentile. PHYSICAL EXAMINATION AT DISCHARGE: Weight 1.53 kilograms, length 41.5 cm, head circumference 28 cm. General: Nondistressed preterm infant in open crib, room air. Skin: Warm and dry. Color pink, well perfused. Head, ears, eyes, nose, and throat: Anterior fontanel open and flat, soft. Symmetrical facial features. Palate intact. Oral mucosa clear. Positive red reflex bilaterally. Neck: Supple without masses. Chest: Breath sounds clear and equal. Cardiovascular: Grade [**2-1**] soft systolic murmur left upper sternal border consistent with peripheral pulmonic stenosis. Femoral pulses +2. Normal S1, S2. Abdomen: Soft, nontender, nondistended, no masses, active bowel sounds. Cord off. Umbilicus healing. GU: Normal preterm female. Spine straight, normal sacrum. Extremities: Moves all well. Hips stable. Clavicles intact. Neuro: Alert with vigorous tone and cry. Positive suck. Positive grasp. HOSPITAL COURSE: 1. RESPIRATORY: This infant had transitional respiratory distress requiring treatment with continue positive airway pressure. She weaned to room air on day of life number 2 and remained in room air for the rest of her neonatal intensive care unit admission. She required treatment for apnea of prematurity with caffeine citrate. At the time of discharge she is breathing comfortably with a respiratory rate of 30 to 60 breaths per minute. Oxygen saturations on room air on greater than or equal to 94%. 2. CARDIOVASCULAR: This infant has maintained normal heart rates and blood pressures. A soft murmur has been noted intermittently during admission and is well localized to the left upper sternal border with characterization consistent with peripheral pulmonic stenosis. At the time of discharge her baseline heart rate is 140 to 160 beats per minute with a recent blood pressure of 75/31 with a mean arterial pressure of 46 millimeters of mercury. 3. FLUIDS, ELECTROLYTES, NUTRITION: The infant had an umbilical venous catheter placed for parenteral nutrition. Enteral feedings were started on day of life number 2 and gradually advanced to full volume. At the time of discharge she is taking 150 milliliters per kilo per day of preemie Enfamil or breast milk 28 calories per ounce. Her feedings are by gavage. Serum electrolytes were checked in the first week of life and were within normal limits. Weight of the day of discharge is 1.53 kilograms. 4. INFECTIOUS DISEASE: Due to the unknown group beta strep status of her mother and her respiratory distress, this infant was evaluated for sepsis on admission to the neonatal intensive care unit. A complete blood count was 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 58%. This infant has not received any transfusions of blood products. She is being treated with supplemental iron. 6. GASTROINTESTINAL: This infant required treatment for unconjugated hyperbilirubinemia with phototherapy. Peak serum bilirubin occurred on day of life 2, a total of 5.9 milligrams per deciliter. She was treated with phototherapy for approximately 5 days. Rebound bilirubin on day of life number 8 was 4.6 milligrams per deciliter. 7. NEUROLOGY: This infant showed signs of narcotic withdrawal thought to be related to the mother's methadone maintenance. She was treated with neonatal opium solution initiated on [**2186-1-29**]. Her initiating dose was 0.8 milligrams per kilo per day. After her symptoms were controlled this dose was gradually weaned. On [**2186-2-6**] the dose was discontinued and the approximately dosing at that time was less than 0.2 milligrams per kilo per day. At the time of discharge her neonatal abstinence scale scores are 0 to 2 and she has some anal excoriation. A head ultrasound was performed on [**2185-1-26**] and all results were within normal limits. A follow up head ultrasound is recommended at 1 month and at 36 weeks postmenstrual age. The infant's neurological exam is appropriate. 8. SENSORY: AUDIOLOGY: Hearing screening has not yet been performed, but is recommended prior to discharge. OPHTHALMOLOGY: This infant will require ophthalmological exams, screening for retinopathy of prematurity. Her eyes have not yet been examined. Her first eye exam is due at 4 to 5 weeks of age. PSYCHOSOCIAL: [**Hospital1 69**] social work has been involved with this family. Contact social worker is [**Name (NI) 46381**] [**Name (NI) 36527**] and she can be reached at ([**Telephone/Fax (1) 24237**]. CONDITION ON DISCHARGE: Stable. DISCHARGE DISPOSITION: Transfer to [**Hospital3 **] for continuing level II care. PRIMARY PEDIATRICIAN: Dr. [**First Name8 (NamePattern2) 1123**] [**Last Name (NamePattern1) 5699**], Pediatric Associates of [**Location (un) 1468**], ([**Telephone/Fax (1) 44940**]. CARE RECOMMENDATIONS AT THE TIME OF DISCHARGE: 1. Feeding: 150 ml per kilo per day of breast milk 28 calorie per ounce or preemie Enfamil 28 calorie per ounce formula. The breast milk is formulated 4 calories by human milk fortifier, 4 calories by medium chain triglyceride oil, and [**12-28**] teaspoon of beneprotein powder per 100 ml of breast milk. Feedings are by gavage. 2. Medications: Caffeine citrate 11.4 mg p.g. once daily, ferrous sulfate 25 mg/ml dilution 0.1 ml p.g. once daily, vitamin E 5 IU p.g. once daily. 3. Iron and vitamin D supplementation: a. Iron supplementation is recommended for preterm and low birth weight infants until 12 months corrected age. b. All infants feeding predominantly breast milk should receive vitamin D supplementation at 200 IU ([**Month (only) 116**] be provided as a multivitamin preparation.) daily until 12 months corrected age. 4. Car seat position screening is recommended prior to discharge. 5. State newborn screens were sent on [**1-21**] and [**2-4**], [**2185**]. No notification of abnormal results have been received. 6. Immunizations: No immunizations have been administered. 7. Immunizations recommended: a. Synagis RSV prophylaxis should be considered from [**Month (only) **] through [**Month (only) 958**] for infants who meet any of the following four criteria: First - born at less than or equal to 32 weeks; Second - born between 32 and 35 and 0/7 weeks with two of the following: childcare during RSV season, a smoker in the household, neuromuscular disease, airway abnormalities, or school age siblings; thirdly - chronic Lyme disease; or fourth - hemodynamically significant congenital heart disease. b. Influenza immunization is recommended annually in the fall for all infants once they reach 6 months of age. Before this age if in the first 24 months of the child's life, immunization against influenza is recommended for household contacts and out of home caregivers. c. This infant has not received rotavirus vaccine. The American Academy of Pediatrics recommends initially vaccination of preterm infants at or following discharge from the hospital if they are clinically stable and at least weeks, but fewer than 12 weeks of age. DISCHARGE DIAGNOSES: 1. Prematurity at 29 and 1/7 weeks gestation. 2. Transitional respiratory distress. 3. Suspicion for sepsis, ruled out. 4. Unconjugated hyperbilirubinemia. 5. Apnea of prematurity. 6. Narcotic abstinence syndrome. [**Name6 (MD) **] [**Last Name (NamePattern4) **], [**MD Number(1) 55472**] Dictated By:[**Name8 (MD) 75740**] MEDQUIST36 D: [**2186-2-12**] 01:46:30 T: [**2186-2-12**] 15:58:27 Job#: [**Job Number 76436**] ICD9 Codes: 7742
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Medical Text: Admission Date: [**2136-11-7**] Discharge Date: [**2136-11-10**] Date of Birth: [**2057-1-28**] Sex: F Service: MEDICINE Allergies: Penicillins / Sulfa (Sulfonamide Antibiotics) Attending:[**First Name3 (LF) 10842**] Chief Complaint: Pericardial effusion Major Surgical or Invasive Procedure: Drainage of a pericardial effusion History of Present Illness: 79 yo female with h/o COPD on home O2, HTN, HLP, DM, osteoporosis, morbid obesity who presented to an OSH with worsening SOB. She had been treated with Z-pack without benefit. She continued to have worsening SOB throughout her admission there. She had an echocardiogram initially which showed a pericardial effusion, which was fairly small without any evidence of tamponade physiology, but she then had a repeat echo cardiogram on [**11-5**] with which showed a large anterior and posterior pericardial effusion which measured 17 mm in diastole and 21 mm in systole. She was then transferred for further evaluation and potential pericardiocentesis. On review of systems, she denies any prior history of stroke, TIA, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. She denies recent fevers, chills or rigors. She denies exertional buttock or calf pain. All of the other review of systems were negative. Cardiac review of systems is notable for absence of chest pain, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. Past Medical History: 1. CARDIAC RISK FACTORS: (+)Diabetes, (+)Dyslipidemia, (+)Hypertension 2. CARDIAC HISTORY: -CABG: -PERCUTANEOUS CORONARY INTERVENTIONS: -PACING/ICD: 3. OTHER PAST MEDICAL HISTORY: COPD on home O2 Diverticulitis Morbid Obesity Hypothyroidism Chronic LBP Chronic Headaches Glaucoma Social History: The patient is retired; used to work in a stitching factory; lives alone. -Tobacco history: [**11-23**] ppd x 10 yrs Quit smoking: quit 30 yrs ago -ETOH: none -Illicit drugs: none Family History: No family history of early MI, otherwise non-contributory. Physical Exam: VS: T=97.9 BP=132/94 HR=70 RR=16 O2 sat=100% on 2L GENERAL: WDWN female in 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 12 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. few bibasilar crackles with a scattered expiratory wheezes throughout lung fields. ABDOMEN: Soft, NTND. No HSM or tenderness. Abd aorta not enlarged by palpation. No abdominial bruits. EXTREMITIES: No c/c. 2+ BLE edema [**11-23**] to knees. No femoral bruits. SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. PULSES: Right: Carotid 2+ Femoral 2+ Popliteal 1+ DP 2+ PT 2+ Left: Carotid 2+ Femoral 2+ Popliteal 1+ DP 2+ PT 2+ Pertinent Results: Admission labs: [**2136-11-8**] 03:43AM BLOOD WBC-17.3* RBC-4.11* Hgb-11.4* Hct-33.7* MCV-82 MCH-27.6 MCHC-33.7 RDW-14.4 Plt Ct-300 [**2136-11-8**] 03:43AM BLOOD Neuts-79.5* Lymphs-11.2* Monos-8.9 Eos-0.4 Baso-0 [**2136-11-8**] 03:43AM BLOOD PT-12.2 PTT-23.9 INR(PT)-1.0 [**2136-11-8**] 03:43AM BLOOD Glucose-86 UreaN-31* Creat-0.8 Na-137 K-4.3 Cl-98 HCO3-32 AnGap-11 [**2136-11-8**] 03:43AM BLOOD ALT-42* AST-14 LD(LDH)-224 CK(CPK)-27 AlkPhos-67 TotBili-0.7 [**2136-11-8**] 03:43AM BLOOD Albumin-4.0 Calcium-9.2 Phos-4.6* Mg-2.5 [**2136-11-8**] 03:43AM BLOOD TSH-5.2* [**2136-11-9**] 05:30AM BLOOD Free T4-1.5 Discharge labs: [**2136-11-10**] 07:35AM BLOOD WBC-11.5* RBC-4.05* Hgb-11.6* Hct-33.8* MCV-83 MCH-28.6 MCHC-34.3 RDW-14.3 Plt Ct-237 [**2136-11-10**] 07:35AM BLOOD PT-12.5 PTT-23.7 INR(PT)-1.1 [**2136-11-10**] 07:35AM BLOOD Glucose-115* UreaN-18 Creat-0.7 Na-138 K-5.3* Cl-100 HCO3-33* AnGap-10 [**2136-11-10**] 07:35AM BLOOD Calcium-8.6 Phos-2.7 Mg-2.3 [**11-8**] Pericardial fluid: GRAM STAIN (Final [**2136-11-8**]): 1+ (<1 per 1000X FIELD): POLYMORPHONUCLEAR LEUKOCYTES. NO MICROORGANISMS SEEN. FLUID CULTURE (Preliminary): NO GROWTH. ANAEROBIC CULTURE (Preliminary): NO GROWTH. ACID FAST SMEAR (Final [**2136-11-9**]): NO ACID FAST BACILLI SEEN ON DIRECT SMEAR. ACID FAST CULTURE (Preliminary): FUNGAL CULTURE (Preliminary): NO FUNGUS ISOLATED. [**11-8**] pericardial fluid cytology: Pending [**11-8**] pericardial fluid OTHER BODY FLUID ANALYSIS WBC Hct,Fl Polys Lymphs Monos [**2136-11-8**] 02:30PM 889*1 21*2 48*3 44* 8* PERICARDIAL FLUID BLOODY, SUPERNATANT MODERATELY XANTHOCHROMIC SPUN HCT SPUN HEMATOCRIT PERFORMED 50 CELL DIFFERENTIAL OTHER BODY FLUID CHEMISTRY TotProt Glucose Amylase Albumin [**2136-11-8**] 02:30PM 4.4 127 26 3.1 STUDIES EKG: NSR HR approx 70, left shift axis; slightly decreased voltage on precordial leads, and possibly alternans in precordial leads 2D-ECHOCARDIOGRAM: [**2136-11-5**] 1) RV systolic function is decreased 2) A large anterior and posterior pericardial effusion is present, posteriorly measuring 17 mm in diastole and 21 mm in systole. TTE [**11-8**]: The left atrium is mildly dilated. The estimated right atrial pressure is 10-20mmHg. Overall left ventricular systolic function is normal (LVEF>55%). Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. The estimated pulmonary artery systolic pressure is normal. There is a large circumferential pericardial effusion with a small layer (0.9 cm) echo dense material on the right ventricle consistent with blood, inflammation or other cellular elements. No right ventricular diastolic collapse is seen. There is brief right atrial diastolic collapse. The heart swings with each cardiac cycle and the anterior echolucent pericardial effusion varied between 2 cm and 0 cm. Apically, the effusion varied between 2.1 cm and 0.8 cm. IMPRESSION: Large circumferencial pericardial effusion with no clear evidence of tamponade. There is significant cardiac motion with variable local pericardial effusion size between cardiac cycles. Cath [**11-8**]: COMMENTS: 1. Resting hemodynamics revealed elevated right sided pressures and equalization of of RA, PCW and pericardial pressures consistent with tamponade. 2. Subxiphoid pericardiocentesis removed 820 cc of bloody fluid. Pericardial pressure fell to 2 mmHg with RA pressure of 8 mmHg. Fluid was sent for cytology, culture, and chemistries. Echo confirmed pericardial effusion was now only small post-pericardiocentesis. FINAL DIAGNOSIS: 1. Large pericardial effsusion with tamponade physiology. 2. Successful pericardiocentesis with removal of 820 cc of fluid. Repeat TTE [**11-8**]:There is a small pericardial effusion (mostly posterior to the LV). Compared with the prior study (images reviewed) of [**2136-11-8**], the amount of pericardial effusion has significantly decreased. TTE [**11-9**]: Overall left ventricular systolic function is normal (LVEF>55%). with normal free wall contractility. There is a small pericardial effusion. The effusion is echo dense, consistent with blood, inflammation or other cellular elements. IMPRESSION: Very small residual echodense pericardial effusion. Compared with the prior study (images reviewed) of [**2136-11-8**], pericardial effusion size has further decreased. TTE [**11-10**]: Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. Overall left ventricular systolic function is normal (LVEF>55%). There is abnormal septal motion/position. The mitral valve leaflets are mildly thickened. There is a small pericardial effusion. There are no echocardiographic signs of tamponade. IMPRESSION: Small pericardial effusion, located posterior to the right atrium without evidence of tamponade. There is a septal bounce seen which could be consistent with effusive-constrictive pericardial disease. Compared with the prior study (images reviewed) of [**2136-11-9**], the size of the effusion is similar. The septal bounce may be slightly more prominent. Brief Hospital Course: 79 yo F with COPD, DM, HTN, hyperlipidemia, who was transferred from an OSH for worsening SOB found to have a large pericardial effusion with tamponade physiology on ECHO no s/p drainage. # PERICARDIAL EFFUSION: The patient was admitted to the outside hospital with increasing shortness of breath over weeks and was found to have an increasing pericardial effusion with tamponade physiology. She underwent pericardiocentesis during which 800 cc of bloody fluid was removed. The main differential for her effusion includes malignancy, TB, post viral, autoimmune, infectious. A TSH was checked and was slightly elevated at 5.2, however her free T4 was normal at 1.5. Her fluid cultures have been no growth to date and fluid cytology is pending. Malignancy is highly possible given her age and size of effusion. She remained hemodynamically stable during her admission. She had several echos after drainage which showed no reaccumulation of fluid. She will continue to undergo workup for this as an outpatient with her cardiologist. # CORONARIES: The patient has no known history of coronary artery disease. She was transferred on a B-blocker from the OSH, however she was not on one at home. This was stopped given the concern for tamponade physiology and was not restarted. She was started on 81 mg of ASA daily for primary prevention given her history of DM and hypertension. She was continued on her home statin. # Acute systolic heart faliure: The patient had slight edema on exam on admission and was thought to be in acute systolic heart failure secondary to the pericardial effusion/tamponade physiology. She was treated initally with 40 mg IV lasix and then changed back to her home dose of lasix 40 mg po daily. Her EF normalized on TTE after drainage of the effusion. # RHYTHM: The patient remain in normal sinus rhythm during her hospitalization. # COPD: The patient had been treated for a COPD exacerbation at the OSH, however her SOB was likely due to the pericardial effusion and resolved once it was drained. She was continued on her home medications including advair [**Hospital1 **], flonase, and albuterol prn. She was also treated with atrovent while she was hospitalized, but was not discharge on this. She had been treated with prednisone at the OSH, so this was quickly tapered and she will complete the taper the day after discharge. # DM: The patient takes avandamet as an outpatient, however this was held during her hospitalization. She was initally covered with sliding scale insulin, however her sugars were elevated so she was given a small dose of lantus in addition to the sliding scale. She was discharged back on her home regimen of avandamet. # HTN: She was generally normotensive while hospitalized and was intially given IV lasix for diuresis, but then was continued on her home dose of 40 mg po lasix daily. # Hyperlipidemia: The patient was continued on her home statin. # Hypothyroidism: The patient was continued on her home levothyroxine. Medications on Admission: MEDICATIONS AT HOME: Lasix 40 mg daily Antivert 25 mg TID Lipitor 10 mg daily Prilosec 20 mg daily Synthroid 125 mcg daily Xalatan 0.005% each eye qhs Advair diskus 500/50 mcg [**Hospital1 **] Nasonex 1 squirt in each nose [**Hospital1 **] Avandamet 25/250 mg [**Hospital1 **] Albuterol 2.5 mg q2H nebulized PRN Claritin 10 mg QHS Fosamax 70 mg daily Hydroxyzine MEDICATIONS AT TRANSFER: Prednisone 50 mg daily - taper Metoprolol tartrate 12.5 mg [**Hospital1 **] Synthroid 125 mcg daily Prevacid 30 mg [**Hospital1 **] Nystatin powder daily Lasix 40 mg daily Lipitor 10 mg daily Xalatan 0.005% QHS each eye Nasonex [**Hospital1 **] Claritin 10 mg daily Heparin sc Tylenol PRN Lorazepam 0.5 mg Q6H PRN Antivert 25 mg PO Q6H PRN dizziness Discharge Medications: 1. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Meclizine 25 mg Tablet Sig: One (1) Tablet PO three times a day as needed for dizziness. 3. Psyllium Packet Sig: One (1) Packet PO DAILY (Daily). 4. Claritin 10 mg Tablet Sig: One (1) Tablet PO at bedtime. 5. Synthroid 125 mcg Tablet Sig: One (1) Tablet PO once a day. 6. Lasix 40 mg Tablet Sig: One (1) Tablet PO once a day. 7. Prilosec 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day. 8. Latanoprost 0.005 % Drops Sig: One (1) Drop Ophthalmic HS (at bedtime). 9. Advair Diskus 500-50 mcg/Dose Disk with Device Sig: One (1) puff Inhalation twice a day. 10. Fluticasone 50 mcg/Actuation Spray, Suspension Sig: One (1) Spray Nasal [**Hospital1 **] (2 times a day). 11. AVANDAMET Oral 12. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) neb Inhalation every four (4) hours as needed for shortness of breath or wheezing. 13. Fosamax 70 mg Tablet Oral 14. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). Disp:*30 Tablet, Chewable(s)* Refills:*2* 15. Prednisone 10 mg Tablet Sig: One (1) Tablet PO daily () for 1 days. Disp:*1 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: All Care VNA of Greater [**Location (un) **] Discharge Diagnosis: Primary - Pericardial effusion Secondary - Hypertension Diabetes Hypothyroidism Chronic obstructive pulmonary disease Hyperlipidemia Discharge Condition: Hemodynamically stable, without shortness of breath. Discharge Instructions: You were transferred to this hospital becuase you had a large pericardial effusion. You underwent a pericardiocentesis (drainage of the fluid around your heart). It is unclear what caused the pericardial effusion, however tests on the fluid are pending. You may need to undergo further tests and imaging studies as an outpatient to figure out the cause of the effusion. You were also treated for an exacerbation of your chronic obstructive pulmonary disease prior to transfer to this hospital. You will need to take one more day of prednisone to complete treatment for this exacerbation. You were started on aspirin 81 mg daily. You will need to take 10 mg of prednisone the day after discharge. Otherwise continue your outpatient medications as prescribed. Go to the emergency room or call your primary docotor if you experience fevers, chills, chest pain, shortness of breath, dizziness, blood in your stool, or black stool. Followup Instructions: You will need to follow up with Dr. [**Last Name (STitle) **] in [**11-23**] weeks. His office number is [**0-0-**]. Please call and make an appointment on Monday. It is very improtant that you follow up with him in this time frame. You should also follow up with your primary doctor within in the next month. Completed by:[**2136-11-10**] ICD9 Codes: 496, 4019, 2724, 2449, 4280
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Medical Text: Admission Date: [**2184-9-9**] Discharge Date: [**2184-9-19**] Date of Birth: [**2137-5-6**] Sex: F Service: SURGERY Allergies: Penicillins / Acetaminophen / Ultram / Oxycontin / Zantac / Levofloxacin Attending:[**Last Name (NamePattern1) 15344**] Chief Complaint: Abdominal pain. Major Surgical or Invasive Procedure: Exploratory laparotomy, lysis of adhesions, small bowel resection, primary repair of recurrent ventral hernia, placement of left femoral vein triple lumen central venous line, placement of PICC. History of Present Illness: The patient is a 47-year-old female with end stage renal disease on hemodialysis, status post epigastric ventral hernia repair in the distant past, who was noted recurrence of the ventral hernia but without any symptoms. The day PTA, during hemodialysis, she developed abdominal discomfort and nausea, and thereafter, severe pain at the side of the recurrent epigastric ventral hernia. She came to the emergency room where a CT scan of the abdomen revealed a small omental fat- containing ventral hernia above the umbilicus with mild adjacent inflammatory fat stranding. Adjacent to this region, there were multiple prominent loops of small bowel with fecalization of bowel contents and surrounding inflammatory fat stranding and fluid locally. The loops of bowel distal to these prominent loops appeared decompressed and the findings were suggestive of a recent reduction of an incarcerated hernia with high grade obstruction. She now presents for exploratory laparotomy. Past Medical History: 1. Significant for end-stage renal disease secondary to glomerulonephritis possibly secondary to IgA diagnosed in [**2165**], and the patient has been on hemodialysis since [**2170**]. She is anuric and is on Monday, Wednesday, and Friday dialysis schedule. 2. The patient has had bilateral below-the-knee amputations secondary to calciphylaxis in [**2181-1-19**] as well as multiple finger amputations during the same year. 3. She is status post a parathyroidectomy for previous admissions for hypercalcemia. 4. The patient is status post a left arteriovenous fistula on her left upper extremity placed in [**2179**], which became injured during a fistulogram in [**2183-3-22**]. 5. She has chronic pain. 6. She is status post a mitral valve replacement in [**2180-3-21**] with a mechanical Carbomedics 29-mm valve for rheumatic heart disease; and she is on Coumadin for this valve. She also has a history of endocarditis. 7. History of hypertension. 8. Anxiety. Social History: The patient smokes one-third of a pack per day. She denies any EtOH and is disabled. Family History: Non-contributory Physical Exam: On admission: 99.8 100 90/49 19 A&Ox3 in obvious pain MMM, w/o JVD RRR, tachy, no murmur CTAB soft +BS, epigastric TTP, voluntary gaurding, non-distended, no rebound guaiac negative s/p bilat BKA Pertinent Results: [**2184-9-17**] 01:10PM BLOOD WBC-4.6 RBC-3.30* Hgb-9.9*# Hct-28.9* MCV-88 MCH-30.0# MCHC-34.2# RDW-18.4* Plt Ct-176 [**2184-9-15**] 06:05AM BLOOD WBC-6.3 RBC-2.66* Hgb-7.2* Hct-23.1* MCV-87 MCH-26.9* MCHC-31.0 RDW-18.5* Plt Ct-148* [**2184-9-14**] 06:48AM BLOOD WBC-5.6 RBC-2.72* Hgb-7.4* Hct-23.9* MCV-88 MCH-27.1 MCHC-30.8* RDW-18.0* Plt Ct-142* [**2184-9-13**] 08:10AM BLOOD WBC-6.2 RBC-2.69* Hgb-7.5* Hct-23.8* MCV-89 MCH-27.8 MCHC-31.3 RDW-18.3* Plt Ct-146* [**2184-9-13**] 05:39AM BLOOD WBC-5.9 RBC-2.73* Hgb-7.5* Hct-24.5* MCV-90 MCH-27.4 MCHC-30.6* RDW-18.1* Plt Ct-135* [**2184-9-12**] 06:15AM BLOOD WBC-6.9 RBC-2.99* Hgb-8.5* Hct-26.8* MCV-90 MCH-28.6 MCHC-31.9 RDW-17.9* Plt Ct-127* [**2184-9-11**] 03:03AM BLOOD WBC-7.2 RBC-3.17* Hgb-8.9* Hct-27.5* MCV-87 MCH-28.2 MCHC-32.4 RDW-17.9* Plt Ct-120* [**2184-9-10**] 07:43PM BLOOD Hct-30.2* [**2184-9-10**] 03:08AM BLOOD WBC-12.5* RBC-3.66* Hgb-10.1* Hct-31.1* MCV-85 MCH-27.6 MCHC-32.6 RDW-18.1* Plt Ct-118* [**2184-9-9**] 02:15PM BLOOD WBC-16.1* RBC-3.51* Hgb-9.7* Hct-29.0* MCV-83 MCH-27.7 MCHC-33.6 RDW-18.2* Plt Ct-114* [**2184-9-9**] 08:00AM BLOOD WBC-15.9* RBC-3.61*# Hgb-10.0*# Hct-31.1*# MCV-86 MCH-27.7 MCHC-32.2 RDW-18.6* Plt Ct-107* [**2184-9-8**] 09:40PM BLOOD WBC-11.5*# RBC-5.47* Hgb-15.5 Hct-46.2 MCV-84 MCH-28.3 MCHC-33.5 RDW-17.9* Plt Ct-138* [**2184-9-17**] 09:30AM BLOOD PT-23.8* PTT-49.4* INR(PT)-4.1 [**2184-9-16**] 05:40AM BLOOD PT-24.5* PTT-59.0* INR(PT)-4.4 [**2184-9-15**] 09:12PM BLOOD PT-23.6* PTT-48.0* INR(PT)-4.0 [**2184-9-15**] 06:05AM BLOOD PT-27.4* PTT-56.0* INR(PT)-5.5 [**2184-9-14**] 06:48AM BLOOD PT-24.3* PTT-54.4* INR(PT)-4.3 [**2184-9-13**] 08:55PM BLOOD PT-23.1* PTT-50.8* INR(PT)-3.9 [**2184-9-13**] 05:39AM BLOOD PT-22.9* PTT-104.3* INR(PT)-3.8 [**2184-9-12**] 06:15AM BLOOD PT-18.0* PTT-58.2* INR(PT)-2.3 [**2184-9-11**] 03:03AM BLOOD PT-16.8* PTT-56.5* INR(PT)-1.9 [**2184-9-8**] 07:00AM BLOOD PT-18.9* INR(PT)-2.5 [**2184-9-16**] 05:40AM BLOOD Glucose-68* UreaN-22* Creat-5.0*# Na-141 K-3.4 Cl-96 HCO3-28 AnGap-20 [**2184-9-15**] 06:05AM BLOOD Glucose-68* UreaN-43* Creat-7.3*# Na-141 K-3.7 Cl-102 HCO3-23 AnGap-20 [**2184-9-14**] 06:48AM BLOOD Glucose-86 UreaN-35* Creat-6.0*# Na-144 K-4.0 Cl-102 HCO3-25 AnGap-21* [**2184-9-12**] 06:15AM BLOOD Glucose-70 UreaN-45* Creat-6.6*# Na-144 K-4.3 Cl-100 HCO3-24 AnGap-24* [**2184-9-11**] 03:03AM BLOOD Glucose-92 UreaN-32* Creat-5.3*# Na-143 K-4.4 Cl-102 HCO3-24 AnGap-21* [**2184-9-10**] 03:08AM BLOOD Glucose-74 UreaN-46* Creat-6.7* Na-139 K-4.5 Cl-98 HCO3-22 AnGap-24* [**2184-9-9**] 02:15PM BLOOD Glucose-89 UreaN-37* Creat-5.9* Na-140 K-4.6 Cl-99 HCO3-25 AnGap-21* [**2184-9-9**] 08:00AM BLOOD Glucose-141* UreaN-33* Creat-5.5* Na-141 K-4.2 Cl-100 HCO3-25 AnGap-20 [**2184-9-8**] 11:20PM BLOOD Glucose-142* UreaN-28* Creat-5.7* Na-141 K-4.5 Cl-94* HCO3-27 AnGap-25* [**2184-9-8**] 09:40PM BLOOD Glucose-119* UreaN-25* Creat-5.7*# Na-139 K-4.7 Cl-90* HCO3-30 AnGap-24* [**2184-9-8**] 09:40PM BLOOD ALT-66* AST-41* AlkPhos-468* Amylase-415* TotBili-0.5 [**2184-9-16**] 05:40AM BLOOD Calcium-8.6 Phos-3.8 Mg-1.4* [**2184-9-15**] 06:05AM BLOOD Calcium-8.3* Phos-4.4 Mg-1.5* [**2184-9-14**] 06:48AM BLOOD Calcium-8.8 Phos-4.6* Mg-1.7 [**2184-9-13**] 08:10AM BLOOD Albumin-3.0* Calcium-8.7 Phos-5.8* Mg-1.7 UricAcd-6.7* [**2184-9-12**] 06:15AM BLOOD Calcium-8.9 Phos-5.2* Mg-1.7 [**2184-9-11**] 03:03AM BLOOD Calcium-9.3 Phos-5.1* Mg-1.9 [**2184-9-10**] 03:08AM BLOOD Calcium-8.4 Phos-5.2* Mg-1.5* [**2184-9-9**] 02:15PM BLOOD Calcium-8.3* Phos-4.5 Mg-1.5* [**2184-9-9**] 08:00AM BLOOD Calcium-8.3* Phos-4.3 Mg-1.5* [**2184-9-8**] 09:40PM BLOOD Albumin-4.9* Calcium-10.0 Phos-4.8* Mg-1.8 [**2184-9-10**] 11:25AM BLOOD freeCa-1.14 [**2184-9-9**] 02:22PM BLOOD freeCa-1.15 [**2184-9-9**] 06:33AM BLOOD freeCa-1.04* [**2184-9-9**] 05:23AM BLOOD freeCa-1.04* Brief Hospital Course: Pt admitted to surgery from the ED. Ct showed: 1. Prominent loops of proximal small bowel adjacent to an omental fat containing ventral hernia with fecalization of bowel contents, adjacent inflammatory fat stranding, and small amount of fluid and extraluminal air consistent with bowel ischemia and contained perforation. There also is apparent caliber change just below the level of the ventral hernia within the small bowel loops, as the distal loops of small bowel are markedly collapsed. All these findings are suggestive of interval reduction of an incarcerated hernia with high-grade bowel obstruction. At this time, no bowel loops are demonstrated within the ventral hernia. 2. Patent mesenteric vessels. 3. 2, low-density lesions within the spleen, likely representing hemangiomas. 4. Stable appearance of simple hepatic cyst within the dome of the liver. 5. Diffuse increase in density of the osseous structures consistent with renal osteodystrophy. 6. Collateral vessels within the right lateral chest wall. These findings are suggestive of a right subclavian vein stenosis. Clinical correlation is recommended. Pt taken to the OR for operation. Taken to the ICU intubated. Renal consulted for HD and recs. Pt extubated on POD1. Renal was consulted for continuation of her hemodialysis, which went on with out complication. She was kept NPO until bowel function resumed on POD 3, She transferred out of the ICU once extubated on POD 1. She was kept on heparin gtt due to her need for anti-coagulation. Once she had resumed POs, coumadin was started, and she was brought up to her normal coagulation level of 2.5-3. She will follow up in the coumadin clinic and hemodialysis for follwing her INR. Through the remained of her postoperative course, she was advnced through sips, to clears, fulls, then to a regular diet which she tolerated well. By POD 10, she was tolerating regular diet, having bowel movements and her coumadin was theraputic. She was d/c'ed home. Medications on Admission: xanax MS [**First Name (Titles) **] [**Last Name (Titles) **] protonix fentanyl levoxyl dilaudid coumadin Discharge Medications: 1. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). Disp:*30 Tablet(s)* Refills:*2* 2. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO QID (4 times a day). 3. B Complex-Vitamin C-Folic Acid 1 mg Capsule Sig: One (1) Cap PO DAILY (Daily). 4. Levothyroxine Sodium 25 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Cinacalcet 30 mg Tablet Sig: One (1) Tablet PO daily (). 6. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO TID W/MEALS (3 TIMES A DAY WITH MEALS). 7. Fentanyl 75 mcg/hr Patch 72HR Sig: One (1) Patch 72HR Transdermal Q72H (every 72 hours). Discharge Disposition: Home Discharge Diagnosis: Recurrent ventral hernia with small bowel obstruction and compromised bowel. Chronic renal failure Discharge Condition: good Discharge Instructions: You may resume your home medications, please take all new medications as prescribed. You may resume your regular activities. You may shower, pat the wound dry. Do not soak the wound for one week. The staples will be removed at your follow up appointment. Please refrain from driving while taking narcotic pain medication. Please call your physician or return to the hoptial if you experience: - Increasing pain - Fever (>101.5) - Inability to eat/persistant vomiting - Other symptoms concerning to you Followup Instructions: Please follow up with Dr. [**Last Name (STitle) **]. Call ([**Telephone/Fax (1) 10820**] to make an appointment. Completed by:[**2184-9-19**] ICD9 Codes: 5856, 4019, 3051
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Medical Text: Admission Date: [**2145-7-19**] Discharge Date: [**2145-7-25**] Service: MEDICINE Allergies: Acetaminophen Attending:[**First Name3 (LF) 3326**] Chief Complaint: Shortness of breath, fever Major Surgical or Invasive Procedure: Intubation with mechanical ventilation; central venous line placement History of Present Illness: [**Age over 90 **] y/o F with PMHx of Afib, HTN, PNA in [**3-24**] who presented with shortness of breath and fevers. Per NH report, pt at baseline is very independent but was feeling unwell on sunday evening, without specific complaints. Temp was 99.1 and pt did not receive Tylenol due to allergy but po intake was encouraged. Per pt's daughter, she may have received 2 tylenol at that time. She ate breakfast well this am but had some shortness of breath while walking back to her room after being weighed. She also had some urinary incontinence at that time. Vitals were 98.6, 158, 180/100, 30 with 80-88% sats on 3L NC and EMS was called. . She was transported to the [**Hospital1 18**] ED with vitals 190/83, 144, 30 98% on NRB. Monitor showed sinus tach, and EMS exam found crackles in lower lung fields with wheezing in upper lung fields. Pt was tachypneic and sating in the low 80s on arrival to the ED. Past Medical History: Paroxysmal Atrial Fibrillation Hypertension Malnutrition General Weakness h/o Cdiff colitis [**3-25**] h/o CAP prior to c diff ("breathing problem" in [**3-25**] per daughter) Social History: Pt lives at [**Hospital3 2558**] and at baseline is independent of ADLs Family History: non-contributory Physical Exam: Physical exam at discharge: Vitals: T: 97.3 BP: 118/42 P: 97 R: 18 Sats 94% on RA General: not following commands, sedated HEENT: Sclera anicteric, dry MM, pupils pinpoint but reactive Neck: supple, JVP not elevated, no LAD Lungs: bilateral inspiratory rales, no wheezes appreciated CV: RRR, normal S1 + S2, no murmurs, rubs, gallops Abdomen: soft, non-tender, non-distended, bowel sounds present Ext: cool, 1+ pulses, no clubbing, cyanosis or edema Pertinent Results: labs at admission [**2145-7-19**]: WBC-22.0* RBC-3.85* Hgb-12.0 Hct-35.9* MCV-93 MCH-31.1 MCHC-33.3 RDW-14.3 Plt Ct-311 Neuts-69 Bands-11* Lymphs-14* Monos-6 Eos-0 Baso-0 Atyps-0 Metas-0 Myelos-0 PT-11.0 PTT-26.2 INR(PT)-0.9 Glucose-257* UreaN-29* Creat-1.1 Na-134 K-5.0 Cl-99 HCO3-20* AnGap-20 ALT-64* AST-80* CK(CPK)-50 AlkPhos-128* Amylase-80 TotBili-0.9 CK-MB-NotDone cTropnT-0.02* Calcium-8.4 Phos-4.0 Mg-2.3 calTIBC-130* Ferritn-328* TRF-100* Cortsol-116* . Labs prior to discharge: WBC-10.9 RBC-3.00* Hgb-8.9* Hct-27.9* MCV-93 MCH-29.5 MCHC-31.8 RDW-14.2 Plt Ct-298 Glucose-219* UreaN-16 Creat-0.6 Na-136 K-4.5 Cl-108 HCO3-20* AnGap-13 CK-MB-5 cTropnT-0.04* Calcium-7.4* Phos-2.8 Mg-1.8 . Micro: MRSA positive Sputum cx: no growth BCx [**2145-7-19**]: NGTD UCx: no growth Urine legionella: negative . CXr [**2145-7-22**]: Compared to the most recent study from approximately an hour ago, increased left perihilar opacity likely represents pulmonary edema or aspiration. Multifocal pneumonia as compared to yesterday shows decreased consolidation in the right lower lobe and unchanged consolidation in the left lower lobe. Biapical opacities are minimally worsened. There is improved but persistent small bibasal pleural effusions and atelectasis. Allowing for rotation, the cardiomediastinal silhouette is within normal limits. Extensive mural atherosclerosis of the aortic arch and descending aorta is unchanged. There is no pneumothorax. . EKG: sinus tachycardia with LVH and ST depressions seen inferolaterally. Brief Hospital Course: In the ED, initial vs were: T 97.1 P 140 BP 170/100 R 30 O2 sat 99% on NRB. Pt was intubated for hypoxic respiratory distress and was given a total of 5L of NS IVF. CXR revealed right lower lobe infiltrates and pt was given Levo, Ceftriaxone and Vanc. BP dropped to 56/40 after intubation and pt was given narcan without any improvement. A right subclavian was placed with CVP 9-12 and levophed was started at 0.04 mcg/kg. Initial ABG was 7.33/45/136 on AC, FiO2% of 50, TV of 1200 and Lactate of 1.4. Pt was intubated and sedated on arrival to the ICU. She was not following commands, gag response was present and she was still requiring low dose levophed. . # Hypoxic Resp Failure: Pt with fever and shortness of breath who presented in resp distress and was found to have multifocal infiltrates on CXR. Per HCP, pt had recent PNA in 4/[**2144**]. Pt was started on vanc/zosyn/azithromycin for multifocal HAP (given nursing home setting) and atypical pneumonia. Sputum cultures were sent and remained negative for growth. She likely sustained an NSTEMI with troponin peak of 0.25 in setting of hypoxic respiratory distress on admission. Pt had difficulty maintaining MAP>65 and required intermittent pressor support. With no improvement in her condition, antibiotic coverage was expanded to include meropenem and ciprofloxacin. Pt continued to have difficulty being weaned from ventilator. Pt self-extubated twice and required re-intubation with increasing sedation requirements. Goals of care were then discussed with the family given pt's lack of clinical improvement and her distress associated with intubation. Five days after admission, the family decided against escalation of care. Ms. [**Known lastname **] was extubated and placed on comfort measures only. She expired from cardiopulmonary arrest at 5:47am on [**2145-7-25**]. . # NSTEMI: Pt had elevated cardiac enzymes with troponin peak to 0.25 before trending downwards. Pt was started on a statin and EKG changes resolved. Medications on Admission: Milk of Magnesia prn Bisacodyl prn Ultram prn Duoneb prn Senna prn Mag Oxide MIV Vitamin C Synthroid 50mcg daily Discharge Medications: none Discharge Disposition: Expired Discharge Diagnosis: 1. Cardiopulmonary arrest . 2. Multifocal pneumonia Discharge Condition: Expired Discharge Instructions: none Followup Instructions: none ICD9 Codes: 486, 2762, 5849, 0389, 2859, 2449, 4019, 4275
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Medical Text: Admission Date: [**2194-12-12**] Discharge Date: [**2194-12-20**] Date of Birth: [**2114-1-24**] Sex: M Service: NEUROSURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 3227**] Chief Complaint: Subdural Hematoma Major Surgical or Invasive Procedure: None History of Present Illness: Pt is a 80 yo male w/ PMHx sig for CABGx4, pacemaker,recent hospitalization and rehab for R MRSA ankle infection who present after falling at home, found to have a R SDH. The patient has been at home for 1 week after a 5 week rehab stay. He was on his porch walking into the house and tripped on a step an fell backwards. Unclear if he hit his head. No LOC. The patient was brought to an OSH where CT head showed a R frontal SDH along falx. He was transferred to [**Hospital1 18**] for further management. In [**Name (NI) **], pt was noted to have left facial droop. He was given 2 units of FFP. Repeat INR 1.8. Past Medical History: CABG x 4, L knee repair, MRSA infection of R ankle, pacemaker. Social History: Lives at home with wife. Family History: Non-contributory Physical Exam: Physical Exam: Vitals: T 99.2; BP 127/81; P 70; RR 16; O2 sat 100% General: lying in bed NAD HEENT:dry mucous membranes Extremities: no c/c/e. Neurological Exam: Mental status: Awake & alert, year [**2174**] corrects to [**2194**], month - [**Month (only) **], Fluent speech with no paraphasic errors. Adequate comprehension. Cranial Nerves: II: PERRL, 4-->2mm with light. III, IV, VI: EOMI. no nystagmus. V, VII: facial sensation intact, L facial droop [**Doctor First Name 81**]: SCM [**5-13**] XII: Tongue midline without fasciculations. Motor: Normal bulk. Normal tone. No pronator drift. Delt Tri [**Hospital1 **] WE WF FE FF IP QD Ham C5 C7 C6 C8 L2 L3 L4-S1 RT: 5 5 5 5 5 5 5 4 5 4 LEFT: 5 5 5 5 5 4 5 4 5 4 Sensation: intact to light touch Reflexes: Bic T Br Pa Ac Right 2 2 2 1 - Left 2 2 2 1 - Upon Discharge: right facial droop alert and oriented x3 (year only) limited ROM left shoulder due to chronic injury. Pertinent Results: CT Head [**2194-12-12**]: IMPRESSION: 1. New right frontoparietal subdural hematoma measuring 4 mm. 2. Interval enlargement of the right parafalcine subdural hematoma layering along the right tentorium as well as enlargement of the left frontal intraparenchymal hemorrhage as described above. Areas of hypodensity within the right parafalcine subdural hematoma are concerning for hyperacute bleeding. 3. No shift of normally midline structures. CT Head [**2194-12-13**]: IMPRESSION: Stable appearance of parafalcine and right tentorial subdural hematoma, and left periventricular hemorrhage, with no new bleeding and no herniation. CT Head [**2194-12-14**]: IMPRESSION: Unchanged right convexity, parafalcine and tentorial hematoma. Unchanged left periventricular hemorrhage. CT Head [**2194-12-15**]: unchanged Brief Hospital Course: [**Known firstname **] [**Known lastname 9996**] was admitted to [**Hospital1 18**] Neurosurgery on [**2194-12-12**] who is s/p fall and found to have a right subdural hematoma and left frontal subcortical IPH. He was admitted to the ICU for close observation. On [**12-13**] he was note to be more confused and it was unknown if this was due to sundowning vs. worsening bleed and a Head CT was repeated revealed no significant interval change. On [**12-14**], he had left arm and leg jerking x3, self resolved, no Ativan was required. He was on Keppra 500mg [**Hospital1 **] and it was increased to 1000mg [**Hospital1 **] and he also received a 250mg IV bolus. A STAT Head CT which revealed no evidence of interval hematoma progression. He was kept in the ICU overnight and Neurology consulted for seizure management. Neurology agreed with the Keppra increase and recommended an EEG which was done on [**2194-12-15**]. Pt was neurologically stable and transferred to the Step Down Unit on [**2194-12-15**]. A repeat head CT showed stable intracranial findings. On [**12-17**], He had some intermittent right hemiparesis. Neurology was again consulted. No stroke was identified on imaging. CTA did not reveal any significant hemadynamic lesions. Work up was notable only for a UTI for which the patient received a course of Ciprofloxicin. He was started on ASA and closely followed by neurology for these intermittent symptoms which persisted through the remainder of his hospitalization. Ultimately, the patient was cleared for discharge by the neurology consult. The patient was transferred to a [**Hospital1 1501**] on [**2194-12-20**] Medications on Admission: Prilosec 20 mg q day, Cordarone 200 mg q day, ASA 81 mg q day, Lopressor 50 mg [**Hospital1 **], Vit C 500 mg [**Hospital1 **], Zocor 80 mg qhs, Xalatan OS qhs, HCTZ 25 qod, Coumadin 2 mg q day, Digoxin 125mcg q day, Lasix 80 mg q day, MVI, KCl 20 meq q day, Vit D 800 units q day, Vit E 200 units q day, Colace 100 mg q day. Discharge Medications: 1. Simvastatin 40 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 2. Latanoprost 0.005 % Drops Sig: One (1) Drop Ophthalmic HS (at bedtime). 3. Multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: Two (2) Tablet PO DAILY (Daily). 5. Vitamin E 100 unit Capsule Sig: Two (2) Capsule PO DAILY (Daily). 6. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 7. Insulin Regular Human 100 unit/mL Solution Sig: RISS Injection ASDIR (AS DIRECTED). 8. Silver Sulfadiazine 1 % Cream Sig: One (1) Appl Topical DAILY (Daily). 9. Digoxin 125 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 10. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID (2 times a day): Hold SBP<110 HR<60. 11. Levetiracetam 500 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 12. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for Pain. 13. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for Constipation. 14. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 15. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 16. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 17. Furosemide 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 18. Ciprofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours) for 10 days. 19. Tobramycin Sulfate 0.3 % Ointment Sig: One (1) Appl Ophthalmic [**Hospital1 **] (2 times a day) for 5 days. 20. Ondansetron 4 mg IV Q8H:PRN nausea 21. Ondansetron HCl (PF) 4 mg/2 mL Solution Sig: One (1) Injection Q8H (every 8 hours) as needed for n/emesis. Discharge Disposition: Extended Care Facility: Aberjona Nursing Center - [**Hospital1 2436**] Discharge Diagnosis: Right Subdural Hematoma and Left frontal subcortical IPH Urinary Tract Infection Discharge Condition: neurologically stable Discharge Instructions: General Instructions ??????Take your pain medicine as prescribed. ??????Exercise should be limited to walking; no lifting, straining, or excessive bending. ??????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, or Ibuprofen etc. ??????If you were on a medication such as Coumadin (Warfarin), or Plavix (clopidogrel), or Aspirin prior to your injury, please refrain from taking until you are seen by Dr. [**First Name (STitle) **] in follow-up ??????You have been given Keppra to take. Please continue with this medication until you are seen in follow-up with Dr. [**First Name (STitle) **] ??????No Driving. You had multiple seizures while in hospital. Followup Instructions: You will need to follow-up with Dr. [**First Name (STitle) **] in 4 weeks with a Head CT w/o contrast. Please call [**Location (un) 3230**] for this appointment at [**Telephone/Fax (1) 3231**] Please call [**Telephone/Fax (1) 3231**] with any questions or concerns. Completed by:[**2194-12-20**] ICD9 Codes: 5990
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Medical Text: Admission Date: [**2140-4-5**] Discharge Date: [**2140-4-8**] Service: [**Last Name (un) 7081**] HISTORY OF PRESENT ILLNESS: Briefly, this is an 82 year old nonsmoker, active female who had undergone a right upper lobe resection for T1 N0 adenocarcinoma in [**2139-12-20**], who presented with right upper lobe mass found on routine computerized tomography scan for follow up. It was discussed with Dr. [**Last Name (STitle) 175**] and his plan was to do a resection at this time. PAST MEDICAL HISTORY: Past medical history is significant for high cholesterol, osteoarthritis, and thrombocytosis. She is status post appendectomy. MEDICATIONS ON ADMISSION: Avapro, Lipitor, Hydrochlorothiazide, Vioxx, Nexium, Os Cal, aspirin, multivitamins, _______ eyedrops and Hydroxyurea. ALLERGIES: No known drug allergies. SOCIAL HISTORY: She is a nondrinker, nonsmoker. FAMILY HISTORY: Significant for lung cancer in her brother, pancreatic cancer in another brother, colon cancer in a sister. PHYSICAL EXAMINATION: Physical examination shows her afebrile with stable vital signs. Her lungs were clear. Heart was regular. Abdomen was soft, nontender, nondistended. Bowel sounds were present. Extremities were warm and well perfused. LABORATORY DATA: Laboratory studies were all within normal limits. HOSPITAL COURSE: The patient was taken to the Operating Room on [**2140-4-5**], for a video-assisted thoracoscopic wedge resection of the right upper lobe mass, please see the operative report for further details. The patient was transferred to the floor postoperatively. She had an epidural for pain. Her chest tubes were put in in the Operating Room and these were kept to suction. The patient continued to do well postoperatively. On postoperative day #1, it was noted that her sodium had dropped from a normal preoperative level in [**Month (only) 404**], to 123. Therefore, she was followed for serial sodiums to monitor for changes. Her sodium dropped to as low as 117. At this point in time, she had mental status changes and it is decided the patient would be transferred to the Intensive Care Unit. She was started on a 3 percent sodium chloride drip for slow correction of her sodium. She slowly improved from this and her sodium improved. By postoperative day #2, the sodium had climbed up to 123. Renal was consulted for evaluation for syndrome of inappropriate antidiuretic hormone. They felt that the management was correct and when her sodium was corrected up to a level of mid 20s that she could be started on a fluid restriction and salt tablets. Her sodium slowly corrected over the next couple of days and she was put on fluid restriction as well as a high sodium diet. Her sodium was followed closely and on the day of discharge it had climbed back up to 127. It was felt that this drop in sodium was linked either to the long surgery itself or to the possibility of the mass causing trouble and it was also felt that this could be treated with sodium tablets and fluid restriction. Physical therapy was consulted for evaluation of her ambulation and her strength and it is found that she was doing quite well and could be discharged home when medically stable. She did well over the next couple of days and her chest tubes were removed. On postoperative day #3, she was doing well, tolerating a regular diet and her sodium returned to a level of 127 prior to discharge. Therefore it was decided that the patient could be discharged home. The patient was discharged home in stable condition. She was instructed to follow up with her primary care physician for [**Name Initial (PRE) **] recheck of her sodium as well as follow up with Dr. [**Last Name (STitle) 175**] in two to three weeks for evaluation of her wounds. She was discharged on all of her home medications as well as ________for pain, Colace, stool softener and sodium chloride tablets, 2 gm p.o. t.i.d. The patient is discharged in stable condition. DISCHARGE DIAGNOSIS: 1. Right upper lobe mass, status post video-assisted thoracoscopic wedge resection of the right upper lobe. 2. Severe acute hyponatremia, status post correction with 3 percent normal saline drip as well as sodium chloride tablet. 3. Right upper lobe adenocarcinoma, status post right upper lobe wedge resection. 4. High cholesterol. 5. Osteoarthritis. 6. Thrombocytosis. 7. Status post appendectomy. CONDITION ON DISCHARGE: Stable. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], [**MD Number(1) 7082**] Dictated By:[**Doctor Last Name 11225**] MEDQUIST36 D: [**2140-4-8**] 19:21:26 T: [**2140-4-8**] 21:12:38 Job#: [**Job Number 14202**] ICD9 Codes: 2761, 2720
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Medical Text: Admission Date: [**2160-12-30**] Discharge Date: [**2161-1-1**] Date of Birth: [**2108-5-5**] Sex: M Service: MEDICINE Allergies: Phenergan / Zofran Attending:[**First Name3 (LF) 1711**] Chief Complaint: Torsades, ICD firing Major Surgical or Invasive Procedure: None History of Present Illness: Mr [**Known lastname 97106**] is a 52M with recent admission for Vtach [**2-5**] QT prolongation s/p ICD placement and h/o narcotics abuse who presented to [**Hospital1 18**] [**Location (un) 620**] for SOB concerning for COPD exacerbation as well as N/V and was found to have QT prolondation to 510. He was given steroids, abx, zofran. He was given mag sulfate 2g IV preemptively for long QT of 510, Mg 1.8 and plans were made for admission for COPD exacerbation. Shortly after Mag was hung, pt reports feeling short of breath and lightheaded and had a witnessed episode of torsades, with subsequent ICD firing. He was given lidocaine 100mg IV, 1mg drip which was increased to 2mg. He had 4 episodes total. Per [**Hospital1 **] cards, pacer rate was increased to 80 and he was transferred to [**Hospital1 18**] for further management. . On arrival to our ED, vitals were 97.9 80 146/111 17 100% ra. Labs were notable for phos of 1.8 and K of 3.3 without any other abnormalities. QTc was 460. He was given additional Mg, 40meq K in IVF, Ativan for anxiety and nausea. Lidocaine was continued. He had another episodes of torasdes and his ICD fired for the second time. On transfer to the CCU, VS: HR 92, 150/99, 20 98% 2L NC. . Currently, the patient denies any symptoms other than significant diffuse chest pressure which he experienced both after the first ICD firing and following the second ICD firing. He continues to experience the chest pressure/pain without change. He denies shortness of breath or lightheadedness, denies arm or jaw pain, n/v. . Of note, the patient does note he had been experiencing green loose stool x1-2 days, abdominal pain, and nausea/vomiting. He reports experiencing these same symptoms every other week since his gastric bypass, and denies any sick contacts, unusual food intake, fevers, or changes to his typical GI symptoms. . On review of systems, he denies any prior history of stroke, TIA, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, cough, hemoptysis, black stools or red stools. He denies recent fevers, chills or rigors. He denies exertional buttock or calf pain. All of the other review of systems were negative. . Cardiac review of systems is notable for absence of baseline dyspnea on exertion or exertional chest pain or pressure, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations. Past Medical History: 1. CARDIAC RISK FACTORS: +Dyslipidemia, +Hypertension 2. CARDIAC HISTORY: -CABG: none -PERCUTANEOUS CORONARY INTERVENTIONS: none -PACING/ICD: s/p pacemaker/ICD placed [**2160-11-7**] during prior episode of torsades [**2-5**] prolonged QT 3. OTHER PAST MEDICAL HISTORY: -Asthma vs COPD -Bronchitis -Morbid obesity -Gout -Obstructive Sleep Apnea -Depression/Anxiety -Narcotic dependence/abuse Social History: Quit tobacco [**2154**], 30 pack-year history. Wife reports patient is still currently smoking. Social EtOH Dependence on prescribed narcotics Family History: Father with CAD, s/p CABT in 40's; otherwise non-contributory. Physical Exam: VS: T=37.2 BP=145/107 -> 160/80 HR=97 R=15 PO2=100%RA GENERAL: Alert, interactive, in NAD. Oriented x3. Mood, affect appropriate. HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa, white plaque on tongue. No xanthalesma. NECK: Supple with JVP of ~11 cm. No carotid bruits. 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. EXTREMITIES: No c/c/e. SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. PULSES: Right: Carotid 2+ DP 2+ PT 2+ Left: Carotid 2+ DP 2+ PT 2+ Pertinent Results: [**2161-1-1**] 06:10AM BLOOD WBC-12.2* RBC-5.01 Hgb-14.7 Hct-42.5 MCV-85 MCH-29.3 MCHC-34.6 RDW-15.7* Plt Ct-434 [**2160-12-31**] 09:38AM BLOOD WBC-14.8* RBC-4.74 Hgb-14.0 Hct-40.5 MCV-85 MCH-29.6 MCHC-34.6 RDW-15.9* Plt Ct-456* [**2160-12-31**] 06:08AM BLOOD WBC-13.0* RBC-4.47* Hgb-13.3* Hct-38.7* MCV-87 MCH-29.7 MCHC-34.3 RDW-15.9* Plt Ct-453* [**2160-12-30**] 11:47AM BLOOD WBC-10.4 RBC-5.38# Hgb-15.8# Hct-46.6# MCV-87 MCH-29.3 MCHC-33.9 RDW-15.9* Plt Ct-471* [**2160-12-30**] 11:47AM BLOOD Neuts-91.6* Lymphs-7.0* Monos-0.4* Eos-0.5 Baso-0.5 [**2161-1-1**] 06:10AM BLOOD PT-13.3 PTT-25.3 INR(PT)-1.1 [**2160-12-30**] 11:47AM BLOOD PT-12.9 PTT-23.2 INR(PT)-1.1 [**2161-1-1**] 06:10AM BLOOD Glucose-87 UreaN-2* Creat-0.5 Na-130* K-3.9 Cl-95* HCO3-24 AnGap-15 [**2160-12-31**] 09:38AM BLOOD Glucose-109* UreaN-3* Creat-0.5 Na-134 K-4.0 Cl-99 HCO3-26 AnGap-13 [**2160-12-31**] 06:08AM BLOOD Glucose-95 UreaN-3* Creat-0.5 Na-137 K-4.0 Cl-101 HCO3-26 AnGap-14 [**2160-12-30**] 10:30PM BLOOD Na-137 K-4.1 Cl-104 [**2160-12-30**] 11:47AM BLOOD Glucose-120* UreaN-2* Creat-0.7 Na-138 K-3.3 Cl-99 HCO3-25 AnGap-17 [**2161-1-1**] 06:10AM BLOOD CK(CPK)-49 [**2160-12-31**] 05:35PM BLOOD CK(CPK)-59 [**2161-1-1**] 06:10AM BLOOD CK-MB-2 cTropnT-<0.01 [**2160-12-31**] 05:35PM BLOOD CK-MB-2 cTropnT-<0.01 [**2161-1-1**] 06:10AM BLOOD Calcium-8.4 Phos-2.8 Mg-1.9 [**2160-12-30**] 11:47AM BLOOD Calcium-9.3 Phos-1.8*# Mg-2.1 [**2160-12-30**] 10:30PM BLOOD TSH-0.99 . [**2160-12-30**] ECG Atrial paced, ventricular sensed rhythm with atrial premature beats. Since the previous tracing the atrial pacing then was associated with a P wave and there is no longer ventricular pacing. Perhaps the pateint was in atrial fibrillation on the prior two tracings. Clinical correlation is suggested. . [**2160-12-31**] ECG Atrial paced, ventricular sensed rhythm with a single atrial premature beat. Since the previous tracing the Q-T interval is shorter. Otherwise, unchanged. Brief Hospital Course: 52 yo gentleman with history of ventricular arrhythmias in the setting of prolonged QT presents with torsades and ICD firing in the setting of medication prolonging QT. . # RHYTHM: Mr. [**Known lastname 97106**] presented in [**Month (only) **] in the setting of prolonged QT, believed to be secondary to Zofran and had an ICD placed during that time. He presented again dyspneic and developed torsades de [**Last Name (un) **] after receiving zofran. QT interval was 510 at outside hospital and 460 in [**Hospital1 18**] ED after receiving magnesium repletion prior to transfer. Episodes of torsades appear to be provoked by QT-prolonging medications, and threshold may also have been lowered by electrolyte abnormalities. He was additionally repleted with magnesium and potassium and was initially put on a lidocaine drip for continued anti-arrythmic effect overnight. Daily EKGs performed to monitor QT interval. He was discharged with close follow up and no changes were made to his medications. He was instructed to continue avoiding QT prolonging medications. . # CORONARIES: On recent catheterization prior to admission, no intervenable lesions however patient with several narrowed vessels as well as evidence of microvascular disease. No history of chest pain on admission and cardiac enzymes cycled and were unremarkable. He was continued on aspirin, statin , betablocker and ace inhibitor at home dose. . # Chronic CHF: History of mild systolic CHF post-torsades (last EF 45%). Euvolemic on admission without evidence of exacerbation. He was continued on home dose of betablocker and lisinopril and put on a low sodium diet. . # HTN: Mildly blood pressures on admission. He was continued on home regimen as outlined above. . # HLD: Continued Simvastatin. . # Thrush: White plaque on tongue consistent with flush. He was started on nystatin swish and swallow. . # Hx COPD/Asthma: No wheeze or evidence of active flare. Albuterol, flovent and ventolin were available. . # Depression/Anxiety: He was continued on celexa daily with ativan as needed. He was encouraged to follow-up with his primary care physician and former psychiatrist to address underlying anxiety. . # Chronic pain: Continued on tylenol and cyclobenzaprine for chronic pain in setting of past history of narcotics abuse. . Medications on Admission: Zocor 20mg daily Aspirin 81mg daily Lisinopril 5mg daily Lopressor 25mg [**Hospital1 **] Celexa 40mg daily Docusate 100mg [**Hospital1 **] Miralax 1 packet daily Ambien prn Discharge Medications: 1. Zocor 20 mg Tablet Sig: One (1) Tablet PO once a day. 2. aspirin 81 mg Tablet Sig: One (1) Tablet PO once a day. 3. lisinopril 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. metoprolol tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 5. Celexa 40 mg Tablet Sig: One (1) Tablet PO once a day. 6. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO twice a day. 7. Miralax 17 gram Powder in Packet Sig: One (1) PO once a day. 8. zolpidem 5 mg Tablet Sig: 0.5 Tablet PO HS (at bedtime) as needed for insomnia. Discharge Disposition: Home Discharge Diagnosis: Ventricular Tachycardia/Torsades de Pointes related to prolonged QT interval Acute Systolic Dysfunction 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 management of an abnormal cardiac rhythm, ventricular tachycardia or torsades de pointes that caused your internal cardiac defibrillator (ICD)to fire. This abnormal rhythm was likely caused by a medication that you took for symptoms of nausea (zofran). You should avoid any medicines that make you more prone to ventricular tachycardia, please continue to avoid these medications, you have been given a list of these medications. No changes were made to your medications. Weigh yourself every morning, please call Dr. [**Last Name (STitle) **] if weight goes up more than 3 lbs. Followup Instructions: Name: [**Last Name (LF) 97107**],[**First Name8 (NamePattern2) 306**] [**Last Name (NamePattern1) **] Address: [**Location (un) **]., [**Apartment Address(1) 25389**], [**Location (un) **],[**Numeric Identifier 1700**] Phone: [**Telephone/Fax (1) 74684**] Appt: [**1-7**] at 3pm ***Please ask dr [**Last Name (STitle) **] to assist you in establishing with a psychiatrist during this office visit.**** Department: CARDIAC SERVICES When: [**Last Name (STitle) **] [**2161-1-16**] at 10:00 AM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 5855**], NP [**Telephone/Fax (1) 285**] Building: [**Hospital6 29**] [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage ICD9 Codes: 4271, 496, 4280, 2724, 4019, 2749
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6515 }
Medical Text: Admission Date: [**2103-11-1**] Discharge Date: [**2103-11-5**] Date of Birth: [**2027-5-26**] Sex: M Service: NEUROLOGY Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 618**] Chief Complaint: seizures Major Surgical or Invasive Procedure: Intubation (done at OSH) Extubation History of Present Illness: [**Known firstname **] [**Known lastname 85686**] is a 76 year-old man with history significant for Left PCA-territory stroke in [**2101**] (details uncertain at this time) and remote MI ([**2089**]) with ischemic cardiomyopathy (EF reportedly 35% per OSH notes), as well as HTN, HL, and mild COPD. The patient is intubated and unresponsive at this time and no family is present and there are no contact numbers for family, so the minimal history at this point is derived from ED transfer note from [**Last Name (un) 63261**] Hospital, where ED physicians spoke with his wife. Per OSH note, he was in his USOH last night when he went to bed around 8pm with no complaints except that he was "slightly congested." Around 5:15am this morning ([**11-1**], [**Holiday 1451**] Day), his wife was awakened by a "screaming noise" and a loug bang. She found him on the floor, convulsing and unresponsive. He reportedly has no seizure history. She called EMS. EMS reportedly noted on-going convulsions on arrival (but we do not have their documentation), which resolved spontaneously. They brought him to the OSH within roughly 20 minutes of onset. He arrived with VS of afebrile, HR 124, BP 136/86 - 190/113, RR 20, SaO2 96% RA, FSBG 134 at 06:40am. There, he had a convulsive episode not witnessed by the ED phsycian, which again self-resolved. On exam, his eyes were open, but he was not looking or moving on command. He was thought to have a stroke because, although he moved LUE/LLE spontaneously, he would not move the RUE to noxious stimulation, and only weakly withdrew the RLE one time to noxious stimulation. His Right toe was up-going. His EKG had frequent PVCs and sinus tachycardia at 115. Routine lab studies were unremarkable (CBC, BMP, Ca, CK/MB/trop, coags), except for dig <0.4 (he was listed as taking dig as of 10/[**2102**]). They did a NCHCT, which was said to show no hemorrhage or acute changes (it is being uploaded into our PACS at this time). He had another convulsive episode at CT, so they gave him 2mg Ativan, after which they intubated him (paralyzed/sedated rapid-sequence, with succ and etomidate) for unclear reason. He was pulling at the ETT, so he was given fentanyl 100mcg bolus IV, after which he became hyPOtensive to the 70s SBP, so he was given IVF and started on dopamine gtt. He was sedated with MDZ and fentanyl gtt and med-flighted over to [**Hospital1 18**]. Apparently he was given 2mg Ativan en route by Med Flight staff, for agitation. He arrived here intubated, sedated with midazolam and fentanyl. VS on arrival were: afebrile (97.5) HR 74 BP 144/76 (on 0.4 norepinephrine gtt). RR 18/SaO2 100% on PEEP 5 / 100% FiO2. He was not opening his eyes and not responsive to command, and the ED staff said he moved his Right hand and both legs now. We were consulted re. diagnosis and management. ROS: cannot obtain (non-responsive) Past Medical History: (by report from OSH ED transfer note) 1. Stroke, L-PCA territory in [**2101**] with no residual 2. CAD / MI, remote ([**2089**]; vessel(s) uncertain) 3. Ischemic cardiomyopathy with EF 35% 4. Hypertension 5. Hyperlipidemia 6. "mild" COPD 7. bilateral carpal tunnel syndrome, [**1-10**] inflammatory arthropathy (serologies negative) per Rheum notes here at [**Hospital1 18**] reportedly no history of seizure Social History: current details unknown per Rheum notes: lives at home with wife. Quit smoking [**2076**]. 4 drinks EtOH per week. Denied illicits. Family History: details unknown at this time Physical Exam: ADMISSION PHYSICAL EXAM: 97.5F HR 55, reg BP 161/9x on norepi 0.4 --> 132/98 @0.3 --> 111/XX off norepi RR 15-17 (set rate = 16) SaO2 100% on FiO2 100% / PEEP 5 General: Intubated with OG tube. Lying in bed in NAD (sedating meds -- fentanyl 50 and MDZ 1 were running, which I had stopped on arrival). Smells of fresh (?cdiff) diarrhea. HEENT: Normocephalic and atraumatic except for small lac below left eye. No scleral icterus. Mucous membranes are moist. No lesions noted in oropharynx. Neck: exam limited by neck brace applied at OSH. Pulmonary: Coarse lung sounds diffusely, bilaterally. Non-labored; not overbreathing vent, but does buck briefly a couple times after sedation is lifted. Cardiac: RRR with occasional extra beat, normal S1/S2. Abdomen: Mildly distended ++tympanic, esp epigastric / LUQ. Non-tender. No bowel sounds appreciated in loud ED setting. Extremities: Cool, but well-perfused with 2+ DPs bilaterally. No clubbing or cyanosis. No edema. Skin: no gross rashes or lesions noted. ***************** Neurologic examination: best GCS after lifting sedating meds: 7 (E2 V1 M4) level of arousal - 2 (opens eyes briefly to sternal rub) best verbal - 1 (no verbal response to pain) best motor - 4 (withdraws to pain) Mental Status exam: Eyes closed. Grimaces, bucks torso, and withdraws all extremities to mild noxious stimulation (sternal rub, mild nail-bed pressure). Does not regard, track, or blink to threat (with eyes held open). Does not follow command to open eyes or open/close fist or show thumbs-up. -Cranial Nerves: II: Pupils round, equal, sluggish (Right pupil eccentrically positioned on [**Doctor First Name 2281**], ?post-surgical change), 3 to 2.5mm. Does not blink to threat anywhere. III, IV, VI: Does not track or look on command. Eyes are both mid-position. Neck brace limits VOR/OCR testing. V: Weak corneals bilaterally. Strong grimace to nasopharyngeal stimulation with cotton swab, bilaterally similar. VII: Face grossly symmetric at rest. Symmetric grimace to pain. VIII: Unable to test (neck brace limits OCRs; pt not responsive to loud noise on either side). IX, X: RT says cough and gag are robust at this time (tracheal suctioning immediately prior to exam). [**Doctor First Name 81**]: unable to test. XII: unable to test. -Motor: Moderately reduced tone of all four extremities at rest. No adventitious movements, no tremor, no posturing or clonic movements. Vigorous, immediate withdrawal of all four extremities to pain (mild nailbed pressure) in that extremity. No gross assymetry. -Sensory: responsive to mild noxious stimuli x four and face as above. -Reflex examination (left; right): Biceps (++;++) Triceps (+;+) Brachioradialis (++;++) Quadriceps / patellar (++;++) Gastroc-soleus / achilles (+;+) Plantar response was EXTENSOR bilaterally, more rapidly up-going on the RIGHT (left up-going with longer latency). -Coordination: cannot test -Gait: cannot test DISCHARGE PHYSICAL EXAM: Vitals: 97.8, BP 142/70, HR 68, RR 18, 97%RA General: AAOX3, very hard of hearing HEENT: Normocephalic and atraumatic except for hematoma around R eye. No scleral icterus. Mucous membranes are moist. No lesions noted in oropharynx. Neck: supple, mildly limited ROM Pulmonary: CTA-B Cardiac: RRR with occasional extra beat, normal S1/S2. Abdomen: soft, NT, ND Extremities: Cool, but well-perfused with 2+ DPs bilaterally. No clubbing or cyanosis. No edema. Skin: no gross rashes or lesions noted. ***************** Neurologic examination: Mental Status exam: AAOx3, follows commands, appropriately answers questions -Cranial Nerves: II: Pupils round, equal, and reactive (Right pupil eccentrically positioned on [**Doctor First Name 2281**], ?post-surgical change), 4 to 2mm. III, IV, VI: EOMI V: facial sensation intact throughout VII: Face grossly symmetric VIII: Decreased hearing bilaterally R>L, per pt this is chronic IX, X: tongue midline [**Doctor First Name 81**]: uvula midline, palate rises symmetrically XII: shoulder shrug [**4-12**] throughout -Motor: 5/5 strength in all muscle groups symmetrically -Sensory: intact to LT throughout -Reflex examination (left; right): 2+ and symmetrical as biceps, triceps, brachioradialis and patella, 1+ a bilateral achilles, Plantar response was EXTENSOR bilaterally, more rapidly up-going on the RIGHT (left up-going with longer latency). -Coordination: FNF intact bilaterally -Gait: deferred Pertinent Results: ADMISSION LABS: [**2103-11-1**] 09:18AM BLOOD WBC-13.0* RBC-4.27* Hgb-13.4* Hct-40.1 MCV-94 MCH-31.3 MCHC-33.4 RDW-12.6 Plt Ct-215 [**2103-11-1**] 09:18AM BLOOD Neuts-87.9* Lymphs-7.5* Monos-3.9 Eos-0.5 Baso-0.2 [**2103-11-1**] 09:18AM BLOOD PT-13.4 PTT-23.5 INR(PT)-1.1 [**2103-11-1**] 09:18AM BLOOD Glucose-144* UreaN-20 Creat-1.0 Na-144 K-3.6 Cl-107 HCO3-25 AnGap-16 [**2103-11-2**] 02:24AM BLOOD ALT-14 AST-27 CK(CPK)-489* AlkPhos-48 TotBili-0.6 [**2103-11-1**] 09:18AM BLOOD Calcium-9.3 Phos-3.3 Mg-2.1 [**2103-11-2**] 02:24AM BLOOD %HbA1c-5.2 eAG-103 [**2103-11-2**] 02:24AM BLOOD Triglyc-85 HDL-50 CHOL/HD-2.6 LDLcalc-64 [**2103-11-2**] 02:24AM BLOOD TSH-0.91 [**2103-11-1**] 09:01AM BLOOD Type-ART Rates-16/ Tidal V-500 PEEP-5 FiO2-100 pO2-420* pCO2-52* pH-7.32* calTCO2-28 Base XS-0 AADO2-247 REQ O2-48 -ASSIST/CON Intubat-INTUBATED [**2103-11-1**] 09:35AM BLOOD Glucose-129* Lactate-3.3* K-3.7 DISCHARGE LABS: No labs done at the time of discharge as patient was stable. IMAGING: [**2103-11-1**] CXR: IMPRESSION: 1. Standard position of endotracheal tube 4.5 cm from the carina. 2. Nasogastric tube within the stomach, though side port above the left hemidiaphragm, and advancement is recommended. 3. Mediastinal widening, partly due to the AP technique though is concerning for underlying mediastinal pathology. Recommend dedicated PA and lateral chest radiographs or chest CT for further characterization. CT C-SPINE [**2103-11-1**]: IMPRESSION: 1. No acute fracture allowing for the osteopenia and deg. changes. Multilevel, multifactorial degenerative changes with mild-moderate canal stenosis and foraminal stenosis as above. 2. Moderate posterior disc protrusion at C5/6 with mild spinal canal narrowing. If concern for spinal cord/ligamentous injury, MRI of the C-spine might be considered if not CI. CTA CHEST [**2103-11-1**]: IMPRESSION: 1. No acute cardiothoracic process including no evidence of no pulmonary embolism, aortic dissection, aortic aneurysm formation, mediastinal hemorrhage, pneumonia or pneumothorax. 2. Incidentally found hypoattenuating left lobe liver lesions likely represent simple cysts, however, further workup with ultrasound might be considered on a nonurgent basis. CT HEAD [**2103-11-1**]: IMPRESSION: 1. Symmetric linear hyperdensities in the cerebellar hemispheres bilaterally- DDX: hemorrhage/ calcification, however, followup CT in 24 hours might be considered for reassurance. No priors are available. No obvious fracture. 2. No obvious acute territorial infarction. 3. Chronic left PCA infarct. 4. Soft tissue swelling with increased attenuation of fat in the right temporal and lateral orbital regions without fracture. MRI/MRA [**2103-11-2**]: IMPRESSION: 1. No obvious acute infarction. 2. Thin linear increased signal intensity overlying the right parietal and the occipital lobes likely in the meninges on the FLAIR sequence. Non-scattered FLAIR hyperintense foci as described above. Recommend post-contrast images for better assessment for parenchymal or meningeal abnormal enhancement given the history of seizures. 3. Patent major arteries as above; study somewhat suboptimal and MCAs are better seen on the source images. LUMBAR SPINE [**2103-11-2**]: IMPRESSION: Single AP view only, with multilevel degenerative changes. LUMBAR SPINE A/P [**2103-11-2**]: FINDINGS: Two views of the lumbar spine demonstrate lumbar vertebral body height to be maintained. There is no malalignment. There are large osteophytes at all levels with loss of disc height. Aorta is moderately calcified. There is facet arthrosis at all levels. There are mild degenerative changes at the sacroiliac joints and femoroacetabular joints. VIDEO SWALLOW [**2103-11-2**]: IMPRESSION: Penetration with thin liquids, but no aspiration. MR W/ CONTRAST [**2103-11-3**]: IMPRESSION: Limited study with only T1 axial post-gadolinium images are obtained which are somewhat degraded by motion. Mild streaky pachymeningeal enhancement is seen in the parietooccipital region. This is a nonspecific finding and could be related to prior lumbar puncture. No mass effect seen. No definite intraparenchymal enhancement. LIVER U/S [**2103-11-3**]: IMPRESSION: 1. 1-cm hepatic cyst within the left lobe. Further evaluation is limited due to adjacent cardiac motion. The remainder of the liver examination is normal. 2. Normal gallbladder. Brief Hospital Course: Mr. [**Known lastname 85686**] is a 76 yo man with a history of a left occiptal lobe stroke, presenting with 3 seizures. He was intubated at [**Hospital3 26615**] hospital and transferred to [**Hospital1 18**] for further care. He was quickly extubated, and was stable in the ICU. He had an MRI which showed meningeal thickening over the right occipital lobe, which was felt to be likely from multiple LP attempts at OSH. # NEURO: we started pt on keppra 750mg [**Hospital1 **] to help prevent further seizures. While here, he did not have any further seizures. We did not obtain an EEG, as it would not change management, because pt was to go home on an AED no matter what the EEG showed. While there are no clear guidelines for length of AED use in seizures likely caused by old strokes, we recommend a 6 month course of keppra for Mr. [**Known lastname 85686**]. He is going to f/u with his neurologist in [**Location (un) 5028**], who can ultimately make the decision for length of medication treatment. While here, we initially held pt's ASA and plavix until is could be determined that the meningeal enhancement on MRI wasn't a SDH. Post-contrast images were obtained and it was clear that the enhancement was not a SDH, so his ASA and plavix were restarted. # Infectious Disease: pt did not demonstrate any infectious sx while here. His BCx is NGTD and he remained afebrile. His WBC was mildly elevated to 13.0 on arrival, but this quickly normalized. # Cardiovascular: We continued pt on his home cardiac medications including amlodpine, digoxin, metoprolol succinate, losartan and simvastatin. As above, we initially held his ASA and plavix until it could be determined he didn' have a SDF. He was monitored on tele while here, and there was no arrythmia noted. # Pulmonology: patient had a widened mediastinum noted on initial CXR, but CTA was normal. Patient was able to be extubated without incident. # Endocrine: on this admission LDL was 64 and HgA1C was normal. He was put on an ISS but his FS's remained WNL. # GI/Liver: On pt's CTA he was noted to have a liver lesion, which a dedicated liver U/S determined was a cyst. If he develops any liver sx, he will need this followed. PENDING RESULTS: BCx [**2103-11-1**] TRANSITIONAL CARE ISSUES: His outpatient neurologist will need to detemine how long his keppra should be continued for. Medications on Admission: 1. albuterol inh PRN - 2 puffs oral 4 times a day PRN 2. amlodipine 5mg daily (taken q.AM) 3. clopidogrel 75mg daily (taken q.NOON) 4. DIGOXIN 0.125mg (taken QOD, not daily, changed recently to QOD by Cardiologist due to sedation with daily dosing) 5. losartain 50mg daily 6. metoprolol 25mg ([**12-10**] of 50mg tablet) taken q.SUPPERTIME 7. simvastatin 80mg (taken QHS) 8. sulfasalazine 1000mg (two 500mg tablets) q.AM and q.SUPPERTIME 9. aspirin 81mg daily (taken q.AM) 10. multivitamin daily Discharge Medications: 1. Tylenol Arthritis 650 mg Tablet Extended Release Sig: Three (3) Tablet Extended Release PO once a day as needed for pain. 2. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 3. multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. albuterol sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig: Two (2) Puff Inhalation Q6H (every 6 hours) as needed for SOB, wheezing. 5. amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. digoxin 125 mcg Tablet Sig: One (1) Tablet PO EVERY OTHER DAY (Every Other Day). 8. losartan 50 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. metoprolol succinate 25 mg Tablet Extended Release 24 hr Sig: One (1) Tablet Extended Release 24 hr PO once a day. 10. simvastatin 80 mg Tablet Sig: One (1) Tablet PO once a day. 11. sulfasalazine 500 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 12. Keppra 750 mg Tablet Sig: One (1) Tablet PO twice a day. Disp:*60 Tablet(s)* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Seizures Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. NEURO EXAM: pt with impaired hearing bilaterally, easily distactable, full strength throughout Discharge Instructions: Dear Mr. [**Known lastname 85686**], You were seen in the hospital because of multiple seizures. They were felt to be caused from some of your old strokes. You were put on antiseizure medications to help prevent future seizures. We made the following changes to your medications: 1) We STARTED you on KEPPRA 750mg twice a day. Please take this until your neurologist (Dr. [**First Name (STitle) **] tells you to stop. This medication will help prevent seizures. DO NOT DRIVE for 6 months from the date of your last seizure. It is illegal to drive in the state of Massachussetts until you have been seizure free for 6 months. Do not bathe unsupervised, or stand near open flames without supervision. Avoid any activities where a seizure could put you in immediate danger. Please continue to take your other medications as previously prescribed. If you experienc any of the below listed Danger Signs, please contact your doctor or go to the nearest Emergency Room. It was a pleasure taking care of you on this hospitalization. Followup Instructions: You have an appointment with Dr. [**First Name8 (NamePattern2) 85687**] [**Last Name (NamePattern1) **] on Tuesday [**11-13**] at 10am; The office is located at [**Location (un) 85688**]in [**Location (un) 5028**], MA. The phone number there if you have any questions is [**Telephone/Fax (1) 85689**] and their fax is [**Telephone/Fax (1) 85690**]. Department: RHEUMATOLOGY When: TUESDAY [**2104-1-15**] at 8:30 AM With: [**First Name8 (NamePattern2) 11595**] [**Last Name (NamePattern1) 11596**], MD [**Telephone/Fax (1) 2226**] Building: LM [**Hospital Ward Name **] Bldg ([**Last Name (NamePattern1) **]) [**Location (un) 861**] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage [**Name6 (MD) **] [**Name8 (MD) **] MD, [**MD Number(3) 632**] ICD9 Codes: 412, 496, 4589, 4019, 2724
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6516 }
Medical Text: Admission Date: [**2148-11-25**] Discharge Date: [**2148-12-5**] Date of Birth: [**2085-6-11**] Sex: M Service: CARDIOTHORACIC Allergies: Lidocaine / Morphine Attending:[**First Name3 (LF) 5790**] Chief Complaint: Recurrent right chest wall hernia. Major Surgical or Invasive Procedure: [**2148-11-25**]: Right thoracotomy and repair of chest wall hernia. History of Present Illness: Mr. [**Known lastname 13646**] is a 63 year old male s/p right chest wall hernia repair with [**Doctor Last Name 4726**]-tex mesh on [**2148-10-25**] who presented to the postoperative clinic in pain, with erythematous right thoractomy and drainage out the chest tube site. A CT chest revealed rupture of the [**Doctor Last Name 4726**]-tex mesh. Antibiotics were started. He returns for redo right thoractomy and repair of the hernia. Past Medical History: -COPD -OSA -Diabetes II, complicated by neuropathy -Chronic Sinusitis -Obesity -BPH -GERD -Cold induced asthma -OA -Allergic Rhinitis -HTN -PTSD -Hyperlipidemia (on simvastatin) . Past Surgical History: The patient had previous L4-L5 microdiscectomy in [**2142-4-9**]. He has had multiple discectomies in the past in [**2118**], [**2124**], and [**2133**]. -Status post operative fusion of his left ankle following a bimalleolar ankle fracture -Cervical C3-4 spine fusion with persisting cervical cord compression and plexopathy -Lumbar laminectomy for spinal stenosis. Social History: He lives at home with his wife and his son [**Name (NI) **]. [**Name2 (NI) **] 4 adult children who live away and are all described as healthy. He does not smoke. He uses wine or beer occasionally, and 2 cups of coffee a day. He reports the use of a regular diet and sleeps 8 hours per night with nocturia interrupting his sleep every [**3-13**] hours. Family History: He has a daughter today sutures old and two sons 19 and 33 years old all of which are healthy. Physical Exam: VS: T: 98.6 HR: 77-95 SR BP: 108-112/60 Sats: 93% RA Wt: 119 kg BS 121/154/161 General: 63 year-old male in no apparent distress HEENT: normocephalic, mucus membranes moist Card: RRR. normal S1,S2 no murmur Resp: bilateral diminshed breath sounds with bibasilar crackles no wheezes GI: obese, BS+ abdomen soft non-tender/non-distended Extre: warm tr edema Incision: right thoracotomy site with staples, mild erythema extending downward Neuro; Awake, alert, oriented. Walks with a walker Pertinent Results: [**2148-12-3**] WBC-6.4 RBC-3.37* Hgb-10.4* Hct-31.3 Plt Ct-467* [**2148-12-1**] WBC-5.4 RBC-3.14* Hgb-9.8* Hct-29.4 Plt Ct-398 [**2148-11-29**] WBC-5.7 RBC-3.11* Hgb-9.8* Hct-29.1 Plt Ct-344 [**2148-11-28**] WBC-6.0 RBC-2.93* Hgb-9.1* Hct-27.2 Plt Ct-283 [**2148-11-25**] WBC-9.1 RBC-3.99* Hgb-12.2* Hct-37.3 Plt Ct-401 [**2148-12-4**] Glucose-113* UreaN-9 Creat-0.9 Na-136 K-4.7 Cl-97 HCO3-31 [**2148-12-3**] Glucose-171* UreaN-10 Creat-0.8 Na-135 K-4.6 Cl-95* HCO3-32 [**2148-12-2**] Glucose-129* UreaN-8 Creat-0.8 Na-137 K-4.5 Cl-98 HCO3-30 [**2148-12-3**] Calcium-8.3* Phos-4.2 Mg-1.8 [**2148-11-29**] Glucose-117* UreaN-10 Creat-0.7 Na-137 K-4.3 Cl-103 HCO3-26 [**2148-11-28**] Glucose-129* UreaN-15 Creat-1.0 Na-131* K-4.3 Cl-102 HCO3-25 [**2148-11-26**] Glucose-254* UreaN-16 Creat-1.1 Na-125* K-4.9 Cl-95* HCO3-24 [**2148-11-25**] Glucose-352* UreaN-13 Creat-0.9 Na-136 K-4.7 Cl-100 HCO3-25 [**2148-11-29**] Calcium-8.3* Phos-3.6 Mg-1.8 CXR: [**2148-12-3**]: Surgical material is again noted along the inferolateral right chest wall. The amount of pleural fluid tracking along the right chest wall and into the medial right apex, posteriorly, appears to have increased over several days. Heterogeneous opacities at the right lung base are unchanged. The left lung remains well aerated. There is no left pleural effusion or pneumothorax. The cardiomediastinal silhouette is unchanged. IMPRESSION: Apparent increase in right pleural fluid layering along the lateral right chest wall, and in a loculated collection at the posterior right lung apex. [**2148-11-29**]: Moderate right pleural effusion is again seen that tracks along the lateral chest wall and the major fissure. The area of opacification at the right base remains constant. Left lung is well aerated without evidence of definite effusion or consolidation. Persistent cardiomegaly without evidence of vascular congestion. [**2148-11-27**]: Overall stable right pleural effusion and atelectasis following right chest tube removal with no pneumothorax or new abnormality. [**2148-11-26**]: some improved aeration bilaterally without evidence of pneumothorax. Continued enlargement of the cardiac silhouette with atelectatic changes at the bases. No evidence of pulmonary vascular congestion. [**2148-11-25**]: The large right pleural effusion may be smaller in size, or fluid may have shifted to the medial hemithorax. Relatively diffuse opacity at the right lung base may represent atelectasis. There is no left-sided consolidation or pleural effusion. There is no pneumothorax. The cardiomediastinal silhouette is grossly unchanged. Echocardiogram: [**2148-12-2**] The left atrium is mildly dilated. Left ventricular wall thickness, cavity size and regional/global systolic function are normal (LVEF >55%). The estimated cardiac index is normal (>=2.5L/min/m2). 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. There is moderate pulmonary artery systolic hypertension. There is no pericardial effusion. IMPRESSION: Pulmonary artery systolic hypertension. Normal biventricular cavity sizes with preserved global and regional biventricular systolic function. Brief Hospital Course: Mr. [**Known lastname 13646**] is 63 year-old male admitted following right redo thoracotomy and chest wall hernia repair. He was extubated in the operating room, and monitored in the PACU prior transfer to the floor. Once transfer to the floor he was found to be hypovolemic with low urine output requiring large fluid challenges. On [**2148-11-27**] he was transferred to the TSICU for hypotension, which he was given more fluids. He transfer back to the floor in stable condition on [**2148-11-29**]. Respiratory: The patient required aggressive pulmonary toilet with around the clock nebulizers. He continued with his home CPAP for OSA/COPD at night. Pulmonology followed him throughout his hospital course. On [**2148-12-2**] it was felt he was volume overloaded gently diuresed with good effect. He was weaned off oxygen saturating mid 90's on room air. Goal oxygen saturations: 89-94%. Chest tube was removed on [**2148-11-28**]. Followed by serial chest films (see above report) Cardiac: He was tachycardic in the ICU which responded to Lopressor. On the floor he became hypertensive and his tachycardia in low 100's persisted. An echocardiogram was done and showed normal EF with moderate pulmonary artery systolic hypertension of 45 mm Hg. His home dose lisinopril of 40 mg po bid was restarted and up titrated his metoprolol to 37.5 mg po tid, with good effect. GI: He had normal bowel movements and remained on proton pump inhibitors. Renal: He was hyponatremic with sodium of 126, which improved with normal saline to 137. Renal function remained within normal range. The Foley was removed on [**2148-11-29**] once the epidural was removed, and he voided well thereafter. He was diuresed for volume overload on [**2148-11-29**] once and started daily on [**2148-12-2**], with positive response in overall clinical status. Endocrine: His blood sugar range varied 100-400. [**Last Name (un) **] was consulted and adjusted his insulin to maintain adequate glucose control. Pain: Epidural Bupivacaine and morphine PCA was initially used for pain control. The was transition ed to MS Contin and lidocaine patch for good pain control. His pain improved on [**2148-11-29**] the epidural and PCA were stopped. He continued with MS Contin and morphine immediate release for breakthrough pain. ID: incision with staples mild erythema extending downward. He remained afebrile WBC within normal range. A 10 day course Augmentin 875 [**Hospital1 **] was started for possible cellulitis in a patient with Gortex mesh. During admission, pt noted tooth pain and subsequently received panorex which did reveal abscess and pt was cleared by dental consultation service. Disposition: He was seen by physical therapy who recommended short term rehab. He was discharged to [**Hospital1 19286**] in [**Hospital1 3597**] ([**Telephone/Fax (1) 94339**]) on [**2148-12-5**] and will follow-up with Dr. [**Last Name (STitle) **] as an outpatient. Medications on Admission: NPH 55 units QHS Novolog 27 units before dinner Glipizide 2.5 mg in AM and 7.5 mg in PM Buspirone 10 mg [**Hospital1 **] PER LAST D/C summary: Lisinopril 40 mg [**Hospital1 **] Oxybutynin Chloride 2.5 mg TID Paroxetine HCl 50 mg Daily Simvastatin 20 mg daily Aspirin 81 mg DAILY Omeprazole 40 mg daily Cyanocobalamin (Vitamin B-12) 100 mcg daily Albuterol Sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig: Two (2) puffs Inhalation every 4-6 hours as needed for shortness of breath or wheezing. Fluticasone-Salmeterol 250-50 mcg/Dose 1 puff [**Hospital1 **] Pregabalin 25 mg TID Prednisone 10 mg Tablets, Dose Pack Sig: dose pack, see instructions Tablets, Dose Pack PO once a day for 6 days: take 4 tablets a day for 2 days, 2 tablets a day for 2 days, 1 tablets a day for 2 days then stop. Azithromycin 250 mg for 4 day Discharge Medications: 1. oxybutynin chloride 5 mg Tablet Sig: 0.5 Tablet PO TID (3 times a day). 2. pregabalin 25 mg Capsule Sig: One (1) Capsule PO TID (3 times a day). 3. simvastatin 20 mg Tablet Sig: One (1) Tablet PO once a day. 4. buspirone 10 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 5. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: Two (2) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 6. morphine 30 mg Tablet Sustained Release Sig: One (1) Tablet Sustained Release PO Q12H (every 12 hours). 7. lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: One (1) Adhesive Patch, Medicated Topical DAILY (Daily). 8. senna 8.6 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime). 9. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 10. polyethylene glycol 3350 17 gram/dose Powder Sig: One (1) packet PO DAILY (Daily). 11. paroxetine HCl 25 mg Tablet Sustained Release 24 hr Sig: Two (2) Tablet Sustained Release 24 hr PO DAILY (Daily). 12. morphine 15 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for breakthrough pain. 13. fluticasone-salmeterol 250-50 mcg/dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). 14. Lasix 20 mg Tablet Sig: One (1) Tablet PO once a day: for a week then reevaluate volume status. You should have electrolytes checked on lasix and replaced as necessary. 15. heparin (porcine) 5,000 unit/mL Solution Sig: One (1) injection Injection TID (3 times a day): if immobile in rehab. 16. lisinopril 20 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 17. metoprolol tartrate 25 mg Tablet Sig: 1.5 Tablets PO Q 8H (Every 8 Hours). 18. ipratropium bromide 0.02 % Solution Sig: One (1) neb Inhalation Q6H (every 6 hours) as needed for shortness of breath or wheezing. 19. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) neb Inhalation Q4H (every 4 hours) as needed for shortness of breath or wheezing. 20. amoxicillin-pot clavulanate 875-125 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) for 10 days. 21. Humalog sliding scale 71-100 mg/dL 5 Units 5 Units 5 Units 0 Units 101-150 mg/dL 5 Units 5 Units 5 Units 0 Units 151-200 mg/dL 7 Units 7 Units 7 Units 0 Units 201-250 mg/dL 9 Units 9 Units 9 Units 2 Units 251-300 mg/dL 11 Units 11 Units 11 Units 4 Units 301-350 mg/dL 13 Units 13 Units 13 Units 6 Units 351-400 mg/dL 15 Units 15 Units 15 Units 8 Units 22. insulin glargine 100 unit/mL Solution Sig: Twenty (20) units Subcutaneous at bedtime. Discharge Disposition: Extended Care Facility: [**Hospital1 **] Discharge Diagnosis: -COPD -OSA -Diabetes II, complicated by neuropathy -Chronic Sinusitis -Obesity -BPH -GERD -Cold induced asthma -OA -Allergic Rhinitis -HTN -PTSD -Hyperlipidemia (on simvastatin Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Call Dr.[**Name (NI) 2347**] office [**Telephone/Fax (1) 2348**] if you experience: -Fevers > 101 or chills -Incision develops drainage or increased redness -Shortness or breath or cough Staples will be removed on your follow-up visit. You may shower. No tub bathing or swimming until all incisions healed Antibiotics: Augmentin 875 mg [**Hospital1 **] for 10 days. Followup Instructions: Follow-up with Dr. [**Last Name (STitle) **] [**Telephone/Fax (1) 2348**] [**2148-12-17**] 1:00pm on [**Hospital1 18**] [**Hospital Ward Name **] [**Hospital Ward Name 23**] 9 Chest X-Ray [**Location (un) 861**] Radiology 30 minutes before your appointment Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 143**], MD Phone:[**Telephone/Fax (1) 142**] Date/Time:[**2148-12-11**] 3:30 Followup with your dentist if your right back gum lesions to do disappear. You had a panorex in the hospital showing this area was not absessed. Completed by:[**2148-12-5**] ICD9 Codes: 2762, 4280, 3572, 2724, 4019
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Medical Text: Admission Date: [**2142-9-14**] Discharge Date: [**2142-9-21**] Date of Birth: [**2070-7-26**] Sex: M Service: MEDICINE Allergies: Penicillins Attending:[**First Name3 (LF) 800**] Chief Complaint: Generalized Malaise w/Fevers x 2 weeks, Hypoxia, and pancytopenia Major Surgical or Invasive Procedure: None History of Present Illness: Patient is a 72 y/o M with a history of CAD, HTN, and BPH who reports having fevers at home x2 weeks as well as urinary urgency x 2 weeks that is new for him. Prior to the onset of the patient's fevers, he reports being bitten by a long green bug while in the parking lot of [**Company 10414**]. The bite area became indurated, erythematous, but never necrotic. The day following the bite, the patient reported feeling generalized malaise, then began developing fevers, mainly at night, but continued working throughout the day. Given his symptoms, the pt went to see his PCP 3 times over the last week, and was prescribed Ciprofloxacin on [**2142-9-11**] for his symptoms. He underwent an abdominal CT as well as blood testing, which showed new pancytopenia as well as splenomegaly on CT. Lyme serology sent as an outpatient was negative. In addition, the pt's PCP had noted the pt's BP to be slowly downtrending over the last week, and several of his anti-hypertensives were held. The patient was then referred to the ED to be evaluated for his persistent fevers, malaise and new pancytopenia Past Medical History: CAD s/p stent placement in '[**35**] off Plavix/ASA -->Exercise MIBI in [**2-19**]: IMPRESSION: 1. Moderate size and intensity reversible perfusion defect in the LAD territory. 2. Mild hypokinesis in the area of decreased perfusion, consistent with post-stress stunning. Calculated EF 47%. *HTN *BPH *Hematuria *Infraaortic aneuysm: 3.4 x 3.2 cm Social History: Works as a psychologist. Divorced, but dating two women, which has apparently become a stressful situation. Denies illicit drug use, drinks 3-4 alcoholic drinks daily. No history of ETOH withdrawl or seizures. 20 pk year history of tobacco, quit 20 years ago. Family History: none, one brother healthy Physical Exam: Vitals: T:97.4 BP:119/75 P:76 RR:24 O2Sat: 93%3L Gen: Somewhat diaphoretic appearing, pleasant, elderly gentleman HEENT: PERRL, EOMI, mild scleral icterus, pale conjunctiva. NECK: supple, no LAD appreciated CV: Regular, nl S1/S2 without audible murmur. No carotid bruits. LUNGS: [**Hospital1 **]-basilar crackles without wheezing. ABD: softly distended. No tenderness to palpation. Normal bowel sounds. No hepatomegaly. Spleen tip not palpable. No ascites. EXT/SKIN: No asterixis, no rashes, no petechiae. Skin appears slightly jaundiced. No splinter hemorrhages, no [**Last Name (un) **] lesions. Extremities warm, well perfused without lower extremity edema. GU: Dried blood and external hemorrhoids visualized. Prostate smooth and somewhat tender on exam. Guaiac +. Pertinent Results: [**2142-9-13**] 01:05PM BLOOD WBC-4.4 RBC-3.57* Hgb-11.0* Hct-30.6* MCV-86 MCH-30.8 MCHC-35.9* RDW-15.5 Plt Ct-57* [**2142-9-19**] 05:45AM BLOOD WBC-4.5 RBC-2.44* Hgb-7.3* Hct-21.5* MCV-88 MCH-30.0 MCHC-34.1 RDW-16.4* Plt Ct-112* [**2142-9-19**] 04:38PM BLOOD Hct-27.9*# [**2142-9-21**] 06:50AM BLOOD WBC-8.1 RBC-2.87* Hgb-8.5* Hct-25.4* MCV-89 MCH-29.8 MCHC-33.7 RDW-16.6* Plt Ct-197 [**2142-9-20**] 05:50AM BLOOD Neuts-72.9* Lymphs-22.4 Monos-3.6 Eos-1.0 Baso-0.2 [**2142-9-13**] 01:05PM BLOOD Neuts-70 Bands-4 Lymphs-14* Monos-10 Eos-0 Baso-2 Atyps-0 Metas-0 Myelos-0 [**2142-9-14**] 03:54PM BLOOD PT-14.4* PTT-66.4* INR(PT)-1.3* [**2142-9-17**] 11:00AM BLOOD PT-13.4 PTT-32.1 INR(PT)-1.2* [**2142-9-16**] 04:15AM BLOOD Fibrino-536* [**2142-9-15**] 08:28AM BLOOD Parst S-POS [**2142-9-20**] 05:50AM BLOOD Parst S-THICK SMEAR REVIEWED [**2142-9-15**] 01:13AM BLOOD Ret Aut-0.6* [**2142-9-18**] 05:25AM BLOOD Ret Aut-0.7* [**2142-9-14**] 10:05AM BLOOD Glucose-137* UreaN-44* Creat-2.0* Na-136 K-3.2* Cl-99 HCO3-26 AnGap-14 [**2142-9-21**] 06:50AM BLOOD Glucose-113* UreaN-35* Creat-1.5* Na-138 K-4.1 Cl-104 HCO3-29 AnGap-9 [**2142-9-13**] 01:05PM BLOOD ALT-45* AST-99* AlkPhos-34* TotBili-2.1* DirBili-0.8* IndBili-1.3 [**2142-9-17**] 11:00AM BLOOD ALT-276* AST-389* LD(LDH)-999* AlkPhos-40 TotBili-1.8* [**2142-9-20**] 05:50AM BLOOD ALT-180* AST-116* LD(LDH)-574* AlkPhos-41 Amylase-68 TotBili-1.3 [**2142-9-14**] 03:54PM BLOOD Calcium-7.2* Phos-2.9 Mg-2.1 [**2142-9-21**] 06:50AM BLOOD Calcium-8.4 Phos-4.0 Mg-1.8 [**2142-9-15**] 01:13AM BLOOD calTIBC-164* Hapto-<20* Ferritn->[**2134**] TRF-126* [**2142-9-14**] 10:05AM BLOOD HBsAg-NEGATIVE HBsAb-POSITIVE IgM HAV-NEGATIVE [**2142-9-15**] 01:13AM BLOOD Type-ART Temp-37.5 O2 Flow-52 pO2-68* pCO2-31* pH-7.51* calTCO2-26 Base XS-1 [**2142-9-18**] 12:18AM BLOOD Type-ART pO2-68* pCO2-34* pH-7.54* calTCO2-30 Base XS-6 . CXR [**9-15**] No acute intrathoracic process. Low lung volumes. [**9-16**] Low lung volumes. Bibasilar atelectasis. [**9-17**] In comparison with study of [**9-16**], there is substantial increase in the thick streaks of atelectatic change at both bases. The upper zones are essentially clear. No evidence of pleural effusion or vascular congestion [**9-18**] In comparison with study of [**9-17**], some decrease in the thick streaks of atelectasis at both bases. However, some significant atelectasis persists in this patient with even lower lung volumes . CT abdomen 1. Interval development of splenomegaly with a linear/wedge-shaped peripheral hypodensity, most consistent with a perfusion abnormality. Clinical correlation is recommended. Given the patient's history of fever, the enlargement of the spleen may be secondary to a viral process. 2. Abdominal aortic aneurysm measuring 3.6 x 3.4 cm in size. 3. Colonic diverticulosis. 4. Enlargement of the prostate gland. 5. Atherosclerosis with involvement of the coronary arteries. . LE US There is normal compressibility, augmentation, color Doppler signal, and Doppler waveform within the common femoral vein, superficial femoral vein, popliteal vein bilaterally. Tibial and peroneal veins also demonstrate normal signal and compression. . ECHO The left atrium is normal in size. There is mild symmetric left ventricular hypertrophy. The left ventricular cavity size is normal. Overall left ventricular systolic function is normal (LVEF>55%). The right ventricular cavity is mildly dilated with normal free wall contractility. The aortic valve leaflets are mildly thickened. There is no aortic valve stenosis. Trace aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Trivial mitral regurgitation is seen. There is a trivial/physiologic pericardial effusion. Brief Hospital Course: Pt presented to the Ed from PCP office with fever, confusion, down-trending BP pancytopenia and CT evidence of splenomegaly. He also was found to have an oxygen saturation of 89%. . He was admnited to the MICU where he was found to have babesiosis on peripheral smear. Lyme and Erlichia serologies were sent. Lyme serology was negative, Elrichia is still pending. ID and Hem/Onc consultations were obtained. He was started on quinine, doxy and clindamycin. He was also found to have hemolytic anemia, elevated liver enzymes and acute renal failure. During his stay in the MICU the patient experineced dyspnea and had cracles on PE. An echo showed EF of 55 and no other acute processes. After two days in the MICU, the patient admited to symptomatic improvement and he was transfered to the floor. Both his pancytopenia, elevated liver enzymes and the number of parasites on the smear were improved at this point in time. . In the [**Hospital1 **] the patient was switched from quinine/clindamycin to atovoquine/azithromycin. . The patient's leucopenia and thrombocytopenia continued to improve, yet his HCT was trending down. His reticulocyte count at this time was 0.9, while LDH was trtending down. The patient was started on Folate and B12 to assist the marrow response. The pateient reached a nadir HCT of 21.5 reuiring transfusion of 1 unit pRBCs. This lead to HCT elevation to 27.9, which then stabilized at 25-26. The patient's ARF remained stable in this setting, while his liver function test improved. . The patient's dyspnea improved with inhaled Albuterol and Ipratropium bromide, as well as gentle diuresis. The patient had bilateral LE U/S, negative for DVT. He was able to saturate in the mid 90's in the absence of oxygen, and while ambulating prior to discharge. . The patient is to continue atovoquine and azithromycin and Doxycycline as outpatient therapy. . The patient is recommended to have outpatient follow up to determine resolution of his anemia and ARF. Medications on Admission: Metoprolol 25 mg b.i.d. - reduced to 25mg daily Lisinopril 20 mg daily - on hold Lipitor 40 mg daily HCTZ 25mg daily - on hold Lorazepam prn Cialis prn . Discharge Medications: 1. Metoprolol Succinate 25 mg Tablet Sustained Release 24 hr Sig: 0.5 Tablet Sustained Release 24 hr PO BID (2 times a day). 2. Lisinopril 20 mg Tablet Sig: One (1) Tablet PO once a day. 3. Lipitor 40 mg Tablet Sig: One (1) Tablet PO once a day. 4. Hydrochlorothiazide 25 mg Tablet Sig: One (1) Tablet PO once a day. 5. Atovaquone 750 mg/5 mL Suspension Sig: One (1) PO BID (2 times a day) for 11 days. Disp:*22 Doses* Refills:*0* 6. Azithromycin 250 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours) for 11 doses. Disp:*11 Tablet(s)* Refills:*0* 7. Doxycycline Hyclate 100 mg Tablet Sig: One (1) Tablet PO twice a day for 4 days. Disp:*8 Tablet(s)* Refills:*0* 8. Albuterol 90 mcg/Actuation Aerosol Sig: One (1) Inhalation every four (4) hours as needed for shortness of breath or wheezing. Disp:*1 Inhaler* Refills:*3* 9. Ipratropium Bromide 0.02 % Solution Sig: One (1) Inhalation Q6H (every 6 hours) as needed for wheeze. Disp:*1 Inhaler* Refills:*3* 10. Outpatient Lab Work Blood draw: CBC, ferritin, iron, TIBC, Vitamin B12, Folate. To be drawn at the time of your outpatient follow-up apppointment on [**2142-9-26**]. Discharge Disposition: Home Discharge Diagnosis: Babesiosis Discharge Condition: Stable Discharge Instructions: You were admited with fever and hypotension and found to have Babesia infection and may also have Ehrlichia - both tick borne illnesses. You were started on an antibiotic regimen and your infection is getting beter. Please complete a course of antibiotics for this problem. Take Azithromycin and Atovaquone until [**2142-10-1**] and Doxycycline until [**2142-9-24**]. You also had shortness of breath which is also getting better with fluid removal. This likely was due to fluid overload plus a component of reactive airway disease. You may continue to take an albuterol and ipratropium inhaler as necessary for shortness of breath. Please discuss this issue further with your primary care doctor. Your infection was complicated by anemia, which we attributed to blood cell destruction secondary to infection. You required transfusion of red blood cells while in the hospital. You must have your blood checked early next week to monitor your blood count to further work-up your anemia. Please call your regular doctor or return to the ED if you develop: fevers chills shortness of breath chest pain fatigue lightheadedness bleeding or any other symptom that is unusual for you. Followup Instructions: Please make sure to follow up with your regular doctor. [**First Name (Titles) 6**] [**Last Name (Titles) 10415**]t has been scheduled for you with Dr [**Last Name (STitle) 2903**] on Wed, [**9-26**]. Please call the office on Monday to determine the time of appointment. Please have your blood drawn at that appointment to monitor for anemia and further work-up this problem. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 810**] MD, [**MD Number(3) 811**] Completed by:[**2142-9-21**] ICD9 Codes: 5849, 2875, 4019
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Medical Text: Admission Date: [**2147-11-13**] Discharge Date: [**2147-11-15**] Service: NEUROSURGERY Allergies: Diovan / Fosamax / Prinivil / 4-Aminoquinolines / pecans and fish Attending:[**First Name3 (LF) 78**] Chief Complaint: Elective admission for evacuation of the subdural hematoma Major Surgical or Invasive Procedure: [**2147-11-13**]: Left sided burr holes for evacuation of SDH History of Present Illness: Elective admission for evacuation of the left subdural hematoma Past Medical History: HTN CAD Hypothyroidism Dementia High cholesterol Cardiac stent > 10 yrs ago Social History: Previously lived alone in an apartment with a daughter who lives upstairs, but sent to rehab from her last admission. Family History: Non-contributory Physical Exam: On admission: Awake, Alert, Oriented to self, place, and month. [**Last Name (LF) 2994**], [**First Name3 (LF) 2995**]. Upon discharge: Neurologically intact left sided cranial wound C/D/I with nylon suture closure Pertinent Results: [**2147-11-14**] Head CT w/o contrast: S/p evacuation of septated left subdural hematoma. Decreased posterior compartment of the hematoma with decreased mass effect on the left parietal and temporal structures. In the anterior compartment of the hematoma, fluid has been replaced by air, and mass effect on the left frontal structures is unchanged. Brief Hospital Course: 87F elective admission for surgical evacuation of the subdural hematoma. Please see operative report for full details. Post-op she was admitted to the ICU for monitoring. She remained stable overnight. A post-op CT Head was performed on [**11-14**] which showed decreased posterior compartment of the hematoma with decreased mass effect on the left parietal and temporal structures. She was transferred to the floor on [**11-14**] where she was assessed by PT/OT for transfer back to rehab. Her neurological status remained stable. She is discharged to extended care facility in stable condition. Medications on Admission: levothyroxine, Plavix, One Daily Multivitamin, calcium, Aspirin, Isordil Titradose, amlodipine, simvastatin, donepezil, metoprolol tartrate Discharge Medications: 1. pneumococcal 23-valps vaccine 25 mcg/0.5 mL Injectable Sig: One (1) ML Injection NOW X1 (Now Times One Dose). 2. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed for pain fever. 3. metoprolol tartrate 50 mg Tablet Sig: Two (2) Tablet PO TID (3 times a day). 4. levothyroxine 88 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. calcium carbonate 200 mg calcium (500 mg) Tablet, Chewable Sig: One (1) Tablet, Chewable PO TID (3 times a day). 7. amlodipine 5 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime). 8. simvastatin 40 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 9. donepezil 10 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 10. levetiracetam 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 11. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 12. isosorbide dinitrate 20 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). Discharge Disposition: Extended Care Facility: [**Location (un) 34004**] Nursing & Rehabilitation Center - [**Location (un) 14663**] Discharge Diagnosis: Left subacute subdural hematoma with midline shift Discharge Condition: Mental Status: Confused - sometimes. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). 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 in three days. ?????? 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 (Levetiracetam), you will not require blood work monitoring for this med, but continue to take until directed to discontinue by your Neurosurgeon. ?????? Clearance to drive and return to work will be addressed at your post-operative office visit. ?????? Make sure to continue to use your incentive spirometer while at home, unless you have been instructed not to. Followup Instructions: Please follow-up with Dr [**First Name (STitle) **] in 4 weeks with a Head CT w/o contrast. Please call [**Telephone/Fax (1) 4296**] to make the appointment. Please follow up with your PCP regarding this admission. Completed by:[**2147-11-15**] ICD9 Codes: 4019, 2449, 2720
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Medical Text: Admission Date: [**2122-9-22**] Discharge Date: [**2122-9-29**] Date of Birth: [**2059-1-8**] Sex: F Service: MEDICINE Allergies: Percocet / Motrin / Nsaids / Aspirin / Dilantin / Ativan Attending:[**First Name3 (LF) 1973**] Chief Complaint: Altered mental status Major Surgical or Invasive Procedure: Intubation History of Present Illness: 63F with multiple medical problems and multiple admissions for altered mental status presenting with abdominal pain and altered mental status. Ms. [**Known lastname **] [**Last Name (Titles) 1834**] exploratory laparotomy on [**2122-9-11**] and was found to have benign cecal pneumatosis. The patient presents now for progressive confusion and decreased mental acuity. The family is not available to discuss their concerns and the patient complains of unchanged abdominal pain. In the ED her vitals were 98.2 99 123/39 17 99%RA. FSG was 86 on arrival. Exam showed A+O x 1. Labs were c/w ESRD, with AG acidosis, but no hyperkalemia. Neurology was consulted given the AMS, and felt it was due to a toxic-metabolic encephalopathy and not a central insult or seizure. CXR was unrevealing except for LLL atelectasis. No urine able to be obtained but blood cultures were sent. A CT head was negative. A CT abdomen and pelvis was obtained which showed no acute process or abscess, but a small hematoma/stranding in the anterior subcutaneous tissues and likely also left rectus, c/w recent surgery. Her HR did increase to the 140s in the ED, responded to IV labetolol, but pressure dropped. This responded to IVF. She was given 250mg of levetiracetam and admitted to medicine for further workup of AMS and correction of electrolytes. Past Medical History: PMH: 1. Multiple admission with altered MS recently ([**10-13**]) - with recent extensive neurological workup revealing multifocal etiology likely due to HD fluid/electrolyte shifts, ? uremia prior to HD, also component of vascular dementia. Started on [**Month/Year (2) 13401**] [**9-14**]. 2. Diabetes mellitus. 3 End-stage renal disease secondary to diabetes mellitus s/p failed dual extended-criteria donor renal transplant (BK virus nephropathy) 4. Hemodialysis. 5. Hypertension. 6. Hyperlipidemia. 7. Thrombosis of bilateral IVJ (catheter placement)-- DVT associated with HD catheter RUE on anticoagulation (Coumadin) --balloon angioplasty performed [**1-13**]. 8. Osteoarthritis. 9. PER OMR NOTES (?) - Arthritis of the left knee at age nine, treated with ACTH resulting in secondary [**Location (un) **]. She was diagnosed with rheumatic fever. 10. h/o Trach and PEG [**1-13**] (reversed [**2-13**]). 11. h/o L tension pneumothorax [**2-7**] intubation . Past Surgical History: 1. Kidney transplant in [**2119**] b/l in RLQ 2. Left arm AV fistula for dialysis. 3. Removal of remnant of AV fistula, left arm. 4. Catheter placement for hemodialysis. 5. Low back surgery (unspecified) Social History: The patient smokes half a pack of cigarettes a day for the last 20 years. She does not drink alcohol or has ever experienced with recreational drugs, has no tattoos. The patient has had transfusions in [**2119**] and [**2120**]. The patient is a homemaker. The patient has experienced economic problems lately. . Family History: Family History: From prior d/c summary Mother and sister with diabetic mellitus. Kidney failure in mother, sister Physical Exam: On admission to ICU PE: intubated, sedated, NAD VS: T 98.0 BP 157/64--> 80s/40s with propofol HR 96 RR 12, 100% AC 100% 500 x 20 5 General: intubated, sedated HEENT: tongue is swollen and protruding from her mouth, blood visible around ET tube, lips swollen. L pupil briskly reactive to light from 3 mm --> 1 mm; R pupil is sluggish, 3 mm --> 2 mm. anicteric . NECK: no JVD, supple CV: +s1s2 RRR 2/6 systolic murmur, no R/G. +L.sided tunnel cath no erythema, C/D/I, currently accessed/receiveing IVF. PULM: CTA B/L ABD: +bs, midline inscision c/d/i, staples in place, soft, ND. EXT: no C/C/edema 2+pulses b/l NEURO: intubated/sedated. moves all 4. Pertinent Results: Admission labs: [**2122-9-21**] 04:00PM PLT COUNT-415 [**2122-9-21**] 04:00PM NEUTS-67.4 LYMPHS-20.1 MONOS-9.8 EOS-2.6 BASOS-0.1 [**2122-9-21**] 04:00PM WBC-8.3 RBC-2.72* HGB-9.1* HCT-27.7* MCV-102* MCH-33.3* MCHC-32.7 RDW-16.1* [**2122-9-21**] 04:00PM ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG [**2122-9-21**] 04:00PM CALCIUM-9.7 PHOSPHATE-8.0*# MAGNESIUM-2.5 [**2122-9-21**] 04:00PM GLUCOSE-58* UREA N-49* CREAT-13.8*# SODIUM-136 POTASSIUM-6.8* CHLORIDE-99 TOTAL CO2-21* ANION GAP-23* [**2122-9-21**] 04:09PM LACTATE-1.4 K+-4.6 [**2122-9-21**] 05:24PM PT-18.3* PTT-29.2 INR(PT)-1.7* [**2122-9-22**] 06:50AM PLT COUNT-421 [**2122-9-22**] 06:50AM WBC-8.5 RBC-2.83* HGB-9.2* HCT-29.4* MCV-104* MCH-32.7* MCHC-31.4 RDW-15.5 [**9-21**] CT ABD/PELVIS: no acute process, diverticulosis, extensive atherosclerotic changes, left anterior subcutaneous tissue stranding with hematoma-post surgical, extensive collateral circulation, suggestive of an upper extremity thrombus. CT HEAD (noncontrast) [**9-21**]: no acute intracranial process, multiple lacunar infarcts, chronic small vessel ischemic disease (unchanged) EEG: This is an abnormal 24-hour video EEG telemetry in the waking and sleeping states due to the occasional left mid-temporal sharp waves suggestive of a potential focus of epileptogenesis. In addition, there were bursts of generalized delta frequency slowing suggestive of midline subcortical dysfunction. Nonetheless, there were no electrographic seizures and no pushbutton activations noted. [**2122-9-29**] 01:30PM BLOOD WBC-6.4 RBC-3.28* Hgb-10.9* Hct-33.7* MCV-103* MCH-33.3* MCHC-32.4 RDW-16.6* Plt Ct-470* [**2122-9-29**] 01:30PM BLOOD Plt Ct-470* [**2122-9-29**] 01:30PM BLOOD PT-27.6* PTT-131.8* INR(PT)-2.8* [**2122-9-29**] 01:30PM BLOOD Glucose-134* UreaN-36* Creat-9.5*# Na-136 K-3.7 Cl-97 HCO3-26 AnGap-17 [**2122-9-29**] 01:30PM BLOOD Calcium-8.6 Phos-5.8* Mg-2.2 Brief Hospital Course: 1. Altered mental status/seizure/intubation: most likely etiology is multiple missed hemodialysis sessions/uremia. It is possible the Tylenol with codeine she was taking for post operative pain control contributed. The morning following admission she had an episode of decreased responsiveness, clonic jerks, lip smacking and hand automatisms. She was evaluated by neurology and was given Ativan and Depakote for complex partial seizure. Approximately 1 hour after this she became unresponsive and her tongue was swollen. She was intubated for airway protection due to angioedema. Her mental status normalized (thought to be related to post-ictal state and medications), EEG was negative for status epilepticus, head CT and toxicology screens were negative. The patient required daily dialysis from [**Date range (3) 45315**] and her mental status normalized and was stable for several days at discharge. 2. Angioedema/respiratory failure: Her tongue was noted to be swollen prior to the administration of Depakote during suctioning prior to intubation. The angioedema seemed to correlate with the Ativan administration. There is a report of angioedema in the past, attributed to Dilantin--but she received Ativan at that time as well. She was treated for 24 hours with steroids with remarkable improvement. Her lisinopril was also discontinued. Her intubation was for airway protection in the setting of altered mental status and angioedema. She had persistent apneic episodes on the ventilator and never developed a cuff leak. She has presumed tracheal stenosis from prior tracheostomy. She was successfully extubated in the presence of anesthesia on [**2122-9-25**]. It is recommended she have an outpatient sleep study to evaluate for obstructive sleep apnea as well as an outpatient allergy evaluation. 3. Seizures: The patient suffered a partial complex seizure on the morning after admission. The neurology team followed the patient throughout her admission. She was initially loaded with depakote, however, this was then tapered off and her [**Date Range 13401**] dosing was increased to 500 mg twice daily and an additional dose following hemodialysis. She will follow up with Neurology as an outpatient. 4. ESRD on HD: She missed two outpatient HD sessions prior to admission. She was dialyzed daily in the MICU from [**Date range (1) 45316**] then returned to her scheduled of T/T/Saturday. 5. Atrial fibrillation: Rate control with metoprolol. She had a single episode of RVR in the ED prior to admission which responded to labetalol, otherwise, she was effectively rate controlled. Her INR was subtherapeutic at admission, but was therapeutic at discharge. Her INR will need to be followed in rehabilitation and outpatient monitoring set up prior to discharge home. 6. Abdominal Pain: likely post operative, waxed and waned on this admission. At the time of discharge, the pain was controlled by Tylenol. Her staples were removed by the surgical team during this hospitalization. She had increased discharge from her abdominal wound noted on [**2122-9-28**]. The surgery team evaluated and felt the wound was healing well and there was no evidence of a wound infection. They recommended daily dry dressing changes. 7. Benign Hypertension: continued on amlodipine and metoprolol. Lisinopril discontinued in the setting of angioedema and not restarted. The amlodipine was started in its place. Her blood pressure ranged 110-140s/50-70s prior to discharge. 8. Disposition: the patient was discharged to a rehabilitation facility. She will benefit from a home safety evaluation and visiting nurses to evaluate medication understanding/compliance. She requires INR monitoring. As an outpatient, she should have an allergy evaluation for the recurrent angioedema as well as a sleep study to evaluate sleep apnea. Medications on Admission: MEDS: 1. Metoprolol Succinate 100 mg Tablet Sustained Release 24 hr [**Date Range **]: One (1) Tablet Sustained Release 24 hr PO once a day. 2. Atorvastatin 20 mg Tablet [**Date Range **]: One (1) Tablet PO once a day. 3. B Complex-Vitamin C-Folic Acid 1 mg Capsule [**Date Range **]: One (1) Cap PO DAILY (Daily). 4. Cinacalcet 90 mg Tablet [**Date Range **]: One (1) Tablet PO once a day. 5. Sertraline 100 mg Tablet [**Date Range **]: One (1) Tablet PO once a day. 6. Lisinopril 5 mg Tablet [**Date Range **]: One (1) Tablet PO DAILY (Daily). 7. Acetaminophen-Codeine 300-30 mg Tablet [**Date Range **]: One (1) Tablet PO Q4H (every 4 hours) as needed for pain. Disp:*20 Tablet(s)* Refills:*0* 8. Warfarin 1 mg Tablet [**Date Range **]: Two (2) Tablet PO once a day: Please restart [**2122-9-18**]. Do NOT dose on [**9-17**]. 9. Levetiracetam 250 mg Tablet [**Month/Year (2) **]: One (1) Tablet PO twice a day: Started with previous admission 10. Levetiracetam 250 mg Tablet [**Month/Year (2) **]: One (1) Tablet PO following HD. Discharge Medications: 1. Metoprolol Tartrate 50 mg Tablet [**Month/Year (2) **]: One (1) Tablet PO TID (3 times a day). 2. Atorvastatin 20 mg Tablet [**Month/Year (2) **]: One (1) Tablet PO DAILY (Daily). 3. B Complex-Vitamin C-Folic Acid 1 mg Capsule [**Month/Year (2) **]: One (1) Cap PO DAILY (Daily). 4. Cinacalcet 30 mg Tablet [**Month/Year (2) **]: Three (3) Tablet PO DAILY (Daily). 5. Sertraline 100 mg Tablet [**Month/Year (2) **]: One (1) Tablet PO DAILY (Daily). 6. Warfarin 1 mg Tablet [**Month/Year (2) **]: One (1) Tablet PO DAILY (Daily). 7. Levetiracetam 500 mg Tablet [**Month/Year (2) **]: One (1) Tablet PO BID (2 times a day). 8. Levetiracetam 500 mg Tablet [**Month/Year (2) **]: One (1) Tablet PO HD PROTOCOL (HD Protochol). 9. Amlodipine 5 mg Tablet [**Month/Year (2) **]: Two (2) Tablet PO DAILY (Daily). 10. Acetaminophen 500 mg Tablet [**Month/Year (2) **]: 1-2 Tablets PO Q6H (every 6 hours) as needed: not to exceed 4 grams/24 hours. Discharge Disposition: Extended Care Facility: [**Hospital3 1186**] - [**Location (un) 538**] Discharge Diagnosis: Primary: Altered mental status Uremia Angioedema Respiratory failure Complex partial seizure Secondary Hypertension End stage renal disease on hemodialysis Atrial fibrillation Seizure Disorder Failed renal transplant X 2 Hyperlipidemia Discharge Condition: At mental status baseline, pain controlled, tolerating diet Discharge Instructions: You were admitted with confusion in the setting of missed hemodialysis sessions. In the hospital, you had a seizure and a reaction to a medication which caused your tongue to swell and necessitated a breathing tube. You had several daily dialysis sessions and your confusion resolved. You had abdominal pain which was controlled with Tylenol. Surgery evaluated your wound and thought you were healing well. You are being discharged to a rehabilitation facility to regain your strength after the long hospitalization. Followup Instructions: Please call your primary provider, [**Last Name (NamePattern4) **]. [**Last Name (STitle) **] [**Telephone/Fax (1) 45317**] for an appointment within 1 week of rehabilitation discharge. Surgery Follow Up: Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1330**], MD Phone:[**Telephone/Fax (1) 673**] Date/Time:[**2122-10-16**] 2:00 Neurology Follow Up: Provider: [**Name Initial (NameIs) 1220**]. [**Name5 (PTitle) 540**] & [**Doctor Last Name **] Phone:[**Telephone/Fax (1) 44**] Date/Time:[**2122-11-10**] 4:30 Renal Transplant Appointment: Provider: [**Name10 (NameIs) 2105**] [**Name11 (NameIs) 2106**], MD Phone:[**Telephone/Fax (1) 673**] Date/Time:[**2123-1-15**] 9:00 Completed by:[**2122-9-29**] ICD9 Codes: 5856, 2762, 2724
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Medical Text: Admission Date: [**2128-11-22**] Discharge Date: [**2128-11-26**] Date of Birth: [**2128-11-22**] Sex: M Service: NB HISTORY OF PRESENT ILLNESS: Baby [**Name (NI) **] [**Known lastname 56602**] twin one is the 2385 gram product of a spontaneous twin, 34 and [**2-4**] week gestation, born to a 29 year old gravida I, para 0, now II, mother by cesarean section for preterm labor with breech presentation of the second twin. Prenatal screens included maternal blood type A positive, antibody negative, RhoGAM given at 28 weeks, hepatitis B surface antigen negative, RPR nonreactive, rubella immune, GBS unknown. Pregnancy was complicated by hypothyroidism in the mother and preterm labor at 29 weeks, treated with Magnesium and made Betamethasone complete. Delivery was uncomplicated and Apgar scores were eight at one minute and nine at five minutes of life. PHYSICAL EXAMINATION: On admission, in general, Baby [**Name (NI) **] [**Known lastname 56602**] number one was well appearing, with an examination consistent with his gestational age. Birth weight was 2385 grams, which is the 75th percentile, birth length was 47 centimeters, which is the 75th percentile, and head circumference was 32.75 centimeters, again the 75th percentile. Head, eyes, ears, nose and throat examination was significant for some molding of the head with the anterior fontanelle that was open, soft and flat. Red reflexes were present bilaterally. His palate was intact. Chest examination revealed lungs that were clear to auscultation bilaterally with mild intercostal retractions. His heart was regular rate and rhythm without a murmur. His femoral pulses were two plus bilaterally, and his capillary refill was less than two seconds. His abdomen was soft, with active bowel sounds and no masses. His extremities were warm but with acrocyanosis. Genitourinary examination revealed normal preterm male with testes palpable in the canal. His anus was patent. His spine revealed no clefts or dimples. His hips were stable. His neurologic examination was appropriate for his gestational age. HOSPITAL COURSE: Respiratory: Baby [**Name (NI) **] [**Known lastname 56602**] number one was in room air on admission and remained with good saturations throughout the hospitalization. Cardiovascular: Baby [**Name (NI) **] [**Known lastname 56602**] number one was hemodynamically stable throughout the admission, with normal perfusion and blood pressure. Fluids, Electrolytes and Nutrition: Baby [**Name (NI) **] [**Known lastname 56602**] number one was initially held NPO on D10W at 80 cc/kg/day. His glucoses were stable. Enteral feedings were initiated at about twelve hours of life with mother's milk or Special Care 20. Feeds were easily advanced and at the time of transfer, he is on total fluids of 140 cc/kg/day, taking feeds p.o./PG. On the morning of transfer, he took one full feed p.o. He has been voiding and stooling appropriately. His electrolytes at 24 hours of life were within normal limits. Hematology: Bilirubin at 24 hours of life was 5.6 with a direct component of 0.2. At 48 hours, it had risen to a maximum value of 11.3, so he was placed on single phototherapy. The following day it had fallen again to 8.9, so the plan was made to discontinue phototherapy on day of life four, [**2128-11-26**], and check a rebound bilirubin on [**2128-11-27**]. Baby [**Name (NI) **] [**Known lastname 56602**] number one is blood type A positive, Coombs negative. His initial hematocrit was 59.9 percent with platelet count of 223,000. Infectious Disease: Secondary to prematurity and unknown GBS status, Baby [**Name (NI) **] [**Known lastname 56602**] number one was begun on a rule out sepsis course of Ampicillin and Gentamicin. His initial white blood cell count was 7.8 with 22 percent polys and 0 bands and 71 percent lymphocytes. His cultures were negative at 48 hours, so antibiotics were discontinued. Sensory: Hearing screen was performed with automated auditory brain stem responses on [**2128-11-26**], and was passed in both ears. CONDITION ON DISCHARGE: Good. DISPOSITION: To [**Hospital3 **], level II nursery. PRIMARY PEDIATRICIAN: The family has not made their final selection of pediatrician yet. CARE/RECOMMENDATIONS: 1. At the time of transfer, Baby [**Name (NI) **] [**Known lastname 56602**] number one is feeding Special Care 20 or breast milk 20 140 cc/kg/day p.o./PG. 2. He is on no medications. 3. He has not yet had car seat position screening but should have this prior to discharge home. 4. State Newborn Screen has been sent. 5. Hepatitis B vaccine was given on [**2128-11-26**]. 6. Synagis RSV prophylaxis should be considered from [**Month (only) 359**] through [**Month (only) 547**] for infants who meet any of the following three criteria: Born at less than 32 weeks; born at 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 with chronic lung disease. Influenza immunization is recommended annually in the fall for all infants once they reach six months of age. Before this age (and for the first 24 months of the child's life), immunization against influenza is recommended for household contacts and out of home caregivers. DISCHARGE DIAGNOSES: 1. Prematurity at 34 and 1/7 weeks gestation. 2. Suspected sepsis, ruled out. 3. Hyperbilirubinemia. 4. Immature feeding. Reviewed By: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 53043**], [**MD Number(1) 53044**] Dictated By:[**Doctor Last Name 56737**] MEDQUIST36 D: [**2128-11-26**] 09:55:39 T: [**2128-11-26**] 11:08:39 Job#: [**Job Number 57671**] ICD9 Codes: 7742, V290, V053
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Medical Text: Unit No: [**Numeric Identifier 74607**] Admission Date: [**2145-10-20**] Discharge Date: [**2145-11-6**] Date of Birth: [**2145-10-18**] Sex: M Service: Neonatology HISTORY: This infant was referred to the NICU by the pediatrician, Dr. [**Last Name (STitle) 52362**], for evaluation of cyanotic episode while in the newborn nursery. He is the 3435 gram product of a 38 week gestation born to a 32-year-old G2 P0, now 1 mother by spontaneous vaginal delivery on [**2145-10-18**]. Prenatal labs were blood type O negative, antibody negative, RPR nonreactive, rubella immune, HBSAG negative, GBS negative. This pregnancy was uncomplicated. Mother was on no medications. At delivery, there was no maternal fever. Rupture of membranes revealed clear fluid about 4 hours prior to delivery. The infant was vigorous at birth and required only warming, stimulation and bulb suction for resuscitation. Apgars were 8 and 9. He was admitted to the newborn nursery. At about 2-1/2 hours of life, he had a brief dusky spell that responded to stimulation and blow-by O2. There was no apnea noted. He was examined by [**Name8 (MD) **] NNP and was thought to be well appearing so the decision was made for further observation in the newborn nursery. He was well until the morning of admission to the NICU at about 60 hours of life when he had two more cyanotic episodes. They both occurred after crying. He became quiet, developed shallow breathing and had facial and oral cyanosis. He made swallowing movements shortly afterward but had not fed for 3 to 3-1/2 hours before these episodes. He was transferred to the NICU for further evaluation and management of cyanotic spells. On admission to the NICU, he had another cyanotic episode with a desaturation to 65%. PHYSICAL EXAMINATION: On admission, his birth parameters were weight 3435 grams which is 75th-90th percentile. Length 50.2 cm which is 75th percentile. Head circumference 34 cm which is 75th percentile. General: Alert, nondysmorphic, term male on an open warmer. HEENT: Anterior fontanel soft and flat. Sutures approximated. Red reflex deferred. Nares patent. Mucous membranes moist. Palate intact. Neck: No masses. CV: Normal rate and rhythm, no murmur. 2+ femoral and radial pulses. Brisk cap refill. Pulmonary: Clear to auscultation bilaterally. No increased work of breathing. Abdomen soft, nontender, nondistended, bowel sounds present, no mass, no hepatosplenomegaly. GU: Normal term male genitalia, uncircumcised. Testes descended bilaterally. Patent anus. Back: No cleft, tuft or dimple. Extremities: Warm, well perfused. Hips stable. Neuro: Alert, normal tone. Suck, gag, grasp, Moro reflex all within normal limits. Skin pink with few petechiae scattered on forehead, minimal jaundice. HOSPITAL COURSE: 1. Respiratory: The infant has remained in room air. At admission to the NICU although he had numerous episodes of desaturations mostly with feedings but occasionally drifts in desaturations at rest. At discharge, the infant has been five days spell-free of any episodes. The infant has required no methylxanthine therapy. A chest x-ray was within normal limits. 2. Cardiovascular: The infant has maintained cardiovascular stability but due to the cyanotic episodes, a cardiac evaluation was done. Four extremity blood pressures were within normal limits. Pre and post-ductal saturations were also within normal limits. Heart size on chest x-ray was within normal limits. Cardiology was consulted and an echocardiogram was done. The echocardiogram revealed essentially normal cardiac structure with a small PFO with bidirectional shunt and the left superior vena cava could not be completely excluded. Otherwise, the infant has remained cardiovascularly stable. An EKG on [**10-20**], [**2145**] showed right axis deviation and prolonged QTC-wave. The followup EKG on the 18th was normal. However, the infant will still have follow-up with Cardiology. 3. Fluid, electrolytes and nutrition: The infant has been ad lib p.o. feeding throughout the hospital course while in the NICU. At the time of discharge, the weight is 3855 grams. The infant is growing well, is feeding approximately greater than 200 ml/kg/day of 20 cal feedings, breast milk or Enfamil. The infant is voiding and stooling normally. The infant was started on iron and Tri-Vi-[**Male First Name (un) **] on [**2145-10-24**]. 4. GI: Bilirubin was done on day of life 3 which was 7.6/0.3. The infant has required no phototherapy and has had no further bilirubins checked. 5. Neurology: The infant has maintained a normal neurologic exam other than the cyanotic episodes mentioned above. 6. Audiology: The hearing screen was performed with automated auditory brain stem responses and the infant passed in both ears. 7. Psychosocial: A [**Hospital1 18**] social worker has been involved with the family. The contact social worker can be reached at [**Telephone/Fax (1) 8717**] if there are any concerns. CONDITION ON DISCHARGE: Good. DISCHARGE DISPOSITION: Home with the parents. Name of primary pediatrician is [**First Name8 (NamePattern2) 714**] [**Last Name (NamePattern1) **]. Telephone number [**Telephone/Fax (1) 74608**]. CARE RECOMMENDATIONS: Ad lib p.o. feedings of breast milk or breast feeding with Enfamil 20 cal/ounce as needed. MEDICATIONS: 1. Tri-Vi-[**Male First Name (un) **] one ml a day. 2. Ferrous sulfate 0.3 ml p.o. daily (concentration 25 mg/mL) which is 2 mg/kg/day. 3. Iron and vitamin D supplementation: 1. Iron supplementation is recommended for preterm and low birth weight infants until 12 months corrected age. 2. All infants on predominantly breast milk should receive vitamin D supplementation at 200 international units which may be provided as a multivitamin preparation daily until 12 months corrected age. Car seat position screening: passed. State newborn screens were sent on [**2145-10-21**] and [**2145-11-1**]. No results have been received by the NICU. Immunizations received: The infant has received no immunizations thus far though the family had requested waiting until an outpatient pediatric visit for the hepatitis B vaccine to be given. Immunizations recommended: 1. Synagis RSV prophylaxis should be considered from [**Month (only) **] through [**Month (only) 958**] for infants who meet any of the 4 following criteria: 1: Born less than 32 weeks gestation. 2: Born between 32 and 35 weeks with two of the following: Either daycare during RSV season, a smoker in the household, neuromuscular disease, airway abnormalities or school age siblings. 3: Chronic lung disease or 4: Hemodynamically significant congenital heart defect. 2. Influenza immunization is recommended annually in the fall for all infants once they reach 6 months of age. Before this age and for the first 24 months of the child's life, immunization against influenza is recommended for household contacts and out of home caregivers. 3. This infant has not received the rotavirus vaccine. The American Academy of Pediatrics recommends initial vaccination of preterm infants at or following discharge from the hospital if they are clinically stable and at least 6 weeks or fewer than 12 weeks of age. FOLLOWUP: Followup appointment will be made by the parents for Monday, [**2145-11-8**]. DNA referral has been made. Followup is recommended with [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] from cardiology at [**Hospital3 1810**], [**Telephone/Fax (1) 74609**] at approximately 6 weeks of age. DISCHARGE DIAGNOSES: 1. Cyanotic spells. 2. Sepsis ruled out. [**Name6 (MD) **] [**Last Name (NamePattern4) **], [**MD Number(1) 55472**] Dictated By:[**Name8 (MD) 62299**] MEDQUIST36 D: [**2145-11-5**] 23:07:00 T: [**2145-11-6**] 11:25:09 Job#: [**Job Number 74610**] ICD9 Codes: V290
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Medical Text: Admission Date: [**2175-7-14**] Discharge Date: [**2175-8-11**] Date of Birth: [**2175-7-14**] Sex: F Service: DISCHARGE DIAGNOSES: 1. Premature female infant at 32 weeks gestation. 2. Transient tachypnea of newborn. 3. Peripheral pulmonary artery stenosis murmur. HISTORY OF PRESENT ILLNESS: [**Known lastname **] [**Known lastname 51656**] is the former 1.265 kilogram female infant [**Known lastname **] at 32 weeks gestation to an O positive, 34-year-old, primigravida, whose prenatal screens were noncontributory. Maternal history was remarkable for hypertension which was treated with Aldomet. The mother also received betamethasone. She was also on Prozac during her pregnancy. Fetal heart monitoring on the day of delivery showed decelerations which prompted a cesarean section. The baby was [**Name2 (NI) **] with [**Name (NI) **] scores were 7 at one minute of age and 8 at five minutes of age and was admitted to the Neonatal Intensive Care Unit at [**Hospital1 188**] for prematurity. On admission, the infant weighed 1265 grams (which was the 25th percentile), head circumference was 27 cm (which was the 10th percentile). and length was 37 cm (which was less than 10th percentile). PHYSICAL EXAMINATION ON PRESENTATION: Physical examination demonstrated some mild retractions with grunting and fair air exchange. SUMMARY OF HOSPITAL COURSE BY ISSUE/SYSTEM: Problems during this hospital stay. 1. RESPIRATORY ISSUES: The infant was initially placed on continuous positive airway pressure which she remained on for 12 hours and then weaned directly to room air. 2. CARDIOVASCULAR ISSUES: The infant had stable blood pressures throughout her hospital stay. A systolic murmur was heard after the first days of life and remains. It is a grade 2/6 systolic murmur and heard throughout the precordium, out to the apex, and over both scapula. There was no hepatosplenomegaly. No bounding pulses. The infant remained asymptomatic. It was thought that this was consistent with peripheral pulmonary stenosis. If the murmur is still present two months status post discharge, the patient will be followed up at [**Hospital1 **] Cardiology by Dr. [**Last Name (STitle) 1537**]. 3. FEEDING AND NUTRITION ISSUES: At the time of discharge, the infant weighed 1785 grams, was ad lib feeding of NeoSure 26 calories per ounce; made up with 2 cals of corn oil. This can be weaned as the infant demonstrates good weight gain at home. 4. INFECTIOUS DISEASE ISSUES: The infant was initially placed on ampicillin and gentamicin ;with a benign complete blood count and negative blood cultures, the antibiotics were discontinued at 48 hours. 5. HEMATOLOGIC ISSUES: Both mother and baby were O positive and [**Name (NI) 36243**] negative. The infant had a peak bilirubin of 8; for which she underwent several days of phototherapy. The infant's hematocrit on [**7-15**] was 54. The infant is currently Fer-In-[**Male First Name (un) **] 0.1 cc by mouth once per day. 6. AUDIOLOGY ISSUES: Hearing screening was performed on [**8-2**] and was normal. 7. OPHTHALMOLOGIC ISSUES: Retinal examination performed and revealed immaturity in both eyes zone III. A follow-up appointment needs to be made in three weeks at [**Hospital1 35174**] Ophthalmology with Dr. [**Last Name (STitle) 40944**]. 8. IMMUNIZATIONS ISSUES: Hepatitis B immunization was deferred until the infant reaches 2 kilograms. 9. SCREENING: A screening head ultrasound done on [**7-24**] was normal. DISCHARGE STATUS: The patient was to be discharged in a carseat. DISCHARGE INSTRUCTIONS/FOLLOWUP: 1. The infant is to follow up at [**Hospital1 **] by Dr. [**Last Name (STitle) **]. An appointment has been made for [**8-15**]. 2. A visiting nurse will come to the home to check on the infant one day status post discharge. 3. Dr. [**Last Name (STitle) **] to schedule and approve follow-up eye examination of baby, for Dr. [**Last Name (STitle) 40944**] within three weeks of discharge. 4. Followup of peripheral pulmonary stenosis murmur with Cardiology (Dr. [**Last Name (STitle) 1537**] in two months if murmur is still present. [**First Name11 (Name Pattern1) 37693**] [**Last Name (NamePattern4) 37927**], M.D. [**MD Number(1) 37928**] Dictated By:[**Last Name (NamePattern1) 38304**] MEDQUIST36 D: [**2175-8-9**] 08:54 T: [**2175-8-10**] 08:50 JOB#: [**Job Number 51657**] ICD9 Codes: 7742
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Medical Text: Admission Date: [**2156-5-5**] Discharge Date: [**2156-6-3**] Date of Birth: [**2084-3-11**] Sex: F Service: MEDICINE Allergies: Aspirin / Aleve / Codeine / Depakote Attending:[**First Name3 (LF) 613**] Chief Complaint: Altered Mental Status after dialysis on [**2156-5-5**] Major Surgical or Invasive Procedure: Thoracentesis Central Line Placement (left IJ) Lumbar puncture PICC line placement Dialysis History of Present Illness: 72F h/o T2DM, ESRD on HD, GAVE, HTN, MR, CAD, CHF w/ RV failure and seizure disorder who presented to the ED on [**5-5**] after experiencing somnolence at dialysis. It is not known how much fluid was removed during HD. The pt has no recollection of being at dialysis. In the ED, she stated that she felt fine, and denied HA, vision changes, nausea, weakness, or sensory changes. She also specifically denied any f/c/ns, abdominal pain, or CP. She did report a non-productive cough for several days and gradually worsening shortness of breath. . ED course: VS: 97.4, 121, 104/68, 14, 91RA Ms. [**Known lastname **] mental status cleared throughout her course in the ED. She had no leukocytosis, and chem 7 was notable for K 2.7, Mg 1.5, Phos 0.5, with new mild elevations in her transaminases, alk phos and Tbili. CT head was negative. CXR with improving effusion but satting 91% RA. RUQ U/S was done given elevated LFTs: there was a negative son[**Name (NI) 493**] [**Name2 (NI) **] sign, and echogenic focus within GB wall c/w sludge, unchanged from [**Month (only) **] [**2155**]. Levaquin was given for possible PNA. Pt also received gentle IVF (1L NS), potassium and D50 as her BG was in the 60s and her K was 2.7. HR improved slightly to the 100s at admission. Of note, shortly after being transfered to the floor, she developed [**Year (4 digits) **]. She was triggered and transfered to the MICU. Past Medical History: * Chronic Gastric Angiodysplasia (GAVE)and consequent chronic low-grade UGIB, and has therefore been advised not to take aspirin or other antiplatelet agents. * DM type II: c/b nephropathy and neuropathy - currently not on diabetic meds, has hypoglyemia [**12-27**] poor nutritional stores * ESRD: HD MWF has fistula L arm * CAD * CHF, R-sided, [**Month/Day (2) 7216**] EF 50-55% with 4+ TR 2+ MR [**8-/2155**] TTE, and in ICU with this admission * Anemia: multifactorial (ESRD + iron deficiency [**12-27**] GIB) * colon polyps (hyperplastic) [**7-/2153**] colonoscopy * gastritis and duodenitis [**7-/2153**] EGD * gout * pleural effusion s/p thoracentesis [**8-/2153**] negative cytology, chemistry c/w exudate * Seizure disorder -dose not know how seizures manifest Social History: Pt lives at [**Location **]. No ETOH, tobacco, or drugs. Pt has four children, all involved in her care. There were several family meetings during this admission with all her children. They are very supportive and close family. No health care proxy is assigned at this time ([**2156-5-31**]). She is aware that she needs to choose one. . Family History: [**Name (NI) 1094**] son and daughter have DM. Her son also has HTN. Her mother had an MI in her 80s. Physical Exam: At time of admission: Physical exam: VS: 97.3 102/palp 118 16 972L Gen: elderly female in NAD. HEENT: NCAT. Sclera icteric. PERRL, EOMI. No pallor or cyanosis of the oral mucosa. No xanthalesma. Neck: Supple with JVP not elevated. CV: RR, normal S1, S2. No m/r/g. No thrills, lifts. No S3 or S4. Chest: Resp were unlabored, no accessory muscle use. CTAB, no crackles, wheezes or rhonchi. Decreased BS about [**11-27**] way up left field w/ dullness to percussion. Abd: Distended but soft. No HSM or tenderness. +BS, small reducible umbilical hernia Ext: No c/c/e. Good pulses, no asymmetry. Skin: No rashes. Neuro: non-focal, a&ox3, moving all ext's, 4-5/5 strength, 1+ reflex b/l, following commands . At time of transfer from ICU to Med floor: VS: TM-97.2, TC-96.7 BP: 113/45 (85-132/31-50) HR: 81 (63-84) RR: 20 SaO2: 100% 2L NC Gen: elderly female, only resposive to some simple commands, some moans HEENT: NCAT. + Scleral ictertis, Mucous membranes slightly dry Neck: Supple, no JVD, bandage from central line on the L neck CV: irregular regular rhythm, normal rate, normal S1, S2. Unable to ascultate a murmur (pt making noise) Chest: Breathing comfortably, rhonchi bilaterally. Abd: Soft, NT/ND. No HSM or tenderness. +BS, umbilical hernia Ext: Pitting 1+ edema to the knees, peumatic compression devices in place, 2+ DPs bilaterally Skin: No rashes, or bed sores Neuro: 1+ reflex b/l, will squeeze fingers bilaterally, PEERL, unable to test other CN, pt does not move toes or open eyes to command., pt moans occasionally, GCS of 9 Lines: PICC on rt arm, NGT, rectal tube (liquide dark green stool) Pertinent Results: Admission labs: [**2156-5-5**] 04:12PM GLUCOSE-66* LACTATE-1.7 K+-2.7* [**2156-5-5**] 04:12PM HGB-12.5 calcHCT-38 [**2156-5-5**] 04:00PM GLUCOSE-66* UREA N-8 CREAT-1.8*# SODIUM-142 POTASSIUM-2.7* CHLORIDE-100 TOTAL CO2-35* ANION GAP-10 [**2156-5-5**] 04:00PM estGFR-Using this [**2156-5-5**] 04:00PM ALT(SGPT)-43* AST(SGOT)-95* CK(CPK)-205* ALK PHOS-249* TOT BILI-3.8* DIR BILI-2.3* INDIR BIL-1.5 [**2156-5-5**] 04:00PM LIPASE-112* [**2156-5-5**] 04:00PM cTropnT-0.17* [**2156-5-5**] 04:00PM CK-MB-4 [**2156-5-5**] 04:00PM ALBUMIN-2.5* CALCIUM-7.8* PHOSPHATE-0.6*# MAGNESIUM-1.5* [**2156-5-5**] 04:00PM WBC-5.5 RBC-3.62* HGB-11.9* HCT-36.7 MCV-102* MCH-33.0* MCHC-32.5 RDW-20.0* [**2156-5-5**] 04:00PM NEUTS-75* BANDS-0 LYMPHS-9* MONOS-16* EOS-0 BASOS-0 ATYPS-0 METAS-0 MYELOS-0 [**2156-5-5**] 04:00PM HYPOCHROM-NORMAL ANISOCYT-OCCASIONAL POIKILOCY-NORMAL MACROCYT-NORMAL MICROCYT-NORMAL POLYCHROM-OCCASIONAL [**2156-5-5**] 04:00PM PLT COUNT-117*# . Discharge Labs: . . Reports: CXR [**5-5**] - AP upright and lateral views of the chest are obtained. Cardiomegaly is again noted with large tapering left pleural effusion. Right lung is essentially clear and unchanged. There is no evidence of pneumothorax. Osseous structures reveal a compression fracture in the upper- to-mid thoracic spine which is new since [**2156-1-19**]. CT head [**5-5**] - IMPRESSION: No hemorrhage, edema, or fracture. US liver [**5-5**] - Moderate ascites with gall bladder wall thickening and edema, unchanged from prior study, likely due to third spacing. No evidence of acute cholecystitis. Echogenic focus within the gall bladde possibley adherent sludge. CT chest [**5-6**] - CONCLUSION: 1. No pulmonary embolism or aortic dissection. Extensive atherosclerosis is present in the coronary arteries and there is an aberrant origin of the right coronary artery which traverses between the aortic root and the pulmonary artery. 2. Cardiomegaly, pleural and pericardial effusion as well as ascites could represent congestive cardiac failure. There has been significant interval increase in the right pleural effusion with almost complete collapse/atelectasis of the left lung. 3. Enlarged mediastinal lymph nodes are unchanged since the prior examination and may be assessed further to exclude indolent lymphoma. Echo [**5-13**] - A small secundum atrial septal defect is present (cine loop #34). There is mostly left-to-right shunting, but after injection of aerated saline into the right atrium, right-to-left bubble transit is seen, as well. The estimated right atrial pressure is 10-20mmHg. Left ventricular wall thickness, cavity size and regional/global systolic function are normal (LVEF >55%) The right ventricular cavity is moderately dilated with moderate global free wall hypokinesis. There is abnormal [**Month/Year (2) 7216**] septal motion/position consistent with right ventricular volume overload. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. The mitral valve leaflets are mildly thickened. Moderate (2+) mitral regurgitation is seen. The tricuspid valve leaflets fail to fully coapt. Severe [4+] tricuspid regurgitation is seen. The pulmonary artery systolic pressure could not be determined. There is a trivial/physiologic pericardial effusion. IMPRESSION: Dilated and hypokinetic right ventricle. Preserved left ventricular systolic function. Moderate mitral regurgitation. Severe tricuspid regurgitation secondary to annular dilation. Small secundum ASD with bidirectional flow. . CT of head [**5-13**] - IMPRESSION: No acute intracranial abnormalities. Old infarct of the left frontal lobe and insula as well as the left thalamus. . CT chest/abd/pelvis [**5-13**] - IMPRESSION: 1. No acute intra-abdominal process is seen. There is no evidence of ischemic bowel. 2. Moderate free intraperitoneal fluid is seen. 3. Reflux of contrast into the hepatic veins and intrahepatic IVC does suggest right heart failure. 4. Dilated common bile duct without evidence of an obstructing lesion. This has in fact progressed in diameter since a prior torso imaging. Therefore, an MRCP is recommended for further evaluation of this finding. 5. Bilateral pleural effusions, decreased in size since the prior exam. 6. Areas of consolidation at the lung bases as detailed above. 7. Endotracheal tube extends into the main stem bronchus. . MRI/MRA brain [**5-13**] - MRI of the Brain: The [**Doctor Last Name 352**]-white matter differentiation of the brain is well preserved. The ventricles and extra-axial CSF spaces appear normal. There are old lacunar infarcts in the centrum semiovale bilaterally visualized with adjacent view of this. There is no evidence of an acute infarct. There is no evidence of intracranial edema, mass effect, shift of normally midline structures, or hydrocephalus. The posterior structures appear unremarkable. The major vascular flow voids are well preserved. There is hyperintensity visualized in both mastoid air cells suggestive of fluid within the mastoid air cells. There are multiple susceptibility artifacts visualized in the left temporal lobe, right aspect of the pons, and in both cerebellar hemispheres, which may represent multiple cavernomas or dystrophic calcifications. Visualized orbits and paranasal sinuses appear normal. . MRA OF THE BRAIN: The anterior circulation including the intracranial internal carotid artery, anterior and middle cerebral arteries bilaterally appear normal. The vertebrobasilar system and both posterior cerebral arteries appear normal. There is no evidence of an aneurysm (greater than 3 mm), flow-limiting stenosis, or occlusion. . CXR [**5-22**] - Increased consolidation of left lung, which could be compatible with pneumonia or aspiration. . EEG [**5-25**] - IMPRESSION: Possibly normal EEG in an extremely drowsy patient. Whether this is related to sleep deprivation or medications that the patient is taking or represents an early encephalopathy cannot be determined from this record. No definitive epileptiform abnormalities were, however, seen. . US upper extremity [**5-27**] - IMPRESSION: No evidence of DVT in the right upper extremity. - (done because had erythma around PICC site.) . EKG [**6-1**] - Compared to prior tracing irregular sinus mechanism at rate about 55 has replaced atrial flutter. There are occasional atrial premature beats and ventricular premature beats. Generalized low voltage remains. In addition, there is Q-T interval prolongation consistent with drug effect and also rightward axis. Anteroseptal myocardial infarction of indeterminate age cannot be excluded in either tracing. Brief Hospital Course: 71 yo F with DM, ESRD on HD, GAVE, HTN, CHF w/ RV failure, who p/w altered MS [**First Name (Titles) **] [**Last Name (Titles) **]. Admitted to the ICU, intubated and on vasopressors. Was successfully extubated and had several days of altered mental status, where she was uncommunicative and unable to eat. She was refusing NGT and PEG was contraindicated with her ascites. Improved, started taking PO. Had intact mental status with some memory problems upon discharge. . After admission and ICU course: Admitted to floor after dialysis [**12-27**] somnolence. Transferred to MICU after only a few hrs [**12-27**] [**Month/Day (2) **]. Pt had a an ECHO in the ICU that showed dilated, hypokinetic RV w/ 4+TR. Pt was emperically treated w/ Vanc/Meropenem, then was switched to cefepime for possible PNA (now s/p 10-D course). Pt also has a L-sided chronic pleural effusion (exudative), pt is s/p thoracentesis of 1.5 L w/ exudate, but no infection. Pt had a possible seizure during thoracentesis, so she was intubated and started on neosynepherine. Neuro was consulted and EEG showed no seizure activity. LP was performed w/o evidence of bacterial meningitis, however pt was placed on acyclovir. HSV PCR was negative and acyclovir was stopped.. Pt has gone in and out of aflutter, but was transfered to the floor in sinus rhythm with 2-3 beat runs of NSVT. Pt was on heparin ggt briefly but this has been stopped. She was extubated on [**2156-5-16**], and has been off pressors since [**2156-5-17**]. Pt has stayed in ICU [**12-27**] mental status which waxes and wanes, and at best the pt is resposive to only some simple commands. Has NGT and on tube feeds. Pt does reportely have some baseline altered mental status, but is signifcantly changed from baseline. Pt was transfered to the medicine floor on [**2156-5-19**], with vitals of 113/45, 84 (sinus), 20, 99% on 2L. . On the floor, the patient continued to have significantly altered mental status. She was uncommunicative and would follow some simple commands. She improved quite quickly over several days and returned close to baseline mental status according to her family. Her major issue for most of her time on the floor was nutrition status. She had pulled out her NG tube and kept not cooperating for replacement. Family did not want to have to restrain her to place it. She was unable to get a PEG tube d/t ascites. When she woke up, she was able to take PO and start repleting nutrition deficits. She had episodes of atrial flutter with [**Date Range 13223**] into the 110s/120s. Pt also had c.diff infection diagnosed. Please see below for specific details of each problem... # Altered mental status: At baseline pt able to walk from chair to bathroom, and communicate. Pt's mental status declined while in pt when she became hypotensive. The differential consists of seizure (EEG x2 did not show seizure activity) or encephalitis (HSV-but PCR was negative, and CSF studies WNL) or a global hypoxia or a metabolic encephalopathy. Also possible is adrenal insuffiency, therefore, tx with IV steroids, without change, so stopped steroids. No radiologic evidence of intracranial pathology. Pt believed to have seizure during thoracotomy as stated above. Pt remained in stuporous state until approximately [**5-24**] when her mentation started to improve. Likely cause of mental status changes was multifactorial - including metabolic derangements from kidney and liver disease. She was continued on her home dose of Keppra her entire stay in the hospital. She is leaving the hospital back at her baselin. . # [**Month/Year (2) **]: Unclear etiology, originally thought due to possible pneumonia, as stated above, pt required pressers in ICU. CTA negative for PE. Echo showed no pericardial effusion or tamponade. Pt improved in the ICU and was successfully weaned from pressors. She maintained appropriate blood pressures, and all her antihypertensive medicines were held, and are still being held upon discharge, SBPs are in 140s upon discharge, but often drop lower after [**Month/Year (2) 13241**]. She will be on no antihypertensive medicines on discharge. . # Possible PNA, hypoxia: with coughs (though no leukocytosis, no fever). CXR showed worsening pleural effusion and collapse of LLL initially. Pt treated with empiric vancomycin and meropenem (switched from imipenem due to lower seizure threshold from imipenem)for 10 day course. Sputum cx was negative. Follow up CXRs showed persisent effusions. Pt was breathing well on RA upon discharge. No cough. . # Arrhythmia: In ICU pt had transient [**Month/Year (2) 13223**] which improved with IVF, pt alternated between sinus tach and atrial tach. Improved somewhat w/metoprolol, which was later stoped d/t bradycardia into the 30s. [**Month/Year (2) **] most likely initially reflected hypovolemia, but not compeletly clear. No PE on chest CTA. Pt was monitored on telemetry and had intermitenty ectopic beats, NSVT up to 3 beats, which may have been related to hypokalemia. While on floor, patient converted into atrial flutter with rates between 110 and 130. Pt was started on metoprolol. Pt then converted to NSR with HRs in 60s. Metoprolol was stopped at this time and she was not discharge . # Effusions: large left pleural effusion. Prior fluid analysis showed exudative process, w/o identifiable cause, cytology negative as well. Currently being followed by pulmonary, Dr. [**Last Name (STitle) 2168**]. During this stay, thoracentesis was performed but resulted in intubation as stated above. Pt continues to have effusions, but not symptomatic. Pt breathing well on RA upon discharge. . # Transaminitis: Likely due to congestive hepatitis in setting of RV failure. Pt's LFTs trended down during her hospital course. Pt does have elevated INR, likely d/t some liver dysfunction. No evidence of liver pathology on any imaging studies. . # Hyperlipidemia: statin was held in setting of transaminitis. Still held on discharge. . # ESRD/HD: On HD MWF. HD was continued while in pt, pt on Phoslo, and renal labs were closly monitored. Pt will need to continue HD upon discharge MWFs for fluid status management. Phoslo had been discontinued during admission. Upon discharge phos level was low at 1.2. On the day of admission, pt was given 4 packets of neutrapohs. The renal fellow was called about her level and thought discharge was still appropriate. Pt is scheduled for dialysis the day after discharge. Her phos level will be checked there. Dr. [**Last Name (STitle) **], her nephrologist, will be faxed the results and is aware of the problem. . # Hypoglycemia: Pt had several episodes of hypoglycemia in ICU, likely in setting of NPO; got dextrose and FS improved after adjusted RISS. Continued to have episodes of hypoglycemia while on floor and there was no way to have nutritional support (no NGT or PEG and somnelent). Was on D10W for several days and still had blood sugars in 60s and 70s. Pt then started to have improved mental status. She passed a speech/swallow test and was started on ground food and thin liquids. She will go home on a diet that remains ground. Per swallow team, she can have repeat study with her denturs if she is to be made full diet. Endocrine team was also following and ruled out insulinoma as possible cause. Insulin level was low and c-peptide was likely elevated because it is usually cleared by the kidney. Encourage small and frequent meals to maintain blood sugar. Can use glucose tabs if needed. . # DM: held all diabetic medicines due to hypoglycemia. See above. . # C.diff - had diarrhea during most of her time on the floor. Stool culture was positive for C.diff. On Flagyl PO tid. Needs to complete 14 day course. Day 1 of antibiotics was [**2156-5-30**]. Pt will be given prescription for rest of course upon discharge. She was still having diarrhea at the time, but no white count, fevers or abdominal pain. . # New thoracic compression fracture: pt asymptomatic, no treatment. . # Megaloblastic anemia: B12 and folate levels are normal, unclear etiology, was monitored and remained stable throughout admission. . # Code: FULL. Had several family meetings during stay. Palliative care was consulted and helped us coordinate the meetings and discuss the patients prognosis. Family is aware of her end organ failure and fragile state. Medications on Admission: Medications: from dc summary in [**1-24**]. Isosorbide Dinitrate 30 mg PO BID 2. Pantoprazole 40 mg Q24H 3. Metoprolol Tartrate 75 mg PO TID 4. Lisinopril 20 mg PO DAILY 5. Levetiracetam 250 mg PO BID ?? not on list from NH 6. B Complex-Vitamin C-Folic Acid 1 mg PO DAILY 7. Hydroxyzine HCl 25 mg PO Q6H as needed. 8. Atorvastatin 20 mg PO DAILY 9. Cinacalcet 30 mg PO DAILY ?? not on list from NH 10. Gabapentin 300 mg PO QHD ?? not on list from NH 11. Citalopram 20 mg PO DAILY ?? not on list from NH 12. Acetaminophen 325 mg 2tbl PO Q6H as needed. 13. Glipizide 2.5 mg 24hr PO once a day. 14. Phoslo 667mg po TID with meals Discharge Medications: 1. Camphor-Menthol 0.5-0.5 % Lotion Sig: One (1) Appl Topical QID (4 times a day) as needed. Disp:*1 tube* Refills:*0* 2. Omeprazole 20 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. Metronidazole 500 mg Tablet Sig: One (1) Tablet PO TID (3 times a day) for 10 days. Disp:*30 Tablet(s)* Refills:*0* 4. Keppra 100 mg/mL Solution Sig: Two [**Age over 90 1230**]y (250) mg PO twice a day: Please take 2.5 ml twice daily to get a dose of 250 mg [**Hospital1 **]. Disp:*150 ml* Refills:*2* 5. Ergocalciferol (Vitamin D2) 50,000 unit Capsule Sig: One (1) Capsule PO 2X/WEEK (MO,TH) for 2 months. 6. Vitamin D 1,000 unit Capsule Sig: One (1) Capsule PO once a day: Start after 2 months of 50,000u twice weekly is completed. 7. Outpatient Lab Work Please check phosphate level at [**Hospital1 13241**] on [**2156-6-4**] and fax result to [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **]: fax ([**Telephone/Fax (1) 8387**]. Discharge Disposition: Extended Care Facility: [**Hospital6 1643**] Discharge Diagnosis: Primary Diagnosis: 1. Altered Mental Status of multifactorial etiology 2. chronic liver disease with ascites, likely secondary to R heart failure 3. chronic kidney disease stage V 4. Pleural effusions of undetermined etiology 6. C.difficile colitis Secondary diagnoses: 1. Siezure disorder 2. Anemia 3. Compression Fracture 4. GAVE syndrome with hx UGI bleed Discharge Condition: Pt was afebrile, stable vital signs. Pt was unable to ambulate by herself, she was able to walk a short distance with the help of physical therapy. She was A+Ox3. She was having diarrhea at the time of discharge. Discharge Instructions: You were admitted for being somnulent after a dialysis session. It was thought that you may have had a pneumonia, and there was fluid in your lungs. The medical team tried to get the fluid off of your lung with a procedure called a thoracentesis. During this your blood pressure became very low and you had to go to the ICU where they kept your blood pressure high with IV medicine and helped you breathe with intubation. Your body started to recover and you were brought to a regular medical floor. On the floor, you remained somnolent and confused. You were unable to eat and we could not feed you through a tube. Eventually you started to improve. You passed a swallow test and started eating. We were worried because your blood sugar kept dropping low, probably due to your kidney failure and poor nutritional stores. You need to keep eating at regular intervals to keep your blood sugars up. You also had an irregular heart beat at times. Sometimes it was too fast, and sometimes it was too slow. We monitored you on telemetry because of that. When you left the hospital, your heart rate was regular and going about 60 beats per minute (a normal rate). You also were diagnosed with an infection of your bowels call c.diff. You need to take flagyl, an antibiotic for a total of 14 days to treat this infection. We stopped some medicines you had been taking at home before this hospitalization. Please see the discharge sheet for what you will take now. You must continue [**Hospital6 13241**] M, W, F or as your renal doctor recommends. You will continue physical therapy in rehab to try to regain your strength. Please call or return to the hospital for any chest pain, shortness of breath, worsening diarrhea, or any other concerns. You should see your doctor regularly. Call 911 for any emergencies. Followup Instructions: Please make appointment with PCP for two weeks to follow up on C.diff infections: [**Last Name (LF) **],[**Known firstname **] L. [**Telephone/Fax (1) 7976**] Please follow up with your renal doctor [**First Name (Titles) **] [**Last Name (Titles) 13241**]. You need to go to dialysis tomorrow. Dr. [**Last Name (STitle) **], your nephrologist, will continue to follow you. [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) **] MD [**MD Number(2) 617**] Completed by:[**2156-6-3**] ICD9 Codes: 486, 5119, 5856, 4280, 4240, 3572, 2875
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6524 }
Medical Text: Admission Date: [**2190-9-18**] Discharge Date: [**2190-9-24**] Date of Birth: [**2151-10-24**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 6169**] Chief Complaint: refractory AML, comfort measures only Major Surgical or Invasive Procedure: None History of Present Illness: 38 yo F F AML s/p chemo, depression, asthma, who presents from OSH with delta MS, fever, and intubation for airway protection. per OSH records: Pt was c/o HA then began to hallucinate, aggitated, and then c/o photophbia. She took 2 mg of ativan PO. She then became unresponsive and apneic. She was intubated for [**Month (only) **] consciousness and poor control of secretions. Pt admitted with resp failure, HA and seziure like activity. Intubated in the field. Head CT negative. Also noted to be in SVT, adenosine unsucceful, lopressor 5 mg IV x 2 successful. VS 101.8, HR 145, BP 165/92. PE with supple neck but some stiffness, neg Kernig or Brudinski's. Given braod spectrum abx and steroids. . Of note pt, was recently admitted to [**Hospital1 18**] and d/c on [**9-16**]. She was admitted with a dx of functional neutropenia and fever. Initially treated with CTX/vanc, then changed to levofloxacin, and then changed back to CTX/vanco which was d/c on. She remained afebrile x 4 days and then send home. No clear source was found. In addition she recieved two doses of high dose ara-c. . Admitted to [**Hospital Unit Name 153**] for delta MS/seizures. On arrival, pt sedated, Unable to obtain history. . Patient was extubated and transferred to floor today. Per family she is [**Hospital Unit Name 3225**]. All meds were d/c'd and morphine drip started. Past Medical History: Onc hx: She was initially diagnosed with AML in [**8-/2189**] after presenting with fatigue and CBC was abnormal. She was treated with idarubicin and ARA-C, standard 7+3 remission induction therapy. She then underwent HIDAC consolidation chemo. The patient was admitted [**2190-1-18**] through [**2190-1-19**] and finished her 3rd cycle of HIDAC. She represented in [**4-12**] with hip pain and found to be in AML relapse. She is now s/p allogeneic transplant from a sibling donor with fludarabine and Cytoxan (2.5 months ago) for conditioning regimen. The patient was noted to have disease recurrence shortly after recovery of her counts. She has been managed as an outpatient on Hydrea. She has been receiving platelet and blood support as needed. Her last platelet transfusion was [**7-5**]. A couple of weeks prior to this admission she had severe left leg pain just below her knee and found to having increasing white count with blasts. Her Hydrea was increased and she received a week of subcutaneous Ara-C. . PMH: s/p MVA [**5-11**] w/ long rehab course w/ residual chronic back pain and R hip fracture, R wrist fracture, rib fractures AML, M4 w/ normal cytogenetics, course as above Depression GERD s/p Appendectomy s/p ovarian cyst removal Asthma Social History: Lives w/ husband, 3kids; smoked 1.5packs per day x 30(?) year; still occasionally smokes, No ETOH Family History: Denies any family hx of heme malignancy. The patient's father died in [**Country 3992**], her mother is currently being treated for Breast CA. Mother with MI in late 30s Physical Exam: No thorough physical exam performed, pt is [**Name (NI) 3225**], on morphine drip, not awake, RR 12/min. Pertinent Results: [**2190-9-18**] 11:15PM GLUCOSE-107* UREA N-16 CREAT-0.5 SODIUM-144 POTASSIUM-3.3 CHLORIDE-112* TOTAL CO2-20* ANION GAP-15 [**2190-9-18**] 11:15PM ALT(SGPT)-24 AST(SGOT)-64* LD(LDH)-1571* CK(CPK)-35 ALK PHOS-218* TOT BILI-1.5 [**2190-9-18**] 11:15PM CK-MB-7 cTropnT-0.06* [**2190-9-18**] 11:15PM ALBUMIN-3.3* CALCIUM-8.3* PHOSPHATE-4.1 MAGNESIUM-1.8 [**2190-9-18**] 11:15PM TSH-0.31 [**2190-9-18**] 11:15PM WBC-7.0 RBC-2.70* HGB-8.0* HCT-23.6* MCV-87 MCH-29.5 MCHC-33.8 RDW-16.4* [**2190-9-18**] 11:15PM NEUTS-0 BANDS-0 LYMPHS-5* MONOS-0 EOS-0 BASOS-0 ATYPS-2* METAS-0 MYELOS-0 BLASTS-93* NUC RBCS-1* [**2190-9-18**] 11:15PM HYPOCHROM-NORMAL ANISOCYT-1+ POIKILOCY-1+ MACROCYT-NORMAL MICROCYT-1+ POLYCHROM-NORMAL OVALOCYT-1+ SCHISTOCY-OCCASIONAL BURR-1+ [**2190-9-18**] 11:15PM PLT COUNT-20* [**2190-9-18**] 11:15PM PT-20.3* PTT-25.4 INR(PT)-1.9* Brief Hospital Course: 38 yo F with refractory AML s/p chemo, who presents from home intubated with fever, delta MS, and tachycardia. Now extubated and breathing , despite continued fevers and MS changes, [**Month/Day/Year 3225**] per family. The patient passe away on [**2190-9-18**] in presence of her family. Medications on Admission: morphine drip Discharge Medications: N/A Discharge Disposition: Expired Discharge Diagnosis: refractory AML Discharge Condition: n/a Discharge Instructions: n/a Followup Instructions: n/a Completed by:[**2190-10-19**] ICD9 Codes: 486, 2760, 3051
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6525 }
Medical Text: Admission Date: [**2179-2-6**] Discharge Date: [**2179-2-22**] Date of Birth: [**2110-11-29**] Sex: F Service: MEDICINE Allergies: Penicillins Attending:[**First Name3 (LF) 3513**] Chief Complaint: acute renal failure Major Surgical or Invasive Procedure: hemodialysis PICC line placement Hemodialysis line placement-tunneled catheter to left subclavian Ultrasound guided renal biopsy History of Present Illness: [**Known firstname 97626**] [**Known lastname 174**] is a 68-year-old female with known lymphoplasmacytic lymphoma. She initially presented in [**Month (only) 958**] [**2177**] to the heme onc clinic with complaing of neck pain due to bulky lymphadenompathy and CT scan revealed extensive lymphadenopathy, more severe in the deep pelvis, but also involved her paraspinal regions, retroperitoneum, inguinal regions as well as porta hepatis. She also presented with an elevated creatinine, and kidneys were normal in appearance and there was no evidence of hydronephrosis. She also had a large neck mass more prominent on the right side. The patient presented to clinic today with a report of decreased urine output over the last few months and was noted to have elevated creatinine over 7. She also had increased bilateral leg edema over the past three weeks, dyspnea on exertion, and increased fatigue. She denied mental confusion, shortness of breath, chest pain, abdominal pain or any bloating. Denied any fever, chills or night sweats. She was eating and drinking okay. She otherwise denied any bleeding or bruising difficulties, any numbness or tingling in her fingers or toes. She's had some difficulty with ambulation due to the edema amd is currently using a cane. . She was sent from hem/onc clinic to the ED. In the ED, her creatinine was significantly elevated (up to 8.1), CXR showed L-sided effusion with atelectasis/failure. She stated that she has been feeling more short of breath of late and has woken up at times SOB in the middle of the night. She statedshe had more confusion lately (difficulty with word finding) as well. She denied any chest pain, abdominal pain, decreased appetite, fever, chills; she states that her urne has been decreasing over the past few weeks (but she still makes urine). She was currently thinking about whether or not she wants to have hemodialysis and/or chemotherapy for her lymphoma and is admitted at this time for further management. This patient is a [**Doctor First Name **] scientist and had refused any treatment in the past; however, with support of her family she opted to commence chemotherapy and was admitted to the heme/onc service. . She was transferred to the [**Hospital Unit Name 153**] for monitoring because of high risk of TLS as she agreed to have chemotherapy initiated. In the setting of her renal failure, hemodialysis was required during chemotherapy to clear tumor lysis toxins and preserve renal function during this time. She received the CVP (cytoxan, vincristine, prednisone) regimen with daily hemodialysis without complication. She was transferred to the medicine service for monitoring for tumor lysis and for continued hemodialysis until outpatient dialysis is arranged. At that time, she noted increased confusion lately that is worse in the hospital but has been improving in the past few days. She was tolerating a small amount of renal prudent solid food and drinking nepro supplements. She denied fever, chills, dysuria, nausea, vomiting, diarrhea, or distention. She had intermittent constipation. She denies any chest pain, cough, fever, chills. . Home Meds: Verapamil, Atenolol . ICU Meds: Acetaminophen, Allopurinol, Calcium Acetate, Docusate Sodium, Dolasetron Mesylate, SC Heparin, Levofloxacin, Metoprolol, Nephrocaps, Pantoprazole, Prochlorperazine, Prednisone, Senna, . Verapamil HCl Past Medical History: Lymphoplasmacytic Lymphoma, diagnosed 1.5 yrs ago, had not received any treatment until now, has significant bulky LAD. Treatment was deferred until this visit when CVP protocol cycle 1 was started [**2179-2-12**]. Has significant bulky LAD. Atrial Fibrillation Hypertension Social History: She does not smoke and does not drink. She smoked tobacco for 2 years 48yrs ago. She is married, 2 sons and 2 daughters. [**Name (NI) **] daughters are [**Name2 (NI) **] Scientists; husband and sons are not, but are supportive of her religious beliefs and of her decisions in the past and presently about treatment. She is a retired [**Doctor First Name **] Science nurse. Family History: There is no family history of cancer, renal disease, or MI. She has 1 brother who is alive and well. Her mother is 86 years old and alive. Her father died at the age of 38 at an accident. Her son has atrial fibrillation Physical Exam: 97.9 140/70 79 20 96% RA Gen: NAD, A&Ox3 HEENT: few loose white plaques on inner cheeks, EOMI, MMM, no petechiae Neck: bulky LAD right neck (6x6 cm at least), soft, mobile; smaller LAD left neck, NT Lungs: faint crackles at bases, bibasilar [**Month (only) **] breath sounds CV: irregularly irregular, nl S1/S2, no m/r/g Chest: HD LSC line and L peri-aurealar ecchymoses improved. Abd: soft, ND, nabs, mild tendermess in RUQ and epigastric regions without guarding or rebound, no HSM Extr: 2+ pitting edema to knees bilaterally, non tender, negative [**Last Name (un) 5813**] sign bilaterally Neuro: AOx3, moving all extremities, ambulating with cane, sensation grossly intact, no tremor or asterixis Skin: L chest ecchymoses improving. no petechiae. Pertinent Results: Admission Data: PTH: 175 137 / 106 / 91 ---------------< 82 3.6 / 23 / 8.1 Ca: 7.7 Mg: 2.2 P: 6.6 Uric Acid: 14.3 Vit-B12:Pnd Folate:Pnd MCV= 103 WBC= 4.2 HgB= 8.6 Plt= 229 Hct= 27.5 N:56.0 L:36.9 M:4.0 E:2.3 Bas:0.7 Hypochr: 2+ Macrocy: 3+ PT: 14.9 PTT: 26.4 INR: 1.4 URINE Color-Yellow Appear-Cloudy Sp [**Last Name (un) **]-1.020 Blood-LG Nitrite-NEG Protein->300 Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-0.2 pH-6.5 Leuks-MOD RBC-[**5-28**]* WBC-[**2-20**] Bacteri-FEW Yeast-NONE Epi-[**2-20**] . CXR [**2179-2-5**]: L sided pleural effusion with discoid atelectasis, failure; right paratracheal mass . CXR [**2179-2-13**]: No significant change since prior study. Persistent bilateral atelectases and bibasilar consolidations as described. No pneumothorax. . Renal US: no hydronephrosis; ?parenchymal renal disease . Hospital Course: Lipase-41 URINE Hours-RANDOM Creat-127 TotProt-567 Prot/Cr-4.5* 02Hapto-71 calTIBC-308 Ferritn-75 TRF-237 VitB12-1077* Folate-9.6 [**Doctor First Name **]-NEGATIVE HBsAg-NEGATIVE [**Name (NI) 97627**] [**Name (NI) 97628**] PTH-175* Osmolal-316* HBsAg-NEGATIVE HBsAb-NEGATIVE HBcAb-NEGATIVE HCV Ab-NEGATIVE PEP-POLYCLONAL IgG-4368* IgA-299 IgM-53 IFE-NO MONOCLO C3-54* C4-12 HIT antibody NEGATIVE . CT CHEST W/O CONTRAST [**2179-2-10**] 1) Marked progression of diffuse systemic lymphadenopathy, particularly in the retroperitoneum and pelvis. 2) Diffuse soft tissue edema, bilateral pleural effusions, ascites, and right atrial enlargement, all consistent with fluid overload/anasarca. . [**Last Name (un) **] DUP EXTEXT BIL (MAP/DVT) [**2179-2-15**] Duplex ultrasonography was performed at the level of the veins and arteries of the bilateral upper extremities. There are single brachial arteries in each arm, with normal triphasic waveforms. . Discharge Labs: BLOOD WBC-3.0* RBC-2.80* Hgb-8.9* Hct-27.3* MCV-97 MCH-31.7 MCHC-32.5 RDW-16.6* Plt Ct-158 PT-16.7* PTT-30.3 INR(PT)-1.8 Fibrino-187 Glucose-90 UreaN-32* Creat-4.1* Na-133 K-3.7 Cl-99 HCO3-28 AnGap-10 Calcium-8.8 Phos-3.3 UricAcd-5.6 Brief Hospital Course: Acute Renal failure: The etiology of the acute renal failure is unclear but likely lymphomatous infiltration, urate nephropathy, glomerulonephritis, or acute tubular necrosis that may be reversible after dialysis and reduction of her tumor burden. She had a renal biopsy on [**2-9**] that showed glomerular sclerosis consistent with end stage disease, likely from the lymphoma. Urine lytes were consistent with renal pathology. Renal ultrasound was without signs of hydronephrosis. The following laboratory tests were performed: hepatitis serologies negative, [**Doctor First Name **] negative, SPEP negative, UPEP with albumin band, C3 low at 54, C4 normal, HIT antibody negative. She decided to pursue treatment for her lymphoma, so a tunnelled dialysis catheter was placed in the interventional radiology suite, and she commenced hemodialysis on [**2-11**]. She was transferred to the ICU on [**2-12**] to undergo simultaneous chemotherapy (CVP; cytoxan, vincristine, prednisone) and daily hemodialysis. On [**2178-2-13**], she was transferred to the medicine service to continue monitoring and continue dialysis, preparing for outpatient dialysis. She finished her chemotherapy course and proceeded to get dialyzed on a M, W, F schedule with concomitant laboratory testing. Tumor lysis and disseminated intravascular coagulopathy laboratory testing were stabilized at discharge and will be monitored at hemodialysis. She underwent bilateral upper extremity venous mapping to prepare for eventual AV fistula placement and will contine dialysis at an outpatient facility after discharge. The renal service provided recommendations throughout the hospital stay. . Lymphoplasmacytic lymphoma: It is low grade but she has significant disease, including bulky cervical lymphadenopathy. She did not desire treatment in the past but decided to proceed with therapy. Staging CT showed extensive disease. Allopurinol was started for tumor lysis syndrome. She was transferred to the [**Hospital Unit Name 153**] on [**2-12**] to begin chemotherapy coupled with hemodialysis and then to the medicine service [**2-14**] for continued monitoring and dialysis. Tumor lysis and DIC labs were monitored and were stabilized at discharge, although they were briefly moderately positive the week after completing chemotherapy. During her hospital course, she was given renally dosed allopurinol. Platelets and hematocrit briefly decreased secondary to chemotherapy. HIT antibody testing was negative. She received 1 unit of PRBCs [**2179-2-18**] with hct increase from 24.9 to 28.9. She did not require cryoprecipitate, FFP, or platelet transfusion and had no acute bleeding. She was started on nystatin sw/sw for thrush. The oncology service provided recommendations. She will need CBC, chemistries, electrolytes, serum urate, and PT/PTT drawn at hemodialysis and results should be faxed to Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] at [**Telephone/Fax (1) 21962**]. Phone ([**Telephone/Fax (1) 3936**]. Her next outpatient chemotherapy will be [**2179-3-5**]. She will continue hemodialysis every M, W, F. She was discharged to inpatient rehab for continued physical therapy. She can ambulate with a cane. She was tolerating an oral diet and bowel regimen for occasional constipation. . Verapamil and Atenolol were continued for rate control of atrial fibrillation. Anemia labs were consistent with anemia of chronic disease/inflammation. Her hematocrit trended down slowly due to chemotherapy and increased appropriately after transfusion of 1 unit PRBCs (see above). . A health care proxy was designated (her daughter) in the event that she has complications of her disease at any point in the future. Medications on Admission: Verapamil Atenolol ALL: PCN causes itching/rash Discharge Medications: 1. B Complex-Vitamin C-Folic Acid 1 mg Capsule Sig: One (1) Cap PO DAILY (Daily). 2. Calcium Acetate 667 mg Tablet Sig: Two (2) Tablet PO TID W/MEALS (3 TIMES A DAY WITH MEALS). 3. Verapamil HCl 80 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours). 4. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 5. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 6. Heparin Sodium (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection TID (3 times a day). 7. Prochlorperazine 10 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for nausea. 8. Levofloxacin 250 mg Tablet Sig: One (1) Tablet PO Q48H (every 48 hours) for 4 days. 9. Allopurinol 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 10. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 11. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 12. Nystatin 100,000 unit/mL Suspension Sig: Five (5) ML PO QID (4 times a day). 13. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal DAILY (Daily) as needed. 14. Acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed. 15. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO Q6H (every 6 hours) as needed. 16. Sodium Chloride 0.9% Flush 3 ml IV DAILY:PRN Peripheral IV - Inspect site every shift 17. Dolasetron Mesylate 12.5 mg IV Q8H:PRN 18. 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. 19. Sodium Chloride 0.9% Flush 3 ml IV DAILY:PRN Peripheral IV - Inspect site every shift Discharge Disposition: Extended Care Facility: [**Hospital3 7**] & Rehab Center - [**Hospital1 8**] Discharge Diagnosis: Lymphoplasmacytic Lymphoma on chemotherapy Anemia, thrombocytopenia, hyperuricemia, hypocalcemia Atrial Fibrillation Hypertension Discharge Condition: in her usual state of health ambulating with cane and tolerating oral diet Discharge Instructions: Please take all medications as prescribed. Call your doctor or go to the ED for shortness of breath, chest pain, bleeding, excessive bruising, abdominal pain, nasea/vomiting, diarrhea, fever, chills, or other concerning symptoms. Followup Instructions: Please draw a CBC, chemistries, electrolytes, serum urate, and PT/PTT [**2179-2-22**] and fax to Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] at [**Telephone/Fax (1) 21962**]. Phone ([**Telephone/Fax (1) 3936**]. Next outpatient chemotherapy will be [**2179-3-5**]. Continue hemodialysis every M, W, F. Provider: [**Name10 (NameIs) **] Where: [**Hospital6 29**] CARDIAC SERVICES Phone:[**Telephone/Fax (1) 128**] Date/Time:[**2179-2-24**] 11:00 Provider: [**First Name11 (Name Pattern1) 2053**] [**Last Name (NamePattern4) 2761**], MD Where: [**Hospital6 29**] CARDIAC SERVICES Phone:[**Telephone/Fax (1) 5003**] Date/Time:[**2179-5-10**] 10:00 ICD9 Codes: 4280, 5849, 486, 5990
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6526 }
Medical Text: Admission Date: [**2164-3-27**] Discharge Date: [**2164-4-5**] Date of Birth: [**2094-7-25**] Sex: M Service: BLUE SURGERY HISTORY OF PRESENT ILLNESS: The patient is a 69 year-old man with a history of coronary artery disease status post coronary artery bypass graft times four, who presented to [**Hospital1 69**] for an esophagectomy on [**2164-3-27**]. PAST MEDICAL HISTORY: 1. Coronary artery disease, status post myocardial infarction in [**2158**]. 2. Transient ischemic attack. 3. Hypothyroidism. 4. Hypercholesterolemia. 5. Hypertension. 6. Esophageal cancer. PAST SURGICAL HISTORY: 1. Coronary artery bypass graft times four in [**2158**]. 2. Back surgery. 3. Shoulder surgery. 4. Cholecystectomy. 5. Hernia repair. ALLERGIES: 1. Tetracycline. 2. Zestril. 3. Ibuprofen. 4. Demerol. 5. Motrin. 6. Advil. MEDICATIONS AT HOME: 1. Synthroid. 2. Lipitor. 3. Avalide. FAMILY HISTORY: Noncontributory. SOCIAL HISTORY: The patient is a former smoker and denies any history of alcohol use. HOSPITAL COURSE: The patient underwent an Ivor-[**Doctor Last Name **] esophagectomy and feeding jejunostomy on [**2164-3-27**]. The patient tolerated the procedure well, received 8 liters of intravenous fluids intraoperatively and estimated blood loss was 700 cc. The patient was admitted to the surgical Intensive Care Unit for management immediately postoperatively. The patient had two chest tubes placed intraoperatively, and the Foley catheter was placed as well as an nasogastric tube. The patient was kept NPO with intravenous fluids. The patient was placed on Kefzol and Flagyl for infection prophylaxis. On postoperative day number one the patient was hemodynamically stable. The patient was started on tube feeds at 10 cc an hour. On postoperative day number two the patient was determined to be stable enough for transfer to the floor for care. The patient was transferred to the floor on telemetry. The patient's tube feeds were gradually increased to a goal of 70 cc an hour. On postoperative day number six the patient underwent a barium swallow study. The barium swallow study showed no leakage at the anastomosis site. The patient's nasogastric tube was taken out. The patient was started on a clear liquid diet. The patient tolerated the diet well and was advanced gradually to a full diet. The patient's tube feeds were cycled for nutritional support. The patient was able to ambulate on his own. Chest tubes were discontinued on postoperative day number eight with a follow up chest x-ray showing no pneumothorax. The patient is stable for discharge on [**2164-4-5**]. DISCHARGE CONDITION: Stable. DISCHARGE STATUS: To home. DISCHARGE MEDICATIONS: 1. Lipitor 20 mg q day. 2. Synthroid .137 mg q.d. 3. Avalide 300/12.5 mg q.d. 4. Zantac 150 mg b.i.d. 5. Percocet one to two tablets po q 4 to 6 hours as needed for pain. 6. Colace 100 mg b.i.d. when taking Percocet. DISCHARGE DIAGNOSES: 1. Coronary artery disease. 2. Transient ischemic attack. 3. Hypothyroidism. 4. Hypercholesterolemia. 5. Hypertension. 6. Carcinoma of the esophagus. FOLLOW UP PLANS: The patient was instructed to follow up with Dr. [**Last Name (STitle) 957**]. The patient was instructed to call Dr.[**Name (NI) 7012**] office for an appointment. The patient was instructed not to lift heavy objects. The patient should also follow up with the oncology service with Dr. [**First Name (STitle) **] as well as Dr. [**Last Name (STitle) 776**] from radiation/oncology for postoperative cancer management. [**Name6 (MD) **] [**Name8 (MD) **], M.D. [**MD Number(1) 4007**] Dictated By:[**Last Name (NamePattern1) 1909**] MEDQUIST36 D: [**2164-4-5**] 10:38 T: [**2164-4-5**] 10:59 JOB#: [**Job Number **] ICD9 Codes: 4240, 2449, 2720, 412
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Medical Text: Admission Date: [**2144-1-5**] Discharge Date: [**2144-1-21**] Date of Birth: [**2059-8-25**] Sex: F Service: CARDIOTHORACIC Allergies: Codeine / Sulfa (Sulfonamide Antibiotics) / Tetracycline / Novocain / Levaquin / Zoloft / Penicillins Attending:[**First Name3 (LF) 922**] Chief Complaint: Chest pain Major Surgical or Invasive Procedure: [**2144-1-7**] 1. Left video-assisted thoracoscopic surgery converted to left anterior thoracotomy. 2. Drainage of pleural and pericardial effusion. 3. Pericardial window. History of Present Illness: 84 year old female with history of mitral regurgitation and a chronic pericardial effusion who was admitted for mitral valve replacement with Dr [**Last Name (STitle) 914**] on [**12-13**], post op course c/b likely thromboembolic ischemic event involving the frontal lobes and parietal regions, she recovered significantly, was started on Dilantin and Keppra and discharged to rehabilitation at [**Hospital1 **]-[**Location (un) 86**] on [**12-21**]. She now returns w/chest pain and hypotension. Echo done in ED c/w loculated pericardial effusion-no evidence of tamponade. Past Medical History: 1. Mitral regurgitation s/p mitral valve replacement [**2143-12-13**] 2. Atrial fibrillation s/p MAZE procedure [**2143-12-13**] 3. Complex partial seizures secondary to ischemic stroke after surgery 4. Hypertension 5. Hyperlipidemia 6. Non-insulin dependent diabetes mellitus, type 2 7. Obesity 8. Fibromyalgia 9. Osteopenia 10. Irritable bowel syndrome 11. Obstructive sleep apnea 12. h/[**Initials (NamePattern4) **] [**Last Name (NamePattern4) **]-[**Doctor Last Name **] tear ([**3-/2142**]) - Transfused with 4 Units of RBC 13. Cystic pancreatic mass ([**9-/2142**]) - Bx negative 14. Mild coronary artery disease (no prior cath reports available) 15. Congestive heart failure 16. Esophageal ulcers/GERD 17. Brain Schwannoma's (4 which are stable by MRI) 18. Left metatarsal fracture 19. Type 2 Diabetes 20. Anemia Social History: Race: Caucasian Last Dental Exam: > 2 years ago Lives with: Alone in [**Location (un) 5110**], MA Contact: Daughter Phone # Occupation: Alone Cigarettes: Smoked no [X] yes [] last cigarette _____ Hx: Other Tobacco use: ETOH: < 1 drink/week [X] [**12-31**] drinks/week [] >8 drinks/week [] Illicit drug use Family History: No noted Premature coronary artery disease Physical Exam: Pulse: 96 AF Resp: 18 O2 sat: 96% 1L B/P Right: 96/62 Left: General: Lying in bed talking in full sentances Skin: Dry [x] intact [] HEENT: PERRLA [x] EOMI [] Neck: Supple [x] Full ROM [x] Chest: BS diminished bilat half way up Heart: RRR [] Irregular [x] Murmur-no Abdomen: Soft [x] non-distended [x] non-tender [x] +BS [x] Extremities: Warm [x], well-perfused [] Edema [x]2+ bilat Neuro: A&O x3. MAE, left sided weakness upper greater than lower Pulses: DP Right: 2+ Left: 2+ Radial Right: 2+ Left: 2+ Pertinent Results: [**2144-1-5**] Echo: Normal left ventricular wall thickness and cavity size. Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. Overall left ventricular systolic function is mildly depressed (LVEF= 40%). The aortic valve leaflets (3) appear structurally normal with good leaflet excursion. There is no aortic regurgitation. A well-seated bioprosthetic mitral valve prosthesis is present. No mitral regurgitation is seen. Moderate [2+] tricuspid regurgitation is seen. There is mild pulmonary artery systolic hypertension. There is a large, partically echofilled pericardial effusion most prominent inferlateral to the left ventricle (2-2.6cm). The effusion is echo dense, consistent with blood, inflammation or other cellular elements. There are no echocardiographic signs of tamponade. IMPRESSION: Suboptimal image quality. Large loculated ?bloody pericardial effusion most prominent along the inferolateral wall of the left ventricle and anterior to the right ventricle but without echocardiographic signs of tamponade. Mildly depressed global left ventricular systolic function. Well seated bioprosthetic mitral valve replacement with no mitral regurgitation. Compared with the findings of the prior study (images reviewed) of [**2143-9-8**], the pericardial effusion is slightly smaller and appears more loculated. Global left ventricular systolic function is now lower, and the patient is now in atrial fibrillation. The mitral valve has been replaced. . [**2144-1-6**] Chest CT: 1. Status post mitral valve replacement and Maze procedure with expected appearance of the mitral valve and left atrium. 2. Small left and small-to-moderate right pleural effusion. Substantial atelectasis of the left lower lobe, with no evidence of central compression with not re-expanding left lung and substantial left mediastinal shift. 3. Evidence of substantial pulmonary hypertension. . [**2144-1-6**] Lower Ext. U/S: Left and right subclavian veins are patent with normal flow and compressibility. Left internal jugular vein is patent with normal flow and normal compressibility. There is normal compression and augmentation of the left axillary, left brachial, left basilic, and left cephalic veins. . [**2144-1-7**] Echo: No spontaneous echo contrast is seen in the body of the left atrium or left atrial appendage. Left ventricular wall thicknesses are normal. The left ventricular cavity size is normal. Regional left ventricular wall motion is normal. Right ventricular chamber size and free wall motion are normal. There are complex (>4mm) atheroma in the descending thoracic aorta. The aortic valve leaflets (3) are mildly thickened. There is no aortic valve stenosis. Mild (1+) aortic regurgitation is seen. A bioprosthetic mitral valve prosthesis is present. Mild (1+) mitral regurgitation is seen. Moderate to severe [3+] tricuspid regurgitation is seen. There is a large pericardial effusion. No right atrial or right ventricular diastolic collapse is seen. Dr. [**First Name (STitle) **] was notified in person of the results at time of surgery. Post evacuation\window: no effusion, otherwise no change. . [**2144-1-21**] 06:10AM BLOOD WBC-6.4 RBC-3.51* Hgb-10.1* Hct-30.7* MCV-87 MCH-28.7 MCHC-32.8 RDW-15.4 Plt Ct-145* [**2144-1-21**] 06:10AM BLOOD Plt Ct-145* [**2144-1-21**] 06:10AM BLOOD Glucose-106* UreaN-31* Creat-0.6 Na-147* K-3.7 Cl-105 HCO3-39* AnGap-7* Brief Hospital Course: 84 yr old s/p MVR/MAZE on [**12-13**] discharged to rehab on [**12-21**]. She returned from rehab to [**Hospital1 18**] on [**2144-1-4**] with complaints of chest pain associated with hypotension. TEE showed loculated pericardial effusion. On [**1-7**] she underwent pericardial window via left anterior thoracotomy. In [**Name (NI) 13042**] PT was not able to be extubated due to low o2 and high CO2. She was therefore transferred to CVICU vented on Neo gtt and bilateral [**Doctor Last Name **] drains. She eventually extubated and was transferred to floor the following day, CTs' were removed prior to transfer. The following day while on the floor she became hypoxic and CXR revealed large left effusion with collapse. She was therfore transferred back to the CVICU for care. Left pigtail placed by IP for drainage of effusion and she required reintubation for left lower lobe collapse. She was bronched and mucus plug was extracted. She was rebronched the following day with improvement in lung findings. However she remained intubated for several days longer due to continued tachypnea and SOB. She eventually self extubated on [**1-13**] and continued an 8 day course of antibiotics for VAP coverage. She also received a short course of steroids for possible reactive airway disease. She remained hemodynaically stable. TTE revaled that she was underfilled and was transfused to optimize her BP. During her ICU stay she was in rapid afib and was started on amiodarone for rate contol. At times she bacame bradycardic into the 30's therefore her lopressor was adjusted. She was seen by speach and swallow and was placed on modified diet for mild swallowing difficulties regular with nectar thick. She was restarted on anticoagulation for her a-fib with goal INR 20-2.5. Once her respiratory status improved she transferred to floor on [**1-17**] where she continued to progress slowly. Patient became resistent to care and very depressed stating that she wanted to die. She was restarted on her preopertaie doses of ativan, Zoloft and Keppra for her seizure history. She was also seen by the social service department for her depression which at the time of discharge was improved. She required a lot of encourgement and support. Patient has a history of IBS and has had persistent loose stool but was c-diff negative and required immodium with good effect. Her PA &lat CXR on [**1-20**] showed moderate right effusion the plan is to continue with diuresis and CXR to be obtained at f/u with Dr. [**Last Name (STitle) 914**]. She continues to have a metabolic alkalosis and is being discharged short course of diamox. She will need to have her renal function followed closely at rehab. On POD#13 she was seen by ENT for worsening hoarseness. She was determined to have a left cord hypomobility, bowing and bilateral TVC nodules. She was compensating well and was cleared for cleared for a modified diet. Her injury was likely related to her recent intubations and observation was favored for now with close oral f/u: - Voice rest - Maximize PPI therapy - Diet per speech and swallow - Humidification - Avoid use of nasal cannula oxygen if possible; trial oxygen delivery via humified face mask. - Nasal saline spray to both nostrils at least TID. -F/U with Dr.[**First Name (STitle) **] She was seen by the physical therapy department for strengtening and conditioning and it was determined that due her continued needs she would require rehab placement. She was discharged to [**Hospital 100**] Rehab MACU all questions and concerns addressed. Follow-up appts arranged Medications on Admission: 1. potassium chloride 20 mEq Q12H for 10 days. 2. metoprolol tartrate 50 mg [**Hospital1 **] 3. aspirin 81 mg DAILY 4. acetaminophen 325-650 mg Q4H as needed for pain. 5. amiodarone 400 mg [**Hospital1 **] for 5 days: After 5 days decrease the dose to 400 mg daily for 1 week, then after 1 week, decrease dose to 200 mg daily. 6. levetiracetam 1500 mg [**Hospital1 **] 7. rosuvastatin 20 mg DAILY 8. fexofenadine 180 mg [**Hospital1 **] 9. Protonix 40 mg once a day. 10. furosemide 40 mg once a day for 10 days. 11. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) Inhalation Q6H (every 6 hours) as needed for wheezing. 12. alprazolam 0.25 mg TID as needed for anxiety. 13. Coumadin once a day: titrate to an INR of [**12-26**].5. 14. diphenoxylate-atropine 2.5-0.025 mg [**Date Range 8426**] Sig: One (1) [**Date Range 8426**] PO Q6H (every 6 hours) as needed for loose stool. Discharge Medications: 1. bisacodyl 5 mg [**Date Range 8426**], Delayed Release (E.C.) Sig: Two (2) [**Date Range 8426**], Delayed Release (E.C.) PO DAILY (Daily) as needed for Constipation. 2. senna 8.6 mg [**Date Range 8426**] Sig: 1-2 Tablets PO BID (2 times a day) as needed for Constipation. 3. docusate sodium 50 mg/5 mL Liquid Sig: One (1) PO BID (2 times a day). 4. rosuvastatin 20 mg [**Date Range 8426**] Sig: One (1) [**Date Range 8426**] PO DAILY (Daily). 5. amiodarone 200 mg [**Date Range 8426**] Sig: Two (2) [**Date Range 8426**] PO DAILY (Daily) for 1 weeks: then decrease to 200mg daily until seen by cardiology. 6. aspirin 81 mg [**Date Range 8426**], Delayed Release (E.C.) Sig: One (1) [**Date Range 8426**], Delayed Release (E.C.) PO DAILY (Daily). 7. levetiracetam 500 mg [**Date Range 8426**] Sig: Three (3) [**Date Range 8426**] PO twice a day. 8. acetaminophen 325 mg [**Date Range 8426**] Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for pain/fever. 9. warfarin 1 mg [**Date Range 8426**] Sig: [**Name8 (MD) **] MD [**First Name (Titles) 8426**] [**Last Name (Titles) **] DAILY (Daily): take as directed for INR goal 2.0-2.5. 10. fexofenadine 60 mg [**Last Name (Titles) 8426**] Sig: Three (3) [**Last Name (Titles) 8426**] PO BID (2 times a day). 11. albuterol sulfate 90 mcg/actuation HFA Aerosol Inhaler Sig: Six (6) Puff Inhalation Q4H (every 4 hours) as needed for wheezing. 12. metoprolol tartrate 50 mg [**Last Name (Titles) 8426**] Sig: One (1) [**Last Name (Titles) 8426**] PO TID (3 times a day). 13. sertraline 25 mg [**Last Name (Titles) 8426**] Sig: Two (2) [**Last Name (Titles) 8426**] PO DAILY (Daily). 14. ipratropium bromide 0.02 % Solution Sig: Two (2) Inhalation Q6H (every 6 hours) as needed for shortness of breath or wheezing. 15. guaifenesin 100 mg/5 mL Syrup Sig: Five (5) ML PO Q6H (every 6 hours). 16. alprazolam 0.25 mg [**Last Name (Titles) 8426**] Sig: One (1) [**Last Name (Titles) 8426**] PO BID (2 times a day). 17. alprazolam 0.25 mg [**Last Name (Titles) 8426**] Sig: Two (2) [**Last Name (Titles) 8426**] PO QHS (once a day (at bedtime)). 18. sodium chloride 0.65 % Aerosol, Spray Sig: [**11-25**] Sprays Nasal TID (3 times a day). 19. Protonix 40 mg [**Month/Day (2) 8426**], Delayed Release (E.C.) Sig: One (1) [**Month/Day (2) 8426**], Delayed Release (E.C.) PO twice a day. 20. Lasix 40 mg [**Month/Day (2) 8426**] Sig: One (1) [**Month/Day (2) 8426**] PO twice a day: for 1 week then decrease to daily and evaluate. 21. potassium chloride 25 mEq Packet Sig: One (1) PO twice a day for 1 weeks: then decrease to daily while on lasix. 22. Diamox Sequels 500 mg Capsule, Extended Release Sig: One (1) Capsule, Extended Release PO once a day for 1 weeks: while on [**Hospital1 **] lasix. 23. immodium Sig: One (1) four times a day as needed for diarrhea. Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - MACU Discharge Diagnosis: 1. Mitral regurgitation s/p mitral valve replacement [**2143-12-13**] 2. Atrial fibrillation s/p MAZE procedure [**2143-12-13**] 3. Complex partial seizures secondary to ischemic stroke after surgery 4. Hypertension 5. Hyperlipidemia 6. Non-insulin dependent diabetes mellitus, type 2 7. Obesity 8. Fibromyalgia 9. Osteopenia 10. Irritable bowel syndrome 11. Obstructive sleep apnea 12. h/[**Initials (NamePattern4) **] [**Last Name (NamePattern4) **]-[**Doctor Last Name **] tear ([**3-/2142**]) - Transfused with 4 Units of RBC 13. Cystic pancreatic mass ([**9-/2142**]) - Bx negative 14. Mild coronary artery disease (no prior cath reports available) 15. Congestive heart failure 16. Esophageal ulcers/GERD 17. Brain Schwannoma's (4 which are stable by MRI) 18. Left metatarsal fracture 19. Type 2 Diabetes 20. Anemia Discharge Condition: Alert and oriented x3 nonfocal Out with bed with assistance Incisional pain managed with Tylenol Lungs: diminished Right greater than left Incisions: Sternal - healing well, thoracotomy incision clean, dry and intact Edema +1 lower extremity bilaterally Discharge Instructions: Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight goes up more than 3 lbs. 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: Cardiac Surgeon: Dr. [**Last Name (STitle) 914**] on [**2144-2-17**] 1pm Cardiologist: Dr. [**Last Name (STitle) **] on [**2144-2-3**] 1:30 Thoracic surgeon: Dr. [**First Name (STitle) **] on [**2144-1-28**]/12 @9AM ENT: Dr. [**First Name (STitle) **] on [**2-21**] at 9:00 [**Telephone/Fax (1) 2349**] Please call to schedule appointments with your Primary Care: Dr. [**Last Name (STitle) **] in [**11-25**] 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: Atrial fibrillation Goal INR 2-2.5 First draw [**2144-1-22**] Results to phone fax to PCP's office [**Hospital1 **] after discharge from rehab Completed by:[**2144-1-21**] ICD9 Codes: 5119, 4168, 5990, 5180, 4019, 2724
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Medical Text: Admission Date: [**2170-11-15**] Discharge Date: [**2170-11-17**] Date of Birth: [**2140-5-11**] Sex: F Service: MEDICAL ICU HISTORY OF PRESENT ILLNESS: The patient is a 30 year old female with a history of depression +/- suicide attempts who presents after being found down and unresponsive by her roommate on the evening of admission. The patient's friends are worried that she may have ingested GHB (the patient has a history of taking this recreationally) plus Ativan (the patient for maintenance in caplets). The remainder of history was unable to be obtained as roommates were not there and the patient has no records or telephone numbers in the electronic record of [**Hospital1 **] Hospital. Per the patient's father, she is on probation in [**Name (NI) 108**] and has violated her probation to come to [**Location (un) 86**]. For the past few weeks, they have noticed her to be more "sleepy and depressed". Per her roommate, the patient has had suicidal ideations for the past two weeks, however, did not have a plan. When the roommate found the patient down, a note was present by report indicating that her suicide was intentional. "[**Name (NI) 18659**] (son) will be better with my sister". The patient's last contact was with her boyfriend around 5:00 to 6:00 p.m. the evening of admission over the telephone where she stated that she was tired and needed to lay down. In the Emergency Department, the patient was given Narcan without effect and activated Charcoal 60 times one dose. The patient was intubated in the field and vomited times one upon intubation. PAST MEDICAL HISTORY: Unknown. Per the patient's family, the patient has a negative medical history with the exception of depression and suicide attempts. ALLERGIES: No known drug allergies. MEDICATIONS ON ADMISSION: None. SOCIAL HISTORY: Positive tobacco, unclear amount. History of Ecstasy, Klonopin, GHB and Valium. PHYSICAL EXAMINATION: Temperature is 99.4, pulse 85, blood pressure 110/70, oxygen saturation 100% on AC ventilator mode, tidal volume 650, respiratory rate 12, FIO2 100%, PEEP 5. The patient is not responsive. The pupils are 2.0 millimeters bilaterally with minimal responsiveness. Head, eyes, ears, nose and throat - The oropharynx is with endotracheal tube in place, no response to voice or pain. Chest - coarse bronchial breath sounds in right upper lung zone. Cardiovascular is regular rate and rhythm, no murmurs, rubs or gallops. The abdomen is soft, nontender, no hepatosplenomegaly, hypoactive bowel sounds. Skin - no edema, no rash, no tenderness, has old scars on wrists bilaterally. She has 1+ dorsalis pedis, posterior tibial, radial pulses bilaterally. LABORATORY DATA: Upon admission, white blood cell count was 16.5, hematocrit 49.5, platelet count 288,000. Urinalysis was negative. Chemistries showed sodium 143, potassium 3.4, chloride 109, bicarbonate 15, blood urea nitrogen 6, creatinine 0.9, glucose 108, anion gap 19. ALT 24, AST 68, LDH 794, CK 2062, alkaline phosphatase 85, amylase 45, lipase 28, troponin negative, albumin 4.6. Initial blood gas showed a pH 7.33, pCO2 35, pO2 98, lactate 1.3. Serum osmolarity 304, calculated osmolarity 294 with a gap of 10. Electrocardiogram showed normal sinus rhythm, Q-T normal, QRS 90, normal axis and intervals. Chest x-ray showed a right upper lobe infiltrate. Head CT showed no bleed or acute process. HOSPITAL COURSE: 1. Likely ingestion - Toxic ingestion was initially unclear. The leading thoughts were GHB which correlated with the patient's cyclical agitation and sedation. Ecstasy was a possibility, however, the amphetamine toxicology was negative and there was no pupil dilation, tachycardia or fever. benzodiazepines were also thought to be a player as her toxicology screen was positive for these. A toxic alcohol screen was checked with negative findings for ethylene glycol, ethanol, isopropanol, methanol, acetone. The patient had no ketones in her urine and acetone was negative and thus alcohol ingestion was unlikely. Due to the initial worry for toxic alcohol ingestion, Fomepizole times one dose was given without effect. The patient was supported overnight on the ventilator and was closely monitored in the Intensive Care Unit and remained hemodynamically stable. 2. Respiratory failure - The patient was intubated in the field secondary to apnea. Aspiration likely occurred during the intubation but was thought to be a pneumonitis. Antibiotics were held and the patient was afebrile during admission. Antibiotics were never started. The patient was extubated on day after admission with ease. She was quickly titrated to room air and maintained good oxygen saturation during the rest of hospital course. 3. Suicide attempt - The patient is not helpful and denies suicide attempt. Once extubated, a psychiatry consultation was obtained. It was thought that although she disputes suicidal thoughts, she made a serious attempt with a suicide note after talking about suicide with her roommate. The patient has never sought treatment for her depression and requires involuntary commitment to a psychiatric hospitalization. The patient was agreeable to this and did not go to a psychiatry unit involuntarily. She wishes to seek treatment for her depression. 4. Elevated CK - [**Month (only) 116**] have been due to a seizure that occurred while the patient was unconscious. Serial CKs trended down nicely with no evidence of renal failure. DISPOSITION; The patient remained in the Intensive Care Unit for 48 hours after admission, she stabilized and will be transferred to a psychiatric inpatient unit, likely [**Hospital1 **] Three. DISCHARGE STATUS: Stable. CONDITION ON DISCHARGE: To inpatient psychiatric unit. MEDICATIONS ON DISCHARGE: None upon transfer from Medical Intensive Care Unit. FOLLOW-UP PLANS: The patient will follow-up with psychiatry as indicated by her hospital admission. The patient will continue with a one to one sitter upon discharge from the Intensive Care Unit and will remain on suicide precautions. [**First Name8 (NamePattern2) 1176**] [**Name8 (MD) 1177**], M.D. [**MD Number(1) 1178**] Dictated By:[**Last Name (NamePattern1) 9244**] MEDQUIST36 D: [**2170-11-17**] 12:06 T: [**2170-11-17**] 12:33 JOB#: [**Job Number 53826**] ICD9 Codes: 5070, 2762, 311
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Medical Text: Admission Date: [**2160-7-16**] Discharge Date: [**2160-7-22**] Date of Birth: [**2120-4-18**] Sex: M Service: LIVER TRANSPLANT SURGERY SERVICE ADMITTING DIAGNOSES: End-stage liver disease, admission for possible liver transplant. HISTORY OF PRESENT ILLNESS: Patient is a 40-year-old male with history of hepatocellular carcinoma type 2 with hepatitis. Patient underwent an ex-lap on [**2160-3-7**] with attempts at resection. However, he had evidence of cirrhosis. Resection was not performed. He underwent radiofrequency ablation. Current MELD score is 22. He has not had encephalopathy, [**2160-6-18**] aFP 1.8, hepatitis A/B nonreactive, ALT 34, AST 34, alkaline phosphatase 75, total bilirubin 0.7. PT 13.3. Platelets 141. Albumin 4.5. Currently taking adefovir 10 mg nightly. Thus, HB viral load undetectable. Feeling well. Denies recent illness. REVIEW OF SYSTEMS: Denies fever, chills, cough, nausea, vomiting, shortness of breath, chest pain, dizziness, indigestion, rashes, constipation, diarrhea, dysuria, or any mental status changes. On exposure, patient's sister-in-law had pharyngitis, on antibiotics. Lives with brother and sister-in-law. PAST MEDICAL HISTORY: End-stage liver disease secondary to hepatitis B cirrhosis stage 2, HCC, radiofrequency ablation [**2160-3-13**]. PAST SURGICAL HISTORY: On [**2160-3-7**], ex-lap, question tonsillectomy, question uvulectomy. ALLERGIES: No known drug allergies. MEDICATIONS: Adefovir 10 mg daily, Protonix 40 mg q.12., clotrimazole 5 times a day. PHYSICAL EXAMINATION: Patient is alert, awake, and oriented, pleasant. Pupils are equal, round, and reactive to light. EOMs are full. Trace scleral icterus. Pharynx: No thrush, no erythema, no soft tissue swelling. Neck: No JVD. Carotids are 2+, no bruits, no LAD. Lungs: Clear, nonlabored. CV: No S1, S2 without murmurs, rubs, or gallops. Abdomen: Positive bowel sounds, soft, nontender, and nondistended, well-healed ex-lap incision. Vascular: Good femoral pulses, 2+ DPs, no lower extremity edema, no rashes, no lesions. Neuro exam: Awake, alert, and oriented x3. Cranial nerves II through XII: Intact. Strength: Equal. No asterixis. Toes: Down bilaterally. Portable chest x-ray: There is no acute cardiopulmonary process. EKG: Normal sinus rhythm, no acute ischemia. HOSPITAL COURSE: Bloods were obtained. Preop antibiotic was given on call. Immunosuppressant medications were on call. So patient went to the OR on [**2160-7-16**], which an orthotopic liver transplant performed by Drs. [**Last Name (STitle) 816**], [**Name5 (PTitle) **], [**Name5 (PTitle) **]. Patient received 10 liters of plasma, 2 units of FFP, 1 unit of pack red blood cells. Please see OR note from [**2160-7-16**] for more details. Postoperatively, the patient went to the unit intubated. Patient was given HBIG 10,000 units, CellCept [**Pager number **] mg b.i.d., and given 2 units of FFP for an INR of 1.5. Postop day 1, patient was extubated. Patient was on fluconazole, ganciclovir, Bactrim, and Unasyn. Patient was given Solu-Medrol, continued on MMF. Patient was weaned off propofol and morphine sulfate for pain control. Patient was given another dose of hepatitis B immune globulin postop day 1. On postop day 1, patient did get a duplex ultrasound of his liver showing satisfactory ultrasound and Doppler appearance on the recent liver transplant. There is good upstroke in the right and left hepatic arteries and full patency of all portal and hepatic veins. Small right pleural effusion was noted, but there are no peritransplant fluid collections. On [**2160-7-17**], line placement was attempted. Chest x-ray was obtained after right internal jugular placed which demonstrated a right internal jugular central venous catheter overlies the right atrium and there was a small pneumothorax on the right, and it was confirmed on a followup left lateral decubitus. There was no need for chest tube because of the small size of the pneumothorax. On postop day 2, the patient continued with 2nd day of Unasyn, awake, alert, and oriented x3. Lungs are clear bilaterally. CV: Regular rate and rhythm. Making good urine output. Patient had drain in place. Continued MMF, Solu- Medrol 150 mg IV. Patient received tacrolimus 4 and 4 and HBIG 5000 units. On [**2160-7-19**], patient was transferred from the ICU to [**Hospital Ward Name 121**] 10. Patient continued on morphine with good pain management. Incision was intact with staples. There was a scant amount of JP drainage. On postop day 4, patient doing very well. Moved his lateral JP drain without complications. Continued on Solu-Medrol, MMF, tacrolimus was tapered to level. [**Hospital Ward Name **] on [**2160-7-20**] demonstrated WBC of 4.7, hematocrit of 28.7. PT of 12.7, 21.4, platelets 106, INR 1.1. Sodium 140, 3.8, 106, 23, 15, BUN and creatinine 22 and 0.7, glucose of 149. ALT 1035, AST 1226, and alkaline phosphatase 230. On hospital day 6, doing remarkably well, ambulating well, eating well without problems, urinating. [**Name2 (NI) **] on [**7-22**] demonstrate ALT of 483, AST of 48, alkaline phosphatase 180, total bilirubin 0.7. Rest of the [**Month (only) **] are pending. So patient should be able to go home today on the following medications: Adefovir dipivoxil NF 10 mg oral daily, fluconazole 400 mg p.o. q.24h., MMF 1000 b.i.d., Percocet [**1-20**] p.o. q.4-6h. p.r.n. Patient should get HBIG immunoglobulin on days 7, 14, and 28. Patient should continue with insulin- sliding scale. Protonix 40 mg q.24, prednisone 20 mg daily, Bactrim SS 1 tablet daily, and right now tacrolimus 4 mg b.i.d., ursodiol 300 mg b.i.d., valganciclovir 900 mg daily. Patient should have [**Month/Day (2) **] every Monday and Thursday starting this Thursday in which CBC, Chem-10, AST, ALT, alkaline phosphatase, albumin, total bilirubin, and Prograf should be obtained and faxed immediately to [**Telephone/Fax (1) 697**]. Patient should follow up with Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 497**] in [**Hospital Unit Name **] on [**2160-7-23**] at 3 p.m. Please call [**Telephone/Fax (1) 673**] if you have any questions about your appointment. Also please follow up with Dr. [**Last Name (STitle) **], [**Telephone/Fax (1) 673**] to make an appointment. FINAL DIAGNOSES: End-stage liver disease secondary to hepatitis B virus, hepatocellular carcinoma, status post orthotopic liver transplantation on [**2160-7-16**]. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], MD, PHD[**Numeric Identifier **] Dictated By:[**Last Name (NamePattern1) 4835**] MEDQUIST36 D: [**2160-7-22**] 08:52:59 T: [**2160-7-22**] 09:29:19 Job#: [**Job Number 59503**] ICD9 Codes: 5715
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Medical Text: Admission Date: [**2130-2-14**] Discharge Date: [**2130-2-23**] Date of Birth: [**2054-8-27**] Sex: F Service: VSU CHIEF COMPLAINT: Abdominal aortic aneurysm. HISTORY OF PRESENT ILLNESS: This is a patient who has known breast carcinoma with questionable metastatic disease who is receiving radiation therapy and she was brought onto the medical service and evaluated for shortness of breath. A CT scan showed a large chronic dissection of her aorta with an aneurysmal enlargement below the renal. Her left renal artery is noted to come off the false lumen. The patient returns now for elective aortic aneurysm repair. PAST MEDICAL HISTORY: Congestive heart failure, hypertension. The patient has a history of arthritis, history of depression. The patient has undergone a cardiac catheterization on [**2127-5-29**] which showed clear coronary arteries. The patient is a type 2 diabetic, controlled. The patient has pruritus and periorbital edema. PAST SURGICAL HISTORY: Bilateral lumpectomies with radiation therapy and CMP. The patient's ejection fraction is 25%. She also has a history of hyperlipidemia. The patient is a known smoker. She quit 20 years ago. She smoked 13 pack years. She does admit to a gin and tonic at bed time. ALLERGIES: Sulfa. MEDICATIONS ON ADMISSION: Diovan, Coreg, Lasix, simvastatin, Ativan, omeprazole, paroxetine, lisinopril, Colace. PHYSICAL EXAMINATION: Unremarkable. She had Dopplerable DP and PTs bilaterally and palpable DPs bilaterally. HOSPITAL COURSE: The patient was admitted to the preoperative holding area on [**2130-2-14**]. She underwent an abdominal aortic resection. She was transferred to the PACU in stable condition. Her postoperative hematocrit was 32.5, BUN 6, creatinine 0.9. The patient was neurologically intact. She had palpable DPs bilaterally. The patient went into flash pulmonary edema on postoperative day 1 and was transferred to the ICU for continued care from the PACU. The patient remained intubated. The patient's postoperative pain was controlled with epidural infusion. Pressors were weaned off. Lasix for diuresis was begun. Her triple lumen catheter was rewired. She remained in the SICU. Beta-blockade was increased for heart rate management. On postoperative day #3, the patient had an episode of mental status change. A CT was done which was negative for acute bleed or infarct. Ativan was discontinued. She continued to be diuresed for a goal of 1.5 L/24 hours. The patient was extubated on postoperative day 3 and transferred to the VICU for continued monitoring and care. Lopressor was increased and hydralazine was discontinued. Subcu heparin was continued. Physical examination showed diminished breath sounds at the bases. The remaining exam was unchanged. She had palpable DP and PT bilaterally. She was afebrile. Her white count was 8.7, hematocrit 31.8. The patient's EKG postoperatively was without any ST changes. Her troponin was less than 0.01. Ambulation to chair was begun on postoperative day 4. Physical therapy was requested to see the patient in anticipation for discharge planning. The epidural was discontinued. She was converted to oral agents. The patient demonstrated on postoperative day 5 with a much improved lung exam. Chest x-ray was improved. Ambulation was begun. Diet was advanced as tolerated with aspiration precautions. Hyperkalemia was repleted. On postoperative day #6, the patient was weaned by physical therapy. We felt the patient would be able to be discharged to home with physical therapy. The patient continues to progress. She will need to be evaluated for rehab. OT was requested to see the patient to evaluate cognitive of function. The patient will be discharged when medically stable and cleared by physical therapy. DISCHARGE MEDICATIONS: Pentamidine 20 mg b.i.d., metoprolol 50 mg t.i.d., valsartan 150 mg daily, simvastatin 20 mg daily, acetaminophen 325-650 mg q.4-6 hours p.r.n. pain, oxycodone immediate release 2.5-5.0 mg q.4 hours p.r.n. pain, aspirin 81 mg daily, senna tablets 1 b.i.d. p.r.n., Colace 100 mg b.i.d. p.r.n. DISCHARGE DIAGNOSIS: 1. Abdominal aortic aneurysm status post open resection. 2. Postoperative pulmonary edema, resolved. 3. Postoperative confusion, resolved. 4. Type 2 diabetes, diet controlled. 5. History of hypertension, controlled. 6. History of congestive heart failure, last episode prior to this was [**2128-10-28**]. 7. History of cardiomyopathy with systolic dysfunction and diastolic dysfunction. 8. History of hypertension. 9. History of mild coronary artery disease. 10. History of cardiac evaluation status post catheterization on [**2127-6-4**], no coronary artery disease, mild mitral regurgitation with severe systolic ventricular dysfunction, ejection fraction was 26%, mild pulmonary hypertension. 11. Episode of syncope secondary to fall resulting in a subdural hematoma and left wrist fracture on [**Month (only) 359**] [**2128**], resolved. 12. History of breast cancer, bilateral, status post lumpectomies with chemotherapy with CMP and radiation therapy. The patient is a former tobacco smoker. Has not smoked for 14 years. Prior to that was 10 pack-year history. 13. History of mild depression with sleep disorder. The patient should follow-up with Dr. [**Last Name (STitle) 1391**] in 2 weeks' time. She may shower but no tub baths. No driving. She is continued on all medications as directed. She should not lift anything heavier than 2 pounds for the next 4 weeks. She should call his office if she develops fever greater than 101.5, if the wounds become red or drain. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2380**], [**MD Number(1) 2381**] Dictated By:[**Last Name (NamePattern1) 2382**] MEDQUIST36 D: [**2130-2-20**] 12:30:25 T: [**2130-2-20**] 14:13:42 Job#: [**Job Number 109690**] ICD9 Codes: 2851, 4254, 4280, 4240, 4019, 4168, 2724, 2768
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Medical Text: Admission Date: [**2108-6-19**] Discharge Date: Date of Birth: [**2108-6-19**] Sex: M Service: NB IDENTIFICATION: Baby boy [**Known lastname 3825**] [**Known lastname **] is an 18 day old term infant with respiratory distress syndrome who is being discharged from the [**Hospital1 69**] neonatal intensive care unit. HISTORY: Baby boy [**Known lastname **] was born on [**2108-6-19**] as a 4900 gram product of a 38 and [**5-19**] week gestation pregnancy to a 37- year-old gravida 5 para 1-2-2 mother with estimated date of confinement of [**2108-6-29**]. Maternal history is notable for Crohn disease treated with prednisone. Prenatal laboratory studies included blood type O positive, antibody negative, hepatitis B surface antigen negative, rubella immune, RPR nonreactive and group B strep unknown. The infant was born by repeat cesarean section without any sepsis risk factors noted. At delivery, the infant was vigorous with Apgar scores of 8 and 9. The infant was initially admitted to the newborn nursing and was noted to develop tachypnea and mild work of breathing. Oxygen saturations were in the low 80s and the infant was brought to the neonatal intensive care unit for admission. GROWTH PARAMETERS AT BIRTH: Weight 4900 grams, greater than 90th percentile. Length 50 cm, 90th percentile. Head circumference 37.5 cm, greater than 90th percentile. HOSPITAL COURSE: 1. Respiratory: On admission, the infant was placed on nasal cannula oxygen for mild hypoxia. The infant required up to 150-200 cc of nasal cannula oxygen. The infant initially was noted to have mild work of breathing with mild tachypnea. These symptoms gradually improved over the first 24-48 hours of admission. Chest x-ray revealed hazy granularity in the basilar regions consistent with mild hyaline membrane disease. Over the next several days, the infant's respiratory status gradually improved such that by day of life [**4-15**], the infant was comfortably breathing with minimal work of breathing and was requiring low nasal cannula oxygen at 25-50 cc of flow. However, this oxygen requirement persisted with attempts to wean the infant to room air failing due to drifting oxygen saturations to the low 90s and high 80s. Repeat chest x-ray at approximately 1 week of life was similar to initial with mild haziness at the bases consistent with mild respiratory distress syndrome. Chest x-ray at 2 weeks of life was largely normal. Arterial blood gas at 2 weeks of life was reassuring with a pH of 7.49, PCO2 38, PO2 114. On day of life 16, due to generalized edema on exam and persistent oxygen requirement, the infant was given a dose of Lasix with a brisk diuresis. The infant was successfully weaned to room air shortly thereafter. The infant remained on room air for the next 48 hours and was thus discharge to home on day of life 18. 2. Cardiovascular: The infant remained cardiovascularly stable throughout admission. Due to persistent oxygen requirement, a cardiac evaluation was performed with an EKG that was normal, hyperoxia test that was normal and 4-extremity blood pressures that were normal. An echocardiogram was finally done on day of life 14 that revealed normal anatomy with a small atrial septal defect with left to right flow, normal ventricular function and no evidence of pulmonary hypertension. 3. Fluids, electrolytes, nutrition: The infant was initially maintained on IV fluids due to mild respiratory distress as well as initial D-stick in the 30s. Subsequent D- sticks were all within normal limits. Enteral feeds were begun on day of life 1 and advanced gradually. By day of life [**4-15**], the infant was ad lib feeding Similac 20 without difficulty. The infant continued to feed well with excellent intake and adequate weight gain. Urine and stool output remained brisk throughout. Electrolytes were measured on day of life 14 and these were within normal limits. Weight at the time of discharge was 5200 grams. 4. ID: CBC and blood cultures were sent on admission. White count was 15.8 with 68% polys and 1% bands. Hematocrit 50.7 and platelets were 223. Ampicillin and gentamicin were started and these were discontinued at 48 hours with negative blood cultures. The infant was noted to develop a candidal rash in the diaper area, treated with Miconazole powder. 5. GI: The infant was noted to develop mild hyperbilirubinemia that did not require phototherapy. Peak bilirubin was 15.6/0.3 on day of life 5. 6. Development: The infant's temperature remained stable in an open crib throughout admission. The neurologic exam remained normal throughout. CONDITION ON DISCHARGE: The infant was stable on room air with oxygen saturation greater than 94%. The infant was feeding similac 20 on an ad lib basis with adequate intake and adequate weight gain. Weight is 5.200 kg. DISPOSITION: Home. NAME OF PRIMARY PEDIATRICIAN: Dr. [**First Name4 (NamePattern1) 37327**] [**Last Name (NamePattern1) 72857**]. Phone number [**Telephone/Fax (1) 35938**]. ROUTINE HEALTHCARE MAINTENANCE: Hearing screen was performed and passed prior to discharge. Car seat safety screening was performed and passed prior to discharge. The infant received first hepatitis B vaccination on [**2108-7-4**]. State screens were sent on [**6-22**] and [**2108-7-3**] with no abnormal results received to date. FOLLOWUP: The infant will follow with the pediatrician three days after discharge. DISCHARGE DIAGNOSES: 1. Large for gestational age term infant. 2. Respiratory distress syndrome. 3. Testis evaluation negative. [**First Name8 (NamePattern2) **] [**Name8 (MD) **], MD [**MD Number(2) 56682**] Dictated By:[**Name8 (MD) **] MEDQUIST36 D: [**2108-7-6**] 20:10:42 T: [**2108-7-6**] 22:41:52 Job#: [**Job Number 72858**] ICD9 Codes: 769, V053, V290
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Medical Text: Admission Date: [**2102-10-28**] Discharge Date: [**2102-11-2**] Service: MEDICINE Allergies: Codeine / Ultram Attending:[**First Name3 (LF) 1990**] Chief Complaint: Vomiting x1 day and dizziness Major Surgical or Invasive Procedure: None History of Present Illness: [**Age over 90 **] yo Russian speaking female w/CML s/p gleevec, diastolic CHF (EF > 55%), afib who presents from [**Hospital3 **] facility after feeling lightheaded. She has also been having nausea with one episode of vomiting. Patient denies CP, SOB, abd pain, back pain, dysuria. Has chronic L shoulder and L knee pain. No falls, fevers, abdominal pain, diarrhea. . In the ED: BP 67/40 (baseline SBP 90s per OMR notes) HR 101, afebrile, sat normal. VERY dry MM. Patient received ketolorac IV for pain. She was guaiac:neg. Got 3 lts of NS in ED. CXR showed mild chf. Lactate was 2.8 and urine was dirty. Past Medical History: 1. Chronic myelogenous leukemia, on Gleevec, followed by Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 2539**]. Gleevec held, Dr. [**Last Name (STitle) 2539**] aware and will follow as outpt. 2. PAF - rate control, no anticoag by pt's choice 3. CHF- chronic diastolic 4. Spinal stenosis with chronic low back pain - s/p epidural steroid injections in [**First Name4 (NamePattern1) 1193**] [**Last Name (NamePattern1) 1194**] Clinic 5. Chronic R shoulder pain 6. s/p R total knee replacement 7. s/p R total hip replacement 8. s/p L comminuted tibial fx repair 9. Unsteady gait 10. h/o Dizziness, on meclizine 11. Hypercholesterolemia 12. h/o Dyspepsia 13. s/p cataract surgery bilaterally 14. OA Social History: Pt lives alone in a senior community. She has a caregiver that see her on a daily basis. She denies any tobacco, ETOH, or IVDU. Family History: Noncontributory. Physical Exam: 97.8, 75/58, 90, 16, 100%/2L NC, pulsus 6-8 mm hg GEN: pleasant, comfortable, NAD HEENT: PERRL, EOMI, dry MM NECK: no supraclavicular or cervical lymphadenopathy, JVD ~10 cm, no carotid bruits, no thyromegaly or thyroid nodules RESP: CTA b/l with good air movement throughout CV: RR, S1 and S2 wnl, 2/6 systolic murmur at apex, LSB, ?diastolic murmur at LSB ABD: epigastric/RUQ pain, no guarding/rigidity, BS+ EXT: 2+ bilateral edema SKIN: no rashes/no jaundice NEURO: AAOx3. Cn II-XII intact. strength exam limited by pain but able to move all extremities. strength throughout. No sensory deficits to light touch appreciated. No pass-pointing on finger to nose. 2+DTR's-patellar and biceps RECTAL: guiac negative Pertinent Results: [**2102-10-28**] 12:35PM PT-15.0* PTT-32.3 INR(PT)-1.3* [**2102-10-28**] 12:35PM PLT COUNT-201 [**2102-10-28**] 12:35PM HYPOCHROM-1+ ANISOCYT-NORMAL POIKILOCY-1+ MACROCYT-1+ MICROCYT-NORMAL POLYCHROM-NORMAL OVALOCYT-OCCASIONAL BURR-1+ BITE-OCCASIONAL [**2102-10-28**] 12:35PM NEUTS-89* BANDS-6* LYMPHS-4* MONOS-1* EOS-0 BASOS-0 ATYPS-0 METAS-0 MYELOS-0 [**2102-10-28**] 12:35PM WBC-9.5 RBC-2.84* HGB-8.7* HCT-26.5* MCV-93 MCH-30.6 MCHC-32.9 RDW-15.8* [**2102-10-28**] 12:35PM ALBUMIN-3.1* CALCIUM-8.6 PHOSPHATE-3.2 MAGNESIUM-2.0 [**2102-10-28**] 12:35PM CK-MB-NotDone [**2102-10-28**] 12:35PM cTropnT-0.05* [**2102-10-28**] 12:35PM LIPASE-9 [**2102-10-28**] 12:35PM ALT(SGPT)-11 AST(SGOT)-23 CK(CPK)-50 ALK PHOS-115 AMYLASE-21 TOT BILI-0.6 [**2102-10-28**] 12:35PM estGFR-Using this [**2102-10-28**] 12:35PM GLUCOSE-101 UREA N-56* CREAT-2.5*# SODIUM-135 POTASSIUM-5.5* CHLORIDE-102 TOTAL CO2-19* ANION GAP-20 [**2102-10-28**] 12:48PM LACTATE-2.8* K+-5.2 [**2102-10-28**] 12:48PM COMMENTS-GREEN [**2102-10-28**] 02:15PM URINE RBC->50 WBC-[**1-30**] BACTERIA-MANY YEAST-NONE EPI-[**1-30**] TRANS EPI-0-2 [**2102-10-28**] 02:15PM URINE BLOOD-LG NITRITE-NEG PROTEIN-30 GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-NEG [**2102-10-28**] 02:15PM URINE COLOR-Amber APPEAR-Hazy SP [**Last Name (un) 155**]-1.021 [**2102-10-28**] 08:50PM URINE HOURS-RANDOM UREA N-279 CREAT-98 SODIUM-12 [**2102-10-28**] 09:30PM CORTISOL-17.9 [**2102-10-28**] 09:30PM CK-MB-4 cTropnT-0.03* [**2102-10-28**] 09:30PM CK(CPK)-32 [**2102-10-28**] 10:23PM CORTISOL-36.3* Brief Hospital Course: * The following is the D/C summary as written by the attending of record ([**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **]) from [**10-30**] through discharge [**11-2**] * For details of her ICU STAY from admission ([**2102-10-28**]) until transfer to the medical [**Hospital1 **] on [**10-30**], please refer to Dr. [**Last Name (STitle) **] of Pulmonary and Critical Care. [**Age over 90 **] yo Russian speaking female w/CML, diastolic CHF (EF > 55%), afib, presented with symptoms of dizziness, found to be hypotensive. . # Sepsis, source unclear, with bacteremia (group B strep) and hypotension: Required pressors and 10 L volume repletion in the ICU. Stabilized and called out to the medical floor. Blood cultures positive for Group B strep, source unclear. Initially maintained on Vancomycin and Zosyn. This was narrowed to penicillin once the sensitivities returned. In lenthy discussion with patient, family, palliative care, pt. stated repeatedly that she did not want any care that would prolong her life. On [**2100-11-1**], according to her wishes, abx. were stopped. She was sent to [**Location (un) 582**] [**Hospital1 1501**] with Hospice care on [**2102-11-2**] in stable contdition. She was afebrile, with stable vital signs, and tolerating some po liquids. . #Pain Control: In conjuction with the palliative care service, the patient was given fentanyl patch, lidocaine patch, oral dilaudid and tyelenol. She was prescribed liquid morphine for use in Hospice po, if she is unable to swallow the dilaudid pills. . # Nausea - treated with oral ondansetron. . # ARF: felt due to ATN in the setting of hypotension from sepsis. Renal function recovered toward baseline by the end of admission, but, given the patient's wishes for comfort only care, no labs were at the end of her stay and renal function was no longer monitored by serum cr. assay. . # Atrial Fibrillation: Chronic, not on coumadin. BB initially held in ICU given hypotension. Resumed on medical floor as BP stable, and in order to control RVR. . # CHF w/ diastolic dysfunction, chronic: Pt. was overall volume overloaded, with intravascular depletion after ICU volume rescussitation as above. Given ARF, lasix was held; towards the end of her hospitalization, once comfort only care was chosen, lasix was not re-administered as she appeared to be auto-diuresing, with large volumes of urine output, and her respiratory status was stable. . # HTN: Hypotensive on admission. Will hold antihypertensives until BP normalizes. . # CML - Pt. choses comfort only care, as above. No further treatment for CML. Discharged to [**Location (un) 582**] with Hospice care, as above. Medications on Admission: allopurinol 100 mg daily Toprol-XL 50 mg daily Lasix 40 mg twice a day potassium 20 mEq daily aspirin 81 mg daily Gleevec 200 mg QD oxycodone as needed for pain iron daily Celebrex 100 mg twice a day Prilosec daily Senokot as needed trazodone 50 mg at bedtime Discharge Medications: 1. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 2. Allopurinol 100 mg Tablet Sig: One (1) Tablet PO EVERY OTHER DAY (Every Other Day). 3. Senna 8.6 mg Tablet Sig: 1-2 Tablets PO BID (2 times a day) as needed for constipation. 4. Lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: One (1) Adhesive Patch, Medicated Topical DAILY (Daily). 5. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 6. Trazodone 50 mg Tablet Sig: 0.5 Tablet PO HS (at bedtime) as needed. 7. Hydromorphone 2 mg Tablet Sig: One (1) Tablet PO Q3H (every 3 hours) as needed. Tablet(s) 8. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO Q6H (every 6 hours) as needed. 9. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). 10. Fentanyl 25 mcg/hr Patch 72 hr Sig: One (1) Patch 72 hr Transdermal Q72H (every 72 hours). 11. Docusate Sodium 50 mg/5 mL Liquid Sig: Ten (10) mL PO BID (2 times a day). 12. Ondansetron 4 mg Tablet, Rapid Dissolve Sig: One (1) Tablet, Rapid Dissolve PO Q8H (every 8 hours) as needed. 13. Morphine 10 mg/5 mL Solution Sig: 1-5 mg PO Q 2 H PRN (). 14. Acetaminophen 160 mg/5 mL Solution Sig: Six [**Age over 90 1230**]y (650) mg PO Q6H (every 6 hours) as needed. 15. Ativan 0.5 mg Tablet Sig: One (1) Tablet PO every six (6) hours as needed for nausea, anxiety. Discharge Disposition: Extended Care Facility: [**Location (un) 582**] Of [**Location (un) 620**] Discharge Diagnosis: CML Bacteremia with sepsis Chronic, diastolic, heart failure Atrial fibrillation Acute renal failure due to ATN Chronic pain Discharge Condition: Stable Discharge Instructions: Take all medications as prescribed. Follow up with Hospice Care at [**Location (un) 582**] Skilled Nursing Facility as arranged. Followup Instructions: As above. [**Location (un) 582**] [**Location (un) 620**] [**Hospital1 1501**] with Hospice care. ICD9 Codes: 5845, 4280
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Medical Text: Admission Date: [**2103-8-21**] Discharge Date: [**2103-8-28**] Date of Birth: [**2036-12-27**] Sex: M Service: ORTHOPAEDICS Allergies: Latex Attending:[**First Name3 (LF) 3645**] Chief Complaint: I had the pleasure of seeing Mr. [**Known lastname 6330**] in orthopedic spine clinic for his chief complaint of back problems. Major Surgical or Invasive Procedure: 1. C4-C5 anterior arthrodesis. 2. Application of interbody VG2 device. 3. Anterior cervical decompression C4-C5. 4. Posterior laminectomy, medial facetectomy, foraminotomy, C3-C4, C4-C5, C5-C6. 5. Posterior arthrodesis C3-C4, C4-C5, C5-C6, C6-C7. 6. Posterior instrumentation C3-C7 segmental. 7. Application and removal of tongs. 8. Application of local autograft. 9. Application of morcelized allograft. 10. Spinal cord monitoring with motor evoked NSCCP's. History of Present Illness: As you know, he is a 66-year-old gentleman with acute and chronic back pain. For the past six months, he states his back pain has been increasing. At this time, he states his back pain is [**8-7**] at rest and [**11-7**] with activity. He does not complain of any changes in his bowel, bladder, or balance. He denies any numbness or tingling of the lower extremities. He also denies any weakness or calf pain with walking. He states that there was no specific accident but this has just gradually kind of come on. He also complains of medial left thigh pain. He says any activity makes it worse and he has not had any physical therapy prior to this exam. Past Medical History: Significant for high blood pressure, which he states is under control. He has had thyroid disease. Specifically, he does have Addison's disease. In addition, he has been on steroid medications for approximately fifteen years. He states that over the last six months, due to his last hospitalization, they upped his steroids to 150 mg per day, he has since backed off to 30 mg per day. Social History: He states he is currently working. He smokes a pipe and he has approximately two or three drinks per week. He lives at home with his wife. Family History: Family history is significant for cancer on his mother's side and heart disease on his father's side. Physical Exam: On physical exam, he is approximately 5 feet 8 inches tall, weighing 225 pounds with a blood pressure of 115/70. His gait is quite antalgic. He is able to stand on his heels and toes. His gait is very small steps steppage gait with a narrow base. He has negative Romberg. Lower extremity strength is [**6-2**] in all fields. He is neurologically intact to light touch in all fields. Reflexes of his lower extremities when compared to his reflexes of his upper extremity exhibit hyperreflexia. He does have clonus x4 on the right and a sustained clonus on the left. He also has a large degree of pitting edema in his lower extremities. He states he believes that this is secondary to the increase to his steroid medication and the removal hydrochlorothiazide from his medical regimen. Physical exam of his upper extremity, he has good strength 5/5 in all fields of bilateral upper extremities and he is neurologically intact to light touch. He does state he has some numbness and tingling in his pinky of both hands. Pertinent Results: [**2103-8-22**] 03:00AM BLOOD WBC-13.7* RBC-4.17* Hgb-13.3* Hct-38.8* MCV-93 MCH-31.9 MCHC-34.3 RDW-15.3 Plt Ct-229 [**2103-8-23**] 01:56AM BLOOD WBC-20.5* RBC-4.27* Hgb-14.0 Hct-41.1 MCV-96 MCH-32.8* MCHC-34.1 RDW-15.0 Plt Ct-252 [**2103-8-23**] 06:14AM BLOOD WBC-15.6* RBC-3.95* Hgb-12.7* Hct-38.3* MCV-97 MCH-32.1* MCHC-33.1 RDW-14.9 Plt Ct-276 [**2103-8-24**] 01:08AM BLOOD WBC-12.5* RBC-3.62* Hgb-11.8* Hct-34.1* MCV-94 MCH-32.7* MCHC-34.7 RDW-15.2 Plt Ct-221 [**2103-8-25**] 03:52AM BLOOD WBC-12.8* RBC-3.64* Hgb-11.9* Hct-34.8* MCV-96 MCH-32.7* MCHC-34.2 RDW-15.1 Plt Ct-268 [**2103-8-23**] 06:15AM BLOOD CK(CPK)-575* [**2103-8-24**] 01:08AM BLOOD ALT-30 AST-35 LD(LDH)-177 AlkPhos-211* Amylase-49 TotBili-1.3 [**2103-8-23**] 06:15AM BLOOD CK-MB-13* MB Indx-2.3 cTropnT-0.03* [**2103-8-24**] 01:08AM BLOOD Albumin-3.1* Calcium-8.3* Phos-2.8 Mg-2.0 [**2103-8-25**] 03:52AM BLOOD Calcium-8.5 Phos-2.6* Mg-2.2 [**2103-8-21**] 02:47PM BLOOD Type-ART PEEP-5 pO2-120* pCO2-46* pH-7.41 calTCO2-30 Base XS-4 Intubat-INTUBATED [**2103-8-21**] 10:14PM BLOOD Type-ART pO2-187* pCO2-40 pH-7.41 calTCO2-26 Base XS-1 [**2103-8-22**] 03:07AM BLOOD Type-ART pO2-154* pCO2-46* pH-7.40 calTCO2-30 Base XS-3 [**2103-8-23**] 01:39AM BLOOD Type-ART pO2-97 pCO2-106* pH-7.07* calTCO2-33* Base XS--2 [**2103-8-23**] 04:21AM BLOOD Type-ART Rates-20/ Tidal V-600 PEEP-8 FiO2-60 pO2-73* pCO2-41 pH-7.34* calTCO2-23 Base XS--3 Intubat-INTUBATED [**2103-8-23**] 01:55PM BLOOD Type-ART pO2-169* pCO2-30* pH-7.52* calTCO2-25 Base XS-2 [**2103-8-23**] 02:47PM BLOOD Type-ART pO2-116* pCO2-41 pH-7.42 calTCO2-28 Base XS-2 [**2103-8-23**] 06:11PM BLOOD Type-ART pO2-295* pCO2-41 pH-7.42 calTCO2-28 Base XS-2 [**2103-8-23**] 07:42PM BLOOD Type-ART Rates-0/10 FiO2-40 pO2-146* pCO2-43 pH-7.42 calTCO2-29 Base XS-3 Intubat-INTUBATED Vent-SPONTANEOU [**2103-8-24**] 01:33AM BLOOD Type-ART Temp-38.6 Rates-/10 FiO2-40 pO2-184* pCO2-47* pH-7.40 calTCO2-30 Base XS-3 Intubat-INTUBATED Vent-SPONTANEOU [**2103-8-24**] 04:18AM BLOOD Type-ART Temp-38.1 Rates-/12 PEEP-8 FiO2-40 pO2-178* pCO2-47* pH-7.39 calTCO2-30 Base XS-3 Intubat-INTUBATED Vent-SPONTANEOU [**2103-8-24**] 06:22AM BLOOD Type-ART Temp-37.5 Rates-/13 Tidal V-560 PEEP-5 FiO2-40 pO2-163* pCO2-45 pH-7.42 calTCO2-30 Base XS-4 Intubat-INTUBATED Vent-SPONTANEOU [**2103-8-24**] 08:40AM BLOOD Type-ART pO2-177* pCO2-34* pH-7.48* calTCO2-26 Base XS-3 [**2103-8-24**] 10:52AM BLOOD Type-ART pO2-89 pCO2-48* pH-7.38 calTCO2-29 Base XS-1 [**2103-8-24**] 06:55PM BLOOD Type-ART pO2-99 pCO2-44 pH-7.44 calTCO2-31* Base XS-4 Brief Hospital Course: Mr. [**Known lastname 6330**] was brought to [**Hospital1 18**] for treatment of his cervical stenosis with myelopathic changes. Medications on Admission: hydrocortisone 20 mg Altace 10 mg Norvasc 10 mg Protonix 40 mg testosterone 7 mL Discharge Medications: 1. Hydrocortisone 5 mg Tablet Sig: One (1) Tablet PO QPM (once a day (in the evening)). 2. Hydrocortisone 5 mg Tablet Sig: Three (3) Tablet PO QAM (once a day (in the morning)). 3. Levothyroxine 50 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Percocet 5-325 mg Tablet Sig: 1-2 Tablets PO every 4-6 hours. Disp:*90 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: Southeastern Discharge Diagnosis: 1. Cervical myelopathy. 2. Cervical stenosis. 3. Morbid obesity. 4. Panhypopituitarism from pituitary tumor 5. Hypertension Discharge Condition: Stable to home with physical therapy. Discharge Instructions: Please keep your incision clean and dry. You may shower but please do not soak the incision. Please reusme all your home medication as prescribed by your primary care. If you notice redness or drainage from your incision or if you have a fever greater than 100.5, please call the office at [**Telephone/Fax (1) **]. Please refer to the discharge sheet for questions on activity and follow up. Followup Instructions: Please follow up with Dr. [**Last Name (STitle) 1352**] two weeks from the date of surgery. Completed by:[**2103-9-5**] ICD9 Codes: 4019
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Medical Text: Admission Date: [**2165-3-12**] Discharge Date: [**2165-3-20**] Date of Birth: [**2094-11-26**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1253**] Chief Complaint: Altered Mental Status Major Surgical or Invasive Procedure: central venous line placement and subsequent removal hemodialysis line removal History of Present Illness: 70 yo M presented to ED from nursing home w/ altered mental status and low grade fever. Per the patient's son, patient's penile gangrene had worsened - prior dry gangrene isolated to glans penis treated conservatively given not operative candidate and followed closely by urology. On evaulation in the ED patient was oriented only to self. In the ER initial VS were: T 100.6 HR 53 BP 135/67 RR 14. VS prior to transfer to the ICU 86, BP 146/65 98% on 2L RR 12. He rec'd 20u sc insulin in total, he rec'd 500cc of IVF. Had a L SC CVL placed. He was transferred to the MICU for concern of sepsis. CT groin showed sq air diagnostic for fournier's gangrene. He was treated with vanc/zosyn/cipro and urology was consulted who had a long discussion with son about patient not being an operative candidate and the natural course of fournier's gangrene without surgical intervention. Decision made to make patient DNR/DNI with no escalation of care. Patient was hemodynamically stable throughout MICU course. He was transferred to the floor and upon evaluation patient denied pain, CP, SOB, abd pain or other ROS. Past Medical History: -5/08 L BKA for gangrene -[**12-30**] glans penis dry gangrene conservatively managed -DM2 -Hypertension -CKD baseline 3.5-4.2, up to 9 in [**6-28**] -blindness -neuropathy, possibly demyelinating polyneuropathy -systolic CHF EF 50% as of [**4-28**] Social History: Originally from [**Location (un) 4708**]. Very remote tobacco use. Denies EtOH or drugs. Wheelchair bound, lives at home with family who are very involved - has nurse visit 3x/day. Family History: Diabetes, CAD in children. One son died of MI. Physical Exam: VS: 138/67 87 15 98.7 90-98% on RA GEN: elderly gentleman, lying in bed,looking straight. HEENT: R corenal haziness, reduced vision, EOMI, no icterus, MMM NECK: no cervical lymphadenopathy CV: RRR, no r/g/m PULM: clear to auscultation bilaterally ABD: soft, mildy distended, non tender GROIN: deferred temporarily. EXT:warm and well perfused. R foot with dorsal edema, dry ulcer, well circumscribed, no drainage. left BKA. NEURO: difficult to assess, patient able to verbalize. hard of hearing. can follow some simple commands. could not move feet when asked. unclear if he understood. Exam at discharge: T 96 HR 99 158/60 92% RA GEN: elderly gentleman, lying in bed, alert and oriented to person, comfortable HEENT: R corenal haziness, reduced vision, EOMI, no icterus, MMM NECK: no cervical lymphadenopathy CV: RRR, no r/g/m PULM: clear to auscultation bilaterally ABD: soft, mildy distended, non tender GROIN: gangrene of glans and shaft with some purulence at coronal sulcus. Crepitus notable along lenth of penile shaft. Urethra with some purulence but appears patent. Erythema extending to suprapubic region EXT:warm and well perfused. R foot with dorsal edema, dry ulcer, well circumscribed, no drainage. left BKA. Pertinent Results: CT A/P: IMPRESSION: 1. Extensive subcutaneous and soft tissue emphysema involving essentially all compartments of the penis extending its entire length, consistent with Fournier's gangrene. Emergent surgical evaluation is recommended. 2. Extensive diffuse atherosclerotic disease, with possible right proximal superficial femoral artery occlusion as described. Please correlate clinically for further evaluation. Current study is not tailored for CT angiography. 3. Moderate-to-large bilateral pleural effusions with compressive atelectasis, right greater than left. 4. High-density exophytic small lower pole right renal lesion, new since [**2160**], is not fully characterized. This may be further evaluated by ultrasound on a non-emergent basis. 5. Diffuse severe anasarca. 6. Fat-containing umbilical hernia. 7. Moderate amount of fecal material throughout the colon. CT HEAD: No intracranial hemorrhage, large vascular territory infarct, or large mass. Please note MRI with gadolinium is superior for evaluation of intracranial mass if not contraindicated. LABS: - CBC: WBC-20.9 Hgb-8.3 Hct-28.3 MCV-80 Plt Ct-556 - DIFF: Neuts-91.5* Lymphs-5.3* Monos-2.9 Eos-0.2 Baso-0.2 - COAGS: PT-13.3 PTT-28.6 INR(PT)-1.1 - CHEM 10: Glucose-393 UreaN-80 Creat-8.4 Na-137 K-5.3 Cl-97 HCO3-24 AnGap-21 Calcium-8.5 Phos-6.6* Mg-2.6 - LFT's: ALT-13 AST-15 CK(CPK)-49 AlkPhos-363 TotBili-0.3 - cTropnT-0.83* - Lactate-1.4 Labs prior to discharge: WBC RBC Hgb Hct MCV MCH MCHC RDW Plt Ct 30.8* 3.89* 9.6* 30.8* 79* 24.7* 31.2 21.4* 475 Brief Hospital Course: ASSESSMENT & PLAN: 70 year old male with h/o DM, HTN, ESRD on HD and systolic CHF EF 30% presented with altered mental status, fever, found to have Fourniers gangrene of the groin. He was septic and started on Vanco/Zosyn/Clindamycin in the ICU. The patient was a high surgical risk, and any survival and per urology the benefit to be obtained from debridement would likely be small and associated with significant pain and painful dressing changes. He was continued on antibiotics and an aggressive pain regimen. This alleviated his symptoms. His mental status also cleared as his pain control improved. He was hemodynamically stable and he was tranferred to the floor where further discussion regarding goals of care were pursued with the assitance of the palliative care team. During a family meeting, it was made clear that the patient's Fournier's gangrene was non-operative and was terminal. Following this discussion with [**Hospital 228**] health care proxy, son [**Name (NI) 14175**], the decision was made that the patient would want his care to be focused at home with hospice without return to a health care facility if his condition worsened. Hemodialysis was discontinued, and his HD line was removed. Hospice care was arranged, and the patient was discharged on [**2165-3-20**] home with hospice. He had a mid-line placed so that he could continue to receive antibiotics for his non-operative Fournier's gangrene. Pain control was optimized with a fentanyl patch and sublingual morphine. The patient was comfortable and alert upon discharge. Medications on Admission: HOME MEDICATIONS: Amlodipine 5 mg daily Aspirin 325 mg po daily Atorvastatin 40 mg po daily Insulin Lispro sliding scale Metoprolol Succinate 25 mg SR daily B Complex-Vitamin C-Folic Acid 1 mg po daily Acetaminophen 325 mg 1-2 tablets q6hrs prn Ranitidine HCl 150 mg po daily Insulin Glargine 2 units daily Docusate Sodium 100 mg po bid Polyethylene Glycol 3350 17 gram/dose po daily Bisacodyl 5 mg po daily Senna 8.6 mg po bid MEDICATIONS ON TRANSFER: Acetaminophen 1000 mg PO/NG TID Artificial Tears 1-2 DROP BOTH EYES Q4 HOURS HYDROmorphone (Dilaudid) 0.25 mg IV Q3H:PRN pain Clindamycin 600 mg IV Q8H Piperacillin-Tazobactam 2.25 g IV Q12H Vancomycin 1000 mg IV HD PROTOCOL Discharge Medications: 1. Polyvinyl Alcohol-Povidone 1.4-0.6 % Dropperette Sig: [**12-22**] Drops Ophthalmic Q4 HOURS (). 2. Acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO TID (3 times a day). 3. Zosyn 2.25 gram Recon Soln Sig: One (1) Intravenous every eight (8) hours for 1 months. Disp:*qs * Refills:*2* 4. Fentanyl 25 mcg/hr Patch 72 hr Sig: One (1) Transdermal every seventy-two (72) hours. Disp:*5 0* Refills:*0* 5. Clindamycin HCl 150 mg Capsule Sig: Three (3) Capsule PO Q6H (every 6 hours). 6. Morphine Concentrate 20 mg/mL Solution Sig: 1-2 mg PO Q1H (every hour) as needed for breakthrough pain/dyspnea. Discharge Disposition: Home With Service Facility: [**Hospital 269**] Hospice Care Discharge Diagnosis: Primary Diagnosis: Forneir's Gangrene End stage renal disease Type II Diabetes Mellitus Secondary Diagnosis: Hypertension Discharge Condition: Mental Status: alert and oriented to person Level of Consciousness: alert Activity Status: bedrest, out of bed with assist Discharge Instructions: Mr. [**Known lastname 12543**] - It was a pleasure to care for you during your hospitalization. You were admitted due to a very serious infection of the skin and soft tissue of the penis. You were evaluated by urology and surgery was thought to be very dangerous. You were continued on antibiotics. The urologists did not think that you would be able to tolerate a painful surgery to cure the infection, which is a terminal infection. The decision was made by you and your family to treat your pain and other symptoms with pain medications and antibiotics. Following a family meeting, arrangements were made for hospice services at home to continue comfort measures. Dialysis was discontinued, and your hemodialysis line was removed. You had another IV placed to continue receiving antibiotics at home. You went home on [**2165-3-20**] with the intent to continue comfort measures only and not to return to the hospital. See below for a list of medications you will given at home. You will continue to receive hospice care at home. Followup Instructions: You will continue to receive hospice care at home. ICD9 Codes: 0389, 5856, 2762, 4280, 3572
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Medical Text: Admission Date: [**2171-9-11**] Discharge Date: [**2171-9-17**] Date of Birth: [**2120-2-12**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**Last Name (NamePattern1) 1171**] Chief Complaint: mitral [**Last Name (NamePattern1) **] Major Surgical or Invasive Procedure: mitral [**Last Name (NamePattern1) **] [**2171-9-13**] History of Present Illness: Patient is a 51 year old Cantonese speaking man with history of rheumatic mitral stenosis, prior pulmonary embolism, and left atrial clot. He presents today for admission for heparin drip in preparation of TEE and mitral [**Month/Day/Year **]. Of note, patient was admitted in [**2171-4-23**] for chest pain, and was found to be in atrial fibrillation. During that admission, a transthoracic echocardiogram demonstrated rheumatic mitral stenosis with an ejection fraction of 40-50%. A transesophageal echocardiogram demonstrated a left atrial appendage, and he was started on Coumadin. A [**Year (4 digits) **] and cardioversion were deferred at that time given the finding of the clot. History done through an interpreter. Since [**Month (only) 547**] admission patient's symptoms have been stable (not worse or better). Describes shortness of breath with exertion. Tends to feel dizzy when he bends over. Denies chest pain, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, or syncope. Patient describes mild nausea, denies abdominal pain or vomiting. Wife states he had an EGD which demonstrated ulcers and was started on "medication" for 2 months. Denies black or bloody stool. Patient aware he is in a hospital for a valve procedure. He has not taken his warfarin since last saturday night. Past Medical History: - Rheumatic mitral stenosis - History of pulmonary embolism [**2169**] - Atrial fibrillation Social History: Worked in a restaurant kitchen. Lives with wife. Smoked [**11-11**] cigarettes daily for 10 years, not currently smoking. No EtOH or drug use. Family History: Father with "enlarged heart" died at age 84. Mother has [**Last Name **] problem, but patient does not know what it is. Physical Exam: On Discharge: VS: T97.8, BP105/84, HR 85, RR12, 100% 2lNC Gen: NAD, no resp dist. Oriented x3. HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. CV: PMI located in 5th intercostal space, midclavicular line. RR, normal S1, S2. No S4, no S3, 3/6SEM heart over precordium Chest: No chest wall deformities, scoliosis or kyphosis. Resp were unlabored, no accessory muscle use. No crackles, wheeze, rhonchi. Abd: soft, nt/nd, positive bowel sounds, no HSM or tenderness. Ext: No c/c/e. No femoral bruits, L and R femoral sites without signs of bleed or hematoma. Skin: No stasis dermatitis, ulcers, scars, or xanthomas. Right: Carotid 2+ without bruit; Femoral 2+ without bruit; 2+ DP Left: Carotid 2+ without bruit; Femoral 2+ without bruit; 2+ DP Pertinent Results: [**2171-9-11**] ALT(SGPT)-32 AST(SGOT)-24 LD(LDH)-199 ALK PHOS-93 AMYLASE-90 TOT BILI-0.4 [**2171-9-11**] WBC-6.3 RBC-4.31* HGB-13.4* HCT-40.2 MCV-93 MCH-31.1 MCHC-33.3 RDW-14.9 [**2171-9-11**] PT-15.1* PTT-32.9 INR(PT)-1.3* H. pylori: POSITIVE MITRAL [**Month/Day/Year **]/CARDIAC CATH [**2171-9-13**]: 1. Severe mitral stenosis with mean gradient of 15mmHg and area of 0.68cm2. 2. Successful transeptal puncture with intracardiac echo guidance. 3. Successful mitral [**Month/Day/Year **] using Inoue balloon inflated to a maximum diameter of 30mm. POST-PROCEDURE ECHOS: TTE [**2171-9-13**] at 12:45:00 PM: Study immediately post balloon mitral [**Year (4 digits) **]. Overall left ventricular systolic function is normal (LVEF>55%). The right ventricular cavity is mildly dilated with normal free wall contractility. The aortic valve leaflets are moderately thickened. The mitral valve shows characteristic rheumatic deformity. There is moderate valvular mitral stenosis (area 1.0-1.5cm2). Moderate (2+) mitral regurgitation is seen. The tricuspid valve leaflets are mildly thickened. Moderate [2+] tricuspid regurgitation is seen. Compared with the prior study (images reviewed) of [**2171-4-29**], the MVA area is greater and the mean mitral gradient has decreased. There is now moderate mitral regurgitation. TEE [**2171-9-13**] at 2:40:05 PM: The left atrium is dilated. Moderate to severe spontaneous echo contrast and a layering thrombus is present in the left atrial appendage. There is organizinf thrombus in the LAA situated deep within the structure and away from the mouth of the structure, measuring 2.2x 2.1cm in maximal diameter. The left atrial appendage emptying velocity is depressed (<0.2m/s). The right atrium is dilated. The right atrial appendage ejection velocity is depressed (<0.2m/s). There are simple atheroma in the descending thoracic aorta. There are three aortic valve leaflets that are moderately thickened. The left and right leaflet appears fused but frank aortic stenosis ids not present. Trace aortic regurgitation is seen. The mitral valve leaflets are moderately thickened and shows characteristic rheumatic deformity. There is at least moderate valvular mitral stenosis (area 1.0-1.5cm2). There is no chordal deformation/thickening. Trivial mitral regurgitation is seen. [Due to acoustic shadowing, the severity of mitral regurgitation may be significantly UNDERestimated.] There is no pericardial effusion. Compared with the prior study (images reviewed) of [**2171-5-3**], the left atrial appendage thrombus is consdierably smaller, not as mobile, and situated away from the mouth of the atrial appendage. CT Abdomen/Pelvis [**2171-9-13**]: 1. Resting hemodynamics revealed a mean mitral valve gradient of 15mmHg and estimated valve area of 0.68cm2. 2. Successful transeptal puncture and mitral [**Month/Day/Year **] using a an Inoue balloon inflated to 26mm, 28mm and 30mm diameter. 3. Improvement of mean gradient to 6mmHG and valve area to 1.98cm2. Patient left cathlab in stable condition. CXR [**2171-9-14**]: Moderate-to-marked cardiomegaly is stable. Small bilateral pleural effusions are unchanged. There is no overt CHF. There are bibasilar atelectases. ULTRASOUND [**2171-9-15**]: No evidence of bilateral groin hematoma, fluid collections or vascular abnormalities in the common femoral vessels. Brief Hospital Course: Mitral Stenosis secondary to Rheumatic disease: Mitral [**Month/Day/Year **] [**2171-10-14**]. Intra-procedure SBPs 70s-110 and required doputamine support. Post-procedure SBP 70s and was transferred to CCU for observation. Hypotension differential included tamponode vs. bleed (RP or groin). ECHO X 2 negative for tamponode or effusion. Groin sites intact and CT ab/pelvis negative for bleed. Most likely related to procedure medications and new onset MR. [**Name13 (STitle) **] was stable in unit and transferred back to the floor on [**2171-10-15**]. On [**2171-10-16**] patient developed hematoma at R cath site, heparin was continued but coumadin was held. Blood pressure and HCT were stable, ultrasound imaging on [**2171-10-16**] was negative for hematoma b/l. Patient developed mild-moderate MR [**First Name (Titles) 767**] [**Last Name (Titles) **]. Patient's SBP averaged 100s and felt too low to start afterload reducer inpatient. Consider outpatient afterload reducer if BP tolerates. Follow-up ECHO in [**2-24**] weeks. Rhythm: Atrial fibrillation. No RVR during entire admission, heart rate < 100. TEE demonstrated persistant left atrial thrombus, though smaller and less mobile since [**2171-5-3**] TEE. Unable to convert due to thrombus. Continued Metoprolol Tartrate 50 mg PO BID for rate control during admission, discharged on Toprol XL 100 mg. Anti-coagulation: Required for 1) L atrial thrombus 2) History of PE 3) A Fib. On weight-based heparin drip throughout admission. Restarted Coumadin 4 mg qhs during admission, discharged on Lovonex until therapeutic. Mild Nausea: Patient reported mild nausea on admission. No abnormalities on CT abdomen or pelvis. All stools guaiac negative. Started and discharged on Omeprazole 20 mg qd. H. pylori POSITIVE, pending at discharge. Will contact primary care provider regarding results. Patient was discharged on Omeprazole, but will require course of antibiotics. Medications on Admission: - Coumadin 4 mg qhs - Metoprolol XR 100mg qd Discharge Medications: 1. Lovenox 100 mg/mL Syringe Sig: One (1) Subcutaneous once a day for 10 days: 10 day supply . Disp:*10 syringe* Refills:*0* 2. Warfarin 2 mg Tablet Sig: Two (2) Tablet PO Once Daily at 4 PM: Take as instructed. 3. Toprol XL 100 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO once a day. 4. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). Disp:*30 Capsule, Delayed Release(E.C.)(s)* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Primary: Mitral stenosis status post valvuplasty Secondary: Atrial fibrillation with left atrial thrombus History of Pulmonary embolism Discharge Condition: Ambulating with stable vitals. Pain free. Discharge Instructions: You were admitted for a mitral valvuplasty for your mitral stenosis. It was necessary to give you heparin and stop your coumadin due to your history of clot in your heart and lung. You underwent the mitral [**Month/Day/Year **] and were monitored in the cardiac intensive care unit afterwards. You were started on Lovenox, a medication to thin your blood, until your coumadin level (called INR) was therapeutic. . Please call your primary care physician or cardiologist if you experience any bleeding, shortness of breath, chest pain, or other concerning symptoms. You will need a follow up echocardiogram to assess your heart function and valve function. . You will need to take the Lovenox injections once daily until your Coumadin level (INR) is at goal. You will see Dr. [**First Name (STitle) **] [**Name (STitle) **] on [**Name (STitle) 2974**] to have your Coumadin level (INR) checked. . You were started on Lovenox and should take this until instructed otherwise. You were started on a medication called omeprazole for symptoms of reflux. Please take this for one month and discuss further with your primary care provider. No other medications were changed. Followup Instructions: Please attend the following appointments: 1) Cardiology: Please follow up with Dr. [**First Name (STitle) **] in the department of cardiology at an appointment made for you on [**10-5**] at 4:15 PM. The number for Dr.[**Name (NI) 65972**] office is ([**Telephone/Fax (1) 65973**]. Please have them schedule a follow-up ECHO in [**2-24**] weeks for mitral regurgitation. 2) Primary care provider: [**Name10 (NameIs) 357**] follow up with Dr. [**Last Name (STitle) **] at an appointment made for you on [**Last Name (LF) 2974**], [**9-20**] at 10:00 AM. You will need your Coumadin level (INR) checked at that time to determine whether you should continue the Lovenox injections. Completed by:[**2171-9-23**] ICD9 Codes: 412, 4168
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Medical Text: Admission Date: [**2168-12-29**] Discharge Date: [**2169-1-9**] Date of Birth: [**2085-12-3**] Sex: M Service: MEDICINE Allergies: Penicillins Attending:[**First Name3 (LF) 2009**] Chief Complaint: GI Bleed Major Surgical or Invasive Procedure: None History of Present Illness: History of Present Illness: Mr. [**Known lastname 76901**] is an 83 y/o M with a h/o AF not on coumadin, CHF with an EF of 20%, severe AS, RA (chronic prednisone 5), CKD (baseline Cr around 1.3) and ? COPD on adviar with who initially presented to [**Hospital1 **] [**Location (un) 620**] on [**2168-12-26**] after having episodes of painless BRBPR at home. On [**2168-12-26**] he was admitted to the ICU at [**Hospital1 **] [**Location (un) 620**] and underwent a colonoscopy that day which showed diverticuli but did not reveal any active bleeding. On [**12-26**] his HCT dropped from 31.3 to 27.7 and he was give PRBCs. The night of [**12-27**] he had more BRBPR and his HCT drifted down to 26, but he remained hemodynamically stable. On [**12-28**] he underwent another colonoscopy with no localized source of bleeding but did show a large amount of blood in the colon. Also in the course of the work up of his GI bleed he underwent a CTA of his abdomen on [**12-28**] with no active GI bleeding seen. Got total of 7 units PRBC to maintain Hct ~ 27 throughout his stay at [**Hospital1 18**], Surgery was also consulted who agreed with the CTA and recommended a transfer to [**Hospital1 18**] if the family wished to pursue a further work up or aggressive treatment such as angio for embolization or surgical resection. Prior to transfer he past 400 mL BRBPR with associated clots. He reports [**2-7**] bowel movements per day. . Also during his stay at [**Hospital1 **] [**Location (un) 620**] given his history of systolic heart failure and murmur heard on exam he had an echocardiogram which showed an improvement in his EF to 55%, but significantly worsening of his aortic stenosis. He notes some shortness of breath with exertion at baseline but notes he mobility is limited by his RA and not breathing. His AS was previously characterized as mild but was found to be severe with a valve area of 0.8 to 1.0 cm2. . On the floor patient comfortable denying any chest pain, shortness of breath, fever, chills, night sweats, diarrhea, constipation or vomiting. Does not chronic arthralgias due to RA. . 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 rashes or skin changes. Past Medical History: Severe AS (valve area 0.8 to 1.0) Chronic Systolic CHF EF of 55% Atrial Fibrillation off coumadin Rheumatoid Arthritis Chronic Kidney Disease Social History: Lives at home with his wife, denies any tobacco, drinks [**2-7**] bottle of whiskey per week Family History: Maternal aunt with [**Name2 (NI) **], father with DM, no family history of heart or valvular disease Physical Exam: ADMISSION EXAM Vitals: T: 96 BP:123/67 P: 97 R: 18 O2: 99% RA 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: irregularilty irregular, normal S1 + S2, III/VI systolic murmur heard best at RUSB with radiation to the carotids 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, brisk capillary refill. Joint swelling in the MCPs, PIPs bilaterally as well as bilateral feet consistent with RA. + Rheumatoid nodules. DISCHARGE EXAM: General: Alert, oriented, no acute distress HEENT: Sclera anicteric, mmm, oropharynx clear Neck: supple, JVP not elevated, no LAD Lungs: CTAB CV: irregular rate and rhythm, normal S1 + S2, [**4-10**] mid peaking systolic murmur heard best at RUSB, no rubs or gallops Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly Ext: warm, well perfused, 2+ pulses. Joint swelling in the MCPs, PIPs bilaterally as well as bilateral feet consistent with RA. + Rheumatoid nodules. Left shoulder has dressing covering it, incision C/D/I. Edema and bruising in left arm improved. Good passive ROM of upper extremity joints with minimal pain, active ROM improving. Neuro: A&Ox3 Pertinent Results: ADMISSION LABS [**2168-12-29**] 03:30PM BLOOD WBC-11.8* RBC-3.81* Hgb-11.9* Hct-32.8* MCV-86 MCH-31.2 MCHC-36.2* RDW-15.5 Plt Ct-145* [**2168-12-29**] 03:30PM BLOOD Neuts-85.0* Lymphs-9.2* Monos-5.3 Eos-0.3 Baso-0.2 [**2168-12-29**] 03:30PM BLOOD PT-14.0* PTT-33.1 INR(PT)-1.2* [**2168-12-29**] 03:30PM BLOOD Glucose-85 UreaN-20 Creat-1.1 Na-133 K-4.1 Cl-102 HCO3-21* AnGap-14 [**2168-12-29**] 03:30PM BLOOD ALT-10 AST-14 LD(LDH)-139 AlkPhos-62 TotBili-4.4* DISCHARGE LABS [**2169-1-9**] 06:07AM BLOOD WBC-6.7 RBC-3.29* Hgb-10.0* Hct-30.4* MCV-92 MCH-30.5 MCHC-33.0 RDW-14.9 Plt Ct-322 [**2169-1-9**] 06:07AM BLOOD Glucose-81 UreaN-16 Creat-0.9 Na-138 K-3.7 Cl-104 HCO3-26 AnGap-12 [**2169-1-9**] 06:07AM BLOOD Calcium-8.2* Phos-3.3 Mg-1.4* . CARDIAC ENZYMES [**2168-12-29**] 03:30PM BLOOD CK-MB-2 cTropnT-<0.01 [**2168-12-30**] 04:04AM BLOOD CK-MB-2 cTropnT-0.02* . Digoxin level [**2168-12-29**] 03:30PM BLOOD Digoxin-1.2 [**2168-12-31**] 03:07AM BLOOD Digoxin-0.9 [**2169-1-9**] 06:07AM BLOOD Digoxin-0.9 . Vancomycin level [**2169-1-4**] 09:10PM BLOOD Vanco-26.3* [**2169-1-6**] 07:35PM BLOOD Vanco-23.9* [**2169-1-7**] 06:23PM BLOOD Vanco-21.1* Misc [**2169-1-6**] 05:51AM BLOOD CRP-81.6* [**2169-1-6**] 05:51AM BLOOD ESR-45* IMAGING: [**12-29**] TTE: The left atrium is dilated. The right atrium is moderately dilated. There is mild symmetric left ventricular hypertrophy with normal cavity size. Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. Overall left ventricular systolic function is normal (LVEF>55%). Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets are severely thickened/deformed. There is severe aortic valve stenosis (valve area 0.8-1.0cm2). Trace aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Mild (1+) mitral regurgitation is seen. The tricuspid valve leaflets are mildly thickened. There is borderline pulmonary artery systolic hypertension. There is no pericardial effusion. There is an anterior space which most likely represents a prominent fat pad. [**1-2**] CXR: Lungs are clear. Heart size is normal, although the configuration suggests right atrial enlargement. Lungs are clear and there is no pleural effusion. [**1-2**] Left shoulder xray: IMPRESSION: Degenerative changes in the AC and glenohumeral joints but no evidence of dislocation or fracture. [**1-3**] CT abd/pelvis: 1. Small right pleural effusion with adjacent atelectasis. 2. Distal pancreatic ductal dilitation concerning for stricture. Recommend ERCP for further evaluation. 3. Colonic diverticulosis without diverticulitis. 4. Ectasia of the infrarenal abdominal aorta. 5. Near complete loss of L1 vertebral body height, new since [**2162**] with associated disc extrusion. No evidence of discitis. 6. Bilateral renal cysts. [**1-4**] CXR: FINDINGS: As compared to the previous radiograph, there is a very subtle newly appeared parenchymal opacity at the right lung base. Simultaneously, there is persistent peribronchial thickening at the left lung base. Overall, the changes could reflect chronic aspiration or early pneumonia [**1-7**] ECHO: The left atrium is dilated. The right atrium is moderately dilated. The estimated right atrial pressure is 0-5 mmHg. Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. Overall left ventricular systolic function is normal (LVEF 70%). Right ventricular chamber size and free wall motion are normal. The aortic arch is mildly dilated. There are focal calcifications in the aortic arch. The aortic valve leaflets are severely thickened/deformed. There is severe aortic valve stenosis. The mitral valve leaflets are mildly thickened. Moderate (2+) mitral regurgitation is seen. [Due to acoustic shadowing, the severity of mitral regurgitation may be significantly UNDERestimated.] Moderate [2+] tricuspid regurgitation is seen. There is mild pulmonary artery systolic hypertension. There is no pericardial effusion. . . MICRO: [**1-2**] blood cultures negative [**1-3**] shoulder joint culture - 4+ PMNs, no growth on culture. Brief Hospital Course: PRIMARY REASON for ADMISSION 83 y/o M with a h/o AF not on coumadin, CHF with an EF of 20%, severe AS, RA (chronic prednisone 5), CKD (baseline Cr around 1.3) and ? COPD on advair who initially presented to [**Hospital1 **] [**Location (un) 620**] with BRBPR 7 likely [**3-9**] to a sigmoid diverticular bleed, transferred to [**Hospital1 18**] for further management. Diverticular bleed self-resolved, however course was complicated by septic arthritis of the shoulder. ACTIVE ISSUES BY PROBLEM: # Lower GI bleed: Patient transferred from BIDN with a continued GI Bleed without localized source. Colonoscopy at [**Location (un) 620**] were suggestive of bleeding from sigmiod diverticuli. CTA did not show active bleeding. Patient was transferred for potential IR vs surgical intervention. On admission to the [**Hospital Unit Name 153**] patient was noted to be hemodynamically stable. HCT was monitored and remained statble between 28 and 30. He had received a total of 7 units of PRBCs at [**Location (un) 620**] and did not require further transfusion while in the ICU. GI was consulted and recommended IR procedure should bleeding recur. Patient was noted to be intermittently hypotensive with SBPs in the 70s which responded to bolus IVFs with improvement to the 90s-100s. He had no further episodes of bloody bowel movements while in the ICU and was transferred to the medicine floor. His bleeding then self-resolved with no further interventions. Transfused a total of 2 units PRBCs during his stay. # Septic arthritis: Patient triggered on [**1-2**] for fever to 103.7 axillary, WBCs rising, developed hypotension requiring transfer to the MICU. Began complaining of shoulder pain, so joint was aspirated by orthopedic surgery. Found to have likely septic arthritis of left shoulder joint-- 122K WBCs on joint aspiration and frank pus on washout, however no organisms on gram stain and no growth yet on cultures. Cannot completely rule out crystal disease because there was not enough specimen for crystal analysis. Taken to OR on [**1-3**] for washout with no complications, started on ceftriaxone and vancomycin. His shoulder began to improve clinically at this point. ID was consulted, recommended repeat TTE to rule out vegetations (negative) and course of 4 weeks ceftriaxone 1g q24hours (through [**1-31**]). A PICC was placed for outpatient abx administration, and he will have weekly safety labs during his abx therapy. #Afib- Patient has a known history of afib on digoxin qod at home, however level noted to be low on admission so digoxin increased to [**Month/Year (2) 24018**]. He was noted to be intermittently tachycardic with RVR to 170s when OOB, though he remained asymptomatic at these times. He was started on metoprolol for his frequent RVR, to be continued at rehab with close monitoring. # Diastolic CHF: Echo at OSH with EF of 55%, LVEF confirmed on echo here with evidence of grade 1 diastolic dysfunction. Was taking PRN lasix at home, however this was held initially given transient hypotension. He had no evidence of fluid retention, so this medication was not restarted and is not being continued on discharge. # Aortic stenosis: Last echo in [**2166**] showed mild AS, however echo on this admission shiwed EF 55%, severe AS (valve area 0.8-1.O cm2), LVH, 1+ MR/TR. Notes he has some dyspnea on exertion, but he denies any syncope or angina. Fluid status was carefully monitored throughout his stay, given his AS. # Acute renal failure: Creatinine at [**Location (un) 620**] was 1.4 on admission. This was felt to likely be pre-renal in nature. Creatinine improved to 1.1 with admistration of blood products and remained stable throughout the remainder of his hospital course. # Elevated troponin and EKG changes: Patient was noted to have elevated troponin elevation at OSH felt to be possibly [**3-9**] demand ischemia with non specific EKG changes. ACS was felt to be unlikely given patient remained symptom free with negative troponin x 2 and normal CK MB. . # Rheumatoid arthritis: Patient was continued on home prednisone. He was given tylenol for pain in place of his home aleve. . TRANSITIONAL ISSUES - Digoxin: changed dosing to [**Last Name (LF) 24018**], [**First Name3 (LF) **] need to have level checked at next PCP visit [**Name Initial (PRE) **] Septic shoulder: follow up appt made with surgeon on [**1-19**] for follow up of I&D - Will need to have weekly safety labs (CBCw/diff, CMP, ESR/CRP) drawn while taking ceftriaxone, fax results to [**Hospital **] clinic at [**Telephone/Fax (1) 1419**]. First due: [**1-16**] - Pancreatic mass: incidentally found on CT, will need further evaluation with if more work up is desired. Pt aware, family not currently interested in pursuing. Patient was DNR/DNI throughout this hospitalization . Pending results: acid fast culture from shoulder joint. Medications on Admission: Home Medications (confirmed w/wife [**2168-12-31**]): Lasix [**2-7**] 20 mg tablets QD Prednisone 5 mg 1 tablet PRN (QD recently) Digoxin 0.125 mg QOD Advair 250-50 1 puff [**Hospital1 **] ASA 81 mg QD Aleve 2 tabs qAM PRN Omeprazole 20 mg PRN Potassium 20 mEq PO QD Acidophilus 1 tab QD (metoprolol stopped 2 years ago) . Medications on Transfer: Magnesium Sulfate 2g IV daily Advair 1 puff [**Hospital1 **] Prednisone 5mg daily Nexium 40mg daily Digoxin 0.125mg daily Vitamin B12 1000mcg daily Colace prn Zofran prn Acetaminophen prn Discharge Medications: 1. prednisone 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. fluticasone-salmeterol 250-50 mcg/dose Disk with Device Sig: One (1) puff Inhalation [**Hospital1 **] (2 times a day). 3. digoxin 125 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 5. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 6. metoprolol tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day): Please hold for SBP <100, HR <60. 7. oxycodone 5 mg Tablet Sig: 0.5 Tablet PO Q4H (every 4 hours) as needed for pain. 8. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO TID (3 times a day). 9. ceftriaxone in dextrose,iso-os 1 gram/50 mL Piggyback Sig: One (1) gram Intravenous Q24H (every 24 hours) for 22 days: Please continue through [**2169-1-31**]. 10. senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 11. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 12. bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for Constipation. 13. multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). Discharge Disposition: Extended Care Facility: [**Location (un) 1036**] - [**Location (un) 620**] Discharge Diagnosis: Lower GI bleed Septic arthritis Atrial fibrillation with rapid ventricular response Rheumatoid arthritis Aortic stenosis Pancreatic mass 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: Dear Mr. [**Known lastname 76901**], You were transferred to [**Hospital1 18**] due to rectal bleeding. You stayed briefly in the ICU, but your bleeding slowed down significantly and you were transferred to the medicine floor. We believe your bleeding was due to diverticuli (small out-pouchings) in your colon, many of which will stop bleeding on their own like yours. While you were here, you developed severe left shoulder pain and fevers and were found to have an infection of the joint. You were taken to the operating room for the surgeons to open up your shoulder and clean it out. You will need to keep taking intravenous antibiotics until [**1-31**] to fully treat this infection. Physical therapy to improve your shoulder mobility will also be important. Changes to your medications: STOP furosemide 20-40 mg daily STOP potassium INCREASE digoxin 125 mcg to daily (instead of every other day) START ceftriaxone 1g every 24 hours through [**1-31**] START metoprolol 12.5 mg twice daily START oxycodone 2.5 mg tabe every 4 hours as needed for pain START acetaminophen 650mg three times a day START senna 8.6mg tab twice daily START docusate 100mg twice daily START bisacodyl 10mg daily as needed for constipation Followup Instructions: Department: ORTHOPEDICS When: THURSDAY [**2169-1-19**] at 12:20 PM 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: THURSDAY [**2169-1-19**] at 12:40 PM With: [**First Name11 (Name Pattern1) 2191**] [**Last Name (NamePattern4) 2192**], NP [**Telephone/Fax (1) 1228**] Building: [**Hospital6 29**] [**Location (un) 551**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: INFECTIOUS DISEASE When: WEDNESDAY [**2169-1-25**] at 10:30 AM With: [**First Name11 (Name Pattern1) 1037**] [**Last Name (NamePattern4) 2335**], MD [**Telephone/Fax (1) 457**] Building: LM [**Hospital Unit Name **] [**Hospital 1422**] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage ICD9 Codes: 0389, 2851, 5849, 4241, 4280, 5859, 496
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Medical Text: Admission Date: [**2110-3-31**] Discharge Date: [**2110-4-6**] Date of Birth: [**2035-5-9**] Sex: F Service: CARDIOTHORACIC Allergies: Erythromycin Base Attending:[**First Name3 (LF) 1283**] Chief Complaint: Elective cardiac surgery Major Surgical or Invasive Procedure: 3/1008 - CABGx2(Vein->Obtuse marginal, Vein->Posterior Left Ventricular Branch); PFO Closure; AVR(21mm St. [**Male First Name (un) 923**] Epic Porcine Valve) History of Present Illness: 74 year old female who is currently asymptomatic who has been followed the last 2 years for aortic stenosis. Her most recent echo showed severe AS with an aortic valve area of 0.5cm2. She is now admitted for surgical management. Past Medical History: AS PFO CAD Hyperlipidemia HTN CVD Social History: Retired microbiologist. Never smoked. Denies drinking alcohol. Lives with Husband and oldest son. Family History: Father died of stroke. Physical Exam: Admission VS: HR 78 BP 162/77 RR 14 HT 62" WT 175lbs GEN: WDWN in NAD SKIN: Warm, dry, no clubbing or cyanosis. HEENT: PERRL, Anicteric sclera, OP Benign NECK: Supple, no JVD, FROM. LUNGS: CTA bilaterally HEART: RRR, III-IV/VI holsystolic murmur ABD: Soft, ND/NT/NABS EXT:warm, well perfused, no bruits, no varicosities, no peripheral edema, pulses [**1-22**]+ peripherally. No carotid bruit appreciated. NEURO: No focal deficits. Discharge Pertinent Results: [**2110-4-1**] CXR The ET tube tip is 5.3 cm above the carina. The NG tube tip is in the stomach. The Swan-Ganz catheter tip currently terminates in right interlobar pulmonary artery. The patient is after removal of chest tube and mediastinal drains. There is no pneumothorax or increasing pleural effusion is identified. Bibasilar left more than right atelectasis is unchanged. [**2110-3-31**] ECHO PRE-CPB:1. The left atrium is mildly dilated. No spontaneous echo contrast is seen in the body of the left atrium or left atrial appendage. No spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. No spontaneous echo contrast is seen in the body of the right atrium. No spontaneous echo contrast or thrombus is seen in the body of the right atrium or the right atrial appendage. 2. A patent foramen ovale is present. A left-to-right shunt across the interatrial septum is seen at rest. 3. There is mild symmetric left ventricular hypertrophy. The left ventricular cavity size is normal for the patient's body size. Overall left ventricular systolic function is normal (LVEF>55%). Transmitral Doppler and tissue velocity imaging are consistent with Grade III/IV (severe) LV diastolic dysfunction. 4. Right ventricular chamber size and free wall motion are normal. 5. There are simple atheroma in the ascending aorta. There are simple atheroma in the aortic arch. There are complex (>4mm) atheroma in the descending thoracic aorta. 6. There are three aortic valve leaflets. The aortic valve leaflets are severely thickened/deformed. There is severe aortic valve stenosis (area <0.8cm2). Mild (1+) aortic regurgitation is seen. 7. Trivial mitral regurgitation is seen. The tricuspid valve leaflets are mildly thickened. 8. There is a trivial/physiologic pericardial effusion. POST-CPB: On infusion of phenylephrine. Well-seated bioprosthetic valve in the aortic position. Mild residual stenosis, no paravalvular leak. Atrial septum intact without visible shunt. Biventricular systolic function is preserved. Aortic contour is normal post decannulation. [**2110-3-31**] 01:28PM UREA N-8 CREAT-0.3* CHLORIDE-119* TOTAL CO2-20* [**2110-3-31**] 01:28PM WBC-28.1*# RBC-3.52*# HGB-9.8* HCT-29.3*# MCV-83 MCH-28.0 MCHC-33.6 RDW-14.2 [**2110-3-31**] 01:28PM PLT COUNT-195 [**2110-3-31**] 01:28PM PT-15.7* PTT-37.7* INR(PT)-1.4* [**2110-3-31**] 12:57PM FIBRINOGE-197 [**2110-4-6**] 06:45AM BLOOD WBC-19.2* RBC-3.03* Hgb-8.8* Hct-26.7* MCV-88 MCH-28.9 MCHC-32.9 RDW-16.1* Plt Ct-428 [**2110-4-6**] 06:45AM BLOOD PT-32.2* INR(PT)-3.3* [**2110-4-5**] 06:10AM BLOOD PT-34.6* INR(PT)-3.6* [**2110-4-4**] 05:00AM BLOOD PT-17.3* PTT-26.0 INR(PT)-1.6* [**2110-4-5**] 06:10AM BLOOD UreaN-22* Creat-0.8 K-4.0 CHEST (PA & LAT) [**2110-4-4**] 10:04 AM CHEST (PA & LAT) Reason: eval for pleural effusions [**Hospital 93**] MEDICAL CONDITION: 74 year old woman s/p AVR/CABG/PFO closure REASON FOR THIS EXAMINATION: eval for pleural effusions REASON FOR EXAMINATION: Followup of a patient after aortic valve replacement, CABG and patent foramen ovale closure. PA and lateral upright chest radiograph compared to [**2110-4-1**]. Patient was extubated in the meantime interval with removal of the NG tube and Swan-Ganz catheter. The moderate cardiomegaly is stable. The bibasal opacities are consistent with post-surgical atelectasis, improved. Small amount of pleural effusion is demonstrated, bilateral. There is no evidence of failure. There is no pneumothorax. Brief Hospital Course: Mrs. [**Known lastname 78151**] was admitted to the [**Hospital1 18**] on [**2110-3-31**] for surgical management of her aortic valve and coronary artery disease. She was taken directly to the operating room where she underwent coronary artery bypass grafting to two vessels, and aortic valve replacement with a 21mm St. [**Male First Name (un) 923**] Epic Porcine valve and a PFO closure. Please see operative note for details. Postoperatively she was taken to the cardiac surgical intensive care unit for monitoring. On postoperative day one, Mrs. [**Known lastname 78151**] awoke neurologically intact and was extubated. She awoke mildly confused but slowly cleared mentally. She was transfused with two units of packed red blood cells for postoperative anemia. Mrs. [**Known lastname 78151**] developed atrial fibrillation for which amioadrone and coumadin was started. On postoperative day two, she was transferred to the step down unit for further recovery. Beta blockade, aspirin and a statin were resumed. She was gently diuresed towards her preoperative weight. The physical therapy service was consulted to assist with her postoperative strength and mobility. She became confused and was pancultured given her WBC of 20. Her INR rose quickly to 3.6. Her confusion improved and her INR stabilized and she was ready for discharge home on POD #6. Medications on Admission: Vasotec 5mg [**Hospital1 **] Aspirin 81mg QD Lipitor 10mg QD Discharge Medications: 1. Amiodarone 200 mg Tablet Sig: Two (2) Tablet PO once a day: for 7 days, then decrease to 200 mg daily until d/c'd by cardiologist. Disp:*90 Tablet(s)* Refills:*2* 2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 3. 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. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig: One (1) Tab Sust.Rel. Particle/Crystal PO Q12H (every 12 hours) for 7 days. Disp:*14 Tab Sust.Rel. Particle/Crystal(s)* Refills:*0* 5. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 6. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). Disp:*90 Tablet(s)* Refills:*2* 7. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 8. Furosemide 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) for 7 days. Disp:*14 Tablet(s)* Refills:*0* 9. Ciprofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours) for 3 days. Disp:*6 Tablet(s)* Refills:*0* 10. Warfarin 1 mg Tablet Sig: One (1) Tablet PO once a day for 1 days: then as directed by Dr. [**Last Name (STitle) 58623**]. Disp:*120 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital 2255**] [**Name (NI) 2256**] Discharge Diagnosis: CAD/AS/ASD s/p AVR(21mm Porcine), PFO closure, CABGx2 [**2110-3-31**] HTN Hyperlipidemia PVD AF Discharge Condition: Stable Discharge Instructions: 1) Monitor wounds for signs of infection. These include redness, drainage or increased pain. In the event that you have drainage from your sternal wound, please contact the [**Name2 (NI) 5059**] at ([**Telephone/Fax (1) 1504**]. 2) Report any fever greater then 100.5. 3) Report any weight gain of 2 pounds in 24 hours or 5 pounds in 1 week. 4) No lotions, creams or powders to incision until it has healed. You may shower and wash incision. Gently pat the wound dry. Please shower daily. No bathing or swimming for 1 month. Use sunscreen on incision if exposed to sun. 5) No lifting greater then 10 pounds for 10 weeks. 6) No driving for 1 month. 7) Call with any questions or concerns. Followup Instructions: Follow-up with Dr. [**Last Name (STitle) 1290**] in 1 month. ([**Telephone/Fax (1) 1504**] Follow-up with Dr. [**Last Name (STitle) 40149**] in 2 weeks. ([**Telephone/Fax (1) 78152**] Follow-up with Dr. [**Last Name (STitle) 58623**] in 1 week. [**Telephone/Fax (1) 58624**]. Coumadin will be followed by the office of Dr. [**Last Name (STitle) 58623**] and INR should be drawn on Monday [**2110-4-7**] and then called to her office. Plan confirmed with Dr. [**Last Name (STitle) 58623**]. Please call all providers for appointments. Completed by:[**2110-4-8**] ICD9 Codes: 4241, 2724, 4019, 2859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6538 }
Medical Text: Admission Date: [**2187-9-30**] Discharge Date: [**2187-10-8**] Date of Birth: [**2119-12-3**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2745**] Chief Complaint: UGIB, ?infection Major Surgical or Invasive Procedure: ERCP Messenteric catheterization +/- embolization History of Present Illness: This is a 67 y.o male with h.o metastatic RCC to the pancreas, recent ICU course for UGIB (12units pRBCs) who reports sudden intermittent chills since wednesday for which he took tylenol. Pt also reports R.side gnawing rib pain, while lying in bed before the onset of chills. In addition, pt reports dark stools for the last few days which started after taking "iron pills". Pt states he went to [**Hospital1 2436**] ED because of a fever of 101.3, however he felt better and did not want to wait to be seen. He returned to [**Hospital1 2436**] today and was transferred to [**Hospital1 18**] after a dose of zosyn, HCT 25. Pt denies headache/dizziness/blurred vision, URI/cough, sick contacts, CP, +palp when anxious, -abd pain/n/v/d/brbpr, dysuria/hematuria, joint pain, rash, paresthesias. . At [**Hospital1 18**], pt found to be hypotensive to 75/40, asymptomatic. He was given 3L IVF, lactate 6.8. HCT 22.8 from a baseline of 35 a few weeks ago. He was found to have black, guaiac +stool. GI saw pt, pt s/p stent to pancreatic ampulla, ?blocked from blood. Plan is to transfuse, ERCP tomorrow. ED also treated for possible cholangitis/sepsis and pt was given dose of vanco. Vitals 99.2, BP 99/66 HR 88 sat 98% on RA. Access 3PIV's 2, 20's, 18. Pt also found to be in ARF. . Currently, pt reports that he is anxious. . Past Medical History: # GIB [**2184**], EGD revealed duodenal ulcer c/w malignancy # Hypertension. . 1. Status post left nephrectomy followed by high-dose IL-2 [**2166**]. 2. LAK therapy in [**2167**]. 3. st. post resection of residual renal bed mass in [**2168**] 4. Recurrence in the left renal fossa and pancreas in [**4-/2182**] 5. Low-dose interleukin-2 in 12/[**2181**]. 6. Atrasentan medication trial 11/[**2181**]. 7. initiated on Nexavar 400 mg twice daily, dose reduced on 10/1005 in the setting of hypertension. His course has been complicated by a GI bleed with possible small bowel obstruction, and an admission to [**Hospital3 **] in [**8-/2185**] for anemia and acute renal failure while on full dose Nexavar 400 mg given twice daily. 8. Nexavar dose reduced to 400 mg q.a.m., 200 mg q.p.m. 9. Nexavar dose increased to 400 mg b.i.d. following CT in [**9-/2186**], which showed progression of pancreatic metastases. 10. Enrolled in perifosine trial 06-408 on [**2187-2-28**]. 11. Perifosine held since [**2187-6-13**] due to GI bleed. 12. ERCP on [**2187-6-20**] showed a malignant appearing mass in duodenum, pathology consistent with metastatic renal cell Ca. 13. Perifosine restarted [**2187-6-27**] for one week, held on [**7-4**] due toSBO requiring hospital admission in [**Hospital3 2783**], and restarted again on [**7-11**]. 14. Perifosine held due to elevated LFTs on [**2187-7-25**]. 15. ERCP on [**2187-8-3**] - biliary stent placed to proximal CBD. . Social History: He is married and has two children. He is retired from GM. Reports quit smoking [**2186-11-21**], former 1/2ppd, quit ETOH as well in [**Month (only) **], no drug use Family History: Non-contributory Physical Exam: Per admission note: vitals:T. 96.9, BP 102/65, HR 92, RR 27, sat 96% on RA gen-nad, lying in bed, appears stated age, cooperative, anxious HEENT-perrla, eomi, anicteric, mmm, poor dentition neck-no lad, no JVD, supple chest-b/l ae no w/c/r heart-s1s2 +2/6 systolic flow murmur, no r/g abd-+bs,soft, NT, ND, +irregular hepatomegaly, ~2cm below costal margin, +abdominal masses ext-no c/c/e 2+pulses neuro-aaox3, CN2-12 intact, non-focal. . Pertinent Results: [**2187-9-30**] 07:36PM WBC-5.1 RBC-2.82*# HGB-7.5*# HCT-22.8*# MCV-81* MCH-26.6* MCHC-32.8 RDW-18.1* [**2187-9-30**] 07:36PM NEUTS-73* BANDS-14* LYMPHS-9* MONOS-2 EOS-0 BASOS-0 ATYPS-1* METAS-1* MYELOS-0 [**2187-9-30**] 07:36PM PLT SMR-NORMAL PLT COUNT-142* . [**2187-9-30**] 07:36PM HYPOCHROM-2+ ANISOCYT-2+ POIKILOCY-1+ MACROCYT-2+ MICROCYT-OCCASIONAL POLYCHROM-1+ BURR-1+ . [**2187-9-30**] 07:36PM PT-15.6* PTT-35.0 INR(PT)-1.4* . [**2187-9-30**] 07:36PM GLUCOSE-78 UREA N-28* CREAT-1.6* SODIUM-141 POTASSIUM-3.1* CHLORIDE-109* TOTAL CO2-13* ANION GAP-22* [**2187-9-30**] 07:36PM ALT(SGPT)-59* AST(SGOT)-59* LD(LDH)-181 CK(CPK)-14* ALK PHOS-513* TOT BILI-2.5* [**2187-9-30**] 07:36PM LIPASE-12 . [**2187-9-30**] 07:36PM cTropnT-<0.01 [**2187-9-30**] 07:36PM CK-MB-NotDone . TRENDS: HCT: Admit -> 23, 27, 22, 25, 27, 34, 28, 27, 26, 22, 28 . Bands on Diff: Admit -> 14, 10, 7, 0 . [**2187-9-30**] 07:42PM BLOOD Lactate-6.8* [**2187-10-1**] 02:52AM BLOOD Lactate-4.8* [**2187-10-1**] 05:30AM BLOOD Lactate-3.3* [**2187-10-1**] 02:22PM BLOOD Lactate-1.8 . ECG:sinus, poor baseline, similar morphology to [**2187-8-21**] EKG. . Imaging: CXR: [**2187-9-30**]: Added density behind the left heart border in the left lower lobe may represent a focus of pneumonic consolidation; alternatively metastases from the known metastatic renal cell cancer cannot be entirely excluded. CT would be of benefit for further evaluation. A CBD stent is seen in the upper abdomen. . Liver U/S [**2187-9-30**]: Increase in size and number of hepatic mets. CBD or stent not seen. Small perihepatic ascites. Portal vein remains occluded with numerous collaterals. Gallladder wall thickening and edema but no focal tenderness during scanning. Large hypoechoic mass in the region of the pancreatic head not well assessed due to overlying bowel gas. "findings equivocal for cholecystitis, stones" . [**2187-10-1**] ERCP/Biliary: IMPRESSION: 1. No filling defects within previously placed metallic common bile duct stent. 2. Smooth impression on the common bile duct, proximal to stent, suggests extrinsic compression. Correlate with real-time findings. Please refer to GI procedural note for further details. . [**2187-10-3**] MESSENTERIC CATHETERIZAION +/- EMBOLIZATION: ***Prelim Report*** Gastrointestinal arteriograms demonstrated massive tumor staining from multiple feeding arteries originating from celiac artery, superior mesenteric artery, and isolated pancreatic artery without active ______. Brief Hospital Course: 67 y.o male with metastatic RCC who presents with HCT drop, melena, recent fever, hypotension. . #melena/HCT drop - Pt has h.o GIB in past that were secondary to bleeding metastasis. Pt had recent admit to MICU course [**7-30**] where angiography was performed to stop bleeding. Hct on admit was 22.8, down from 35 on discharge. Patient underwent ERCP in which showed ulcerated mass at duodenum, able to temporarily stem blood flow. On day 3 of ICU stay he had more melena and was taken by IR for messenteric catheterization +/- embolization, but were unable to isolate source of bleeding. Melena continued and ERCP, IR and surgery say pt is not eligible for further interventions to stop the bleeding. . Pt continued to be transfused units of PRBC while H/H was being followed. This was consistent with patient's stated goals of living long enough to make it to hospice care, where he can be closer to family. . # Infection - Pt with fever, normal white count but with bandemia, recent RUQ/rib pain. Slightly elevated LFT's, elevated bili -> RUQ u/s finding gallbladder wall thickening and edema, "possible cholecystitis". Potentially transient cholangitis. Pt completed a total of 7 days of Vancomycin and Pip/Tazo. . # Metastatic RCC - Pain controlled. Heme met with family offered chemo for one final round but with the caution that this could make the duodenal met bleed faster. The patient and family did not want to pursue this. . # Lactic acidosis - likely from poor perfusion secondary to recent hypotension and infection. Could also be secondary to metastatic disease. Resolved within 2 days. . #ARF - baseline 0.9-1.0, admitted at 1.6. Likely prerenal in the setting of hypotension, hypovolemia. Resolved with hydration. . #HTN-currently normotensive, hold home anti-HTN medications. . # Anxiety - receiving scheduled ativan per pt request. . # Thrombocytopenia: - PLT count now improving - no heparin d/t bleed - HIT Ab negative - Transfused prn for bleeding . CODE: DNR/DNI DISPO: discharged to hospice care: [**Last Name (un) 1502**] Family Hospice House - [**Location (un) **]. [**Telephone/Fax (1) 21227**] Medications on Admission: allopurinol 100mg,2 tabs daily atenolol 50mg daily diltiazem 180mg, 2 capsules daily nexium 40mg daily lisinopril 40mg daily lorazepam 0.5mg 1-2tabs q6h prn anxiety compazine 5mg 1-2tab [**Hospital1 **] nausea acetaminophen 500mg [**11-22**] Q6h prn ferrous sulfate 325mg 1 daily. Discharge Medications: 1. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed for pain/fever. 2. Trazodone 50 mg Tablet Sig: 0.5 Tablet PO HS (at bedtime). 3. Loperamide 2 mg Capsule Sig: One (1) Capsule PO QID (4 times a day) as needed for diarrhea. 4. Lorazepam 1 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4 hours). 5. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO twice a day. 6. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) neb Inhalation Q6H (every 6 hours) as needed. 7. Ipratropium Bromide 0.02 % Solution Sig: One (1) neb Inhalation Q6H (every 6 hours) as needed. 8. Ondansetron HCl (PF) 4 mg/2 mL Solution Sig: Four (4) mg Injection Q8H (every 8 hours) as needed. Discharge Disposition: Extended Care Facility: [**Last Name (un) 1502**] Family Hospice House [**Location (un) **] Discharge Diagnosis: # Gastrointestinal bleed; ongoing # Cholecystitis/Cholangitis # Metastatic renal cell carcinoma # Acute renal failure; resolved # Thrombocytopenia Discharge Condition: poor; dying. Discharge Instructions: Patient is being discharged to hospice. Please take medications as necessary for patient comfort. Followup Instructions: Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 9402**], MD Phone:[**Telephone/Fax (1) 22**] Date/Time:[**2187-10-17**] 3:30 Provider: [**Name10 (NameIs) 11021**] [**Name11 (NameIs) 11022**], MD Phone:[**Telephone/Fax (1) 22**] Date/Time:[**2187-10-17**] 3:30 ICD9 Codes: 5849, 2762, 5789, 2851, 2875
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6539 }
Medical Text: Admission Date: [**2177-4-25**] Discharge Date: [**2177-4-28**] Date of Birth: [**2108-5-28**] Sex: M Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 800**] Chief Complaint: nausea, vomiting, decreased PO intake Major Surgical or Invasive Procedure: None History of Present Illness: Mr [**Known lastname **] is a 68 year old male with past history of asthma/COPD and hypertension transferred from the MICU for continued treatment of Acute Renal Failure. . Per the patient had been in USOH on Saturday evening at a relatives house having dinner when developed acute onset nausea and vomiting on Sunday morning. He cites that nausea and vomiting peaked on Saturday and Sunday with roughly 2-3episodes/day. From Sunday to presentation to the ED developed progressive lethargy and noted decreased to zero UOP from Sunday to Thursday. feeling lethargic. . Pertinent +/- Denies fevers, chills, night sweats, sick contacts, recent travel, EtOH use, abdominal pain or distension, diarrhea, constipation, chest pain, myalgias. . Progressive lethargy and confusion noted by family prompted presentation to the ED. . In the ED, triggered on presentation for hypotension of 67/31. Recieved 3L NS with improvment in BP to 110/70's. NG lavage negative, guiac positive. Labs notable for acute renal failure with creatinine 7.5 (baseline 1.5) and BUN 123. LFTS WNL, HCT 50.4. Admitted to MICU for hypotension and concern for GI bleed. Vitals prior to transfer, 96 110/60 17 100% on 2L. . MICU course: Received 3L of IVF; lisinopril and diuretic held. Mental status cleared with hydration and creatinine improved from 5.6 -> 3.3 (baseline 1.5) with increased UOP. Of note though guaiac +; HCT stable in house. . Prior to transfer to the floor patient with minimal complaint. . ROS at time of transfer: Denies fevers, chills, sweats, anorexia, headache, vision changes, abdominal pain, chest pain, palpitation, abdominal pain, dysuria, flank pain, myalgias. Past Medical History: 1. Asthma/COPD/bronchiectasis. - FVC 122% predicted, Lung volumes >100% predicted, DLCO ~70% predicted 2. Pulmonary nodules. 3. Hypertension. 4. Chronic renal insufficiency with creatinine 1.5. 5. History of eosinophilia. 6. Vitamin D deficiency. Social History: Formerly worked at [**Hospital1 **] as chef. Lives with wife; retired Tobacco: smoked for about 20 years and quit 25 years ago. EtoH: denies current use Remote h/o drug abuse Family History: No history of GI pathology; no h/o malignancy Physical Exam: 68 year old male with history of asthma/COPD, hypertension, chronic kidey insufficiency admitted to the MICU for management of acute kidney injury and hypotension in setting of 4 days nausea, vomiting and decreased PO intake.. # Hypotension. Etiology likely hypovolemic in the setting of nausea, vomiting and limited PO intake in days preceding hospitalization. Alternative etiolgies entertained on admission included hypotension secondary to septic shock, secondary to GI bleed. Regarding potential for infection patient afebrile in house with WBC wnl and without complaints of localized infection. GI bleed on presenting differential as pt Guaiac positive on admission, however patients HCT remained stable after dilutional drop. Patient received total of 7L of IVF with improvement in hemodynamics. Nausea resolved quickly after admission and patient able to take in adequate PO prior to discharge. Decision made to hold anti-hypertensives to time of discharge with plan to likely re-implement after post-discharge appt. OUTPATIENT: -- Continue to monitor hemodynamics -- Re-initiate anti-hypertensives at [**Hospital 1944**] clinic after both BP and renal function monitored. . # Acute on Chronic Renal Failure. Baseline creatinine 1.5. Creatinine on Admission 7.5 -> 5.5 ->3.3 in the setting of IVF. Etiology likely pre-renal in setting of decreased PO intake, emesis as function has improved markedly with hydration. Urine lytes: FeNa: 3.4 consistent with pre-renal -> ATN. Patient with adequate urine output throughout stay so low clinical suspicion for obstructive component. At time of discharge, creatinine 1.3; decision made to hold lisinopril and HCTZ until renal function monitored and stabilization ensured. OUTPATIENT ISSUES -- Repeat chemistry 7 as outpatient to monitor renal functino -- Continue to hold lisinopril and HCTZ until repeat lab values obtained. # Persistent nausea, vomiting. Admission differential diagnosis to Nausea/Vomiting broad with consideration of underlying Cardiac, Neurologic, Hepatic, Gastric, Renal and Pancreatic pathology. After work-up surmised that viral gastroenteritis was likely causative factor for nausea, vomiting. Regarding alternative diagnosis: LFTs wnl, Lipase 66. Patient without overt cardiac history (only RF is HTN, HL), EKG without ischemic changes and though admission Trop elevated it was in setting of creatinine of 7.5. Cerebellar ischemia can manifest as n/v and patient does describe gait unsteadiness but less likely than viral gastroenteritis especially as patients neuro exam is intact. It was possible that ARF preceded emesis and uremia incited nausea/emesis however the fact ARF improved so rapidly with IVF argues against intrinsic or post-renal etiology. During hospitalization, anti-emetics were used as needed; nausea resolved and prior to discharge patient tolerated full diet without nausea, vomiting, abdominal pain. #. Guaiac Positive Stool. On admission to the ED, rectal exam guaiac + with initial concern for UGIB in setting of hypotension. Subsequent NG Lavage negative. Hct hemoconcentrated on admission; did downtrend in setting of aggressive IV hydration which was attributed to dilution. Patient was started on pantoprazole 40 mg [**Hospital1 **]. In house, patient did report one black bowel movement in house however HCT remained stable and decision made to work-up question of GI bleed as outpatient with potential EGD/colonoscopy. Of note patient with last colonscopy in [**2174**] which demonstrated diverticular disease as well as cecum and sigmoid polyps s/p polypectomy (cecum path: fragments of adenoma; sigmoid path: hyperplastic tissue). OUTPATIENT ISSUES: -- Continue PPI and enteric coated aspirin -- Consider need for outpatient work-up: EGD, colonscopy. . #. COPD. Patient without respiratory complaints in house. Exam demonstrated intermittent wheeze and patient treated with nebulizers as needed. In house continued on home albuterol, advair, spiriva and singulair. No need for supplemental oxygen in house. Pertinent Results: On Admission: [**2177-4-25**] 12:40PM BLOOD WBC-6.0 RBC-5.69 Hgb-16.8 Hct-50.4 MCV-89 MCH-29.5 MCHC-33.3 RDW-13.6 Plt Ct-395# [**2177-4-25**] 05:19PM BLOOD WBC-5.9 RBC-4.82 Hgb-14.4 Hct-42.6 MCV-88 MCH-29.8 MCHC-33.7 RDW-13.6 Plt Ct-287 [**2177-4-26**] 04:24AM BLOOD WBC-4.2 RBC-4.31* Hgb-12.9* Hct-37.8* MCV-88 MCH-30.0 MCHC-34.2 RDW-13.6 Plt Ct-310 [**2177-4-25**] 12:40PM BLOOD Neuts-50.6 Lymphs-38.7 Monos-7.7 Eos-1.0 Baso-2.1* [**2177-4-25**] 12:40PM BLOOD PT-13.2 PTT-26.2 INR(PT)-1.1 [**2177-4-25**] 12:40PM BLOOD Glucose-129* UreaN-123* Creat-7.5*# Na-135 K-7.4* Cl-98 HCO3-17* AnGap-27* [**2177-4-25**] 05:19PM BLOOD Glucose-100 UreaN-109* Creat-5.6*# Na-140 K-5.3* Cl-107 HCO3-18* AnGap-20 [**2177-4-26**] 04:24AM BLOOD Glucose-100 UreaN-87* Creat-3.3*# Na-141 K-5.2* Cl-111* HCO3-19* AnGap-16 [**2177-4-25**] 12:44PM BLOOD Glucose-122* Lactate-2.5* Na-138 K-5.4* Cl-103 calHCO3-15* [**2177-4-25**] 05:29PM BLOOD Lactate-1.9 [**2177-4-25**] 02:49PM URINE Color-Straw Appear-Clear Sp [**Last Name (un) **]-1.008 [**2177-4-25**] 02:49PM URINE Blood-SM Nitrite-NEG Protein-TR Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-NEG pH-5.0 Leuks-NEG [**2177-4-25**] 02:49PM URINE RBC-2 WBC-<1 Bacteri-FEW Yeast-NONE Epi-0 [**2177-4-25**] 04:34PM URINE Hours-RANDOM Creat-125 Na-107 K-19 Cl-81 . On Discharge [**2177-4-28**] 05:50 . WBC RBC Hgb Hct MCV MCH MCHC RDW Plt Ct 4.4 4.25* 12.5* 36.7* 87 29.5 34.1 13.6 286 . Glucose UreaN Creat Na K Cl HCO3 AnGap 113 28 1.3 142 4.8 112 19 16 . ALT AST LD(LDH) CK(CPK) AlkPhos Amylase TotBili DirBili 15 20 53 0.4 . CXR: FINDINGS: Single frontal view of the chest is obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. Please note that pulmonary nodules noted on prior chest CT are not as well appreciated on the current study, as CT is more sensitive, and recommendations per that study remain. IMPRESSION: No acute cardiopulmonary process. Brief Hospital Course: Mr [**Known lastname **] is 68 year old male with history of asthma/COPD, hypertension, chronic kidey insufficiency who presented with acute renal failure and hypotension in the setting of nausea, vomiting and decreased PO intake x4-5days. . # Hypotension. Etiology likely hypovolemic in the setting of nausea, vomiting and limited PO intake in days preceding hospitalization. Alternative etiolgies to hypotension on admission included septic shock in setting of infection, hypovolemia secondary to GI bleed.Infectious trigger unlikely as patient afebrile in house with WBC wnl and without complaints of localized infection. Though GI bleed was on admission differential as pt guaiac positive on admission, degree of hypotension on admission would have necessitated brisk bleed which was not present; bolstered by negative NG lavage. In house received a total of 7L of IVF with improvement in hemodynamics. Patient without need for IV hydration in 48hrs preceding discharge. Decision made to hold anti-hypertensive at time of discharge with likely re-implementation as an outpatient. OUTPATIENT ISSUES -- Continue to monitor hemodynamics -- Re-initiate anti-hypertensives if pressures stable and renal function at baseline . # Acute on Chronic Renal Failure. Baseline creatinine 1.5. Creatinine on Admission 7.5 -> 5.5 ->3.3-> 1.5 ->1.3 in the setting of IVF. Etiology likely pre-renal in setting of decreased PO intake, emesis as function improved markedly with hydration. Urine lytes: FeNa: 3.4 consistent with pre-renal progression to ATN. Patient with adequate urine output throughout stay making post-obstructive component less likely. At discharge creatinine 1.3 and decision made to hold HCTZ and lisinopril at time of discharge until post-discharge labs ensured stable renal function. OUTPATIENT ISSUES: -- Post-discharge monitoring of renal function -- Re-initiation of lisinopril and HCTZ if hemodynamics and renal allow . # Persistent nausea, vomiting. Admission etiology to Nausea/Vomiting broad and Cardiac, Neurologic, Hepatic, Gastric, Renal or Pancreatic pathology in initial differential. After work-up, surmised viral gastroenteritis likely prompted n/v. Regarding alternative diagnosis: LFTs wnl, Lipase 66. Patient without overt cardiac history (only RF is HTN, HL), EKG without ischemic changes and though Trop elevated it was is in setting of creatinine of 7.5. Though cerebellar ischemia can manifest as n/v and patient did cite gait unsteadiness, diagnosis is less likely than viral gastroenteritis especially as patients neuro exam remained intact throughout. Though it is possible that ARF preceded emesis and uremia incited nausea/emesis the fact ARF improved so rapidly with IVF argued against intrinsic or post-renal etiology. In house patient received supportive care with IVF and anti-emetics. Prior to discahrge tolerated a full diet without nausea, vomiting or abdominal pain. . #. Guaiac Positive Stool. On admission, intially hypotension concerning for UGIB in setting of guaiac + stool however NG Lavage negative. Admission patient hemoconcentrated with dilutional drop after aggressive hydration. HCT monitored daily and remained stable after hydration. Patient did report one black stool in house (not saved for inspection). Patient started on PPI and ASA changed to enteric coated. As HCT stable, decision made to forego inpatient work-up with plan for likely GI work-up as an outpatient with potential EGD/C-scope to evaluate for source of GI bleed. Of note, patient with previous c-scope in [**2174**] which demonstrated diverticular disease as well as cecum and sigmoid polyps s/p polypectomy; cecum path: fragments of adenoma, sigmoid path: hyperplastic. OUTPATIENT ISSUES: -- Continue PPI and enteric coated ASA for primary prevention -- Close follow-up with PCP to discuss future GI work-up . #. COPD. Patient without respiratory complaint in house. Did demonstrate intermittent wheeze on exam that was controlled with prn nebulizers. Continued on home albuterol, advair, spiriva and singulair. No need for supplemental O2 in house. . Medications on Admission: Albuterol inhaler 2-4 puffs q6h prn SOB Albuterol nebulizer q6h prn SOB Calcitriol 0.25 mcg every other day Advair 500-50 1 disk ing [**Hospital1 **] HCTZ 25 qday Lisinopril 10 mg qday Montelukast 10 mg qday Viagra prn Simvastatin 40 mg daily Spiriva 18mcg qday ASA 81 mg daily Vitamin D 1000 unit daily Benadryl prn Discharge Medications: 1. albuterol sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig: 1-2 Puffs Inhalation every six (6) hours as needed for shortness of breath. 2. fluticasone-salmeterol 500-50 mcg/dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). 3. calcitriol 0.25 mcg Capsule Sig: One (1) Capsule PO EVERY OTHER DAY (Every Other Day). 4. simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. montelukast 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. tiotropium bromide 18 mcg Capsule, w/Inhalation Device Sig: One (1) Cap Inhalation DAILY (Daily). 7. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) Inhalation every six (6) hours. 8. aspirin, buffered 81 mg Tablet Sig: One (1) Tablet PO once a day. 9. pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 10. Viagra Oral 11. Vitamin D 1,000 unit Tablet Sig: One (1) Tablet PO once a day. 12. Outpatient Lab Work Please have your hematocrit and creatinine checked this week. Discharge Disposition: Home Discharge Diagnosis: Primary: Viral Gastrenteritis Acute Kidney Injury . Secondary Hypertension COPD Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Dear Mr [**Known lastname **] it was a pleasure taking care of you. . You presented to [**Hospital1 18**] due to progressive nausea, vomiting and inability to take in food or water by mouth thought secondary to a viral gastroenteritis. You were severely dehydrated and subsequently your kidneys were not functioning properly. You received IV fluids and your kidney function improved and it time of discharge it had normalized. . While hospitalized you were noted to have dark stools with concern for bleeding in your gastrointestinal tract. Your blood counts remained stable and there was little concern for active bleed. It will be important to continue to monitor your bowel movements after discharge and discuss need for further work-up with your PCP including potential GI follow and need for imaging (EGD, colonscopy). . CHANGES TO YOUR MEDICATIONS: Due to your recent episode of low blood pressures: STOP taking your LISINOPRIL and HYDROCHLOROTHIAZIDE until you are seen by your PCP. [**Name10 (NameIs) **] decrease acid production in your stomach: START taking PANTOPRAZOLE 40mg PO. Take on tablet daily . To prevent your stomach for excess irritation: TAKE BUFFERED ASPIRIN 81mg tablets. Take one daily . Again it was a pleasure taking care of you. Please feel free to contact with any questions or concerns. Followup Instructions: Department: [**Company 191**] POST [**Hospital 894**] CLINIC [**Telephone/Fax (1) 250**] When: MONDAY [**2177-5-5**] at 10:00 AM With: Dr [**First Name (STitle) **] [**Name (STitle) **] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 895**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage This appointment is with a hospital-based doctor as part of your transition from the hospital back to your primary care provider. [**Name10 (NameIs) 616**] this visit, you will see your regular primary care doctor in follow up. Department: [**Hospital3 249**] When: WEDNESDAY [**2177-7-16**] at 12:00 PM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 5377**], MD [**Telephone/Fax (1) 250**] Building: [**Hospital6 29**] [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: WEST [**Hospital 2002**] CLINIC When: MONDAY [**2177-12-8**] at 10:00 AM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 2088**], MD [**Telephone/Fax (1) 721**] Building: De [**Hospital1 **] Building ([**Hospital Ward Name 121**] Complex) [**Location (un) **] Campus: WEST Best Parking: [**Street Address(1) 592**] Garage [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 810**] MD, [**MD Number(3) 811**] Completed by:[**2177-4-30**] ICD9 Codes: 5845
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6540 }
Medical Text: Admission Date: [**2173-11-10**] Discharge Date: [**2173-11-19**] Date of Birth: [**2124-10-13**] Sex: M Service: CARDIOTHORACIC Allergies: Percocet / Quinine Attending:[**First Name3 (LF) 1505**] Chief Complaint: Increasing fatigue Major Surgical or Invasive Procedure: [**2173-11-11**] Mitral valve repair with 26 millimeter [**Doctor Last Name 405**] band History of Present Illness: This is a 49 yo African - American male with severe MR [**First Name (Titles) **] [**Last Name (Titles) **] HTN for past 10 years. This has progressed significantly and the patient has had increasing fatigue. He was referred for MVrepair vs. replacement and was admitted pre-operatively to the CSRU for Swan placement. He had dialysis this morning prior to admission. He has ESRD and is on dialysis for the past 2 years. He is also anticipating renal transplant in the near future and his wife is the planned donor. Catheterization prior to this admission showed elevated RA pressures (17) with PA 92/38, and wedge 40, CI 1.7, EF 42% with effective EF 29%. He also had global HK, mod. MR, mod. TR, mild PR. Past Medical History: severe MR [**Last Name (Titles) **]. HTN CHF HTN IDDM mild GERD ESRD ( on HD 2 years) s/p R index finger amp. ? eye surgery Social History: Mmarried. No ETOH/tobacco/drugs Family History: No premature CAD Physical Exam: General - NAD HEENT - PERRL, EOMI, sclera non-iceric Neuro - CN II-XII grossly intact, MAE [**6-10**] strengths Lungs - CTA bilaterally Heart - RRR with 2/6 diastolic murmur abd - soft, nt, nd, + BS Ext - no peripheral edema, DP 2+ nilat. with warm extrems Pertinent Results: [**2173-11-19**] 08:00AM BLOOD WBC-9.4 RBC-3.48* Hgb-11.2* Hct-33.1* MCV-95 MCH-32.2* MCHC-33.8 RDW-15.1 Plt Ct-365 [**2173-11-10**] 03:32PM BLOOD WBC-11.0 RBC-3.73* Hgb-12.9* Hct-37.3* MCV-100* MCH-34.6* MCHC-34.6 RDW-14.5 Plt Ct-177 [**2173-11-19**] 08:00AM BLOOD PT-14.3* PTT-29.9 INR(PT)-1.4 [**2173-11-19**] 08:00AM BLOOD Plt Ct-365 [**2173-11-19**] 08:00AM BLOOD Glucose-143* UreaN-51* Creat-9.3*# Na-134 K-5.2* Cl-92* HCO3-25 AnGap-22* [**2173-11-10**] 03:32PM BLOOD ALT-22 AST-26 AlkPhos-141* TotBili-0.7 [**2173-11-10**] 03:32PM BLOOD Glucose-47* UreaN-25* Creat-6.5* Na-141 K-4.5 Cl-94* HCO3-36* AnGap-16 [**2173-11-19**] 08:00AM BLOOD Calcium-9.7 Phos-7.5*# Mg-2.7* [**2173-11-10**] 06:27PM BLOOD freeCa-1.09* Brief Hospital Course: Just prior to admission, patient underwent hemodialysis. He was then directly admitted to floor, then to the CSRU for Swan placement and evaluation of pressures and volume status. He was subsequently started on a Nitro drip for pulmonary hypertension. He remained hemodynamically stable. The following day, he underwent a MV repair with Dr. [**Last Name (STitle) **], and was transferred to CSRU in stable condition on epinephrine, milrinone, insulin, and propofol drips. He awoke neurologically intact and was extubated on POD#2. He continued on his regular dialysis schedule. His inotropic support was gradually weaned over several days. An echocardiogram on POD#4 revealed only trivial MR and a LVEF of 55% - improved from prior studies. He otherwise maintained stable hemodynamics and remained in a normal sinus rhythm. Medical therapy was optimized and he was transferred to the floor on POD#7. He was followed closely by the renal and cardiology services. He worked daily with physical therapy. He continued to make clinical improvements and was cleared for discharge to home on POD#8. At time of discharge, he was tolerating room air and his chest x-ray showed improved aeration and CHF with only a small residual left pleural effusion. He had adequate pain control with Dilaudid. Medications on Admission: digoxin 0.125 mg daily glipizide 10 mg daily insulin NPH 10 units [**Hospital1 **] Avandia 4 mg daily lopressor 75 mg [**Hospital1 **] norvasc trandolapril 4 mg daily zantac 150 mg daily nephrocap one cap daily Discharge Medications: 1. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 3. Hydromorphone 2 mg Tablet Sig: One (1) Tablet PO every four (4) hours as needed. Disp:*40 Tablet(s)* Refills:*0* 4. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 5. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 6. Isosorbide Mononitrate 60 mg Tablet Sustained Release 24HR Sig: One (1) Tablet Sustained Release 24HR PO DAILY (Daily). Disp:*30 Tablet Sustained Release 24HR(s)* Refills:*2* 7. Nephrocaps 1 mg Capsule Sig: One (1) Capsule PO once a day. Disp:*30 Capsule(s)* Refills:*2* 8. Zestril 40 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*0* 9. PhosLo 667 mg Tablet Sig: Two (2) Tablet PO qac. Disp:*60 Tablet(s)* Refills:*0* 10. Glucotrol XL 10 mg Tab, Sust Release Osmotic Push Sig: One (1) Tab, Sust Release Osmotic Push PO once a day. 11. Avandia 4 mg Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: s/p MV Repair End stage renal disease/ hemodialysis Insulin dependent diabetes mellitus [**Hospital **]. Hypertension Congestive heart failure Hypertension Gastro-esoph. reflux disease Right upper extrem AV fistula Discharge Condition: good Discharge Instructions: no lotions, powders or creams on incision may shower, and pat wound dry no lifting greater than 10 pounds for 10 weeks no driving for one month Followup Instructions: see Dr. [**Last Name (STitle) 5456**] in [**2-7**] weeks see Dr. [**Last Name (STitle) **] in office at 4 weeks [**Telephone/Fax (1) 170**] Dr. [**Last Name (STitle) **] 2 weeks Completed by:[**2173-12-13**] ICD9 Codes: 4240, 5856, 4280
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6541 }
Medical Text: Admission Date: [**2110-6-30**] Discharge Date: [**2110-7-3**] Date of Birth: [**2061-3-23**] Sex: F Service: MEDICINE Allergies: Bactrim Attending:[**First Name3 (LF) 465**] Chief Complaint: Confusion Major Surgical or Invasive Procedure: Intubation Insertion of right-sided internal jugular catheter History of Present Illness: 49 yo F with h/o DM, CHF, sleep apnea, morbid obesity, cholelithiasis, DM2, and HTN presented to [**Hospital3 3765**] with confusion. She noted decreased urine output over the previous 4 days as well as fatigue. Per report, pt had recently started Klonopin and had decreased PO intake with some nausea and vomiting. She denied fevers, chills, or pain. At [**Hospital1 **], patient was found to be in ARF with elevated Cr to 8.0 (from 0.9) and K of 6.8 but no EKG changes. Patient was subsequently transfered to [**Hospital1 18**] ED where she was given 1 amp of bicarbonate, 70mg of Kayexalate, NS x 1 L, CaCl, insulin 10 units with dextrose. She also had a RIJ placed. Patient was also found to have pH of 7.16, pCO2 59 (baseline 50s). HCO3 20. She was poorly responsive and incoherent. BIPAP was initiated in the ED. Initial ABG showed improvement in pH. . ICU course: On repeat ABG, pH was again 7.16 and pt continued to be poorly responsive. She was intubated for airway protection and acidosis management. She was put on IV fluids with HCO3 for her ARF and acidosis. Her hyperkalemia was managed with Calcium, Insulin and Dextrose, and Kayexelate, and her potassium normalized. At the time of transfer to the floor, the patient had been extubated. Her mental status had improved, and she was alert and oriented x 3. Her Cr had decreased to 1.4 Past Medical History: 1. Arthritis - on methadone for pain 2. Asthma 3. Diabetes Mellitus - oral antihyperglycemics 4. Obesity - considered too high risk currently for gastric bypass 5. OSA - supposed to be on CPAP at home 6, ? R sided heart failure from pulm HTN 7. Cholelithiasis - recent bout of cholecystitis, tx w/ abx, needs ccy 8. Dysfuntional uterine bleeding - refused exam in past 9. Anemia - Hct ranges from 29-34 since [**4-11**], MCV 82, iron 27 10. Anxiety Social History: Supportive family. Lives w/ "husband" [**Doctor Last Name **]. Has 3 children, but not all of them live together. No tob, no EtOH. On disability, not working. Family History: non-contributory Physical Exam: 97.7 94/45 17 97 [**Telephone/Fax (1) 107364**] getting intubated General: obese female, opening eyes to voice, following commands, incoherent, HEENT: PERRL, anicteric, clear OP Neck: obese, no JVD visualized CV: distant HS, rrr Lungs: CTAB/L anteriorly ABd: larger protruberant, soft, no fluid wave, non-distended extremities: mild edema, no cyanosis, no evidence of rash or cellulitis. Pertinent Results: [**2110-6-30**] 06:30PM GLUCOSE-107* UREA N-131* CREAT-7.7*# SODIUM-131* POTASSIUM-6.0* CHLORIDE-96 TOTAL CO2-20* ANION GAP-21* [**2110-6-30**] 06:30PM ASA-NEG ETHANOL-NEG ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**2110-6-30**] 06:30PM URINE HOURS-RANDOM UREA N-351 CREAT-217 SODIUM-23 CHLORIDE-17 TOT PROT-61 PROT/CREA-0.3* [**2110-6-30**] 06:30PM WBC-7.5 RBC-3.82* HGB-10.6* HCT-30.5* MCV-80* MCH-27.8 MCHC-34.7 RDW-14.8 [**2110-6-30**] 09:28PM TYPE-ART TEMP-36.5 O2-20 PO2-61* PCO2-52* PH-7.21* TOTAL CO2-22 BASE XS--7 INTUBATED-NOT INTUBA COMMENTS-O2 DELIVER Brief Hospital Course: 49 y.o. F with morbid obesity, OSA, DM2 who presented with mental status changes from ARF with hyperkalemia and acidosis. . # ARF - Etiology likely prerenal from dehydration, although NSAID use may suggest intrinsic component. Cr resolved to 0.8 at time of discharge. Patient was educated re: need to watch hydration when taking lasix and she was discharged on a low dose (lasix 40mg po bid) to prevent recurrence of prerenal failure. In addition, her aldactone and ibuprofen were stopped to prevent any damage to kidneys until she could be assessed as an outpatient. . # Respiratory distress-- patient was intubated for acidosis that did not respond to IV bicarb as well as airway protection given her poor mental status. She was extubated 1 day later. During her hospitalization, she returned to her baseline oxygen requirement of 2L nasal cannula at night and intermittently during the day. . # Hyperkalemia--patient was admitted with potassium 6.8. She did not have EKG changes. She was given Calcium, Insulin and Dextrose, and Kayexalate. As her kidneys recovered, her potassium normalized. . # Acidosis--was felt to be both metabolic from her renal failure and respiratory from her baseline hypoventilation/CO2 retention. - resolved with intubation and recovery of renal function . # Chest pain--patient had an episode of chest pressure which she says was brought on by anxiety. - Cardiac enzymes negative x 2, no EKG ST segment changes - pt was given oxygen, morphine, and aspirin while being ruled out for MI - pt has no h/o MI, states that she often experiences chest pressure during episodes of stress . # Anxiety - on Celexa - started Clonazepam 0.5 mg PO BID PRN--discharged on 1mg Clonazepam in accordance with OMR record. . # Hypernatremia--most likely secondary to post-acute tubular necrosis diuresis. Patient was given 1/2 NS and her hypernatremia resolved. . # DM2 - RISS; hold metformin until discharge given recent acidosis. . # BP - hypertensive at baseline, but metoprolol and lisinopril were held during admission to prevent renal damage and b/c her systolic BP was <120 during her stay. . # OSA/obesity hypoventilation - pt was maintained on inhalers during her stay. She was advised to continue using CPAP on discharge. . # Arthritis--patient takes methadone 10mg [**Hospital1 **] at home--this was held during hospital stay because of her altered mental status. Medications on Admission: Advair 250/50 1 puff [**Hospital1 **] Aldactone 25mg daily Ambien 5 qHs ASA 325mg daily Celexa 40mg daily Alb/Atroven INH q6 prn Lasix 120 PO BID Ibuprofen 800 prn Lisinopril 5mg daily Ativan prn Metformin 850 [**Hospital1 **] Metoprolol 50 PO BID Prilosec 20mg [**Hospital1 **] Simvastatin 10mg daily METHADONE 10 MG [**Hospital1 **] Discharge Medications: 1. Simvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Citalopram 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 3. Albuterol 90 mcg/Actuation Aerosol Sig: 1-2 Puffs Inhalation Q6H (every 6 hours) as needed. 4. Ipratropium Bromide 17 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation QID (4 times a day). 5. Aspirin 325 mg Tablet Sig: One (1) Tablet PO once a day. 6. Fluticasone-Salmeterol 250-50 mcg/Dose Disk with Device Sig: One (1) inhalation Inhalation twice a day. 7. Clonazepam 1 mg Tablet Sig: One (1) Tablet PO twice a day as needed for anxiety. 8. Lasix 40 mg Tablet Sig: One (1) Tablet PO twice a day. Disp:*30 Tablet(s)* Refills:*0* 9. Lisinopril 5 mg Tablet Sig: One (1) Tablet PO once a day. 10. Metformin 850 mg Tablet Sig: One (1) Tablet PO twice a day. 11. Prilosec OTC 20 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO twice a day. Discharge Disposition: Home With Service Facility: [**Hospital3 3765**] Hospice Program Discharge Diagnosis: Primary Diagnosis: Acute Renal Failure Secondary Diagnoses: Hyperkalemia, Acidosis, Obesity, Obstructive Sleep Apnea, Diabetes mellitus, Anxiety Discharge Condition: Patient was alert and oriented x 3. Her renal failure and hyperkalemia had resolved at time of discharge. Vital signs were stable and she was at her baseline oxygen requirement of 2L nasal cannula. She was assessed by PT, who recommended she go home with home physical therapy, which was arranged. Discharge Instructions: 1. Please return to the hospital if you develop increased shortness of breath, confusion, or any other concerning symptom. 2. Please attend all follow-up appointments as listed below. 3. Please take all medications as prescribed. You will notice the following changes: - Please do not take your aldactone, ibuprofen, metoprolol, or methadone until you see your doctor and get further instructions. - Please take lasix 40mg in the morning and 40 mg in the evening until you see your doctor in the outpatient clinic. Followup Instructions: Provider: [**Name10 (NameIs) 14876**] [**Name11 (NameIs) **], MD Phone:[**Telephone/Fax (1) 250**] Date/Time:[**2110-7-8**] 2:50 Provider: [**Name Initial (NameIs) 703**] (C4) TCC RADIOLOGY Phone:[**Telephone/Fax (1) 327**] Date/Time:[**2110-8-14**] 2:30 Provider: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], MD Phone:[**Telephone/Fax (1) 250**] Date/Time:[**2110-8-14**] 4:00 [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] MD [**MD Number(2) 472**] Completed by:[**2110-7-6**] ICD9 Codes: 5849, 2762, 2760, 4280, 4019, 2859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6542 }
Medical Text: Admission Date: [**2135-7-2**] Discharge Date: [**2135-8-23**] Date of Birth: [**2081-3-20**] Sex: F Service: MEDICINE Allergies: Nafcillin / Vancomycin Attending:[**Doctor First Name 3290**] Chief Complaint: Back pain due to epidural abscesses complicated by bacteremia and acute respiratory distress Major Surgical or Invasive Procedure: 1. [**2135-7-3**]. Cervical decompression via laminectomies C2-C6 bilaterally, insertion of 2 epidural drains. Laminectomy T12-L1-L2, insertion of 2 drains 2. [**2135-7-5**] Right knee arthrocentesis and washout 3. [**2135-7-13**] Anterior cervical discectomy and fusion as well as epidural abscess evacuation. 4. [**2135-7-25**] IR-guided paraspinal abscess drainage History of Present Illness: 54 yo F presents to ED w/ 1 week of worsening back pain. Pain reportedly started while riding a bike. Began in lower back and has steadily risen up to her neck over the past week. Also reports some shooting pain down right leg. + fevers and chills. For the past 3 days, her legs have been feeling weak, she has had difficulty urinating. Fevers and chills have resolved. Reports tremors starting two days ago. She denies fecal incontinence although this was reportedly endorsed to ED staff. Denies any numbness or tingling in her extremities. Past Medical History: None Social History: Works for a mission network. No IVDA. Social EtOH Family History: N/C Physical Exam: ADMISSION PHYSICAL EXAM: T:98.7 BP: 155/100 HR:140-150s RR: 20 O2Sats 100% on NRB Gen: Anxious, Uncomfortable HEENT: Pupils: 4->3 EOMs - Full Abd: Soft, NT Extrem: Warm and well-perfused. Neuro: Mental status: Awake and alert, cooperative with exam, normal affect. Orientation: Oriented to person, place, and date. Motor: D B T WE WF IP Q H AT [**Last Name (un) 938**] G R 5 5 5 5 5 5 5 5 5- L 5 5 5 5 5 5 5 5 5- Sensation: Intact to light touch, propioception, pinprick and vibration bilaterally. Reflexes: Pa Ac Right 2+ Mute Left 2+ Mute Rectal exam - normal sphincter control, normal perianal sensation DISCHARGE PHYSICAL EXAM ([**8-17**]): VS: Afebrile >36hr, Tc: 98.1 BP: 130/76 (140-170/80-92) 94% 2L 02 saturation yesterday: 97--100% on 1-2L; 94% RA GEN: Sleeping but arousable, oriented, no acute distress HEENT: non-icteric sclera, MMM NECK: Gauze and tegaderm in place over former RIJ, no tenderness HEART: RRR, nl S1 S2, 3/6 systolic murmur, heard best at LUSB, radiating to neck bilaterally, no rubs LUNGS: anterior lung fields clear, slightly decreased bs at bases, no wheezes ABD: ecchymoses on lower abdomen, +NABS, soft, non-distended, non-tender, without rebound or guarding EXT: warm, 1+ edema to ankle b/l, right knee with healed surgical scar T/L/D - Left PICC line in place; no surrounding tenderness, erythema Pertinent Results: ADMISSION LABS: [**2135-7-2**] 01:45PM URINE RBC-[**5-5**]* WBC->50 BACTERIA-MANY YEAST-NONE EPI-0-2 [**2135-7-2**] 01:50PM WBC-21.2* RBC-4.70 HGB-14.2 HCT-43.9 MCV-93 MCH-30.2 MCHC-32.4 RDW-14.4 [**2135-7-2**] 01:50PM GLUCOSE-287* UREA N-51* CREAT-1.7* SODIUM-136 POTASSIUM-3.6 CHLORIDE-96 TOTAL CO2-21* ANION GAP-23* [**2135-7-2**] 02:17PM LACTATE-2.9* DISCHARGE LABS ([**8-17**]) WBC RBC Hgb Hct MCV MCH MCHC RDW Plt Ct 16.6* 2.87* 8.0* 24.4* 85 27.8 32.7 17.9* 227 DIFF Neuts Bands Lymphs Monos Eos Baso Atyps Metas Myelos Promyel NRBC 59 9* 8* 21* 0 0 1* 2* 0 Glucose UreaN Creat Na K Cl HCO3 AnGap 96 22* 0.5 141 3.7 102 32 11 Inflammatory Markers ([**8-16**]) ESR: 115* CRP: 30.9 . MICRO: Micro: [**7-2**] - Blood Cx - [**2-27**] MSSA [**7-3**] - Epidural Swab - MSSA [**7-5**] - Joint Fluid + Swab - MSSA [**7-13**] - Epidural Swab - MSSA [**7-25**] Abscess - MSSA . C. diff - [**8-1**] (-), [**7-30**] (-), [**7-26**] (-), [**8-16**] (-) . Antimicrobial History: Vanco+Cefepime [**7-10**]->[**7-15**] Vanco [**7-10**] -> [**7-15**] Nafcillin [**7-15**] -> [**7-19**] Vanco [**7-19**] -> [**8-8**] Cefepime [**7-26**] -> [**8-2**] Meropenem 1000mg IV Q8 ([**8-8**] - [**8-14**]) Daptomycin 600mg IV Q24 ([**8-8**] - present) [**2135-8-17**] 10:22 am STOOL CONSISTENCY: NOT APPLICABLE Source: Stool. **FINAL REPORT [**2135-8-18**]** CLOSTRIDIUM DIFFICILE TOXIN A & B TEST (Final [**2135-8-18**]): Feces negative for C.difficile toxin A & B by EIA. (Reference Range-Negative). IMAGING: MRI Spine [**7-3**]: 1. Cervical anterior epidural collection, with severe narrowing of the thecal sac from C2 through C5, without evidence of spinal cord edema. Sagittal post-contrast images suggest that this collection contains fluid at the level of C2, which would indicate an abscess rather than a phlegmon. However, axial post-contrast images suggest that the central hypoenhancing portion of the collection at C2 may not be fully liquefied, or that the fluid may be highly viscous. 2. Anterior epidural collection from T11 through the upper sacrum, compressing the thecal sac and crowding the cauda equina. This collection appears to contain fluid from T12 through L3, indicative of an abscess rather than a phlegmon. 3. No evidence of discitis or osteomyelitis. 4. Bilateral posterior paravertebral muscle phlegmon at the level of L4-5 with a possible 5 mm abscess on the right. Contrast enhancement surrounding the L4-5 facet joints may represent inflammation secondary to the severe degenerative facet arthropathy, but septic facet arthropathy cannot be excluded Echo [**7-4**]: IMPRESSION: Suboptimal image quality. Mild mitral leaflet thickening but without discrete vegetation or pathologic flow. Mild pulmonary artery systolic hypertension. Normal left ventricular cavity size with preserved global and regional systolic function MRI Spine [**7-4**]: 1. Cervical region: No STIR signal abnormality in the cord. No evidence of cord compression. Expected post-op changes. 2. Lumbar region: Small epidural signal abnormality, could represent residual abscess collection from debridement or post-surgical changes. XRAY-Knee IMPRESSION: Small to moderate-sized knee joint effusion. CTA [**7-9**] IMPRESSION: 1. No pulmonary embolism or acute aortic pathology. 2. Moderate bilateral pleural effusions with subtotal lower lobe collapse. Evidence of loculated pleural effusions tracking up in the right upper lateral pleural space. 3. Multiple lung nodules likely infectious in this cl inical setting. Follow- up to resolution is recommended 4. No pneumothorax. MR [**Name13 (STitle) **] [**8-12**] Significant increase in volume of the epidural fluid collection/abscess extending from the uppermost C1 epidural space to the inferior aspect of the study at L1, largest at the upper cervical spine where it measures approximately 1 cm in greatest thickness. The patient is status post cervical laminectomy from approximately C2-C6 but the epidural collection displaces the cervical cord posteriorly and the cervical cord appears compressed against the posterior ring of C1. There is increased signal within the cervical cord from the medulla to C3. 2. The epidural collection/abscess within the thoracic spine mildly displaces the thoracic cord without evidence of cord signal abnormality. CT-Thoracentesis (drainage) [**7-13**] IMPRESSION: Successful diagnostic and therapeutic thoracentesis yielding 270 cc of serosanguineous fluid from the right pleural cavity. An 8 French pigtail catheter was placed within the pleural cavity and is currently attached to waterseal. Samples were sent for microbiology and chemistry per the ordering team's request. MR C/T/L-Spine [**7-21**] IMPRESSION: 1. New soft tissue paraspinal pockets of fluid collection are seen in the lumbar region since the examination of [**2135-7-2**] and [**2135-7-4**], visualized in the lower lumbar region involving the psoas muscles and the erector spinae muscles. The largest collection in the right erector spinae muscle is approximately 3 cm and the largest collection in the right psoas muscle is approximately 2 cm. Additional left psoas muscle fluid pocket measures 2.8 cm. Smaller foci are also visualized. 2. Lumbar epidural fluid collection ventral and dorsal to the thecal sac in the lower lumbar region may be slightly smaller compared to [**2135-7-2**]. 3. Epidural collection in the cervical region extending from C2 inferiorly is not significantly changed since the MRI of [**2135-7-14**]. Minimal indentation on the spinal cord in cervical region is unchanged. Postoperative changes and laminectomies are seen in this region. 4. Thoracic epidural collection has not changed and there is no cord compression in thoracic region. 4. Laminectomies are seen in the lower thoracic/upper lumbar region. Thin rim of epidural collection again seen in the thoracic region which is unchanged. No cord compression is identified in the thoracic region. CT-Chest/Abdomen/Pelvis [**7-26**] IMPRESSION: 1. Overall, stable appearance of multiple small fluid collection seen in the paraspinal muscles along with the erector spinae and psoas muscles, as described above. No new intraabdominal or intrapelvic collections identified. 2. Stable bilateral pleural effusion with bibasilar airspace disease. 3. Stable appearance of mediastinal and bilateral hilar lymphadenopathy. U/S Abdomen [**7-29**] IMPRESSION: 1. Cholelithiasis with edematous and thick walled but contracted gallbladder. No son[**Name (NI) 493**] evidence of acute cholecystitis. Gallbladder wall thickening and edema may be caused by multiple factors such as liver disease and hypoalbuminemia, and clinical correlation is recommended. 2. Splenomegaly. CT-Chest/Abdomen/Pelvis [**8-1**] IMPRESSION: 1. Multiple soft tissue abscesses appear similar to prior examination with erector spinae abscess on the right, left iliopsoas abscess, and fluid pockets overlying the lower lumbar spine spinous processes. 2. Left posterior rotator cuff region possible new abscess, not well seen on prior studies. 3. Bilateral basal pulmonary volume loss and consolidation, similar to prior examination in lesion addition to bilateral pleural effusions, more pronounced and somewhat loculated on the right but similar to prior study. 4. Nonspecific gallbladder wall thickening. Cholecystitis is not excluded, although the appearance is stable compared to prior examination and has been previously evaluated with ultrasound. 5. Nonspecific lesion in the right renal upper pole. This was not well seen on prior examination. If there is clinical suspicion for renal abscess, targeted ultrasound could be performed to further assess. 6. Left proximal thigh abscess, incompletely assessed but similar to prior study allowing for difference in technique. 7. Splenomegaly. MRI C-Spine [**8-6**] IMPRESSION: Again, epidural enhancement and abscesses identified in the anterior cervical region. As described above, the fluid collection around C2-C3 level appears slightly increased in thickness, but the differences in measurements are small and this could also be due to partial volume averaging, but continued followup is recommended. Otherwise, the examination is stable MRI T-Spine [**8-6**] IMPRESSION: Overall stable appearance of the thoracic spine compared to the previous MRI of [**2135-7-21**]. Again, lower thoracic and upper lumbar laminectomies and epidural enhancement is seen in the thoracic region without epidural abscess. CT Scan Abd/Pelvis ([**8-9**]): with abdominal pain of unclear etiology, look for possible underlying abdominal abscess. COMPARISON: CT torso from [**2135-8-1**]. TECHNIQUE: Non-contrast MDCT of the abdomen. The patient not received any oral or IV contrast. FINDINGS: Of note, evaluation of abdominal organs is limited without any intravenous or oral contrast administered. Once again, there are bilateral pleural effusions with overlying collapse/consolidation that has slightly improved from previous study. Once again, the right is significantly greater than the left and appears loculated. A nodular density previously seen in the right middle lobe is not visualized in the current study. CT ABDOMEN W/O Contrast: There is no focal liver lesion seen. There is evidence of a large stone within the gallbladder; however, there are no signs of gallbladder wall thickening or other associated signs to suggest inflammation or infection. The spleen is enlarged. There is no focal splenic lesion or abscess seen. Pancreas appears normal. Adrenals appear normal. The kidney is normal in appearance. Right kidney appears normal in appearance. The small area of hypoattenuation seen in the left kidney on the previous study was not appreciated on the current exam. Small periaortic and portacaval lymph nodes are again seen, however, they do not meet CT criteria for lymphadenopathy. There is no bowel obstruction. The appendix is normal. There is no significant mesenteric lymphadenopathy or fluid collection seen. CT PELVIS W/O contrast: Once again seen is a low-attenuation fluid collection in the left iliopsoas muscle, extending from the lower lumbar-upper pelvic regions along the psoas. This collection appears unchanged, both in size and in character and further characterization is limited without contrast. Once again seen are the small areas of low attenuation, representing fluid in the proximal thigh as well as stranding in the left greater trochanter. This appears unchanged from the previous study of [**2135-8-1**]. There is no epidural abscess seen in the thoracic region. The rectum, sigmoid colon, bladder, and uterus are normal. 3D reconstructions, coronal and sagittal reconstructions were essential in delineating the anatomy and pathology. BONES: There is no osseous destruction seen. As mentioned, evidence of priorlaminectomies at the lower thoracic spine and upper lumbar spine are seen.There are no epidural collections suggestive of epidural abscess in the lumbaror visualized thoracic spine. IMPRESSION: 1. Unchanged left iliopsoas abscess 2. Slight interval decrease in bilateral basal pulmonary volume loss and consolidation and pleural effusions. 3. Large gallstone within the gallbladder without sign of gallbladder inflammation. 4. Unchanged fluid collection in the left proximal thigh compared to prior. 5. This study was discussed with Dr. [**First Name8 (NamePattern2) 1169**] [**Last Name (NamePattern1) **] at 4:30 p.m. on [**2135-8-9**]. . Unilateral upper extremity venous ultrasound. ([**8-17**]) COMPARISON: Upper extremity venous ultrasound [**2135-7-11**]. FINDINGS: Color and grayscale son[**Name (NI) 1417**] of bilateral subclavian and left-sided internal jugular, basilic, brachial and cephalic vessels were evaluated. Evaluated vessels demonstrated normal flow, compressibility and augmentation. There is a PICC line in the basilic. There is duplication of the brachial vessels. IMPRESSION: PICC in the basilic vein but no DVT. . Brief Hospital Course: Ms [**Known lastname **] is a 54 yo female with no significant past medical history who initially presented with back pain, urinary retention on [**7-3**], found to have multiple epidural abscesses s/p multiple surgical debridements with hospital course complicated by episodes of flash pulmonary/respiratory compromise requiring intubation and febrile neutropenia secondary to lasix and vancomycin administration. . # Bacteremia/Abscesses/Antibiotic therapy . Patient initially presented with back pain, associated urinary retention and LE weakness. Admission imaging positive for cervical and lumbar epidural abscesses (though patient with no known risk factors). She was empirically started on vancomycin/cefepime/levofloxacin. She underwent C2-C6/T12-L2 bilateral laminectomies with insertion of 4 drains on [**2135-7-3**]. She subsequently developed a septic right knee and returned to the OR on [**2135-7-4**] for right knee washout. Regarding further initial infectious work-up at that time: a TEE was obtained which showed no vegetations; CT head without evidence of intracranial abscess. . On [**2135-7-6**], antibiotic coverage was narrowed to nafcillin when cultures from abscesses, right knee, and blood grew MSSA. However, due to signs and symptoms of leukocytosis, hypoxia there was concern for hospital acquired pneumonia and antibiotic coverage was broadened to vancomycin, cefepime, and ciprofloxacin on [**7-10**]. Patient remained febrile. Surveillance imaging obtained on [**7-12**] which demonstrated increased epidural collection within anterior cervical epidural space and displacement of the cervical cord. The patient returned to the OR on [**7-13**] for abscess decompression and evacuation and fusion of C3-4, C4-5, and C5-6. After reviewing microbial date with all cultures + MSSA, her antibiotic coverage was again narrowed to nafcillin. . Patient had been doing well with normalized temperature and WBC however four days after starting nafcillin, developed a abdominal rash. Derm was consulted, biopsies were taken which were c/w drug rash secondary to nafcillin. Nafcillin was subsequently discontinued and replaced by IV vancomycin. . Repeat MR spine with new paraspinal fluid collections, and mild epidural fluid collection throughout the spine. Due to concern for continued infection cefepime was added to antibiotic regimen. On [**7-25**], the patient underwent paraspinal abscess drainage by interventional radiology. Follow-up CT torso was obtained on [**8-1**] due to persistent fevers on cefepime and vanc; finding were stable to previous imaging and cefepime was discontinued. On [**8-5**], her C-collar was removed. Surveilance MR C/T-Spine on [**8-6**] showed stable epidural enhancement and abscesses identified in the anterior cervical region, thoracic region without epidural abscess. CT scan on [**8-9**] demonstrated left iliopsoas abscess/phlegmen and left thigh fluid collection; both of which were too small to be drained by IR. . Unfortunately side effects necessitated further antibiotic adjustment. CBC with noted leukopenia on [**8-5**] with progression to neutropenia [**8-8**]. Out of concern that vancomycin could be contributing to decreasing counts, vanc d/c'ed and IV daptomycin started. Per ID will plan to treat MSSA bacteremia/abscesses with IV daptomycin to total of 6-8wk course. At time of discharge utility of repeat imaging discussed. Plan to repeat CT abd/pelvis; MRI spine further into antibiotic treatment. . # Febrile Neutropenia . Patient's WBC count began to slowly decline on [**8-5**] with progression to neutropenia on [**8-8**]. Neutropenia was felt secondary to medication effect; subsequently omeprazole, furosemide, vancomycin and seroquel were discontinued. Hematology was consulted, and felt that furosemide or vancomycin were likely offending agents. Antibiotic coverage altered on [**8-8**]: vancomycin discontinued and daptomycin started for treatment of MSSA. On [**8-9**] she was febrile 102.6 and meropenem started for treatment of neutropenic fever. GCSF initiated. After administration of GCSF counts slowly became to rise and fevers abated. GCSF was stopped on [**8-14**] when ANC>1000 for more than 48hrs. . Respiratory Distress . On admission patient found to be tachypnic. LENIs negative. On [**7-8**], developed worsening tachypnea and hypoxemia (95% on 4L by nasal canula). The patient diureased 500ml on IV Lasix and improved slightly. CTA ruled out PE, however showed evidence of bilateral loculated pleural effusions and multiple lung nodules. Cardiac enzymes negative. Pro-BNP 2777 on [**7-8**]. Estimated EF by TEE was >55%; 2 repeat echos without evidence of valvular pathology. In MICU, IV Lasix and morphine lessened respiratory distress. On [**7-10**], transferred to the floor; latered became hypoxic and was transfered back to the MICU and started on BiPAP. Pleural effusion studies suggested parapneumonic effusion. Patient intubated and extubated several time while in MICU. On [**7-16**], the patient was again extubated. She developed hypertension to 180 SBP and respiratory distress secondary to pulm edema, which responded to lasix and labetolol. On [**7-19**], she was comfortable oxygenating with only nasal cannula. She was electively intubated on [**7-25**] for paraspinal abscess drainage and extubated post-procedure. Unfortunately, again developed worsening hypercarbic respiratory distress, requiring reintubation on [**7-27**]. She was gently diuresed, in an effort to decrease the work of breathing. On [**8-3**] she was succesfully extubated, satting well on face mask. On [**8-5**] she was weaned to NC. CT on [**8-9**] showed improvement in pleural effusions and basilar consolidations. She continued to do well on supplemental oxygen by nasal cannula. On the floor her oxygen requirement was weaned. She had one episode of flash pulmonary edema, during which she desaturated to high 80s. She was diuresed with bumex with good effect. For the remainder of her stay, team allowed for auto-diuresis. At time of discharge patient saturating 94% RA, >95% 1L. . # Blood Pressure . During MICU stay pt had repeated episodes of transient bradycardia and hypotension as well as episodes of paroxysmal hypertension into the SBP 180-200s. Her hypertension responded to 5mg-10mg doses of IV labetalol. After significiant diuresis, her SBP remained stable in the 150-160s. On the floor, BP ran consistently high. Patient was started on metoprolol and amlodipine. These medications were gradually uptitrated and at time of discharge pressures were better controlled on metoprolol 50mg TID, amlopidine 10mg QD. She was transitioned to toprol xl 150mg daily at the time of discharge. . # Nutrition . Patient underwent severeal video swallowing evaluation due to concern for silent aspiration. In the MICU, several methods of nutrition employed: NG tube feeds as well as PPN. On transfer to floor patient on NG tube feeds. Repeat speech and swallow on [**8-15**] demonstrated improved oral and pharyngeal swallow with continued swallow delay, premature spillover and reduced base of tongue retraction. Patient continued to aspirate thin liquids silently, but speech deemed it safe to initiate a PO diet of nectar thick liquids and moist, ground solids with the aspiration precautions documented below. It is important to note aspiration is silent, and she will need continued speech therapy follow up with likely repeat video swallow before advancing her diet. # Delirium . In the MICU observed waxing and [**Doctor Last Name 688**] mental status worse at night and with spikes in fever. Symptoms improved with zyprexa at night. The pt became more alert following extubation on [**8-3**], however, she had some disorientation. She received several doses of seroquel, which was discontinued when the patient became neutropenic, as it can be a potential cause of leukopenia. Over the course of the next few days, her became more alert and interactive. By time of transfer from MICU to floor on [**8-10**], she was fully oriented and had a good understanding of the medical plan. On the floor, patients mentation continued to improve. At time of discharge patient mental status was clear and coherent. . # Elbow mass . Mass noted on right elbow. Derm consulted; felt to be consistent with lipoma. . # UTI: She developed low grade fevers on [**8-21**] to 100.4, prompting urinalysis, which demonstrated UTI. She will complete a 10 day course of ciprofloxacin 500mg [**Hospital1 **] to end [**2135-9-1**]. Medications on Admission: None Discharge Medications: . 1. Fentanyl 25 mcg/hr Patch 72 hr Sig: One (1) Patch 72 hr Transdermal Q72H (every 72 hours). 2. Amlodipine 5 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 3. Daptomycin 500 mg Recon Soln Sig: Six Hundred (600) Recon Soln Intravenous Q24H (every 24 hours). 4. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection TID (3 times a day). 5. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for fever/pain. 6. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 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. Outpatient Lab Work Please check weekly CBC with differential, BUN/Cr, LFTs, CK, ESR/CRP . All laboratory results should be faxed to Infectious disease R.Ns. at ([**Telephone/Fax (1) 1353**] 9. Lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: One (1) Adhesive Patch, Medicated Topical DAILY (Daily). 10. Lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: One (1) Adhesive Patch, Medicated Topical DAILY (Daily). 11. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) as needed for anxiety. 12. OXYGEN At time of discharge patient requires 1L nasal cannula for comfort. Discharge Disposition: Extended Care Facility: [**Hospital3 105**] Northeast - [**Location (un) 1110**] Discharge Diagnosis: PRIMARY Methicillin Sensitive Staph Aureus Bacteremia SECONDARY Hypertension Anemia Discharge Condition: Mental Status: Clear and coherent Discharge Instructions: Dear Ms [**Known lastname **] it was a pleasure taking care of you. . You were initially admitted to [**Hospital1 18**] due to symptoms of back pain. Upon imaging it was found that you had several abscesses throughout your spine as well as in your right knee. You underwent several surgeries to evacuate these infection and you were also started on antibiotics. Your antibiotic regimen was altered several times due to significant side effects. You experienced a rash after Nafcillin, and Vancomyocin was thought to contribute to low cell counts. You were placed on Daptomycin without side effect for a planned 8week course. A PICC line was placed prior to discharge to faciliate antibiotic administration as an outpatient. You will receive repeat imaging after completion of your antibiotic therapy for interval evaluation of infection. . Unfortunately, side effects from various medications prolonged your hospital course. It was thought that a combination of vancomycin and lasix contributed to decreased white blood cells (WBC). While your WBC counts were low you were placed on broad spectrum antibiotics to protect you from infection. We discontinued the medications we felt responsible for declining counts (lasix and vancomycin) and also administered a medication called Neupogen to increase WBC production. After several days of Neupogen treatment your white cell counts increased and stabilized. Neupogen as well as broad spectrum antibiotics were discontinued prior to discharge. . We also found your blood pressures to be elevated at times during your hospitalization. You were started on medications, metoprolol and amlodipine, to better control your blood pressure. . Regarding nutrition, after extubation you were noted to have difficultly swallowing. Speech and swallow was consulted and after several attempts you completed and passed your evaluation. After completion, you were started on a thickened nectar liquid regimen and a soft, ground solid diet. You will need repeat speech and swallow evaluation at rehab. . CHANGES TO YOUR MEDICATIONS. On arrival to the hospital you were no prescription medications. . MEDICATIONS WE STARTED . --To treat your infection we STARTED Daptomycin 600mg IV Q24 (start date: [**2135-7-26**], stop date: [**2135-9-19**] (total 8 weeks)) . --To treat PAIN we STARTED: 1. FENTANYL 25 mcg/hr Patch, which can be reapplied every 72 hr; 2. Two LIDOCAINE 5 %(700 mg/patch) Adhesive Patchs, Apply each Adhesive Patch daily to back 3. ACETAMINOPHEN 325 mg Tablet; you can take 1-2 tablets by mouth every 6 hours. . --To treat your high blood pressure we started: 1. AMLODIPINE 10mg daily; you will take two 5mg tablets daily 2. Metoprolol succinate (toprol XL) 150mg tablet daily . -- To prevent blood clot formation while you heal and are relatively limited in your movement you will continue to receive: Heparin (Porcine) 5,000 unit/mL Solution Injections three times a day . --To help treat your anxiety we started: 1. Lorazepam 0.5 mg Tablet, you can take one 0.5 tablet by mouth at at bedtime as needed for anxiety. . You will need Outpatient Lab Work which your facility can obtain and fax to [**Hospital **] clinic . New allergies: LASIX - contraindication - neutropenia NAFCILLIN - contraindication - rash VANCOMYCIN (relative contraindication) - neutropenia Followup Instructions: Department: INFECTIOUS DISEASE When: FRIDAY [**2135-9-16**] at 11:00 AM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 27625**], MD [**Telephone/Fax (1) 457**] Building: LM [**Hospital Ward Name **] Bldg ([**Last Name (NamePattern1) **]) [**Hospital 1422**] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage ICD9 Codes: 5849, 7907, 5119, 2930, 5990, 2760, 4589, 2859
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Medical Text: Admission Date: [**2141-12-19**] Discharge Date: [**2142-1-12**] Date of Birth: [**2141-12-19**] Sex: M Service: Neonatology BIRTH HISTORY: This is a two-day old full-term 3,770 gram infant with new onset of cyanotic episodes associated with rhythmic jerking of upper extremities and lip smacking consistent with seizure activity. The infant was admitted to the Neonatal Intensive Care Unit at two days of age for MATERNAL HISTORY: This was a 29-year-old gravida 2, para 021 mother, hepatitis negative, RPR nonreactive antibody negative, rubella immune, GBS negative. There was no history of maternal fever noted and there was spontaneous rupture of membranes at seven hours prior to delivery. Fluid was meconium stained at the time of delivery and there was no PERINATAL HISTORY: Neonatology was called to the delivery room due to meconium staining. The infant emerged with a strong cry, very vigorous, pink, good tone, no intervention was required. Apgar scores were 8 and 8 at one and five minutes respectively. The patient was transitioned to the newborn nursery for routine case. This baby then had an uneventful postnatal course until the afternoon of admission whereby the mother reported the infant had a dusky spell with cyanosis around the lips. After another such episode, the baby was transferred to the Neonatal Intensive Care Unit for close observation, here he had two short-lived episodes of upper extremity jerking and lip smacking. One of these episodes was associated with a desaturation requiring blow-by oxygen. The infant was loaded with phenobarbital and an lumbar puncture was completed. An antibiotic was initiated. Head CT was obtained and shown to be unremarkable with no significant evidence of bleeding or infarct. On physical examination the birth weight was 3,770 at the 73rd percentile. Head circumference was 34.5 cm at the 50th percentile and the length was 20.5 inches at the 90th percentile. Vital signs were stable. The patient was noted to be alert with acceptable tone but not a very vigorous infant. Color was pink. The infant was quiet and awake, and the neurologic examination was nonfocal. Genitourinary examination was within normal limits and the patient was not dysmorphic. There was no heart murmur heard. The lumbar puncture was unremarkable. The cerebrospinal fluid results were as follows: White blood cells 6, red blood cells [**Pager number **] with 17 polys, 17 lymphocytes, 67 monocytes. The protein glucose was within normal limits and the cerebrospinal fluid culture was negative. Electrolytes were unremarkable as well as the liver function tests. The ammonia was 83. Repeat testing showed NH3 levels that ranged from 70 to 103 during his hospital stay. The most recent level was 80 on [**1-10**] . During the first NICU day the time the patient was loaded with phenobarbital and put on maintenance phenobarbital for seizure and neurology was consulted. HOSPITAL COURSE: From a respiratory standpoint the patient continued to do well without any need for supplemental oxygen or mechanical ventilation. He did however require a brief night of supplemental oxygen which was attributed to hypoventilation. His CBG was within normal limits and the phenobarbital level at that time was above 50. After decreasing the phenobarbital dose which yielded a phenobarbital level of under 50 the patient's need for oxygen was resolved. From a neurological standpoint the patient had a magnetic resonance imaging scan that was unremarkable. He also had three electroencephalograms, one of which was continuous. The initial EEGs did not show frank seizure activity however the continuous EEG upon reexamination did show electrical activity that was very suspicious for electrographic seizures. This was represented by sharp waves over the left temporal and central regions. There were multiple movement artifacts as well. The overall impression of the continuous EEG was an abnormal bedside EEG telemetry due to multifocal sharp discharges seen over the left posterior temporal regions and over the right temporal and right central regions. "On one occasion there appeared to be a brief electrographic seizure emanating from the right posterior temporal region with extension into the bilateral parasagittal regions, however this interpretation is limited due to subsequent movement artifacts seen near the same region." Pertaining to the seizure control it was difficult to control the seizures with monotherapy initially. The patient continued to show seizure activity despite a phenobarbital level in the high 40s. Dilantin was started in order to capture the baby successfully. This Dilantin was discontinued after about 48-72 hours of use and the patient was left on monotherapy with good seizure control. However on the day of planned discharge, the patient had clinical seizures which were noted by his mother. EEG confirmed epiliptogenic foci but no frank seizures. The phenobarb level at that time was in the mid 30s. Pyridoxine and folinic acid were started at the suggestion of the CH neuro team and the phenobarb level was increased to acheive a level in the mid to high 40s. The moast recent level on the 31st was 48.3. Alevel on the 30th was 44.3 on a stable dose. Phenobarb level is to be repeated on [**1-15**] by Dr [**Last Name (STitle) 40493**]. During the course of his NICU stay, the patient also was put on a course of acyclovir as the rule out herpes PCR test was underway. The acyclovir was discontinued after the PCR result was negative. The patient's metabolic work-up was nonspecific: The ammonia was consistently slightly above normal in the nonspecific range. The maximum was 123. The significance of this ammonia level at this point is unknown, as normal newborns in this period can sometimes show a somewhat elevated ammonia level. The patinet ahs been seen in consultation by the CH metabolism team. Other metabolic laboratory studies were as follows: Repeat RFTs on [**12-26**] were normal. Lactic acid was 1.6. Pyruvate level was pending at the time of this dictation. Amino acid panel was within normal limits. The cerebrospinal fluid amino acid was nonspecific. The glycine was somewhat decreased. Newborn screen was within normal limits. Organic acids were notable for the presence of glycerol. This may be artefact due to creams used in the diaper. Repeat testing has been sent off. FOLLOW UP CARE: The patient will be following up with several services: 1. Neurology: The patient will have a follow-up neurology appointment soon after discharge for follow up of seizure management. Hopefully the pending metabolic laboratory studies will be back by the time of the clinic appointment. 2. The patient will also be following with metabolism/genetics soon after discharge for the rest of the metabolic work-up. OTHER SYSTEMS: During his hospital stay the patient continued to do well with his feeds and continued to display good growth. He passed a hearing screen. He did not have any hematological issues and did not have any active infectious disease issues. His electrolytes were within normal limits. Cardiovascularly he did have an intermittent soft ejection murmur that was not hemodynamically significant. This was consistent with a probable flow murmur. His pulses and his perfusion were within normal limits at all times. CONDITION AT DISCHARGE: The patient was well and with seizures under control. DISCHARGE DISPOSITION: To home. Extensive conversation concerning the care and the precautions for this baby were discussed with the mother. She understands the conversation and all questions were answered. The baby will follow up with the pediatrician on the Monday following discharge. A phenobarb level will be done at this time. FU with Dr [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 46082**] has been arranged for [**1-19**]. DISCHARGE MEDICATIONS: Phenobarbital, Pyridxoine, Folinic Acid [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 36142**], M.D. [**MD Number(1) 36143**] Dictated By:[**Name8 (MD) 46588**] MEDQUIST36 D: [**2142-1-4**] 08:55 T: [**2142-1-4**] 09:03 JOB#: [**Job Number 46589**] ICD9 Codes: V053
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Medical Text: Admission Date: [**2198-2-20**] Discharge Date: [**2198-2-24**] Date of Birth: [**2137-5-11**] Sex: M Service: Vascular Surgery CHIEF COMPLAINT: Bilateral iliac artery dissections. HISTORY OF PRESENT ILLNESS: A 60 year old nondiabetic Russian-speaking white male with coronary artery disease, status post myocardial infarction/coronary artery bypass graft with hypertension and hypercholesterolemia, complained of sudden onset abdominal and back pain. The patient presented to the Emergency Room at [**Hospital6 649**]. Abdominal computerized tomography scan showed isolated bilateral iliac artery dissections. There was no history of recent trauma or instrumentation. The patient was admitted for further evaluation. PAST MEDICAL HISTORY: 1. Coronary artery disease: Myocardial infarction/coronary artery bypass graft in [**2197-1-11**]; percutaneous transluminal coronary angioplasty/stent of saphenous vein graft in [**2197-5-11**]. 2. Hypertension. 3. Hypercholesterolemia. 4. Severe, acute hemolytic anemia in [**2197-9-11**]. FAMILY HISTORY: Non-contributory. SOCIAL HISTORY: The patient emigrated from [**Country 532**] in [**2193**]. He lives with his wife. [**Name (NI) **] is an engineer. He does not drink alcohol. He has a history of cigarette smoking. ALLERGIES: No known drug allergies. MEDICATIONS ON ADMISSION: 1. Plavix 75 mg p.o. q.d. 2. Aspirin. 3. Atenolol 25 mg p.o. q.d. 4. Lipitor 10 mg p.o. q.d. 5. Percocet prn. PHYSICAL EXAMINATION: Vital signs revealed temperature 97.1, pulse 65, respirations 18, blood pressure 161/80. General: Alert, cooperative white male in no acute distress. Chest: Heart regular rate and rhythm, lungs have slight expiratory wheezing. Abdomen, soft, nontender. No palpable masses. Rectal examination, normal sphincter tone, stool guaiac negative. Pulse examination, carotid, radial, femoral, popliteal and pedal pulses are all palpable. Neurological examination, nonfocal. LABORATORY DATA: Laboratory data on admission revealed white blood count 16.0, hemoglobin 14.5, hematocrit 41.6, platelets 311,000. PT 12.2, PTT 25.9, INR 1.0. Sodium 142, potassium 3.9, chloride 109, bicarbonate 26, BUN 21, creatinine 0.9, glucose 90. ALT 27, AST 19. Alkaline phosphatase 71, amylase 64, total bilirubin 0.4. CK 179. Electrocardiogram showed a sinus rhythm at 68. No significant change from tracing of [**2197-9-13**]. Chest x-ray showed no acute pulmonary disease, status post sternotomy. HOSPITAL COURSE: The patient was evaluated in the Emergency Room for epigastric pain radiating to the back. He had a thallium scan which showed normal perfusion at rest. The stress MIBI portion was cancelled. The patient was evaluated for aortic dissection with computerized tomography scan of the chest, abdomen and pelvis. The aorta was intact. There was dissection of both the right and left common iliac arteries with extension of the left common iliac dissection to the external iliac. The patient was admitted to the Vascular Surgical Service and was admitted to the SICU for observation. The patient's peripheral pulses were strongly palpable and equal throughout his hospitalization stay. His epigastric and back pain resolved. His abdomen remained soft. His peripheral pulses remained equal and strongly palpable. Systolic blood pressure was 110 on his usual 25 mg of Atenolol. His creatinine was 1.0. His hematocrit was stable at 38. The patient was to follow up with his cardiologist, regarding the need to continue Plavix nine months after having a percutaneous transluminal coronary angioplasty/stent of his saphenous vein graft in [**2197-5-11**]. The patient will follow up with Dr. [**Last Name (STitle) **] in the office in four weeks after having a repeat computerized tomography scan of the chest, abdomen and pelvis. MEDICATIONS ON DISCHARGE: 1. The patient was to resume all preadmission medications. CONDITION ON DISCHARGE: Satisfactory. DISPOSITION: Home. PRIMARY DIAGNOSIS: 1. Isolated dissection of bilateral iliac arteries. SECONDARY DIAGNOSIS: 1. Coronary artery disease. 2. Hypertension. 3. Hypercholesterolemia. [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern4) 2604**], M.D. [**MD Number(1) 6223**] Dictated By:[**Last Name (NamePattern1) 3954**] MEDQUIST36 D: [**2198-4-16**] 18:59 T: [**2198-4-16**] 19:25 JOB#: [**Job Number 24849**] ICD9 Codes: 4019, 2720
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Medical Text: Admission Date: [**2151-12-23**] Discharge Date: [**2151-12-27**] Date of Birth: [**2085-9-18**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 5790**] Chief Complaint: recurrent left effusion Major Surgical or Invasive Procedure: [**2151-12-23**] Left VATS pleural biopsy and talc pleurodiesis, and flexible bronchoscopy by Dr. [**Last Name (STitle) **]. History of Present Illness: Mr. [**Known firstname **] [**Known lastname **] is a pleasant 66 year old male s/p endostenting of his aortic aneurysm as well as left subclavian to left common carotid artery bypass and a left common carotid to right common carotid artery bypass on [**2151-11-15**]. During his hospitalization the patient had a left thoracentesis by Dr. [**Last Name (STitle) **] on [**2151-11-17**] for large left exudative pleural effusion. Cytology was negative for maligant cells. The patient was discharged from the hospital [**2151-11-19**] and returns to see Dr [**Last Name (STitle) **] today for followup of his left effusion. The patient states his breathing has improved, but he does not exert himself much. He doesn't walk outside. He denies fevers, chills, but has "some" nightsweats. He has yellow sputum productive cough. He denies dizziness, or any other issues and has multiple appointments to see various physicians. Past Medical History: Past Medical History: - Coronary Artery Disease - COPD - Hyperlipidemia - Hypertension - Calcified aorta - New finding of Left lingula lung mass - Bilateral Pleural Effusions; s/p left thoracentesis [**2151-11-8**] - Hypothyroidism - Trauma to lower extremities - Emphysema Past Surgical History: - coronary artery bypass grafting surgery x5 in [**2137**] - [**Hospital3 **] Dr.[**Name (NI) 43096**] - Polypectomy [**2151**] - Right elbow seroma, s/p debridement and drainage - Appendectomy Social History: Occupation: retired Last Dental Exam:has only 2 native teeth; no recent dental care Lives with wife in [**Name (NI) 1411**] Race:Caucasian Tobacco:[**1-15**] cigarettes daily ETOH:[**4-18**] glasses of wine daily Family History: Brothers with CAD. One brother died of MI at age 57, another brother with CABG in early 50's. Physical Exam: VS: T98.6, BP 120/70, HR 94 SR, RR 18, O2 sats on RA 92% Physical Exam: Gen: pleasant in NAD Lungs: rales BLL, clear B upper CV: RRR, S1, S2, no MRG Abd: distended, nontender Ext: l>r edema 1+ in left leg, trace in right, warm extremities. Uro: intact foley catheter. Neuro: A and O x 4, ambulating halls. Pertinent Results: [**2151-12-27**] 06:35AM BLOOD WBC-9.0# RBC-3.09* Hgb-9.2* Hct-28.7* MCV-93 MCH-29.6 MCHC-31.9 RDW-16.8* Plt Ct-202 [**2151-12-27**] 06:35AM BLOOD Glucose-93 UreaN-22* Creat-1.0 Na-133 K-4.7 Cl-96 HCO3-31 AnGap-11 [**2151-12-27**] 06:35AM BLOOD Calcium-8.5 Phos-3.2 Mg-2.1 Brief Hospital Course: Mr. [**Known lastname **] was admitted on [**2151-12-23**] where he underwent left VATs pleurodiesis for recurrent pleural effusion. Initially he was kept overnight in the PACU related to retained CO2, and required CPAP, which was weaned off, and CO2 on ABG was per patients baseline. The patient also required fluid bolus and albumin for low urine output which eventually resolved itself. The patient was transferred to the floor [**2151-12-24**]. Chest tubes were removed on [**2151-12-25**] without issue. Unfortunately the patient had a foley catheter placed with prostatic trauma, therefore urology was consulted and recommended foley placement x 7 days with follow up in one week. The patient's urine output has cleared. Of note the pleural biopsy revealed a small amount of enterococcus sensitive to only linezolid. ID approval was obtained to discharge patient on such. The patient has adequate pain control, is on room air, ambulating the halls, has had a bowel movement, and has been cleared by Dr. [**Last Name (STitle) **] for discharge home. The patient will have a CBC and urology visit in one week, and see Dr. [**Last Name (STitle) **] with CXR in 2 weeks. He has been given written and verbal discharge instructions. He has had physical therapy home referral as recommended by Physical therapy. Discharge Medications: 1. Colace 100 mg Capsule Sig: One (1) Capsule PO twice a day as needed for constipation. 2. Levothyroxine 137 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 4. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours). 5. Oxycodone 5 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours). Disp:*30 Tablet(s)* Refills:*0* 6. Ipratropium-Albuterol 18-103 mcg/Actuation Aerosol Sig: [**1-15**] Puffs Inhalation Q6H (every 6 hours) as needed for wheeze. 7. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 9. Linezolid 600 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours). Disp:*28 Tablet(s)* Refills:*0* 10. Cyanocobalamin 50 mcg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*0* 11. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 12. Lasix 20 mg Tablet Sig: One (1) Tablet PO once a day: follow up with primary care doctor [**First Name (Titles) **] [**Last Name (Titles) **] panel in next 2 weeks regarding dose. Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: 1. Recurrent left pleural effusion s/p Left VATS pleurodiesis. 2. COPD 3. CAD 4. Hyperlipidemia 5. HTN 6. Endostenting of his aortic aneurysm as well as left subclavian to left common carotid artery bypass and a left common carotid to right common carotid artery bypass on [**2151-11-15**] Discharge Condition: Stable. Discharge Instructions: -You may shower, but cover chest tube sites with a bandaid. -Do not drive while taking narcotics. -Walk with family three times a day. -Keep urinary catheter in, and secure with leg bag. Make sure you do not tug at this. Followup Instructions: 1. Follow up with Dr. [**First Name (STitle) **] [**Name (STitle) **] office (urology - for your urinary catheter) in one week. Please call for follow up appointment ([**Telephone/Fax (1) 4376**]. Tell them when making your appointment that you have catheter and you have just left the hospital. 2. Follow up with Dr. [**Last Name (STitle) **] on [**2152-1-11**] at 10am in [**Hospital1 **] 116 on [**Hospital Ward Name 517**]. Please get chest xray 45 minutes prior in clinical center [**Hospital Ward Name **] 3th floor radiology. 3. Follow up with your primary care physician in the next two weeks. 4. You will need a CBC, and chemistry blood draw in one week. Completed by:[**2151-12-27**] ICD9 Codes: 5119, 496, 2724, 4019, 2449
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Medical Text: Admission Date: [**2191-5-11**] Discharge Date: [**2191-5-20**] Service: MEDICINE Allergies: Megace Attending:[**First Name3 (LF) 1055**] Chief Complaint: Shortness of breath Hypotension Major Surgical or Invasive Procedure: Intubation Chest tube placement Femoral Line placement History of Present Illness: 84 y/o M w/dementia, LE edema, and hyperlipidemia, who presented to ED with acute SOB. This initially happened while he was on the toilet. His wife called EMS, and he was initially tachycardiac to 120, bp 112/76, rr 36 . He was diaphoretic, denied CP. He had CXR at OSH which by report showed assymm pulm edema R>L. Pt had ECG w/sinus tach, nl axis/int, ST depression inf/lat. ABG 7.41/25/150 on NRB. He was started on CPAP, given MS 2 mg IV, Lasix 80 IV, nitro gtt, heparin gtt for concern of PE. LENI at OSH of swollen LLE neg for DVT. BP dropped from 126/65 to 71/37 with the nitro, which resolved when the drip as stopped. He was intubated at noon after not tolerating CPAP, and becoming tachypneic on NRB. Here, he was noted to have anisocoria not previous noted. Head CT showed no bleed, no shift. CXR showed widened mediastinum, so he had a CTA. This revealed bilateral PEs as well as an apical ptx. He was restarted on the heparin gtt and a chest tube was placed. Pt admitted to MICU for stabilization. Pt was extubated on [**5-13**]. Past Medical History: Althzeimers Dementia Hyperlipidemia Social History: Lives at home with wife. Family History: Unable to obtain Physical Exam: VITALS: Afebrile, 108/60, 90, 98%RA GEN: Pleasant elderly male, NAD, NRB on although pt is not tachypeic and appears comfortable. HEENT: Pupils are equal, round, reactive. Head is normocephalic, atraumatic. Neck is supple, no lymphadenopathy. LUNGS: R ant field clear, L ant field with rale and subQ emphysema, R base with good air movement and occ rales, L base with rale. HEART: Regular rate and rhythm, no murmurs, rubs, or gallops. Carotids: Normal pulsation without bruits. Extremities: 3+ pedal edema to knee, non-palpable pulses, feet are warm with good color. Abdomen: soft, nondistended, and nontender, normoactive BS. Neurologic exam: Alert, oriented to Person only. Babinskis are equivocal. Skin: No rash. Pertinent Results: CTA of chest: CT ANGIOGRAPHY OF THE CHEST: Multiple pulmonary emboli are seen; in the proximal portion of the right pulmonary artery posterior branch near the bifurcation, extending into the superior segment of the lower lobe. A smaller amount of clot is seen in the pulmonary artery feeding the right middle lobe medial segment. On the left, clot is seen in the pulmonary artery feeding the posterior left upper lobe, and also in the segment feeding the anteromedial left lower lobe. The aorta is normal in caliber, with wall calcifications. No dissection is seen. There are calcifications within the coronary arteries. No pericardial effusion is present. CT OF THE CHEST WITHOUT AND WITH IV CONTRAST: A small pneumothorax is seen on the left; additionally, there is a small amount of mediastinal air along the left superior mediastinal border, into the apex of the lung. Dependent atelectasis is seen on both sides; additionally, a peripheral portion of consolidation in the right lower lobe superior segment is distal to the portion of largest clot, and may represent developing pulmonary infarction. There are shotty mediastinal lymph nodes. A nasogastric tube is seen coiling in the stomach. The patient is intubated. The imaged portions of the abdomen, including the superior aspect of the spleen and liver, are unremarkable. A nasogastric tube is seen in the esophagus, which is mildly thickened; some debris and air bubbles within it, without obvious tear. Osseous structures are remarkable for degenerative changes of the spine. There is an old healed rib fracture of the anterior aspect of right rib number seven. A small amount of air seen in the subclavian vein on the left, probably due to phlebotomy. Coronal and sagittal reformations were essential in delineating the anatomy and pathology. MPR value 4. IMPRESSION: 1. Segmental pulmonary emboli in bilateral pulmonary arteries. Associated peripheral consolidation in the right lower lobe, concerning for infarct vs consolidation. 2. Small left pneumothorax and pneumomediastinum in intubated patient. 3. Nasogastric tube in mildly thickened esophagus, with debris and small amount of air, but no obvious tear. 4. Aortic calcifications, without evidence of dissection or dilatation. . . ECHO: Conclusions: The left atrium is normal in size. Left ventricular wall thicknesses are normal. 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 probably normal (LVEF>55%). Right ventricular chamber size is normal. Right ventricular systolic function is normal. The aortic valve leaflets are mildly thickened. There is no aortic valve stenosis. The mitral valve leaflets are mildly thickened. The tricuspid valve leaflets are mildly thickened. There is no pericardial effusion. . . CT HEAD W/O CONTRAST [**2191-5-11**] 1:21 PM No intracranial hemorrhage. Diffuse chronic changes. There appears to be interval marked atrophic change since [**2185**] which could represent an accelerated degenerative process. Additionally, there is marked interval enlargement of the ventricles which may in part represent hydrocephalus (partly related to atrophy) - there is hypo-attenuation of the periventricular white matter which may represent chronic ischemic changes or trans-ependymal edema. Further evaluation with MRI might be helpful if clinically indicated. CTA CHEST W&W/O C &RECONS [**2191-5-11**] 2:46 PM bilateral pulmonary emboli. left lower lobe superior segment peripheral consolidation suspicious for infarction. right pneumothorax, pneumomediastinum. endotracheal tube and ng tube; esophagus has some debris and a few air bubbles in it but no obvious tear. . LABS ON ADMISSION: [**2191-5-11**] 11:34PM TYPE-ART PO2-107* PCO2-33* PH-7.47* TOTAL CO2-25 BASE XS-0 [**2191-5-11**] 11:34PM LACTATE-2.8* [**2191-5-11**] 11:34PM HGB-10.6* calcHCT-32 [**2191-5-11**] 06:35PM PT-14.9* PTT-50.6* INR(PT)-1.5 [**2191-5-11**] 03:50PM TYPE-ART TEMP-37.2 RATES-/15 TIDAL VOL-550 O2-80 PO2-249* PCO2-41 PH-7.40 TOTAL CO2-26 BASE XS-0 AADO2-295 REQ O2-54 -ASSIST/CON INTUBATED-INTUBATED [**2191-5-11**] 03:29PM PT-100* PTT-150* INR(PT)-66.1 [**2191-5-11**] 01:12PM GLUCOSE-234* UREA N-38* CREAT-1.5* SODIUM-146* POTASSIUM-3.5 CHLORIDE-108 TOTAL CO2-18* ANION GAP-24* [**2191-5-11**] 01:12PM ALT(SGPT)-12 AST(SGOT)-35 CK(CPK)-102 ALK PHOS-99 TOT BILI-0.7 [**2191-5-11**] 01:12PM CK-MB-4 cTropnT-0.04* [**2191-5-11**] 01:12PM TOT PROT-7.2 ALBUMIN-3.3* GLOBULIN-3.9 CALCIUM-8.6 PHOSPHATE-4.4 MAGNESIUM-1.9 IRON-23* [**2191-5-11**] 01:12PM calTIBC-205* VIT B12-412 FOLATE->20 FERRITIN-347 TRF-158* [**2191-5-11**] 01:12PM WBC-5.1# RBC-4.00* HGB-12.5* HCT-38.7* MCV-97 MCH-31.3 MCHC-32.4 RDW-13.7 [**2191-5-11**] 01:12PM PLT COUNT-275 Brief Hospital Course: HOSPITAL COURSE BY PROBLEM: . 1. PE/DVT: Pt presented with resp failure and hypotension. Found to have PE on CTA and subsequently found to have L leg DVT. Wife reports that patient is very sedentary at home and only gets up with assitance which may be once per day. In addition, he was on Megase which can be prothrombotic. The patient was intubated in the ED for ventilation and started on heparing gtt. The patient was extubated within 48 hours and his respiratory status continued to improve. On transfer from the MICU the patient had an O2 sat of 95% on RA. IVC filter was considered for prophylaxis, however it was felt that coumadin would be a better long term management of his DVT and PE. The risk of fall was considered, however the patient will be going to rehab and likely a longterm care facility and would be able to ambulate with assistance. The patient was GUIAC neg which was checked prior to initiating heparin. The patient was transitioned to Lovenox 50mg [**Hospital1 **] during a bridge to a therapeutic INR. Goal INR is [**1-27**]. The Lovenox was discontinued after the patient maintained an INR >2 for 48 hours. The patient should be maintained on coumadin for at least 6 months. . 2. Ptx: Pt with PTX likely [**1-26**] barotrauma. Although this was a very small PTX, pt was hypotensive in ED and thought that PTX was expanding. Large bore needle was placed followed by a chest tube and patiet received fluid resusciation. Pt had chest tube removed on [**5-13**]. Serial CXR's showed PTX decreased in size and was no longer present on [**5-18**]. Pt maintained O2 sats at 97% on RA and SBP stable in 130's. . 3. UTI: Pt found to have UTI after multiple days with foley catheter in place. Foley was d/c'd and patient started on Cipro. E.coli on cx was pan-sensitive but patient remained on quinolone for complicated UTI. Pt should be treated for 7 days. . 4. Hypotension: Pt was hypotensive on admission. Initially thought to be due to sepsis vs volume depletion. Resolved with IVF. Pt was volume repleted in MICU and BP's stable at time of discharge. Pt is on no BP medications at home. . 5. Anisocoria: On initial exam in ED, patient found to have anisocoria. Pt had head CTA in MICU to assess for posterior aneurysm. This was normal and anisocoria resolved on hospital day 2. Unclear cause of inital exam findings. . 6. Anemia: Pt was GUIAC neg during admission. Iron low but ferritin elevated, likely reactive suggesting anemia of chronic disease. Also likely decreased HCT from procedures and fluid shifts from resucitation. . 7. Dementia: Pt has an extensive history of Alzthiemers dementia noted in past records. On this admission, MS improved after infections treated and resp status stable. Pt was continued on Exelon. . 8. FEN: After extubation, pt was evaluated for ability to swallow different consistencies given poor mental status. Pt passed barium swallow study for ground solid food and thin liquids. Pt should have a boost with every meal for added nutritional supplementation. . 8. Ppx: Pt was on a heparin gtt and then lovenox. Pt was started on an PPI. 9. Code: DNR/DNI- While in MICU, wife and family physician had long discussion with MICU team and decided to make patient DNR/DNI. Medications on Admission: Exelon 0.6mg [**Hospital1 **] Lipitor 10mg Multivit Discharge Disposition: Extended Care Facility: [**Last Name (un) 1687**] - [**Location (un) 745**] Discharge Diagnosis: Primary: Pulmonary Embolism Deep Vein Thrombosis Urinary Tract Infection Secondary: Dementia Hyperlipidemia Discharge Condition: Stable. Patient discharged to [**Hospital1 1501**]. Will probably require long term placement. Discharge Instructions: Please return to the hospital if you experience shortness of breath, chest pain, leg swelling, severe nausea/vomiting/diarrhea or any other severe symptoms. Please call your physician if you have any questions about your symptoms. - Please have your INR checked until a stable dose of coumadin maintinas your INR between [**1-27**]. Followup Instructions: Please follow-up with your PCP in one week. Completed by:[**0-0-0**] ICD9 Codes: 5990, 2765, 2859
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Medical Text: Admission Date: [**2103-4-6**] Discharge Date: [**2103-4-7**] Date of Birth: [**2052-12-24**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 99**] Chief Complaint: Hypotension Major Surgical or Invasive Procedure: Placement of [**Last Name (un) 10045**] tube for variceal bleeding Cardiopulmonary resuscitation History of Present Illness: Mr. [**Known lastname 51106**] is a 50M with history of hepatitis C s/p aborted IFN treatment and alcohol cirrhosis, who is transferred from OSH with GI bleed and hypotension. On transplant list. Discharged on 20th hepatic encephalopathy. . Presented yesterday morning to [**Hospital 792**]Hospital with massive esophageal bleed with hgb 5, sbp 50s. [**Last Name (un) **] was placed in the ED, had esoph banding x 5. A total 10u rbc, 8u ffp, 15u platelets, 15mg vit K, 7L NS was given in the course. Post banding he arrived to the OSH MICU. He was progressively hypotensive and was started on 20 of levophed + vasopressin. He was placed on protonix and octreotide drip. Decision to transfer to [**Hospital1 18**] yesterday. This now on 2 of levophed, off vasopressin, map 65. Intubated on pressure control 40 fio2, 22/5. This AM prior to transfer hgb 8.8, plt 120--> 71 despite transfusion, wbc 8.7. Was placed on cefotaxime for empiric sbp coverage but climb from 1.2-2.6. Potassium to 6 this am-- got ca gluc, insulin, d50, starting bicarb gtt, no peaked T wave changes on EKG. INR from 5--> 1.8 after vit k, ffp. T bili 16.1, AST 1323, 314. Prior to tranfer map 65, hr 70 (L arm 20mm difference),patient intubated sedated (morphine and ativan). Note of a distended abdomen with report of kub with gas. No further active hematemesis. Yesterday blood coming from mouth and nasopharynx which was thought [**1-15**] trauma. [**Last Name (un) **] has been discontinued. He received 4mg morphine, 4mg ativan over past 24h. Access included R IJ TLC, 2 periph 18, 1 20gg IV. They had planned to order 2u RBC for transport. Discussion with [**Hospital1 18**] hepatology service was done prior to transfer. Last MELD 42. . On arrival to the [**Hospital1 18**] ICU patient hypotensive to 70/40, vasopressin added with good result MAP to 62. Abdomen markedly distended. . Patient is known to the liver service at [**Hospital1 18**]. Hepatitis C genotype 3 s/p IFN, treatment stopped due to thrombocytopenia, participated in Eltrombopag study, last HCV VL 1,540 IU/mL, has been decreasing w/o treatment. Cirrhosis with encephalopathy and ascites with hx of SBP on norfloxacin prophylaxis, diuretics. Esophageal varices s/p banding at [**Hospital 792**]Hospital [**2103-3-8**]. No EGD in [**Hospital1 18**]. Creatinine baseline 0.6-0.9. No hx of hepatorenal. Past Medical History: - hepatitis C genotype 3 s/p IFN, treatment interrupted due to thrombocytopenia, participated in Eltrombopag study, last HCV VL 1,540 IU/mL, has been decreasing w/o treatment - cirrhosis c/b encephalopathy and ascites; workup started for transplant - varices (?type) s/p banding at [**Hospital 792**]Hospital [**2103-3-8**] - bronchitis - asthma - h/o seizure in the setting of alcohol withdrawal - h/o negative PPD Social History: He lives alone in a rooming house. His daughter lives 15 minutes a way, and another daughter lives close by. He has a companion who is supportive but is also a recovering alcoholic. He smokes cigarettes. He has smoked for 35-40 years at 2-3 packs per day, but now has cut down to less than 1 pack per day. He has been drinking alcohol since age 14-15 with 6-12 beers a day with shots of liquor, but has been sober for 21 months. He previously used quite a bit of recreational drugs including marijuana, cocaine, psychedelic drugs. Brief IVDA in the past. Family History: His father, uncle, brother and wife all died of alcoholic cirrhosis. There is no history of heart disease, diabetes or cancer in the family. Physical Exam: VS: 104, 80/40, 98.4, CVP 33, bladder pressure 25. AC PEEP 5, RR 14, TV 550. GEN: ill appearing male with distended abdomen on ventilator, jaundiced HEENT: icteric difficult to assess JVP. Blood suctioned from oropharynx, ET tube present CV: RRR no MRG CHEST: diminished breath sounds bilaterally ABD: distended, tense, dullness to percussion. No bowel sounds heard. Hepatosplenomegaly present. Site of previous para with oozing of peritoneal fluid, echymoses. EXTR: edema, cool LE, palpable distal pulses NEURO: sedated. Pertinent Results: CHEST (PORTABLE AP) [**2103-4-6**]: SINGLE PORTABLE AP UPRIGHT CHEST: Compared to CT of [**2103-4-1**]. The extreme lung apices are excluded on this study as is the left CP angle. There is a NG tube in place with its tip in the fundus of the stomach. The visualized lung parenchyma is clear. There is no evidence of CHF/volume overload. The heart size is within normal limits and the mediastinal and hilar contours are unremarkable. ABDOMEN U.S. (COMPLETE STUDY) PORT [**2103-4-6**]: IMPRESSION: 1. Findings consistent with cirrhosis. 2. Bidirectional Doppler waveform in the main portal vein, indicating mixed hepatopetal and hepatofugal flow. 3. Gallstones with gallbladder wall thickening, stable. 4. Small amount of ascites. CHEST (PORTABLE AP) [**2103-4-7**]: SINGLE SUPINE PORTABLE RADIOGRAPH: Compared to study of one hour prior. The [**Last Name (un) **] tube remains in place with its tip coursing off the inferior aspect of the image. It loops on the superior aspect of the image, perhaps residing outside of the patient, but may be coiled in the hypopharynx. The balloon has been deflated since the prior radiograph. There is no definitive evidence of pneumomediastinum or pneumothorax. There remains moderate volume overload. Right IJ tip is difficult to directly visualize given technique. ABDOMEN (SUPINE ONLY) PORT [**2103-4-7**]: FINDINGS: There is a nasogastric tube and [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] tube identified. There is a large amount of gas seen within the stomach. There are prominent loops of likely colon. There is also increased density throughout the abdomen consistent with known ascites. There is no definite evidence for free intra-abdominal air or pneumatosis. This bowel gas pattern is nonspecific. If there is high clinical concern, a CT scan could be performed. HEMATOLOGY: [**2103-4-6**] 03:18PM BLOOD WBC-10.3# RBC-2.71* Hgb-9.0* Hct-23.7* MCV-87# MCH-33.1* MCHC-37.8* RDW-19.6* Plt Ct-85* [**2103-4-6**] 09:51PM BLOOD WBC-5.8 RBC-1.47*# Hgb-4.9*# Hct-13.2*# MCV-90 MCH-33.0* MCHC-36.6* RDW-21.1* Plt Ct-46* [**2103-4-6**] 11:14PM BLOOD WBC-5.8 RBC-1.54* Hgb-4.9* Hct-14.2* MCV-92 MCH-32.1* MCHC-34.7 RDW-20.2* Plt Ct-41* [**2103-4-7**] 12:06AM BLOOD WBC-4.6 RBC-2.03*# Hgb-6.4*# Hct-18.8*# MCV-93 MCH-31.3 MCHC-33.7 RDW-17.0* Plt Ct-69*# COAGS: [**2103-4-6**] 03:18PM BLOOD PT-34.0* PTT-50.7* INR(PT)-3.6* [**2103-4-6**] 09:51PM BLOOD PT-38.9* PTT-70.7* INR(PT)-4.2* [**2103-4-6**] 11:14PM BLOOD PT-41.9* PTT-80.6* INR(PT)-4.6* [**2103-4-7**] 12:06AM BLOOD PT-22.4* PTT-81.7* INR(PT)-2.1* [**2103-4-6**] 03:18PM BLOOD Fibrino-113* CHEMISTRIES: [**2103-4-6**] 03:18PM BLOOD Glucose-82 UreaN-38* Creat-2.7*# Na-138 K-5.9* Cl-104 HCO3-21* AnGap-19 [**2103-4-6**] 09:51PM BLOOD Glucose-35* UreaN-37* Creat-3.3* Na-140 K-5.8* Cl-106 HCO3-17* AnGap-23* [**2103-4-6**] 11:14PM BLOOD Glucose-94 UreaN-35* Creat-3.0* Na-139 K-6.3* Cl-106 HCO3-15* AnGap-24* [**2103-4-7**] 12:06AM BLOOD Glucose-108* UreaN-31* Creat-2.7* Na-144 K-5.8* Cl-110* HCO3-14* AnGap-26* [**2103-4-6**] 03:18PM BLOOD ALT-2844* AST-8550* AlkPhos-709* TotBili-21.5* [**2103-4-6**] 09:51PM BLOOD ALT-1794* AST-6158* LD(LDH)-4494* AlkPhos-529* TotBili-15.9* [**2103-4-6**] 11:14PM BLOOD ALT-1462* AST-4930* LD(LDH)-3660* CK(CPK)-1274* AlkPhos-437* TotBili-13.6* [**2103-4-6**] 03:18PM BLOOD Albumin-2.4* Calcium-7.7* Phos-8.6*# Mg-1.8 LACTATES: [**2103-4-6**] 03:34PM BLOOD Lactate-5.9* [**2103-4-6**] 06:32PM BLOOD Lactate-7.1* [**2103-4-6**] 10:00PM BLOOD Lactate-9.0* [**2103-4-6**] 11:19PM BLOOD Lactate-10.8* [**2103-4-7**] 12:15AM BLOOD Lactate-10.7* ASCITIC FLUID STUDIES: ASCITES ANALYSIS [**2103-4-6**] 05:00PM WBC 80, RBC 3925, Polys 18, Lymphs 13 ASCITES CHEMISTRY [**2103-4-6**] 05:00PM Glucose 100, LD(LDH) 154 Brief Hospital Course: Following patient's admission he immediately required addition of vasopressin to norepinephrine to support his blood pressure. Hepatology service was aware of patient prior to transfer and was consulted at time of admission. Due to low tidal volumes on ventilator and a tense abdomen at admission, a therapeutic paracentesis was performed with removal of 5 liters of ascitic fluid and noted improvement in both tidal volumes and bladder pressures. The fluid proved to have a high RBC count; however, was not consistent with SBP as there were only 80 total WBCs. 100 grams of albumin were given at time of paracentesis in order to support intravascular volume. Patient was also ordred for 2 units of PRBCs to be transfused at time of admission; however, his HCT was stable upon transfer from outside hospital. Several hours following admission, the patient's blood pressure began to drop with MAPs in the mid-50s despite 1 L NS as well as the previously mentioned 100 g albumin. PRBCs were unable to be obtained for transfusion due to the patient having antibodies making crossmatch exceedingly difficult. At this time 1 L NS was infused and phenylephrine was initiated as a third vasoactive [**Doctor Last Name 360**] to support blood pressure. In recognition of falling blood pressure, NG tube was hooking to suction and appromiately 500 mLs of dark red blood were pulled to suction trap. Then in recognition of likely repeat variceal bleeding, additional NS was infused and blood bank was contact[**Name (NI) **] for emergency release of blood prior to complete crossmatch. Hepatology service was simultaneously contact[**Name (NI) **] and they came into the hosptial with plans to place [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] tube to tamponade the bleeding. Shortly after blakmore was inserted and prior to confirmatory CXR or inflation of [**Last Name (un) **] balloon, the patient became bradycardic and lost a pulse. CPR was initiated as indicated for pulseless electrical activity. During code compressions were done continuously save rhythm checks. Several rounds of atropine and epinephrine were given. A femoral cordis was placed and many units of blood were given via rapid transfuser. In all, patient received 9 units of PRBCs, 8 units of FFP, 2 bags of platelets, and 2 units of cryoprecipitate. He was shocked a single time following identification of an unstable narrow-complex tachycardia. A pulse and stable blood pressure were regained and code was ceased. Despite the massive amount of blood products transfused, the patient's HCT only changed from 13 prior to code to 19 at the end of the code. Patient's two daughters had been present for most of code. They were updated on the patient's poor prognosis following the code and decided to make the patient DNR/DNI as well as "comfort measures only". Prior to being able to carry out cessation of supportive medication and ventilation, the patient became bradycardic and lost his pulse again. He was pronounced dead shortly following this second episode of bradycardia and loss of pulse. Medications on Admission: MEDICATIONS AT HOME (per last D/C summary): Albuterol 90 mcg 2 puffs every day Advair 250/50 1 INH [**Hospital1 **] Furosemide 40 mg once a day Spironolactone 100 mg once a day, Nadolol 20 mg once a day Esomeprazole (Nexium) 40 mg once a day, Lactulose 30cc QID Norfloxacin 400mg daily Trazodone 50 mg qHS Magnesium oxide 400mg daily Citalopram 40mg daily Nicotine 21mg [**12-15**] patch daily MEDICATIONS AT TIME OF TRANSFER: Levophed gtt Octreotide gtt Protonix gtt Morphine prn Ativan prn Discharge Medications: None, patient expired. Discharge Disposition: Expired Discharge Diagnosis: Primary: Gastrointestinal bleeding Secondary: Hepatic cirrhosis Hepatic failure Discharge Condition: None. Patient expired. Discharge Instructions: None. Patient expired. Followup Instructions: None. Patient expired. Completed by:[**2103-4-18**] ICD9 Codes: 5845, 2767
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Medical Text: Admission Date: [**2156-5-28**] Discharge Date: [**2156-5-28**] Date of Birth: [**2087-4-14**] Sex: M Service: NEUROSURGERY Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 1271**] Chief Complaint: "My head hurts" Major Surgical or Invasive Procedure: none History of Present Illness: 69M presents to [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] Hospital with one week history of left headache, tinnitus left ear and as of this am, nausea and vomiting, worse when bending forward. He has not had any recent trauma, but a head injury in [**2155-11-24**] but no residual symptoms since then. He has not had any change in vision or other focal neurological deficits. He was seen at OSH, where a CT demonstrated bilateral SDH and he was transferred to [**Hospital1 18**]. Today, he reports of moderate headaches controlled on current regimen. He denies any nausea or vomiting. Past Medical History: - HTN - hypothyroid - HLD Social History: Lives at home with wife, currently suffers from alcohol abuse, +tobacco Family History: Non-contributory Physical Exam: Admission: O: Tempo 97 HR 55 BP 149/70 RR 18 98% 2L Gen: WD/WN, comfortable, NAD. HEENT: Pupils: equal and reactive to light EOMs intact Neck: Supple. Lungs: CTA bilaterally. Cardiac: RRR. S1/S2. Abd: Soft, NT, BS+ Extrem: Warm and well-perfused. Neuro: Mental status: Awake and alert, cooperative with exam, normal affect. Orientation: Oriented to person, place, and date. Recall: [**3-25**] objects at 5 minutes. Language: Speech fluent with good comprehension and repetition. Naming intact. No dysarthria or paraphasic errors. Cranial Nerves: I: Not tested II: Pupils equally round and reactive to light, to mm bilaterally. Visual fields are full to confrontation. III, IV, VI: Extraocular movements intact bilaterally without nystagmus. V, VII: Facial strength and sensation intact and symmetric. VIII: Hearing intact to voice. IX, X: Palatal elevation symmetrical. [**Doctor First Name 81**]: Sternocleidomastoid and trapezius normal bilaterally. XII: Tongue midline without fasciculations. Motor: Normal bulk and tone bilaterally. No abnormal movements, tremors. Strength full power [**5-27**] throughout. No pronator drift Sensation: Intact to light touch, propioception, pinprick and vibration bilaterally. Toes downgoing bilaterally Coordination: normal on finger-nose-finger, rapid alternating movements, heel to shin On Discharge: Pt alert, awake oriented x 3, PERRL, EOM full, face symmetric, Motor is full b/l, no pronator drift, sensory intact, reflexe2+ bilaterally Pertinent Results: [**2156-5-28**] 03:48AM GLUCOSE-153* UREA N-21* CREAT-0.9 SODIUM-140 POTASSIUM-4.6 CHLORIDE-105 TOTAL CO2-26 ANION GAP-14 [**2156-5-28**] 03:48AM CALCIUM-9.0 PHOSPHATE-3.9 MAGNESIUM-2.0 [**2156-5-28**] 03:48AM WBC-9.5 RBC-4.44* HGB-15.1 HCT-42.6 MCV-96 MCH-34.0* MCHC-35.4* RDW-12.7 [**2156-5-28**] 03:48AM PLT COUNT-235 [**2156-5-28**] 03:48AM PT-14.5* PTT-24.0 INR(PT)-1.3* [**2156-5-27**] 11:45PM GLUCOSE-148* UREA N-20 CREAT-0.9 SODIUM-139 POTASSIUM-4.7 CHLORIDE-103 TOTAL CO2-26 ANION GAP-15 [**2156-5-27**] 11:45PM estGFR-Using this [**2156-5-27**] 11:45PM WBC-8.7 RBC-4.72 HGB-16.1 HCT-45.2 MCV-96 MCH-34.2* MCHC-35.7* RDW-12.7 [**2156-5-27**] 11:45PM NEUTS-89.2* LYMPHS-7.8* MONOS-2.3 EOS-0.3 BASOS-0.5 [**2156-5-27**] 11:45PM PLT COUNT-227 [**2156-5-27**] 11:45PM PT-14.6* PTT-23.2 INR(PT)-1.3* Brief Hospital Course: Patient was admitted to Neuro ICU overnight on [**2156-5-27**] for frequent neuro checks. He was evaluated by Dr. [**Last Name (STitle) 739**] and he remained stable during his course. It was recommend that we would monitor his chronic subdurals on interval basis as an outpatient. He was evaluated by PT as he has history of falls and they recommend Home. Now DOD [**2156-5-28**], pt is afebrile, VSS, neurologically unchanged and tolerating a good PO diet. His headache was controlled with tylenol and codeines. He is set for d/c home and will f/u with Dr. [**Last Name (STitle) 739**] accordingly. Medications on Admission: diovan 80 mg daily; l-thyroxine 0.112 mg daily; vit D 1000 IU daily; ASA 81 mg daily; Fish oil 1000 mg daily Discharge Medications: 1. valsartan 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. levothyroxine 112 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. folic acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. butalbital-acetaminophen-caff 50-325-40 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for headache. Disp:*60 Tablet(s)* Refills:*0* 7. Dilantin Kapseal 100 mg Capsule Sig: One (1) Capsule PO three times a day for 4 weeks: please f/u with PCP. 8. Tylenol-Codeine #3 300-30 mg Tablet Sig: One (1) Tablet PO three times a day as needed for pain. Disp:*80 Tablet(s)* Refills:*0* Discharge Disposition: Home Discharge Diagnosis: Acute of Chronic bilateral Subdural hematoma Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: ?????? Take your pain medicine as prescribed. ?????? Exercise should be limited to walking; no lifting, straining, or excessive bending. ?????? 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, or Ibuprofen etc. ?????? If you have been prescribed Dilantin (Phenytoin) for anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing in one week. This can be drawn at your PCP??????s office, but please have the results faxed to [**Telephone/Fax (1) 87**]. CALL YOUR SURGEON IMMEDIATELY IF YOU EXPERIENCE ANY OF THE FOLLOWING ?????? New onset of tremors or seizures. ?????? Any confusion, lethargy 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. ?????? New onset of the loss of function, or decrease of function on one whole side of your body. Followup Instructions: ??????Please call ([**Telephone/Fax (1) 88**] to schedule an appointment with Dr. [**Last Name (STitle) 739**], to be seen in 4 weeks with a repeat head CT in 4 weeks - Please follow up with your PCP [**Name Initial (PRE) 72304**] 2-3 days after discharge. [**Name6 (MD) 742**] [**Name8 (MD) **] MD [**MD Number(2) 1273**] Completed by:[**2156-5-28**] ICD9 Codes: 4019, 2449, 2724, 3051
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Medical Text: Admission Date: [**2173-7-29**] Discharge Date: [**2173-8-13**] Date of Birth: [**2099-12-8**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 3016**] Chief Complaint: Delirium Major Surgical or Invasive Procedure: none History of Present Illness: Mrs. [**Known lastname 82732**] is a 73 you woman with squamous cell head and nexk cancer currently undergoing XRT, COPD, HTN, CAD s/p MI and stent implantation in [**2171**] who presents from [**Hospital 100**] Rehab with delirium and fever. . She is a vague historian, but denies chest pain, fevers, cough, sputum production, shortness of breath, chest pain, LE swelling, blood in her stool or urine. She denies abdominal pain or vomiting. . In the ED, her initial VSs were 102.4, 116, 145/81, 14, 98%RA. She received IVF, levofloxacin and metronidazole. . PAST ONCOLOGIC HISTORY: ====================== The patient noticed a right neck mass approximately in [**3-15**]. She brought the mass to the attention of her physician who obtained [**Name Initial (PRE) **] CT of the neck, chest, abdomen, and pelvis at the [**Hospital1 16549**]. Neck, chest, and abdominal CT on [**2173-4-7**] showed marked thickening of the right lateral oropharyngeal wall up to approximately 2 cm and a 4.5 x 3 cm lobulated, heterogeneous, right neck mass deep to the sternocleidomastoid muscle that displaced the right carotid artery. No other lymphadenopathy was visualized and there were no suspicious lung nodules. A 10 cm right adnexal mass was visualized. This right ovarian mass has been stable and was previously evaluated. Neck ultrasound on [**2173-4-22**] at the [**Hospital6 2910**] showed a 5.5 x 4 cm neck mass suspicious for neoplastic process. On [**2173-4-26**], Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 66245**] took the patient to the operating room for direct laryngoscopy and tonsillar biopsy. The right tonsil contained an ulcerative lesion, which was biopsied. The larynx and hypopharynx appeared normal. Pathology was read at the [**Hospital1 **] as invasive moderately differentiated squamous cell carcinoma. She is currently undergoing radiotherapy. Past Medical History: PAST MEDICAL HISTORY: ==================== Chronic obstructive pulmonary disease Hypertension Hypercholesterolemia Pernicious anemia CAD s/p MI and stent implantation in [**2171**] h/o GI bleed Social History: EtOH: Doesn't drink Tobacco: quit in [**2171**], 60-75 PY history Family History: nc Physical Exam: Vitals - T: 98.4 BP: 130/70 HR: 100 RR: 16 02 sat: 93%RA/ GENERAL: NAD, alert and oriented x 2; "[**Hospital6 **]" HEENT: AT/NC, EOMI, PERRLA, anicteric sclera, pink conjunctiva, patent nares, no LAD, no JVD, Reactive change in pharynx in field of radiation. Dry MM. CARDIAC: RRR regular skipped beats, normal S1/S2, no mrg appreciated LUNG: bronchial breath sounds and crackedin left middle lung field. ABDOMEN: soft, large echymossis on LLQ, G tube with moderate amount of erythema surrounding it. 5 inch midline incision c/d/i M/S: moving all extremities well, no cyanosis, clubbing. s, no obvious deformities PULSES: 2+ DP pulses bilaterally NEURO: CN II-XII intact. Pertinent Results: [**2173-8-11**] 05:50AM BLOOD WBC-10.6 RBC-3.06* Hgb-9.5* Hct-28.1* MCV-92 MCH-31.1 MCHC-33.9 RDW-18.6* Plt Ct-344 [**2173-8-10**] 03:16AM BLOOD WBC-8.6 RBC-2.65* Hgb-8.2* Hct-24.6* MCV-93 MCH-31.0 MCHC-33.3 RDW-18.8* Plt Ct-249 [**2173-8-5**] 02:25AM BLOOD WBC-8.9 RBC-3.63*# Hgb-11.0*# Hct-31.5*# MCV-87 MCH-30.3 MCHC-34.9 RDW-17.8* Plt Ct-195 [**2173-7-29**] 05:00PM BLOOD WBC-8.4 RBC-2.38* Hgb-7.7* Hct-23.4* MCV-98 MCH-32.3* MCHC-32.8 RDW-21.5* Plt Ct-244 [**2173-8-9**] 05:20AM BLOOD PT-14.8* PTT-26.2 INR(PT)-1.3* [**2173-8-11**] 05:50AM BLOOD Glucose-97 UreaN-10 Creat-1.2* Na-142 K-3.0* Cl-104 HCO3-29 AnGap-12 [**2173-8-10**] 10:35AM BLOOD Creat-0.9 Na-141 K-3.7 Cl-104 [**2173-8-10**] 03:16AM BLOOD Glucose-78 UreaN-8 Creat-0.9 Na-143 K-2.8* Cl-105 HCO3-26 AnGap-15 [**2173-7-29**] 05:00PM BLOOD cTropnT-0.15* [**2173-7-30**] 09:00AM BLOOD CK-MB-12* cTropnT-0.13* [**2173-7-31**] 07:20AM BLOOD CK-MB-8 cTropnT-0.12* [**2173-8-5**] 02:25AM BLOOD CK-MB-6 cTropnT-0.09* Brief Hospital Course: Patient was admitted from [**Hospital **] rehab on [**2173-7-29**] with delirium. She denied all symptoms. In the ED, she was found febrile and to have consolidation in her LLL. Additionally, she was then discovered to be in ARF and anemic with a troponinemia and EKG with various territories of mild ST depression. Accordingly, she was treated for HAP with Vanc/Zosyn. Admitted on tele and transfused with two units. There was some concern for an aspiration PNA. She passed a video-swallow and was put on a diet of thins and purees in which her pills were crushed. The patient proceeded to improve rapdily and in the AM of [**2173-7-30**], restarted XRT to the neck with Dr. [**Last Name (STitle) 3929**]. She stayed in house, receiving IV abx and XRT. While in hospital, the patient was restarted on tube feeds to ensure proper nutrition and avoid the burden that PO was placing on the friable mucosa of the pharynx in the field of the XRT. She will be discharged on 55 ml/hour of fibersource per nutrition consultation. The G tube site remained a persistent concern, however. Accordingly, we asked consultants from both surgery and then GI to evaluate the g tube. There was leaking of a dark and viscous fluid from around the 20 french tubing. Given how new it was and the fact that it was not placed by a [**Hospital1 18**] practioner, the goals of gtube management shifted to wound care. While the site remained irritated and bled about a tea-spoon per day, it was stable and did not bother the patient. Overnight on [**8-3**], the patient had three dark red bowel movements with a hct that trended from 26 to 24.4 to 19.5. The morning of [**8-4**], she had another large black tarry bowel movement and was tachycardic to the 120s from a baseline fo 90-100. Her g-tube was also flushed and demonstrated coffee grounds, and was also noted to have an increase in BUN from 16 to 26 from the prior day. The patient received 1.6L IVF and was ordered for 2 units PRBC prior to transfer to the [**Hospital Unit Name 153**]. On admission to the [**Hospital Unit Name 153**], the patient was evaluated for active bleeding and transfused 2 unites PRBCs. Endoscopy was performed to evaluate the bleeding around the G-tube site and clamping was attempted, but not successful. Patient was sent for surgery where the bleeding artery was oversewn and the G-tube was replaced and re-sited with another G-tube. The patient recieved two more units of PRBCs and was then transferred post-op back to the ICU for monitoring. Post-operatively, the pt had episodes of hypertension, which improved with pain control. On post-op day 1, the patient was hemodynamically stable the entire day. She was transferred back to the OMED service on [**8-6**] hemodynamically stable with Hematocrit 29.3, pain well controlled. On the day of planned discharge, the patient began to experience some tachycardia by tele. She was asymptomatic and clinically better than ever before. Nevertheless, an EKG was ordered that was improved when compared to the admission EKG and a unit of blood was transfused over three hours. On [**8-8**], the patient was transferred back to the [**Hospital Unit Name 153**] for acute respiratory distress with increased oxygen requirements. A large mucus plug was suctioned from the patient's oropharynx and her respiratory distress resolved. A CXR showed no worsening infiltrate although there was possibly increased pulmonary edema/ atelectasis. The patient was continued on her antibiotic course for HAP and was gently diuresed with fluid goal of -500 to -1L. During the night, the patient intermittently required increased oxygen for saturations down to 88%- this was thought to be related to inadequate clearing of oropharyngeal mucus plugs with a component of sleep apnea. The patient continued to have guiac positive stools, but this was felt to be residual from her GI bleed and her hct remained stable. Overall, the patient's respiratory status improved and she was transferred back to the OMED service on [**8-10**]. On post-op day 2, the patient was noted to have a possible expressive aphasia. Final review of a CT Head showed a right parietal hypodensity. Neurology was consulted and suspected a right temporal stroke. The patient's mental status improved, but the patient had possible left sided hypesthesia and mild left upper extremity motor weakness. ASA was restarted but her plavix was held in light of the patient's recent GI bleed. Initially there was concern that the right carotid artery may be compressed by tumor, so neurology recommended permissive hypertension until MRA of neck and CNS assessed patency of vessels. TTE with bubble study showed no PFO or ASD as possible source for emboli. Carotid dopplers and MRI looked good but official reads were pending. On the floor, we shifted focus and treated the patient for a CHF exacerbation. After a negative balance of 1500 cc, she was markedly improved clinically and we prepared her for discharge to rehab. <b> SUMMARY </b> . 1. Delirium - while the patient has some baseline dementia, she is fully oriented and interactive ([**Location (un) 1131**] the paper) at baseline. She presents with delirium for Pneumonia, CHF, and GI bleed . 2. GI bleed - after the operative repair she is stable. It was related to an exposed vessel. Continue tube feeding. . 3. Arterial Disease - Patient should remain on Aspirin and Clopidogrel. Also, continue lovenox. Most likely, the patient did not have a CVA. . 4. CHF - This patient has an EF of 45-50%. She is sensitive to fluids. We used a short course of lasix to improve the balance . 5 Respiratory Failure - the patient had some trouble clearing secretions, requiring deep suction. We recommend regular nebulizer treatments, oral care and suctioning. . 6. Head and Neck cancer - The patient has completed her treatment at present Medications on Admission: Enoxaparin 40 daily Clopidogrel 75 daily Hydrocodone-Acetaminophen 5 mg-500 mg Nystatin 100,000 unit/mL 5 ml by mouth tid Aspirin 81 mg daily Acetaminophen prn Captopril 25 mg tid Alprazolam 0.25 mg tid prn Simvastatin 40 daily Metoprolol Tartrate 25 tid Bisacodyl 10 mg prn Albuterol prn Lansoprazole 15 daily Discharge Medications: 1. Enoxaparin 40 mg/0.4 mL Syringe [**Location (un) **]: One (1) Subcutaneous Q 24H (Every 24 Hours). 2. Clopidogrel 75 mg Tablet [**Location (un) **]: One (1) Tablet PO DAILY (Daily). 3. Hydrocodone-Acetaminophen 5-500 mg Tablet [**Location (un) **]: 1-2 Tablets PO Q6H (every 6 hours) as needed for pain. 4. Nystatin 100,000 unit/mL Suspension [**Location (un) **]: Five (5) ML PO QID (4 times a day) as needed for thrush. 5. Aspirin 81 mg Tablet, Chewable [**Location (un) **]: One (1) Tablet, Chewable PO DAILY (Daily). 6. Acetaminophen 325 mg Tablet [**Location (un) **]: Two (2) Tablet PO Q6H (every 6 hours) as needed for pain, fever. 7. Captopril 25 mg Tablet [**Location (un) **]: One (1) Tablet PO TID (3 times a day). 8. Alprazolam 0.25 mg Tablet [**Location (un) **]: One (1) Tablet PO TID (3 times a day) as needed for anxiety. 9. Simvastatin 40 mg Tablet [**Location (un) **]: One (1) Tablet PO DAILY (Daily). 10. Metoprolol Tartrate 25 mg Tablet [**Location (un) **]: One (1) Tablet PO TID (3 times a day). 11. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) [**Location (un) **]: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for constipation. 12. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization [**Location (un) **]: One (1) Inhalation Q6H (every 6 hours) as needed for shortness of rbeath, wheeze. 13. Lansoprazole 30 mg Tablet,Rapid Dissolve, DR [**Last Name (STitle) **]: One (1) Tablet,Rapid Dissolve, DR [**Last Name (STitle) **] DAILY (Daily). 14. Vancomycin in Dextrose 1 gram/200 mL Piggyback [**Last Name (STitle) **]: One (1) Intravenous Q 12H (Every 12 Hours) for 4 days. 15. Piperacillin-Tazobactam-Dextrs 4.5 gram/100 mL Piggyback [**Last Name (STitle) **]: One (1) Intravenous Q8H (every 8 hours) for 4 days. 16. Metoprolol Tartrate 25 mg Tablet [**Last Name (STitle) **]: One (1) Tablet PO TID (3 times a day). 17. Trazodone 50 mg Tablet [**Last Name (STitle) **]: 0.25 Tablet PO ONCE MR1 (Once and may repeat 1 time) for 1 doses. 18. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization [**Last Name (STitle) **]: One (1) Inhalation Q4H (every 4 hours) as needed for wheezing or SOB. 19. Ipratropium Bromide 0.02 % Solution [**Last Name (STitle) **]: One (1) Inhalation Q4H (every 4 hours) as needed for wheezing or SOB. 20. Pantoprazole 40 mg Recon Soln [**Last Name (STitle) **]: One (1) Recon Soln Intravenous Q24H (every 24 hours). 21. Outpatient Physical Therapy Patient with deconditioning and requiring help in building strength/stability 22. Outpatient Lab Work Patient should have chemistry (sodium, postassium, chloride, bicarbonate, creatinine, BUN) and CBC checked in PM of [**2173-8-11**] and AM of [**2173-8-12**] and as directed by rehab physicians thereafter Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - MACU Discharge Diagnosis: Primary: Squamous cell cancer of the head and neck Secondary: sp GI bleed, s/p Laparotomy and G-Tube replacement COPD, HTN, Hypercholesterolemia, Pernicious anemia, CAD s/p MI and stent implantation in [**2171**], G-tube placed Discharge Condition: tolerating po and tube feeds, afebrile, hemodynamically stable Discharge Instructions: You were admitted with confusion and fevers. We discovered that you had a pneunomia, considered healthcare associated. We worried about aspiration pneumonia, so we ordered a video swallow test that showed you could tolerate purees and thin liquids. We treated you for this. We also transfused you with blood given your low blood count. Your gastric tube was leaking, so we asked surgery and gastroenterology to help us manage it. Eventually, you started bleeding from a large vessel around the tube and this required an operation. After the operation you went back and forth between the ICU and the floor because we were worried about your breathing. You had a good deal of secretions in your lung but also extra fluid because your heart was overloaded. You were discharged to a rehab facility. appointments [**Last Name (LF) **],[**First Name3 (LF) **] [**Telephone/Fax (1) 35276**] [**Last Name (un) 27542**] Return to the hospital if you develop confusion, fever or any other symptoms that concern you Followup Instructions: PCP: [**Name10 (NameIs) **],[**Name11 (NameIs) **] [**Telephone/Fax (1) 35276**] Oncologist [**Last Name (un) 27542**] [**Name6 (MD) **] [**Name8 (MD) 831**] MD, [**Doctor First Name 3018**] Completed by:[**2173-8-11**] ICD9 Codes: 5070, 2930, 5849, 5789, 2851, 2762, 4168, 496, 4019, 2720, 412, 4280
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Medical Text: Admission Date: [**2161-4-22**] Discharge Date: [**2161-4-23**] Date of Birth: [**2128-10-6**] Sex: M Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**Last Name (NamePattern1) 1167**] Chief Complaint: S/p arrest Major Surgical or Invasive Procedure: Arterial line placement History of Present Illness: 32 yo M with PMH of alcohol abuse who is admitted s/p asysolic arrest at home. . Per his family, around 8:45pm last night they heard a thump and found the patient face down in the bathroom. Bystander CPR was started immediately and EMS arrived 5 minutes later. He was found to be in asystole. He was collared, boarded, intubated and ACLS initiated. Per cardiology fellow note, on route to OSH, EKG showed torsades at 9:07 s/p shock into VF/VT. In total, he received 3 of Epi enroute to [**Hospital1 **] and was asystolic on arrival there at 21:21. He was intubated, not sedated and was comatose on arrival with no voluntary movements and fixed and dilated pupils. He received 3 epi, 2 atropine 1 of bicarb and was reportedly briefly in PEA, followed by VF and afib with "diffuse ischemia" by 21:24. He was started on lidocaine gtt at that time, followed for neo gtt for systolic blood pressures in the 60s. By 22:00 he was in sinus tachycardia. The multiple EKGs from [**Hospital1 **] reveal a lot of baseline artifact but 21:48 reveals sinus tach with STE in AVR, V1 with diffuse st depressions inferolaterally. Labs there signifcant for trop <0.06, WBC 12, h/H 11.6/35.6, K4.5 and Creat 0.9. AST 412ALT 160. Mg was not ordered. The arctic protocol was initiated and he was transferred to [**Hospital1 18**] for further care. . In the ED, initial vital signs were BP 169/117, HR 120, RR 22, O2 sat 100% on RA. Patient was unresponsive off sedation and hypertensive even off neo. Temperature was 34 degrees at 23:50. He received 2 grams of magnesium and 100 thiamine. Initial labs showed a hct of 35.9 with a MCV of 101, WBC of 7.3. Urine and serum tox were negative. LFTs were notable for ALT 254, AST 859, AP 248, Tbili 1.7. Lactate was 12. 5, CK was 782, troponin 0.04. ABG showed pH7.30 pCO230 pO2>600 HCO315, with repeat lactate of 8.6. CT head showed occipital sub-galeal hemorrhage and loss of the [**Doctor Last Name 352**]-white matter distinction suggestive of anoxic brain injury. CT torso showed rib fractures anteriorly but no acute intra-abdominal process. He was seen by the cardiac arrest team who recommended inducing hypothermia to 33 degrees, elevating HOB to >30 degrees to minimize ICP and keeping pCO2 around 35-45. He was then seen by cardiology who recommending d/c-ing the lidocaine drip. He was admitted to the CCU for further management. His vital signs on transfer were BP 198/134 HR84 RR23 O2 sat 100% on AC ventilation. He has 2IOs and 2PIVs for access. . In the CCU, patient was intubated and unresponsive. Past Medical History: PAST MEDICAL HISTORY: 1. CARDIAC RISK FACTORS: -Diabetes, -Dyslipidemia, -Hypertension 2. CARDIAC HISTORY: -CABG: None -PERCUTANEOUS CORONARY INTERVENTIONS: None -PACING/ICD: None 3. OTHER PAST MEDICAL HISTORY: Alcohol abuse Social History: From [**Country 2045**]. Lives with parents in [**Location (un) 5110**], MA. -Tobacco history: None per family. -ETOH: Extensive. Family not certain as to how much he drinks, but endorse excessive drinking for at least the past 10 years. -Illicit drugs: None per family. Family History: No family history of early MI, arrhythmia, cardiomyopathies, syncope (except in the setting of alcohol use) or sudden cardiac death; otherwise non-contributory. Physical Exam: PHYSICAL EXAMINATION: VS: T=91 (on artic sun) BP=188/134 HR=78 RR=23 O2 sat=35% GENERAL: well developed young man, unresponsive, not following commands HEENT: NCAT. Sclera anicteric. Pupils 3 -->2 mm b/l. endotracheal and orogastric tubes in place. NECK: C-collar on; appears to be extended 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. Active BS. EXTREMITIES: No c/c/e. No femoral bruits. SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. Cool to touch. PULSES: Right: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ Left: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ Neuro: Decorticate posturing; pupils 3-->2 mm b/l; no corneal or gag reflex w/ suctioning; spontaneous movements of the eyelids; non-purposeful movement of upper extremities; no observed movement of LEs; hyporeflexive throughout Pertinent Results: ADMISSION LABS: [**2161-4-22**] 12:10AM WBC-7.3 RBC-3.57* HGB-12.3* HCT-35.9* MCV-101* MCH-34.4* MCHC-34.2 RDW-15.0 [**2161-4-22**] 12:10AM NEUTS-83* BANDS-3 LYMPHS-12* MONOS-2 EOS-0 BASOS-0 ATYPS-0 METAS-0 MYELOS-0 [**2161-4-22**] 12:10AM HYPOCHROM-NORMAL ANISOCYT-1+ POIKILOCY-NORMAL MACROCYT-1+ MICROCYT-NORMAL POLYCHROM-NORMAL [**2161-4-22**] 12:10AM GLUCOSE-211* UREA N-10 CREAT-0.9 SODIUM-126* POTASSIUM-4.6 CHLORIDE-91* TOTAL CO2-10* ANION GAP-30* [**2161-4-22**] 12:10AM ALT(SGPT)-254* AST(SGOT)-859* CK(CPK)-782* ALK PHOS-248* TOT BILI-1.7* [**2161-4-22**] 12:10AM LIPASE-47 [**2161-4-22**] 12:10AM ALBUMIN-3.8 CALCIUM-9.4 PHOSPHATE-6.3* MAGNESIUM-32* [**2161-4-22**] 12:10AM cTropnT-0.04* [**2161-4-22**] 12:10AM ASA-NEG ETHANOL-NEG ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**2161-4-22**] 12:10AM URINE HOURS-RANDOM [**2161-4-22**] 12:10AM URINE bnzodzpn-NEG barbitrt-NEG opiates-NEG cocaine-NEG amphetmn-NEG mthdone-NEG [**2161-4-22**] 12:10AM URINE COLOR-Straw APPEAR-Hazy SP [**Last Name (un) 155**]-1.006 [**2161-4-22**] 12:10AM URINE BLOOD-LG NITRITE-NEG PROTEIN-100 GLUCOSE-TR KETONE-10 BILIRUBIN-NEG UROBILNGN-NEG PH-6.5 LEUK-NEG [**2161-4-22**] 12:10AM URINE RBC-8* WBC-10* BACTERIA-FEW YEAST-NONE EPI-0 [**2161-4-22**] 12:11AM LACTATE-12.6* [**2161-4-22**] 01:59AM LACTATE-10.2* [**2161-4-22**] 01:59AM cTropnT-0.10* [**2161-4-22**] 02:10AM LACTATE-8.6* IMAGING: [**2161-4-22**] EKG: Sinus tachycardia. Non-specific ST-T wave changes. No previous tracing available for comparison. [**2161-4-22**] CXR: Mild pulmonary vascular engorgement. [**2161-4-22**] TTE: The left atrium is dilated. There is mild symmetric left ventricular hypertrophy with normal cavity size. There is moderate to severe global left ventricular hypokinesis (LVEF = 30-35%). No masses or thrombi are seen in the left ventricle. There is no ventricular septal defect. Right ventricular chamber size is normal. with borderline normal free wall function. 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 appears structurally normal with trivial mitral regurgitation. There is no mitral valve prolapse. The estimated pulmonary artery systolic pressure is normal. There is no pericardial effusion. IMPRESSION: Moderate to severe global hypokinesis with evidence of spontaneous echo contrast in left ventricle. No significant valvular abnormality seen. [**2161-4-22**] EEG: IMPRESSION: This is an abnormal continuous EEG due to the presence of a burst suppression pattern, with runs of high amplitude fast activity, occurring at a 0.5-1 Hz periodicity, in runs up to 8 seconds, separated by extremely prolonged periods of suppression up to 2 minutes. This pattern is consistent with a severe diffuse encephalopathy, likely secondary to hypothermia. However, as the patient is being rewarmed, the bursts gradually become lower voltage and the interburst intervals shorten, indicating a worsening encephalopathy. This pattern is seen after severe diffuse hypoxic injury, and portends a poor prognosis. There are no epileptiform features seen. [**2161-4-22**] CT HEAD: 1. Poor [**Doctor Last Name 352**]-white differentiation, diffusely, which, in the setting of cardiac arrest, is very concerning for global hypoxic-ischemic injury. 2. No hemorrhage. 3. Large occipital scalp subgaleal hematoma, with diffuse edema in the extracranial soft tissues. [**2161-4-22**] CT Torso: 1. No acute findings to explain the patient's decompensation. 2. Fatty liver without focal lesions identified. 3. Pulmonary atelectasis. [**2161-4-23**] EEG: IMPRESSION: This is an abnormal continuous EEG due to the presence of a burst suppression pattern, with runs of bursts of low voltage theta activity, separated by extremely prolonged periods of suppression up to 1 minute. As the patient is being rewarmed, the bursts gradually become lower voltage, and the interburst intervals lengthen indicating a worsening encephalopathy. This pattern is consistent with severe diffuse encephalopathy, likely secondary to the patients known history of severe diffuse hypoxic injury, and portends an extremely poor prognosis. Between 1 pm and 5:30 pm, there is significant shivering artifact. There are no epileptiform features seen. The study is discontinued at 7:30 pm. Brief Hospital Course: 32 year old M with history of alcohol abuse found down s/p asystolic cardiac arrest. . # S/P Cardiac Arrest: Patient found asystolic in the field with ROSC after ACLS. Initial rhythm strips were suggestive of torsades and patient's EKG showed a long QT (between 460 and 490 depending on the rate and EKG). Cooling was started at the OSH, and transferred to [**Hospital1 18**] for further management. On arrival, was unresponsive and comatose in absence of sedating agents, with CT head suggestive of global anoxic injury. Cooling process was continued at [**Hospital1 18**], but EEG protended poor prognosis. He was seen by EP and neurology. EP deferred futher workup and evaluation pending neurologic recovery. Patient was rewarmed per protocol and repeat EEG consistent with severe diffuse encephalopathy, likely secondary to the patients known history of severe diffuse hypoxic injury, portending an extremely poor prognosis. Neurology felt that pending re-evaluation after rewarming he would be brain dead. A family meeting was held, and the patient's family decided to terminally extubate the patient. He expired shortly thereafter. Medications on Admission: None Discharge Medications: None- Expired Discharge Disposition: Expired Discharge Diagnosis: EXPIRED Discharge Condition: EXPIRED Discharge Instructions: EXPIRED Followup Instructions: EXPIRED Completed by:[**2161-4-24**] ICD9 Codes: 4275, 431, 2875
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Medical Text: Admission Date: [**2161-3-28**] Discharge Date: [**2161-4-17**] Date of Birth: [**2108-1-8**] Sex: M Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1384**] Chief Complaint: Transfer from OSH with acute renal failure Major Surgical or Invasive Procedure: Renal biopsy [**2161-4-2**] left nephrectomy [**2161-4-3**] tunnelled HD line [**2161-4-16**] History of Present Illness: 53M etoh cirrhosis (MELD 37), CAD, COPD, presents from OSH with acute renal failure and confusion. He was diagnosed with cirrhosis about a year ago. He has been followed by hepatology at [**State 792**]Hospital. Recent meld was 24 in [**12-10**] with cr 1.2, INR 1.8, and t. bili 9.1. The patient routine labs drawn on [**3-23**] which showed a Cr of 5.5. He was called by his physician and asked to come to the ED on [**3-24**]. At OSH, he was being treated with vanc, although uncleear about the actual or suspected source of infection. Paracentesis was considered but not done as he did not have obvious ascites on exam. The pt arrived in stable condition, satting 100 on RA, appearing comfortable. He was A+O x3 and appropriate with very mildly slurred speech, though no asterixis. Seen and evaluated by transplant medicine team on [**3-28**]. The patient states that he was feeling at his baseline. However, he was unable to provide detailed history about his medical problems. [**Name (NI) **] wife, he has been very forgetful over the past few months with increasing confusion. He is fairly independent at home and able to carry out routine ADLs. He always complains of thirst and has been staying well hydrated with fluids. However, he has had tea-colored urine for the past few months. Over the last few weeks, he began to have decrease in appetite with intermittent episodes of nausea, non-bilious, non-bloody emesis. The wife feels the increased fullness is from an increase in abdominal girth also over the same period of time. He has not had alcohol since he stopped about 1 year ago. He denies any SOB, fevers, chills, myalgias. ROS is positive for BRBPR which has intermittently although he has had a negative w/u including EGD/[**Last Name (un) **] which showed only hemorrhoids, adenomas and portal gastropathy. Past Medical History: Cirrhosis Hepatic encephalopathy CAD COPD Social History: Married, lives with wife. Worked as mechanic until he became sick smoker for 30 years. Abstinent from EtOH for 1 year, no drug use. Family History: Father had EtOH cirrhosis, mother died from CA Physical Exam: 97.3 142/64 58 22 98RA 86.5 kg I/O = [**Telephone/Fax (1) 71883**] GEN: A+O x2, slurred speech, no asterixis HEENT: scleral icterus, PERRL, EOMI, dry MM, OP clear RESP: CTA b/l with good air movement throughout CV: RR, S1 and S2 wnl, no m/r/g, JVP +12 ABD: soft, NT, no ascites, no caput medusae, no shifting dullness EXT: trace edema, 2+ DP pulses SKIN: mild jaundice NEURO: AAOx3. Cn II-XII intact. 5/5 strength throughout. No sensory deficits to light touch appreciated. No pass-pointing on finger to nose. 2+DTR's-patellar and biceps Brief Hospital Course: Patient transferred from [**Hospital **] Hospital for further evaluation of ARF, MELD 32. Patient seen by Renal, Hepatology while on Medicine service. Patient remained confused since his admission (encephalopathic). Urine ouptut was low. Lasix was not helpful. He required intermittent hemodialysis via temporary hemodialysis catheter. On [**4-2**] (HD6) a renal biopsy was performed. He received 3 bags of platelets and 3 units of FFP prior to the biopsy on [**4-2**] with a platelet count of 86,000, INR 1.7. Following the biopsy, he became diaphoretic with chest pain. His Hct was 23.9% and dropped to 21% post-procedure with a platelet count of 107,000. He received 2 more units of PRBC, 2 units of plt, and DDAVP and was then transferred to the ICU. In the first 24 hours of being in the ICU, he received 8 units of PRBCs without any response in his Hct (stable at 24%), 10 units of FFP, 4 bags of platelets, DDAVP 75mcg (total), Vit K (5mg), and cryoprecipitate administered. He went to IR for embolization of suspected renal bleed, but tolerated this poorly with 9/10 chest pain with ST depression in anterior leads. A nitro drip was started. CK was 1326, MB 163 and troponin 5.[**Street Address(2) **] depression. He sustained an anterior NSTEMI. CT of abdomen done on [**4-3**] showed an unchanged large left perinephric hematoma. Due to his continued blood requirement, he was brought to the operating room for urgent left nephrectomy. Patient transferred back to the ICU post-op. PLease see the operative [**Last Name (un) **] for further details. No obvious area of bleeding could be found on the kidney. For further details of the procedure, see operative dictation. Hct remained stable post nephrectomy. JP fluid output was initially high. This decreased over time. Of note, the kidney biopsy demonstrated IgA nephropathy.There was also ongoing transplant evaluation for liver transplant. At issue was cardiac clearance given PMH of angina. Cardia echo revealed mild (1+) mitral regurgitation is seen. There was mild pulmonary artery systolic hypertension. LVEF was >55%. Cardiac cath was deferred. Stress MIBI was performed on [**4-15**]. Findings showed no evidence of reversible ischemia or clinical symptoms of angina. Recommendations included continuation of asa qd, continuation of beta blockers, and initiation of captopril with up titration of dose. If tolerated, captopril could be switched to lisinopril 5mg qd. IV BB was recommended perioperatively should he undergo further surgery. Tube feedings were administered via an NG tube that was in place postop nephrectomy. The nasogastric tube was self d/c'd. Calorie counts suggested that he was only meeting 50% of his needs. Ensure plus was given tid. Calorie counts were continued for eval of further need for tube feedings. Calorie counts ________. Neurologically he experienced varying degrees of encephalopathy. Lactulose was given. A psyche consult was obtained for evaluation of judgement given that he refused treatments on [**4-13**]. Recommendations included 1:1 sitter, identification of source of delerium and prn haldol. Haldol was not given. Rifaximin was resumed to decrease encephalopathy. He continued to present with a waxing/[**Doctor Last Name 688**] delerium/encephalopathy. During this time he was verbally abusive to his wife and staff. On [**2161-4-16**] The temporary hemodialysis catheter was changed to a tunnelled HD line without complications. An outpatient hemodialysis center was located in [**Last Name (un) 30514**], R.I. ([**Telephone/Fax (1) 71884**]). Patient received hemodialysis on Friday [**4-17**] prior to discharge. Medications on Admission: Vancomycin Metoprolol 50" Asa 81' HCTZ 25' Imdur 30' Lipitor 10' NTG SL Protonix 40' Lactulose Thiamine Mupirocin nares Advair 250/50" Combivent inahler Lexapro 10' Colace Discharge Medications: 1. Ipratropium Bromide 17 mcg/Actuation Aerosol Sig: Six (6) Puff Inhalation Q4-6H (every 4 to 6 hours) as needed. Disp:*1 * Refills:*1* 2. Fluticasone 110 mcg/Actuation Aerosol Sig: Four (4) Puff Inhalation [**Hospital1 **] (2 times a day). Disp:*1 * Refills:*2* 3. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 4. Lactulose 10 g/15 mL Syrup Sig: Thirty (30) ML PO TID (3 times a day): adjust to have [**3-8**] bowel movements per day. Disp:*2700 ML(s)* Refills:*2* 5. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). Disp:*30 Tablet(s)* Refills:*2* 6. Rifaximin 200 mg Tablet Sig: Two (2) Tablet PO TID (3 times a day). Disp:*180 Tablet(s)* Refills:*2* 7. Captopril 12.5 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). Disp:*90 Tablet(s)* Refills:*2* 8. Protonix 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* Discharge Disposition: Home With Service Facility: [**Doctor Last Name 792**]VNA Discharge Diagnosis: Primary: Renal failure EtOH cirrhosis Hepatic encephalopathy Anemia Thrombocytopenia Coronary artery disease . Secondary: COPD Discharge Condition: fair Discharge Instructions: Please call your doctor or return to the emergency room if you develop chest pain, shortness of breath, decrease in or loss of urination, fevers, chills, confusion, increasing abdominal girth or significant weight gain, blood in your stool or dark, tarry colored stools. . Please follow up with your appointments as outlined below. Followup Instructions: [**Name6 (MD) **] [**Name8 (MD) **], MD Phone:[**Telephone/Fax (1) 673**] Date/Time:[**2161-4-30**] 10:30 [**Last Name (LF) **],[**First Name3 (LF) 156**] TRANSPLANT SOCIAL WORK Date/Time:[**2161-4-30**] 11:00 Completed by:[**2161-4-17**] ICD9 Codes: 9971, 5856, 496, 2851, 4280
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Medical Text: Admission Date: [**2119-10-16**] Discharge Date: [**2119-10-26**] Service: Cardiothoracic Surgery HISTORY OF PRESENT ILLNESS: This is an 84 year old female with a known past medical history of hypertension and borderline hypercholesterolemia, who presented at [**Hospital **] Hospital two days prior to admission at [**Hospital6 649**] with one day history of chest pain. On the evening of [**Holiday 1451**] she developed some chest pain that radiated to her back and scapula with some slight diaphoresis. She thought it was heartburn but the pain persisted. The next day she went to the [**Hospital **] Hospital Emergency Room. Electrocardiogram showed ST elevations. She received Nitropaste, Oxygen, Lopressor and Aspirin. Repeat electrocardiogram showed inferior T wave inversion with ST segment resolution anteriorly. She ruled in for myocardial infarction with peak creatinine kinase of 1182, MB 62, and index of 52 and troponin of 14.2. She was started on Heparin and Integrilin drip but they were discontinued on [**10-15**] due to a large left antecubital hematoma and a symptomatic scleral bleed of her right eye. She was painfree since admission and was transferred in from [**Hospital **] Hospital [**Hospital6 1760**] today. PAST MEDICAL HISTORY: 1. Hypertension; 2. Borderline hypercholesterolemia. PAST SURGICAL HISTORY: Status post dilatation and curettage in her remote history. ALLERGIES: She was allergic to Penicillin which causes hives. SOCIAL HISTORY: She was not a smoker and used alcohol rarely. MEDICATIONS: Medications at home revealed Lasix and [**Doctor First Name 233**]-Ciel, although the patient was unable to give us the doses. Medications on transfer include Lopressor 25 mg p.o. q. 6 hours, Aspirin 325 mg p.o. q.d., Lisinopril 5 mg p.o. q.d., Protonix 40 mg p.o. q.d. LABORATORY DATA: Admission laboratory revealed white count 7.4, hematocrit 32.1, platelets 212,000, sodium 139, potassium 3.9, chloride 110, bicarbonates 28, BUN 16, creatinine 0.8. Her troponin was cycled as follows, 14.2, 11.6, 12.5, and 7.67. HOSPITAL COURSE: Plan was that she would have cardiac catheterization done. She was seen by Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] of Cardiothoracic Surgery Service. On his examination she had no bruits and no jugulovenous distension. She was alert and oriented, neurologically she appeared to be intact. Her heart was regular rate and rhythm, her abdomen was benign. Her lungs were clear and she had weak peripheral pulses with varicosities in her lower extremities. Her blood pressure on the right was 145/84 and blood pressure on the left was 138/76 and she was sating 94% on room air. A Foley catheter was in place on transfer. Cardiac catheterization took place on [**10-16**], after transfer which showed an ejection fraction of 50% with no mitral regurgitation. The 50% left main lesion, proximal 50% left anterior descending lesion with an 80% diagonal 1 lesion, 80% circumflex and 100% thrombotic occlusion of the right coronary artery. On [**10-17**], she underwent coronary artery bypass grafting times three by Dr. [**Last Name (STitle) **] with left internal mammary artery to the left anterior descending, vein graft to the obtuse marginal 2 and vein graft to the right coronary artery. She was transferred to the Cardiothoracic Intensive Care Unit in good condition on Epinephrine drip at 0.01 mcg/min, Neo-Synephrine drip at 1.5 mcg/kg/min and a Propofol drip which was titrated. When she arrived in the unit she initially had a fairly labile blood pressure. She required significant volume. She received some packed red blood cells for a hematocrit of 23%. She was waking up slowly in the course of the evening. She was alert and oriented and following commands but fell asleep very quickly when not stimulated. She was switched to CPAP so that she could be more awake when extubation was attempted. At approximately 2140 in the evening she was extubated without incident and was able to clear her secretions and continue with deep breathing. She had some hypotension in the 70s to 80s with a little bit of exertion. She was given additional fluid and her hemodynamics improved. Her heartrate dropped slightly. She had some transient nausea but the Reglan treated this successfully. On postoperative day #1 she had been extubated over night. She was a little bit tachycardiac. She received some fluid and some beta blockade and started her Aspirin. Postoperatively her hematocrit was 29.3 and 31.0 with a BUN of 7, creatinine 0.4. Her platelet count did drop to 57,000 and her lactate came back at 1.8. She remained on Epinephrine drip at 0.01 and a Neo-Synephrine drip at 1.25. Her Lopressor was started at 25 b.i.d. She was receiving fluid boluses prn and continued on her perioperative antibiotics. At approximately 9 PM in the evening, she became distressed and sort of anxious with functioning and thrashing in bed. Her heartrate went up to 150s and the patient went into atrial fibrillation, and she did require reintubation for hyperventilation. She also received some more packed red blood cells to treat her hematocrit. On postoperative day #2, she remained on epinephrine at 0.01 and Neo-Synephrine adhesion been decreased to 0.75 with a good blood pressure of 115/58. She remained on CPAP with pressure support. Her hematocrit stabilized to 31.2, a BUN 9 and creatinine 0.6. The decision was made to do a slower wean today and decrease her pressure support and to wean off of the epinephrine. Functioning was otherwise unremarkable. She was neurologically intact, and the patient was extubated on the fifth at noon and was doing well post extubation. On postoperative day #3, she converted back into normal sinus rhythm, was Amiodarone drip at 0.5 and a Neo-Synephrine drip at .7. Epinephrine had been turned off. She had a reasonable index of 2.49. Her hematocrit dropped slightly 26.7. Her examination was otherwise unremarkable. The Swan-Ganz catheter was removed with plans to wean her Neo-Synephrine during the day. She remained on the Amiodarone drip to maintain sinus rhythm. She was seen by the Clinical Nutrition Team for evaluation for tube feedings. On postoperative day #4, she continued with Diuresis and Amiodarone for atrial fibrillation. Her Metoprolol was changed to 12.5 b.i.d. and she continued on Aspirin. She was also receiving aggressive pulmonary toilet and she was transferred out to Far 2. She was evaluated by the physical therapy team there and also with the venous access team as she had no reasonable peripheral intravenous site and still had a left very large antecubital hematoma from her Integrilin therapy at the outlying hospital prior to admission. Her pacing wires were removed on the morning of #7 and she was transferred out to Far 2. When she was alert and oriented on the morning of [**10-21**], she was very pleasant, jovial and was regaining her strength and was mentating appropriately. When she was transferred out to Far 2 on [**10-23**] where she remained on Telemetry monitoring. She slept periodically and napped throughout the day. Physical therapy was reconsulted to continue her ambulation, which she continued to improve at. On postoperative day #7, which was the day of transfer she was in sinus rhythm in the 70s, 96% on 3 liters nasal cannula. Her creatinine was stable at 0.7 with a hematocrit of 31.4, her white count was normal. Her extremities continued to have 2 to 3+ pitting edema but her incisions were clean, dry and intact. Her sternum was stable. She continued diuresis and physical therapy and screening for rehabilitation placement. The addendum to the discharge summary will be dictated tomorrow morning on [**10-26**], when she is discharged. DISCHARGE DIAGNOSIS: 1. Status post coronary artery bypass grafting times three 2. Hypertension 3. Borderline hypercholesterolemia 4. Postoperative atrial fibrillation 5. Congestive heart failure 6. Postoperative respiratory failure requiring reintubation 7. Preoperative and postoperative anemia requiring blood transfusion [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern1) **], M.D. [**MD Number(1) 3113**] Dictated By:[**Last Name (NamePattern1) 76**] MEDQUIST36 D: [**2119-10-25**] 16:19 T: [**2119-10-25**] 16:45 JOB#: [**Job Number 54204**] ICD9 Codes: 9971, 4280, 5185, 4019, 2720, 2859
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Medical Text: Admission Date: [**2175-4-30**] Discharge Date: [**2175-5-11**] Date of Birth: [**2109-4-6**] Sex: F Service: HISTORY OF PRESENT ILLNESS: The patient is a 55 year old female with a history of hemorrhagic cerebrovascular accident, seizure disorder, hypertension, and hydrocephalus who was admitted to the Medical Intensive Care Unit on [**4-30**], after being found unresponsive at the nursing home with a temperature of 102.4. In the Emergency Department her temperature remained 102.4, her blood pressure was 210/100, her pulse was 132, her respiratory rate 42 and she was 100% on 100% nonrebreather. She was given Tylenol and Nitroglycerin paste, insulin drip, tuberous normal saline Nipride drip, Rocephin, a triple lumen was placed in the right groin. She was given Decadron 10 mg intravenously. Ceftriaxone and Vancomycin were also given. Head computerized tomography scan revealed new left frontoparietal infarct. She was admitted to the Medicine Intensive Care Unit. Medicine Intensive Care Unit course was notable for: 1. Infectious disease - Lumbar puncture was performed, 20,000 white blood cells, 4+ polys, 4+ gram negative rods, 909 protein, 0 glucose, consistent with bacterial meningitis. In addition 1 out of 4 bottles of blood culture grew out gram positive cocci. She was started on Ceftriaxone and Meropenem to double cover for the gram negative rods as well as Vancomycin to cover for the gram positive cocci in the blood. She had an echocardiogram on [**5-1**] revealing no vegetations. She also had a right upper quadrant ultrasound because of possible sludge of the gallbladder. HIDA scan as well as negative. Vancomycin was discontinued after four days because the 1 out of 4 bottles of blood cultures grew out coagulase negative Staphylococcus and it was felt to be a contaminate. She spiked a temperature to 101.7 on [**5-4**]. Her femoral line at that point was discontinued and Vancomycin was restarted. She had no repeat lumbar puncture per the family's wishes as they decided not to be aggressive. Ceftriaxone and Vancomycin were discontinued because the patient spiked through them anyway. She was continued on Meropenem for gram negative rod meningitis. Femoral line grew back [**Female First Name (un) 564**] and she was started on Fluconazole. 2. Neurological - Bacterial meningitis and cerebrovascular accident. Blood pressure maintained goal 170. Her head computerized tomography scan revealed no left frontoparietal infarct. She was unable to tolerate the magnetic resonance given patient movement. She was continued on Dilantin given her history of seizure disorder. Head computerized tomography scan was repeated on [**5-4**] showing hydrocephalus with prominent mass effect. Circulation Service suggested multiple studies and neurosurgery evaluation but the patient's family declined. Electroencephalogram showed encephalopathy. 3. Oncology - Abdominal ultrasound was performed and it showed a question of ovarian cancer with an ovarian mass. This was discussed with the family and the decision was not to proceed with further workup. 4. Heme - Her hematocrit decreased to 27 without obvious source. Her stool guaiacs were negative. 5. Cardiovascular system - Hypertension, the patient with systolic blood pressures elevated throughout the hospital course. Initially she was treated with Labetalol and then her Metoprolol was increased and Norvasc was added. 6. Endocrine - Diabetes mellitus, she was started on an insulin drip and then changed to NPH and regular insulin sliding scale. 7. Fluids, electrolytes and nutrition - She was started on tube feeds via nasogastric tube. She was given free water boluses. The patient was cleared to the floor on [**2175-5-5**]. PAST MEDICAL HISTORY: 1. Hemorrhagic cerebrovascular accident with residual left hemiparesis eight years ago; 2. Seizures disorder after the hemorrhagic cerebrovascular accident; 3. Hydrocephalus with high intracranial pressure by lumbar puncture in [**2171-11-30**] with opening pressure of 25, evaluated by Neurosurgery for ventriculoperitoneal shunt, but the patient declined. 4. Hypertension; 5. Hypercholesterolemia; 6. Depression; 7. Status post gastrostomy. ALLERGIES: Sulfa, Thiazide, diuretics, and Enalapril. MEDICATIONS ON TRANSFER: NPH and regular insulin sliding scales. Fluconazole, Aspirin, Meropenem, Lansoprazole, Senna, Talwin, Colace and Metoprolol. SOCIAL HISTORY: She is a [**Location 11785**] native and lives at [**First Name4 (NamePattern1) 1188**] [**Last Name (NamePattern1) **] Nursing Home. PHYSICAL EXAMINATION: Examination on transfer to floor, temperature 99.2, 198/82, 68, 11, 100% on 2 liters, unresponsive. Eyes opened, right sided gaze. Moving right arm. Pupils 3 cm and sluggish, reactive to light. Regular rate and rhythm, no murmurs, rubs or gallops appreciated. Coarse breathsounds anteriorly. No wheezes, no crackles. Soft, moderately distended, hyperactive bowel sounds. Positive upper extremity edema bilaterally, no lower extremity edema. Neurological, left neglect, left pupil deviation, no purposeful movements, no gag. LABORATORY DATA: Laboratory data on admission revealed white blood cell count 11.5, hematocrit 34.2, platelets 278, INR 1.4, 76% neutrophils, 8% bands, 10% lymphocytes, 4% monocytes, 2% atypical study, 140,000, 4.6 potassium, chloride 108, carbon dioxide 18, BUN 38, creatinine 2.8. Blood cultures from [**4-30**] to [**Month (only) **] no blood cultures to date. Micro data [**4-30**], cerebrospinal fluid, white blood count 20,000, red blood count 217, polymorphonuclear lymphocytes 93, bands 2, lymphocytes 3, monocytes 2, protein 909 and glucose 0. Cerebrospinal fluid culture, 4% polys, 2% gram negative rods, culture ultimately grew Klebsiella which was Meropenem sensitive. HOSPITAL COURSE: After being admitted to the Medical Intensive Care Unit the patient was transferred to the floor on [**2175-5-5**]. She continued to spike fevers despite being on Meropenem and Fluconazole. Her culture from her cerebrospinal fluid grew out Klebsiella that was sensitive to Meropenem. Family meeting was performed with Neurology present. The decision was made to make the patient comfort-measures-only, to withdraw antibiotics, intravenous lines and drains and to continue to only treat with seizure prophylaxis. The patient remained stable, continued to spike fevers and was starting on standing Acetaminophen and was continued on Dilantin. Of note, she did have seizure activity on [**2175-5-6**]. She was given a bolus of Dilantin and her seizure ceased at that time. Her standing Dilantin level was increased to 150 mg p.o. t.i.d. The decision was made to discontinue her intravenous medications and she was discharged on intramuscular Fosphenytoin b.i.d. and Diastat p.r. prn for seizure activities as well as sublingual Morphine. CONDITION ON DISCHARGE: Poor. DISCHARGE STATUS: Discharged to hospice. FINAL DIAGNOSIS: 1. Seizure without status 2. Tachycardia 3. Hypertension 4. Klebsiella 5. Meningitis 6. Cerebrovascular accident DISCHARGE MEDICATIONS: 1. Acetaminophen 650 mg p.r. q. 6 hours 2. Fosphenytoin 225 mg intramuscularly b.i.d., alternate arms 3. Morphine Sulfate 1 to 5 mg sublingual q. 2 to 3 hours as needed 4. Diazepam p.r. 15 mg q.d. as needed for seizures [**Name6 (MD) **] [**Last Name (NamePattern4) **], M.D. [**MD Number(1) 29803**] Dictated By:[**Last Name (NamePattern1) 2918**] MEDQUIST36 D: [**2175-5-11**] 14:39 T: [**2175-5-11**] 15:30 JOB#: [**Job Number 29804**] ICD9 Codes: 5849
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Medical Text: Admission Date: [**2125-8-22**] Discharge Date: [**2125-8-31**] Date of Birth: [**2061-2-21**] Sex: M Service: MEDICINE Allergies: Motrin / Codeine / Nortriptyline Attending:[**First Name3 (LF) 783**] Chief Complaint: Gm + Bacteremia Major Surgical or Invasive Procedure: Hemodialysis History of Present Illness: 64 yo M with multiple medical problems including hep C, HIV, ESRD on HD who was recently hospitalized for MRSA bacteremia and was evaluated in the ED on [**8-21**]. He presented to HD febrile/tachy, he was dialized and subsequently sent to the ED on [**8-21**] with hallucinations. Blood cultures were drawn. Work-up was negative and he was sent back to [**First Name4 (NamePattern1) 3504**] [**Last Name (NamePattern1) **], NH on [**8-21**]. Pt called back on [**8-22**] to ED for further eval since for [**1-11**] positive blood cultures with gm + cocci in clusters. Pt with difficult access and indwelling cath/cuffed femoral line for several months. Past Medical History: 1) HIV: diagnosed in [**2106**], followed by Dr. [**Last Name (STitle) 1057**] at [**Hospital1 18**]. 2) Diabetes Mellitus, type 2, since ~[**2106**] with neuropathy, charcot foot, nephropathy, and ? mild retinopathy. 2) ESRD on Hemodialysis and graft infections, thrombus: dx approx. [**2115**]. Started HD in 2/[**2118**]. On HD on tues, thurs, sat at [**Doctor Last Name **] hospital. Dialysis unit - ([**Telephone/Fax (1) 17592**] / Nephrologist - Dr. [**Last Name (STitle) **] [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] -([**Telephone/Fax (1) 94989**] 3) [**Female First Name (un) 564**] esophagitis 4) Hepatitis C: genotype IB-> last viral load [**8-/2124**] 175,000 5) Congestive heart failure: echocardiogram [**10/2123**] w/ EF 60%. 6) Necrotizing Fasciitis: [**2112-10-17**]- [**2113**]: multiple surgeries and circumcision during hospitalization. 7) Hypertension 8) Hypercholesterolemia 9) LE Diabetic ulcers 10) Herpes zoster of the left mandibular distribution of the trigeminal nerve. [**2115**] 11) R suprapatellar abscess: [**2115**]. 12) IVDU (heroin and cocaine) [**2079**]-[**2102**], none since [**2102**] 13) Obesity 15) GI Bleed: [**2117**]. OB positive stool. No frank blood. Negative colonoscopies. 16) Anemia: [**2117**]. Started Epogen. 18) Colonic Polyps 19) Gastritis with large hiatal hernia. 20) Lipodystrophy 21) Charcot foot: dx in [**9-12**]. 22) Colonic AVM: seen on [**3-8**] colonoscopy on the ileocecal valve. Treated with thermal therapy. At that time was also offerred hormonal therapy, but this was deferred. 23) Positive AFB in sputum: [**2119-11-17**]. MYCOBACTERIUM GORDONAE. No abnormalities on CT chest in [**2121**]. 24) MRSA- grew out from culture from L anterior chest wound, s/p I+D 25) Peripheral neuropathy: on a narcotics contract 26) Diastolic CHF: [**2-/2125**] TTE: LV cavity is unusually small. Hyperdynamic LV systolic fxn (EF >75%), trivial MR, trivial/physiologic pericardial effusion 27) Thrombosis of dialysis line, on chronic anti-coagulation 28) Emphysema Social History: History of tobacco abuse (quit 20 years ago), alcohol abuse (quit >20 years ago) and heroin and cocaine abuse (quit >20 years ago). Has a fiance who visits him frequently and is involved in his care. Recently lost his home after several hospitalizations and has been in an extended care facility for 5-6 months, but hopes to return home to his fiance. He has not been ambulating for approximately one year. He has a wheelchair and a walker, but reports that he is starting to ambulate slowly with assistance. Family History: Non-contributory. Physical Exam: -VS: 99.0 BP 105/40 HR 104 16 100% on 2LNC -GEN: awake, resting comfortably in bed, answering questions appropriately, eyes closed but opens when told to -HEENT: MMM, OP clear, no teeth upper/lower -CV: Reg Nml S1, S2, no m/r/g LUNGS: CTABL, No crackles or wheezing ABDOMEN: Soft ND/NT +BS EXT: Large left thigh mass encircling anterior left leg which is warm and tender. L PICC with dressing over line no evidence of oozing, L femoral line in place-no oozing, no peripheral edema; R chest area without open wound, no purulent discharge currently NEURO: A/O X3, no focal deficits, strength 4/5 throughout, no tremors. Pertinent Results: . CXR [**8-20**]: IMPRESSION: Diffuse airspace process, new since [**7-25**], and most likely representing pulmonary edema; extensive aspiration pneumonitis is a more remote consideration. . CT HEAD noncontrast [**8-21**]: IMPRESSION: Stable head CT examination demonstrating chronic microvascular ischemic changes as above. . CT ABDOMEN, CHEST, PELVIS W/O CONTRAST [**2125-8-24**] 1:31 PM 1. No evidence of intraperitoneal or retroperitoneal bleeding. 2. Grossly unchanged appearance of large left groin hematoma, which contains layering fluid-fluid levels suggestive of hematocrit effect, likely reflective of recent bleeding. 3. New smaller right groin hematoma. 4. Moderate hiatal hernia. 5. Multiple sub 5-mm noncalcified pulmonary nodules. Followup chest CT recommended in [**6-19**] months' time. . CHEST U.S. RIGHT Study Date of [**2125-8-28**] 3:54 PM Right chest wall collection with apparently artificial tram tracking tubular structure that likely represents foreign body. . SHOULDER [**2-10**] VIEWS NON Study Date of [**2125-8-29**] 5:49 PM There are areas of sclerosis and lucency in the femoral head, probably related to the previously seen osteoarthritic changes. If there is strong clinical suspicion of septic arthritis, joint aspiration may be of use. Brief Hospital Course: #. Mental Status changes: per OMR notes, pt with h/o delirium in setting of infectious process, however, was oriented during MICU stay and upon transfer to the floor. Was intermittently somnolent without clear etiology - all electrolytes, glucose levels, O2 saturations WNL, which was likely related to poor sleep during stay. Continued to be oriented upon return to floor. On day of discharge was alert and oriented, without concern for mental status changes. . # HTN - Blood pressure was initially low in the MICU secondary to acute blood loss. Upon transfer to the floor he was restarted on his home dosing of metoprolol initially poorly controlled upon admit to the floor. Started on metoprolol 25mg po TID in MICU. Now on Metoprolol 100mg po TID, lisinopril 40mg and Norvasc 10mg with much improvement. Was monitored throughout stay and discharged on this regimen. - Discharged on ACE, BB and CCB dosing, monitor. . # Gram + bacteremia- Was called to return to the hospital once return of positive blood culture growing coag (-) staph on [**2125-8-22**]. Being treated with vancomycin on HD protocol since with good effect. Original source of infection remains unclear - HD catheter, thigh hematoma, or right chest wall wound with known foreign body. Additionally there were concerning changes on prior spinal imaging, however pt refused MRI to assess for osteomyelitis. He continually denied tenderness in low back on exam. Infectious disease, renal and transplant surgery were consulted and helped facilitate therapy. TTE to evaluate for endocarditis was inconclusive, however TEE was not persued given it would not change the duration of recommended therapy. Ultimately the chest wall foreign body was removed by transplant surgery. Wound consult was obtained and followed his chest wound throughout his stay. Following this, a new HD catheter was placed by Interventional Radiology as requested by Renal given that he has a history of access problems. Infectious disease recommended 6 weeks of Vancomycin therapy and he was discharged on this medication. - Vanc per HD protocol for 6 weeks per HD protocol, check vanco level at HD . # Right chest wall wound - Discovered on admission with open, nonpurulent drainage. Ultrasound evaluation of the area revealed a foreign body consistent with prior wick or catheter remnant. Transplant surgery was consulted and and attempted to remove the foreign body while inpatient without complication. He was followed by Transplant surgery throughout his stay. He should have dressing changed daily and packed with [**Last Name (un) **] packing strip and covered with dry sterile bandage. . # Right shoulder - Deformed on admit. Unable to raise arm past 7cm off of bed. Likely diagnosis include torn rotator cuff vs. frozen shoulder. Not erythematous, warm or painful with movement. Was considered to be possible site of bursitis/infection. Xray with degenerative OA changes. Given our low suspicion for septic arthritis and exam inconsistent with diagnosis - shoulder tap was not pursued. Instructed to follow-up with PCP for further management. . # Large left thigh hematoma: Prior to admit had L femoral HD cath placed. Upon admit had falling Hct in setting of elevated INR, and was transfused PRBC, FFP and Vitamin K. Surgery was consulted but did not recommend intervention. Repeat CT imaging revealed stable left groin hematoma. Hct was monitored at least once daily and remained stable for the remaining of his inpatient stay. He should have hematocrit checked the day after line changed over wire which would be [**9-4**] (tuesday). . # CHF- echo [**10/2123**] w/ EF 60%, pt does not appear overloaded on exam, no respiratory symptoms. Throughout stay he did not have signs/symptoms consistent with CHF exacerbation. Was restarted on metoprolol with the addition of lisinopril for improved BP control as well as cardioprotection. - Dishcarged on BB, statin, ACE. - ASA held on discharge do to acute bleed, should restart next week. . # HIV- last VL [**11/2124**] <50, CD4 290. Currently on HAART, followed by Dr. [**Last Name (STitle) 1057**]. Confirmed his regimen with Dr. [**Last Name (STitle) 1057**] upon admit and his medication was only adjusted per HD dosing. - Continued current HAART regimen of indinavir, ritonavir, lamivudine . # ESRD- Secondary to DM. On normal tues/thurs/sat HD schedule. Was continued on his HD schedule inpatient and was continued on nephrocaps and sevelamer. - Continue nephrocaps and sevelamer. - Continue current HD schedule Tues/Thurs/Sat - Follow-up with Renal for continued line monitoring . # Diabetes- insulin dependent, last hgb A1c 6.3% in 11/[**2124**]. Was started on an ISS and his home dose of NPH on admit, but did not require NPH. Throughout his stay his fingersticks were well controlled with only rare ISS. Gabapentin was continued for his peripheral neuropathy with a minor decrease in dose given his HD dependent status. - Continue gabapentin, renal dose adjusted - Continue insulin, should follow-up with PCP concerning good control without need for daily NPH while inpatient. . # Anemia- Secondary to acute blood loss. Mr. [**Known lastname 7493**] was dialyzed [**8-23**] and given 2UPRBC. Simultaneously, while his L fem HD line was being accessed, it began oozing. Pt noted to have a large thigh hematoma and initial INR 9.0. He was then transfused an additional 2 UPRBC and 1UFFP with inappropriate response from HCT 18.3-->22.7-->19.5. Thus, he was transferred to the MICU with an additional 1UPRBC transfused. On [**8-24**] his Hct continued to drop to 19 despite 2UPRBC, he was given a dose of Vit K and FFP. Surgery was consulted, recommended serial exams but no surgical intervention. Once he coagulopathy was reversed, he was followed with [**Hospital1 **] Hct for 3 days. He did not require further transfusion. Upon discharge his Hct was stable, and there was no evidence of acute bleed for several days. - Transfused 5u PRBC - INR elevation reversed with Vit K and FFP - Thigh hematoma & Hct stable at discharge . #. Coagulopathy. History of multiple clots in grafts and IVC in past, so is now on chronic coumadin. Upon admit he had a supratherapuetic INR 9.0 that was reversed with VitK and 1unit FFP to 1.5. He was then held at this level awaiting new HD catheter placement. After having a stable Hct of three days duration, a new HD catheter was placed in IR. Prior to discharge he was restarted on anticoagulation with goal INR [**2-10**]. - Continue anticoagulation, goal INR [**2-10**]. . # Access problems - [**Name (NI) **] renal team, pt with extensive h/o access problems, [**Name (NI) 94992**] occluded, [**Name (NI) 94993**] thrombosed, IVC occlusion, R-AVgraft failed. Thus, was consulted to replace his HD line in a presumedly patent RIJ. Upon transport to Interventional, however, it was found to be non-patent. Was discharged with schedule to change the line on [**Last Name (LF) 766**], [**9-3**] in IR. Medications on Admission: 1. Albuterol Sulfate 2. Methadone 80 mg daily 3. Indinavir 800 mg Capsule [**Hospital1 **] 4. B Complex-Vitamin C-Folic Acid 1 mg 5. Gabapentin 300 mg [**Hospital1 **] 6. Quinine Sulfate 325 mg PO HS 7. Ritonavir 100 mg [**Hospital1 **] 8. Oxycodone-Acetaminophen 5-325 mg 9. Senna 8.6 mg [**Hospital1 **] 10. Docusate Sodium 100 mg [**Hospital1 **] 11. Stavudine 20 mg daily 12. Metoprolol Tartrate 25 mg [**Hospital1 **] 13. Sevelamer 800 mg TID 14. Ammonium Lactate 12 % [**Hospital1 **] 16. Lamivudine 150 mg Tablet QHD 17. Insulin 18. cymbalta Discharge Medications: 1. Albuterol Sulfate 0.083 % (0.83 mg/mL) Solution [**Hospital1 **]: One (1) Inhalation Q6H (every 6 hours) as needed. 2. Indinavir 400 mg Capsule [**Hospital1 **]: Two (2) Capsule PO BID (2 times a day). 3. B-Complex with Vitamin C Tablet [**Hospital1 **]: One (1) Tablet PO DAILY (Daily). 4. Folic Acid 1 mg Tablet [**Hospital1 **]: One (1) Tablet PO DAILY (Daily). 5. Ritonavir 80 mg/mL Solution [**Hospital1 **]: 1.25 mL PO BID (2 times a day). 6. Senna 8.6 mg Tablet [**Hospital1 **]: One (1) Tablet PO BID (2 times a day) as needed. 7. Docusate Sodium 100 mg Capsule [**Hospital1 **]: One (1) Capsule PO BID (2 times a day). 8. Duloxetine 30 mg Capsule, Delayed Release(E.C.) [**Hospital1 **]: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 9. Sevelamer 800 mg Tablet [**Hospital1 **]: One (1) Tablet PO TID W/MEALS (3 TIMES A DAY WITH MEALS). 10. Atorvastatin 10 mg Tablet [**Hospital1 **]: One (1) Tablet PO DAILY (Daily). 11. Psyllium 1.7 g Wafer [**Hospital1 **]: One (1) Wafer PO DAILY (Daily). 12. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) [**Hospital1 **]: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 13. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) [**Hospital1 **]: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed. 14. Insulin Lispro 100 unit/mL Solution [**Hospital1 **]: ISS per scale Subcutaneous ASDIR (AS DIRECTED). 15. Gabapentin 300 mg Capsule [**Hospital1 **]: One (1) Capsule PO Q24H (every 24 hours). 16. Oxycodone 5 mg Tablet [**Hospital1 **]: 1-2 Tablets PO Q6H (every 6 hours) as needed for pain. 17. Stavudine 20 mg Capsule [**Hospital1 **]: One (1) Capsule PO Q24H (every 24 hours). 18. Lamivudine 100 mg Tablet [**Hospital1 **]: 0.5 Tablet PO DAILY (Daily). 19. Amlodipine 5 mg Tablet [**Hospital1 **]: Two (2) Tablet PO DAILY (Daily). 20. B Complex-Vitamin C-Folic Acid 1 mg Capsule [**Hospital1 **]: One (1) Cap PO DAILY (Daily). 21. Lisinopril 20 mg Tablet [**Hospital1 **]: Two (2) Tablet PO DAILY (Daily). 22. Metoprolol Tartrate 50 mg Tablet [**Hospital1 **]: Two (2) Tablet PO TID (3 times a day). 23. Vancomycin in Dextrose 1 g/200 mL Piggyback [**Hospital1 **]: One (1) g Intravenous HD PROTOCOL (HD Protochol) for 5 weeks: Levels to be checked in HD and dosed appropriately. 24. [**Last Name (un) **] packing strip please change right chest wall wound daily w/ [**Last Name (un) **] packing strip. Discharge Disposition: Extended Care Facility: [**First Name4 (NamePattern1) 3504**] [**Last Name (NamePattern1) **] [**Last Name (NamePattern1) **] & Nursing Center - [**Location (un) 538**] Discharge Diagnosis: Primary: GPC bacteremia, altered mental status Secondary: HIV, Diabetes Mellitus, type 2, ESRD on Hemodialysis, Hepatitis C, Congestive heart failure, Hypertension, Hypercholesterolemia, LE Diabetic ulcers, Obesity, acute blood loss anemia, Peripheral neuropathy, Diastolic CHF, Hyperdynamic LV systolic fxn, Thrombosis of dialysis line, Emphysema Discharge Condition: Good, hemodynamically stable and afebrile. Discharge Instructions: You have been hospitalized for fever and altered mental status and were found to have Gram Positive bacteria in your blood. You have been treated with antibiotics, specifically vancomycin at hemodialysis. Your hospital course was complicated by acute blood loss with an elevated INR (coagulopathy) that required both transfusion of red blood cells and plasma. Once your blood levels were stable, you were transferred to the floor. Since that time, we attempted to place a new HD catheter but were unable to because you have a clot in your neck vein. Thus, you are being discharged back to your facility and instructed to return to [**Hospital1 18**] for exchange of your catheter. . Return to the Emergency Department if you develop new fevers, chills, altered mental status or any other symptoms for which you are concerned. . Your medications were continued while inpatient with the following changes. - We held your aspirin and coumadin because you had acute blood loss anemia - Your blood pressure medications have been changed to the following: Metoprolol 100mg po TID, lisinopril 40mg daily and norvasc 10mg daily. . Please keep all scheduled appointments. . Please keep your HD schedule Tuesday, Thursday, and Saturday. You will be given antibiotics at these sessions. . Please return to [**Hospital1 18**] [**Hospital Ward Name 121**] Building, [**Location (un) **], Day care unit on [**Last Name (LF) 766**], [**9-3**] at 8:30am for placement of a new HD catheter. Followup Instructions: Provider: [**Name10 (NameIs) 454**],SIX [**Name10 (NameIs) 454**] Date/Time:[**2125-9-3**] 8:30 . Provider: [**Name10 (NameIs) 6122**] WEST OUTPATIENT RADIOLOGY Phone:[**Telephone/Fax (1) 8243**] Date/Time:[**2125-9-3**] 10:00 [**First Name11 (Name Pattern1) 734**] [**Last Name (NamePattern1) 735**] MD, [**MD Number(3) 799**] ICD9 Codes: 7907, 2851, 5856, 2930, 4280, 3572, 2720
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Medical Text: Admission Date: [**2153-5-23**] Discharge Date: [**2153-6-7**] Date of Birth: [**2093-1-24**] Sex: F Service: MEDICINE Allergies: Cefaclor Attending:[**First Name3 (LF) 3233**] Chief Complaint: Confusion, fevers, right eye vision loss Major Surgical or Invasive Procedure: Lumbar puncture TEE History of Present Illness: This is a 60-year-old woman with CLL, recently hospitalized for anemia and fatigue, who presents today with severe headache, blurry vision, high fever, and confusion. About 1-year-ago, blood work at PCP's office showed evidence of hematologic malignancy. Patient decided to forgo traditional work-up and treatment at that time and instead pursued homeopathic remedies with a naturalist (including injections of [**7-18**]-X compound). According to her husband, patient was doing well until about 1 month ago when she noticed profound shortness of breath and fatigue. She sought medical care at [**Hospital1 18**] on [**2153-5-16**] and was admitted to the BMT service for further work-up. Bone marrow biopsy and flow cytometry were indicative of CLL. Patient still refused treatment (was seen by psychiatry to evaluate competence) but agreed to continue following with heme/onc service. About 4 days prior to admission, patient began experiencing fevers, chills, and worsening malaise. She took her temperatures on a few occasions, and had readings as high as 102. On day of admission patient developed a profound headache and blurry vision/central vision loss in her right eye. Also noticed crusted lesions on her lower lip. Husband called oncologist who told her to go straight to the hospital. In the ED the initial vitals were: 100.5 103 135/58 20 97. However, according to ED notes, patient spiked a fever as high as 105. A code stroke was called in context of acutely abnormal neuro exam; CTA head showed possible filling defect in MCA territory. Neuro was also concerned about possibility of septic emboli on CT and recommended MRI. Patient was noted to have a WBC count of 23.4 (which is significantly decreased from prior). Patient was given Vancomycin 1g, Acyclovir 700mg, dexamethasone 10mg. Upon transfer, vitals were: 104, 144/54, 116, 32, 96% 2L. ROS: Unable to obtain, as patient is alternately agitated and somnolent and unable to answer questions appropriately. Past Medical History: --Hypertension (though improved since losing weight) --Obesity: s/p 87 pound weight loss --Anxiety --s/p 2 C-sections Social History: Married, 4 children. Husband is [**Name (NI) 86**] [**Name (NI) **] Fighter. Former smoker, quit in [**2113**]. No alcohol since [**2152-12-5**]. Used to be a heavy beer drinker. Family History: Mother: Breast cancer Father: [**Name (NI) **] cancer Sister: [**Name (NI) **] cancer No family history of myeloproliferative/lymphproliferative disorders, easy bruising or easy bleeding. No FH or leukemia or lymphoma Physical Exam: Vitals: T: 102.2 BP: 124/66 P: 113 R: 33 SPO2: 94% 3L General: lethargic, moderate respiratory distress HEENT: Sclera anicteric, MMM, multiple crusted lesions on bottom lip. Neck: massive lymphadenopathy bilaterally Lungs: coarse breath sounds diffusly. CV: tachycardic, normal S1 + S2, no murmurs, rubs, gallops Abdomen: firm, splenomegaly, hepatomegaly, +BS, non tender, nondistended. GU: foley Ext: trace edema Pertinent Results: EEG [**6-2**]:: This continuous record for a period of approximately five hours showed mild diffuse encephalopathy changes along with a focal abnormality over the right central region that was, at times, somewhat rhythmic suggesting there may be a convulsive component to it but also suggestive of structural pathology and rare independent slowing and sharp slow activity was noted from the left anterior sylvian region. EEG [**6-1**]:: IMPRESSION: This telemetry captured no pushbutton activations. Routine sampling showed a diffusely slow and disorganized background consisting of mixed theta and delta frequencies reaching up to [**6-11**] Hz. There were frequent periods of right hemispheric delta slowing as well as less frequent periods of bihemispheric delta activity. Spike detection files showed artifact. Seizure detection files also showed artifact as well as rhythmic delta activity. No electrographic seizures were seen on this recording and no epileptiform discharges were noted. EEG [**5-31**]: This telemetry captured no pushbutton activations. It captured one clear electrographic seizure correlated with twitches of the left arm and tremor of the head. This seizure had an onset in the right parasagittal area and spread bilaterally. In addition, there were long periods of right PLEDs with a parasagittal predominance during the first half of the recording. During the second half of the recording, the activity was nearly normal during sleep and wakefulness with intermittent focal slowing in the right parasagittal region suggestive of subcortical dysfunction in that area. MRI [**2153-5-24**]: 1. No acute hemorrhage or ischemic stroke. 2. Possible pachymeningeal thickening/enhancement along the frontotemporal meninges and falx. The differential for this is broad including infectious, autoimmune/inflammatory and more remote neoplastic etiology. 3. Questionable small fluid level in the left lateral ventricle which does not appear hemorrhagic, though other proteinaceous material may be present. Attention of follow up imaging recommended. CSF [**2153-5-24**]: Abundant neutrophils, lymphocytes and some macrophages, consistent with acute menigitis. ECHO [**2153-5-29**]: No atrial septal defect or patent foramen ovale is seen by 2D, color Doppler or saline contrast at rest. 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 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. No aortic regurgitation is seen. The mitral valve appears structurally normal with trivial mitral regurgitation. No vegetation/mass is seen on the pulmonic valve. There is a trivial/physiologic pericardial effusion. IMPRESSION: No vegetations or clinically-significant regurgitant valvular disease seen. No PFO or ASD. [**2153-5-24**] 04:04PM CEREBROSPINAL FLUID (CSF) WBC-7700 RBC-2400* Polys-84 Lymphs-6 Monos-10 [**2153-5-24**] 04:04PM CEREBROSPINAL FLUID (CSF) WBC-8000 RBC-1700* Polys-88 Lymphs-5 Monos-7 [**2153-5-24**] 04:04PM CEREBROSPINAL FLUID (CSF) TotProt-280* Glucose-44 [**2153-5-24**] 04:04PM CEREBROSPINAL FLUID (CSF) HERPES SIMPLEX VIRUS: negative Brief Hospital Course: This is a 60-year-old female with a history of untreated CLL who presents with fevers, AMS and crusted lip lesions. # FEVERS/ALTERED MENTAL STATUS: # S. Pneumonia Meningitis # Necrotic Lymphadenopathy # Seizure Disorder Clinical picture and lumbar puncture consistent with meningitis; this is an immunocompromised patient with high fevers, altered mental status, and abnormal neurologic exam. Blood and CSF cultures were positive for strep pneumonia, while HSV was suspected (had herpetic lip lesion). CT imaging of the neck revealed large, necrotic lymphadenopathy, presumably related to an intense lymphatic reaction to systemic disease. Her broad spectrum abx were rationalized to ceftriaxone when sensitivities permitted. ID reccomended a 14 day course, which finished on [**2153-6-6**]. TEE was negative for vegetations. Upon transfer to BMT, blood cultures had cleared. From [**5-29**] to [**6-1**], bizarre, aggressive and often hypersexual behaviour was noted. Continuous EEG, while at first unrevealing, ultimately found evidence of seizures. Keppra was loaded and started on an indeterminate course. Her AMS gradually improved. RIGHT FACIAL DROOP/?RIGHT SIDED-NEGLECT: Upon first presentation, a code stroke was called due to a right facial droop, right eye blindness, and question of right-sided neglect. A CTA of patient's head showed a question of an MCA infarct. However, a subsequent MRI showed no evidence of acute ischemia. There was also concern for septic emboli to the brain from a valvular vegetation; however, this was ruled out by TEE. As such, it was decided that Ms. [**Known lastname 85166**] did not have a stroke. RIGHT EYE BLINDNESS: Unclear etiology, but according to opthalmology, likely the result of CLL. Multiple fundoscopic exams consistent with retinal hemorrhage. On [**2153-6-6**], after having a stable eye exam over the course of her hospitalization, patient had acutely painful and injected eye. She was evaluated by ophthamology who felt the etiology was either infectious or due to CLL infiltration (though rare). Right vitrectomy was performed, and vitreous samples were sent for culture and cytology. Patient will need f/u from these results, has schedule appt with ophthamology. # CLL: Diagnosed 1 year ago but untreated. It presented in an advanced stage with marrow insufficiency. Extensive discussions between BMT and patient regarding CLL therapy however, patient and husband have refused chemotherapy in the past. Instead they have pursued herbal treatments that involved the daily injection of homeopathic preparations into the subcutaneous tissue of the groin (brand name 714-X). She will follow with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] on discharge. # RESPIRATORY STATUS: Patient presented with tachypnea but her ABGs were within normal limits. She was eventually intubated in order to perform diagnostic procedures such as an LP (she was too agitated otherwise). Patient was succesfully extubated without complications. # TACHYCARDIA: Likely in setting of fever, infection, and agitation. Tachycardia resolved with treatment of infection and fluid resuscitation. Medications on Admission: Xanax 1mg every 6 hours prn anxiety. Discharge Medications: 1. Keppra 500 mg Tablet Sig: One (1) Tablet PO twice a day. Disp:*60 Tablet(s)* Refills:*2* 2. Prednisolone Acetate 1 % Drops, Suspension Sig: One (1) drop Ophthalmic four times a day: to right eye. Disp:*1 bottle* Refills:*0* 3. Alprazolam 1 mg Tablet Sig: One (1) Tablet PO every six (6) hours as needed for anxiety. Discharge Disposition: Home With Service Facility: [**Hospital 2255**] [**Name (NI) 2256**] Discharge Diagnosis: 1. Strep pneumo meningitis 2. Right eye vision loss and possible endophthalmitis 3. Seizures Discharge Condition: Mental Status: Confused - sometimes. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Dear Ms. [**Known lastname 85166**], It was a pleasure taking care of you on this admission. You came to the hospital because of fevers, confusion, and right eye blindness. We found an infection in your blood and cerebral spinal fluid. We treated you with a medication called Ceftriaxone for 14 days. We also discovered worsening of your CLL. You were closely followed by the BMT doctors [**Name5 (PTitle) 1028**] in the hospital. It is extremely important you follow up with your new oncologist, Dr. [**Last Name (STitle) **]. You had problems with your right eye as well and had a procedure requiring close follow-up with an eye doctor. DO NOT MISS [**First Name (Titles) **] [**Last Name (Titles) 85167**]T. The following changes were made to your medications: 1. Start Keppra 500mg twice a day 2. Start Prednisolone eye drops four times a day to your right eye Please take all of your medications as directed. Please keep all of your follow-up appointments. Return to the hospital if you develop chest pain, shortness of breath, confusion, fever, abdominal pain, nausea, vomiting, diarrhea, cough, pain with urination, or any other concerning signs or symptoms. Followup Instructions: Please follow-up with the neurologist, Dr. [**Last Name (STitle) **] on [**7-16**] at 4pm. They are located in [**Hospital Ward Name 23**] 8. The phone number is ([**Telephone/Fax (1) 11299**]. Please follow-up with the ophthamologist, Dr. [**Last Name (STitle) **] ([**Telephone/Fax (1) 7572**] on [**2153-6-13**] at 8am ([**Hospital Ward Name 23**] 4). Please follow-up with your new oncologist, Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], ([**Telephone/Fax (1) 58564**], his assistant will contact you in the next day for an exact time. Please call them if you have any concerns or do not hear from them somehow. ICD9 Codes: 2761, 2760, 2875, 2930, 4019
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Medical Text: Admission Date: [**2130-9-1**] Discharge Date: [**2130-9-5**] Service: MEDICINE Allergies: Vioxx / Bactrim / Codeine / Aspirin / Ranitidine Attending:[**First Name3 (LF) 7651**] Chief Complaint: Chest pain Major Surgical or Invasive Procedure: s/p cardiac catheterization History of Present Illness: 88 year old female with PMH significant for HTN, DM who was brought by EMS to [**Hospital1 18**] ER for chest pain and diaphoresis. Per ED intake BP in field 68/p, ASA given. Patient's presenting vitals in ED were HR 92, BP 148/91, 100 NRB, however shortly after presentation patient became hypotensive with BP 50/30. EKG demonstrated ST elevations lead I, lead aVL, V1, V2; ST depression lead III, aVR. Patient was taken emergently to cardiac cath which demonstrated thrombus with occlusion in proximal LAD; wiring of this lesion restored flow, export removed clot, however it traveled to LCx. Patient then began having recurrent chest pain, respiratory distress, and hypotension. She was intubated and an IABP was placed. A small amount of residual thrombus remained in the LCx near the OM1. No stents were placed as no underlying plaque apparent. Patient was started on integrilin and heparin and transferred to the CCU for further care. . While in the CCU RN noticed blood in the oropharynx, while placing an OG patient regurgitated approximately 25 cc of bright red blood with clots. Upon placement of OG approximately 10 cc of bright red blood was suctioned. Patient was transfused 2 units pRBC, started on IV PPI and GI consulted. EGD demonstrated diffuse friable mucosa with clotted blood in the lower third of esophagus and GE junction. Blood clot felt to be partially tamponading the bleed. For full report please see reports below. GI recommended conservative care unless clinical picture changes overnight. . Past Medical History: 1. CARDIAC RISK FACTORS: + Diabetes insulin dependent, + Hypertension 2. CARDIAC HISTORY: -CABG: None -PERCUTANEOUS CORONARY INTERVENTIONS: [**2116-6-18**] 1.)Coronary angiography of this codominant system showed single vessel coronary artery disease. The left main was without significant stenosis, and the LAD was also without stenosis, but the first diagonal had an ostial 50% lesion. The circumflex had no significant disease. The RCA was also without any significant stenoses. 2.) Resting hemodynamics showed normal right and left sided filling pressures (RVEDP 7, LVEDP 5) with a mean PCWP of 6. The cardiac output was normal at 5.5 with an SVR of 1207 and a PVR of 58. 3.) Left ventriculograpy revealed a normal ejection fraction of 62% with mild mitral regurgitation and no significant wall motion abnormalities. -PACING/ICD: None 3. OTHER PAST MEDICAL HISTORY: - diverticulosis [**2127**] requiring 8 units transfusion with negative angiogram. - grade 1 internal hemorrhoids - sigmoid diverticulitis with an adjacent abscess [**9-/2129**] - Afib: not on coumadin - Chronic diarrhea - Asthma - Gout - Recurrent urinary tract infections - gastroesphogeal reflux - Tremor: essential tremor, followed previously by Dr. [**Last Name (STitle) 17281**] - Chronic Renal Failure - Choledocholithiases/cholangitis ([**2126-4-20**]): found to have pseudomonas bacteremia, treated with ceftazidime and flagyl, and referred for cholecystectomy but patient refused - Neuropathic pain - Right hip fracture - bilateral knee replacements - right leg pins - cataract repair Social History: No alcohol, tobacco, or other drugs. Currently living with her daughter in [**Location (un) 686**]. From [**State 2690**] originally. Three children, six grandkids, 7 greatgrandkids Family History: Father died of MI at 43 yo. Maternal history of breast cancer. Uncle with stomach cancer, uncle with liver cancer, brother with prostate cancer. Brother and 2 daughters with diabetes. Physical Exam: VS: T=92.9 BP=118/39 HR=88 RR=vent O2 sat=100% on FiO2 1 GENERAL: Opens eyes to name. Intubated. HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Blood surrounding ET tube. NECK: No JVP appreciated. CARDIAC: RRR, IABP noises, unable to appreciate murmurs, rubs, gallops. LUNGS: Coarse breath sounds bilaterally. ABDOMEN: Soft, NTND. No HSM or tenderness. Abd aorta not enlarged by palpation. No abdominial bruits. EXTREMITIES: Cold feet, pulses not palpable. SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. Pertinent Results: [**2130-9-1**] 08:45AM BLOOD WBC-9.8# RBC-2.75* Hgb-8.5* Hct-25.1* MCV-91 MCH-30.8 MCHC-33.8 RDW-16.2* Plt Ct-193 [**2130-9-1**] 08:45AM BLOOD PT-19.2* PTT-43.3* INR(PT)-1.8* [**2130-9-1**] 10:00AM BLOOD Glucose-273* UreaN-61* Creat-1.9* Na-134 K-3.8 Cl-107 HCO3-16* AnGap-15 [**2130-9-1**] 03:05PM BLOOD Calcium-8.0* Phos-4.0 Mg-1.8 Brief Hospital Course: In summary, this is a 88 year old female with DM, HTN who presented with STEMI and was brought emergently to cath lab, was transferred to the CCU following procedure with IABP given hypotension. Hospital course was complicated by upper GI bleed, slow afib requiring cardiopulmonary resusitation. The pt was made DNR during the admission and passed on [**2130-9-5**] at 12:08 AM while in the CCU, cause of death noted to be cardiogenic shock following STEMI. . # CORONARIES: Patient presented with STEMI. During cath patient had successful thrombectomy of proximal LAD occlusion with 20% residual stenosis. However, developed acute occlusion of OM (due to an embolus) treated with thrombectomy and PTCA (2.5x12mm balloon) with a 60% residual thrombotic occlusion but restoration of flow. Patient was unstable during procedure and consequently was intubated and IABP placed. No stent was placed during procedure. She was transferred to the CCU on IABM, integrillin, hepain. Attempts were made to wean the balloon pump but were unsuccessful due to hypotension. On day 3 of the hospitalization, family meeting was held and pt was made CMO, IABP weaned, pt started on morphine gtt. . # PUMP: ECHO performed on the [**9-2**] showed EF of 30% to 35% with mild regional left ventricular systolic dysfunction and dilated right ventricle with moderate regional systolic dysfunction. New changes secondary to ACS. . # RHYTHM: Sinus. Patient has history of A Fib, patient presumably on Verapamil for rate control. No anti-coagulation had been given in the past due to prior history of GI bleed. During this admission, she developed slow afib and the family was called and decided to make DNR after the first code, no escalation of care. . # Upper GI bleed: EGD demonstrates friable esophagus with blood clot at GE junction. Patient's HCT and hemodynamics currently stable. Due to ballon pump patient was initially placed on heparin, started on IV PPI. Crits were followed. . # Diabetes: Insulin sliding scale . # Hypertension: Outpatient Lisinopril, Lasix and Verapamil were held due to hypotension after cath . # Chronic Renal Failure: Recent creatinine range as outpatient 1.3 - 1.9. During this admission, pt developed [**Last Name (un) **] with creatinine rising to 2.3, unclear etiology but concerning for pre-renal vs cholesterol emboli vs contrast-induced nephropathy (less likely due to timing of onset). . # Shock: on day 2 of the admission, pt developed mixed cardiogenic/septic shock, 2 blood cxs growing gram + cocci, was started on vanc/cefepime for broad coverage. . # Coagulopathy: Pt with declining platelets, hct, concerning for DIC, platelet distruction in the setting of IABP. . # Asthma: Patient intubated. . # Gout: Hold Allopurinol in acute setting. . # GERD: IV PPI given UGI bleed. Medications on Admission: MEDICATIONS: per OMR - unable to obtain from patient ACETAMINOPHEN - 500 MG CAPLET - 2 TABS BY MOUTH Q 8 HRS ALBUTEROL SULFATE [PROVENTIL HFA] - 90 mcg HFA Aerosol Inhaler - 2 puffs(s) inhaled tid prn ALLOPURINOL - 100 mg Tablet - 1 Tablet(s) by mouth twice a day ATORVASTATIN - 10 mg Tablet - 1 (One) Tablet(s) by mouth once a day FUROSEMIDE - 20 mg Tablet - one Tablet(s) by mouth every day HYDROCODONE-ACETAMINOPHEN - 5 mg-500 mg Tablet IPRATROPIUM BROMIDE [ATROVENT] LISINOPRIL - 10 mg Tablet - one Tablet(s) by mouth daily PANTOPRAZOLE [PROTONIX] - 40 mg Tablet, Delayed Release (E.C.) - 1 (One) Tablet, Delayed Release (E.C.)(s) by mouth twice a day TRAMADOL - (Prescribed by Other Provider: [**Last Name (NamePattern4) **]. [**Last Name (STitle) **] - 50 mg Tablet - one Tablet(s) by mouth once a day as needed for prn pain VERAPAMIL - 120 mg Cap,24 hr Sust Release Pellets - 1 Cap(s) by mouth once a day ZAFIRLUKAST [ACCOLATE] - 20 mg Tablet - 1 (One) Tablet(s) by mouth twice a day . Medications - OTC CALCIUM CARBONATE [TUMS] - (Prescribed by Other Provider) - 500 mg Tablet, Chewable - Tablet(s) by mouth DIPHENHYDRAMINE HCL [BENADRYL] - (OTC) - Dosage uncertain INSULIN NPH HUMAN RECOMB [HUMULIN N] - 100 unit/mL Suspension - 14 units subcutaneous every morning and 10 units subcutaneous every evening INSULIN SYRINGE-NEEDLE U-100 [BD INSULIN SYRINGE] - 25 gauge X 1" Syringe - as directed twice a day one ml syringe, brand name med necessary, no substitutions - No Substitution LACTASE [LACTAID] - (Prescribed by Other Provider) - Dosage uncertain LOPERAMIDE [IMODIUM A-D] - (Prescribed by Other Provider) - 2 mg Tablet - 4 Tablet(s) by mouth every other day MULTIVITAMIN - (Prescribed by Other Provider; OTC) - Tablet - 1 Tablet(s) by mouth once a Discharge Medications: none Discharge Disposition: Expired Discharge Diagnosis: STEMI/cardiogenic shock Discharge Condition: expired Discharge Instructions: none Followup Instructions: none ICD9 Codes: 5849, 2762, 2749, 5859
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Medical Text: Admission Date: [**2103-10-3**] Discharge Date: [**2103-10-7**] Date of Birth: [**2045-8-13**] Sex: M Service: CARDIOTHORACIC Allergies: Codeine Attending:[**First Name3 (LF) 1505**] Chief Complaint: CAD Major Surgical or Invasive Procedure: CABG x4 History of Present Illness: Mr. [**Name13 (STitle) 9955**] is a 65-year-old male, with worsening anginal symptoms, who underwent catheterization that showed left main disease with a small right coronary artery with no disease. He also has LAD disease and ramus disease and is presenting for revascularization Past Medical History: HTN, hyperlipidemai, back pain Social History: nc Family History: nc Physical Exam: AVSS NAD CTA b/l RRR, S1S2 soft, NT/ND AxOx3 Pertinent Results: [**2103-10-3**] 12:39PM BLOOD WBC-12.4* RBC-3.15*# Hgb-10.0*# Hct-27.3*# MCV-87 MCH-31.6 MCHC-36.4* RDW-12.9 Plt Ct-119*# [**2103-10-6**] 05:20AM BLOOD WBC-13.5* RBC-2.90* Hgb-9.0* Hct-25.6* MCV-88 MCH-30.9 MCHC-35.0 RDW-13.1 Plt Ct-163 [**2103-10-3**] 12:39PM BLOOD PT-14.4* PTT-39.4* INR(PT)-1.3* [**2103-10-4**] 03:53AM BLOOD PT-13.9* PTT-32.7 INR(PT)-1.2* Brief Hospital Course: The patient was admitted on [**2103-10-3**] for a scheduled CABG with Dr. [**Last Name (STitle) **]. Please see operative note for details. The patient went to the ICU directly after his surgery. He did well post-operatively and was transferred tot he floor POD 1. Chest tubes were removed prior to transfer. On POD 3, we removed his pacer wirse. PT saw him and thought he was safe to go home. He was discharged home POD 4. Medications on Admission: ASA 325', zocor 40', atenolol 25', plavix 75' Discharge Medications: 1. Simvastatin 10 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 2. 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* 3. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*50 Tablet(s)* Refills:*0* 4. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 5. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 6. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: CAD s/p CABGx4 Discharge Condition: good Discharge Instructions: Please call or come to the ED with any worrisome symptoms, including shortness of breath, chest pain, fevers over 100, nausea, vomiting, increased redness of your incisions, or any other isses that may arise. Please continue all new medications as directed. Please let your PCP know about any new medication changes. Followup Instructions: Please call the office of Dr. [**Last Name (STitle) **] to schedule a follow up appointment. Provider: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], [**Name Initial (NameIs) **].D. Phone:[**Telephone/Fax (1) 5003**] Date/Time:[**2103-12-14**] 10:00 Completed by:[**2103-10-7**] ICD9 Codes: 4019, 2724
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Medical Text: Admission Date: [**2155-10-21**] Discharge Date: [**2155-11-27**] Service: SURGERY Allergies: Sulfa (Sulfonamide Antibiotics) Attending:[**First Name3 (LF) 371**] Chief Complaint: abdominal pain Major Surgical or Invasive Procedure: [**2155-10-21**] ERCP for stent placment [**2155-10-26**] PICC line placement [**2155-11-5**] exploratory laparotomy, lysis of adhesions History of Present Illness: Ms. [**Known lastname **] is an 88 year old woman with h/o HTN, who presented to [**Hospital3 **] with abdominal pain and fevers, transferred to [**Hospital1 18**] for management of cholangitis. . Patient presented to [**Hospital3 **] today with abdominal pain and fevers x1 day. ASA 325mg PO x1 given by EMS. At the OSH ED, VS: T 99.0 BP 120/44 HR 140 RR 21 O2sat 92% 2LNC, 95% 4LNC. She was given 1LNS, Lopressor 25mg PO x1, Nitro 0.4mg SL x1, Zofran 4mg IV x1, Morphine 2mg IV x1, Tylenol 625mg PO x1, Imipenem 500mg IV x1, Flagyl 500mg IV x1. CT abd/pelvis concerning for cholangitis vs pancreatitis, so the patient was transferred to [**Hospital1 18**] for possible ERCP. . In the ED, initial vs were: 96.7 50 86/44 19 96% 4L Nasal Cannula. Patient was AOx3 initially, complaining of severe abdominal pain. Per ED report, patient wanted everything to be done at that time. Given bradycardia and hypotension, patient was intubated, sedated with Fentanyl/Versed, CVL was placed. HR improved to the 70s with a dose of Atropine. She was started on Dopamine and Levophed. Given a dose of Vanc and Zosyn, 4L IVF. Surgery and ERCP were notified. Surgery recommends decompression by ERCP. ERCP planning to intervene around 6am in the ICU. Given concern for ?CCB/BB overdose, patient was given a dose of Calcium chloride in the ED. Bedside ECHO showed poor contractility. Vital prior to transfer: P 97 BP 133/60 RR 16 O2sat 100%. Patient has PIVs and CVL. . On the floor, patient is intubated and sedated. . Review of sytems: unable to assess Past Medical History: HTN Depression COPD MGUS Osteopenia GERD, treated for Hpylori in the past Cardiac cath [**2151**] - minimal, non-obstructive disease Social History: No tobacco/EtOH. Lives alone in her home. Husband and son are deceased. Friend [**Name (NI) 5969**] is HCP. Only family is nephew in [**Name (NI) 2784**]. Family History: unknown Physical Exam: On admission: Vitals: T: 98.4 BP: 154/65 P: 108 R: 20 O2: 100% Vent: FiO2 50%, TV 470, RR 20, PEEP 5 General: intubated, sedated HEENT: Sclera anicteric, ETT in place Neck: supple, no LAD Lungs: Clear to auscultation anteriorly CV: tachy, then brady, S1 + S2, no murmurs, rubs, gallops Abdomen: soft, non-distended, bowel sounds present, tender abdomen GU: foley Ext: cool extremities, + distal pulses, no clubbing, cyanosis or edema Neuro: intubated, sedated On discharge: General: A&O, flat affect, speech clear and coherent Lungs: bilateral wheezes occasionally CV: normal S1 + S2, no murmurs, rubs, gallops Abdomen: soft, slightly distended, bowel sounds present, mildly tender to palpation Ext: + distal pulses, no clubbing or cyanosis, mild LE edema Pertinent Results: [**2155-11-16**] 05:00AM BLOOD WBC-8.5 RBC-3.01* Hgb-9.0* Hct-28.7* MCV-96 MCH-29.9 MCHC-31.2 RDW-15.3 Plt Ct-168 [**2155-11-15**] 07:00AM BLOOD WBC-7.1 RBC-2.94*# Hgb-8.8*# Hct-27.4* MCV-93 MCH-29.8 MCHC-32.0 RDW-15.1 Plt Ct-158 [**2155-11-15**] 04:59AM BLOOD WBC-5.7 RBC-2.35*# Hgb-7.0*# Hct-22.4* MCV-95 MCH-29.9 MCHC-31.4 RDW-15.4 Plt Ct-122* [**2155-10-21**] 02:53PM BLOOD WBC-26.9* RBC-2.73* Hgb-8.4* Hct-25.6* MCV-94 MCH-30.9 MCHC-32.9 RDW-17.6* Plt Ct-235 [**2155-10-21**] 04:15AM BLOOD WBC-32.1* RBC-2.77* Hgb-8.6* Hct-25.7* MCV-93 MCH-31.0 MCHC-33.4 RDW-16.9* Plt Ct-311 [**2155-10-20**] 11:20PM BLOOD WBC-33.9* RBC-3.06* Hgb-9.4* Hct-28.2* MCV-92 MCH-30.8 MCHC-33.5 RDW-16.9* Plt Ct-304 [**2155-11-5**] 04:01PM BLOOD Neuts-86.5* Lymphs-7.5* Monos-5.5 Eos-0.3 Baso-0.3 [**2155-11-16**] 05:00AM BLOOD Plt Ct-168 [**2155-11-15**] 07:00AM BLOOD Plt Ct-158 [**2155-11-12**] 04:48AM BLOOD Plt Ct-72* [**2155-11-11**] 09:47AM BLOOD Plt Ct-60* [**2155-11-17**] 05:21AM BLOOD Glucose-119* UreaN-31* Creat-0.7 Na-139 K-4.1 Cl-103 HCO3-34* AnGap-6* [**2155-11-16**] 05:00AM BLOOD Glucose-124* UreaN-28* Creat-0.7 Na-139 K-3.7 Cl-101 HCO3-34* AnGap-8 [**2155-10-23**] 04:51PM BLOOD Glucose-179* UreaN-39* Creat-2.0* Na-142 K-3.5 Cl-109* HCO3-19* AnGap-18 [**2155-10-23**] 04:07AM BLOOD Glucose-74 UreaN-36* Creat-1.8* Na-141 K-3.5 Cl-110* HCO3-20* AnGap-15 [**2155-10-20**] 11:20PM BLOOD Glucose-150* UreaN-24* Creat-1.3* Na-137 K-4.1 Cl-101 HCO3-26 AnGap-14 [**2155-11-4**] 05:50AM BLOOD ALT-6 AST-15 LD(LDH)-191 AlkPhos-90 TotBili-0.7 [**2155-11-2**] 05:52AM BLOOD ALT-10 AST-17 LD(LDH)-169 AlkPhos-69 TotBili-0.6 [**2155-10-21**] 04:15AM BLOOD CK-MB-3 cTropnT-<0.01 [**2155-10-20**] 11:20PM BLOOD cTropnT-<0.01 [**2155-11-16**] 05:00AM BLOOD Calcium-8.4 Phos-3.7 Mg-2.1 [**2155-10-31**] 05:49AM BLOOD calTIBC-185* VitB12->[**2143**] Folate-12.9 Ferritn-448* TRF-142* [**2155-10-31**] 05:49AM BLOOD Triglyc-167* [**2155-10-21**] 04:15AM BLOOD TSH-0.79 [**2155-11-6**] 02:52AM BLOOD Glucose-97 [**2155-11-5**] 02:46PM BLOOD Glucose-145* Lactate-2.4* Na-134 K-4.1 Cl-101 [**2155-11-6**] 02:52AM BLOOD freeCa-1.10* [**2155-11-5**] 02:46PM BLOOD freeCa-1.10* [**2155-10-20**]: EKG: Baseline artifact. Probable atrial fibrillation with a controlled ventricular response. Left axis deviation. Consider left anterior fascicular block. No previous tracing available for comparison. Clinical correlation is suggested. [**2155-10-21**]: ERCP; A periampullary diverticulum was seen and the papilla was inverted within the diverticulum. Multiple attempts were made to cannulate with the patient in the supine position, however, it was not possible to approach the ampulla en-face. The patient was then rotated onto the left side. Successful cannulation was achieved after manipulating the diverticulum with the sphincterotome. The procedure was highly difficult. Fluoroscopic views were limited due to the portal C-arm and patient positioning, so aspiration was performed to confirm biliary location. Pus was aspirated from the bile duct. Contrast medium was injected resulting in partial opacification. The wire could not pass beyond the mid-CBD. A 5cm by 10FR biliary stent was placed successfully in the bile duct, with immediate passage of pus and small stone fragments Otherwise normal ERCP to 3rd part of duodenum [**2155-10-24**]: ECHO: The left atrium is 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%). There is lipomatous hypertrophy of the interatrial septum. No mass is seen in the left atrium. The prior study of [**2155-10-22**] was also reviewed. Based on review of both studies, the echodense region in the left atrium is consistent with artifact. [**2155-10-25**]: X-ray of the abdomen: FINDINGS: Technically limited radiograph. No safe evidence of free air. Upper abdominal endo-drain in situ. No pathological calcifications. Moderate distention of bowel loops with multiple air-fluid levels on the left lateral decubitus view. No bowel wall thickening. CT [**11-12**]- layering pleural effusions, atelectasis, PO contrast through small and large bowel to rectum, normal bowel loops, mesenteric haziness, perihepatic ascites, postERCP pneumobilia, cbd stent, trace free fluid in pelvis [**2155-11-20**]: x-ray of the abdomen: Impression: No ileus or obstruction Brief Hospital Course: Ms. [**Known lastname **] is an 88 year old woman with h/o HTN, who presented with acute cholangitis s/p ERCP with stent, whose course has been complicated by sepsis, with improving pressures throughout the hospitalization. Her course has also been complicated by respiratory failure, ARF, delirium, and partial SBO/ileus. Medical course ([**Date range (3) 91498**]): . #. cholangitis/sepsis: ERCP was performed and stent placed in biliary duct. Biliary tree was incompletely visualized however stones and pus were released following stent placement. LFTs downtrended and patient was treated with Zosyn, switched to cefazolin when sensitivities returned with pan-sensitive e.coli from OSH cxs, no further cxs positive at [**Hospital1 18**]. Pt did require pressor support for a short amount of time initially while in the ICU. . # Atrial fibrillation: New diagnosis during her stay. She was initially managed with IV diltiazem drip in the ICU and then shifted to diltiazem 90 mg four times a day. She was called out of the ICU in stable condition. While on the medical floor, NG tube was replaced given worsening of her abdominal pain and distension. During relpacement, she went into Aflutter with RVR at rate of 180's but remained hemodynamically stable and asymptomatic. She was given diltiazem 10mg and rate decreased to low 100's, then up to 150's and received another 10mg dilt. Cardiology was consulted who recommended diltiazem 20mg IV, given with HR into 90's however her HR went back to 150's. Her BP was in the 140-150's. She was transferred to inpatient cardiology floor for further management. There, she was initiated on diltiazem drip along with iv metoprolol 5 mg every six hours. The next day her rhythm was sinus in rate of 70's-80's with occasional bursts into Afib. IV diltiazem was discontinued and metoprolol IV was resumed. Given she had bowel movements and her residual after NG tube clamping was only 100 cc, She was given carvedilol 12.5 mg through the NG tube and transferred back to the medical floor for further management of her other comorbidities. . #. Respiratory failure: Patient intubated for airway protection, as she was bradycardic and hypotensive in the ED. CXR with bibasilar opacities c/w atelectasis and pleural effusion. Initial ABG 7.27/48/114. She was extubated on [**10-22**] with minimal difficutly; agitation controlled with seroquel/haldol. She did desat after extubation, sats improved with diuresis. . #. Bradycardia/tachycardia: Likely [**1-8**] to BB - takes Bisoprolol at home and given Lopressor at OSH. She subsequently became tachycardic with new afib with RVR, requiring dilt drip and eventually transitioned PO dilt. CHADs score of 2, risk/benefit of anticoagulation to be discussed with PCP. . #. Acute renal failure: peaked at 2.1, however now downtrending, likely pre-renal in the setting of hypotension. Cr now stable at 1.2-1.3. . # HTN: BP elevated later in the admission. Initially her HCTZ was restarted. While on the inpatient cardiology floor, this was held. Amlodipine 5 mg daily was given for 2 days ([**10-29**] and [**10-30**]) through NG tube. Carvedilol PO 12.5 mg x1 was given [**10-30**] morning for SBP of 150's-180. Can consider initiating ACEi or [**Last Name (un) **] given her Cr is stable now at 1.2-1.3. . #. COPD: concern for exacerbation given wheezing post-extubation, treated with prednisone x5 days . #. Depression: She expressed her wishes to die but no active plans. home paroxetene which was held initially was restarted while on the cardiology floor. She expressed her misery that her husband and son are dead. Social work was consulted. . #. Concern for L atrial mass: seen on initial ECHO performed to r/o cardiogenic cause of hypotension, not present on repeat ECHO, likely lipomatous hypertrophy of the interatrial septum. . # Partial SBO/ileus: Pt with increasing abd pain on day 6 of the admission. CT showed possible partial SBO, also concerning for ileus secondary to cholangitis. Improved with NG tube with suctioning and supportive care. She was treated conservatively for approximately two weeks. On HD16 was then taken to the OR for failure of conservative management. She underwent exploratory laparotomy with extensive lysis of adhesions. Postoperatively, her care was transferred to the Acute Care Surgical service. Please see section below for hospital course following this transfer. The following describes the patients surgical course and postoperative management up until [**2155-11-23**]. On [**11-23**], after discussion with the patient and family, the decision was made to withdraw medical interventions and transfer the patient to hospice. On [**11-24**], paliative care became involved and she was officially made CMO status. On HD16 she was then taken to the OR for failure of conservative management of her partial SBO. She underwent exploratory laparotomy with extensive lysis of adhesions. Postoperatively, she remained intubated and was thus admitted to the ICU. She was successfully extubated on POD 1. She developed Afib, which was rate-controlled with IV lopressor. She was additionally hyperkalemic, which improved with continued fluid administration. She was transferred to the floor in stable conditon NPO, with an NGT to suction, and on TPN [**2155-11-6**]. On the floor her vital signs were monitored routinely along with her oxygen saturations through until [**11-24**]. Prior to being made CMO, she remained afebrile and hemodynamically stable with intermittent hypertension in the 170s systolic and HR in the 90s. Her pain level was routinely assessed and she was given analgesics as needed thoughout her entire hospitalization. On [**2155-11-7**], her NG tube was removed and her diet was advanced as tolerated. However, on [**2155-11-10**] she developed hypertension, tachycardia and had bilious emesis. Her abdomen was distended and an NG tube was replaced. Her NG output remained high over the following few days, and she was repleted with IV fluids along with the continuing TPN. On [**11-14**] her NG output decreased and the tube was removed. On [**11-17**] she was started on regular diet and her TPN was stopped. She was started on a bowel regimen and also given fleets enemas as needed. She continued to have evidence of bowel function, including passing flatus and stool (also see abd xray from [**11-20**] under results section). However, she displayed poor PO intake. Calorie counts were performed for three days during her posoperative course, in which she did not have adequate intake. The possibility of a PEG tube placement was discussed with the patient, her nephew and her health care proxy, all of whom decided that the patient did not want a PEG tube (see last paragraph for details). A foley was replaced perioperatively for urine output monitoring. It was removed on POD2. However, she was incontinent after and it was difficult to monitor her urine output, so it was replaced on [**11-11**]. On [**11-24**], her foley was removed as her care was transitioned to comfort measures only. Her hematocrit was monitored throughout her postoperative course and she was given blood transfusions in the initial postoperative phase as needed, to which she responded appropriately. Her electrolytes were also monitored and repleted as needed. However, after being made CMO, all lab draws were stopped. Throughout her postoperative course she had evidence of pleural effusions, atelectasis and pulmonary edema. She was diuresed as appropriate and pulmonary toileting was encouraged. Her intake and output was monitored closely. Her labs were continually monitored, and she showed evidence of a metabolic alkalosis, and diamox was used as a means of diuresis during this phase. She continued to have an oxygen requirement however, and on [**2155-11-18**] she was transferred back to the ICU for tachypnea and concern for her respiratory status. In the ICU, diuresis was continued with a lasix drip as her bicarb had normalized. On [**11-20**], her pulmonary edema on chest xray showed improvement and she was transferred back to the floor, where diuresis was continued with PO lasix. Her respiratory status is currently stable on supplemental oxygen via nasal cannula. However, at present she is refusing most oral medications, including lasix. Physical therapy was consulted postoperatively and she was encouraged to mobilize out of bed as tolerated. However, aggressive PT measures have been withdrawn at this time. She began to develop thrombocytopenia on heparin postoperatively, which was thought to be due to HITT, as her platelets trended back upward to normal after discontinuing heparin. Therefore, she was placed on fondaparinux and pneumoboots for DVT prophylaxis. This has also been discontinued at this time. Postoperatively, geripsych was involved in the patient's care as the patient continued to expresses her wishes to die, but was also exhibiting signs of delirium. Initially upon evaluation, the psychiatry team deemed her without capacity to make medical decisions. Her health care proxy was [**Name (NI) 653**] who stated to proceed with medical treatment in the initial postoperative phase. However, as the patient became more stable and her bowel obstruction cleared (see above), she continued to express her wishes to die and refused to eat or take oral medications. Social work was involved throughout the hospitalization. The patient's nephew who lives in [**Name (NI) 2784**] was [**Name (NI) 653**] who came to [**Name (NI) 86**] to see the patient. A meeting was held with a member of the surgical team, the social worker and the nephew, after the nephew had a chance to meet with the [**Hospital 228**] health care proxy. The proxy was involved in the meeting via telephone. The decision was made at that time to honor the patient's wishes and cease further medical interventions. Therefore, palliative care was consulted and care was changed to comfort measures only and admitted to hospice. The patient is being discharged to a facility to pursue end of life care. Medications on Admission: Medications (per OSH records): Bisoprolol/HCTZ 5mg/6.25mg PO daily Hydrocodone/Acetaminophen 1tab PO BID Mupirocin 2% cream TP [**Hospital1 **] Paroxetine 30mg PO daily Discharge Medications: 1. senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 2. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) neb Inhalation Q6H (every 6 hours). 3. acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO Q8H (every 8 hours). 4. citalopram 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. 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. 6. oxycodone 5 mg Tablet Sig: 1-2 Tablets PO Q3H (every 3 hours) as needed for pain. 7. hydromorphone (PF) 1 mg/mL Syringe Sig: 0.25-0.5 mg Injection Q1H (every hour) as needed for pain. 8. morphine concentrate 100 mg/5 mL (20 mg/mL) Solution Sig: 0.25-0.5 mL PO Q1H (every hour) as needed for pain or dyspnea. 9. ondansetron HCl (PF) 4 mg/2 mL Solution Sig: [**1-10**] mL Injection Q8H (every 8 hours) as needed for nausea. 10. Dulcolax 10 mg Suppository Sig: One (1) suppository Rectal at bedtime as needed for constipation. 11. haloperidol 1 mg Tablet Sig: 0.5 Tablet PO Q8H (every 8 hours) as needed for nausea. Discharge Disposition: Expired Discharge Diagnosis: 1. pancreatitis 2. small bowel obstruction 3. postoperative ileus 4. atrial fibrillation 5. sepsis 6. acute renal failure 7. delirium Discharge Condition: Level of Consciousness: Alert and interactive. Activity Status: Out of Bed with assistance to chair or wheelchair. Mental Status: Confused - sometimes. Discharge Instructions: You were admitted to the hospital with abdominal pain. You had a CT scan of the abdomen done which showed pancreatitis. You underwent an ERCP and placement of a stent into the bile duct. Once the stent was placed you passed a few stones as well as pus. You were started on antibiotics. During this time you dropped your blood pressure and developed signs suggestive of infection. Despite this procedure, your abdominal pain continued and you were taken to the operating room for an exploratory laparotomy and lysis of adhesions for a bowel obstruction. Your bowel function has returned after this procedure. After discussion with you, your family and your health care proxy, the decision was made to transfer you to a facility to pursue end of life care. Followup Instructions: none- comfort measures only Completed by:[**2156-10-27**] ICD9 Codes: 5849, 311, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6559 }
Medical Text: Admission Date: [**2175-6-4**] Discharge Date: [**2175-6-9**] Date of Birth: [**2110-2-25**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 603**] Chief Complaint: shortness of breath Major Surgical or Invasive Procedure: none History of Present Illness: 65M with hx of hypertension, hypothyroidism presenting with shortness of breath and fever. He was in his usual state of health until ~2 weeks ago at which time he developed mild shortness of breath and cough. He described cough as the dominant symptom when he first came to the MICU; on transfer to the medicine service he emphasized the history of dyspnea on exertion. He denied sinus congestion, headache, rhinorrhea or sore throat. His dyspnea on exertion continued; he says that today he came to the emergency department because "my wife made me" come. He had chest wall pain bilaterally by his history with me (described as left-sided when he first came in), which he says was worsened by deep breathing and coughing. . In the ED, his initial vital signs were 100.7 132 230/80 42 99% NRB. He was initially placed on nitroglycerin gtt for blood pressure control. A CXR was inconclusive for edema vs. infiltrate. His BNP returned low so the nitroglycerin gtt was discontinued in favor of labetalol. He received ceftriaxone and levofloxacin; he grew out GPCs so was started on vancomycin; these returned as pan-sensitive pneumococcus, so vanco was d/c'ed and IV penicillin G was started while the patient was in the MICU. He was called out to the floor as his clinical condition improved. . ROS: no HA, abd pain, no dysuria, no rash, no leg swelling. no weight gain. no increasing abd girth. + snores, no known apneic spells during sleep. Past Medical History: hypertension past hypothyroidism ?newly detected ascites Social History: Lives with wife and 18 year old grandson. distant smoking history >40 years ago. On admission: Says he drinks alcohol (shots Bourbon or vodka) 2-3x/week unless celebrating; last drink 2 weeks ago. Later: history suggested a much heavier consumption pattern prior to one year ago, and possibly heavier at present. Family History: Father - deceased hx of stroke. Mother - deceased hx of alzheimers. No cancers. no MI, no DM2 Physical Exam: On arrival at [**Hospital1 18**]/MICU VS: 99.6 96 120/72 28 100% (15L mask) GEN: tachypneic. speaking in full sentences, obese male HEENT: AT, NC, PERRLA, EOMI, no conjuctival injection, anicteric, OP clear, dry MM, Neck supple, no LAD, no carotid bruits, JVP not seen due to body habitus CV: distant heart sounds RRR, nl s1, s2, no m/r/g. chest pain reproduced with palpation. PULM: late crackles at the bases with faint wheeze bilat. ABD: soft, NT, mod distension, + BS, no HSM, + fluid EXT: warm, dry, +2 distal pulses BL, no femoral bruits NEURO: alert & oriented x3, no right/left neglect, CN II-XII grossly intact, 5/5 strength throughout upper and lower extremities. No sensory deficits to light touch appreciated. No asterixis PSYCH: appropriate affect . Additional findings on transfer from the MICU: PULM: Egophony at the left lower half of lung field; bronchial breath sounds from right middle to bottom of lung field. Fair air movement above these findings. GENITAL: macerated, depigmented area on underpart of foreskin, appears to be some constriction of foreskin around distal portion of penis shaft; no isolated lesions Pertinent Results: [**2175-6-4**] 08:50PM BLOOD WBC-17.4*# RBC-4.03* Hgb-11.7* Hct-35.1* MCV-87 MCH-28.9 MCHC-33.2 RDW-13.4 Plt Ct-557*# Neuts-73* Bands-3 Lymphs-16* Monos-8 Eos-0 Baso-0 Atyps-0 Metas-0 Myelos-0 [**2175-6-5**] 03:46AM BLOOD WBC-19.2* RBC-3.16* Hgb-9.2* Hct-28.1* MCV-89 MCH-29.1 MCHC-32.7 RDW-13.8 Plt Ct-454* [**2175-6-9**] 06:50AM BLOOD WBC-11.7* RBC-3.20* Hgb-9.9* Hct-28.7* MCV-90 MCH-30.8 MCHC-34.3 RDW-13.7 Plt Ct-508* . [**2175-6-5**] 01:30PM BLOOD PT-16.9* PTT-30.6 INR(PT)-1.5* . [**2175-6-4**] 08:50PM BLOOD Glucose-159* UreaN-20 Creat-1.6* Na-136 K-4.3 Cl-98 HCO3-21* AnGap-21* [**2175-6-9**] 06:50AM BLOOD Glucose-102 UreaN-16 Creat-1.3* Na-137 K-4.9 Cl-99 HCO3-27 AnGap-16 . [**2175-6-4**] 08:50PM BLOOD ALT-52* AST-38 LD(LDH)-265* CK(CPK)-223* AlkPhos-162* TotBili-1.3 [**2175-6-8**] 06:40AM BLOOD ALT-87* AST-88* AlkPhos-223* TotBili-0.8 . [**2175-6-5**] 05:43AM BLOOD calTIBC-161* VitB12-526 Folate-9.6 Ferritn-1309* TRF-124* [**2175-6-5**] 12:05PM BLOOD %HbA1c-6.6* [**2175-6-4**] 08:50PM BLOOD TSH-37* [**2175-6-5**] 05:43AM BLOOD Free T4-0.45* Brief Hospital Course: A/P: 65M with hx of hypertension, hypothyroidism who presented with fever, cough and respiratory distress. . # Respiratory Distress: Exam and imaging were very consistent w pneumococcal pneumonia, and most conclusively, [**3-31**] blood cultures from [**6-4**] were positive for strep pneumo. Urine legionella was negative. There was a small left sided effusion visualized on CT chest but this was too small for thoracentesis; ultimately since Mr [**Known lastname **] was improving clinically, the team felt there was no urgent need to pursue this further unless he were to worsen. His cultures were no growth starting on [**6-5**]; he had started on effective treatment in the emergency department on [**6-4**]. He was continued on penicillin G while on the floor, and ultimately after consulting the infectious disease service we decided he would finish out his course on amoxicillin, with eight more days of antibiosis after the six days he had received in the hospital. . # Hearing loss: Mr. [**Known lastname **] complained of a sensation of discomfort in his ear just prior to coming into the hospital, and while here he noted decreased hearing in the left ear. On examination, there were very small bullae in the upper portion of the tympanic membrane, suggestive of early/mild bullous myringitis which can be seen with strep pneumoniae. We set him up with audiologic evaluation, and will refer him to ENT if indicated based on the audiologic evaluation. # Penile lesion: Mr [**Known lastname **] had a slightly bulbous and circumferential depigmented lesion around the foreskin of his penis. Originally we thought this might have been an unfortunate effect of the condom catheter but it remained after discontinuing the catheter. We referred him for [**Known lastname **] follow-up with concern that this might represent a malignancy. . # Hypothyroidism: He had not been on medicines since he had lost his health care insurance about 5 years prior; he reported weight gain and poor energy and recalled a past diagnosis of low thyroid. His TSH was elevated to 37 with FT4 low at 0.45. We started levothyroxine at previous home dose of 75mcg; given that his values were checked in the inpatient setting of critical illness these should be followed up when he is more stable. . # Hypertension: He was hypertensive coming in to ED, was mostly normotensive in the days after that, and then towards the end of his admission was hypertensive again; he was sent out on a starting dose of HCTZ. This should be followed up in subsequent outpatient visits. . # Anemia: There was no evidence of blood loss. His labs were consistent with an anemia of chronic inflammation. This might be from the pneumonia or some more chronic cause and should be followed. . # Acute renal failure: He was originally in acute renal failure, likely from pre-renal state exacerbated by NSAIDs. His creatinine had normalized by the time of discharge. . # Abdominal distension: Abdominal U/S showed no ascites or other acute issues; it did show a possibly fibrotic/cirrhotic liver but no ascites nor splenomegaly to suggest portal hypertension. His LFTs were normal as was synthetic function and normal platelets. His physical exam was benign and as he improved clinically we saw no evidence of abdominal process, and his abdominal appearance may simply be from disproportionate abdominal obesity. . # FEN: He was given a heart-healthy diet and lytes were repleted PRN. . #ACCESS: PIV . #PPx - Heparin sub-q for DVT prophylaxis . #CODE: FULL . #COMMUNICATION: patient . #DISPO: to home with close follow-up. . Medications on Admission: benadryl prn advil 400 mg [**Hospital1 **] (for past 2 weeks) . previously prescribed: metoprolol, synthroid Discharge Medications: 1. Amoxicillin 875 mg Tablet Sig: One (1) Tablet PO twice a day for 8 days. Disp:*16 Tablet(s)* Refills:*0* 2. Levothyroxine 75 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 3. Hydrochlorothiazide 12.5 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Pneumococcal pneumonia Discharge Condition: Good Discharge Instructions: You were diagnosed with pneumonia. You need to keep taking your antibiotics for the prescribed time. It is extremely important that you take ALL your antibiotics even if you are feeling better. . You have had some high blood pressure. We've prescribed you some blood pressure pills. You also had low thyroid levels, which means you need to keep taking your thyroid medication. It's very important that you take all the medicines that have been prescribed to you. . You had some hearing loss. It's most likely that this was a complication of the pneumonia you had, and we hope it will get better, but it's important that this be followed up. Go to the audiology appointment (hearing test) to check if your hearing has got better. . You should go to the doctor's office next week to make sure that everything is going OK. Call [**Telephone/Fax (1) 30910**] on Wednesday to make an appointment for Thursday or Friday. . You'll then have another check up on [**7-5**], which will also be where you have a complete history and physical to start your primary care. . Come back to the emergency department if you have new fevers, if you are having more difficulty breathing, if you are coughing up blood, or if you are having other concerning symptoms. . We are concerned about the skin discoloration on your penis and are concerned that it might be a sign of a problem that may need treatment. We have set up a [**Month (only) **] appointment for you (a doctor [**First Name (Titles) **] [**Last Name (Titles) 14903**] in this type of problem); please go to this appointment as it will be important to follow up. . Follow up with your new primary care physician on [**7-5**] (appointment shown below). . Followup Instructions: . Call on Wednesday or Thursday: [**Telephone/Fax (1) 30910**]--for visit at [**Hospital3 **] for hospital visit follow-up. . AUDIOLOGY APPOINTMENT (hearing test) [**6-19**] 11:15 Dr [**First Name (STitle) 3175**] . Provider: [**Name10 (NameIs) **] UNIT Phone:[**Telephone/Fax (1) 164**] Date/Time:[**2175-6-21**] 9:00 . Go to a follow-up appointment with your new primary care provider: [**Known firstname **] [**Last Name (NamePattern4) 15398**], MD Phone:[**Telephone/Fax (1) 250**] Date/Time:[**2175-7-5**] 3:30 . Provider: [**Name10 (NameIs) 6410**] [**Name Initial (NameIs) **] [**Last Name (NamePattern4) **], AU.D. Phone:[**Telephone/Fax (1) 6411**] Date/Time:[**2175-6-19**] 11:15 . ICD9 Codes: 5849, 7907, 5119, 2449, 4019
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Medical Text: Admission Date: [**2114-11-17**] Discharge Date: [**2114-11-23**] Date of Birth: [**2035-1-11**] Sex: F Service: NEUROLOGY Allergies: Sulfa (Sulfonamides) Attending:[**First Name3 (LF) 2569**] Chief Complaint: transient gait unsteadiness, dysarthria. Major Surgical or Invasive Procedure: MRI/MRA with Gad Echo EEG CTA head lumbar puncture Hemicraniectomy History of Present Illness: 79y/o RH female here presented to ED with c/o unsteadiness, slurred speech which started about 12:30pm today (Neurology consult at 4:35pm). She was carrying shopping bags and about to get into the bus, when she fell as her right leg gave in. Denied head hitting. She noticed that she felt unstable and listed towards to the right. Her friend felt that her speech was slurred. The friend took her home and there, while she was laundring, noticed difficulty manipulating coins in her hands. Her friend brought her to [**Hospital1 18**] [**Name (NI) **] for further evaluation. Stated these symptom did not get worse. She herself did not notice any slurring of speech. She understood well spoekn speech. Denied any weakness, numbness. She stated that this was her first episode. She noticed some line of colors floated in the sight last week. Denied any vision loss, changes. She had light headache, which was almost resolved. She denied any history of migraine, just occasional light headache. At [**Last Name (LF) **], [**First Name3 (LF) **] physician noticed left hemianopsia and right side ataxia, called neurology consult for possible TIA/stroke. ROS: No chest pain, SOB, palpiation, backache, neckache, incontinence, fever, chill. Past Medical History: Autoimmunehepatitis DM Hypothyroidism Social History: Writer, retired educator (religious education) Denied Smoking, drugs. Used to drink occasional etoh, but years ago. Denied alcohol problems. Family History: Mother had some cancer. No stroke, heartattack, HTN, DM. Physical Exam: PEX: T-99.6 BP-120/80 HR-144, reg RR-12 SaO2 97%, r/a Gen: Awake, alert, no distress HEENT: Had bil hearing aid. clear ear canals, ear drums, conjunctivas, oral membrane, no neck bruit, no goiter Chest: vesicular sound, symmetrical, symmetrical chest Heart: S1, S2 nl, no murmur Abd: soft nt/nd no hepatosplenomegaly Skin: no lesions, skin stigmata, moist, turgor nl Exts: no arthralgia, cotraction. High arched Rt foot. NEURO MS: Awake and alert, cooperative with exam, normal affect. Oriented to person, place, and date. Attentive, says name of days of week backwards smoothly and correctly. Speech is slightly slurred with normal comprehension and repetition. No dysarthria. Good pronounciation of kakaka, lalala, papapa. [**Location (un) **] intact. Registers [**4-13**], recalls [**4-13**] in 10 minutes. No right left confusion. No evidence of apraxia or neglect. CN: Fundus bil clear disc margin and color. Left homonimous hemianopsia (both at mono-, biocular test), unclear if it spaced macular region, Pupils round, equal, Pupils round and equal in size, reactive to the light, bilaterally 3mm to 2mm. Symmetrical facial sense, appearance, NLF, WFH, spontaneous and forced smiles, uvla midline, no curtain sign, tongue full, SCM normal volume and strength Motor: Full throughout, normal tone Reflex: DTR brisk, but no clonus, spread, symmetrical, planters going down Sensory: Symmetrical to the light touch, pin prick, vibration, temperature throughout. Normal position sense at digits, toes. Coordination: Smooth and accurate FNF. No DDK. Smooth accurate heel-shin test. Normal, quick finger tapping. Stable sitting, standing. At standing had shifted slightly towards to the right, but no unstability at rest, pushed Gait: Narrow based stable gait. Stable tandem gait. Meningeal signs: No Brudzinski sign. No stiffen neck. Pertinent Results: Other Blood Chemistry: %HbA1c: 6.8 [Hgb]: Done [A1c]: Done New Method (Dcct/Ngsp Traceable) As Of [**2113-4-28**];[**Doctor First Name **] Recommendations:; <7% Goal Of Therapy; >8% Warrants Therapeutic Action CK: 109 MB: 4 Trop-*T*: <0.01 Comments: Ctropnt > 0.10 Ng/Ml Suggests Acute Mi ALT: AP: Tbili: Alb: AST: LDH: Dbili: TProt: [**Doctor First Name **]: Lip: Cholesterol:157 Other Blood Chemistry: Triglyc: 52 HDL: 74 CHOL/HD: 2.1 LDLcalc: 73 Ldl(Calc) Invalid If Trig>400 Or Non-Fasting Sample [**2114-11-17**] 4:00p SPECIMEN SLIGHTLY HEMOLYZED 126 86 12 223 AGap=21 4.0 23 1.0 Comments: Hemolysis Falsely Increases This Result SPECIMEN MODERATELY HEMOLYZED CK: 88 Comments: Hemolysis Falsely Increases This Result ALT: 56 AP: 104 Tbili: 0.5 Alb: 4.2 AST: 64 LDH: 268 Dbili: TProt: [**Doctor First Name **]: 109 Lip: 94 5.3 11.3 186 32.0 PT: 12.1 PTT: 29.3 INR: 1.0 Hematology ANALYSIS WBC RBC Polys Lymphs Monos Macroph [**2114-11-19**] 11 1100* 12 40 46 2 [**2119-11-19**]* 12 36 50 2 TUBE #1 1 HAZY,SUPERNANT - TRACE XANTHROCHROMIC Chemistry CHEMISTRY TotProt Glucose LD(LDH) [**2114-11-19**] 12:16PM 564*1 64 47 TUBE #1; TUBE#3 1 VERIFIED BY DILUTION PROTEIN ELECTROPHORESIS CSF-PEP [**2114-11-19**] 12:16PM PND TUBE #1; TUBE#3 MRI: No evidence of acute infarction. White matter changes suggesting chronic small vessel ischemia. EEG: This is an abnormal EEG in the waking and drowsy states due to the left anterior temporal slowing and bursts of generalized slowing. The first abnormality suggests a left anterior temporal subcortical dysfunction, while the second abnormality suggests a mild encephalopathy, which may be seen with infections, medications, ischemia or toxic metabolic abnormalitites. Echo: Normal global and regional biventricular systolic function. No ASD or PFO seen. Brief Hospital Course: Patient was at baseline on initial examination Day 1. On day 2, had a 30 minute episode of dysarthria and left sided weakness/neglect. Had a stat MRI/MRA within 30 minutes which did not show any DWI abnormalities or vascular compromise. Returned to baseline after 30minutes and had no further episodes of change in speech, vision or weakness. On day 1 and 2 was having low grade fevers up to 101.0 but was asymptomatic. Had a lumbar puncture [**11-19**] which revealed an openiing pressure 12cm H20. Xanthachromic throughout. 1200 RBC/1WBC in tube 1 and 1100 RBC/1WBC in tube 4. Protein was 564 and sugar was normal. Based on these results, she was treated empirically for bacterial and HSV encephalitis with Vanc 1gm Q12, Rocephin 2gm Q12 and Acyclovir 10mg/kg IV Q8. Antibiotics were d/c'd after 24 hours of negative cultures and negative GS. Acyclovir was continued to [**12-23**] after CSF HSV PCR returned negative. Regarding blood and xanthachromia in CSF, underwent CTA to r/o aneurysm or other anomaly which was negative. Discussed utility of doing Angio to further rule out any source of bleed or cortical irritation. Was thought not to be of benefit after long discussion with neurointerventionist. EEG was performed to rule out seizure but showed no spikes. Was focal left temporal slowing however and did MRI with Gad to r/o mass lesion/infrection. See results secion. On [**11-22**], the patient had acute onset of left hemiplegia, right gaze deviation and hemineglect. She was examined closely and repeatedly over one hour and seizure was considered as the likely cause. She did not respond to ativan, however, and became more difficult to arouse. She vomited and was taken emergently to CT scan, which showed a large right temporal hemorrhage. Neurosurgery was called and the patient was taken emergently to the OR for hemicraniectomy. She was admitted postoperatively to the ICU and started on mannitol and hyperventilation. However, her exam showed no improvement, with fixed, dilated pupils with no extraocular movements, clonus and extensor posturing. The decision was made, in a family meeting, to make patient CMO, which is in [**Location (un) **] with her wishes clearly stated in a living will. They agreed to autopsy and wish to receive the remains for cremation afterwards. Medications on Admission: PREDNISONE 3 MG QD METFORMIN 850mg [**Hospital1 **] ARCUPROL 20mg QD Fosamax 70mg Q Sunday LANTUS MVI CaMg LEVOTHYROXINE 100 MCG QD Discharge Medications: Expired Discharge Disposition: Expired Discharge Diagnosis: Right intracranial hemorrhage Discharge Condition: Expired Discharge Instructions: Expired Followup Instructions: Expired [**First Name8 (NamePattern2) **] [**Name8 (MD) 162**] MD [**MD Number(2) 2575**] Completed by:[**2114-11-23**] ICD9 Codes: 431, 2449
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Medical Text: Admission Date: [**2102-3-26**] Discharge Date: [**2102-4-18**] Date of Birth: [**2021-12-25**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1042**] Chief Complaint: Respiratory distress. Major Surgical or Invasive Procedure: Intubation Mechanical Ventilation Arterial Line Placement History of Present Illness: 80 M with hx CAD s/p CABG presents with cough and SOB. The patient reports that about a week ago he went to [**Country 4754**] for the funeral of his brother. There he had fever/chills, and a productive cough as well as rhinorrhea for the last week. He decided to come back one week earlier and came back yesterday. TOday his SOB worsened and he decided to come into the hospital. He denied CP, pedal edema or calf pain. In the ED, the patient was hypoxic to 81% on RA on arrival. Other vitals included T 98.1, 71, 190/89, RR20. A CXR was done with no significant infiltrates. A CTA was performed without PE or infiltrate. The patient was then noted to be progressivley more wheezing and short of breath. He was given several nebs back to back with initial improvement but then continued with laboured breathing. Methylprednisolone 125mg was given x1 and Levofloxacin 750mg. The pt appeared progressively more tired and in respiratory distress. A gas showed pH 6.93 pCO2 132 pO2 113. THe patient was intubated with succinylcholin, etomidate and ativan. Lactate was 1.2. He received a total of 2L of NS. Repeat ABG: pH 7.14 pCO2 69 pO2 83. ROS: pt intubated and sedated, unable to obtain. According to nurse, pt received a double dose of his Atenolol today Past Medical History: 1. Coronary artery disease. 2. Status post myocardial infarction thirty years ago. [**2084**]- CABG: LIMA to LAD, SVG to LPL jump PDA [**2089**]- Stent to LCx, occl noted SVG at LPL-PDA segment [**2096**]- Stent SVG-OMB [**2097**]- Stent SVG-PLV [**2101**]- DES to the distal SVG-LPL and balloon angioplasty of the proximal in-stent restenosis. EF = 50%- Mild anterolateral hypokinesis 3. History of AAA, elective repair 6.6cm on [**3-19**]. 4. Hypertension. 5. Peripheral vascular disease - [**2096**] angio: Severe bilateral lower extremity peripheral vascular disease with severe bilateral SFA disease and single vessel runoff bilaterally. 6. Appendectomy 50 years ago. 7. Diverticulitis. 8. PUD 9. Hypercholesterolemia Social History: Widower, he lives with his daughter. His is a retired auto mechanic. Smokes [**7-25**] cigarettes/day. (1/2-1 PPD x 70 years) Family History: His brother died of an MI at 68 years of age. Physical Exam: T 97.2 BP 118/61 HR 102 RR 20 O2Sat 95 AC 0.3/550/20/5 Gen: NAD, comfortable and sedated HEENT: NC/AT, PERRLA, mmm, hard exophytic mass over left forehead NECK: no LAD, no JVD, no carotid bruit COR: S1S2, irregularly regular rhythm, no m/r/g PULM: moderate air movement, mild diffuse wheezing, no rhonchi ABD: + bowel sounds, soft, nd, nt Skin: warm extremities, no rash, venostasis changes EXT: 2+ DP, no edema/c/c, no CVA tenderness Neuro: moving all extremities, sedated, PERRLA, reflexes 2+ b/l Pertinent Results: EKG: NSR, HR 80, NA, NI, mild Tw changes in I, avl. (unchanged) . CXR: Single upright frontal bedside chest radiograph is compared to [**2101-11-1**]. The lungs are clear. The heart, mediastinal contours, and pulmonary vasculature are unchanged in appearance, remarkable for tortuous aorta. The patient is status post CABG. IMPRESSION: No acute cardiopulmonary process. . CT CHEST WITH CONTRAST: The pulmonary arteries opacify without filling defects. The patient is status post CABG, and there are marked coronary artery calcifications within the LAD and circumflex. The heart appears normal. There are multiple small right hilar lymph nodes as well as a more prominent 12 mm lymph node. There is no pathologic mediastinal or axillary adenopathy. There is emphysema of the lungs, but lungs are otherwise clear. Note is made of a tiny calcified granuloma in the right base. There is no pleural effusion. The airways are patent to the subsegmental level. There are multilevel degenerative changes in the osseous structures. The patient is status post median sternotomy. No suspicious lesions are identified. The visualized portions of the abdomen are unremarkable. There is atherosclerotic disease of the aorta with multiple areas of mural thrombus. IMPRESSION: 1. No evidence for pulmonary embolism. 2. Emphysema, but no evidence for pneumonia. . CT HEAD [**2102-4-11**] COMPARISON STUDY: [**2102-4-1**], head CT scan, also performed for a history of mental status changes, interpreted by Drs. [**Last Name (STitle) **] and [**Name5 (PTitle) **] as revealing "No acute intracranial abnormalities detected. Unchanged expansile osseous lesion consistent with an osseous hemangioma. Destruction of the outer table suggests aggressive potential and further evaluation is indicated." FINDINGS: The images of the posterior fossa region are mildly degraded by patient motion, although a repeat imaging sequence is of reasonably good diagnostic quality in this region. There is no definite interval change in either the appearance of the brain or osseous lesion in the one-week interval between scans. There is no intracranial hemorrhage or shift of normally midline structures observed. CONCLUSION: Stable, abnormal study as noted above. If acute brain ischemia is a clinical consideration, MRI scanning, if feasible, is a more sensitive diagnostic modality. . CHEST CT [**2102-4-17**] 1. Two 3-mm left upper lobe pulmonary nodules. Statistically, these are most likely benign. However, given the patient's history, followup CT in three to six months can be obtained if clinically warranted to exclude an atypical distribution of small metastases. 2. New bilateral lower lobe dependent centrilobular opacities most likely secondary to aspiration or infectious bronchiolitis. [**2102-4-18**] 05:34AM BLOOD WBC-8.5 RBC-3.82* Hgb-12.3* Hct-36.2* MCV-95 MCH-32.3* MCHC-34.1 RDW-16.2* Plt Ct-209 [**2102-3-25**] 10:29PM BLOOD WBC-8.9 RBC-4.33* Hgb-14.0 Hct-40.1 MCV-93 MCH-32.3* MCHC-34.9 RDW-13.8 Plt Ct-185 [**2102-4-18**] 05:34AM BLOOD Glucose-152* UreaN-28* Creat-0.7 Na-137 K-3.7 Cl-98 HCO3-32 AnGap-11 [**2102-3-25**] 10:29PM BLOOD Glucose-175* UreaN-26* Creat-1.1 Na-130* K-4.4 Cl-92* HCO3-29 AnGap-13 [**2102-4-10**] 04:46AM BLOOD ALT-25 AST-21 LD(LDH)-140 AlkPhos-59 TotBili-0.3 [**2102-4-8**] 03:04AM BLOOD Lipase-57 [**2102-3-30**] 03:05AM BLOOD CK-MB-NotDone cTropnT-0.02* [**2102-3-29**] 08:18PM BLOOD CK-MB-NotDone cTropnT-0.02* [**2102-3-29**] 12:03PM BLOOD CK-MB-NotDone cTropnT-<0.01 [**2102-3-31**] 08:14AM BLOOD TSH-0.13* [**2102-3-31**] 08:14AM BLOOD Free T4-1.4 Brief Hospital Course: A/P: 80 y.o. M with CAD s/p CABG, PVD & COPD who p/w hypercarbic respiratory failure, likely [**2-18**] COPD exacerbation and flu, with hospital stay complicated by DTs and prolonged AMS after being off sedation. . # Hypercarbic respiratory failure: Pt presented with profound acidosis [**2-18**] hypercarbic resp failure and was intubated, found to have influenza complicated by newly diagnosed COPD. CT consistent with emphysema and long standing tobacco abuse make diagnosis very likely in the abscence of PFTs. Pt was extubated after 5 days but required reintubation [**2-18**] recurrent hypercarbic resp failure in setting of significant valium administration and MS depression. Second intubation course was prolonged due to depressed MS and likely delayed clearance of benzodiazpines. Pulm status has been stable since extubation on standing nebs, guaifenesin & pulm toilet. Pt has been afebrile, sating well on RA and secretions have decreased with mobilization. Repeat Chest CT was performed to evaluate for metastatic disease from left frontal osteohemangioma. CT reported 2 X 3mm pulm nodules that will require a follow up CT in 6mths but were thought to be likely benign. Centrilobar opacities likely c/w aspiration that have been clinically silent and may be residual from repeat intubations. Pt will need to complete last three days of Prednisone taper, Albuterol & Atrovent nebs & Guaifenesin TID. . # Altered Mental Status: Pt was initially treated with valium due to possible DTs, then required re-intubation for hypercarbic resp failure. Pt had a prolonged 2nd intubation due to sedation that responded to flumazenil (likely benzo induced MS changes). Pt was extubated on [**4-12**] and is currently alert & responding to commands but still disoriented, no focal deficits on neuro exam, though diffusely weak & deconditioned. Etiology of prolonged MS changes thought due to prolong intubation and ICU stay. Per neuro surgery, it is very unlikely that osteohemangioma mass is contributing to MS. Steroids could also be contributing to MS. Please continue with aggressive rehab. . # New onset Afib: Etiology unclear, TSH was mildly decreased but T4 was WNL. There was initial problems with HR control in the ICU, however, HR has been well controlled in 80-90s on Metoprolol with can be increased prn. Pt has a CHADS score of 2 and will need to discuss the risks/benefits of initiating anti-coagulation as an outpt. However, due to his recent h/o GI bleed, decision was made not to anti-coagulate him while in house. Pt was recently changed to Metoprolol 100mg [**Hospital1 **] & was continued on ASA 325 & Plavix 75mg. Recommend f/u thyroid function tests as outpt. . # Scull tumor: Neuro surgery was consulted for a CT read of invasive osteohemangioma. Per neuro, this was not likely contributing to any MS changes but recommended CT chest for staging which showed two different 3mm pulm nodules, unlikely to be metastatic, will need f/u CT in 6mths. . # CAD: Pt s/p CABG in [**2082**] and denied any CP throughout admission. Pt was ruled out for MI on admission and was continued on ASA, Plavix, Metoprolol, Pravastatin. Pt was switched from Captopril to Lisinopril 10mg once daily. . # PVD: Pt is s/p mult peripheral vasc interventions, denied any lower extremity pain thoughout admission, lower extremities warm & PT pulses palpable bilaterally. Pt should continue ASA & plavix. . # FEN: Pt had doboff placed on [**2102-4-12**] and has been managed with pulm nutren tube feeds. Speech & swallow recommended continuing TF for now & advancing a pureed diet with nectar thickened, strict aspiration precautions and 100% monitoring with feeds. . # Prophylaxis: Heparin sc, bowel regimen & protonix Medications on Admission: Clopidogrel 75 mg PO DAILY Aspirin 325 mg PO DAILY Atenolol 25 mg PO DAILY Lisinopril 40 mg PO once a day. Pravastatin 40 mg PO once a day. Norvasc 10 mg PO once a day. Viagra Discharge Medications: 1. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection TID (3 times a day). 4. Pravastatin 10 mg Tablet Sig: Four (4) Tablet PO DAILY (Daily). 5. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed. 6. Insulin Regular Human 100 unit/mL Solution Sig: One (1) Injection ASDIR (AS DIRECTED). 7. Lactulose 10 gram/15 mL Syrup Sig: Thirty (30) ML PO Q8H (every 8 hours) as needed. 8. Albuterol Sulfate 2.5 mg/3 mL Solution for Nebulization Sig: One (1) Inhalation Q4H (every 4 hours) as needed for shortness of breath or wheezing. 9. Ipratropium Bromide 0.02 % Solution Sig: One (1) Inhalation Q6H (every 6 hours). 10. Prednisone 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily) for 3 days. 11. Guaifenesin 100 mg/5 mL Syrup Sig: 5-10 MLs PO TID (3 times a day) as needed for cough. 12. Metoprolol Tartrate 100 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 13. Lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 14. 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: [**Hospital1 700**] - [**Location (un) 701**] Discharge Diagnosis: Primary: 1. Influenza B 2. Hypercarbic respiratory failure 3. Atrial fibrillation 4. Osteohemangioma of the skull 5. Hyponatremia 6. Acute renal failure 7. Incidentally noted pulmonary nodules Secondary: 1. Coronary artery disease 2. Peripheral vascular disease 3. Chronic obstructive pulmonary disease Discharge Condition: Fair Discharge Instructions: You were admitted with influenza & COPD exacerbation. You were intubated and required an ICU stay for respiratory failure and mental status changes. You were noted to develop an arrythmia called Atrial Fibrillation, this has been rate controlled with medications. You will need to discuss long term plans regarding anti-coagulation for A.Fib with your PCP and family. You will likely require a long rehabilitation stay. Upon discharge from rehab, it is important that you call Dr. [**Last Name (STitle) **] to set up a follow up appointment. You will need to obtain a follow up chest CT scan to evaluate incidentally noted nodules in your chest. This scan should be done 3-6 months from now. We would also recommend follow up thyroid function tests as outpt. Followup Instructions: Please follow-up with Dr. [**Last Name (STitle) **] at [**Telephone/Fax (1) 10688**] following your rehabilitation. Please discuss with your primary care physician to obtain [**Name Initial (PRE) **] follow up chest CT scan in [**3-23**] months to evaluate pulmonary nodules. You should discuss the Atrial Fibrillation with your PCP and discuss the risks/benefits of anticoagulation. ICD9 Codes: 2762, 5849, 5180, 4019, 412, 3051
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Medical Text: Admission Date: [**2159-7-27**] Discharge Date: [**2159-8-17**] Date of Birth: [**2119-9-15**] Sex: F Service: SURGERY Allergies: Vasotec / Metformin / Lactose Attending:[**First Name3 (LF) 301**] Chief Complaint: 39 yo female who was sent home on [**2159-7-25**] with TPN/picc now presenting with temp up to 103. Major Surgical or Invasive Procedure: PICC placement History of Present Illness: The patient is a 39F well-known to the Bariatric Surgery service, who is s/p laparoscopic Roux-en-Y gastric bypass c/b intra-abdominal hemorrhage requiring exploratory laparotomy with omentectomy; also c/b a fall, which possibly contributed to a left brachial plexus injury. She was readmitted on [**5-20**] for failure to thrive and wound infection, and then subsequently on [**6-1**] for wound care and pain control; she was discharged on [**6-6**] with wound VAC. On [**6-11**] she began to have nausea and vomiting and was subsequently admitted on [**6-14**]. She had an EGD on [**6-15**], which revealed a benign 8mm stricture at the G-J anastomosis, which was dilated to 13.5mm. Her VAC dressings were changed to wet-to-dry; she was discharged on [**6-20**]. The following say she was readmitted for nausea/vomiting/dizzinness. On [**6-22**], she had an EGD which again showed an 8mm benign stricture, which was dilated to 13.5mm. She progressed well and tolerated a stage 3 diet at the time of her last discharge on [**7-12**]. She was instructed to drink only Isopure until follow up. Discharged on [**7-26**], readmitted on [**7-27**] with presumed line infection. Despite having obstructive sleep apnea, and recommendations for CPAP she refused. Past Medical History: Nonalcoholic steatohepatitis, Insulin dependent DM: Questionable Type I or Type II, Diabetitic nephropathy, HTN, Sleep Apnea, GERD, Psoriasis, Morbid obesity, h/o VRE urinary tract infection, brachial plexus injury s/p fall [**5-10**] Social History: Patient lives at home with her parents, husband, and two children (age 4 and 1). Patient is a house wife, and her husband is a waitor at a chinese restaurant. Patient denies tobacco, alcohol or drug use. Family History: Family history of diabetes: father, paternal grandmother and grandfather. Maternal grandmother with [**Name2 (NI) 499**] cancer. Physical Exam: 103.8 146 104/82 20 97% RA Mild distress, feel hot AAOx3 Tachy reg CTAB soft NT/ND, small central wound opening - no signs of cellulitis around wound no edema, extrem warm, no calf pain mild erythema at PICC site Pertinent Results: [**2159-7-27**] 10:41PM TYPE-ART PO2-86 PCO2-36 PH-7.41 TOTAL CO2-24 BASE XS-0 [**2159-7-27**] 08:43PM LACTATE-1.9 [**2159-7-27**] 08:33PM GLUCOSE-272* UREA N-8 CREAT-0.5 SODIUM-142 POTASSIUM-3.8 CHLORIDE-112* TOTAL CO2-22 ANION GAP-12 [**2159-7-27**] 08:33PM CALCIUM-8.1* PHOSPHATE-2.8 MAGNESIUM-1.5* [**2159-7-27**] 08:33PM WBC-12.8* RBC-3.68* HGB-10.7* HCT-32.3* MCV-88 MCH-29.1 MCHC-33.1 RDW-14.5 [**2159-7-27**] 08:33PM NEUTS-88.5* LYMPHS-7.9* MONOS-3.0 EOS-0.5 BASOS-0 [**2159-7-27**] 08:33PM PLT COUNT-237 [**2159-7-27**] 05:22PM COMMENTS-GREEN TOP [**2159-7-27**] 05:22PM LACTATE-1.3 [**2159-7-27**] 05:20PM CALCIUM-7.2* PHOSPHATE-2.6* MAGNESIUM-1.3* [**2159-7-27**] 05:20PM CORTISOL-25.3* [**2159-7-27**] 05:20PM CRP-28.2* [**2159-7-27**] 02:35PM TYPE-[**Last Name (un) **] PO2-46* PCO2-36 PH-7.44 TOTAL CO2-25 BASE XS-0 [**2159-7-27**] 02:35PM GLUCOSE-267* LACTATE-1.9 NA+-136 K+-3.8 CL--99* TCO2-24 [**2159-7-27**] 02:35PM freeCa-1.09* [**2159-7-27**] 02:30PM GLUCOSE-281* UREA N-15 CREAT-0.6 SODIUM-134 POTASSIUM-3.9 CHLORIDE-100 TOTAL CO2-26 ANION GAP-12 [**2159-7-27**] 02:30PM ALT(SGPT)-26 AST(SGOT)-34 CK(CPK)-36 ALK PHOS-69 TOT BILI-0.5 [**2159-7-27**] 02:30PM LIPASE-35 [**2159-7-27**] 02:30PM CK-MB-NotDone cTropnT-<0.01 [**2159-7-27**] 02:30PM ALBUMIN-3.9 CALCIUM-9.1 PHOSPHATE-1.6*# MAGNESIUM-1.6 [**2159-7-27**] 02:30PM WBC-14.2*# RBC-4.26 HGB-12.2 HCT-36.4 MCV-86 MCH-28.7 MCHC-33.6 RDW-15.4 [**2159-7-27**] 02:30PM NEUTS-89.5* LYMPHS-5.4* MONOS-3.9 EOS-0.9 BASOS-0.2 [**2159-7-27**] 02:30PM PLT COUNT-278 [**2159-7-27**] 02:30PM PT-14.5* PTT-33.0 INR(PT)-1.3* [**2159-7-27**] 02:30PM URINE COLOR-Amber APPEAR-Clear SP [**Last Name (un) 155**]-1.025 [**2159-7-27**] 02:30PM URINE BLOOD-NEG NITRITE-NEG PROTEIN-TR GLUCOSE-100 KETONE-TR BILIRUBIN-SM UROBILNGN-4* PH-5.0 LEUK-TR [**2159-7-27**] 02:30PM URINE RBC-0-2 WBC-[**4-5**] BACTERIA-OCC YEAST-NONE EPI-0-2 [**2159-7-27**] 02:30PM URINE MUCOUS-MOD Brief Hospital Course: The patient is a 39F well-known to the Bariatric Surgery service, who is s/p laparoscopic Roux-en-Y gastric bypass c/b intra-abdominal hemorrhage requiring exploratory laparotomy with omentectomy; also c/b a fall, which possibly contributed to a left brachial plexus injury. She was readmitted on [**5-20**] for failure to thrive and wound infection, and then subsequently on [**6-1**] for wound care and pain control; she was discharged on [**6-6**] with wound VAC. On [**6-11**] she began to have nausea and vomiting and was subsequently admitted on [**6-14**]. She had an EGD on [**6-15**], which revealed a benign 8mm stricture at the G-J anastomosis, which was dilated to 13.5mm. Her VAC dressings were changed to wet-to-dry; she was discharged on [**6-20**]. The following say she was readmitted for nausea/vomiting/dizzinness. On [**6-22**], she had an EGD which again showed an 8mm benign stricture, which was dilated to 13.5mm. She progressed well and tolerated a stage 3 diet at the time of her last discharge on [**7-12**]. She was instructed to drink only Isopure until follow up. Discharged on [**7-26**], readmitted on [**7-27**] with presumed line infection. Despite having obstructive sleep apnea, and recommendations for CPAP she refused. [**8-1**] Went for EMG, while she was gone the PICC nurse came by, thus, TPN tonight will go through the central line and the PICC will be placed tomorrow. [**8-1**] [**Month/Day (4) 878**] consult: Please switch to long acting medication such as MS Contin or Oxycontin. Give standing and not PRN meds. We realize she came in intoxicated on narcotics, but this may be in part due to increased absorption of the Fentanyl patch with fever. If OK from cardiac perspective, consider amitriptyline (25 mg qHS, to go up to 50 qHS if tolerated. This may worsen her sleep apnea, but so do all the sedating drugs.). [**8-2**] D/c central line, PICC in SVC, no pneumothorax, had family meeting where the patient and family agreed to go to a rehad facility as long as it is clean and as long as the mother is allowed to view it beforehand. [**8-3**] Spoke to discharge planning, all the rehab offices are closed for the weekend. VASC C/S RECS [**8-4**]: d/c PICC, start lovenox (1mg/kg) [**Hospital1 **], bridge to coumadin x3mo, re-U/S in 1 wk and again in 3 mo [**8-6**] Has been having fevers into the 102 range for the past day [**2159-8-8**]: - We await the results of the B12, EBV, and CMV serologies - Please minimize medications - Please initiate neutropenic precautions including a neutropenic diet if ANC < 500 - Do not start G-CSF or GM-CSF - Please check CBC with differential daily - Please check ANC daily - Please check folic acid and B12 levels - We strongly suggest finding an alternative to pip/tazo CT neck: no sign of retropharyngeal or any other abscess CT chest/abd/pelvis: minimal to no change from past CTs; post-surgical changes in anatomy, no source of fevers or infection found [**8-9**] add cipro flagyl, has been without fever for 24 hours TTE showed: Compared with the report of the prior study (images unavailable for review) of [**2152-4-10**], the findings are similar. No vegetations identified but the images are suboptimal. Positive EBV. RESPIRATORY CULTURE (Final [**2159-8-9**]): sputum culture MODERATE GROWTH OROPHARYNGEAL FLORA. YEAST. MODERATE GROWTH. GRAM NEGATIVE ROD(S). SPARSE GROWTH. urine negative ID recs: - d/c vanc, cont fluconazole and zosyn, start daptomycin, d/c all unnecessary meds, check monospot, CMV IgG/IgM, check [**Last Name (LF) **], [**First Name3 (LF) **] diff, LDH, haptoglobin, and fibrinogen, get neck/Abd CT Abx (zosyn ([**8-7**]), fluconazole ([**8-7**]), dapto([**8-8**])) d/c'd [**2159-8-10**] [**8-15**] No fevers for 2 days now, spoke to radiology about WBC scan, they will rescan her tomorrow about questionable uptake in the area of the symphysis pubis. [**8-16**] US results: No evidence of right upper extremity deep venous thrombosis. The previous thrombus has resolved. [**8-17**] Pt is feeling well and has been afebrile for the last 72 hours Medications on Admission: Multivitamins desonide cozaar fentanyl patch regular insulin lorazepam Actos oxycodone simvastatin ursodiol Vit B12 omeprazole Discharge Medications: 1. Oxycodone 5 mg/5 mL Solution [**Month/Year (2) **]: [**2-2**] PO every 4-6 hours as needed for pain. Disp:*500 mL* Refills:*0* 2. Multivitamins Oral 3. Thiamine HCl 100 mg Tablet [**Month/Day (2) **]: One (1) Tablet PO DAILY (Daily). 1. Lovenox 80 mg/0.8 mL Syringe [**Month/Day (2) **]: One (1) syrine Subcutaneous twice a day: Please continue for 2 more weeks. Disp:*28 syringes* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital3 **] VNA Discharge Diagnosis: Fever of unknown origin and dehydration Discharge Condition: stable Discharge Instructions: You are being discharged on medications to treat the pain from your operation. These medications will make you drowsy and impair your ability to drive a motor vehicle or operate machinery safely. You MUST refrain from such activities while taking these medications. Please call your doctor or return to the emergency room if you have any of the following: * You experience new chest pain, pressure, squeezing or tightness. * New or worsening cough or wheezing. * If you are vomiting and cannot keep in fluids or your medications. * You are getting dehydrated due to continued vomiting, diarrhea or other reasons. Signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * You see blood or dark/black material when you vomit or have a bowel movement. * You have shaking chills, or a fever greater than 101.5 (F) degrees or 38(C) degrees. * Any serious change in your symptoms, or any new symptoms that concern you. * Please resume all regular home medications and take any new meds as ordered. Activity: No heavy lifting of items [**11-15**] pounds for 6 weeks. You may resume moderate exercise at your discretion, no abdominal exercises. Followup Instructions: [**Month (only) **] nutritionist [**2159-8-29**] at 2 pm [**Hospital Ward Name 23**] 3 Dr. [**Last Name (STitle) **] [**2159-8-29**] at 2:30 pm on [**Hospital Ward Name 23**] 3 Completed by:[**2159-8-17**] ICD9 Codes: 7907, 5859, 3572
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Medical Text: Admission Date: [**2143-2-3**] Discharge Date: [**2143-2-6**] Service: Intensive Care Unit CHIEF COMPLAINT: Bradycardia and hypotension. HISTORY OF PRESENT ILLNESS: This is a [**Age over 90 **]-year-old female who has a history of Crohn's disease, dermatitis, and gastroesophageal reflux disease with a history of a motor vehicle accident approximately two months ago where she sustained a left femur fracture which was compounded and open fracture who had complications of that motor vehicle accident including renal insufficiency. The patient also suffered pelvic fractures at that time. The patient had her left femur fracture with intramedullary nail on the right. The [**Hospital 228**] hospital course at that time was also complicated by enterococcus and pseudomonas wound infection and had been treated with ceftazidime and vancomycin. The patient was discharged to [**Hospital **] Rehabilitation on [**2143-1-23**] for further rehabilitation. At the time of her discharge from the [**Hospital1 190**] her creatinine at that time was 0.8, and according to outside hospital records she had a decrease in mental status and increasing creatinine and blood urea nitrogen, at which time the [**Hospital **] Rehabilitation had decided to initiate hemodialysis at their facility. The patient had a peripherally inserted central catheter line placed and plan was for hemodialysis on the day of admission of [**2143-2-3**]. However, prior to hemodialysis the patient became hypotensive and was taken to the Intensive Care Unit where she was given fluids, and her blood pressure returned. However, subsequent to her hypotension the patient developed bradycardia at a rate of 30 and was given 0.5 mg of Atropine and transferred to the [**Hospital1 188**] for further management. At that time the patient was noted to have a temperature of 90 degrees, and the patient was intubated for airway protection. The patient was brought to the Emergency Room and was found to have a right main stem intubation, and the ETT was repositioned. Outside hospital notes on further review revealed that the patient had been having decreased urine output but normal temperatures until [**2-1**]. A review of systems at that time was unobtainable. Outside hospital laboratories revealed a creatinine of 1.9 on [**1-29**] and a creatinine of 2.2 on [**2-2**]. PAST MEDICAL HISTORY: (Her past medical history includes) 1. A motor vehicle accident. 2. Dermatitis. 3. Crohn's disease. 4. Gastroesophageal reflux disease. MEDICATIONS ON ADMISSION: Her medications on arrival were sodium, calcium carbonate, Protonix, total parenteral nutrition, Tylenol, multivitamin, and levothyroxine 0.025 mg. ALLERGIES: Her allergies included MORPHINE. SOCIAL HISTORY: She denies alcohol and denies tobacco. PHYSICAL EXAMINATION ON PRESENTATION: On examination to the Intensive Care Unit the temperature was 32 degrees centigrade, her blood pressure was 77/53. Her heart rate was 77, and her SaO2 was 96%. In general, she was comfortable-appearing. Her pupils were fixed and pinpoint. Her lungs had diffuse rhonchi and wheezes. Her heart had distant heart sounds. Her extremities showed 2+ pedal edema. She had areas of open wounds on her left upper leg with granulation. She also had an open wound on her left knee. Her stool was green, guaiac-negative. Her neck was supple. She withdrew all four extremities to pain. LABORATORY DATA ON PRESENTATION: Her laboratories and other data included a white blood cell count of 20, a hematocrit of 23.7, and platelets of 41. Her white blood cell count at the outside hospital was 32, hematocrit of 30.7, and platelets of 62. Her sodium was 138, her potassium was 3.3, her chloride was 114, her bicarbonate was 18, her blood urea nitrogen was 60, and her creatinine was 1.5. Her calcium was 6.5, and her total bilirubin was 1.4. RADIOLOGY/IMAGING: Chest x-ray showed a left lower lobe opacity with right pleural thickening and a right-sided effusion. Her electrocardiogram was regular rhythm and sinus tachycardia. HOSPITAL COURSE: This is a [**Age over 90 **]-year-old female with renal failure, hypothermia, leukopenia, and hypotension with a recent episode of bradycardia. 1. HYPOTHERMIA: Differential at that time included infection, renal failure, hypothyroidism, hypoadrenalism, and given leukopenia and renal failure sepsis was likely the highest on that differential. The patient had pan cultures, was given more intravenous fluids, warm bags to her groin. She was given a warming blanket and given Demerol for rigors. She was given aggressive fluid resuscitation for hypotension and was started on multiple pressors including Levophed and vasopressin. She was continued on her ceftazidime and vancomycin for underlying bacteremia, and a cortisol was checked which was 16. Thyroid-stimulating hormone was found to be 17, and her free T4 was 0.4. 2. RENAL FAILURE: The patient's creatinine remained elevated with a creatinine of 2. Her GFR was estimated to be less than 10. She was given aggressive hydration for her presumed sepsis. Urine electrolytes suggested that her FENa was 1.8, but it was more than likely that she had nephropathy of sepsis. Hemodialysis was not indicated at this time. 3. INFECTIOUS DISEASE: The patient was pan cultured. Her 2/4 bottles grew out yeast which did not appear to be [**Female First Name (un) **] albicans. It was still awaiting further identification. She was started on Diflucan 200 mg intravenously q.d. She was continued on her ceftazidime, levofloxacin, and vancomycin. Her sputum has recently grown out coagulase positive Staphylococcus; identification was still pending at this time. 4. HEMATOLOGY: The patient with a drop in hematocrit to 20, assuming it was a pancytopenia induced by sepsis. The patient also received aggressive hydration and hemodiluting out her blood volume. The patient also had a drop in her platelets, likely due to overwhelming sepsis. Her DIC screen was negative, but she also received a large amount of fluid resuscitation which may also have diluted her platelet count. 5. PULMONARY: The patient was intubated for airway protection. The patient was given Combivent as needed. 6. LINES: The patient had a right internal jugular placed and right peripherally inserted central catheter line from which cultures were sent, and grew 2/4 bottles of fungus. The patient also had a Foley in and a right arterial line. 7. WOUND CARE: The patient had open left femur fracture with an open wound which was colonized with multidrug resistant Pseudomonas. The patient remained on broad spectrum antibiotics including ceftazidime and received wound dressings b.i.d. 8. COMMUNICATION: The patient's case was discussed at length with nephew [**Name (NI) **] [**Name (NI) 98241**]. At that time the decision on admission was made not to have cardiopulmonary resuscitation or defibrillation should she suffer any cardiopulmonary arrest. On [**2-5**] Mr. [**Name14 (STitle) 98241**] and his other family members decided to withdraw all aggressive care. The family was in agreement with this and felt as though this would fulfill the patient's wishes. At that time intravenous fluids, antibiotics, and pressors were removed, and at approximately 12 hours to 15 hours after this decision was made the patient's heart stopped. She did not generate a pressure, and there was no evidence of conduction. Her examination was notable for fixed dilated pupils. There were no heart sounds. She did not withdraw to painful stimuli. The family was alerted of her time of death which was at 1:33 on [**2143-2-6**]. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], M.D. [**MD Number(1) 3851**] Dictated By:[**Name8 (MD) **] MEDQUIST36 D: [**2143-2-6**] 13:35 T: [**2143-2-10**] 12:11 JOB#: [**Job Number 98242**] ICD9 Codes: 0389, 5849
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Medical Text: Admission Date: [**2124-12-4**] Discharge Date: [**2124-12-26**] Date of Birth: [**2062-12-13**] Sex: M Service: MEDICINE Allergies: Heparin Agents Attending:[**First Name3 (LF) 2297**] Chief Complaint: Shortness of Breath Major Surgical or Invasive Procedure: Intubation and Mechanical Ventilation Arterial Line Placement Bronchoscopy History of Present Illness: 61 yo M with hypertension, COPD, alcoholism (unclear if active), possible schizophrenia was admitted overnight through the ED. His ability to relate a consistent hx is currently impaired, but per prior notes, it seems that he was told by his neighbor to come to the hospital as he appeared short of breath. The initial assessment of ED staff was that the pt was massively fluid overloaded in the setting of CHF and non-compliance with lasix. He was treated with Lasix IV 40mg x 2, ASA 325 and nitro, although no chest pain and EKG . Further review of OMR reveals that the pt is no on lasix and has no clinical hx of CHF, last echo in [**2119**] showed preserved LVEF of 55 with only mild Ao dilation. . Initial labs were notable for Na of 116 with K of 6.6 (initial 7.8 was hemolyzed) and CR 2.7; no EKG changes. LFTs elevated AST 120, ALT 50, with bili 4.5, INR 1.6, albumin 2.6. With one dose of kayexalate, potassium has trended down to 5.3. Serial troponins 0.04. Initial CK 700 trending down with minimal MB fraction. . In terms of his mental status, his PCP saw him one month ago at which point he was at baseline A&OX3, independent for all ADLs. MS not in ED not clearly documented. At 8AM this morning, he trigerred for tachypnea with RR close to 30 and worsened MS A&Ox1 only to self. [**Hospital **] transferred to the MICU. On arrival, pt was on 2L and confused/somnolent. His audible wheezing, tachypnea, and hypoxia improved rapidly with albuterol. MS improved slightly when taken off supplemental O2. ABG on room air: 7.4/35/73. ROS: Denies any pain but unable to provide detailed ROS. Past Medical History: 1. Multiple ED admissions for ETOH intoxication 2. HTN. 3. Emphysema. 4. Prostate hyperplasia 5. Nocturnal leg cramps 6. Finger reconstructive surgery 7. HIV? (per OMR note from [**2119**]) no ab tx in system Social History: -Tobacco history: 1ppd x 42 years -ETOH: History of alcohol abuse but he claims he has not had a drink in 2 years -Illicit drugs: Patient denies, admission tox negative Family History: uanble to elicit Physical Exam: General Appearance: Overweight / Obese, total body anasarca Eyes / Conjunctiva: PERRL, 3mm pupils reactive Head, Ears, Nose, Throat: Normocephalic, Poor dentition Lymphatic: Cervical WNL, Supraclavicular WNL, No(t) Cervical adenopathy Cardiovascular: (S1: Normal), (S2: Normal), No(t) S3, No(t) S4, No(t) Rub, (Murmur: No(t) Systolic, No(t) Diastolic) Peripheral Vascular: (Right radial pulse: Present), (Left radial pulse: Present), (Right DP pulse: Present), (Left DP pulse: Present) Respiratory / Chest: (Expansion: Symmetric), (Percussion: No(t) Resonant : , No(t) Hyperresonant: , No(t) Dullness : ), (Breath Sounds: Clear : , Wheezes : greatly improved with albuterol) Abdominal: Soft, Distended, pitting edema over entire abdomen Extremities: Right lower extremity edema: 4+, Left lower extremity edema: 4+, Clubbing Skin: Cool, Rash: LE venous stasis BL Neurologic: No(t) Attentive, No(t) Follows simple commands, Responds to: Not assessed, Oriented (to): ONLY SELF, Movement: Purposeful, Tone: Normal Pertinent Results: [**2124-12-4**] 10:25AM BLOOD WBC-11.4*# RBC-3.27* Hgb-10.7* Hct-32.3* MCV-99*# MCH-32.6* MCHC-33.1 RDW-15.2 Plt Ct-218# [**2124-12-11**] 04:26AM BLOOD WBC-12.4* RBC-2.55* Hgb-9.0* Hct-25.6* MCV-100* MCH-35.1* MCHC-35.0 RDW-16.8* Plt Ct-88* [**2124-12-16**] 03:40PM BLOOD WBC-36.4* RBC-2.91* Hgb-9.8* Hct-29.0* MCV-100* MCH-33.8* MCHC-33.9 RDW-17.7* Plt Ct-45* [**2124-12-26**] 04:00AM BLOOD WBC-16.3* RBC-2.58* Hgb-8.9* Hct-28.0* MCV-109* MCH-34.6* MCHC-31.9 RDW-21.0* Plt Ct-33* [**2124-12-4**] 10:25AM BLOOD PT-18.0* PTT-35.4* INR(PT)-1.6* [**2124-12-10**] 01:02PM BLOOD PT-26.0* PTT-54.5* INR(PT)-2.5* [**2124-12-21**] 04:33AM BLOOD PT-39.5* PTT-56.8* INR(PT)-4.1* [**2124-12-22**] 10:16AM BLOOD PT-64.8* PTT-81.0* INR(PT)-7.4* [**2124-12-22**] 06:40PM BLOOD PT-111.4* PTT-105.1* INR(PT)-14.2* [**2124-12-23**] 03:52PM BLOOD PT-105.0* PTT-96.5* INR(PT)-13.2* [**2124-12-25**] 03:52AM BLOOD PT-150* PTT-114.7* INR(PT)->20.2 [**2124-12-25**] 10:45AM BLOOD PT-150* PTT-150* INR(PT)->20.2* [**2124-12-25**] 04:22PM BLOOD PT-150* PTT-150* INR(PT)->20.2 [**2124-12-26**] 04:00AM BLOOD PT-150* PTT-127.5* INR(PT)-27.4* [**2124-12-4**] 10:25AM BLOOD Glucose-72 UreaN-66* Creat-2.8*# Na-116* K-7.8* Cl-87* HCO3-24 AnGap-13 [**2124-12-18**] 04:24AM BLOOD Glucose-112* UreaN-83* Creat-6.4*# Na-138 K-3.3 Cl-99 HCO3-23 AnGap-19 [**2124-12-26**] 04:00AM BLOOD Glucose-80 UreaN-8 Creat-0.9 Na-130* K-3.7 Cl-97 HCO3-20* AnGap-17 [**2124-12-26**] 09:41AM BLOOD Glucose-48* Na-131* K-4.1 Cl-98 HCO3-17* AnGap-20 [**2124-12-4**] 10:25AM BLOOD CK(CPK)-693* [**2124-12-6**] 06:29AM BLOOD ALT-35 AST-71* LD(LDH)-246 CK(CPK)-225* AlkPhos-86 TotBili-4.0* [**2124-12-15**] 04:27AM BLOOD ALT-84* AST-230* AlkPhos-87 TotBili-8.4* [**2124-12-17**] 04:21AM BLOOD ALT-589* AST-1196* LD(LDH)-506* AlkPhos-151* TotBili-9.8* [**2124-12-20**] 06:21PM BLOOD ALT-348* AST-387* CK(CPK)-14* AlkPhos-171* TotBili-14.9* [**2124-12-22**] 05:36AM BLOOD ALT-271* AST-344* AlkPhos-162* TotBili-14.6* [**2124-12-23**] 12:30AM BLOOD ALT-1307* AST-5023* LD(LDH)-2880* AlkPhos-246* TotBili-13.3* [**2124-12-23**] 03:52PM BLOOD ALT-2172* AST-7388* LD(LDH)-2712* CK(CPK)-45 AlkPhos-412* TotBili-13.4* [**2124-12-24**] 05:11AM BLOOD ALT-2203* AST-6404* AlkPhos-492* TotBili-14.6* [**2124-12-25**] 04:22PM BLOOD ALT-1549* AST-2710* LD(LDH)-878* AlkPhos-564* TotBili-16.1* [**2124-12-26**] 04:00AM BLOOD ALT-1325* AST-[**2071**]* LD(LDH)-824* AlkPhos-589* TotBili-16.8* [**2124-12-4**] 10:25AM BLOOD ASA-NEG Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG [**2124-12-4**] 10:00PM BLOOD Ethanol-NEG [**2124-12-8**] 05:22AM BLOOD C3-19* C4-6* [**2124-12-20**] 05:26AM BLOOD IgG-2123* [**2124-12-5**] 06:08PM BLOOD [**Doctor First Name **]-NEGATIVE [**2124-12-5**] 06:08PM BLOOD AMA-NEGATIVE Smooth-POSITIVE * [**2124-12-8**] 04:16PM BLOOD ANCA-NEGATIVE B [**2124-12-23**] 03:52PM BLOOD Smooth-POSITIVE A [**2124-12-5**] 06:08PM BLOOD HBsAg-NEGATIVE HBsAb-NEGATIVE HAV Ab-POSITIVE IgM HBc-NEGATIVE [**2124-12-12**] 02:34PM BLOOD Cortsol-12.1 [**2124-12-12**] 03:15PM BLOOD Cortsol-17.8 [**2124-12-5**] 06:08PM BLOOD calTIBC-163* Hapto-<20* Ferritn-1368* TRF-125* [**2124-12-5**] 10:29AM BLOOD Lactate-1.7 K-5.0 [**2124-12-20**] 11:10AM BLOOD Lactate-2.3* [**2124-12-21**] 04:58AM BLOOD Lactate-3.0* [**2124-12-23**] 04:14PM BLOOD Lactate-5.9* [**2124-12-23**] 11:27PM BLOOD Lactate-7.7* [**2124-12-24**] 04:11PM BLOOD Lactate-6.1* [**2124-12-25**] 04:01AM BLOOD Lactate-7.2* [**2124-12-26**] 04:07AM BLOOD Lactate-7.6* IMAGING: [**2124-12-5**]: PORTABLE SEMI-UPRIGHT CHEST RADIOGRAPH: Low lung volumes and body habitus limits the film. Heart size is probably top normal. There is right hilar fullness and a prominent azygous vein suggested volume overload. Retrocardiac opacification may be dud to suboptimal film. No pneumothorax. Recommend convention PA and lateral with encouraged increased respiratory effort. [**2124-12-5**]: CT Head: IMPRESSION: Limited study secondary to patient motion without evidence of gross acute intracranial abnormality. Global diffuse atrophy [**2124-12-5**]: CT Chest Abd/Pelvis: IMPRESSION: Markedly limited examination secondary to patient body habitus and lack of intravenous contrast. 1. Nodular liver suggestive of cirrhosis. Splenomegaly, likely indicative of portal hypertension. 2. Mild intra-abdominal ascites. 3. Mild centrilobular emphysema. 4. Cholelithiasis. [**2124-12-11**]: CT Chest/Abd/Pelvis: IMPRESSION: 1. Interval development of bilateral lower lobe consolidations with air bronchograms concerning for aspiration pneumonia. Diffuse ground glass opacity throughout both lungs is also identified and may represent superimposed pulmonary edema. 2. Interval development of mediastinal and axillary lymph nodes which may be reactive. 3. Cirrhotic-appearing liver with splenomegaly, unchanged. 4. Interval decrease in intra-abdominal ascites. 5. Cholelithiasis with gallbladder distention. 6. Emphysematous changes. [**2124-12-20**]: Liver U/S: IMPRESSION: No evidence of acute gallbladder process. Gallstones again noted. [**2124-12-21**]: CT Chest/Abd/Pelvis: IMPRESSION: 1. Interval improvement of bilateral lower lobe consolidations, with remaining basilar consolidation and small bilateral pleural effusions. 2. Cirrhotic-appearing liver with splenomegaly, unchanged. 3. Interval increase in intra-abdominal ascites. 4. Cholelithiasis with gallbladder distention. 5. Mild fat stranding around the pancreas. Suboptimal evaluation due to lack of IV contrast. 6. Emphysema. 7. Low attenuation right renal lesion, most consistent with a cyst. Pathology: Liver Biopsy [**2124-12-21**]: Liver, transjugular needle core biopsy: Markedly fragmented biopsy demonstrating: 1. Predominantly fragments of broad, fibrous septa with mild, mixed inflammation and focal cholangiolar proliferation, consistent with established cirrhosis (confirmed by trichrome stain). 2. Scant, nodular foci of hepatic lobular parenchyma (totaling only 20% of the total biopsy volume), with focal microvesicular steatosis and moderate canalicular cholestasis. 3. No central veins or native portal tracts present for evaluation in this limited sample. 4. Iron stain shows moderate iron deposition within hepatocytes. Note: The biopsy consists almost exclusively of fibrous tissue, consistent with established cirrhosis. The scant lobular parenchyma present shows only minimal, non-specific changes of end stage liver disease. Dr. [**First Name (STitle) 4370**] [**Name (STitle) **] was notified of the findings on [**2124-12-22**]. Brief Hospital Course: This is a 61 yom with hx of HTN and COPD who initially presented to the ED c/o SOB and noted to be massively fluid overloaded, in ARF with hyponatremia/hyperkalemia, with transaminitis and synthetic dysfunction who was then admitted to the MICU for altered mental status and eventually intubated for respiratory distress and fluid overload. # Acute on Chronic Liver Failure: Mr. [**Known lastname **] presented with total body fluid overload. He had a transaminitis which improved and worsened several times throughout his hospital stay. He had synthetic dysfunction of the liver manifested by thrombocytopenia and coagulopathy. All of these findings were consistent with cirrhosis. A CT scan on admission confirmed a nodular liver. He slowly developed worsening liver failure during his hospitalization. A liver biopsy was done on [**2124-12-21**] which confirmed cirrhosis. Hepatitis serologies were sent and were negative for Hep B and Hep C. Hep A antibody was positive. Hepatology was consulted and cirrhosis was thought to be [**3-6**] history of EtOH abuse. Tranaminitis in the hospital was unclear but possibly [**3-6**] shock liver in the setting of hypotension. INR continued to rise and peaked to a level of 27 today. Family was involved and a family meeting was held today given his worsensing liver failure and shock which was requiring 4 pressors. He was made CMO by his father, [**Name (NI) **] [**Name (NI) **], and the patient passed away peacefully today at 225pm. # Hypoxic respiratory failure/Pneumonia: Mr. [**Known lastname **] was initially intubated for respiraroty distress in the setting of hypoxemia [**3-6**] fluid overload. He was treated with diuretics with minimal urine output. Renal was consulted and he was diagnosed with Hepatorenal syndrome and required dialysis for fluid removal. He was placed on HD with good removal of fluid intitially. WBC then began to elevate and CXR was consistent with Pneumonia so he was started on Vanco/Zosyn/Levo for treament of hospital acquired pneumonia. He completed a 7 day course for his PNA. He self extubated while in the MICU and was then reintubated for respiratory distress. He then developed VAP while intubated and was treated with Vanco/Zosyn/Cipro. # Shock: Patient had acute decompensated liver failure along with pneumonia which were likely contributing to his shock. Broead infectious workup was done and workup remained negative while in the hospital. He was treated with Vanco/Zosyn/Cipro for treatment of HAP. Flagyl was started out of concern for c.diff although c.diff cultures remained negative. # Altered mental status: Thought to be secondary to hepatic encephalopathy. Initially improved with lactulose. Patient was treated with lactulose and rifaximin throughout his stay. # Acute Renal Failure: Thought to be [**3-6**] hepatorenal syndrome. He developed anuria while in the hospital. Given his fluid overload and pulmonary edema requiring intubation, renal was consulted and a dialysis line was placed. He was placed on HD for removal of fluid. This was changed to CVVH when he became hypotensive to allow for gentle fluid removal. # Hyponatremia: Thought to be [**3-6**] fluid overload in the setting of cirrhosis # Coagulopathy: Likley [**3-6**] cirrhosis and liver failure Medications on Admission: 1. COMBIVENT INHALER 2. CYCLOBENZAPRINE 10 MG TABLET 3. DOXAZOSIN MESYLATE 8 MG TAB 4. FINASTERIDE 5 MG TABLET 5. FLUCONAZOLE 200 MG TABLET 6. GABAPENTIN 100 MG CAPSULE 7. HYDROCHLOROTHIAZIDE 25 MG TAB 8. KETOCONAZOLE 2% CREAM 9. LACLOTION 12% LOTION 10. NYSTATIN 100,000 UNIT/GM POWD 11. UREA 40% CREAM Discharge Medications: Expired Discharge Disposition: Expired Discharge Diagnosis: Expired Discharge Condition: Expired Discharge Instructions: Expired Followup Instructions: Expired ICD9 Codes: 5845, 2761, 2851, 5990, 5789, 5180, 4275, 4019, 3051, 2767
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Medical Text: Admission Date: [**2181-12-20**] Discharge Date: [**2181-12-29**] Date of Birth: [**2130-2-2**] Sex: M Service: CARDIOTHORACIC HISTORY OF PRESENT ILLNESS: The patient is a 51 year-old male with a chief complaint of diffuse aches and stabbing pain across the chest radiating to back down the right arm. The patient also had palpitations, nausea, and diaphoresis. The patient had these similar symptoms one to two weeks prior to presentation, but did not seek medical attention at that time. At the outside hospital the patient had a catheterization, which revealed significant left anterior descending stenosis. It was felt that stenting of this lesion was not possible. The patient was transferred to the [**Hospital1 1444**]. PAST MEDICAL HISTORY: Hypercholesterolemia, hypertension. MEDICATIONS: Vitamin E. ALLERGIES: No known drug allergies. SOCIAL HISTORY: Tobacco one pack per day for forty years. PHYSICAL EXAMINATION: Temperature 97.1. Heart rate 72. Blood pressure 111/33. Respiratory rate 16. 98% on room air. General no acute distress. HEENT sclera anicteric. Cor regular rate and rhythm. No murmurs. Lungs clear to auscultation bilaterally. Abdomen soft, nontender, nondistended. Extremities edema. LABORATORY: From outside hospital, white blood cell count 13.7, hematocrit 46.4, platelets 237, CK 532, MB 65, MB index 8.1, troponin 81. Electrocardiogram ST elevations with T wave inversions i V1 through V4. HOSPITAL COURSE: It was decided that the patient would have a coronary artery bypass graft done at the [**Hospital1 346**]. The patient was brought to the Operating Room on [**2181-12-21**] where he had a coronary artery bypass graft times two with a left internal mammary coronary artery to the left anterior descending coronary artery and saphenous vein graft to diagonal. Postoperatively, the patient was brought to the Intensive Care Unit. There he was rapidly extubated. By postoperative day one a neo-synephrine drip was appropriate weaned. The patient was deemed stable and transferred to the floor on postoperative day one. By postoperative two due to minimal output of the chest tubes, the chest tubes were removed. A chest x-ray revealed no pneumothorax and no consolidations or effusions. The patient had a chest CT for question hilar enlargement seen on a prior chest x-ray. An official [**Location (un) 1131**] on this film revealed no hilar pathology with no enlarged mediastinal lymph nodes. By postoperative day three the patient's pacing wires were removed. Low dose Coumadin was started per the patient's cardiologist for question inferior wall hypokinesis. On postoperative day four small amounts of drainage was seen from the sternal incision at the inferior aspect. The patient was started on Vancomycin and daily white blood cell counts were checked. Drains persisted for a few days until [**12-29**] the drain was stopped. At that time Vancomycin was discontinued. It was decided at that point that the patient should be sent home on oral antibiotics. CONDITION ON DISCHARGE: Stable. DISCHARGE LABORATORIES: Sodium 134, potassium 4.1, chloride 98, bicarbonate 31, BUN 21, creatinine .8, glucose 92, white blood cell count 11.1, hematocrit 37.4, platelet 503. Multiple swabs from the sternal wound revealed growth of no organisms. DISCHARGE MEDICATIONS: Lopressor 75 mg po b.i.d., Coumadin 2 mg q.d., Keflex 500 mg q.i.d. times seven days, aspirin 325 mg, Percocet one to two tabs po q 4 to 6 hours prn, Colace 100 mg po b.i.d. DISCHARGE STATUS: The patient will go home. The patient will follow up with cardiologist for INR checks in one week. The patient will again follow up with the cardiologist in three weeks. He will follow up with Dr. [**Last Name (STitle) **] in four weeks. DISCHARGE DIAGNOSES: Status post coronary artery bypass graft times two. [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern1) **], M.D. [**MD Number(1) 3113**] Dictated By:[**Name8 (MD) 1308**] MEDQUIST36 D: [**2181-12-31**] 10:58 T: [**2181-12-31**] 11:12 JOB#: [**Job Number 38459**] ICD9 Codes: 2720, 4019
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Medical Text: Admission Date: [**2152-2-12**] Discharge Date: [**2152-3-21**] Date of Birth: [**2110-11-20**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 759**] Chief Complaint: Respiratory failure, hepatitis Major Surgical or Invasive Procedure: Central Venous Line Placement Arterial Line Placement Intubation Mechanical Ventilation History of Present Illness: Patient intubated & unable to answer questions. History obtained from medical chart and patient's mother, [**Name (NI) 1258**] [**Name (NI) 5261**]. Ms. [**Known lastname 30949**] is a 41 y/o F with PMH of hepatitis C and IVDU who presented to OSH with several days of abdominal pain, N/V, and jaundice. She described the pain as constant and diffuse. She reported subjective fevers with cough. Denied urinary symptoms or change in stool color. Per the patient's mother, Ms. [**Known lastname 30949**] was seen by her stepfather four days ago and he noticed that she "looked ill and yellow." Reportedly took 4 tylenol tables (unknown strength yesterday morning). At the OSH, she received 3 mg IV dilaudid, 12.5 mg phenergan, and 1 L NS. Blood pressure reported at 106/59 at OSH with tachycardia to 101. Reported CXR no infiltrates (?). Blood cultures were sent and she was found to have transaminases AST > [**Numeric Identifier 3301**], ALT > 8000 and transferred to [**Hospital1 18**] for treatment of liver failure. Of note, in OSH ED, patient reported prolonged sobriety but recent use of opiates and alcohol but stopping 4 days prior to presentation; reported not being able to keep down POs since that time. Initial vitals in [**Hospital1 18**] ED: T 96.8, HR 122, BP 84/32 --> 58/18, O2 98%. She was noted to be lethargic and was given Narcan. She was intubated with succinylcholine, etomidate, vecuronium; she received a repeat dose of etomidate at 0345. She received a total of 5 L NS and code sepsis was initiated. Right IJ was placed. She received vancomycin 1 g IV X 1, levofloxacin 750 mg IV X 1, flagyl 500 mg IV X 1, zofran 4 mg, and zosyn 4.5 mg IV X 1. She was on levophed gtt but this was weaned to off at 0430 due to hypertension (160s systolic). ROS (obtained at OSH): + subjective fever, no chills. no chest pain, diaphoresis, DOE, orthopnea, edema. + cough but nonproductive. + nausea/diarrhea, jaundice, vomiting, anorexia. Denies hematemesis, hematochezia, melena. + dizziness. + cold intolerance. + easy bruising/bleeding. Denied suicidal ideation. Past Medical History: hepatitis C h/o hepatitis B (per records from OSH) h/o pancreatitis h/o IVDU depression/anxiety h/o kidney stones per mother Social History: Recently in prison for DUI/reckless driving and drug convictions. Then let out of prison to rehab in [**Location (un) 86**] and returned to home about one week ago. No permanent housing at present. Living at a shelter or with a male friend per mother. + alcohol use this week, though until last week was at a rehab/shelter in [**Location (un) 86**] and presumably was not drinking. + heroin use (within last 24-96 hours by report). + tobacco, 1 ppd. Family History: Noncontributory. Physical Exam: T: 95.9 BP: 128/51 HR: 127 RR: O2 100% on A/C FiO2 80, Tv 500, RR 20, PEEP 5 Gen: intubated, sedated HEENT: + scleral icterus & conjunctival edema. tongue dry, op clear, poor dentition NECK: supple, no palpable lymphadenopathy, R IJ catheter in place CV: tachycardic, regular, no appreciable murmur LUNGS: no wheeze, crackles R > L ABD: slightly distended, hyperactive bowel sounds EXT: feet & hands cool, good cap refill, no peripheral edema SKIN: no rash NEURO: sedated. able to move all four extremities. pupils small but reactive bilaterally. eyes remain toward ceiling when head moved side to side (+ doll's eyes), withdraws to pain Pertinent Results: OSH LABS: ========= WBC 8.9 (87%N, 6% lymphs, 5% bands), Hct 38, Plt 129 lipase 145 amylase 48 glucose 77 Na 138, K 3.6, Cl 100, CO2 26, BUN 9, Cr 0.8 protein 7.3, albumin 3.7 Bili 3.2 Ca 9.1 AST [**Numeric Identifier 30950**] ALT 8040 Alk phos 141 serum pregnancy negative INR reportedly 3 ADMISSION LABS: =============== [**2152-2-12**] 01:00AM BLOOD WBC-16.3* RBC-4.24 Hgb-13.5 Hct-38.1 MCV-90 MCH-31.9 MCHC-35.4* RDW-12.4 Plt Ct-131* [**2152-2-12**] 06:00AM BLOOD WBC-23.6* RBC-3.54* Hgb-10.7* Hct-33.6* MCV-95 MCH-30.2 MCHC-31.9 RDW-12.4 Plt Ct-120* [**2152-2-12**] 01:00AM BLOOD Glucose-23* UreaN-16 Creat-1.2* Na-143 K-3.2* Cl-103 HCO3-20* AnGap-23 [**2152-2-12**] 06:00AM BLOOD Glucose-94 UreaN-13 Creat-0.8 Na-144 K-3.3 Cl-115* HCO3-14* AnGap-18 [**2152-2-12**] 01:00AM BLOOD ALT-6760* AST-[**Numeric Identifier **]* AlkPhos-142* TotBili-3.5* [**2152-2-12**] 12:12PM BLOOD ALT-4216* AST-7188* LD(LDH)-3595* AlkPhos-84 TotBili-3.9* [**2152-2-12**] 01:00AM BLOOD Albumin-3.6 Calcium-9.0 Phos-2.9 Mg-1.6 MICROBIOLOGY: ============= [**2152-2-17**] BLOOD CULTURE Blood Culture, Routine-FINAL {[**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 30951**], [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) 30951**]}; Aerobic Bottle Gram Stain-FINAL INPATIENT [**2152-2-12**] BLOOD CULTURE Blood Culture, Routine-FINAL {STREPTOCOCCUS PNEUMONIAE}; Anaerobic Bottle Gram Stain-FINAL; Aerobic Bottle Gram Stain-FINAL EMERGENCY [**Hospital1 **] [**2152-2-12**] BLOOD CULTURE Blood Culture, Routine-FINAL {STREPTOCOCCUS PNEUMONIAE}; Anaerobic Bottle Gram Stain-FINAL [**2152-3-13**] BLOOD CULTURE Blood Culture, Routine-PRELIMINARY {STAPHYLOCOCCUS, COAGULASE NEGATIVE, STAPHYLOCOCCUS, COAGULASE NEGATIVE}; Anaerobic Bottle Gram Stain-FINAL; Aerobic Bottle Gram Stain-FINAL STUDIES: ======== CT Abd / Pelvis [**2152-2-12**] 1. Dense bilateral large consolidations with small associated pleural effusion, worrisome for pneumonia. 2. Abdominal fluid, periportal edema and pericholecystic fluid, consistent with volume overload. 3. Left renal cortical defect probably indicative of remote pyelonephritis. 4. Heterogenous liver consistent with hepatitis. 5. Retroperitoneal edema. . [**2-13**] RUQ US RUQ focused ultrasound: There is a small amount of perihepatic ascites. The right, left, and middle hepatic veins demonstrate appropriate flow, although waveforms are not triphasic. The portal vein demonstrates normal hepatopetal flow. IMPRESSION: The hepatic veins demonstrates normal flow but non-triphasic waveforms that may be due to decrease complicance secondary to diffuse hepatic disease. . CTA ABD / PELVIS [**2-15**] IMPRESSION: 1. Interval improvement in bibasilar pulmonary consolidations suggests an interval improvement in the underlying pneumonia. 2. Interval development of the anasarca, bilateral pleural effusion, and progression of the ascitic fluid suggests volume overload status. 3. Mild thickening of sigmoid and descending colon. This most likely reflects colitis-probably C Diff. . No evidence of bowel ischemia is noted. 4. Stable left renal cortical defect probably indicative of remote pyelonephritis. . tte [**2-18**] The left atrium is normal in size. Left ventricular wall thickness, cavity size, and global systolic function are normal (LVEF 60-70%). 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. No masses or vegetations are seen on the aortic valve. The mitral valve appears structurally normal with trivial mitral regurgitation. There is no mitral valve prolapse. No mass or vegetation is seen on the mitral valve. The estimated pulmonary artery systolic pressure is normal. No vegetation/mass is seen on the pulmonic valve. There is no pericardial effusion. IMPRESSION: no obvious vegetations seen on this technically suboptimal study . CT ABD /PELVIS 3.21 1. Interval improvement in both bilateral consolidations and pleural effusions. 2. Anasarca with no significant change in ascites and pelvic free fluid. 3. Cortical thinning at the site of likely old infection in the left kidney. . TTE [**2-25**] No spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. No atrial septal defect is seen by 2D or color Doppler. Left ventricular wall thickness, cavity size and regional/global systolic function are normal. 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. No masses or vegetations are seen on the aortic valve. The mitral valve leaflets are structurally normal with trivial mitral regurgitation. No mass or vegetation is seen on the mitral valve. There is a trivial/physiologic pericardial effusion. IMPRESSION: No echocardiographic evidence of endocarditis. Mild tricuspid regurgitation. . CTA CHEST [**3-14**] FINDINGS: Direct comparison is made to prior examination dated [**2152-3-3**]. Current examination reveals a stable appearing right-sided pneumatocele. Small area of dependent soft tissue attenuation is again identified, as on prior CT. Given the patient's clinical history, fungal ball should be a differential consideration for this finding. Overall, there is significant improvement in the appearance of the lung parenchyma, which do demonstrate a persistent areas of bilateral, diffuse air trapping. Areas of increased interstitial markings seen at the left lung base. This likely represents areas of pulmonary fibrosis. Focal, confluent area of opacity is also seen at the right lung base, which may represent a persistent area of infection or atelectasis. There is no evidence of main, central, or segmental pulmonary embolism. The main pulmonary artery measures 3.1 cm. This enlargement suggests underlying pulmonary arterial hypertension. There is a small-to-moderate sized pericardial effusion. No significant hilar or mediastinal lymphadenopathy is identified. Visualized portions of the upper abdomen are grossly unremarkable. No suspicious lytic or blastic bony lesions are identified. IMPRESSION: 1. No evidence of pulmonary embolism. 2. Continued improvement in the patient's pulmonary disease with pneumatocele identified. Dependent soft tissue attenuation suggests the possibility of a fungal ball. Recommend clinical correlation. Also, area of possible fibrosis seen at the left lung base. Brief Hospital Course: 41 yo female with history of alcohol and IV drug abuse presents with sepsis and hypoxia. . The patient was in the [**Hospital1 18**] MICU from [**2152-2-12**] through [**2152-2-28**]. During this time, she was treated for: -Sepsis: required intubation, siginficant ventilatory support and 3 pressors. DIC. Resp failure/ARDS from presumed aspiration event/s.pneumo pneumonia. She had S. pneumoniae bacteremia, enterococcal UTI, and candidal fungemia during her MICU course. -S. pneumo pneumonia and bacteremia with ceftriaxone, then meropenem because of elevated bilirubin. There was a concern about prolonged altered mental status off all sedation in the periextubation period, raising a concern about meningitis. No LP performed, and her mental status improved without other intervention. The plan was to treat the patient empirically for meningitis. -She also was persistently febrile despite broad spectrum antibiotics. Blood cultures grew [**Female First Name (un) 564**] and the patient was treated with IV caspofungin given her LFT abnormalities. Once her LFTs normalized/returned to baseline, the plan was to change to fluconazole (although she only completed 16 d course of caspofungin). Ophthalmology was consulted, and no evidence of fungal infection was discovered via fundoscopic exam. -Fulminant hepatic failure with INR to 5.9, AST>15,000, ALT>8,000. Thought to be shock liver, also a possible tylenol component and the patient was treated with NAC initially. -Anemia: thought to be a slow drift, guaiac negative, no evidence of hemolysis on most recent labs -Altered mental status: prolonged somnolence off sedation, likely related to liver failure and use of benzos during sedation. Treated with lactulose and MS improved slowly. Methadone held. -Volume overload: patient ~19 L positive at transfer, had been autodiuresing. Cr stable . [**Hospital 30952**] MEDICAL FLOOR COURSE: . She was transferred to the floor, autodiuresed and continued to show significant improvement in her LFTs, when she developed another fever and hypoxia and was transferred back to the MICU for a likely aspiration event. She was re-intubated and continued on treatment for her many infections. She was followed closely by Infectious Disease, and she again improved considerably and was extubated on [**2152-3-8**]. She had completed all courses of antibiotics while in the MICU, and was off of antibiotics on re-transfer to the floor. Her liver enzymes also continued to improve slowly, but remained elevated on transfer to the floor. . On the floor (round 2), she primarily complained of generalized weakness, which was likely due to her critical illness and prolonged ICU course. She worked closely with physical therapy and occupational therapy, and made significant improvement while inpatient. Neurology was consulted for right arm numbness and weakness, which was contributed to possible injury experienced with arterial line placement while in the ICU; it was recommended that she follow up with physical therapy for continued strength training. She was also significantly anxious during this hospital stay. She was seen by social work and addictions consult, and being treated with Xanax initially for her significant anxiety. Psychiatry was consulted for assistance in management of anxiety; she was put on clonazepam [**Hospital1 **] instead. . After [**Hospital1 13835**] 1 week on the floor she developed progressive leukocytosis. Surveillance cultures were obtained and revealed coag negative staph, the source of which was considered to be her PICC line. The line was pulled and she was started on vancomycin for 7 day course. After blood cultures were negative for 48 hrs another PICC line was placed to complete treatment. This second PICC line was pulled on discharge. Furthermore, a CTA was performed to evaluate pleuritic chest pain, which did show improvement of airspace disease with a pneumatoceole. Given her hx of fungemia, this raised concerns for a fungal ball in the right lung. ID and Pulmonary were contact[**Name (NI) **] regarding this issue, and it was determined that the airspace was unchanged, unlikely represented an active infection, and may represent sequelae from previous infection (likely bacterial). She was encouraged to follow up with pulmonary regarding this issue in [**Name (NI) 13835**] 8 weeks time. She also had a progressive eosinophilia upon discharge; this was considered secondary to vancomycin. She will require a follow up CBC with differential in [**Name (NI) 13835**] 5 days post discharge to ensure the leukocytosis / eosinophilia has resolved. . Medications on Admission: None per report. Discharge Medications: 1. Lactulose 10 gram/15 mL Syrup Sig: Thirty (30) ML PO BID (2 times a day): patient should have [**1-9**] loose bowel movements a day. 2. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Multivitamin,Tx-Minerals Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Citalopram 20 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 6. Clonazepam 0.5 mg Tablet Sig: One (1) Tablet PO QHS (once a day (at bedtime)). 7. Clonazepam 0.5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily) as needed. Discharge Disposition: Extended Care Facility: [**Hospital1 **] Discharge Diagnosis: 1) S. Pneumonia Pneumonia 2) ARDS 3) Candidemia 4) Hepatic Failure 5) Substance Abuse 6) Staph bacteremia 7) Pneumatoceole Discharge Condition: Weak physically, with numbness of right hand. Mildly jaundiced. Highly anxious. Left sided PICC line in place. Hemodynamically stable and afebrile. Discharge Instructions: You were admitted to the hospital with a severe lung and blood infection. You were treated in the intensive care unit, and maintained on life support. You also experienced a fungal infection of the blood and a repeat bacterial infection of the blood. You completed treatment for the first bacterial infection and the fungal infection. You are currently being treated with an antibiotic for the most recent bacterial infection (which was likely caused by the first PICC line). You should follow up with infectious disease as below. . You were noted to have liver dysfunction from underlying hepatitis. You should continue to follow up with a liver specialist regarding your care. . You were noted to have anxiety and a history of substance abuse. You will benefit from therapy and a treatment program. Please continue your new medication clonazepam for anxiety as prescribed. Please follow up with psyciatry. . You were also found to have an air pocket in your lung. You should follow up with a lung doctor [**First Name (Titles) **] [**Last Name (Titles) 13835**] 2 months to ensure that this is unchanged. . Please start below attached medications. . If you experience shortness of breath, chest pain, cough, fevers, chills, diarrhea, abdominal pain, please contact your doctor or return to the [**Name (NI) **] for help. Followup Instructions: Please see your primary care physician, [**Name Initial (NameIs) **] pulmonologist, infectious disease doctor, substance abuse counseling/behavioral therapist. . You have an appointment with your infectious disease doctor on [**4-17**] at 9:30am with Dr. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 7443**], phone # [**Telephone/Fax (1) 457**]. . You have an appointment with your pulmonologist on [**4-20**] at 1:30pm, phone# [**Telephone/Fax (1) 612**]. Clinic located at [**Hospital1 18**] [**Hospital Ward Name **], [**Location (un) 436**] [**Hospital Ward Name 23**] building. Please show up at 1:00pm for testing at PULMONARY FUNCTION LAB Phone:[**Telephone/Fax (1) 609**]. . You have an appointment with your primary care physician on [**6-19**], [**2151**] at 8:00am at [**Hospital 189**] Community Health Center, phone# [**Telephone/Fax (1) 30953**]. . You should follow up with Psychiatry. Call [**Telephone/Fax (1) 30954**] for referral to see a psychiatrist for treatment of your anxiety. ICD9 Codes: 5070, 5990, 2851
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Medical Text: Admission Date: [**2194-11-17**] Discharge Date: [**2194-12-25**] Date of Birth: [**2145-9-22**] Sex: M Service: CARDIOTHOR HISTORY OF PRESENT ILLNESS: This is a 48 year old male with adenocarcinoma of the distal esophagus. He underwent neoadjuvant therapy with chemotherapy and radiation. He completed chemotherapy four weeks prior to admission and radiation therapy two weeks prior to admission. The patient had a significant weight loss of approximately 30 pounds. CT scan per Oncology demonstrated partial resolution of the tumor. PAST MEDICAL HISTORY: 1. Nephrolithiasis in [**2172**]. 2. Chronic low back pain. PAST SURGICAL HISTORY: 1. J-tube placement. 2. Porta-Cath placement. ALLERGIES: Erythromycin. PHYSICAL EXAMINATION: Afebrile, vital signs stable. HEENT: No lymphadenopathy. Lungs are clear to auscultation. Cardiac: Regular rate and rhythm. Abdomen soft, nontender, nondistended. HOSPITAL COURSE: The patient was admitted on [**2194-11-17**], where he went to the Operating Room and had an esophagogastrectomy with mediastinal lymph node dissection. Postoperatively, the patient had a mild episode of hypotension which was attributed to the epidural catheter. The patient was doing well until he became febrile on [**2194-11-20**]. On [**11-21**], some wound drainage was seen from the abdominal incision. A CT scan was obtained after several days of monitoring the drainage and the scan revealed a wound dehiscence. The patient went to the Operating Room on [**11-25**], for debridement of fascia and a buttress repair of the wound dehiscence. Postoperatively, the patient had hypotension and was transferred to the Intensive Care Unit. The patient was started on Vancomycin, Levofloxacin and Flagyl. On [**11-29**], the patient had an episode of tachycardias in to the 160s. Copious amounts of green drainage was seen from the right chest tube. Another chest tube was placed which revealed also copious amounts of drainage. The patient was placed on multiple pressors and was intubated. On [**11-30**], the patient was brought to the Operating Room again for esophageal diversion of his split fistula. Infectious Disease consultation was obtained and he was placed on Imipenem, Vancomycin, Fluconazole, Levofloxacin, for multiple organisms. He was started on total parenteral nutrition. On [**12-2**], the patient grew out Methicillin resistant Staphylococcus aureus from his sputum. Gradually, in the Intensive Care Unit his pressors were weaned. Tube feeds were started on [**12-5**]. A follow-up chest CT scan was obtained which revealed a small right fluid collection which was significantly improved from the prior. Tube feeds were advanced to goal and the TPN was discontinued [**12-8**]. On [**12-8**] also, all antibiotics were discontinued except for Vancomycin which was kept for MRSA. The patient had a CT scan guided procedure of a fluid collection by Interventional Radiology on [**12-13**]. After multiple attempts of extubation and weaning, the patient was finally extubated on [**12-18**]. On [**12-19**], all of the chest tubes were removed due to minimal amounts of drainage. On [**12-21**], the patient was transferred to the Floor. On the Floor, the patient did well, had no complaints. Tube feeds were at goal. The patient was afebrile. LABORATORY: Laboratory values upon discharge are as follows: Sodium 141, potassium 3.5, chloride 101, bicarbonate 29, BUN 14, creatinine 0.3, glucose 137, white blood cell count 18, hematocrit 30.6, platelets 446. The patient's white blood cell count significantly decreased from higher values obtained during the admission. CONDITION AT DISCHARGE: Stable. DISCHARGE MEDICATIONS: 1. Epogen 40,000 units subcutaneously q. week. 2. Heparin 5000 units subcutaneously twice a day. 3. Zinc Sulfate 220 mg per J-tube q. day. 4. Clonidine patch 0.2 mg q. week. 5. Vitamin C 500 mg twice a day via NG tube. 6. Vancomycin 2 grams intravenously q. 12 hours. 7. Lopressor 25 mg per J-tube twice a day. 8. Celexa 20 mg per J-tube q. day. 9. Oxy-Codon Elixir 5 to 10 cc q. six hours p.r.n. via J-tube. 10. Haldol Elixir 1 mg per J-tube q. eight hours p.r.n. 11. The patient was also on Impact with fiber tube feeds at 75 cc per hour which was his goal. DISCHARGE STATUS: Rehabilitation facility. DISCHARGE INSTRUCTIONS: The patient will follow-up with the following people: 1. Dr. [**Last Name (STitle) 175**] in two weeks. 2. Dr. [**Last Name (STitle) 1305**] in two weeks. 3. His primary care physician, [**Last Name (NamePattern4) **]. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **]. 4. Infectious Disease Clinic in two weeks. DISCHARGE DIAGNOSES: 1. Status post esophagogastrectomy complicated by wound dehiscence and anastomotic leak. [**First Name11 (Name Pattern1) 177**] [**Last Name (NamePattern4) 178**], M.D. [**MD Number(1) 179**] Dictated By:[**Name8 (MD) 1308**] MEDQUIST36 D: [**2194-12-25**] 10:40 T: [**2194-12-25**] 10:56 JOB#: [**Job Number 35105**] ICD9 Codes: 5119
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Medical Text: Admission Date: [**2133-8-22**] Discharge Date: [**2133-8-29**] Date of Birth: [**2055-1-25**] Sex: F Service: SURGERY Allergies: Percocet Attending:[**First Name3 (LF) 46126**] Chief Complaint: nausea/vomiting, abdominal pain Major Surgical or Invasive Procedure: [**2133-8-27**] laparoscopic cholecystectomy [**2133-8-23**] ERCP with sphincterotomy and stone extraction History of Present Illness: 78F with history of NIDDM, HTN, recent UTI and fall presenting with n/v, increased fatigue, RUQ abdominal pain and poor PO intake for the last three days. Patient reports feeling unwell after starting her nitrofurantion for her UTI diagnosed in ED on [**8-20**]. Began to feel increased fatigue with associated nausea/vomiting and diarrhea last night. Continued this morning. NB/NB. Found by friend who called EMS after 2 hours of continued symptoms. Febrile yesterday. No chest pain. SOB with vomiting. + dysuria. Vital Signs in the ED: Pulse: 115, RR: 34, BP: 99/52, O2Sat: 95, O2Flow: r/a. PT became hypotensive in ED to 76/54. She was given 2L of NS with poor response in BP. She was started on levophed and given vancomycin/zosyn. WBC 20.2 (N:90), ALT:200 AP:163 Tbili:5.3 Alb: 3.9 AST:145. RUQ US Sludge and stones layering in the gallbladder, without evidence for acute cholecystitis, CBD 9mm. Surgery and ERCP was consulted with plan for ERCP tomorrow. On arrival to the MICU, patient's VS were T 99.9, HR 73, BP 131/67 on 0.08 Levophed and 98% RA. Pt was complaining of shoulder pain which she has had since the fall last week. She denies any abdominal pain, nausea, SOB, or CP currently. Past Medical History: -DM II -Hypertension -Hypothyroidism -Urinary incontinence -Venous insufficiency -osteoporosis -h/o DVT -s/p umbilical hernia repair -H/O ANEMIA - [**2128**] colonoscopy: Adenomas - EGD [**10-9**]: Duodenitis, angioectasia - Capsule endoscopy [**2129**]: ileal polyps, consider ileoscopy - Seen by [**Doctor Last Name 2161**], ileocopy/ further w/u deferred as anemia Social History: Has VNA. Originally from [**University/College **]. Lives on [**Social Security Number 94034**]social security. She lives alone with no family near by but has support of friends. [**Name (NI) 4084**] [**Name2 (NI) 1818**]. Denies EtOH/drugs. Family History: non-contributory Physical Exam: Admission Exam: General: Alert, awake, no acute distress CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops Lungs: Clear to auscultation bilaterally, no wheezes, rales, ronchi Abdomen: soft, non-distended, bowel sounds present, no tenderness to palpation, no rebound or guarding Ext: Warm, well perfused, no clubbing, cyanosis or edema Pertinent Results: [**2133-8-27**] 04:18AM BLOOD WBC-12.2* RBC-3.87* Hgb-11.0* Hct-32.6* MCV-84 MCH-28.5 MCHC-33.9 RDW-15.4 Plt Ct-241 [**2133-8-26**] 04:14AM BLOOD WBC-12.0* RBC-3.83* Hgb-10.8* Hct-31.7* MCV-83 MCH-28.2 MCHC-34.0 RDW-15.1 Plt Ct-177 [**2133-8-22**] 01:15PM BLOOD WBC-20.2*# RBC-4.23 Hgb-12.2 Hct-37.3 MCV-88 MCH-28.8 MCHC-32.7 RDW-15.0 Plt Ct-165 [**2133-8-26**] 04:14AM BLOOD Neuts-85* Bands-2 Lymphs-4* Monos-7 Eos-0 Baso-0 Atyps-0 Metas-2* Myelos-0 [**2133-8-22**] 01:15PM BLOOD Neuts-90* Bands-5 Lymphs-2* Monos-2 Eos-0 Baso-0 Atyps-1* Metas-0 Myelos-0 [**2133-8-27**] 04:18AM BLOOD Plt Ct-241 [**2133-8-26**] 04:14AM BLOOD Plt Smr-NORMAL Plt Ct-177 [**2133-8-26**] 04:14AM BLOOD PT-11.4 PTT-30.6 INR(PT)-1.1 [**2133-8-27**] 04:18AM BLOOD Glucose-103* UreaN-8 Creat-0.5 Na-133 K-4.2 Cl-103 HCO3-22 AnGap-12 [**2133-8-26**] 04:14AM BLOOD Glucose-104* UreaN-7 Creat-0.5 Na-134 K-3.7 Cl-102 HCO3-23 AnGap-13 [**2133-8-27**] 04:18AM BLOOD ALT-75* AST-34 AlkPhos-126* TotBili-0.9 [**2133-8-26**] 04:14AM BLOOD ALT-94* AST-40 LD(LDH)-187 AlkPhos-138* TotBili-1.2 [**2133-8-22**] 01:15PM BLOOD ALT-200* AST-145* AlkPhos-163* TotBili-5.3* DirBili-4.3* IndBili-1.0 [**2133-8-27**] 04:18AM BLOOD Calcium-8.2* Phos-3.1 Mg-2.0 [**2133-8-22**] 01:28PM BLOOD Lactate-7.5* [**2133-8-22**]: EKG: Sinus tachycardia. Possible inferior wall myocardial infarction of indeterminate age. Compared to the previous tracing of [**2132-9-3**] the rate has increased. Otherwise, findings are similar. [**2133-8-22**]: Liver/gallbladder ultrasound: IMPRESSION: 1. No intrahepatic biliary duct dilation with prominence of the common bile duct to 9 mm. 2. Sludge and probable stones layering in the gallbladder, without evidence for acute cholecystitis. 3. Mildly echogenic liver, suggestive of fatty infiltration, particularly given the area of sparing around the gallbladder fossa. However, other forms of liver disease including more advanced liver disease such as significant hepatic fibrosis/cirrhosis cannot be excluded on this study. [**2133-8-22**]: chest x-ray: IMPRESSION: Appropriately positioned right IJ central venous catheter. Mild left basal atelectasis. [**2133-8-22**] 1:15 pm BLOOD CULTURE **FINAL REPORT [**2133-8-24**]** Blood Culture, Routine (Final [**2133-8-24**]): ESCHERICHIA COLI. FINAL SENSITIVITIES. Piperacillin/Tazobactam sensitivity testing performed by [**First Name8 (NamePattern2) 3077**] [**Last Name (NamePattern1) 3060**]. Cefazolin interpretative criteria are based on a dosage regimen of 2g every 8h. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ ESCHERICHIA COLI | AMPICILLIN------------ =>32 R AMPICILLIN/SULBACTAM-- 16 I 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---- <=1 S Anaerobic Bottle Gram Stain (Final [**2133-8-22**]): Reported to and read back by DR. [**Last Name (STitle) 32434**] [**Name (STitle) 32435**] @ 2220, [**2133-8-22**]. GRAM NEGATIVE ROD(S). Aerobic Bottle Gram Stain (Final [**2133-8-22**]): GRAM NEGATIVE ROD(S). [**2133-8-22**]: [**2133-8-22**] 1:25 pm BLOOD CULTURE **FINAL REPORT [**2133-8-24**]** Blood Culture, Routine (Final [**2133-8-24**]): ESCHERICHIA COLI. IDENTIFICATION AND SENSITIVITIES PERFORMED ON CULTURE # 351-1469M [**2133-8-22**]. Aerobic Bottle Gram Stain (Final [**2133-8-22**]): GRAM NEGATIVE ROD(S). Anaerobic Bottle Gram Stain (Final [**2133-8-22**]): GRAM NEGATIVE ROD(S). Brief Hospital Course: The patient was admitted to the acute care service with abdominal pain, nausea and vomitting. Upon admission to the emergency room, she was found to be hypotensive and tachycardic requiring pressor support. She was made NPO, given intravenous fluids, and underwent blood work and imaging. On blood work she was reported to have an elevated white blood cell count and elevated liver enzymes. She was started on vancomycin and zosyn. Imaging of the abdomen showed a dilated CBD to 9mm as well as sludge and stones in the gallbladder but no cholecystitis. She was transferred to the intensive care unit for monitoring. Blood cultures drawn upon admission grew gram negative rods which were sensitive to ceftriaxone and the vancomycinn and zosyn were discontinued. Her vital signs, liver enzymes, and white blood cell count were closely monitored. On HD #2, she underwent an ERCP which showed a dilated CBD with stones and sludge in the gallbladder. A sphincterotomy was done with the removal of pus. After the liver enzymes decreased she was taken to the operating room on HD #6 for a laparoscopic cholecystectomy. The operative course was stable and the patient was extubated after the procedure and monitored in the recovery room. The post-operative course has been unremarkable. Her diet was gradually advanced as tolerated, her vitals were stable and she remained afebrile. She received physical therapy for L leg and shoulder pain from a fall prior to admission. She was discharged home on post-operative day 2 (HD 8) with VNA and home PT services. Medications on Admission: Preadmission medications listed are correct and complete. Information was obtained from webOMR. 1. estradiol *NF* 0.01 % (0.1 mg/g) Vaginal 2x/week 2. Levothyroxine Sodium 75 mcg PO DAILY 3. Lisinopril 20 mg PO DAILY 4. Omeprazole 20 mg PO DAILY 5. risedronate *NF* 35 mg Oral q Thursday 6. Simvastatin 20 mg PO QHS 7. Sanctura *NF* (trospium) 20 mg Oral [**Hospital1 **] 8. Aspirin 81 mg PO DAILY 9. Calcium Carbonate 500 mg PO BID 10. camphor-menthol *NF* 0.5-0.5 % Topical PRN leg pruritus 11. Vitamin D 1000 UNIT PO DAILY 12. Multivitamins 1 TAB PO DAILY Discharge Medications: 1. Levothyroxine Sodium 75 mcg PO DAILY 2. Lisinopril 20 mg PO DAILY 3. Multivitamins 1 TAB PO DAILY 4. Omeprazole 20 mg PO DAILY 5. risedronate *NF* 35 mg Oral q Thursday 6. Sanctura *NF* (trospium) 20 mg Oral [**Hospital1 **] 7. Simvastatin 20 mg PO QHS 8. Vitamin D 1000 UNIT PO DAILY 9. Calcium Carbonate 500 mg PO BID 10. Aspirin 81 mg PO DAILY 11. estradiol *NF* 0.01 % (0.1 mg/g) Vaginal 2x/week 12. camphor-menthol *NF* 0.5-0.5 % Topical PRN leg pruritus 13. Acetaminophen 325-650 mg PO Q6H:PRN pain Discharge Disposition: Home With Service Facility: At home VNA Discharge Diagnosis: sepsis cholelithiasis 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 with right upper abdominal pain, nausea and vomitting. Your white blood cell count was elevated and you had a decreased blood pressure. You were monitored in the intensive care unit. You underwent an ultrasound of the abdomen and you were found to have stones and sludge in your gallbladder. You underwent a special test called an ERCP to remove the stones and sludge. After your liver studies decreased, you were taken to the operating room to have your gallblader removed. You are recovering nicely from the surgery and you are preparing for discharge home with the following instructions: Home Care ??????Ask someone to drive you to your appointments for the next 3 days. [**Male First Name (un) **]??????t drive until you are no longer taking pain medication. ??????Wash the skin around your incision daily with mild soap and water. It's okay to shower the day after your surgery. ??????Eat your regular diet. It is wise to stay away from [**Doctor First Name **], greasy, or spicy food for a few days. ??????Remember, it takes about 1 week for you to get most of your strength and energy back. ??????Make an office visit to talk to your doctor if the following symptoms [**Male First Name (un) **]??????t go away within a week after your surgery: &#9702;Fatigue &#9702;Pain around the incision &#9702;Diarrhea or constipation &#9702;Loss of appetite ??????Don't be alarmed if you have discomfort in your shoulder and chest for up to 48 hours after surgery. This is caused by carbon dioxide (gas) used during the operation. The discomfort will go away. Followup Instructions: **Please follow up in Acute Care Surgery clinic in 2 weeks. Call the Acute Care Surgery clinic at [**Telephone/Fax (1) 600**] to schedule this follow-up appointment Provider: [**First Name8 (NamePattern2) 1238**] [**Last Name (NamePattern1) 1239**] [**Name8 (MD) **], [**MD Number(3) 1240**]:[**Telephone/Fax (1) 2010**] Date/Time:[**2133-8-31**] 3:40 Provider: [**First Name11 (Name Pattern1) 1980**] [**Last Name (NamePattern4) 1981**], MD Phone:[**Telephone/Fax (1) 2010**] Date/Time:[**2133-9-23**] 9:50 Provider: [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 542**], DPM Phone:[**Telephone/Fax (1) 543**] Date/Time:[**2133-11-10**] 1:40 ICD9 Codes: 2762, 4019, 2449, 2768
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6569 }
Medical Text: Admission Date: [**2192-4-6**] Discharge Date: [**2192-4-11**] Date of Birth: [**2105-12-7**] Sex: F Service: CARDIOTHORACIC Allergies: morphine Attending:[**First Name3 (LF) 1505**] Chief Complaint: dyspnea on exertion Major Surgical or Invasive Procedure: [**2192-4-6**]: Redo sternotomy, Aortic Valve Replacement (tissue) History of Present Illness: 86 year old female with a history of aortic valve replacement 14 years ago and hypertension, hyperlipidemia who has noticed dyspnea with minimal exertion and fatigue over the past [**4-24**] months. Patient states she will fall asleep numerous times throughout the day after any type of activity. She states she will occasionally feel dizzy while walking which she attributes to her vertigo. She will take her antivert and the dizziness will subside. She underwent a cardiac catheterization in [**Month (only) 958**] which revealed [**First Name8 (NamePattern2) **] [**Location (un) 109**] of 0.6 and 20% LAD stenosis. She was seen by Dr. [**Last Name (STitle) **] after her cardiac catheterization and returns today for preadmission testing. Past Medical History: Aortic Stenosis Hypertension Hyperlipidemia GERD Vertigo Basal Call s/p removal from temple x4 (hands and legs) Anxiety Arthritis Hiatal Hernia Past Surgical History: Tonsillectomy Appendectomy Cholecystectomy Pancreatomy Bowel obstruction surgery [**2190**] Right hip replacement [**2182**] AVR (bovine) 14 years ago Social History: Lives with: alone, supportive family Occupation: retired Tobacco: none ETOH: rare Family History: non-contributory Physical Exam: Pulse:90 Resp:15 O2 sat: 100% 2l NC B/P Right: 105/67 Left: Height: 4'[**90**]" Weight: 64 kg General: Skin: Dry [x] intact [x] Mild bruising noted. HEENT: PERRLA [x] EOMI [x] Neck: Supple [x] Full ROM [x] Chest: Lungs clear bilaterally [x] Heart: RRR [x] Irregular [] Murmur 3/6 SEM Abdomen: Soft [x] non-distended [x] non-tender [x] bowel sounds + [] Extremities: Warm [x], well-perfused [x] Edema Varicosities: None [X] 2+ bilat. LLE edema Neuro: Grossly intact Pulses: Femoral Right: 2+ Left: 2+ DP Right: 1+ Left: 1+ PT [**Name (NI) 167**]: 1+ Left: 1+ Radial Right: 2+ Left: 2+ Carotid Bruit Right: rad murmur Left: rad murmur Pertinent Results: Admission labs [**2192-4-6**] 11:08AM PT-15.8* PTT-39.6* INR(PT)-1.4* [**2192-4-6**] 11:08AM FIBRINOGE-132* [**2192-4-6**] 10:27AM HGB-7.6* calcHCT-23 [**2192-4-6**] 12:31PM UREA N-21* CREAT-0.8 SODIUM-141 POTASSIUM-4.8 CHLORIDE-113* TOTAL CO2-20* ANION GAP-13 Discharge labs [**2192-4-11**] 04:25AM BLOOD WBC-12.7* RBC-3.83* Hgb-12.0 Hct-35.5* MCV-93 MCH-31.2 MCHC-33.7 RDW-14.0 Plt Ct-105* [**2192-4-11**] 04:25AM BLOOD Plt Ct-105* [**2192-4-8**] 04:27AM BLOOD PT-14.4* INR(PT)-1.2* [**2192-4-11**] 04:25AM BLOOD UreaN-33* Creat-0.7 Na-136 K-3.9 Cl-99 [**2192-4-10**] 04:25AM BLOOD Glucose-78 UreaN-33* Creat-0.8 Na-139 K-4.0 Cl-102 HCO3-26 AnGap-15 Radiology Report CHEST (PA & LAT) Study Date of [**2192-4-10**] 11:39 AM Final Report: Right lower lobe density has become more round since [**2192-4-8**] and while it could represent confluent atelectasis, evolving pneumonia is also considered possible. Bilateral pleural effusions are small and have also developed since [**2192-4-8**]. Mild cardiomegaly is unchanged since [**2192-4-5**]. The right internal jugular central venous sheath has been removed. Median sternotomy wires are in satisfactory position and alignment. IMPRESSION: 1. Worsening right lower lobe opacity which could represent atelectasis, but consolidation is considered possible. 2. Bilateral enlarging small pleural effusions. Brief Hospital Course: The patient was a direct admission to the operating room on [**2192-4-6**] where the patient underwent Redo Sternotomy, AVR (porcine). Please see the operative report for details. In summary she had: Redo aortic valve surgery with a 19-mm St. [**Hospital 923**] Medical Biocor Epic tissue valve. Her bypass time was 93 minutes with a crossclamp time of 50 minutes. Overall the patient tolerated the procedure well and post-operatively was transferred to the CVICU in stable condition for recovery and invasive monitoring. The patient was noted to have afriable aorta during the surgery and a decision was made to keep her sedated until the morning after suregery. On POD 1 the patient was weaned from sedation, woke neurologically intact and was extubated. The patient remained hemodynamically stable and weaned from vasopressor support. Beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. She was noted to be thrombocytopenic with a platelet count of 61,000/uL. HIT antibody was sent and was negative. Platelets would trend up by discharge. She remained in the ICU to monitor hemodynamically until POD3 when she wastransferred to the telemetry floor for further recovery. All tubes lines and drains were removed per cardiac surgery protocol. The patient was seen by the physical therapy service for assistance with strength and mobility. The remainder of her hospital course was uneventful. At the time of discharge on POD5, the patient was ambulating freely, the wound was healing and pain was controlled with Ultram. The patient was discharged to [**Hospital 11252**] [**Hospital 90193**] Health Care in good condition with appropriate follow up instructions. Medications on Admission: ALPRAZOLAM 0.5 mg Q8PRN, AMLODIPINE-ATORVASTATIN [CADUET] 5 mg-40 mg Tablet 0.5 Tablet daily, ESOMEPRAZOLE MAGNESIUM 40 mg daily, HYDROCHLOROTHIAZIDE 12.5 mg daily, MECLIZINE 12.5 mg Q8hr PRN, Toprol 25 mg daily, POTASSIUM CHLORIDE 20 mEq daily, RALOXIFENE 60 mg daily, ASPIRIN 81 mg daily, CALCIUM CARBONATE-VITAMIN D3 600 mg-400 unit daily, MULTIVITAMIN daily, OMEGA-3 FATTY ACIDS-FISH OIL 360 mg-1,200 mg daily Discharge Medications: 1. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 2. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4 hours) as needed for pain/fever. 3. atorvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. omega-3 fatty acids Capsule Sig: One (1) Capsule PO BID (2 times a day). 6. cholecalciferol (vitamin D3) 400 unit Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. calcium carbonate 200 mg calcium (500 mg) Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 8. tramadol 50 mg Tablet Sig: 0.5 Tablet PO Q6H (every 6 hours) as needed for pain. 9. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 10. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) Inhalation Q6H (every 6 hours) as needed for SOB/wheezes. 11. simethicone 80 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO QID (4 times a day) as needed for heartburn. 12. Nexium 40 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO daily (). 13. ipratropium bromide 0.02 % Solution Sig: One (1) Inhalation Q6H (every 6 hours) as needed for sob/wheezes. 14. magnesium hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO Q6H (every 6 hours) as needed for constipation. 15. furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day. 16. potassium chloride 10 mEq Tablet Extended Release Sig: Two (2) Tablet Extended Release PO once a day. 17. metoprolol tartrate 25 mg Tablet Sig: 1.5 Tablets PO TID (3 times a day). 18. bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal HS (at bedtime) as needed for for bm. Discharge Disposition: Extended Care Facility: [**Location (un) 11252**] Center Discharge Diagnosis: Aortic Stenosis Hypertension Hyperlipidemia GERD Vertigo Basal Call s/p removal from temple x4 (hands and legs) Anxiety Arthritis Hiatal Hernia Past Surgical History: Tonsillectomy Appendectomy Cholecystectomy Pancreatomy Bowel obstruction surgery [**2190**] Right hip replacement [**2182**] AVR (bovine) 14 years ago Discharge Condition: Alert and oriented x3 nonfocal Ambulating with assistance- deconditioned Sternal pain managed with Tramadol Sternal Incision - healing well, no erythema or drainage Edema trace 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** Females: Please wear bra to reduce pulling on incision, avoid rubbing on lower edge Followup Instructions: You are scheduled for the following appointments: Wound Check at Cardiac Surgery Office [**Telephone/Fax (1) 170**] Surgeon Dr. [**First Name (STitle) **] [**Name8 (MD) 6144**], MD Phone:[**Telephone/Fax (1) 170**] Date/Time:[**2192-5-3**] 1:15 [**Telephone/Fax (1) 170**] Please call to schedule the following: Cardiologist Dr. [**Last Name (STitle) **],[**First Name3 (LF) **]-[**Doctor First Name 10588**] S. [**Telephone/Fax (1) 11254**] in [**2-21**] 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:[**2192-4-11**] ICD9 Codes: 5185, 4019, 2724, 2875, 2859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6570 }
Medical Text: Admission Date: [**2190-6-5**] Discharge Date: [**2190-6-6**] Service: #58 HISTORY OF PRESENT ILLNESS: Mrs. [**Known lastname 42654**] is a [**Age over 90 **] year-old woman with a past medical history of hypertension, coronary artery disease, status post myocardial infarction with pacemaker, who presented with 35 minutes of generalized tonic clonic activities suppressed by 15 mg of Valium. The patient had reported been at her baseline in her usual state of health, interactive, fluent until the day of admission when she was last seen at 2:00 p.m. She had been resting in her room and was found in convulsions at approximately 3:40 p.m., unresponsive with a systolic blood pressure of approximately 180 to 200. Emergency medical services arrived within twenty minutes and she was given 5 mg of IM Valium followed by 10 mg of intravenous before resolution of her symptoms. She was reported at this time to hve copious secretions. In the Emergency Room she was loaded with 1 gram of Dilantin and intubated for airway protection. A left femoral central line was initially placed and then removed secondary to a hematoma, a right was later placed. Per nursing home staff and family she had not been ill prior to this. She had no history of prior seizures. Upon admission to the Intensive Care Unit she was intubated and not responsive. PAST MEDICAL HISTORY: 1. Hypertension. 2. Tremor. 3. Coronary artery disease status post myocardial infarction. 4. Left humerus fracture. 5. Hypercholesterolemia. 6. Status post cataract surgery. 7. Status post pancreatic surgery. MEDICATIONS ON ADMISSION: 1. Effexor 37.5 mg po q day. 2. Lipitor 10 mg po q day. 3. Monopril 20 mg po q day. 4. Multivitamins. 5. Plavix 75 mg po q day. 6. Prevacid 15 mg po q day. 7. Pericolace one tab po b.i.d. 8. Celebrex 100 mg po q day. 9. Senokot two tabs q.h.s. ALLERGIES: No known drug allergies. PHYSICAL EXAMINATION ON ADMISSION: Vital signs significant for a temperature of 98.8. Blood pressure 150/75. Heart rate 95, intubated, sating 100% on 40% FIO2. Oral mucosa moist. No lymphadenopathy. Lungs with diffuse crackles. No wheezing. Cardiac examination with a 2 out of 6 systolic ejection murmur heard best at the apex. Regular rate and rhythm. No rubs. No gallops. Abdomen soft, nontender, nondistended with positive bowel sounds. She was moving all four extremities. She had a large left groin hematoma not firm or indurated. She had no active bleeding at the site. Her right dorsalis pedis pulse was not palpable. Posterior tibial was not dopplerable on the left. Her dorsalis pedis pulse was dopplerable, but her posterior tibial pulse was not palpable or dopplerable. Her skin was without rashes. Neurologically she was intubated and sedated. She withdrew mildly to all extremities on examination. She had positive dolls eyes. No corneal reflex was noted upon initial examination. She had a surgical pupil, both were reactive. Her tone was slightly increased. She had mild intermittent tremor of the chin and right upper extremity when she tried to bring it midline. Reflexes were 1+ and symmetric at biceps, triceps, brachial radialis bilateral in upper extremities 1+ at patellar and Achilles. Her toes were up going bilaterally. Ventilator settings upon admission were pressor support of 10 and 5, 40% FIO2, respiratory rates in the 20s with tidal volumes in the 300s. Arterial blood gas at this point was 7.37/46/187. ADMISSION FILMS: CT of the head showing low attenuation with white matter at the junction of the right MCA and PCA territories. Lack of associated mass factor atrophy suggesting a possible subacute watershed infarct. Without prior films for comparison. Acuity was noted to be difficult to ascertain. LABORATORIES ON ADMISSION: White blood cell count of 8.0, hematocrit 33.2, platelets 162, sodium 142, potassium 3.6, chloride 104, bicarb 24, BUN 29, creatinine 1.1, glucose 151. Urinalysis with no nitrites and no ketones. HOSPITAL COURSE: The patient was admitted to the Medical Intensive Care Unit for monitoring. Left groin line placed in the Emergency Department was discontinued secondary to hematoma. She was transfused with 2 units of packed red blood cells for a hematocrit drop in this setting. Post transfusion hematocrit showed an appropriate bump. A groin line was placed for access. Dilantin level was therapeutic after an initial load in the Emergency Department. Potassium, magnesium and calcium were all repleted. She remained hemodynamically stable throughout her Intensive Care Unit stay. She remained intubated during her short stay in the Intensive Care Unit and extubation was deferred secondary to transfer to the outside hospital. At the time of discharge the patient remained intubated, withdraws to painful stimulus in all extremities. Toes are up going bilaterally and dolls eyes were intact. She is to be transferred to [**Hospital3 **] Neurological step down unit as all of her records are at [**Hospital3 **]. DISCHARGE DIAGNOSES: 1. Cerebrovascular accident. 2. Coronary artery disease. 3. Hypertension. 4. Hypercholesterolemia. MEDICATIONS ON TRANSFER: Protonix 40 mg intravenous q.d. Plavix 75 mg po/pngt q.d. Dilantin 100 mg po/pngt b.i.d. Tylenol prn. DISPOSITION: [**Hospital3 **] neurologic step down unit. [**Name6 (MD) **] [**Name8 (MD) **], M.D. [**MD Number(1) 968**] Dictated By:[**Name8 (MD) 4733**] MEDQUIST36 D: [**2190-6-6**] 15:05 T: [**2190-6-9**] 07:14 JOB#: [**Job Number 42655**] ICD9 Codes: 2720, 4019, 412
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6571 }
Medical Text: Admission Date: [**2155-4-9**] Discharge Date: [**2155-5-2**] Date of Birth: [**2072-7-28**] Sex: M Service: CARDIOTHORACIC Allergies: Codeine Attending:[**First Name3 (LF) 165**] Chief Complaint: Abdominal pain Major Surgical or Invasive Procedure: [**2155-4-9**] 1. Emergency repair of type A aortic dissection with ascending aorta and hemiarch replacement with size 30 Gelweave graft. 2. Aortic valve replacement with a size 23 St. [**Male First Name (un) 923**] Epic tissue valve. 3. Right axillary artery cannulation. [**2155-4-10**] Mediastinal exploration for bleeding [**2155-4-15**] Sternal closure [**2155-4-25**] Percutaneous tracheostomy (#8 cuffed) [**2155-4-28**] 39cm double lumen heparin-dependant power PICC tip in the lower SVC [**2155-4-29**] PEG History of Present Illness: Mr. [**Known lastname 110450**] developed acute abdominal pain today while working on his boat. He developed near syncope and 911 was called. He was taken to the outside hospital where he had a non-contrast abdominal CT scan which was negative for abdominal aortic aneurysm. He was admitted to the hospital and developed acute neuro changes with L sided paresis and L neglect. He had CT scan of head/neck/chest and abdomen with contrast wich showed acute aortic disection with extension into the R carotid. His neuro symptoms nearly resolved and he was transferd for surgical repair. Past Medical History: Type A aortic dissection PMH: HTN cataracts Past Surgical History s/p cholecystectomy [**2118**] s/p bilateral hernia repairs Social History: Not documented Family History: Not documented Physical Exam: Pulse:57 SR Resp:14 O2 sat:96% on RA B/P Right: 70/40 Left: 105/56 Height: Weight: General: Skin: Dry [x] intact [x] HEENT: PERRLA [x] EOMI [x] Neck: Supple [x] Full ROM [x] Chest: Lungs clear bilaterally [x] Heart: RRR [x] Irregular [] Murmur-none Abdomen: Soft [x] non-distended [x] mild epigastric tenderness [x] bowel sounds +[x] Extremities: cool [x], well-perfused [x] Edema none Varicosities: None [x] Neuro: awake, alert, oriented to person, place, date, situation. Moves all extremities, strength equal bilaterally, upper and lower extremities, slight facial droop on L Pulses: Femoral Right: Left: DP Right:1+ Left:1+ PT [**Name (NI) 167**]:1+ Left:1+ Radial Right:2+ Left:2+ Pertinent Results: [**2155-5-2**] 03:35AM BLOOD WBC-9.5 RBC-3.32* Hgb-10.2* Hct-32.1* MCV-97 MCH-30.6 MCHC-31.6 RDW-16.8* Plt Ct-382 [**2155-5-1**] 02:11AM BLOOD WBC-10.0 RBC-3.35* Hgb-10.1* Hct-32.6* MCV-97 MCH-30.2 MCHC-31.1 RDW-17.1* Plt Ct-343 [**2155-4-30**] 01:00AM BLOOD WBC-9.5 RBC-3.23* Hgb-9.6* Hct-31.2* MCV-96 MCH-29.6 MCHC-30.7* RDW-17.1* Plt Ct-297 [**2155-5-1**] 02:11AM BLOOD PT-12.6* PTT-29.0 INR(PT)-1.2* [**2155-4-30**] 01:00AM BLOOD PT-12.3 PTT-27.3 INR(PT)-1.1 [**2155-5-2**] 03:35AM BLOOD Glucose-127* UreaN-27* Creat-0.5 Na-144 K-3.7 Cl-112* HCO3-24 AnGap-12 [**2155-5-1**] 07:57PM BLOOD Na-145 K-3.5 Cl-112* [**2155-5-1**] 02:11AM BLOOD Glucose-110* UreaN-24* Creat-0.5 Na-144 K-3.3 Cl-114* HCO3-20* AnGap-13 [**2155-4-30**] 01:00AM BLOOD Glucose-84 UreaN-26* Creat-0.5 Na-148* K-3.4 Cl-116* HCO3-23 AnGap-12. . [**2155-4-9**] ECHO PRE-CPB: The left atrium is moderately dilated. No thrombus is seen in the left atrial appendage. Overall left ventricular systolic function is normal (LVEF>55%). The right ventricular cavity is moderately dilated with severe global free wall hypokinesis. The ascending aorta is moderately dilated. The descending thoracic aorta is moderately dilated. A mobile density is seen in the ascending aorta consistent with an intimal flap/aortic dissection, and this flap extends to the descending thoracic aorta. The dissection flap appears to extend to the aortic root, particularly in the right coronary cusp. The aortic valve leaflets (3) are mildly thickened. Moderate to severe (3+) aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There appears to be prolapse of the area in between the p1 and p2 scallops of the posterior mitral leaflet. There is a central as well as an [**Month/Day/Year 34486**] jet of MR. [**First Name (Titles) **] [**Last Name (Titles) 34486**] jet is anteriorly directed. The MR appears to be moderate to severe (3+). Due to the [**Last Name (Titles) 34486**] nature of the regurgitant jet, its severity may be significantly underestimated (Coanda effect). There is a small pericardial effusion. . [**2155-4-23**] Carotids Impression: Right ICA <40% stenosis. Left ICA <40% stenosis . [**2155-4-24**] CT chest/abd/pelvis IMPRESSION: 1. No retroperitoneal hematoma. 2. Bulbous, large spleen with areas of hypodensity may represent splenic infarct, possibly with liquefaction, incompletely evaluated on this noncontrast CT. If clinically indicated, this could be further evaluated with ultrasound or contrast enhanced CT. 3. Small-to-moderate right hydropneumothorax and small left hydropneumothorax with adjacent atelectasis. 4. Fluid-filled, nondilated small and large bowel may represent ileus. No obstruction. 5. Anasarca. 6. Tiny hyperdensity in the left renal superior pole is nonspecific and may represent a proteinaceous or hemorrhagic cyst. If clinically indicated, dedicated renal ultrasound could be performed for further evaluation. Dr. [**Last Name (STitle) 1603**] discussed findings with [**First Name8 (NamePattern2) 402**] [**Last Name (NamePattern1) **] (PA) by phone, 10:25am [**2155-4-24**]. The study and the report were reviewed by the staff radiologist. DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] DR. [**Last Name (STitle) 64299**] J. MORTELE Approved: [**Doctor First Name **] [**2155-4-24**] 4:54 PM Imaging Lab There is no report history available for viewing. . [**2155-4-24**] ultrasound IMPRESSION: 1. Limited study with suboptimal visualization of the superior pole of the spleen. No focal fluid collection is identified. However, if clinical concern persists further evaluation could be obtained with a contrast enhanced CT abdomen. Findings were discussed with [**First Name8 (NamePattern2) 402**] [**Last Name (NamePattern1) **] on [**2155-4-24**] by phone with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 8631**] at 16:00. The study and the report were reviewed by the staff radiologist. DR. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] DR. [**First Name (STitle) 8913**] SUN Approved: [**Doctor First Name **] [**2155-4-24**] 5:42 PM . Brief Hospital Course: Mr. [**Known lastname 110450**] was admitted to the [**Hospital1 18**] on [**2155-4-9**] via transfer from [**Hospital **] Hospital. He was taken emergently to the operating room where he underwent repair of his type A aortic dissection by way of replacement of his ascending aorta and hemiarch and replacement of his aortic valve. Please see operative note for details. Postoperatively he was taken to the intensive care unit on several drips which include epinephrine, vasopressin, levophed and milrinone. Mr.[**Known lastname 110450**] required maximum pressor and inotropic support with continued hypotension and low C.I/ mixed venous O2SATs and elevated lactate. In addition - episodes of VT occurred and he was placed on amio-lidocaine drips. Over the next day, he had progressive right heart failure. On [**2155-4-10**], sustained VT occurred and CPR was required. His chest was re-opened, washed-out and left open. Aggressive diuresis was initiated. From a renal standpoint: He was Oliguric with worsening renal function from 1.2 to 2.4 and severely volume overloaded. The patient developed acute kidney injury, renal was consulted and CRRT was initiated.[**2155-4-11**] Electrophysiology was consulted regarding continued rhythm problems. Amiodarone was discontinued per EP. Slowly he was weaned off inotropic and pressor support. No further events of Ventricular tachycardia occurred. His rhythm did go into paroxysmal Atrial Fibrillation which was treated with beta-blocker and Amio resumed. On [**4-15**] he was taken back to the operating room and underwent chest closure. Paralytics and sedation were discontinued. Mr.[**Known lastname 110450**] took several days for his mental status to clear. He is neurologically intact and moves all extremities to verbal cues. [**4-23**] Thoracic team was consulted for respiratory failure and ventilator dependence with difficulty weaning. On [**4-25**] Dr. [**First Name (STitle) **] performed a tracheostomy. Please refer to operative report for further details. [**4-25**] GI was consulted for possible bleed. Two days prior his Hct dropped from 32 to 21, received 2 units of PRBC and HCt increased up to 25.5. When given a 3rd unit, his Hct remained at 25.4 along with significant melena. CT abd-pelvis without contrast was done and didn't reveal retroperitoneal bleed. An upper endoscopy was performed and 2 duodenal ulcers were apparant. A vessel required clip placement. Mr.[**Known lastname 110450**] was placed on PPI drip, Tube feeds held and serial hematocrits were followed. He remained stable. H. Pylori was negative. He is to remain on [**Hospital1 **] PPI for 8 weeks, then daily thereafter. Slow progress continued. He remains neurologically intact and doing trach collar trials. Episodes of paroxysmal AFib occur. He remains on Amiodarone. No anticoagulation has been initiated due to his recent upper GI bleed. Nutrition with tube feeds was initiated. His renal function recovered and he makes adequate urine, no longer requiring CRRT for volume removal. His Creatinine has returned to 0.8. He was placed on antibiotics for ventilator acquired pneumonia. Right sided Pigtail catheter was placed for persistent pneumothorax. Air evacuated and air-leak resolved. Tube was discontinued without complication. Follow-up CXR revealed small left pneumothorax which was stable over days. The patient received a Passy-Muir valve on [**2155-4-28**]. On [**2155-4-29**] he received a PEG. He was noted to have ulcerations on his penis. Wound care was consulted and recommendations made. If there is no improvement, urology consult is recommended as an outpatient. He continues to slowly progress and is discharged to [**Hospital1 69097**] in [**Location (un) **] on POD 23. Medications on Admission: Unknown Discharge Medications: 1. docusate sodium 50 mg/5 mL Liquid Sig: One (1) PO BID (2 times a day). 2. polyvinyl alcohol-povidon(PF) 1.4-0.6 % Dropperette Sig: [**12-16**] Drops Ophthalmic PRN (as needed) as needed for dryness. 3. albuterol sulfate 90 mcg/actuation HFA Aerosol Inhaler Sig: Four (4) Puff Inhalation Q4H (every 4 hours) as needed for wheezes. 4. tramadol 50 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for pain. 5. quetiapine 25 mg Tablet Sig: 0.5 Tablet PO QPM (once a day (in the evening)) as needed for sleep. 6. heparin (porcine) 5,000 unit/mL Solution Sig: One (1) Injection TID (3 times a day). 7. chlorhexidine gluconate 0.12 % Mouthwash Sig: One (1) ML Mucous membrane [**Hospital1 **] (2 times a day). 8. lidocaine HCl 2 % Solution Sig: One (1) ML Mucous membrane TID (3 times a day) as needed for mouth pain. 9. metoprolol tartrate 25 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 10. amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 11. 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. 12. CefePIME 2 g IV Q12H thru [**5-5**] 13. Vancomycin 1000 mg IV Q 12H thru [**5-5**] 14. Furosemide 40 mg IV BID 15. Pantoprazole 40 mg IV Q12H 16. Sodium Chloride 0.9% Flush 10 mL IV PRN line flush Temporary Central Access-ICU: Flush with 10mL Normal Saline daily and PRN. 17. potassium chloride 25 mEq Packet Sig: One (1) PO twice a day. 18. insulin regular human 100 unit/mL Solution Sig: One (1) Injection four times a day: see attached sliding scale. 19. wound care Penis/Scrotum: elevate scrotum and penis on soft towel or pillow case ( fold several times ) Cleanse wound with wound cleanser then pat dry, apply aloe vesta as needed to moisturize dry skin, apply Xeroform dressing to provide antimicrobial coverage and dry out wounds, no need for gauze and no need to secure in place, change daily Discharge Disposition: Extended Care Facility: [**Hospital1 **] Pavilion - [**Location (un) **] Discharge Diagnosis: Type A Aortic Dissection - s/p repair s/p tracheostomy s/p upper endoscopy with vessel clipping secondary to Upper GI bleed Hypertension Cataracts s/p cholecystectomy [**2118**] s/p bilateral hernia repairs Discharge Condition: Alert and oriented x 3 Deconditioned Incisional pain managed with oral analgesia Incisions: Sternal - healing well, no erythema or drainage Edema 2+ lower extremities, 4+ scrotal edema penis with necrotic ulcerations- wound care recs attached 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**] **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. [**First Name (STitle) **] [**2155-6-3**], 1:00pm Cardiologist: Dr. [**Last Name (STitle) 76338**], [**Telephone/Fax (1) 92020**], [**Location (un) 110451**], [**Location (un) 1456**] Wed, [**2155-5-28**], 8:45am Please call to schedule appointments with your Primary Care Dr. [**Last Name (STitle) 8448**] in [**3-20**] 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:[**2155-5-2**] ICD9 Codes: 5845, 4271, 2760, 2875, 2762, 4019
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Medical Text: Unit No: [**Numeric Identifier 56787**] Admission Date: [**2119-11-14**] Discharge Date: [**2119-12-1**] Date of Birth: [**2058-6-3**] Sex: M Service: CSU HISTORY OF PRESENT ILLNESS: Father [**Name (NI) **] is a 61-year-old man, with known CAD, status post coronary artery bypass graft on [**2119-10-31**] with a LIMA to the LAD, saphenous vein graft to OM1, saphenous vein graft to D1, and saphenous vein graft to PDA. The patient was discharged home on [**11-5**], and returns on the day of admission complaining of sternal drainage x several days with increasing amounts on the day of admission. The patient denies fever, chills, nausea, vomiting, or malaise. PAST MEDICAL HISTORY: CAD, status post CABG with an EF of 20 percent. Diabetes mellitus, currently insulin dependent. Hypercholesterolemia. GERD. ALLERGIES: None. MEDS ON ADMISSION: 1. Colace 100 mg [**Hospital1 **]. 2. Aspirin 81 mg once daily. 3. Plavix 75 mg once daily. 4. Carvedilol 6.25 mg [**Hospital1 **]. 5. Simvastatin 40 mg once daily. 6. Lasix 40 mg [**Hospital1 **]. 7. Lantus insulin 45 units q pm. 8. Percocet 5/325, 1-2 tabs q 4 h prn. LABS ON ADMISSION: White count 18.6, hematocrit 33.9, platelets 893, PT 17.5, PTT 24, INR 1.1, sodium 139, potassium 4.2, chloride 101, CO2 25, BUN 14, creatinine 0.9, glucose 246. Chest x-ray shows cardiomegaly with left-sided effusion with atelectasis, multiple displaced wires. EKG: Sinus rhythm with a rate of 100, Q's in III and AVF, nonspecific ST changes with poor R wave progression. PHYSICAL EXAM: Temperature 103, heart rate 116--sinus tachycardia, blood pressure 100/47, respiratory rate 30, O2 sat 97 percent on 2 liters nasal prongs. Neuro: Alert and oriented x 3, moves all extremities, follows commands, nonfocal exam. Respiratory: Clear to auscultation with a sucking chest wound. Cardiovascular: Regular rate and rhythm. Sternum with surrounding erythema of about 10 cm, with a positive click. Small draining hole in midincision with milky serous drainage. Staples remain in place. Abdomen is soft, nontender, nondistended with normoactive bowel sounds. Extremities are warm and well-perfused with no edema. Right calf with a healing wound and minimal erythema. Left knee with an endoscopic site that is healing, open to air, clean and dry. HOSPITAL COURSE: The patient was admitted to the Cardiothoracic Intensive Care Unit. He was begun on vancomycin 1 gm q 12 h, as well as levofloxacin 500 mg once daily. He was typed and screened and kept NPO for mediastinal exploration plus/minus a flap closure. On hospital day 2, the patient was brought to the operating room. Please see the OR report for full details. In summary, the patient had a sternal exploration and debridement. He tolerated the operation well and was returned to the Cardiothoracic Intensive Care Unit intubated and sedated with an open chest wound. Plastic surgery was also following the patient. The patient did well in the immediate postoperative period. His anesthesia was reversed. He was weaned from the ventilator and successfully extubated. Several hours following extubation, the patient was found to be in acute respiratory distress and was emergently reintubated. From that point forward, he was kept sedated and ventilated awaiting plastics follow-up for flap closure. On the [**11-19**], the patient returned to the operating room. Please see the OR report for full details. In summary, the patient was brought to the operating room by the plastic surgery service for pectoral advancement with an omentum flap. He tolerated the operation well and was returned to the Cardiothoracic Intensive Care Unit. The patient remained intubated following his surgery. However, his sedation was minimized to allow the patient to overbreathe the ventilator. During that period, the patient had several episodes of coughing which led to a dehiscence of his abdominal incision, and on the [**11-20**] the patient again returned to the operating room for re-exploration and closure of the fascia of his abdominal wound. He tolerated this surgery well also and following that returned to the Cardiothoracic Intensive Care Unit, again ventilated and sedated. The patient remained ventilated and sedated for the next several days in an attempt to give the wound a chance to heal. Ultimately, the patient was successfully extubated on the [**11-24**]. However, he stayed in the Cardiothoracic Intensive Care Unit following extubation for close pulmonary monitoring. It should be noted that during the patient's ICU course, he had several intermittent episodes of atrial fibrillation for which he was begun on amiodarone, as well as heparin and ultimately Coumadin for anticoagulation. The patient did well over the next several days, and ultimately was transferred to the floor on [**11-28**], hospital day 15, postoperative day 13. At that point, a PICC line was placed for long-term antibiotic coverage. Over the next several days, the patient's activity level was increased with the assistance of the nursing and the physical therapy staff. His antibiotic coverage was continued. His anticoagulation was transitioned from intravenous to oral. Finally, on the [**12-1**], the patient's final [**Location (un) 1661**]- [**Location (un) 1662**] drain was removed from his chest, and it was decided that he was stable and ready to be transferred to rehabilitation for long-term antibiotic coverage, as well as glucose control. At that time, the patient's physical exam was as follows: Vital signs: Temperature 98.4, heart rate 82--sinus rhythm, blood pressure 113/66, respiratory rate 18, O2 sat 95 percent on room air, weight day of dictation 106.6 kg, preoperatively 100 kg. Lab data: PT 17.1, INR 1.9, sodium 139, potassium 3.7, chloride 100, bicarb 27, BUN 11, creatinine 0.9, glucose 149, white count 9.1, hematocrit 28.4, platelets 830. Physical exam - Neurologically: Alert and oriented x 3, nonfocal exam. Pulmonary: Clear to auscultation bilaterally. Cardiac: Regular rate and rhythm, S1, S2. Sternum: Incision with staples, clean and dry. No erythema or drainage. Abdomen was soft, nontender, nondistended with normoactive bowel sounds. Abdominal incision with staples, also clean and dry. Extremities were warm with no edema. Right saphenous vein graft harvest site was healing well, open to air, clean and dry. CONDITION ON DISCHARGE: Good. DISCHARGE DIAGNOSES: Coronary artery disease, status post coronary artery bypass grafting complicated by sternal infection requiring sternal debridement and flap closure. Diabetes mellitus. Hypercholesterolemia. Gastroesophageal reflux disease. FOLLOW UP: Follow-up with Dr. [**Last Name (STitle) 13797**] with plastic surgery service in 1 week. He is to call for an appointment at [**Telephone/Fax (1) 56789**]. He is also to have follow-up with Dr. [**Last Name (STitle) **] in 4 weeks. The patient is also to call for that appointment; the number is [**Telephone/Fax (1) 170**]. DISCHARGE MEDICATIONS: 1. Ranitidine 150 mg [**Hospital1 **]. 2. Simvastatin 40 mg once daily. 3. Ferrous sulfate 325 mg once daily. 4. Ascorbic acid 500 mg [**Hospital1 **]. 5. Zinc sulfate 220 mg once daily. 6. Aspirin 81 mg once daily. 7. Erythromycin ophthalmic ointment [**Hospital1 **]. 8. Colace 100 mg [**Hospital1 **]. 9. Metoprolol XL 100 mg once daily. 10.Glargine 24 units q at bedtime. 11.Humalog insulin sliding scale q ac and at bedtime. 12.Lasix 20 mg once daily. 13.Potassium chloride 20 mEq once daily. 14.Amiodarone 400 mg [**Hospital1 **] x 1 week, then 400 mg once daily x 1 week, then 200 mg once daily. 15.Oxacillin 2 grams q 4 h through [**12-28**]. 16.Warfarin as directed to maintain a target INR of 2 to 2.5. The patient's warfarin doses starting with 4 days ago - 3 mg, 5 mg, 5 mg, 5 mg. The patient is to receive 4 mg on the [**2032-11-29**].Albuterol 2 puffs qid prn. DISPOSITION: The patient is to be discharged to rehabilitation. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 1714**], [**MD Number(1) 1715**] Dictated By:[**Last Name (NamePattern4) 1718**] MEDQUIST36 D: [**2119-12-1**] 13:31:57 T: [**2119-12-1**] 14:15:12 Job#: [**Job Number 56790**] ICD9 Codes: 5185, 9971
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Medical Text: Admission Date: [**2129-12-2**] Discharge Date: [**2129-12-6**] Date of Birth: [**2078-8-16**] Sex: M Service: NEUROLOGY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**Last Name (NamePattern1) 1838**] Chief Complaint: Headache and spinning Major Surgical or Invasive Procedure: None History of Present Illness: Mr. [**Known lastname 50483**] is a 51 yo right handed man who presents as a transfer from [**Hospital **] hospital or evaluation of a subacute cerebellar infarct. The patient states that his symptoms began sometime on Tuesday. At that time he noted what he called a "computer headache" which was dull, mostly in his left temple. It was constant but not significantly painful. This continued into Wednesday when around noon, he noted a second pain which started below his left ear. This was again a dull pain, and the patient thought he was developing an ear infection. He had no other symptoms at that time and he continued his normal daily routine which included going to his psychiatry appointments for him and his daughter. Wednesday evening, he recalls eating ice cream, taking his Requip and going to bed. At around 8:45pm, he rolled from his right to his left and had the sudden onset of uncontrollable spinning. He felt as though he was free-falling and he needed to hold on to the bed. He felt as though he had to fight to maintain consciousness. He wanted to call for his daughter who was across the [**Doctor Last Name **], but he couldn't speak secondary to the fear of vomiting if he opened his mouth. He began sweating profusely. He believes his symptoms lasted for nearly 10 minutes and then they stopped, as quickly as they came. He was able to fall asleep without difficulty. The following morning, he felt "fuzzy" and the symptoms from the night before where somewhat fluttering in the background. When he went to get out of bed, he again noted slight room spinning. He reclined on the bed for a few minutes and it passed. He was able to get up and drive to work. Over the course of the morning, the patient began to experience worsening head pain- the headaches he had previously (the left temple, behind the ear), now seemed confluent and the quality changed. It was now a sharp pain which was predominantly behind his left eye. At worse, the pain was a [**2129-6-20**]. He called his PCP and was seen in the afternoon- at that point the doctor was wondering he had Meniere's disease. He was started on meclizine and Fioricet as well as ear drops. He was told to go to the emergency room if his symptoms did not improve. At 5:45, the patient was getting ready to go to a parent teacher's meeting when he felt his symptoms were getting worse and it was at this point he went to [**Hospital **] hospital for evaluation. On arrival to [**Hospital1 **], vitals were T98.3, HR 102, BP 125/85, RR16, 110% on RA. He was given Percocet for pain and a CT of the head was performed which showed a subacute left inferior cerebellar infarct as well as an old right BG lacunar. He was given an aspirin and referred to [**Hospital1 18**] for further workup. At this time, the patient continues to have significant left sided face and neck pain. He feels congested. He denies any additional vertigo. He does feel as if his hearing is less sharp, describing a shallow quality to sounds in his left ear. He also notes a strange background noise like a faucet running off in the distance. He has pain in his neck when he brings his chin to his chest and pain in his eyes when he looks to his far left. Otherwise, neurologic review of systems was negative for dysarthria, dysphagia, difficulties producing or comprehending speech, focal weakness, numbness, parasthesiae, bowel or bladder incontinence or retention. He notes he has been walking cautiously out of fear that he might have vertigo, but he has been able to ambulate without falling. On general review of systems, the patient denied recent fever or chills. He has no history of trauma, he denies lifting heavy weights. He denied cough, shortness of breath, chest pain, tightness or palpitations. Denied changes in bowel or bladder habits. No dysuria. Denied arthralgias or myalgias. His wife reports significant stress as the patient just recently returned to work after 1 year. His wife was just recently diagnosed with MS and they have a daughter with significant behavioral issues. Past Medical History: -Hypertension -Hyperlipidemia -Restless Limb Syndrome -Heart Murmur -Depression/ADD -Sleep Apnea, s/p ulectomy, tonsillectomy [**2111**] prescribed but does not use CPAP -s/p ALIF of the spine (?Lumbar -s1) on [**10/2128**], complicated by an abdominal seroma which required drainage. -s/p right medial meniscus repair [**2109**] per the medical record, also hx of positive PPD Social History: Mr. [**Known lastname 50483**] is married, has 2 daughters. [**Name (NI) **] works as a professional housekeeper/maintenance. Just recently began working for Environmental Services for a convent. He is catholic. He smokes [**1-15**] PPD for 35 years. He denies alcohol use. He occasionally smokes marijuana and last Friday he did do several lines of cocaine (he had not used cocaine in many years). Family History: Father- small cell adenocarcinoma of the lung Brother- small cell adenocarcinoma of the lung just diagnosed Mother- Hypertension, Depression M.[**Name (NI) **] MI Sister- cerebral aneurysm (not ruptured) Family history of carotid disease Physical Exam: T 98.0 BP 114/80 HR 99 99 O2% General: Awake, cooperative, NAD. Head and Neck: no cranial abnormalities, no scleral icterus though slightly injected. MMM. no lesions noted in oropharynx. Neck: Supple, no carotid bruits appreciated. No nuchal rigidity, no paraspinal tenderness. Pulmonary: Lungs clear to auscultation bilaterally Cardiac: regular rate and rhythm, [**3-19**] harsh SEM appreciated throughout the precordium but best at RUSB. Abdomen: soft, non-tender, normoactive bowel sounds, no masses or organomegaly noted. Extremities: 2+ radial, DP pulses bilaterally. Skin: no rashes or lesions noted. Neurologic: -Mental Status: Alert, oriented x 3. Able to relate history without difficulty. Attentive. Language is fluent with intact repetition and comprehension. Normal prosody. There were no paraphasic errors. Pt. was able to name both high and low frequency objects. Speech was not dysarthric (though the patient was missed several teeth). Good knowledge of current events. There was no evidence of apraxia or neglect, calculations intact. Registered [**3-16**] and recalled [**3-16**] at 5 minutes. -Cranial Nerves: I: Olfaction not tested. II: PERRL 4 to 2mm and brisk. Visual fields full on bedside testing with red pin. Funduscopic exam revealed sharp discs bilaterally. III, IV, VI: EOMI with nystagmus on bilateral horizontal gaze, with larger amplitude on left [**Hospital1 **] gaze. Consistent overshoot on saccadic movements to the left. V: Facial sensation intact to light touch. VII: No facial droop, facial musculature symmetric. VIII: Hearing intact to finger-rub bilaterally. IX, X: Palate elevates symmetrically. [**Doctor First Name 81**]: 5/5 strength in trapezii and sternocleidomastoid bilaterally. XII: Tongue protrudes in midline. -Motor: Normal bulk, tone throughout. Possible subtle right pronator drift. No rigidity. No adventitious movements, such as tremors, noted. No asterixis. Delt Bic Tri WrE FFl FE IO IP Quad Ham TA [**First Name9 (NamePattern2) 2339**] [**Last Name (un) 938**] EDB L 5 5 5 5 5 5 5 5 5 5 5 5 5 5 R 5 5 5 5 5 5 5 5 5 5 5 5 5 5 -Sensory: No deficits to light touch, cold sensation, vibratory sense, proprioception throughout. Notes a mild decrease- 10% less then right- in pinprick in the left hand compared to right, only affecting the dorsum of the hand to about the wrist. No extinction to double simultaneous stimuli. -Deep tendon reflexes: [**Hospital1 **] Tri [**Last Name (un) 1035**] Pat Ach L 2 2 2 2 2 R 2 2 2 2 2 Plantar response was flexor bilaterally. -Coordination: No intention tremor, no dysdiadochokinesia noted. No dysmetria on FNF. Possible mild ataxia of the left leg on HKS testing. -Gait: Good initiation. Narrow-based, normal stride and arm swing. Difficulty testing tandem gait has patient was in pain when standing. Romberg initially stable but then patient with sudden eye opening and slight [**Last Name (un) 50484**] to the left. Pertinent Results: [**2129-12-2**] 06:42AM TRIGLYCER-227* HDL CHOL-35 CHOL/HDL-5.3 LDL(CALC)-107 [**2129-12-2**] 02:16AM %HbA1c-5.9 eAG-123 MR head [**2129-12-3**] IMPRESSION: Acute left cerebellar infarct with patent flow voids of the vertebral arteries and basilar artery. The medulla is not involved. No hydrocephalus or mass effect on the fourth ventricle. CTA [**12-2**] 1. Left cerebellar stroke which may be acute/subacute. 2. No contrast opacification seen in the V1/V2 segment of the left vertebral artery indicating segmental occlusion. The underlying etiology may be dissection or atherosclerotic disease. 3. Extensive atherosclerosis and more than 50 to 60 % stenosis of the right internal carotid and 60 to 70 % stenosis of the left internal carotid artery. 4. Apical fibrosis and bullous change predominantly on the right. Correlation with clinical history of smoking and further imaging may be performed as per clinical need. Brief Hospital Course: Mr. [**Known lastname 50483**] is a 51 yo right handed man with a history ofvascualar risk factors including hypertension, hyperlipidemia(poor compliance with treatment) and smoking who present with progressively worsening left sided facial pain and an episode of extreme vertigo a little more than 24 hours ago. He underwent a head CT at [**Hospital **] hospital which identified a subacute left inferior cerebellar infarct without evidence of hemorrhage. Repeat imaging here shows a stable infarct with minimal effacement of the 4th ventricle. CTA demonstrates lack of flow of the left vertebral artery at V1-V2 concerning for atherosclerotic disease or dissection. Given his extensive atherosclerosis in the extracranial carotids and given the location of the left vertebral artery occlusion, it was thought that the most likely cause of the left vertebral occlusion was atherosclerosis. The patient's exam is remarkably intact but is notable for bilateral horizontal gazed evoked nystagmus with a more prominent amplitude on leftward gaze as well as mild overshoot when testing saccadic movements to the left. There may also be a very ataxia of the left leg compared to the right on HKS testing and an even more subtle right pronator drift, the latter being inconsistent on multiple trials. The patient has no history of trauma, no family history of vascular abnormalitis/dissections which could have contributed to his presentation. Given the cerebellar infarct and concern for continued edema, we did the following: Patient was admitted to the Neuro ICU for monitoring of swelling. Patient was started on heparin and bridged to coumadin. Patient has remained stable with normal exam. Heparin was continued until coumadin was therapeutic at INR 2.2 on [**2129-12-6**]. He should have repeat MRI brain imaging/MRA brain and MRA neck imaging at 2.5 months. Will consider switching him from coumadin to an anti-platelet [**Doctor Last Name 360**] at that time. CARDIOVASCULAR: Patient was allowed to autoregulate, initially held lisinopril. and gave hydralazing for SBP >185. Bed was kept <30 degrees. Restarted Lisinopril to lower dose on discharge. FEN: Patient was swallowing without difficulty and therefore diet, was advanced. HEME: LDL 106 Patient was inconsistently taking his simvastatin. Will advise to continue on 40 mg daily and recheck with PCP for [**Name Initial (PRE) **] goal of less than 70. Patient was started on heparin to prevent extension of the clot, and bridged to a therapeutic INR. ENDO: For glucose control patient was kept on SS insulin. HgBA1c was 5.9 Psych: He was strongly advised to never use cocaine again. Concerta was stopped because it is a risk factor for ischemic stroke. Medications on Admission: Lisinopril 40mg daily Requip 2mg 1 hour prior to sleep Fluoxetine 60mg daily in AM Concerta 54mg daily in AM Simvastatin 40mg (does not take regularly) Percocet PRN for back pain Discharge Medications: 1. ropinirole 1 mg Tablet Sig: Two (2) Tablet PO QPM (once a day (in the evening)). 2. fluoxetine 20 mg Capsule Sig: Three (3) Capsule PO DAILY (Daily). 3. simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO TID (3 times a day). 5. warfarin 5 mg Tablet Sig: One (1) Tablet PO Once Daily at 4 PM. Disp:*30 Tablet(s)* Refills:*0* 6. oxycodone-acetaminophen 5-325 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4 hours) as needed for pain. Disp:*40 Tablet(s)* Refills:*0* 7. lisinopril 10 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Left cerebellar infarct and left vertebral artery stenosis Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: You were admitted after developing severe headache and found to have left cerebellar infarct and left vertebral artery stenosis concerning for dissection. Given the large infarct, you were initially admitted to the intensive care unit. You continued to improve and were transferred to the neurology floor. You underwent MRI of the brain which was consistent with the CT head showing left cerebellar stroke in the left PICA distribution. Given the stroke and the vertebral artery stenosis, you were started on heparin and Coumadin. You were continued on the heparin which was discontinued on the day of your discharge when you INR was found to be therapeutic. You will need daily INR checks per your PCP. [**Name10 (NameIs) **] spoke with the office manager who said you can walk in Monday through Friday for checks. [**Telephone/Fax (1) 50485**] Medications changed 1. Started Warfarin 5 mg every night (have INR checked daily - and then monitored by PCP) 2. decreased Lisinopril to 10 mg daily 3. Stopped Concerta Followup Instructions: Please follow-up with your primary care doctor within ~2 weeks of discharge. You are scheduled to see Dr. [**Last Name (STitle) **], neurologist who oversaw your care during this admission: Provider: [**First Name8 (NamePattern2) **] [**First Name11 (Name Pattern1) 640**] [**Last Name (NamePattern4) 3445**], MD Phone:[**Telephone/Fax (1) 2574**] Date/Time:[**2130-1-11**] 3:00 [**Hospital Ward Name 23**] Building, [**Hospital1 18**] [**Location (un) 858**] Completed by:[**2129-12-6**] ICD9 Codes: 3051, 311, 2724, 4019
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Medical Text: Admission Date: [**2116-3-22**] Discharge Date: [**2116-5-8**] Date of Birth: [**2057-12-26**] Sex: F Service: MEDICINE Allergies: Heparin Agents / Cefazolin / Nelfinavir / Morphine / vancomycin / Nafcillin Attending:[**First Name3 (LF) 2763**] Chief Complaint: upper back/neck pain Major Surgical or Invasive Procedure: Mechanical Intubation HD line insertion Arterial Line Insertion History of Present Illness: Ms. [**Known lastname 11182**] is a 55 yo f with HIV ([**2-13**] CD4 375), [**Month/Year (2) **] [**Month/Year (2) 106114**] pneumonitis, pulmonary HTN, ESRD on HD, cardiomyopathy and emphysema on O2 at home who presents with 2 weeks of cough and increased SOB, and 3 days of upper back/neck pain. She is more concerned about the back pain than the cough, which did not bother her too much. She denies F/C at home. She has produced some sputum; is on 3L home O2 at baseline. Last rec'd HD on [**3-20**]. As to her back pain, it started gradually 3 days PTA, and is located around her b/l shoulders, neck, and part of her L arm. No trouble holding objects or moving the L arm. No h/o lifting heavy objects or trauma. No lower back pain or trouble walking. No photophobia although she says she has cataracts. Endorses HA that she has had for 2 weeks or so, b/l frontal HA. She tried using [**Doctor First Name **]-gay for her shoulders to no avail. . In the ED, initial vitals were 102.4, 116, 113/81, 20, 99% 4L . Fiven Levaquin, was wheezing on arrival, received nebulizers and prednisone, with improvement of wheezing. Given her significant comorbidities, admitted to medicine for pneumonia. Got Tylenol, also Percocet for chronic back pain. . Currently, she c/o persistent upper back/neck pain. No vomiting, dysuria, diarrhea. Is hungry. Past Medical History: -HIV ([**2-13**] CD4 375) -ESRD on HD MWF -HTN -severe Pulmonary HTN -Cardiomyopathy [**12-10**] LVEF 31%, severe MR/TR -[**Month/Year (2) 106113**] [**Month/Year (2) 106114**] pneumonitis (LIP) followed by Dr. [**Last Name (STitle) **] [**Last Name (STitle) **] at [**Hospital1 2177**] ([**Telephone/Fax (1) 7799**] #6564 -anemia of chronic disease -AVNRT diagnosed at [**Hospital1 2177**] -Recent vaginal bleed s/p conization -HCV - untreated -Asthma/COPD on home O2 -h/o [**Hospital1 8974**] bacteremia and vertebral osteomyelitis PAST SURGICAL HISTORY -C-section -R knee surgery -Ovarian cysts removed Social History: She lives in [**Location 669**] with her 18 year old son. She has three sons and one daughter. Currently smokes a few cigarettes every few days. She has a 30-40 pack year smoking history. Has used "every drug" including cocaine. Last drug use was "eight years ago). She has never used IV drugs. She has a history alcohol abuse and has not drank in many years. Family History: Her mother is living in her 70s and had a stroke, hypertension and diabetes. Her uncle died of kidney disease. She never met her father. [**Name (NI) **] sister was killed in a motor vehicle crash. Her children are healthy. Her daughter has a single kidney. Physical Exam: ADMISSION PHYSICAL EXAM: VITALS: 99.2, 115, 101/69, 24, 95% 3L NC GEN: in NAD, resting in bed. alert. responds appropriately to questions. HEENT: PERRl, OP clear, MMM CV: RRR, could not appreciate murmurs; tachycardic PULM: CTAB but decreased breath sounds throughout ABD: umbilical hernia, normal BS, no tenderness to palpation, soft. EXT: no clubbing or cyanosis, 1+ edema b/l. 1+ pedal pulses Skin: diffuse dry and flaky skin on trunk, arms, scalp and less so on legs. Neuro: A/O x 3; CN2-12 intact b/l, strength 5/5 throughout b/l . DISCHARGE PHYSICAL EXAM: Tcurrent: 36.7 ??????C (98 ??????F) HR: 119 (104 - 125) bpm BP: 124/55(70) {72/29(45) - 124/67(75)} mmHg RR: 17 SpO2: 97% on 3LNC GENERAL - Chronically ill appearing, no acute respiratory distress at the time of my exam HEENT - PERRL, EOMI, sclera icteric, Dry mucous membranes with and cracked lips, OP clear, wrapped pressure ulcer on occiput. NECK - supple, no [**Doctor First Name **] no thyromegaly, no JVD, no carotid bruits, left IJ with mild oozing of blood but site non-tender, area of soft fullness slightly larger to area on corresponding side and disappears when she lays flat LUNGS - Coarse breath sounds and crackles b/l, reasonable movement throughout HEART - Tachycardic, nl S1 S2 clear and of good quality, RR ABDOMEN - NABS, soft/NT/ND, no rebound/guarding EXTREMITIES - WWP, no c/c/e, soft but palpable peripheral pulses NEURO - awake, A&Ox3, CNs II-XII grossly intact. Denies sensation of her feet and decreased sensation of her lower legs, describes burning sensation in her hands, diminished strength but function grossly. Pertinent Results: ADMISSION LABS: . [**2116-3-22**] 03:00AM BLOOD WBC-6.2# RBC-3.95* Hgb-11.4* Hct-36.4 MCV-92 MCH-28.8 MCHC-31.3 RDW-17.7* Plt Ct-65* [**2116-3-22**] 03:00AM BLOOD Neuts-73.8* Lymphs-22.7 Monos-2.4 Eos-0.7 Baso-0.4 [**2116-3-23**] 06:25AM BLOOD ESR-36* [**2116-3-22**] 03:00AM BLOOD Glucose-95 UreaN-23* Creat-7.4*# Na-137 K-7.3* Cl-101 HCO3-26 AnGap-17 [**2116-3-23**] 06:25AM BLOOD ALT-14 AST-26 AlkPhos-139* TotBili-0.6 [**2116-3-22**] 03:00AM BLOOD cTropnT-0.05* [**2116-3-22**] 03:00AM BLOOD proBNP-[**Numeric Identifier **]* [**2116-3-23**] 06:25AM BLOOD Calcium-7.9* Phos-2.3*# Mg-1.7 [**2116-3-23**] 06:25AM BLOOD CRP-38.1* [**2116-3-23**] 08:49AM BLOOD Lactate-1.9 [**2116-3-24**] 11:23AM BLOOD Lactate-1.1 [**2116-3-23**] 08:49AM BLOOD Type-ART pO2-111* pCO2-43 pH-7.38 calTCO2-26 Base XS-0 [**2116-3-24**] 11:23AM BLOOD Type-ART pO2-96 pCO2-48* pH-7.44 calTCO2-34* Base XS-6 . DISCHARGE LABS: . [**2116-5-8**] 04:05AM BLOOD WBC-4.9 RBC-2.60* Hgb-7.8* Hct-27.3* MCV-105* MCH-30.0 MCHC-28.6* RDW-21.4* Plt Ct-92* [**2116-5-8**] 04:05AM BLOOD Glucose-105* UreaN-18 Creat-3.1*# Na-137 K-3.8 Cl-98 HCO3-31 AnGap-12 [**2116-5-8**] 04:05AM BLOOD Calcium-9.3 Phos-2.5* Mg-1.9 [**2116-5-7**] 04:17AM BLOOD Type-MIX pO2-178* pCO2-61* pH-7.30* calTCO2-31* Base XS-2 Comment-GREEN TOP . PERTINENT MICRO/PATH: BLOOD CULTURES: [**2116-3-22**]: 3 of 3 sets positive as below [**2116-3-23**]: 1 of 1 set positive as below Dates [**2116-3-24**] - [**2116-5-2**]: 17 of 17 sets negative . [**2116-3-22**] 3:00 am BLOOD CULTURE Blood Culture, Routine (Final [**2116-3-30**]): STAPH AUREUS COAG +. FINAL SENSITIVITIES. Consultations with ID are recommended for all blood cultures positive for Staphylococcus aureus, yeast or other fungi. BACTRIM (=SEPTRA=SULFA X TRIMETH) sensitivity testing confirmed by [**First Name8 (NamePattern2) 3077**] [**Last Name (NamePattern1) 3060**]. DOXYCYCLINE AND RIFAMPIN SENSITIVITIES REQUESTED BY [**First Name4 (NamePattern1) 2482**] [**Last Name (NamePattern1) **],[**2116-3-28**]. SENSITIVE TO DOXYCYCLINE , sensitivity testing performed by [**First Name8 (NamePattern2) 3077**] [**Last Name (NamePattern1) 3060**]. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ STAPH AUREUS COAG + | CLINDAMYCIN-----------<=0.25 S ERYTHROMYCIN----------<=0.25 S GENTAMICIN------------ <=0.5 S LEVOFLOXACIN---------- =>8 R OXACILLIN------------- 0.5 S RIFAMPIN-------------- <=0.5 S TRIMETHOPRIM/SULFA---- =>16 R . ABSCESS CULTURE: [**2116-3-25**] 10:30 am ABSCESS NECK/ABSCELL FOR CULTURE. STAPH AUREUS COAG + CLINDAMYCIN-----------<=0.25 S ERYTHROMYCIN----------<=0.25 S GENTAMICIN------------ <=0.5 S LEVOFLOXACIN---------- =>8 R OXACILLIN-------------<=0.25 S TRIMETHOPRIM/SULFA---- =>16 R . PREVERTEBRAL TISSUE CULTURE: STAPH AUREUS COAG + CLINDAMYCIN-----------<=0.25 S ERYTHROMYCIN----------<=0.25 S GENTAMICIN------------ <=0.5 S LEVOFLOXACIN---------- =>8 R OXACILLIN------------- 0.5 S TRIMETHOPRIM/SULFA---- =>16 R . ANAEROBIC CULTURE (Final [**2116-3-29**]): NO ANAEROBES ISOLATED. . BAL Culture [**2116-4-17**]: No growth, negative for PCP . PICC Tip Cx: [**2116-4-8**]: No growth [**2116-4-21**]: No growth . HIV VL [**2116-3-26**]: 183 copies . RPR [**4-20**]: Non-reactive . MRSA SCREEN [**3-24**] & [**4-13**]: Negative . SPUTUM: [**4-5**]: PSEUDOMONAS AERUGINOSA AMIKACIN-------------- 8 S CEFEPIME-------------- 8 S CEFTAZIDIME----------- 16 I CIPROFLOXACIN--------- =>4 R GENTAMICIN------------ =>16 R MEROPENEM------------- 4 S PIPERACILLIN/TAZO----- R TOBRAMYCIN------------ =>16 R . [**4-6**]: PSEUDOMONAS AERUGINOSA AMIKACIN-------------- 16 S CEFEPIME-------------- 16 I CEFTAZIDIME----------- 8 S CIPROFLOXACIN--------- =>4 R GENTAMICIN------------ =>16 R MEROPENEM------------- 4 S PIPERACILLIN/TAZO----- R TOBRAMYCIN------------ =>16 R . [**4-15**]:PSEUDOMONAS AERUGINOSA AMIKACIN-------------- <=2 S CEFEPIME-------------- 8 S CEFTAZIDIME----------- 8 S CIPROFLOXACIN--------- =>4 R GENTAMICIN------------ =>16 R MEROPENEM------------- 4 S PIPERACILLIN/TAZO----- R TOBRAMYCIN------------ 8 I . [**4-16**]: PSEUDOMONAS AERUGINOSA AMIKACIN-------------- S CEFEPIME-------------- 16 I CEFTAZIDIME----------- =>32 R CIPROFLOXACIN--------- =>4 R GENTAMICIN------------ =>16 R MEROPENEM------------- 8 I PIPERACILLIN/TAZO----- =>128 R TOBRAMYCIN------------ 8 I . [**5-5**]: LEGIONELLA CULTURE (Preliminary): NO LEGIONELLA ISOLATED. . STOOL: [**3-29**]: Cdiff Negative [**4-30**]: Cdiff Negative . PATHOLOGY: OR SPECIMEN OF PREVERTEBRAL TISSUE: [**2116-3-25**] DIAGNOSIS: 1. Prevertebral tissue, excision (A): A. Fibrocartilage with focal acute and chronic inflammation and necrosis. See note. B. Fragments of bone. 2. Intervertebral disc, C4-C7, excision (B): A. Fibrocartilage with degenerative change and crushed cells, cannot exclude inflammatory cells. B. Fragments of bone. . IMAGING STUDIES: -CARDIOLOGY: TTE [**3-26**]: IMPRESSION: no echo evidence of endocarditis. Relatively small, hyperdynamic, left ventricle. Dilated and hypokinetic right ventricle with moderate to severe pulmonary hypertension. Mild mitral and moderate tricuspid regurgitation. . Compared with the prior study (images reviewed) of [**2114-4-16**], the degree of mitral regurgitation has increased. The right ventricle appears similar - moderately dilated with mild hypokinesis. The degree of tricuspid regurgitation has increased. Left ventricular function is more hyperdynamic on the current study. . TTE [**4-16**]: IMPRESSION: No echocardiographic evidence of endocarditis. Cannot exclude due to suboptimal image quality. Normal regional left ventricular systolic function. Mildly dilated and mildly hypokinetic right ventricle. If clinically indicated, a transesophageal echocardiogram may better assess for valvular vegetations. . Compared with the prior study (images reviewed) of [**2116-3-26**], pulmonary artery pressures could not be estimated on the current study. The other findings are similar. . RADIOLOGY: -[**2116-3-22**] CXR: IMPRESSION: Overall similar appearance of mild [**Month/Day/Year 106114**] edema and bibasilar scarring and/or atelectasis. Correlate clinically for possibility of early infection. No radiographic evidence of confluent consolidation. . -[**2116-3-23**] C-spine MRI: IMPRESSION: 1. C4-5: Marked narrowing of the disc space, with kyphosis and a disc osteophyte complex indenting the thecal sac with mild-to-moderate canal stenosis. Multilevel foraminal narrowing as described above. New small area of increased signal intensity in the C6-C7 intervertebral disc, -?edema/inflammation/infection. 2. Extensive pre, paravertebral and retropharyngeal T2 hyperintense signal which relates to fluid with or without abnormal enhancement from inflammation or infection. Assessment is limited given the lack of post-contrast images. This is seen to extend from the level of the clivus extending into the thorax, lower limit is not included. There is also mild increased signal intensity in the lateral atlantoaxial joints. . [**2116-3-23**] C-spine CT: IMPRESSION: 1. Findings consistent with C6-7 discitis/osteomyelitis with 1.4 x 1.0- cm prevertebral abscess anterior to C6 vertebral body. Massive likely reactive prevertebral effusion/phlegmon spanning the entire extent of cervical spine without rim enhancement. 2. Evaluation of epidural space is highly limited on CT. When patient able, recommend repeat MRI with gadolinium for further assessment of the epidural space and cord. 3. Prior C4-5 osteomyelitis with disc space destruction and fusion of vertebral bodies with mild 3 mm retropulsion of posterior inferior corner of C4, narrowing the canal at this level. 4. Medialization of internal carotid arteries, which are immersed within the prevertebral fluid/phlegmon. Vascular structures appear patent at this time. 5. Right maxillary mucosal disease. 6. Emphysema and evidence of mild [**Month/Day/Year 106114**] edema. . -[**2116-3-23**] T and L-spine CT: IMPRESSION: 1. Known large prevertebral fluid collection does not extend below cervicothoracic junction. 2. No definite CT evidence of acute process within the thoracic and lumbar spine. 3. Multilevel degenerative disease, worst at L4-5. 4. Precarinal adenopathy and splenomegaly, which may be related to HIV status. 5. Pulmonary arterial hypertension. 6. Small bilateral pleural effusions. 7. Moderate centrilobular emphysema with mild fluid overload. . CT Abdomen/Pelvis [**3-26**]: 1. Cirrhosis, ascites, and splenomegaly. 2. Renal atrophy and multiple hypodense lesions, consistent with cysts in keeping with prior ultrasound. 3. Cholelithiasis. 4. Bilateral adnexal cystic lesions, which should be evaluated by pelvic ultrasound. . Liver/Gallbladder U/S [**3-26**]: 1. Coarse nodular liver, consistent with underlying chronic liver disease with findings of portal hypertension. No definite hepatic lesion, though periphery of the liver was incompletely evaluated. 2. No intra- or extra-hepatic biliary ductal dilatation. 3. Bilateral pleural effusions and moderate ascites. 4. Stable splenomegaly. . CXR ([**2116-3-27**]): 1. Moderate pulmonary edema, not significantly changed since [**2116-3-26**]. 2. Moderate bilateral pleural effusions, slightly increased since prior. 3. Left lung base consolidation, likely atelectasis. . CT Neck/Spine ([**2116-3-31**]): 1. The small residual fluid collection in the cervical spine does not extend below the cervicothoracic junction. No acute abnormality identified in the thoracic spine. 2. Bilateral pleural effusions, increased in size compared to [**2116-3-23**]. . CXR ([**2116-4-1**]): 1. Interval placement of left subclavian line with tip at the mid to distal SVC. Right-sided PICC line in right atrium is withdrawn 3 cm to terminate at the cavoatrial junction. 2. Nasogastric tube with side port at GE junction could be advanced 3-4 cm. 3. Significantly worsened pulmonary edema with worsened bilateral pleural effusions. . CXR ([**2116-4-3**]): Lung volumes have improved, and mild pulmonary edema has decreased. Small right pleural effusion, moderate cardiomegaly and generalized pulmonary vascular congestion persist. Tracheostomy tube in standard placement. Dual-channel left subclavian catheter ends in the mid SVC and a right PICC line extends to or just beyond the superior cavoatrial junction. . CXR ([**2116-4-5**]): There are low lung volumes. Cardiomegaly is stable. There is improved aeration in the lower lobes bilaterally. Small bilateral pleural effusions have decreased. Lines and tubes are in unchanged position including a right central catheter with tip in the upper right atrium. There are no new lung abnormalities or evident pneumothorax. There is mild vascular congestion. Rounded opacities in the right upper lobe could be due to vessels on end and/or lung nodules. Attention in followup studies is recommended, and if they are truly lung nodules they will be suspicious for septic emboli. . CXR ([**2116-4-8**]): Improved bibasilar atelectasis with improved lung volumes. Unchanged mild pulmonary edema. . RUQ U/S [**2116-4-13**]: IMPRESSION: 1. Nodular liver consistent with the patient's known cirrhosis with portal hypertension signs that include splenomegaly and ascites. 2. Cholelithiasis without signs of cholecystitis. 3. No evidence of intra- or extra-hepatic biliary duct dilatation. 4. Right adnexal cyst for which a dedicate pelvis US or MR are recommended. . CTA CHEST [**2116-4-16**]: IMPRESSION: 1. No pulmonary embolism or aortic pathology. No focal opacification concerning for pneumonia. 2. Malignant course of the right coronary artery that is seen passing between the aorta and pulmonary artery, but is not definitively seen arising from the left coronary sinus. 3. Bilateral pleural effusions, both small right greater than left. Findings consistent with provided history of [**Month/Day/Year **] [**Month/Day/Year 106114**] pneumonitis as well as background emphysematous changes. 4. Partially imaged perihepatic ascites. 5. Soft tissue swelling evident in the anterior tissues of the neck, similar to [**3-31**] neck CT. . CT CHEST Non-Con [**4-21**]: IMPRESSION: 1. Small bilateral pleural effusions, right larger than left, are increased in size from [**2116-4-16**]. RLL consolidation very little aerated right lower lobe due to a combination of atelectasis and pneumonia has also worsened in the last 5 days. 2. Atelectasis or scarring in the lingula and left lower lobe is unchanged. 3. Mild centrilobular emphysema is unchanged. Right thin-walled cysts are compatible with provided history of [**Year (4 digits) **] [**Year (4 digits) 106114**] pneumonitis, though not to the degree expected for this diagnosis. 4. Increased perihepatic ascites since [**2116-4-16**]. . RUE U/S & Doppler [**4-21**]: IMPRESSION: Non-occlusive thrombus (DVT) seen surrounding the PICC line within one of the two brachial veins. Findings of non-occlusive thrombus were noted at 2:00 p.m. on [**2116-4-21**] and conveyed by telephone to Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 106124**] at 2:48 p.m. on the same day. . CT Torso with Contrast [**2116-5-3**]: IMPRESSION: 1. Stable to minimally improved right lower lobe consolidation. 2. Bilateral pleural effusions and small pericardial effusion. 3. Cholelithiasis. 4. Multiple renal hypodensities lesions incompletely characterized in this study, previously noted to represent cysts. 5. Right adnexal cystic lesion, for which pelvic ultrasound is recommended. 6. Cirrhosis, ascites, and splenomegaly with splenic varices consistent with portal hypertension. 7. Nonspecific ileal thickening which may represent sequelae of portal hypertension. . Brief Hospital Course: Ms. [**Known lastname 11182**] is a 55 yo f with HIV ([**2-13**] CD4 375), [**Month/Year (2) **] [**Month/Year (2) 106114**] pneumonitis, pulmonary HTN, ESRD on HD, cardiomyopathy and emphysema on O2 at home admitted for [**Month/Year (2) 8974**] sepsis from a prevertebral abscess s/p anterior discetomy with a hospital course complicated by pseudomonal pneumonia, multiple intubations, and 40+ day MICU stay. . ACTIVE ISSUES: . # [**Month/Year (2) 8974**] Sepsis from Prevertebral Abscess s/p Anterior Cervical Diskectomy: Patient was found to have blood cultures positive for [**Month/Year (2) 8974**] on [**3-22**] so she was initially started on daptomycin due to potential allergy to vancomycin but then switched to nafcillin, cefepime, and flagyl for broad coverage. Source was felt to be prevertebral fluid collection noted on CT of the neck on [**3-23**]. She triggered on the floor for hypotension with SBP 80 which was initially fluid responsive but eventually persisted despite boluses so she was transferred to the ICU for further management. After discussion between ENT, ortho spine, and neurosurgery, the patient went for anterior neck exploration by ENT and ortho spine and anterior cervical diskectomy and fusion was performed at C5-6 and C6-7 along with incision and drainage of prevertebral abscess on [**3-25**]. Patient remained intubated post-procedure due to significant procedure-related edema and her antibiotics were narrowed to nafcillin single-[**Doctor Last Name 360**] therapy. Patient's blood pressures were persistently low and she remained pressor dependent until [**2116-4-7**], when she was extubated. Due to patient's persistent hypotension despite resolution of bacteremia and drainage of abscess, studies were undertaken to evaluate for other potential sources of infection and she was broadened to Dapto/Meropenem. U/S of the fistula showed no signs of thrombus, TTE showed no vegetations, and CT Abdomen/Pelvis showed no abscesses or other acute infectious process. Despite persistent hypotension and elevated lactate, patient remained arousable and consistently able to follow commands. After 5 days of Dapto/[**Last Name (un) **] her antibiotics were changed to Nafcillin monotherapy due to improving BP, absence of a 2nd infectious source and decreasing pressor requirement. However, she developed a cholestatic hepatitis and her Nafcillin was switched back to Daptomycin. ID then recommended transitioning Daptomycin to Cefazolin. The pt has a documented Cefazolin allergy, so desensitization was undertaken but the patient developed anaphylaxis (see below). She was planned to have a 8 week total course (last day = [**5-19**]) of Daptomycin for her abscess and will follow up with Ortho Spine and ID for ongoing management. Her surgical wound had intermittent trace bleeding, though her HCT remained stable and her incision appeared well healing at the time of discharge. . #Cefazolin Desensitization/Anaphylaxis: Patient developed cholestatic hepatitis thought to be secondary to nafcillin therapy prompting switch to daptomycin to cover [**Month/Year (2) 8974**] sepsis. Patient had documented cefazolin allergy and desensitization protocol was attempted which she tolerated initially but she then developed anaphylaxis to 1mg of Cefazolin characterized by wheezing, SOB, tripoding, stridor and received Epinephrine, Hydrocortisone, Benadryl and Ranitidine with resolution of her symptoms without recrudescence of symptoms in 48 hours. . # Pseudomonal Pneumonia c/b Respiratory Failure and Sepsis: Pt became stridorous in the setting of a retropharyngeal abscess and was intubated on [**2116-3-24**] for airway protection. She required massive fluid recussitation for sepsis and developed pulmonary edema, which may also have contributed to her failure. She also has underlying COPD, which was a likely contributing factor to her poor pulmonary substrate and respiratory failure. Her abscess was evacuated and she had ACDF of C5-C6 and C6-C7 with ortho spine. She remained intubated due to concern for airway edema until [**2116-4-7**], when she was extubated without event. She then developed fevers, relative hypotension, and respiratory distress with sputum cultures growing pseudomonas. She ultimately required a second intubation and pressors for a priod of time. She was treated with a course of meropenem and amikacin per ID recommendation and improved. She was extubated without further significant issues and weaned off pressors for >2 weeks prior to discharge. She was satting well on nasal cannula, afebrile, and without respiratory distress at the time of discharge. . # Cholestatic Hepatitis: Patient's direct bilirubin and transaminases started to acutely rise on [**3-27**]. On exam, patient was also noted to have increased distention and tenderness. U/S of the gallbladder and CT of the Abdomen showed only cirrhosis and no acute pathology. Cefepime was discontinued due to concern for liver toxicity. Etiology was initially thought to be due to acute hepatic decompensation in the setting of critical illness. Her LFTs remained persistently elevated, and acutely worsened with initiation of Nafcillin therapy, which was subsequently discontinued (see above). Her hepatitis was felt to be [**3-5**] medication effect, though would note that she has underlying HCV. HBV serologies were negative. . # Multifactorial Anemia: Likely anemia of chronic disease and anemia of ESRD. She required intermittent blood transfusions throughout her course, though had no evidence of active bleeding. Stool guiac was repeatedly negative. She should continue receiving Epo with HD per renal. . # Ileus: In the setting of her acute illness and opiate use for pain control, Ms [**Known lastname 11182**] developed an ileus. For this she received Naloxone x1 as well as an aggressive bowel regemin. Her ileus was intermittent and resolved; at the time of discharge she was tolerating her tube feeds and a PO diet of clear liquids. . # Hypotension: Ms [**Known lastname 11182**] was intermittently hypotensive and requiring pressors throughout her course. Initially, her hypotension was almost certainly due to sepsis, which was treated with appropriate antibiotics. Later in her course she continued to require pressors with HD and her Midodrine was increased to 15mg TID. She was also started on high dose Thiamine due to concern for dry Beri-Beri, with marked improvement in her BPs. . # PICC Associated RUE DVT: Given her Heparin allergy, Ms [**Known lastname **] was started on an Argatroban gtt for her DVT after her PICC was removed. Hematology was consulted and recommended an Argatroban normogram, which was continued for the duration of her MICU stay. . # HIV versus Critical Illness Neuropathy: Given her multiple medical problems, poor nutrition, prolonged hospital course and peipheral neuropathy, there was concern for dry Beri-Beri. For this she was started on high dose Thiamine with initial improvement in her neuropathy. However, her neuropathy subsequently returned and neurology was consulted who felt it may be consistent with critical illness polysneuropathy. Her primary team felt her symptoms were likely related to her chronic HIV. She was trialed on low dose gabapentin but intermittently appeared sedated so that medication was discontinued. . CHRONIC ISSUES: . # HIV ([**2-13**] CD4 375): Her home HAART regemin was continued throughout her course. Viral load early on in her admission was 183. . # LIP/COPD/Asthma: Her home Albuterol/Ipratroprium were continued throughout her course. At the time of discharge, she was breathing comfortably on nasal cannula. . # Pulm HTN: Her Sildenafil 50mg PO TID was initially held for hypotension, but was restarted once she was off pressors. . # ESRD: Started on CVVH while on pressor support. She had a L subclavian temp HD line placed and received intermittent CVVH until weaned off pressors. Her temp HD line was pulled on [**2116-4-7**] she thereafter she received intermitted HD through her fistula in order to take off acumulated volume. She was transistioned to T/Th/Sat schedule prior to discharge. . # Chronic Thrombocytopenia: Ms [**Known lastname 11182**] is chronically thrombocytopenic, though her platelet counts on this admission were markedly lower. Her chronic thrombocytopenia may be related to her liver disease, and her acute decompensation may be multifactorial and due to acute hepatic decompensation and CVVH. She had intermittent, small volume bleeding through her surgical incision and from her occipital pressure ulcer. . # Elevated INR: Felt to be partly due to decompensation of patient's underlying cirrhosis but also due to antibiotic use. Patient was intermittently repleted with vitamin K. . TRANSITIONAL ISSUES: . #GOALS OF CARE: After significant discussions with the patient's family (primarily her daughter), she was remained FULL CODE throughout this admission. . #Consider outpatient pelvic US for 4.3 x 3.8 cm right ovarian cyst seen on abdominal CT, which is unchanged since [**2113**]. . #Please follow Q3 month CD4 counts and re-initiate bactrim prophylaxis for CD4 count below 200. Medications on Admission: Discharge Medications from [**11-12**] (pt does not recall any of her Rx, but says takes 4 HIV Rx and then a number of other Rx) 1. sildenafil 25 mg Tablet Sig: Two (2) Tablet PO QAM (once a day (in the morning)). 2. sildenafil 20 mg Tablet Sig: Five (5) Tablet PO QPM (once a day (in the evening)). 3. sulfamethoxazole-trimethoprim 800-160 mg Tablet Sig: One (1) Tablet PO QMON,WED,FRI (). 4. calcium carbonate 200 mg calcium (500 mg) Tablet, Chewable Sig: One (1) Tablet, Chewable PO BID (2 times a day). 5. lamivudine 100 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 6. calcitriol 0.5 mcg Capsule Sig: One (1) Capsule PO QTUE,[**Last Name (un) **],SAT (). 7. cinacalcet 30 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. etravirine 100 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 9. quetiapine 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 10. raltegravir 400 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 11. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) nebs Inhalation Q6H (every 6 hours) as needed for SOB. Disp:*35 nebs* Refills:*0* 12. ipratropium bromide 0.02 % Solution Sig: One (1) neb Inhalation Q6H (every 6 hours). Disp:*35 nebs* Refills:*0* 13. folic acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 14. levofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q48H (every 48 hours) for 4 doses: Tale: Sat [**11-23**], Mon [**11-25**], Wed [**11-27**], Fri [**11-29**]. Disp:*4 Tablet(s)* Refills:*0* 15. lidocaine-prilocaine 2.5-2.5 % Cream Sig: One (1) Appl Topical QHD (each hemodialysis). 16. tenofovir disoproxil fumarate 300 mg Tablet Sig: One (1) Tablet PO QFRI (every Friday). 17. prednisone 10 mg Tablet Sig: One (1) Tablet PO once a day for 7 days: 40mg on [**11-17**] and [**11-25**] 20mg daily on [**11-26**] and [**11-27**] 10mg daily on [**11-28**] and [**11-29**] Discharge Medications: 1. calcium carbonate 200 mg calcium (500 mg) Tablet, Chewable Sig: One (1) Tablet, Chewable PO BID (2 times a day). 2. raltegravir 400 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 3. etravirine 100 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 4. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q8H (every 8 hours) as needed for pain/fever. 5. lidocaine-diphenhyd-[**Doctor Last Name **]-mag-[**Doctor Last Name **] 200-25-400-40 mg/30 mL Mouthwash Sig: 15-30 mL Mucous membrane four times a day as needed for mouth pain. 6. lamivudine 10 mg/mL Solution Sig: 2.5 mL PO DAILY (Daily): Total daily dose is 25 mg. . 7. tenofovir disoproxil fumarate 300 mg Tablet Sig: One (1) Tablet PO QMON (every Monday). 8. sildenafil 20 mg Tablet Sig: 2.5 Tablets PO TID (3 times a day). 9. B complex-vitamin C-folic acid 1 mg Capsule Sig: One (1) Cap PO DAILY (Daily). 10. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 11. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) neb Inhalation Q2H (every 2 hours) as needed for wheeze. 12. guaifenesin 100 mg/5 mL Syrup Sig: 5-10 MLs PO Q6H (every 6 hours) as needed for cough. 13. phenol 1.4 % Aerosol, Spray Sig: One (1) Spray Mucous membrane Q6H (every 6 hours) as needed for irritation. 14. petrolatum Ointment Sig: One (1) Appl Topical TID (3 times a day) as needed for Rash. 15. ipratropium bromide 0.02 % Solution Sig: One (1) neb Inhalation Q2H (every 2 hours) as needed for wheezing, SOB. 16. quetiapine 25 mg Tablet Sig: Two (2) Tablet PO QHS (once a day (at bedtime)). 17. thiamine HCl 100 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 18. pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 19. midodrine 5 mg Tablet Sig: Three (3) Tablet PO TID (3 times a day). 20. lidocaine HCl 5 % Ointment Sig: One (1) Appl Topical Q DIALYSIS, FOR NEEDLE INSERTION (). 21. lidocaine HCl 5 % Ointment Sig: One (1) Appl Topical [**Hospital1 **] (2 times a day). 22. loperamide 2 mg Capsule Sig: Two (2) Capsule PO QID (4 times a day) as needed for diarrhea. 23. quetiapine 25 mg Tablet Sig: 0.5 Tablet PO QAM (once a day (in the morning)) as needed for anxiety/agitation. 24. daptomycin 500 mg Recon Soln Sig: Four Hundred (400) Recon Soln Intravenous Q48H (every 48 hours): To be given AFTER dialysis on the day of dialysis. Last dose is [**2116-5-19**]. . Discharge Disposition: Extended Care Facility: [**Hospital **] Hospital - [**Hospital1 8**] Discharge Diagnosis: Prevertebral Abscess [**Hospital1 8974**] Bacteremia Hypoxic Respiratory Failure Hepatitis Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Out of Bed with assistance to chair or wheelchair. Discharge Instructions: Ms. [**Known lastname 11182**]: You were admitted to [**Hospital1 **] with an infection in your neck. An operation was performed to remove this infection. You also developed a blood stream infection from a bacteria. Lastly, your hospitialziation was complicated by respiratory distress. You were in the intensive care unit for many weeks and are being discharged to a rehab center. . The following changes were made to your medications: 1. Your Sildenafil was changed to 50 mg by mouth three times a day. 2. You were started on Daptomycin 400 mg by IV infusion to be given after each dialysis session. The final dose is to be given on [**2116-5-19**]. 3. Prednisone was stopped. 4. Bactrim (Sulfamethoxazole-Trimethoprim) was stopped as well because your CD4 count has improved. 5. Calcitriol was stopped per renal recommendations. 6. Lamivudine was decreased to 25 mg by mouth daily. 7. Cinacalcet was stopped per renal recommendations. 8. Quetiapine was changed to 12.5 mg by mouth each morning as needed for anxiety and 50 mg by mouth at night. 9. Nephrocaps were started. Take 1 capsule by mouth daily. 10. Folic acid was stopped. 11. Tenofovir was changed to every Friday to every Monday. The dose was not changed. 12. You were started on Midodrine 15 mg by mouth three times a day to increase your blood pressure. Followup Instructions: ** Right adnexal cyst for which a dedicate pelvis US or MR are recommended in the outpatient setting. ** . Department: INFECTIOUS DISEASE When: TUESDAY [**2116-5-12**] at 9:30 AM With: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 4091**], MD [**Telephone/Fax (1) 457**] Building: LM [**Hospital Ward Name **] Bldg ([**Last Name (NamePattern1) **]) [**Hospital 1422**] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage . Please make an appointment to see Dr. [**Last Name (STitle) 363**] in Orthopaeidc Surgery PH: [**Telephone/Fax (1) 106125**] once you are in better condition [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 2764**] Completed by:[**2116-5-8**] ICD9 Codes: 5856, 4271, 4254, 2875, 4168, 2859
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Medical Text: Admission Date: [**2101-10-25**] Discharge Date: [**2101-10-28**] Date of Birth: [**2064-10-2**] Sex: F Service: MEDICINE Allergies: Cephalosporins / Floxin / Penicillins Attending:[**First Name3 (LF) 2108**] Chief Complaint: Xanax, Tylenol & Klonopin Overdose Major Surgical or Invasive Procedure: None History of Present Illness: 37 yo F with history of depression and suicidal attempt in the past presented with obtundation. Of note, her prior attempt was about 15 years ago during which she OD on theophylline, requiring intubation. She has been feeling more depressed over the last few months and has been seeing a therapist, on the ECT waiting list with recent evaluation by Dr. [**Last Name (STitle) 2109**], [**First Name3 (LF) **] her partner. [**Name (NI) **] reports taking 120 mg of Xanax and 80 mg Klonopin in the afternoon of [**2101-10-25**] as well as at least [**4-7**] g of Tylenol daily over the last 2 weeks. She also admitted to taking 20 mg of Ambien. She says that she was taking the tylenol intentionally to worsen her liver function. She says that she decided to do this because she wanted to commit suicide. She also reports having had 1 glass of wine on the day of these medication ingestions. She then called one of her friends afterwards, and her therapist ([**First Name8 (NamePattern2) 2110**] [**Last Name (NamePattern1) **]) was subsequently involved and called the EMS for patient. In the ED, her initial VS were HR 99, BP 102/56, RR 20, and 98% on RA. She arrived with her friend, very lethargic. Per report, was only responsive to sternal rub and GCS of 8 throughout. Tox screen showed positive benzos and acetaminophen only. ECG showed sinus tachycardia. UA was negative. CT head did not show ICH. Her initial Tylenol level was 40. Toxicology was consulted and recommended NAC for 21 hours until level is undetectable and LFT stabilizes. She started NAC in the ED and her repeat level was 29. VS prior to transfer were T95, HR 66, BP 121/73, RR 22, O2Sat 98% RA. She was transferred to the ICU for her poor mental status. While on the floor, appears comfortable, denies any SOB, chest pain/discomfort, abdominal pain/discomfort, urinary symptoms or URI symptoms. She does have some throat tightness and discomfort when swallowing. Her partner reports that patient's mental status seems to have improved since her initial arrival to the ED. Past Medical History: - Asthma, requiring 1x intubation in late teen (unclear if this was related to the theophylline) - GERD with severe esophagitis ([**2098**]) - Insomnia - Bipolar Type 2, currently severe depression, requiring hospitalization at [**Doctor First Name **] in the past - Depression - Suicidal attempts (last [**1-/2099**] following impulsive suicide attempt in which she crashed her cars, 2 other ones with OD in her late teens) Social History: Occupation: a nurse mid-wife at [**Name (NI) 2025**] x 10 years Drugs: Marijuana, last used about 1 week ago Tobacco: None Alcohol: occasionally Married to [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 976**] [**Telephone/Fax (1) 2111**], live in [**Location (un) 538**]. Family History: - mother- depression - maternal grandmother- EtOH abuse, benzodiazepine abuse - maternal uncle- bipolar affective d/o Physical Exam: Physical Exam on Arrival to [**Hospital Unit Name 2112**]: Temp: 36.9 BP 116/51, HR 65, RR25, O2Sat 99% RA General: lethargic, answers questions appropriately but in whispers, follows commands, NAD HEENT: PERRL, EOMi, anicteric, Mucous membrane moist NECK: no supraclavicular or cervical LAD, no JVD, no carotid bruits, no stridor Resp: CTAB with good air movement throughout, no wheeze, crackles, or rhonchi CV: RR, S1 and S2 wnl, no m/r/g ABD: soft, ND, mildly tender in the umbilical area, no hepatosplenomegaly, no guarding. EXT: no c/c/e SKIN: no rashes/no jaundice NEURO: AAOx3. Cn II-XII intact. 5/5 strength throughout. No sensory deficits to light touch appreciated. Pertinent Results: [**2101-10-25**] - CT head: There is no acute intracranial hemorrhage, acute large major vascular territory infarction, discrete masses, mass effect, brain edema or shift of normally midline structures. The ventricles and sulci are normal in size and configuration. The visualized osseous structures are unremarkable. The visualized paranasal sinuses are within normal limits. Incidentally noted is a faintly-calcified likely sebaceous cyst in the left paramedian frontovertex scalp soft tissues (2:26-27); correlate with physical examination. IMPRESSION: No acute intracranial process [**2101-10-27**] 06:50AM BLOOD WBC-4.7 RBC-3.78* Hgb-11.8* Hct-32.8* MCV-87 MCH-31.2 MCHC-36.0* RDW-13.5 Plt Ct-238 [**2101-10-25**] 03:00PM BLOOD WBC-6.0 RBC-4.03* Hgb-12.6 Hct-36.0 MCV-90 MCH-31.4 MCHC-35.1* RDW-12.8 Plt Ct-275 [**2101-10-26**] 05:39AM BLOOD PT-13.5* PTT-24.4 INR(PT)-1.2* [**2101-10-27**] 06:50AM BLOOD PT-12.4 INR(PT)-1.0 [**2101-10-25**] 03:00PM BLOOD Neuts-66.7 Lymphs-26.5 Monos-3.5 Eos-2.2 Baso-1.0 [**2101-10-27**] 06:50AM BLOOD Glucose-82 UreaN-6 Creat-0.6 Na-139 K-3.8 Cl-106 HCO3-26 AnGap-11 [**2101-10-25**] 03:00PM BLOOD Glucose-107* UreaN-7 Creat-0.8 Na-139 K-3.8 Cl-104 HCO3-26 AnGap-13 [**2101-10-27**] 06:50AM BLOOD ALT-21 AST-13 [**2101-10-26**] 02:23AM BLOOD ALT-25 AST-24 LD(LDH)-340* AlkPhos-39 TotBili-0.3 [**2101-10-25**] 03:00PM BLOOD ALT-28 AST-22 LD(LDH)-161 AlkPhos-56 TotBili-0.4 [**2101-10-27**] 06:50AM BLOOD Calcium-9.2 Phos-3.6 Mg-1.9 [**2101-10-25**] 03:00PM BLOOD HCG-<5 [**2101-10-25**] 03:00PM BLOOD ASA-NEG Ethanol-NEG Acetmnp-40* Bnzodzp-POS Barbitr-NEG Tricycl-NEG [**2101-10-25**] 07:30PM BLOOD ASA-NEG Ethanol-NEG Acetmnp-29 Bnzodzp-POS Barbitr-NEG Tricycl-NEG [**2101-10-26**] 02:23AM BLOOD Acetmnp-6* [**2101-10-26**] 07:00PM BLOOD Acetmnp-NEG Brief Hospital Course: 37 yo F with depression on ECT waiting list and remote history of suicidal attempts presents with OD of benzodiazepine and Tylenol Medicaion Overdose, an attempt to suicide. The patient was treated supportively for benzodiazepine overdose and did not require mechanical ventilation. In regards to tylenol toxicity she required a N acetylcysteine drip for a tylenol level of 40 and normal liver function tests, after stopping the NAC drip her tylenol level was negative and LFTs remained normal. She was medically cleared for discharge to a psyhiatric inpatient facility as of the a.m. of [**2101-10-27**], she is also medically cleared for ECT. In regards to her bipolar disorder and suicide attempt psychiatry was consulted and suggested the following medication regimen: Wellbutrin 150mg po bid, duloxetine 60mg po daily, lamotrigine 350mg po daily, risperdal 0.5mg po bid prn, and ambien 10mg po qhs prn insomnia. Asthma. Does not appear to be active currently. prn albuterol / atrovent nebs. GERD: continued home omeprazole Communication/Emergency Contact: partner [**Name (NI) **] [**Name (NI) 976**] [**Telephone/Fax (1) 2111**] Medications on Admission: Meds (at home): cymbalta 60 mg PO daily wellbutrin SR 450 mg PO daily lamictal 350 mg PO daily ambien 10 mg PO QHS prilosec 20 mg PO daily and sometimes [**Hospital1 **] risperdal 0.5 mg PO QAM and 1 mg PO QHS (not taking for 1 week) klonopin 1 mg PO prn was stockpiling xanax, so not taking Meds (in ICU): NAC 560 mg/h IV gtt albuterol nebs prn Wellbutrin SR 150 mg [**Hospital1 **] duloxetine 60 mg PO daily heparin subQ 5000 TID lamictal 350 mg PO daily omeprazole 20 mg PO daily Discharge Medications: 1. Combivent 18-103 mcg/Actuation Aerosol Sig: Two (2) puffs Inhalation four times a day as needed for shortness of breath or wheezing. 2. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 3. bupropion HCl 150 mg Tablet Sustained Release Sig: One (1) Tablet Sustained Release PO BID (2 times a day). 4. duloxetine 30 mg Capsule, Delayed Release(E.C.) Sig: Two (2) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 5. zolpidem 5 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime) as needed for insomnia. 6. risperidone 0.5 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed for anxiety/agitation. 7. polyethylene glycol 3350 17 gram/dose Powder Sig: One (1) PO DAILY (Daily) as needed for constipation. 8. lamotrigine 100 mg Tablet Sig: 3.5 Tablets PO DAILY (Daily). Discharge Disposition: Extended Care Facility: [**Hospital1 69**] - [**Location (un) 86**] Discharge Diagnosis: Primary Diagnosis: Suicide ingestion Tylenol overdose Benzodiazepine overdose Bipolar disorder Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: You were admitted to the hospital after a suicide attempt and treated to prevent organ damage. You were transferred to an inpatient psychiatric facility. Please take your medications as prescribed and make your follow up appointments. Followup Instructions: Please follow up with your psychiatrist within 2 weeks of your discharge from the psychiatric facility. Please follow up with your primary care physician [**Name Initial (PRE) 176**] 1 week of your discharge from the psychiatric facility: [**Last Name (LF) 2113**],[**First Name3 (LF) 2114**] R. [**Telephone/Fax (1) 2115**] ICD9 Codes: 2859
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Medical Text: Admission Date: [**2137-4-18**] Discharge Date: [**2137-4-22**] Date of Birth: [**2076-12-1**] Sex: F Service: CARDIOTHORACIC Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 165**] Chief Complaint: Chest pain Major Surgical or Invasive Procedure: [**2137-4-18**] 1. Coronary artery bypass grafts x3, left internal mammary artery to left anterior descending artery and saphenous vein grafts to right coronary artery and obtuse marginal arteries. 2. Endoscopic harvesting of the long saphenous vein. History of Present Illness: 60 year old female for the past two years she has been experiencing shortness of breath and dyspnea with exertion. This occurs after walking approximately 10 minutes starts in her epigastric area and radiates up to her upper chest. It resolves with rest. She had been trying to lose weight recently and was using a treadmill and was experiencing shortness of breath and chest pain. She underwent a stress test which was abnormal. She was referred for a cardiac catheterization and was found to have coronary artery disease. She was referred to cardiac surgery for revascularization. Past Medical History: Coronary Artery Disease PMH: Paroxysmal Atrial Fibrillation, reported PAF or palpitations since [**2133**] Depression/Anxiety Vitamin D Deficiency Chronic bilateral Leg/Joint pain Dyslipidemia Frequent Headaches Past Surgical History: Tonsillectomy Appendectomy Social History: Lives with:Husband Contact:[**Name (NI) **] (daughter) Phone# [**Telephone/Fax (1) 92267**] Occupation:skin care specialist Cigarettes: Smoked no [] yes [x]Hx: quit 6 years ago, smoked <1ppd x13-15 years Other Tobacco use:denies ETOH: < 1 drink/week [x] [**2-26**] drinks/week [] >8 drinks/week [] Illicit drug use:denies Family History: Premature coronary artery disease- Mother had MI at 65, Sister died at 60 with HTN and ?MI Physical Exam: Pulse:65 Resp:13 O2 sat:98/RA B/P Right:120/72 Left:127/68 Height:5'1" Weight:186 lbs General: NAD, AAOx3 Skin: Dry [] intact [x] HEENT: PERRLA [x] 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] Extremities: Warm [x], well-perfused [x] Edema [] Varicosities: None [x] Neuro: Grossly intact [x] Pulses: Femoral Right: palp Left: palp DP Right: palp Left: palp PT [**Name (NI) 167**]: palp Left: palp Radial Right: palp Left: palp Carotid Bruit Right: none Left: none Pertinent Results: Intra-op TEE [**2137-4-18**] Conclusions PRE-BYPASS: No spontaneous echo contrast is seen in the body of the left atrium or 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. 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. There are simple atheroma in the aortic arch. There are simple atheroma in the descending thoracic aorta. There are three aortic valve leaflets. There is no aortic valve stenosis. Trace aortic regurgitation is seen. Mild (1+) mitral regurgitation is seen. The estimated pulmonary artery systolic pressure is normal. There is no pericardial effusion. Dr. [**Last Name (STitle) **] was notified in person of the results at time of surgery. POST-BYPASS: The patient is A paced. The patient is on a phenylephrine infusion. Biventricular function is unchanged. Mitral regurgitation is unchanged. Tricuspid regurgitation is moderate (2+). The aorta is intact post-decannulation. [**2137-4-22**] 04:17AM BLOOD WBC-9.2 RBC-2.84* Hgb-8.3* Hct-26.9* MCV-95 MCH-29.3 MCHC-31.0 RDW-13.8 Plt Ct-287 [**2137-4-21**] 04:52AM BLOOD Hct-26.2* [**2137-4-20**] 11:26PM BLOOD Hct-25.9* [**2137-4-22**] 04:17AM BLOOD Glucose-97 UreaN-14 Creat-0.8 Na-137 K-4.3 Cl-103 HCO3-29 AnGap-9 [**2137-4-21**] 04:52AM BLOOD UreaN-15 Creat-0.8 [**2137-4-20**] 02:51AM BLOOD Glucose-122* UreaN-11 Creat-0.9 Na-138 K-4.4 Cl-105 HCO3-25 AnGap-12 [**2137-4-19**] 02:52AM BLOOD Glucose-118* UreaN-9 Creat-0.5 Na-135 K-4.0 Cl-105 HCO3-23 AnGap-11 Brief Hospital Course: The patient was brought to the Operating Room on [**2137-4-18**] where the patient underwent CABG x 3 with Dr. [**First Name (STitle) **]. Initial attempt at endoscopic approach was aborted and converted to open CABG. Overall the patient tolerated the procedure well and post-operatively was transferred to the CVICU in stable condition for recovery and invasive monitoring. Left sided chest tube was placed for pleural effusion via endoscopic port site on post operative night before extubation. 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. POD 1 OR chest tubes were removed and left chest tube remained in place. She has paroxysmal atrial fibrillation which she had preoperatively but was in sinus rhtyhm at the time of discharge and was not anticoagulated. Beta blocker was initiated at a low dose with SBP 90's and the patient was gently diuresed toward the preoperative weight. The patient was transferred to the telemetry floor for further recovery. Left Chest tube was removed at this time 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, she was hemodynamically stable in sinus rhythm, the wound was healing and pain was controlled with oral analgesics. The patient was discharged home with VNA services in good condition with appropriate follow up instructions. Medications on Admission: ASPIRIN 81 mg Daily Discharge Medications: 1. magnesium hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO HS (at bedtime) as needed for constipation. 2. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 3. ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) for 1 months. Disp:*60 Tablet(s)* Refills:*0* 4. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4 hours) as needed for pain, fever. 5. metoprolol tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). Disp:*30 Tablet(s)* Refills:*0* 6. potassium chloride 20 mEq Tablet, ER Particles/Crystals Sig: One (1) Tablet, ER Particles/Crystals PO once a day for 7 days. Disp:*7 Tablet, ER Particles/Crystals(s)* Refills:*0* 7. aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 8. bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal DAILY (Daily) as needed for constipation. 9. atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 10. ipratropium-albuterol 18-103 mcg/actuation Aerosol Sig: [**1-21**] Puffs Inhalation Q6H (every 6 hours) as needed for sob, wheezing. Disp:*1 1* Refills:*0* 11. hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO every [**4-26**] hours as needed for pain. Disp:*30 Tablet(s)* Refills:*0* 12. Lasix 40 mg Tablet Sig: One (1) Tablet PO once a day for 7 days. Disp:*7 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: All Care VNA of Greater [**Location (un) **] Discharge Diagnosis: Coronary Artery Disease PMH: Paroxysmal Atrial Fibrillation, reported PAF or palpitations since [**2133**] Depression/Anxiety Vitamin D Deficiency Chronic bilateral Leg/Joint pain Dyslipidemia Frequent Headaches Past Surgical History: Tonsillectomy Appendectomy Discharge Condition: Alert and oriented x3 nonfocal Ambulating, gait steady Sternal pain managed with oral analgesics Sternal Incision - healing well, no erythema or drainage Edema- 1+ 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** Females: Please wear bra to reduce pulling on incision, avoid rubbing on lower edge Followup Instructions: You are scheduled for the following appointments: Wound Check at Cardiac Surgery Office [**Telephone/Fax (1) 170**] on [**2137-4-30**] at 10:15a Surgeon Dr. [**First Name (STitle) **] [**Telephone/Fax (1) 170**] on [**2137-5-28**] at 1:00p Cardiologist Dr. [**Last Name (STitle) 3357**] on [**2137-5-3**] at 11:30 Please call to schedule the following: Primary Care Dr. [**Last Name (STitle) 92268**],[**First Name3 (LF) **] V. [**Telephone/Fax (1) 26774**] in [**4-25**] 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:[**2137-4-22**] ICD9 Codes: 5119, 2762, 311, 2724, 2859
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Medical Text: Admission Date: [**2173-11-15**] Discharge Date: [**2173-11-18**] Date of Birth: [**2112-8-6**] Sex: M Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 3021**] Chief Complaint: Dyspnea. Major Surgical or Invasive Procedure: None. History of Present Illness: ONCO-MED HOSPITALIST ADMISSION NOTE . 61 year old gentleman with COPD, stage IV NSCLC mucinous adenocarcinoma and recent PE who presents with dyspnea. He reports sudden-onset worsening of respiratory status on the morning of admission without associated productive cough, fevers/chills, CP, or other symptoms. . Of note, patient was recently readmitted in early [**2173-10-28**] for SOB/dyspnea, at which time a new LLL consolidation was seen. He was provided with one dose of Vanc/Cefepime, and started on a morphine drip in concert with patient's HCP as well as patient wishes. Improvement in clinical status was noted overnight and his morphine drip was discontinued. His acute respiratory decompensation was attributed to a mucus plug, aspiration, perhaps with contributing atalectasis. He was continued albuterol/ipratropium nebulizers, as well as enoxaparin [**Hospital1 **] for his recent PE's. Antibiotics were not resumed at time of discharge. After discharge, blood cultures from [**2173-11-3**] grew Fusobacterium Nucleatum in one out of two bottles. The patient was contact[**Name (NI) **] on [**2173-11-6**] regarding this lab result, and did not feel any different since discharge from the hospital. Repeat blood cultures at his outpatient oncologist failed to reveal positive cultures. Since his recent discharge, discussion regarding hospice care has been continued with his oncologist Dr. [**Last Name (STitle) 45322**], given the patient's poor prognosis. . In the ED, initial vitals recorded were a RR of 32. Labs showed hyponatremia with a sodium of 129, otherwise unremarkable CMP. CBC with WBC count of 16.0 with 97.3 PMN's and 2.4 % lymphocytes. HCT of 30.6, platelets of 508. Coags showed INR of 1.2, PTT of 31.8. CXR showed Stable right-sided pleural effusion and post-obstructive consolidation, increasing left pleural effusion with basal atelectasis. Patient had his pleurex catheter drained with 300 cc's of straw colored fluid aspirated. He was administered albuterol/ipratropium nebs, vancomycin/zosyn, as well as lorazepam and methylprednisolone. . In MICU, VS: 96.9 103 131/74 14 90%4L NC. He endorsed feeling hungry. His respiratory status stabilized after clearing mucous plug, but still requiring 4-5L NRB. No antibiotics were given as low suspicion for acute infection. He improved with time, albuterol/ipratropium nebs. He was continued on lovenox for recent PE. In addition, as a large component of dyspnea was anxiety, patient was placed on standing clonazepam 1mg TID. Palliative care was consulted for assistance with pain control and was made DNR/DNI. Of note, he was found to be growing G+ cocci in 1 of 2 Bcx bottles, was started on IV vancomycin and was transferred out of ICU. . ROS: He denies F/C/S, N/V, headache, dizziness, chest pain, abdominal pain, back pain, constipation, diarrhea, hematochezia, urinary symptoms, or rash. All other ROS were negative. Past Medical History: 1. Metastatic NSCLC to [**Last Name (LF) 500**], [**First Name3 (LF) **], with malignant effusion, Pleurex placed [**2173-9-16**], s/p carboplatin/paclitaxel x2 cycles, then pemetrexad x2 cycles (last given [**2173-11-11**]). 2. PE, 9/[**2172**]. 3. CVA. 4. Carotid stenosis s/p CEA [**2173-7-31**]. 5. Hypertension. 6. Ocular migraine. 7. Alcohol abuse. 8. Hyperlipidemia. Social History: - Tobacco: Smoked 2 PPD age 20 to 61. - Alcohol: Former heavy drinker, drinks [**11-29**] bottle of wine per night. - Illicits: Denies. - Occupation: ECG engineer. - Exposures: Denies. Family History: Mother - colon cancer at 83 s/p resection, still alive at 88, hypertension. Father - died of multiple myeloma at age 80, high cholesterol. Sister 1 - died of malignant brain tumor at age 24. Sister 2 - hypertension. No FH of stroke, diabetes. Physical Exam: Admission to Floor Physical Exam Vitals: 97.8 108/62 111 21 97%NC 5L, 0/10 pain General: Alert, oriented, no acute distress, dyspnia occasionally interferes with his ability to complete sentences HEENT: Sclera anicteric, MMM, oropharynx clear Neck: supple, JVP not elevated Lungs: Diminished BS at bases b/l, R>L CV: Tachycardic ~110, regular rhythm, normal S1 + S2, no m/r/g Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Pertinent Results: ADMISSION LABS: [**2173-11-15**] 11:30AM WBC-16.0*# RBC-3.16* HGB-9.3* HCT-30.6* MCV-97 MCH-29.6 MCHC-30.5* RDW-17.8* [**2173-11-15**] 11:30AM NEUTS-97.3* LYMPHS-2.4* MONOS-0.2* EOS-0.1 BASOS-0 [**2173-11-15**] 11:30AM PLT COUNT-508* [**2173-11-15**] 11:30AM PT-12.9* PTT-31.8 INR(PT)-1.2* [**2173-11-15**] 11:30AM GLUCOSE-124* UREA N-12 CREAT-0.4* SODIUM-129* POTASSIUM-4.4 CHLORIDE-92* TOTAL CO2-31 ANION GAP-10 . Thoracentesis Fluid [**2173-11-15**] 12:00PM PLEURAL WBC-50* RBC-2725* POLYS-67* LYMPHS-24* MONOS-7* MESOTHELI-2* . [**2173-11-15**] CTA CHEST: IMPRESSION: 1. Extensive right lung mass with post obstructive collapse of the right upper and middle lobes. 2. No pulmonary emboli. The right upper and middle lobe pulmonary arteries are attenuated by the mass. 3. Pleural effusions increased since the preceding exam 14 days ago. 4. Extensive sclerotic metastases to the spine and sternum. 5. Ground glass opacity in left apex is non-specific but could represent infectious process. . [**2173-11-15**] CXR: IMPRESSION: Stable appearance of right-sided pleural effusion and post-obstructive consolidation in the setting of a known right chest mass; increasing left pleural effusion with basal atelectasis. . [**2173-11-15**] CXR: IMPRESSION: Interval decrease in left pleural effusion with associated atelectasis and no pneumothorax. . DISCHARGE LABS: [**2173-11-17**] 07:25AM BLOOD WBC-10.0 RBC-2.87* Hgb-8.9* Hct-28.7* MCV-100* MCH-31.2 MCHC-31.2 RDW-17.6* Plt Ct-382 [**2173-11-16**] 06:36AM BLOOD Neuts-96.7* Lymphs-2.3* Monos-0.6* Eos-0.2 Baso-0.1 [**2173-11-17**] 07:25AM BLOOD PT-12.2 PTT-27.8 INR(PT)-1.1 [**2173-11-17**] 07:25AM BLOOD Glucose-93 UreaN-9 Creat-0.2* Na-129* K-4.0 Cl-92* HCO3-31 AnGap-10 [**2173-11-17**] 07:25AM BLOOD Calcium-8.5 Phos-3.6 Mg-1.5* Brief Hospital Course: 61yo man with metastatic NSCLC to ribs, malignant effusion, and encasement of right hilum, on enoxaparin for PE, Pleurex catheter for malignant effusion, hx of CVA admitted to the ICU for acute dyspnea. He initially required non-rebreather O2m byt after expectorating a mucous plug, his O2 requirement decreased to 5L. Palliative care consulted. Clonazepam added for anxiety. Code status changed to DNR/DNI. Blood cultures grew GPC in clusters and GPC in chains, two separate species. Started on vancomycin. He continued to decline requiring more oxygen again despite suctioning. He was placed on a morphine gtt for comfort and died [**2173-11-18**] at 16:20PM. . # Dyspnea/hypoxia: Due to malignancy and malignant effusion +/- post-obstructive pneumonia. Required non-rebreather in ICU, but improved after mucous plug expectorated. Blood cultures growing GPC in clusters and GPCs in chains. Started vancomycin [**2173-11-16**] for GPC bacteremia, leukocytosis, increased mucous production, leukocytosis, tachycardia, and tachypnea --> sepsis. Continued albuterol prn, fluticasone-salmeterol. Tiotropium changed to ipratropium nebs. Continued guaifenesin/codeine and benzonatate for cough. O2 support as needed. Morphine for dyspnea. Lorazepam for respiratory distress. Suctioned for worsening hypoxia, but no improvement. Trigger for hypoxia 88% on 6L [**2173-11-18**]. Mr. [**Known lastname **] and his girlfriend agreed to comfort care only and inpatient hospice. He was placed on a morphine gtt for comfort and died [**2173-11-18**] at 16:20PM. . # Metastatic NSCLC: Last given pemetrexad [**2173-11-11**]. Palliative care consulted. Stopped folate considering goals of care. . # Leukocytosis: Due to sepsis. No labs considering goals of care. . # Anemia: Likely chemo induced and anemia of inflammation. No labs. . # Chronic PE: Stopped enoxaparin for [**Month/Day/Year 3225**]. . # HTN: Held metoprolol and hydralazine due to hypotension. . # Anxiety: Added clonazepam. . # Pain (rib): Continue MSContin. Increased morphine IV PRN for pain and dyspnea. . # FEN: Regular diet. Hyponatremia possibly SIADH stable. Repleted hypomagnesemia. . # GI PPx: PPI and bowel regimen. . # DVT PPx: Enoxaparin for PE stopped for [**Month/Day/Year 3225**]. . # Precautions: None. . # Lines: Peripheral. . # CODE: DNR/DNI, [**Month/Day/Year 3225**]. Medications on Admission: Benzonatate 100 mg Capsule Sig: [**11-29**] Capsules PO TID prn Metoprolol succinate 50 mg Tablet Extended Release 1 tab po BID Morphine 30 mg Tablet Extended Release 1 po q12hrs Docusate sodium 100 mg Capsule 1 po BID Tiotropium bromide 18 mcg Capsule, w/Inhalation Device Sig: 1 cap qday Oxycodone 5 mg Tablet 1 po q6hrs prn Folic acid 1 mg Tablet 1 po qday Fluticasone-salmeterol 100-50 mcg/dose Disk 1 inh [**Hospital1 **] Enoxaparin 80 mg/0.8 mL Syringe 1 SC q12 hrs Albuterol sulfate 90 mcg/Actuation HFA Aerosol Inhaler PRN SOB Dexamethasone 4 mg Tablet daily Lorazepam 0.5 mg Tablet 1 po q4 hours as needed for anxiety. Hydralazine 50 mg Tablet 1 PO TID Megestrol 20 mg 1 po qday Ondansetron 8 mg Tablet ODT PO three times a day PRN Prochlorperazine maleate 10 mg Tablet 1 PO three times PRN Pantoprazole 40 mg Tablet 1 tab PO twice a day. Nicotine 7 mg/24 hr Patch 24 hr Sig: One (1) Transdermal qday Discharge Medications: N/A. Discharge Disposition: Home with Service Discharge Diagnosis: Sepsis (severe blood infection) Hypoxia (low oxygen levels) Shortness of breath Non-small cell lung cancer Malignant effusion (fluid in the lungs from cancer) Anxiety Death Discharge Condition: Deceased. Discharge Instructions: N/A. Deceased. Followup Instructions: N/A. Deceased. ICD9 Codes: 486, 0389, 5180, 496, 2724, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6578 }
Medical Text: Admission Date: [**2191-1-7**] Discharge Date: [**2191-1-13**] Date of Birth: [**2123-10-24**] Sex: M Service: MEDICINE Allergies: Cephalexin / Heparin Agents Attending:[**First Name3 (LF) 13256**] Chief Complaint: GI bleed Major Surgical or Invasive Procedure: EGD [**2191-1-8**] History of Present Illness: 67 year old male with alcoholic cirrhosis who was admitted in [**2190-6-24**] to [**Hospital1 18**] for alcoholic hepatitis treated with prednsione 40 mg po qdaily for five days. . He reports having progressive shortness of breath for past few days with inability to even walk to block from unlimited activity a week ago. He reports no abdominal pain, nausea, vomiting, hematemesis, BRBPR, dark stools, dysuria, fever, cough, chest pain, dizziness, palpatations or alcohol use (last drink 3 weeks ago). . He presented to OSH today where he as noted to have dark bloody stool and hematocrit of 15 along with elevated LFTs. Unfortunately he refused NG lavage. He was transfused one unit of PRBC and 2 units of FFP. He was given 750 mg levaquin emperically and transferred to [**Hospital1 18**] ED with octreotide and protonix started. . In the ED, his intial vitals were 99.0 94 118/76 18 98% RA. He had guiaic positive but not grossly bloody stool in the vault in the ED. He was continued on his octreotide and protonix gtt while switched to ceftriaxone 1 gm q24. His labs were significant for HCT of 15.4, INR of 2.1, T.Bili of 8.7, lactate of 7.1, WBC of 17.2, Creatinine of 1.6 and sodium of 131. He was transferred to [**Hospital1 18**] MICU for futher evaluation and management. . In the MICU, he reports feeling well except for right shoulder pain which hurts with movement. Past Medical History: Alcoholic Cirrhosis Social History: Last alcoholic beverage was 3 weeks ago. He stopped smoking twenty years ago. No illicit drug use. Lives alone at home. Separated from his wife. Retired. Family History: No family history of liver disease Physical Exam: ADMISSION EXAM Gen: Male in no acute distress Vitals: 98.7 128/59 120 100%RA HEENT: Normocephalic. Nontraumatic. Icteric. Chest: Clear to auscultation bilaterally. No crackles or wheezing noted Heart: Regular rate and rhythm. Systolic murmur heard throughout Abdomen: Soft and distended. Tenderness to deep palpation. Shifting dullness to percussion noted. External: 1+ pitting edema to the knee Neuro: Alert and oriented to person, place and time. Mild confusion with recall. Could not tell me who the current president is. CN 2-12 intact. [**3-29**] muscles strength throughout except R shoulder strength which was limited due to pain. Skin: Jaundiced. B/l upper extremity bruises DISCHARGE EXAM Vitals: Tm/Tc 99.4/97.5, BP 150/85 (135-155)/(65-85), HR 85 (80-90), RR 20, SaO2 96-100%RA In: 1560 PO, 100 IV ... Out: 2450, BM x0 (net fluid bal -800) Gen: NAD Chest: Clear to auscultation bilaterally. No crackles or wheezing. Heart: Regular rate and rhythm. Systolic murmur heard throughout. Abdomen: Soft and distended. Tenderness to deep palpation. Shifting dullness to percussion noted. Extrem: 2+ pitting edema to the knee bilaterally; RUE now symmetrical to the LUE but with limited ROM [**1-26**] pain Neuro: Alert and oriented to person, place and time. [**3-29**] muscle strength throughout except R shoulder strength which was limited due to pain. Skin: Jaundiced. B/l upper extremity bruises. Pertinent Results: ADMISSION EXAM [**2191-1-7**] 08:30PM BLOOD WBC-17.2* RBC-1.57*# Hgb-5.2*# Hct-15.4*# MCV-98# MCH-33.2* MCHC-34.0 RDW-16.3* Plt Ct-124* [**2191-1-7**] 08:30PM BLOOD Neuts-90.2* Lymphs-6.8* Monos-2.2 Eos-0.3 Baso-0.4 [**2191-1-7**] 08:30PM BLOOD PT-22.1* PTT-43.9* INR(PT)-2.1* [**2191-1-7**] 11:35PM BLOOD Ret Aut-4.5* [**2191-1-7**] 08:30PM BLOOD Glucose-160* UreaN-48* Creat-1.6* Na-131* K-4.8 Cl-101 HCO3-18* AnGap-17 [**2191-1-7**] 08:30PM BLOOD ALT-17 AST-27 AlkPhos-77 TotBili-8.7* [**2191-1-7**] 08:30PM BLOOD Lipase-22 [**2191-1-7**] 11:35PM BLOOD Albumin-2.0* Calcium-8.1* Phos-4.1# Mg-1.6 Iron-123 [**2191-1-7**] 11:35PM BLOOD calTIBC-135* VitB12-GREATER TH Folate-14.9 Hapto-30 Ferritn-250 TRF-104* [**2191-1-7**] 08:30PM BLOOD Ammonia-43 [**2191-1-9**] 05:25AM BLOOD AFP-3.6 [**2191-1-7**] 11:46PM BLOOD Lactate-5.2* [**2191-1-7**] 08:39PM BLOOD Lactate-7.1* DISCHARGE LABS [**2191-1-13**] 05:48AM BLOOD WBC-6.9 RBC-3.21* Hgb-10.0* Hct-29.6* MCV-92 MCH-31.1 MCHC-33.7 RDW-17.0* Plt Ct-70* [**2191-1-13**] 05:48AM BLOOD PT-23.3* PTT-45.2* INR(PT)-2.2* [**2191-1-13**] 05:48AM BLOOD Glucose-100 UreaN-13 Creat-0.8 Na-133 K-3.7 Cl-101 HCO3-30 AnGap-6* [**2191-1-13**] 05:48AM BLOOD ALT-20 AST-38 AlkPhos-117 TotBili-7.2* [**2191-1-13**] 05:48AM BLOOD Albumin-1.9* Calcium-7.9* Phos-2.1* Mg-1.8 EKG [**2191-1-7**] Normal sinus rhythm with low limb lead voltage. Non-specific ST-T wave abnormalities. No previous tracing available for comparison. CXR [**2191-1-8**] No active disease. SHOULDER X-RAY [**2191-1-8**] Mild degenerative arthritic change. RUE ULTRASOUND [**2191-1-10**] No evidence of DVT in the right upper extremity. RUQ ULTRASOUND [**2191-1-10**] 1. Fatty liver with no focal lesions seen. Additionally, there is a reversal of portal venous flow in the right and left system as seen on prior. 2. There is mild intra-abdominal ascites around the liver as well is in bilateral lower quadrants, right greater than left. 3. Gallstone with no evidence of cholecystitis. The common bile duct is normal in caliber. 4. Splenomegaly. CT HEAD W/O CONTRAST [**2191-1-12**] 1. No hemorrhage, edema, or evidence of other acute process. 2. Global atrophy, greater than expected for patient's age, likely related to history of ethanol abuse, and sequelae of chronic small vessel ischemic disease. TTE [**2191-1-13**] no vegetations seen EGD [**2191-1-8**] Impression: Ulcer in the first part of the duodenum (thermal therapy) Otherwise normal EGD to third part of the duodenum Brief Hospital Course: BRIEF HOSPITAL COURSE: Mr. [**Known lastname **] is a 67y/o gentleman with alcoholic cirrhosis who was admitted with dark stools/anemia and was found to have duodenal ulcer that was treated with gold probe, with stable Hct. His course was complicated by Strep viridans bacteremia for which he was treated with antibiotics and he was discharged home. . ACTIVE ISSUES . # GI bleed: Duodenal ulcer, Hct stable now. EGD revealed duodenal ulcer which was treated with gold probe. H. pylori negative. He was treated with PPI, Sucralfate, and prophylactic Ceftriaxone. His Hct remained stable and he had no more signs of active bleeding. . # Strep viridans bacteremia: unclear source. He had 1 positive blood culture on [**1-7**], the day of admission. He was initially started on Vanc but after speciation and sensitivities returned, he was kept on Ceftriaxone (which he was on for prophylaxis in the setting of GI bleed anyway). ID consult was obtained; His access at the time was a right IJ which was pulled (and cultured), and when blood cultures were cleared, a PICC line was placed for outpatient antibiotics. TTE was negative for vegetation and he remained afebrile without any other psitive culture data. The plan is to treat with Ceftriaxone for 2 weeks (last day is [**2191-1-21**]). He was discharged home with VNA and he will follow up with his PCP and Hepatologist. . # Alcohlic cirrhosis with ascites and total body volume overload: MELD 27. His diuretics had been held in the ICU and on arrival to the floor he was total body volume overloaded. He was continued on his home dose of diuretics: Lasix 40 daily, Aldactone 100 daily with very good urine output. He will continue on this dose and follow up with his Hepatologist. . # Hyponatremia: likely hypervolemic as well as hypovolemic. While holding home lasix and aldactone, his hyponatremia improved slightly, but it was still stable in the setting of adding back diuretics. Sodium at the time of discharge was 133. . # Thrombocytopenia: Due to ESLD His platelets were monitored and were 60-100 throughout admission; level was 70 at the time of discharge. . # Acute kidney injury: Resolved. Cr peaked at 1.6, likely was due to prerenal state from volume depletion vs. ischemic ATN. His Cr was monitored and up to 1.6 but was 0.8 at the time of discharge. . # Right shoulder pain: Seems to be rotator cuff in nature but unable to do an exam limited by pain. X-ray revealed just arthritic changes. He was seen by PT and was cleared to go home with PT. He may benefit from an outpatient MRI to assess for rotator cuff injury. Medications on Admission: Lasix 40 mg po qdaily Aldosterone 100 mg po qdaily Discharge Medications: 1. furosemide 40 mg Tablet Sig: One (1) Tablet PO qAM. 2. spironolactone 100 mg Tablet Sig: One (1) Tablet PO qAM. 3. 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. 4. ceftriaxone in dextrose,iso-os 2 gram/50 mL Piggyback Sig: One (1) pack Intravenous Q24H (every 24 hours) for 2 weeks: total 2 week course (last day is [**2191-1-21**]). Disp:*14 pack* Refills:*0* 5. pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 6. sucralfate 1 gram Tablet Sig: One (1) Tablet PO qPM: (please take this separately from your other medications because it can affect the absorption of other medications. Disp:*30 Tablet(s)* Refills:*2* Discharge Disposition: Home With Service Facility: [**Hospital 2255**] [**Name (NI) 2256**] Discharge Diagnosis: GI bleed (duodenal ulcer) alcohol cirrhosis Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: You were admitted due to bloody stools, and you were found to have an intestinal ulcer that was treated. We restarted your diuretics (Lasix and Aldactone) and the extra fluid in your body is being removed well. . During the admission, you had right shoulder pain, which you had before admission as well. X-ray showed that you do not have a fracture. Please follow up with your PCP to discuss this (appointment listed below). . We made the following changes to your medications: -start Sucralfate -start Pantoprazole -start Ceftriaxone (last day is [**2191-1-21**]) Followup Instructions: PRIMARY CARE Name: [**Last Name (LF) **],[**Known firstname **] [**Initial (NamePattern1) **]. [**Last Name (NamePattern1) 3947**]. Location: [**Hospital **] MEDICAL CENTER Address: 1 [**Doctor Last Name **] DR, [**Location (un) **],[**Numeric Identifier 72762**] Phone: [**Telephone/Fax (1) 8572**] Appt: [**1-20**] at 2pm HEPATOLOGY Department: LIVER CENTER When: FRIDAY [**2191-1-28**] at 9:00 AM With: [**First Name11 (Name Pattern1) 640**] [**Last Name (NamePattern4) **], MD [**Telephone/Fax (1) 2422**] Building: LM [**Hospital Ward Name **] Bldg ([**Last Name (NamePattern1) **]) [**Location (un) 858**] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage ICD9 Codes: 5849, 2761, 7907, 2875
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6579 }
Medical Text: Admission Date: [**2131-5-10**] Discharge Date: [**2131-6-20**] Date of Birth: [**2081-3-24**] Sex: F Service: MEDICINE Allergies: Aspirin / Codeine / Erythromycin Base / Penicillins / Influenza Virus Vaccine / Latex Attending:[**First Name3 (LF) 2297**] Chief Complaint: COPD, T7-T9 epidural abscess Major Surgical or Invasive Procedure: PROCEDURES: [**2131-5-10**] by: Surgeon: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 3191**], [**MD Number(1) 3192**] 1. Fusion T2-L1. 2. Extra cavitary decompression T7-T8. 3. Multiple thoracic laminotomies. 4. Multiple lumbar laminotomies. 5. Osteotomy T7, 8, 9 6. Instrumentation, T2-L1. 6. Autografts. [**2131-5-10**] by Thoracic Surgery Dr. [**Last Name (STitle) **] Placement of bilateral chest tubes for bil pleural effusions [**2131-5-10**] Vascular Surgery 1. Ultrasound-guided puncture of right common femoral vein. 2. Inferior vena cavogram, 3. Placement of Gunther Tulip IVC filter. [**2131-5-20**] Dr. [**Last Name (STitle) 363**] and Dr. [**First Name (STitle) **] 1. Partial vertebrectomies of T6, 7 and 8. 2. Fusion T6-T9. 3. Anterior spacer. 4. Autograft, bone morphogenic protein, and allograft. 5. Bronchoscopy and: Left posterolateral thoracotomy, partial vertebrectomy of T6, T7 and T8; fusion of T6 to T9; anterior spacer; autograft bone morphogenic protein and allograft; and finally bronchoscopy. [**2131-5-23**] Dr. [**Last Name (STitle) 363**] Revision laminectomies T6, 7 and 8. 2. Incision and drainage. 3. Debridement. [**2131-5-24**] [**Name6 (MD) **] [**Name8 (MD) **], [**MD Number(1) 17274**] Flexible bronchoscopy. Therapeutic aspiration of secretions. [**5-30**] swallow eval: This swallowing pattern correlates to a Dysphagia Outcome Severity Scale (DOSS) rating of level 4, mild to moderate dysphagia. [**2131-6-5**] [**Name6 (MD) **] [**Name8 (MD) **], [**MD Number(1) 67965**] Flexible bronchoscopy with aspiration and 8-0 Portex tracheostomy tube placement. History of Present Illness: 50F with with history of severe COPD requiring oxygen, colon CA s/p resection and colostomy recent MRSA osteomyletis of MTP joint s/p resection in [**1-19**]; this AM at rehab noted to have SOB with sats as low as 45%. EMS placed her on 100% nonrebreather and gave 40mg lasix. O2 sat improved to 99%. Taken to [**Hospital3 **] ED and received levaqiun and BiPAP. She c/o weakness in her legs, weakness with walking. CT chest showed T7-T9 destructive changed associated with swelling, concerning for abscess. MRI, per report, shows evidence of spinal cord compression. She presents for surgical evaluation. Past Medical History: MRSA, sepsis due to osteomyelitis of the MTP joint s/p resection s/p long term tx with vancomycin COPD, severe, O2 dependent; h/o hypercapnic respiratory failure requiring intubation Costocondritis History of PE (on coumadin) Chronic anemia DM with neuropathy CHF Diverticulosis, Colon CA s/p colostomy h/o SBOs s/p hysterctomy c/b abd wound dehiscence h/o Cdiff colitis HTN IgA and IgG deficiency hypercholesterolemia Gout Restless leg syndrome Social History: does not smoke, drink alcohol; widow Family History: Her father had diabetes. Her mother died of CAD and HTN. Physical Exam: On transfer to MICU on [**2131-6-14**]: Vitals: Tc: 99.4 Tm: 101.2 at MN BP: 161/76 P: 116 R: 29 O2: 98% on CPAP 10 PEEP 5 40% FIO2 General: trached, minimally arousable to verbal stimuli and sternal rub Skin: scattered ecchymoses, no rash, left thoracotomy w/ staples, small yellow wound at incisional end overlying L-spine w/ scant yellow discharge HEENT: Sclera anicteric, pupils 2mm and sluggish, MMD, poor dentition w/ gingival inflammation, oropharynx clear Neck: supple, JVP unable to assess [**2-12**] trach collar, no LAD Lungs: Clear to auscultation bilaterally, no wheezes, rales, ronchi CV: Tachy, Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops Abdomen: obese, LLQ ostomy w/ brown liquid stool, mild line incisional scar healed, soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly appreciated Ext: Warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema PICC line in R antecub Neuro: Drowsy [**2-12**] recent narc dosing, reflexes 2+ b/l, withdrawling to pain in all four extremities, intermittent fine motor tremor noted in right lower extremity foley w/ yellow clear urine Pertinent Results: [**2131-5-10**] 01:22AM BLOOD WBC-13.4* RBC-3.26* Hgb-9.0* Hct-30.6* MCV-94 MCH-27.7 MCHC-29.5* RDW-17.8* Plt Ct-569* [**2131-5-10**] 01:22AM BLOOD Neuts-96.5* Lymphs-2.1* Monos-1.4* Eos-0 Baso-0 [**2131-5-10**] 01:22AM BLOOD PT-21.4* PTT-31.1 INR(PT)-2.0* [**2131-5-10**] 01:22AM BLOOD Glucose-221* UreaN-17 Creat-0.5 Na-144 K-4.4 Cl-99 HCO3-30 AnGap-19 [**2131-5-10**] 01:22AM BLOOD Calcium-9.0 Phos-4.1 Mg-1.8 [**2131-5-30**] 10:35AM BLOOD Albumin-2.4* Iron-9* [**2131-5-30**] 10:35AM BLOOD calTIBC-117* Ferritn-367* TRF-90* [**2131-5-30**] 10:35AM BLOOD Triglyc-260* [**2131-6-14**] 07:24AM BLOOD TSH-4.2 [**2131-5-12**] 02:33AM BLOOD CRP-290.6* [**2131-5-23**] 12:02AM BLOOD IgG-561* IgA-158 . [**2131-5-10**] 12:00 pm TISSUE T8. STAPH AUREUS COAG +. RARE GROWTH. CLINDAMYCIN----------- =>8 R ERYTHROMYCIN---------- =>8 R GENTAMICIN------------ <=0.5 S LEVOFLOXACIN---------- =>8 R OXACILLIN------------- =>4 R RIFAMPIN-------------- <=0.5 S TETRACYCLINE---------- 2 S TRIMETHOPRIM/SULFA---- <=0.5 S VANCOMYCIN------------ <=1 S . [**2131-6-13**] 12:15 am URINE Source: Catheter. . [**2131-5-12**] 5:16 pm STOOL CONSISTENCY: LOOSE FECES POSITIVE FOR C. DIFFICILE TOXIN BY EIA. . [**2131-5-25**] 4:05 pm BRONCHOALVEOLAR LAVAGE RIGHT LOWER LOBE. RESPIRATORY CULTURE (Final [**2131-5-28**]): OROPHARYNGEAL FLORA ABSENT. STAPH AUREUS COAG +. 10,000-100,000 ORGANISMS/ML.. 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------------ <=1 S . [**2131-6-1**] 8:27 am SPUTUM Source: Endotracheal. RESPIRATORY CULTURE (Final [**2131-6-4**]): THIS IS A CORRECTED REPORT [**2131-6-4**]. OROPHARYNGEAL FLORA ABSENT. YEAST. RARE GROWTH. PSEUDOMONAS AERUGINOSA. SPARSE GROWTH. . [**2131-6-2**] 3:48 pm URINE Source: Catheter. URINE CULTURE (Final [**2131-6-6**]): PSEUDOMONAS AERUGINOSA. >100,000 ORGANISMS/ML. OF TWO COLONIAL MORPHOLOGIES. CEFEPIME-------------- 8 S CEFTAZIDIME----------- 4 S CIPROFLOXACIN--------- =>4 R GENTAMICIN------------ <=1 S MEROPENEM------------- =>16 R PIPERACILLIN---------- 32 S PIPERACILLIN/TAZO----- 64 S TOBRAMYCIN------------ <=1 S . [**2131-6-11**] 5:09 pm URINE Source: Catheter. URINE CULTURE (Final [**2131-6-12**]): YEAST. >100,000 ORGANISMS/ML.. . [**2131-5-10**] PATH SPECIMEN SUBMITTED: T8 bone, disc T7-8/bone. I. T8 bone (A): Fragments of cartilage and bone with acute osteomyelitis and osteonecrosis. II. Disc T7-8/bone (B): Fragments of skeletal muscle, fibrous connective tissue and bone with acute osteomyelitis and osteonecrosis. CEFEPIME-------------- 2 S CEFTAZIDIME----------- 4 S CIPROFLOXACIN--------- =>4 R GENTAMICIN------------ <=1 S MEROPENEM------------- 8 I PIPERACILLIN---------- 8 S PIPERACILLIN/TAZO----- 8 S TOBRAMYCIN------------ <=1 S . [**2131-5-10**] MRI T & L-SPINE W/ & W/O CONTRAST: IMPRESSION: Limited examination secondary to motion artifacts, vertebral mass lesion identified at T7, T8 and T9 levels, possibly consistent with metastatic disease, versus an over-imposed infectious process with discitis, additionally, there is also spinal cord compression and with edema at T9 level. Compression fracture identified a T11, T12, L1, L2 and L4 levels. Multilevel disc degenerative disease in the cervical, thoracic, and lumbar spine as described above. . [**2131-5-22**] CT T & L-SPINE W/O CONTRAST: 1. Osseous hardware in grossly stable alignment with new vertebral body spacer at T7-T8. Evaluation of intrathecal detail is extremely limited given artifact and thus epidural collection/hematoma cannot be excluded. MRI recommended to evaluate for these findings as indicated. 2. Progression of consolidation/collapse within the left lower lobe of the lung not fully evaluated on this spine study. . [**2131-5-22**] MRI T & L-SPINE W/ & W/O CONTRAST: 1. Significantly limited study due to extensive artifacts from the posterior spinal hardware from T2-L1 levels. Within these limitations, there is posterior spinal T2 hyperintense area extradural in location, at T8-T10 levels, causing displacement of the thecal sac anteriorly with mild deformity of the cord but no definite cord compression. The posterior spinal canal abnormality may relate to fluid collection like seroma/hematoma with or without granulation tissue. 2. Extensive artifacts noted in the upper thoracic spine, significantly limiting evaluation of the cord at this level from T1-T8 as the thecal sac and cord are obscured. There is possibility of soft tissue material in the spinal canal in this location, with mass effect on the cord until proven otherwise. Assessment of the cord at this level is significantly limited due to artifacts. This can be further evaluated with the CT myelogram to assess the outline of the thecal sac and any mass effect on the thecal sac, and the intrathecal contents, if there is continued concern based on the clinical symptoms. 3. Multilevel extensive degenerative changes in the cervical and the lumbar spine as described before causing moderate spinal canal stenosis or neural foraminal narrowing in the lumbar spine. Please see the detailed report on the prior study done on [**2131-5-10**]. 4. Evaluation for prevertebral soft tissue or abnormal enhancement is limited on the present study due to lack of fat saturated sequences. There is increased STIR signal noted in the prevertebral soft tissues at the level of T8-T10, representing prevertebral soft tissue swelling, the cause of which can relate to edema, fluid collection, or abscess. Post-surgical changes in the thoracic spine at multiple levels, most prominently at T7-T9 levels, not adequately assessed due to artifacts. . [**2131-6-2**] UNIL HIP XRAY: Three views of the left hip were reviewed. There is no evidence of fracture. There is no evidence of dislocation. There is no evidence of pathological sclerosis. The vascular calcifications are demonstrated in the femoral artery. . [**2131-6-3**] CT ABD/PELVIS: 1. Large amount of stranding as well as several fluid collections seen along the posterior spine extending from the lower cervical level to the upper thoracic spine level, likely postoperative in nature. No CT sign of infection, however this cannot be completely excluded by imaging alone. 2. Small bilateral pleural effusions, greater on the right with bilateral lower lobe atelectasis. 3. No acute intra-abdominal process. 4. Postoperative thoracic spine changes as described. . [**2131-6-15**] EEG: This is an abnormal portable EEG recording due to the slow and disorganized pattern and the bursts of generalized slowing. This abnormality suggests a widespread encephalopathy. Medications, metabolic disturbances, and infection are among the most common causes. Of note is that although the right leg twitching had no EEG correlate it does not completely exclude the possibility of the patient having focal motor seizures. There are no epileptiform features seen in this recording and no lateralized features. Note is made of a tachycardia with a single ectopic beat. . [**2131-6-16**] CT SINUS/MANDIBLE/MAXILLOFACIAL W/O CONTRAST: Pansinus mucosal thickening, most prominent in the right maxillary sinus where a combination of mucosal thickening and inspissated secretions are observed. The findings may represent sinusitis. No focal fluid collections are seen. . [**2131-6-16**] MRI T-SPINE W/ & W/O CONTRAST: 1. Since the previous MRI of [**2131-5-22**], there is now increased fluid seen surrounding the interbody device placed following corpectomy with fluid extending into the anterior epidural space on the left side, narrowing the spinal canal at T7 and T8 level with compression of the spinal cord. 2. Superficial fluid collection in the left upper thoracic region and also fluid extending from laminectomy site to subcutaneous fat in the upper thoracic region. The fluid extending from the laminectomy site to the subcutaneous fat has considerably decreased since the previous study. 3. Extensive bilateral pleural parenchymal changes in the lungs, which can be further evaluated with CT of the chest. . [**2131-6-16**] MRI L-SPINE W/ & W/O CONTRAST: Compressions of T12 and L1 vertebral bodies identified. The compressions may have slightly increased since the previous study. Multilevel degenerative changes are seen in the lumbar region. No intraspinal fluid collection in the lumbar region. Small fluid collection left of the midline at L3-4 level within the subcutaneous fat as described above. Brief Hospital Course: HPI: 50 y.o female with COPD, htn, DM2, IgG, IgA deficiency, hx colon CA w/ colostomy, from [**Hospital3 **] Hospital from rehab [**5-9**] with SOB, hypoxia though to be secondary to COPD exacerbation. There she complained of LE weakness. Chest CT there showed T7-T9 destruction with soft tissue swelling and concern for disciitis/epidural abscess and MRI T spine showed evidence of cord compression with epidural abscess seen from T7-T10. Brief Hospital Course: Pt transferred from OSH on [**5-10**] underwent Fusion T2-L1, Extra cavitary decompression T7-T8, Multiple thoracic laminotomies, Multiple lumbar laminotomies, Osteotomy T7, 8, 9, Instrumentation, T2-L1, Autografts. Subsequent osteo w/ MRSA growing from T7-T10 to OR [**5-20**]: Partial vertebrectomies of T6, 7 and 8, Fusion T6-T9, Anterior spacer, Autograft, bone morphogenic protein, and allograft, bronchoscopy. Developed hematoma [**5-23**] went back to OR for Revision laminectomies T6, 7 and 8, Incision and drainage, Debridement. [**5-24**] she was bronched w/ Left lung collapse secondary to mucus retention. Pt failed weaning trials off vent and underwent trach [**6-5**]. Low grade temps w/ known MRSA spine osteo, Pseudomonas VAP & UTI, C.Diff. On Vanc + Rif 6wk course to d/c [**7-5**]. On 25mg prednisone since COPD exac [**5-9**], weaning started [**6-12**]. Persistently agitated, q/ questionable pain control during course. Psych, neuro, CPS consults. Neuro rec EEG r/o seizures [**6-13**]. IVC filter placed during hospital course d/t risk of anticoagulation. PEG placed [**6-12**] for TF. Repeated failed trach collar trials, ? vent rehab, but persistent fevers w/ most recent culture sputum pos sparse pseudomonas. blood and urine cultures pending. Known persistent peri-spinous fluid collection, no imaging or surgical procedures intended, per neurosurg. Operative Dates: [**2131-6-12**] PEG (bedside) [**2131-6-5**] trach, bronch [**2131-5-24**] bronch [**2131-5-22**] epidural evac [**2131-5-20**] L thoracotomy, ant T6-8 corpectomies, ant cage T6-T9 [**2131-5-10**] Fusion T2-L1, mulit T-L lami, IVC filter, CT R and L Antibiotic:vanco/cefepime/flagyl/rifampin Anticoagulant:SQH TLD:IVC filter:Day37 Foley:Day4 PMH: MRSA, sepsis due to osteomyelitis of the MTP joint s/p resection s/p long term tx with vancomycin; COPD, severe, O2 dependent; h/o hypercapnic respiratory failure; requiring intubation, Costocondritis History of PE (on coumadin), Chronic anemia, DM with neuropathy CHF, Diverticulosis, Colon CA s/p colostomy, h/o SBOs, s/p hysterctomy c/b abd wound dehiscence, h/o Cdiff colitis HTN, IgA and IgG deficiency, hypercholesterolemia, Gout, Restless leg syndrome Meds: Albuterol 2.5 QID, atrovent 0.5 QID, cardizem 60 QID, prilosec 20', SSI; prednisone po 25', vit C 500", gabapentin 300"; requip 0.25 po tid; mvi, oxycontin cr 40", colace prn; maalox prn; bisacodyl prn; percocet prn ID - flagyl PO until leaves; at that point, switch to PO vanco AND stays on IV vanco - total 6 weeks; rifampin for hardware, will need weekly LFTs Micro/Imaging: [**2131-6-13**] urine pending [**2131-6-13**] blood NGTD [**2131-6-12**] blood NGTD [**2131-6-11**] sputum Pseudomonas, Yeast [**2131-6-11**] urine >100k yeast [**2131-6-11**] blood x2 NGTD [**2131-6-4**] sputum Pseudomonas [**2131-6-2**] blood ngtd [**2131-6-2**] urine GNRs, yeast [**2131-6-2**] sputum Pseudomonas [**2131-6-2**] cath tip ngtd [**2131-6-2**] cdiff neg [**2131-6-1**] sputum Pseudomonas [**2131-5-27**] BAL no PMN, no micro; MRSA [**2131-5-25**] BAL RLL 1+PMN, no micro; MRSA [**2131-5-25**] BAL LLL 1+ PMN, no micro; MRSA [**2131-5-21**] BAL No PMNs, no micros; 3000 yeast [**2131-5-21**] BAL 2+ PMNs, no micros: 3000 yeast [**2131-5-21**] tip NG [**2131-5-18**] cdiff neg [**2131-5-12**] cdiff POSITIVE [**2131-5-12**] sputum >25 PMNs, <10 epis, GPC, GPR; +yeast (sparse) [**2131-5-12**] blood ng final [**2131-5-11**] picc tip ng final [**2131-5-11**] blood ng final [**2131-5-10**] T7 2+ GPC, MRSA [**2131-5-10**] T8 4+ PMN, 1+ GPC, MRSA [**2131-5-10**] blood x2 ng final Events: [**2131-6-14**] transferred to medicine [**2131-6-13**] febrile, recultured, ID reconsulted [**2131-6-12**] PEG, febrile again, foley changed -lots yeast per nsg, ID rec'd surv.clx [**2131-6-12**] psych -rec'd EEG/neuro c/s for jerking, stop zyprexa, check CK [**2131-6-11**] awaiting PEG placement, pancultured for fever - UClx > 100K yeast [**2131-6-10**] diuresing, IP - unable to tap effusions, preop for PEG [**2131-6-10**] episode hypotension after meds?? resolved w/IVF, time [**2131-6-8**] CPS consult [**2131-6-6**] bronch, diuresis, rehab screen - unable to wean off vent [**2131-6-5**] OR for open tracheostomy; ID rec'd no double coverage for pseudomonas [**2131-6-4**] GYN c/s - no vaginal bleeding [**2131-6-3**] CT torso - no intraabd process; vag bleeding [**2131-6-2**] T spike to 101.6 -> started cefepime for presumed VAP [**2131-6-1**] intubated [**2131-5-31**] diamox stopped; ?PICC [**2131-5-30**] passed swallow - thin liquids [**2131-5-28**] extubated; started on rifampin; L CT pulled; ID - add rifampin, weekly LFTs [**2131-5-26**] L chest tube pulled back 4cm [**2131-5-25**] reintubated, bronch [**2131-5-24**] L white out; bronch - mucous plugs, 20 lasix [**2131-5-23**] R CT pull,ed post pull R apical PTX; 3upRBC [**2131-5-22**] new LLE weakness, ?epidural collection [**2131-5-21**] BAL - plugs [**2131-5-20**] OR; 800 EBL, resite L CT; got dose of lovenox [**2131-5-16**] extubated [**2131-6-5**] Trach placed-respl failure secretions. Assessment: 50F epidural abscess on MRI T7-10, s/p T2-L1 fusion, bilat CT placement s/p epidural evac s/p trach/bronch now s/p PEG placement Plan: Neuro: pain regiment per CPS CV: home dilt, PO lopressor, stable hemodynamically thus far Pulm: cont pred taper, remains vent dependent GI: cont TF, advance to goal ID: febrile once again, f/u ID consult recs; d/c hydral/reglan - ??drug fever, cont vanc x 6 wks; per ID; cefepime for VAP; flagyl for CDiff; Rifampin for hardware - weekly LFTs; cont surveillance clx, ??scan back GU: urine > 100K yeast -rec treatment Transferred to medicine [**6-14**]- thank you for your care = = = = = = = = = = = = = = = = = = = = ================================================================ Hospital course after transfer to MICU service (SICU above completed by surgical RN): #. Fevers: Patient had had multiple infectious processes during prolonged hospitalization and had defervesced for several days before again starting to spike fevers. Initial concern was for recurrent epidural process because of persistently draining superficial wound. MRI T and L spine showed with new fluid collection concerning for abscess tracking back to epidural space. An attempt by interventional radiology was made to drain this fluid collection, but was unsuccessful. She was continued on Vancomycin and rifampin for at least a 6 week course (last day [**2131-7-5**]) for her epidural abscess. Will continue flagyl while on this regimen to prevent CDiff. In addition she had copious secretions and completed an 8 day course of cefipime for VAP (last dose [**2131-6-16**]). Also, her urine grew yeast on two different occasions despite changing of the foley and she was treated with fluconazole for 7 days (last dose [**2131-6-20**]). In addition to infectious etiologies, drug fever was also considered and medications that could potentially contribute were discontinued including gabapentin, famotidine, and hydralazine. The patient remained afebrile after these interventions for > 5 days prior to discharge. #. Epidural abscess: Pt continued on vanc and rifampin (last dose [**2131-7-5**]). Pt noted to have continued purulent drainage from surgical site. MRI T and L spine on [**6-15**] showed new fluid collection concerning for abscess tracking back to epidural space with evidence of cord compression on Radiology read. Ortho Spine attending felt that this was mild and recommended CT-guided aspiration on [**2131-6-18**] however per radiology the fluid collection was too small to tap and may all be related to post-op changes so no tap was done. Vanc and rifampin to continue until [**2131-7-5**] and while on these she will remain on flagyl for CDiff. Will f/u with Dr. [**Last Name (STitle) 363**] for further treatment as outpatient in 10 days. #. VAP: Patient had been diagnosed with VAP a few days prior to transfer to medical service and completed 10 day cefepime course for pseudomonal VAP. #. Yeast UTI: Patient was noted to have yeast in the urine even after foley changed. She was treated with fluconazole X 7 days. #. Weakness: The patient noted to have low tidal volumes leading to difficulty with weaning off vent. Thought to have components from both critical illness myopathy as well as oversedation from polypharmacy. She was placed on tapers of clonidine, neurotin, and steroids and was able to be weaned off vent to trach mask for several hours daily at time of discharge. #. Agitation/altered mental status: Had some upper extremity "twitching" after starting zyprexa. EEG consistent with widespread encephalopathy. Evaluated by psych/neuro. Tapered off of nonessential medications including steroids, clonidine, ativan, and neurontin with improvement in mental status. Also started on fentanyl patch for better pain control. #. Tachycardia: Sinus on multiple EKGs with rates 100-130s. Likely [**2-12**] agitation and pain. Has been treated with pain meds and with sleep does come down. Would continue to treat pain and agitation PRN and check EKG if irregular or rate >130. #. Hypercarbic respiratory failure: In setting of VAP and volume overload. Has been tolerating trach mask for 3-4 hours twice daily. PCO2s at baseline on vent are in 70s. Has been receiving lasix (10 mg IV daily PRN for diuresis if appears overloaded on exam. #. Hypercalcemia: Has had slowly trending up calcium. Suspect immobilization. Will need to check calcium at least weekly and more often if symptoms of hypercalcemia develop and treat appropriately. Medications on Admission: Albuterol 2.5mg neb 4x daily Atrovent 0.5 4x daily Cardizem 60mg 4x daily Prilosec 20 po daily ISS Prednisone po 25' Vitamin C 500 po bid Gabapentin 300 [**Hospital1 **] Requip 0.25 po tid MVI Oxycontin cr 40 po q12h Colace prn maalox prn bisacodyl prn percocet prn Discharge Medications: 1. Alum-Mag Hydroxide-Simeth 200-200-20 mg/5 mL Suspension [**Hospital1 **]: 15-30 MLs PO QID (4 times a day) as needed. 2. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) [**Hospital1 **]: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed. 3. Metronidazole 500 mg Tablet [**Hospital1 **]: One (1) Tablet PO TID (3 times a day). 4. Miconazole Nitrate 2 % Powder [**Hospital1 **]: One (1) Appl Topical TID (3 times a day) as needed for to affected skin. 5. Rifampin 300 mg Capsule [**Hospital1 **]: One (1) Capsule PO Q12H (every 12 hours). 6. Chlorhexidine Gluconate 0.12 % Mouthwash [**Hospital1 **]: Fifteen (15) ML Mucous membrane [**Hospital1 **] (2 times a day). 7. Atorvastatin 10 mg Tablet [**Hospital1 **]: One (1) Tablet PO DAILY (Daily). 8. Albuterol Sulfate 90 mcg/Actuation HFA Aerosol Inhaler [**Hospital1 **]: 2-4 Puffs Inhalation Q2H (every 2 hours) as needed for wheezing. 9. Ipratropium-Albuterol 18-103 mcg/Actuation Aerosol [**Hospital1 **]: [**2-14**] Puffs Inhalation Q6H (every 6 hours) as needed for wheezing. 10. Insulin Regular Human 100 unit/mL Solution [**Month/Day (3) **]: per sliding scale units Injection ASDIR (AS DIRECTED). 11. Lorazepam 0.5 mg Tablet [**Month/Day (3) **]: One (1) Tablet PO TID (3 times a day). 12. Heparin (Porcine) 5,000 unit/mL Solution [**Month/Day (3) **]: One (1) injection Injection TID (3 times a day). 13. Prednisone 10 mg Tablet [**Month/Day (3) **]: One (1) Tablet PO DAILY (Daily) for 3 days: switch to 5mg x3 days once this has been completed then off. 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. Ondansetron 4 mg IV Q8H:PRN nausea 16. Sodium Chloride 0.9% Flush 10 mL IV PRN line flush Temporary Central Access-ICU: Flush with 10mL Normal Saline daily and 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. Lansoprazole 30 mg Tablet,Rapid Dissolve, DR [**Last Name (STitle) **]: One (1) Tablet,Rapid Dissolve, DR [**Last Name (STitle) **] once a day. 19. Vancomycin in Dextrose 1 gram/200 mL Piggyback [**Last Name (STitle) **]: One (1) gram Intravenous Q 24H (Every 24 Hours): course to continue until [**2131-7-5**]. 20. 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. 21. 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. 22. Fentanyl 50 mcg/hr Patch 72 hr [**Month/Day/Year **]: One (1) Patch 72 hr Transdermal Q72H (every 72 hours). 23. Transportation Please book transportation to [**Hospital1 18**] for follow-up appointments listed. Discharge Disposition: Extended Care Facility: [**Hospital1 700**] - [**Location (un) 701**] Discharge Diagnosis: Pseudomonal Ventilatory Associated Pneumonia hypercarbic respiratory failure malnutrition spine methacillin-resistant staph aureus osteomylitisepidural abcess clostridium deficile colitis Delirium fungal urinary tract infection anxiety diabetes mellitus Discharge Condition: Hemodynamically stable, requiring CPAP w/ PS from ventilator. Discharge Instructions: You were treated for your epidural abcess and MRSA osteomyelitis of the spine. You required multiple surgical interventions to treat this and will continue to require long-term antibiotics to treat your osteomyelitis and clotridium deficile colitis. During your stay, you also had respiratory failure and continue to require ventilatory support. Medications: - Vancomycin/Rifampin until [**2131-7-5**], with likely plan for bactrim suppression to follow - Flagyl 1 week after vancomycin has been discontinued Followup Instructions: It is essential that you follow up with the infectious disease team as scheduled below in order to continue to insure proper antibiotic treatment: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 456**], MD Phone:[**Telephone/Fax (1) 457**] Date/Time:[**2131-7-2**] 11:30 Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 363**] (spine surgery) on [**2131-6-28**] 1:30pm at [**Hospital1 18**] [**Hospital Ward Name 23**] 2 [**Hospital **] Clinic. Please call ([**Telephone/Fax (1) 3573**] with questions. Completed by:[**2131-6-20**] ICD9 Codes: 5119, 4280, 4019, 2749, 2724, 2859
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Medical Text: Admission Date: [**2147-10-6**] Discharge Date: [**2147-10-12**] Date of Birth: [**2091-5-23**] Sex: M Service: NEUROSURGERY Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 1835**] Chief Complaint: Headache Major Surgical or Invasive Procedure: [**2147-10-9**]: Left occipital craniotomy for biopsy and debulking of brain mass History of Present Illness: This is a 56 year old gentleman without significant PMH with complaint of 3 weeks of headache. He was evaluated by his PCP. [**Name10 (NameIs) **] was given ativan for headache and anxiety without relief. CT done revealed a left parietal mass. He was instructed to go to the ED ([**University/College **] Hitchcock). Was evaluated there and given Dilaudid for pain. His mental status was declining so patient given decadron x10 and medflighted to [**Hospital1 18**]. Neurosurgery consult requested for evaluation. Past Medical History: HL s/p appy s/p vasectomy Social History: He is married. He lives with wife in [**Name (NI) **], [**Name (NI) **]. He works in a chemical comapny. He does not smoke cigarettes or use illicit drugs. He drinks alcohol occasionally. Family History: His parents are alive and well. His mother has memory problems while his father has a history of coronary artery disease and underwent bypass surgery. His sister died in her 40's with a glioblastoma. He has 2 other siblings and they are healthy. He has 3 children; one was born premature and has cerebral palsy while the other two are healthy. Physical Exam: Admission examination: PHYSICAL EXAM: O: T: 97 BP: 127/65 HR: 60 R 12 O2Sats 99%RA Gen: laying on stretcher, asleep HEENT: Pupils: 2.5-2mm Neck: Supple. Extrem: Warm and well-perfused. Neuro: Mental status: lethargic. arouses to voice/light stimuli Orientation: Oriented to self only Cranial Nerves: I: Not tested II: Pupils equally round and reactive to light, 2.5 to 2 mm bilaterally. III, IV, VI: Extraocular movements intact bilaterally without nystagmus. V, VII: Facial strength and sensation intact and symmetric. VIII: Hearing intact to voice. IX, X: Palatal elevation symmetrical. [**Doctor First Name 81**]: Sternocleidomastoid and trapezius normal bilaterally. XII: Tongue midline without fasciculations. Motor: Normal bulk and tone bilaterally. No abnormal movements, tremors. Strength full power [**5-4**] throughout. PHYSICAL EXAM UPON DISCHARGE- awake, alert to self, hospital. PERRL, EOMI face symmetric, tongue midline full strengths x4 Incision- staples intact, well healing Pertinent Results: Admission labs: [**2147-10-6**] 12:35PM BLOOD WBC-10.3 RBC-4.50* Hgb-14.4 Hct-42.5 MCV-95 MCH-32.1* MCHC-33.9 RDW-12.4 Plt Ct-298 [**2147-10-6**] 12:35PM BLOOD Neuts-90.8* Lymphs-6.8* Monos-1.9* Eos-0.4 Baso-0.2 [**2147-10-6**] 12:35PM BLOOD PT-13.4 PTT-21.4* INR(PT)-1.1 [**2147-10-6**] 12:35PM BLOOD Glucose-123* UreaN-16 Creat-0.9 Na-137 K-4.4 Cl-102 HCO3-23 AnGap-16 [**2147-10-6**] 12:35PM BLOOD Calcium-9.0 Phos-3.1 Mg-2.0 [**2147-10-6**] 12:35PM BLOOD ASA-NEG Ethanol-NEG Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG Radiology: CT HEAD W/O CONTRAST Study Date of [**2147-10-6**] 12:40 PM IMPRESSION: Large ill-defined left occipitoparietal mass with associated vasogenic edema and hemorrhage exerting mass effect including subfalcine and uncal herniation. Early signs of hydrocephalus. . MR HEAD W & W/O CONTRAST Study Date of [**2147-10-6**] 4:37 PM IMPRESSION: Left occipital irregularly enhancing mass with chronic blood products and several low-signal areas indicative of areas of necrosis. The findings are suggestive of an infiltrative primary neoplasm such as glioma. There is extensive surrounding edema seen with left-sided uncal herniation and distortion of the midbrain resulting in moderate obstructive hydrocephalus. No restricted diffusion is seen. . CTA HEAD W&W/O C & RECONS Study Date of [**2147-10-7**] 12:56 AM IMPRESSION: Left occipital mass demonstrates no evidence of acute hemorrhage. Increased vascularity is seen predominantly from the left posterior cerebral artery with no large draining veins identified or arteriovenous malformation is seen. Vascular displacement is seen but no aneurysm is identified. . CT HEAD W/O CONTRAST Study Date of [**2147-10-9**] 5:08 PM FINDINGS: There has been interval left parieto-occipital craniotomy, with overlying skin staples and mild pneumocephalus. Changes of tumor debulking are noted in the left parietal region, with adjacent hyperdense material representing hemorrhage and/or post-surgical changes. Just inferior to this region, there is evidence of residual hyperdense tumor involving the left occipital lobe, temporal lobe, and splenium. Persistent surrounding vasogenic edema extends superiorly into the left parietal and posterior frontal lobes, and inferiorly into the left temporal lobe. Left cerebral sulci are diffusely effaced, and the left lateral ventricle is compressed. There is continued 9-mm rightward subfalcine herniation, and 8-mm rightward shift at the level of the third ventricle. Continued slight widening of the left ambient cistern relative to the right is suggestive of impending uncal herniation. Coarse calcifications are noted in the bilateral cavernous carotid arteries. Middle ear cavities and mastoid air cells are clear. Paranasal sinuses are well aerated. The orbits and intraconal structures are intact. IMPRESSION: Tumor debulking, with stable rightward mass effect and subfalcine herniation. . MR HEAD W & W/O CONTRAST Study Date of [**2147-10-10**] 10:22 AM IMPRESSION: Status post left occipital craniotomy and tumor resection with expected postoperative changes. Areas of enhancement within the left occipital and left temporal lobes are consistent with residual tumor. Rightward shift of midline structures and left uncal herniation is unchanged. Brief Hospital Course: This is a 56-year-old left handed man, with no significant past medical history with progressive forgetfulness, confusion, right parietal headache and nausea and voomiting who eventualy developed right-sided weakness and initiallty presented to the [**University/College **] Hitchcock ED on [**2147-10-6**]. CT head scan there revealed a large left parietal mass with signifcant mass effect. Given a decrease in conscious level following narcotics for headache, he was MedFlighted to the [**Hospital1 18**]. He was assessed by neurosurgery, loaded with phenytoin and admitted to the neurosurgery ICU on [**2147-10-6**]. His cognitive symptoms improved somewhat and MRI revealed a left occipital irregularly enhancing mass with chronic blood products and areas suggestive of necrosis in addition to extensive edema with left uncal herniation and distortion of the midbrain resulting in moderate obstructive hydrocephalus. He was administered mannitol and dexamethasone and a CTA head showed increased vascularity is mainly from the left PCA. Neuro-oncology were consulted and he proceeded to a left parietal craniotomy with subtotal tumor debulking and decompression. Postoperatively the patient was extubated and transferred to the ICU for Q1 hour neurochecks and SBP control less than 140. Post op CT was stable, without evidence of hemorrhage and postop MRI demostrated subtotal resection of tumor. He did well post-operatively and was transferred to the floor on [**2147-10-10**]. Decadron was weaned to 2mg TID which he will continue on until follow up. He was seen on PT/OT on [**10-11**]. It was recommended that he be discharged to inpatient rehab. On [**10-12**] he was cleared for discharge. Medications on Admission: Lipitor Ativan Discharge Medications: 1. acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for pain, T>38.5. 2. bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 3. senna 8.6 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 5. phenytoin sodium extended 100 mg Capsule Sig: One (1) Capsule PO TID (3 times a day). 6. heparin (porcine) 5,000 unit/mL Solution Sig: One (1) mL Injection TID (3 times a day). 7. pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 8. dexamethasone 2 mg Tablet Sig: One (1) Tablet PO Q8hrs (). 9. oxycodone 5 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. 10. atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 11. magnesium hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO Q6H (every 6 hours) as needed for no bm . 12. lactulose 10 gram/15 mL Syrup Sig: Thirty (30) ML PO Q6H (every 6 hours) as needed for no bm. Discharge Disposition: Home With Service Facility: [**Location (un) 12017**] VNA Discharge Diagnosis: Left Occipital Brain Tumor Discharge Condition: Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Mental Status: Confused - sometimes. 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. ?????? Dressing may be removed on Day 2 after surgery. ?????? Your wound was closed with staples. You must wait until after they are removed to wash your hair. 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) & Senna 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 Dilantin (Phenytoin) for anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing in one week. This can be drawn at your PCP??????s office, but please have the results faxed to [**Telephone/Fax (1) 87**]. ?????? If 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. Followup Instructions: Follow-Up Appointment Instructions ??????You have an appointment in the Brain [**Hospital 341**] Clinic on [**2147-10-16**] at 11:30 am. The Brain [**Hospital 341**] Clinic is located on the [**Hospital Ward Name 5074**] of [**Hospital1 18**], in the [**Hospital Ward Name 23**] Building, [**Location (un) **]. Their phone number is [**Telephone/Fax (1) 1844**]. Please call if you need to change your appointment, or require additional directions. Completed by:[**2147-10-12**] ICD9 Codes: 2720
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Medical Text: Admission Date: [**2195-12-31**] Discharge Date: [**2196-1-6**] Date of Birth: [**2111-7-23**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 689**] Chief Complaint: GI bleed Major Surgical or Invasive Procedure: Multiple blood transfusions Upper endoscopy History of Present Illness: Briefly, patient is an 84 year-old man with CAD s/p CABG, DM, and HTN who presented with 2 days of black stools and coffee ground emesis. He had been feeling lethargic and lightheaded. He has not been using any new medications and has not had a prior GIB. . In the ED, initial VS: 98.7 88 65/47 98%/RA. He had an NG lavage with coffee ground emesis that cleared with 600 cc of flushing. During the lavage he had chest pressure and an EKG showed STD in V2-4. He did not have radiation, pain, or diaphoresis. EKG was reviewed with cards. His chest pain resolved after getting 1 unit of PRBCs and 1.1 L NS. Subsequent EKGs showed resolution of changes. He was also treated with zofran and protonix bolus + gtt 80/8. Initial Hct 18.7. . In the MICU, his chest pressure and lightheadedness resolved. Patient received 4 more units of PRBCs (total of 5). Pt has not had any further bleeding. He has been hemodynamically stable in the MICU. Access: 2PIVs--18, 20. . Here, he had an upper endoscopy that revealed a duodenal ulcer with stigmata of recently bleeding. He has been hemodynamically stable. He has no complaints at this time except hunger. Past Medical History: Coronary artery disease s/p triple-vessel coronary artery bypass in [**9-/2182**] Hypertension Peripheral arterial disease Hypercholesterolemia Diabetes Osteoarthritis Gout Anemia Baseline 32-35 with unrevealing w/u by heme Right hernia repair in [**2161**] Appendectomy in [**2125**] Prostate disease Physical Exam: GENERAL: NAD, comfortable, A&Ox3 HEENT: [**Last Name (LF) 12476**], [**First Name3 (LF) 15315**] cheeks CARDIAC: RR 2/6 systolic murmur loudest at apex LUNG: CTAB no w/r/r ABDOMEN: +BS, soft, NT, ND EXT: WWP, 2+ PT/DP pulses NEURO: grossly nonfocal DERM: no rashes Pertinent Results: [**2195-12-31**] 06:15PM BLOOD WBC-9.9 RBC-1.98* Hgb-6.3* Hct-18.7* MCV-94 MCH-31.6 MCHC-33.5 RDW-15.8* Plt Ct-139* [**2196-1-1**] 11:25AM BLOOD WBC-8.9 RBC-3.36*# Hgb-10.5*# Hct-29.4*# MCV-88 MCH-31.4 MCHC-35.8* RDW-16.0* Plt Ct-100* [**2196-1-1**] 11:25PM BLOOD Hct-27.3* [**2196-1-6**] 06:50AM BLOOD WBC-6.8 RBC-3.85* Hgb-11.9* Hct-34.3* MCV-89 MCH-30.9 MCHC-34.6 RDW-16.1* Plt Ct-125* [**2196-1-3**] 07:05AM BLOOD PT-12.4 PTT-26.0 INR(PT)-1.0 [**2195-12-31**] 06:15PM BLOOD Glucose-300* UreaN-95* Creat-1.7* Na-145 K-4.6 Cl-108 HCO3-17* AnGap-25* [**2196-1-3**] 07:05AM BLOOD Glucose-175* UreaN-14 Creat-1.0 Na-143 K-4.0 Cl-112* HCO3-24 AnGap-11 [**2196-1-6**] 06:50AM BLOOD Glucose-156* UreaN-17 Creat-1.3* Na-141 K-3.2* Cl-105 HCO3-23 AnGap-16 [**2195-12-31**] 09:27PM BLOOD ALT-12 AST-13 LD(LDH)-183 AlkPhos-25* TotBili-1.0 [**2196-1-1**] 02:44AM BLOOD CK(CPK)-72 [**2196-1-1**] 11:25PM BLOOD CK(CPK)-130 [**2195-12-31**] 06:15PM BLOOD Lipase-72* [**2195-12-31**] 06:15PM BLOOD cTropnT-<0.01 [**2196-1-1**] 02:44AM BLOOD CK-MB-NotDone cTropnT-0.05* [**2196-1-1**] 11:25PM BLOOD CK-MB-5 cTropnT-0.09* [**2196-1-5**] 07:15AM BLOOD Calcium-8.5 Phos-3.3 Mg-1.8 [**2196-1-2**] 02:58PM BLOOD %HbA1c-6.1* [**2195-12-31**] 09:35PM BLOOD Lactate-2.5* **FINAL REPORT [**2196-1-4**]** HELICOBACTER PYLORI ANTIBODY TEST (Final [**2196-1-4**]): POSITIVE BY EIA. (Reference Range-Negative). ECHO [**2196-1-5**] The left atrium is elongated. The left ventricle is not well seen. 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%). Right ventricular chamber size and free wall motion are normal. The number of aortic valve leaflets cannot be determined. The aortic valve leaflets are moderately thickened. There is mild moderate aortic valve stenosis (valve area 1.0-1.2cm2). Trace aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. No mitral regurgitation was seen. The pulmonary artery systolic pressure could not be determined. There is no pericardial effusion. IMPRESSION: Suboptimal image quality. Mild to moderate aortic stenosis (valve calculation may overestimate severity due to underestimation of outflow tract velocity). Preserved biventricular global systolic funcction. Endoscopy Report Ulcer in the apex of duodenal bulb (injection) Tortugas esophagus Otherwise normal EGD to third part of the duodenum Brief Hospital Course: ASSESSMENT & PLAN: Mr. [**Known lastname 4612**] is an 84 man with CAD s/p CABG, DM, HTN who presented with a GI bleed and developed chest pressure. . # Bleeding duodenal ulcer: Duodenal ulcer with stigmata of recent bleeding seen on EGD [**1-1**]. In total, he required 6 units of pRBC's. His hematocrit was stable prior to discharge. He was having dark stools that were gradually clearing. He was tolerating a regular diet. He had plans to re check his hematocrit shortly after discharge. His was discharged on high dose pantoprazole. His serum was positive for H. pylori. He was treated with a course of two weeks of clarithromycin and amoxicillin. . # NSVT: Patient had several runs of NSVT. These were less frequent after optimization of electrolytes. . # Chest pain: No further episodes were present during the hospitalization. Inferior/lateral EKG changes were concerning for demand ischemia. This was not ACS. We continued his home statin. No aspirin was given considering his recent bleeding. His beta blocker was restarted. An echo was repeated whiched showed mild to moderate aortic stenosis. However, the image quality was suboptimal and should be followed up. Of note, Mr. [**Known lastname 4612**] was told to stop his statin for the two weeks he is on clarithromycin. He was told to restart following completion of his antibiotic course. . # Acute renal failure: Given his significant volume depletion, he had acute renal failure. This improved by the time of discharge, but was not at his baseline. . # Diabetes: He was placed on an insulin sliding scale. His oral medications were restarted on discharge. . # Hypertension: On initial presentation all oral medications were stopped. Gradually his home regimens were titrated up. Even on his home doses, he was having blood pressures elevated to 200. His metoprolol dose was increased to 75 mg [**Hospital1 **] which resulted in improved control. . # Thrombocytopenia: Patient's platelet counts decreased to a low of 88. They gradually increased to 125 on the day of discharge. . # PPX: He received high dose pantoprazole and pneumoboots. . # CODE: He was a full code during this admission. Medications on Admission: confirmed with pharmacy on [**1-2**] at 1800 ALLOPURINOL 300 mg Tablet by mouth daily GLIPIZIDE 5 mg Extended Rel by mouth twice as day LOSARTAN [COZAAR] 100 mg by mouth [**Hospital1 **] METFORMIN 500 mg by mouth [**Hospital1 **] METOPROLOL TARTRATE 50 mg [**Hospital1 **] SIMVASTATIN 80 mg Tablet by mouth daily ASPIRIN 81 mg Tablet by mouth daily Discharge Medications: 1. Losartan 50 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 2. 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* 3. Amoxicillin 500 mg Capsule Sig: Two (2) Capsule PO twice a day for 14 days. Disp:*56 Capsule(s)* Refills:*0* 4. Clarithromycin 500 mg Tablet Sig: One (1) Tablet PO twice a day for 14 days. Disp:*28 Tablet(s)* Refills:*0* 5. Metoprolol Tartrate 25 mg Tablet Sig: Three (3) Tablet PO BID (2 times a day). Disp:*180 Tablet(s)* Refills:*2* 6. Metformin 500 mg Tablet Sig: One (1) Tablet PO twice a day. 7. Glipizide 5 mg Tablet Extended Rel 24 hr Sig: One (1) Tablet Extended Rel 24 hr PO twice a day. 8. Allopurinol 300 mg Tablet Sig: One (1) Tablet PO once a day. 9. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO twice a day as needed for constipation. Disp:*60 Capsule(s)* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Final Diagnosis: Upper gastrointestinal bleed Duodenal Ulcer Secondary Diagnosis: Hypertension Coronary Artery Disease 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 with bleeding in your stool. You had a procedure called an endoscopy to look at the source of bleeding. An ulcer was found in your duodenum, the first part of your intestine. A medicine was injected into the area to help stop it from bleeding. It is very important that if you notice any new blood from your rectum to notify your doctor of come to the emergency department immediately. We have changed several of your medications. We stopped your aspirin because of your bleeding. Do not restart this until you discuss it with your GI physician. [**Name10 (NameIs) **] increased your metoprolol to 75 mg twice a day. We are giving you two antibiotics: clarithromycin and amoxicillin. It is important to take these for two weeks. These are treating an infection which may have caused your ulcer to form. Please stop your simvastatin (cholesterol medicine) for two weeks. You can restart this after you are finished with the antibiotics. We started pantoprazole 40 mg twice a day. It is very important to continue to take this until you discuss it with your GI physician. [**Name10 (NameIs) **] needed to help move your bowels, you can take docusate twice a day. Followup Instructions: Appointment #1 MD: Dr. [**First Name (STitle) 15316**] [**Name (STitle) 12646**] Specialty: PCP Date and time: Monday, [**1-11**] at 1:00pm Location: [**Street Address(2) 15317**], [**Location (un) **],[**Numeric Identifier 809**] Phone number: [**Telephone/Fax (1) 4615**] Appointment #2 MD: Dr. [**First Name (STitle) **] [**Name (STitle) **] Specialty: Gastroenterology Date and time: Tuesday, [**2-9**] at 2:00pm Location: [**Last Name (LF) **], [**First Name3 (LF) 452**] Bldg [**Location (un) **], [**Location (un) 86**], MA Phone number: [**Telephone/Fax (1) 463**] Please have your blood checked at Dr.[**Name (NI) 12754**] office tomorrow ([**1-7**]) at 10 AM. ICD9 Codes: 5849, 2851, 4271, 2762, 4241, 2875, 4019, 2749, 2720
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Medical Text: Admission Date: [**2132-11-27**] Discharge Date: [**2132-11-29**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 905**] Chief Complaint: chest pain Major Surgical or Invasive Procedure: none History of Present Illness: 88 F w/ severe Alzheimer's dementia, CAD w/ severe anterior reversible defects on MIBI in '[**29**] on medical management, now w/ rest pain and ECG changes. Per daughter (HCP) pt is not an invasive candidate and DNR/DNI. In [**Name (NI) **], pt recieved asprin 325 and heparin gtt. . Currently, pt feels well and denies SSCP or SOB. Past Medical History: 1. AD 2. HTN 3. Chronic anemia, + thal trait 4. CAD, + angina, stress test [**4-18**] w/ ischemic EKG changes w/o angina, mild reversible perfusion defect at apex and entire anterior wall, EF approx 60%, fam decided for med treatment only. 5. S/p chole 6. S/p appy 7. S/p facelift 8. psoriasis 9. S/p B cataract [**Doctor First Name **] Social History: Lives with daughter. [**Name (NI) 6934**] without assistance. Distant tobacco. No etoh. She is a retired nurse's aid. Family History: m- dm f- asthma Physical Exam: AF 78 104/65 14 98%RA Gen: NAD, A&O X 3 Heent: EOMI, PERRL, MMM Neck: JVP ~7cm H20 Heart: RRR no mr. + S4 Lungs: Clear, no crackles Abd: Benign Ext: No edema, warm extremities, 1+ dp/pt's bilateral. Pertinent Results: Hematology: [**2132-11-27**] 04:00PM BLOOD WBC-7.0 RBC-4.93 Hgb-10.4* Hct-30.6* MCV-62* MCH-21.2* MCHC-34.1 RDW-13.9 Plt Ct-280 [**2132-11-27**] 04:00PM BLOOD PT-11.6 PTT-23.1 INR(PT)-1.0 . Chemistry: [**2132-11-27**] 04:00PM BLOOD Glucose-101 UreaN-17 Creat-1.1 Na-137 K-4.8 Cl-101 HCO3-28 AnGap-13 [**2132-11-27**] 04:00PM BLOOD CK(CPK)-29 [**2132-11-28**] 12:35AM BLOOD CK(CPK)-26 [**2132-11-28**] 07:35AM BLOOD CK(CPK)-29 [**2132-11-29**] 07:30AM BLOOD CK(CPK)-34 [**2132-11-27**] 03:59PM BLOOD cTropnT-<0.01 [**2132-11-27**] 04:00PM BLOOD CK-MB-2 [**2132-11-28**] 12:35AM BLOOD CK-MB-NotDone cTropnT-<0.01 [**2132-11-28**] 07:35AM BLOOD CK-MB-3 cTropnT-<0.01 [**2132-11-29**] 07:30AM BLOOD CK-MB-NotDone cTropnT-LESS THAN . ECG: NSR, 2mm STE in aVR, diffuse ST depressions and TWI including II, aVF, V3-V6. LAFB. No STE in V4R. No ST depressions in V7-V9. . CXR: Clear. . Brief Hospital Course: 87 yo fem c alzheimer's disease, known uncontrolled HTN and known CAD now p/w ACS and ECG worrisome for diffuse subendocardial ischemia. . # CAD/ISchemia: ECG shows diffuse subendocardial ischemia with elevation in aVR and diffuse ST depressions. Spoke to daughter (HCP) today and risks/benefits of cardiac catheterization were discussed in depth. Daughter feels medical management is appropriate. Patient was initially chest pain free but did develop episodic chest pain relieved with nitroglycerin. Treated with no intention for interventional procedure unless SSCP becomes incessant. She was continued on ASA/plavix/BB/statin. Heparin gtt was discontinued after it was determined that there would be no intervention. She was successfully weaned from the nitro gtt. She was started on isordil which her BP tolerated well. . #Pump: Euvolemic. Borderline normal BP. Held ACE intially to leave room for BB/nitro. . # Rhythm: NSR, no issues. . # Anemia: Previous records show Hb EP c/w Thalassemia trait as well as iron deficiency. Fe/TIBC 15.7% with ferritin of 47 in [**1-20**]. She was continued on iron supplements with ascorbic acid while on PPI. Her hematocrit remained low but stable. . # Dementia: Advanced dementia although still alert and very pleasant. Medications on Admission: 1. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 2. Captopril 12.5 mg Tablet Sig: One (1) Tablet 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. Hexavitamin Tablet Sig: One (1) Cap PO DAILY (Daily). 5. Nitroglycerin 0.4 mg Tablet, Sublingual Sig: One (1) Tablet, Sublingual Sublingual PRN (as needed) as needed for chest pain. 6. Ferrous Sulfate 325 (65) mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. Furosemide 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 9. Isosorbide Dinitrate 10 mg Tablet Sig: Two (2) Tablet PO TID (3 times a day). Disp:*180 Tablet(s)* Refills:*0* 10. Prilosec OTC 20 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. Discharge Medications: 1. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 4. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 5. Furosemide 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Ferrous Sulfate 325 (65) mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO once a day. 8. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day. 9. Captopril 12.5 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 10. Isosorbide Dinitrate 10 mg Tablet Sig: Three (3) Tablet PO three times a day. Disp:*270 Tablet(s)* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: primary: unstable angina . secondary: alzheimers disease hypertension chronic anemia with thalassemia trait coronary artery disease status-post cholecystectomy status-post appendectomy status-post facelift psoriasis status-post bilateral cataract surgery Discharge Condition: good Discharge Instructions: Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight > 3 lbs. Adhere to 2 gm sodium diet Fluid Restriction: 2000ml . Please take all medications as prescribed. . Changed medications: imdur . If you experience worsening chest pain, shortness of breath, nausea, vomiting, dizziness, or other concerning symptoms call your doctor or return to the Emergency Department immediately. Followup Instructions: You are scheduled for the following appointments. Please contact the [**Name2 (NI) 11686**] provider with any questions or if you need to reschedule. . Provider: [**Name10 (NameIs) **],[**First Name8 (NamePattern2) 2352**] [**Last Name (NamePattern1) 2352**] - ADULT MEDICINE (SB) Date/Time:[**2132-12-11**] 11:30 [**Name6 (MD) 251**] [**Name8 (MD) **] MD [**MD Number(1) 910**] ICD9 Codes: 4280, 4275, 2762
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6583 }
Medical Text: Admission Date: [**2159-8-17**] Discharge Date: [**2159-8-20**] Date of Birth: [**2129-2-5**] Sex: F Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 13256**] Chief Complaint: "tylenol overdose" Major Surgical or Invasive Procedure: none History of Present Illness: 30F with a history of depression presents upon transfer from an OSH following an acetaminophen overdose. Ms. [**Known lastname 71430**] reports being treated over the recent weeks for a tooth infection, for which she was prescribed Tylenol 650mg tabs. Two nights prior to admission (evening of [**8-15**]) she had quite significant pain and reportstaking 1-2 tabs every time she awoke from her sleep with pain. In the morning she realized that she had taken 23 tabs and proceeded to have nausea/vomiting and lethargy. She also notes that she had been increasing her nightly dose of clonazepam to help her sleep. On day prior to admission she took 2 oxycodone 5mg tabs (leftover from previous surgery) and then presented to [**Hospital3 **] with persistent nausea/vomiting and increasing somnolence. She was found to have ALT/AST >7000 and started on N-acetylcysteine per protocol. She was transfered to [**Hospital1 18**] for further management. In the ER here, the patient was noted to appear "somnolent" with a nonfocal neurologic examination. Asterixis was present. Toxicology, hepatology and psych were consulted. Repeat labs showed ALT 5742 AST 4322, INR 1.6, creatinine 1.2. Patient was then admitted to the ICU and continued on NAC Past Medical History: Recent tooth infection GERD Hx esophageal ulcer, age 17 Anxiety Depression Asthma Chronic abdominal pain attributed to uterine etiology, s/p recent diagnostic laparoscopy in [**Month (only) **] Dx laparoscopy [**1-/2159**] for chronic abdominal pain Social History: lives with fiance and her three children. smokes 1PPD. denies EtOH, drugs. Family History: father died of stage IV colon cancer Physical Exam: ADMISSION EXAM Temp: 98.3, HR: 62, BP: 116/77, RR: 16, O2 Sat: 99% RA GEN: NAD. Lethargic. Oriented x3. HEENT: Sclerae with mild icterus. Mucous membranes moist. Dentition with multiple fillings, no obvious signs of infection. CV: RRR. Systolic murmur heard best at LUSB. PULM: Clear bilaterally. No w/r/r. ABD: Well-healed infraumbilical incision. Soft, nondistended, mild central abdominal tenderness with deep palpation. No R/G. EXT: Warm. No edema. NEURO: Oriented x3. CN 2-12 grossly intact. No focal deficits. Minimal asterixis. DISCHARGE EXAM VS: 97.8 97/48 (97/45-133/71) 55 (55-73) 20 100% RA GENERAL: comfortable, NAD HEENT: PERRL, EOMI, sclerae anicteric, MMM, OP clear NECK: supple, no thyromegaly, no JVD, no LAD HEART: RRR, no MRG, nl S1-S2 LUNGS: CTA bilat, no r/rh/wh, good air movement, resp unlabored ABDOMEN: Soft/ND, +mild RUQ ttp, no masses or HSM, no rebound/guarding EXTREMITIES: WWP, no c/c/e, 2+ peripheral pulses SKIN: no rashes or lesions NEURO: awake, A&Ox3, CNs II-XII grossly intact, muscle strength [**4-12**] throughout, sensation grossly intact throughout, no astrexis Pertinent Results: ADMISSION LABS: [**2159-8-17**] 10:10PM BLOOD WBC-6.2 RBC-4.69 Hgb-14.7 Hct-39.8 MCV-85 MCH-31.3 MCHC-36.9* RDW-12.2 Plt Ct-157 [**2159-8-17**] 10:10PM BLOOD Neuts-83.3* Lymphs-13.4* Monos-1.6* Eos-1.5 Baso-0.3 [**2159-8-17**] 10:45PM BLOOD PT-17.5* PTT-30.0 INR(PT)-1.6* [**2159-8-17**] 10:10PM BLOOD Glucose-104* UreaN-22* Creat-1.2* Na-141 K-3.5 Cl-105 HCO3-21* AnGap-19 [**2159-8-17**] 10:10PM BLOOD ALT-5742* AST-4322* AlkPhos-84 TotBili-1.0 [**2159-8-17**] 10:10PM BLOOD Albumin-3.8 [**2159-8-18**] 05:00AM BLOOD Calcium-8.5 Phos-1.9* Mg-1.6 . OTHER WORK UP [**2159-8-18**] 09:30AM BLOOD HBsAg-NEGATIVE HBsAb-BORDERLINE HAV Ab-POSITIVE [**2159-8-19**] 02:47PM BLOOD [**Doctor First Name **]-NEGATIVE [**2159-8-18**] 03:00AM BLOOD AFP-2.9 [**2159-8-18**] 03:00AM BLOOD HIV Ab-NEGATIVE [**2159-8-17**] 10:10PM BLOOD ASA-NEG Ethanol-NEG Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG [**2159-8-18**] 09:30AM BLOOD HCV Ab-NEGATIVE [**2159-8-18**] 04:17AM BLOOD Type-ART pO2-62* pCO2-34* pH-7.46* calTCO2-25 Base XS-0 Intubat-NOT INTUBA [**2159-8-18**] 04:17AM BLOOD Lactate-1.6 [**2159-8-17**] 10:10PM URINE bnzodzp-POS barbitr-NEG opiates-POS cocaine-NEG amphetm-NEG mthdone-NEG [**2159-8-17**] 10:10PM URINE Blood-SM Nitrite-NEG Protein-30 Glucose-NEG Ketone-10 Bilirub-NEG Urobiln-NEG pH-5.0 Leuks-NEG [**2159-8-17**] 10:10PM URINE RBC-1 WBC-3 Bacteri-FEW Yeast-NONE Epi-2 [**2159-8-17**] 10:10PM URINE Mucous-RARE . MICRO urine cx negative blood cx NGTD VARICELLA-ZOSTER IgG SEROLOGY (Final [**2159-8-21**]): POSITIVE BY EIA. [**Doctor Last Name **]-[**Doctor Last Name **] VIRUS VCA-IgG AB (Final [**2159-8-20**]): POSITIVE BY EIA. [**Doctor Last Name **]-[**Doctor Last Name **] VIRUS EBNA IgG AB (Final [**2159-8-20**]): POSITIVE BY EIA. [**Doctor Last Name **]-[**Doctor Last Name **] VIRUS VCA-IgM AB (Final [**2159-8-20**]): NEGATIVE <1:10 BY IFA. Rubella IgG/IgM Antibody (Final [**2159-8-21**]): POSITIVE by Latex Agglutination. RAPID PLASMA REAGIN TEST (Final [**2159-8-20**]): NONREACTIVE. TOXOPLASMA IgG ANTIBODY (Final [**2159-8-21**]): NEGATIVE FOR TOXOPLASMA IgG ANTIBODY BY EIA. CMV IgG ANTIBODY (Final [**2159-8-21**]): NEGATIVE FOR CMV IgG ANTIBODY BY EIA . IMAGING ECG Normal sinus rhythm. The Q-T interval is prolonged with low voltage in the limb leads and borderline voltage in the precordial leads. Clinical correlation is suggested for drug usage or history of ion channelopathy. ECG Sinus bradycardia. Prolonged Q-T interval. Non-specific ST-T wave changes. Compared to the previous tracing of [**2159-8-18**] no change. . CXR The lung volumes are normal. 3 mm calcified granuloma in the right upper lobe. Otherwise normal chest radiograph without evidence of pulmonary edema or pneumonia. No pleural effusions. No pneumothorax. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. . RUQ ULTRASOUND: normal study . DISCHARGE LABS [**2159-8-20**] 04:45AM BLOOD WBC-5.7 RBC-3.81* Hgb-12.1 Hct-33.2* MCV-87 MCH-31.8 MCHC-36.5* RDW-13.0 Plt Ct-203 [**2159-8-20**] 04:45AM BLOOD PT-11.9 PTT-31.8 INR(PT)-1.0 [**2159-8-20**] 04:45AM BLOOD Glucose-109* UreaN-13 Creat-1.0 Na-144 K-3.4 Cl-111* HCO3-23 AnGap-13 [**2159-8-20**] 04:45AM BLOOD ALT-1622* AST-217* AlkPhos-69 TotBili-0.5 [**2159-8-20**] 04:45AM BLOOD Calcium-8.6 Phos-4.1 Mg-1.8 Brief Hospital Course: This is a 30yo F with h/o depression and previous suicide attempt now here with acute liver failure [**1-10**] Tylenol overdose. . # Tylenol toxicity: Patient presented to [**Hospital 8125**] hospital with nausea/abdominal pain and somnolence. She reported taking 23 tylenol for tooth pain. She was found to have ALT and AST >7000 and transferred to [**Hospital1 18**] for further evaluation and care. In the ER here, the patient was noted to appear "somnolent" with a nonfocal neurologic examination. Asterixis was present. Toxicology, hepatology, transplant surgery, and psych were consulted. Repeat labs showed ALT 5742 AST 4322, INR 1.6, creatinine 1.2. Patient was then admitted to the SICU overnight and continued on NAC at 6.25mg/kg/hr. Transplant evaluation was initiated. However, she clinically improved overnight with improvement in liver function. At this juncture, pt did not meet any of [**First Name4 (NamePattern1) 3728**] [**Last Name (NamePattern1) 1688**] criteria. She was transferred from the SICU to the hepatorenal service for further care the following day. NAC was stopped as INR < 1.5. Liver enzymes continued to improve and patient felt well. She was able to tolerate a full diet and denied abdominal pain, n/v. No further transplant evaluation was pursued. She was discharged with plans to have repeat labs drawn the next week and follow up with her PCP. . # Depression and h/o suicide attempt: Given patient's psychiatric history in the setting of taking 23 tylenol, psychiatry was consulted for evaluation. Initially the patient was felt to meet section 12 criteria as danger to self and was placed on 1:1 sitter. Home medications of zoloft and clonazepam were held. Recommended haldol for psychotic symptoms and ativan for anxiety. The following day psychiatry re-evaluated patient and did not believe that she met criteria for section 12. 1:1 sitter was stopped. Ativan was given for anxiety. At discharge, zoloft was started at 25 mg with plans to titrate back up to 50 mg in one week. Clonazepam also restarted. Patient was discharged with plans to follow up with her primary care doctor and with her therapist. . # Tooth pain: Patient initially presented after taking too many tylenol for tooth pain. She reportedly took one dose of clindamycin prior to admission. Dentist was contact[**Name (NI) **] and patient was restarted on clindamycin for wisdom tooth infection with plans to complete 1 week course. She was given tramadol for pain. . # Tobacco Abuse: given nicotine patch . Medications on Admission: Tylenol Aleve/Ibuprofen ProAir Clonazepam 0.5mg TID Zoloft 50mg daily - stopped three days prior Clindamycin (had been on cipro, and amoxicillin, no known augmentin) Discharge Medications: 1. ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 2. ProAir HFA 90 mcg/Actuation HFA Aerosol Inhaler Sig: [**12-10**] puffs Inhalation every 4-6 hours as needed for shortness of breath or wheezing. 3. clonazepam 0.5 mg Tablet Sig: One (1) Tablet PO three times a day. 4. Zoloft 25 mg Tablet Sig: One (1) Tablet PO once a day for 7 days: when complete 7 days, please resume your home dose of zoloft: 50 mg by mouth daily . Disp:*7 Tablet(s)* Refills:*0* 5. clindamycin HCl 300 mg Capsule Sig: One (1) Capsule PO twice a day for 6 days. Disp:*12 Capsule(s)* Refills:*0* 6. tramadol 50 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for pain. Disp:*20 Tablet(s)* Refills:*0* 7. Outpatient Lab Work Please check AST, ALT, Total bilirubin, alkaline phosphatase, PT, PTT, INR. Fax results to Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] at [**Telephone/Fax (1) 91192**] Discharge Disposition: Home Discharge Diagnosis: primary diagnosis: tylenol toxicity secondary diagnosis: anxiety, depression, gastroesophageal reflux disease Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Dear Ms. [**Known lastname 71430**], It was a pleasure caring for you while you were in the hospital. You were transferred to [**Hospital1 18**] for further care after taking too much tylenol. You were initially admitted to the intensive care unit and given a medication to help your liver. Given your improvement, you were transferred to the liver service the following day. Your liver continued to improve. You were also evaluated by psychiatry while in the hospital. Your medications were stopped given your liver injury. You can resume your zoloft at a lower dose (25 mg) and your clonazepam when you leave the hospital. You will need to follow up with your primary care doctor and your therapist as scheduled. You will also need your blood work checked next week to follow your liver function. The following changes were made to your medication regimen: Please START taking ranitidine. You may take tramadol every 6 hours as needed for pain. Please restart your zoloft at 25 mg (instead of 50mg ). This will be increased back to your dose of 50 mg when you see your primary care doctor. Do not take more than [**2147**] mg of tylenol daily. Continue taking clindamycin for 6 more days. Please ensure you follow up with your dentist. Followup Instructions: Name: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 91193**], MD Specialty: Internal Medicine/OB-GYN Address: [**Doctor Last Name 91194**], [**Location (un) 10068**],[**Numeric Identifier 10069**] Phone: [**Telephone/Fax (1) 91192**] We spoke with your primary care physician, [**Last Name (NamePattern4) **]. [**Last Name (STitle) **]. You will be contact[**Name (NI) **] by his office to schedule an appointment within 1 week. If you do not hear from his office by Wednesday [**8-22**], please call to schedule an appointment at [**Telephone/Fax (1) 91192**]. Completed by:[**2159-8-24**] ICD9 Codes: 311
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Medical Text: Admission Date: [**2146-5-19**] Discharge Date: [**2146-5-25**] Date of Birth: [**2066-8-18**] Sex: F Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 165**] Chief Complaint: Asymptomatic Major Surgical or Invasive Procedure: 1. Ascending aortic and a total arch replacement with a size 28 Gelweave medusa graft. 2. Aortic valve replacement with a size [**Street Address(2) 6158**]. [**Male First Name (un) 923**] tissue valve. 3. Right axillary artery cannulation. History of Present Illness: 70 year old asymptomatic female who states that earlier this year she presented to PCP for routine annual exam and was found to be hypertensive. As part of her work-up she underwent an echocardiogram which revealed dilated ascending aorta (6.9cm) and aortic insufficiency. Subsequently underwent chest CT which revealed ascending aortic aneurysm which measured 6.6cm. While being worked up for surgery at another facility she was found to have elevated Amylase in the [**2135**] range. Given patients family history (pancreatic cancer) she was seen by GI and underwent additional studies. Abd CT revealed multiple large renal cysts and dilatation of the common bile duct and head of pancreas. Underwent ERCP at [**Hospital1 **] which was negative for pancreatic cancer (per pt). She has had surgery cancelled multiple times at another facility and presents today for second opinion. Past Medical History: Aortic Aneurysm Aortic Valve Insufficiency Hypertension Osteoporosis Breast Cancer s/p mastectomy/chemotherapy (6 yrs ago) Elevated Amylase/Lipase (underwent full work-up by GI) Social History: Lives alone Occupation: cafeteria worker Tobacco: quit 25 yrs ago ETOH: rare use Family History: Family History: Sister with Pancreatic cancer Physical Exam: Admission PE Pulse: 73 Resp: 18 O2 sat: 99% B/P Right: - Left: 135/75 Height: 5'5" Weight: 117 lb General: Well-developed female in no acute distress Skin: Dry [X] intact [X] HEENT: PERRLA [X] EOMI [X] Neck: Supple [X] Full ROM [X] Chest: Lungs clear bilaterally [X] Heart: RRR [X] Irregular [] Murmur Abdomen: Soft [X] non-distended [X] non-tender [X] bowel sounds + [X] Extremities: Warm [X], well-perfused [X] Edema: - Varicosities: B/L 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: - Left: - Pertinent Results: [**2146-5-19**] intraop echo PREBYPASS Left ventricular wall thicknesses and cavity size are normal. Overall left ventricular systolic function is low normal (LVEF 50-55%). Right ventricular chamber size and free wall motion are normal. The ascending aorta is markedly dilated and aneurysmal with a diameter of 6.6 cm. There is preservation of the sinotubular junction. The descending thoracic aorta is mildly dilated. The aortic valve leaflets (3) are mildly thickened. Mild to moderate ([**12-11**]+) aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Trivial mitral regurgitation is seen. POSTBYPASS The patient is receiving no inotropic support post-CPB. There is a well-seated bioprothesis in the aortic position with good leaflet excurion. There is no transvalvular or paravalvular regurgitation. The mean transvalvular gradient is 16 mm Hg at a cardiac output of 5 L/min. Biventricular systolic function is preserved and all other findings are consistent with pre-bypass findings. There is a tube graft as the ascending aorta measuring 2.8 cm in diameter. All findings communicated to the surgeon intraoperatively. [**2146-5-25**] 05:05AM BLOOD WBC-9.4 RBC-3.90* Hgb-11.3* Hct-33.4* MCV-86 MCH-28.9 MCHC-33.8 RDW-13.3 Plt Ct-314# [**2146-5-19**] 12:52PM BLOOD WBC-4.5 RBC-2.75*# Hgb-7.9*# Hct-23.5*# MCV-85 MCH-28.9 MCHC-33.8 RDW-13.8 Plt Ct-125*# [**2146-5-24**] 05:20AM BLOOD PT-13.9* INR(PT)-1.2* [**2146-5-19**] 12:52PM BLOOD PT-17.8* PTT-53.9* INR(PT)-1.6* [**2146-5-25**] 05:05AM BLOOD UreaN-17 Creat-0.6 Na-133 K-3.6 Cl-95* [**2146-5-19**] 02:04PM BLOOD UreaN-11 Creat-0.8 Na-137 K-4.0 Cl-110* HCO3-20* AnGap-11 [**2146-5-22**] 02:59AM BLOOD Glucose-98 Lactate-1.1 Na-128* K-4.3 Cl-94* Brief Hospital Course: [**2146-5-19**] Mrs. [**Known lastname 11461**] was taken to the operating room and underwent Ascending aortic and a total arch replacement with a size 28 Gelweave medusa graft/Aortic valve replacement with a size [**Street Address(2) 6158**]. [**Male First Name (un) 923**] tissue valve/ Right axillary artery cannulation with Dr.[**First Name (STitle) **]. Please see Dr[**Doctor First Name **] operative report for further details. She tolerated the procedure well and was transferred to the CVICU on Propofol and Phenylephrine. She was kept intubated due to sedation induced encephalopathy with associated angioedema. She was hemodynamically stable,weaned off drips, and extubated on POD#2 without incident. Beta-blocker/Aspirin/Statin and diuresis initiated. She continued to progress and was transferred to the step down unit on POD#3 for further monitoring. Physical therapy was consulted for evaluation of strength and mobility. [**5-24**] Mrs.[**Known lastname 11461**] reported her voice was "raspy". ENT and speech and swallow were consulted. Left vocal cord paralysis evident. She was cleared for regular diet and voice correction therapy and outpatient follow up was advised. POD# 6 she was cleared by Dr.[**First Name (STitle) **] for discharge [**Last Name (un) 85462**]Nursing and Rehab Center in [**Location (un) 29158**]. All follow up appointments were advised. Medications on Admission: Fosamax 70mg qweekly Aspirin 81mg daily Hydrochlorothiazide 25mg daily Labetalol 100mg [**Hospital1 **] Ativan 0.5mg prn Discharge Medications: 1. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 2. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO HS (at bedtime) as needed for constipation. 3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 4. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO every [**5-17**] hours as needed for fever/pain. 5. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Tramadol 50 mg Tablet Sig: One (1) Tablet PO every 6-8 hours as needed for pain. 7. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 8. Captopril 12.5 mg Tablet Sig: 0.5 Tablet PO TID (3 times a day). 9. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig: One (1) Tab Sust.Rel. Particle/Crystal PO once a day: hold if K > 4.5. 10. Lasix 20 mg Tablet Sig: One (1) Tablet PO twice a day. Discharge Disposition: Extended Care Facility: [**Last Name (un) 5502**]Nursing & Rehabilitation Center - [**Location (un) 5503**] Discharge Diagnosis: aortic aneurysm, aortic insufficiency s/p AVR with Replacement of Ascending Aorta and Total Arch PMH: Hypertension Osteoporosis Breast Cancer s/p mastectomy/chemotherapy (6 yrs ago) Elevated Amylase/Lipase (underwent full work-up by GI) 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 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**] **Please call cardiac surgery office with any questions or concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call person during off hours** Females: Please wear bra to reduce pulling on incision, avoid rubbing on lower edge Followup Instructions: - Dr. [**First Name (STitle) **] on [**2146-6-20**] @ 130PM Phone:[**Telephone/Fax (1) 170**] Please call to schedule the following appointments: - Primary Care/Cardiology Dr. [**Last Name (STitle) **],[**First Name3 (LF) 251**] R [**Telephone/Fax (1) 40420**] in [**12-11**] weeks - ENT follow up as an outpatient:#[**Telephone/Fax (1) 6213**] - Voice therapy as outpt. Speech and swallow # [**Telephone/Fax (1) 3731**] [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 173**] Completed by:[**2146-5-25**] ICD9 Codes: 5185, 4241, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6585 }
Medical Text: Admission Date: [**2138-9-12**] Discharge Date: [**2138-10-29**] Date of Birth: [**2063-11-20**] Sex: F Service: MEDICINE Allergies: Oxycodone Attending:[**Last Name (NamePattern4) 290**] Chief Complaint: weakness Major Surgical or Invasive Procedure: thoracentesis (left and right) dialysis catheter (right IJ) CVVH dialysis chest tube (left) pigtail catheter right HD catheter removed [**10-15**] left subclavian removed [**10-15**] left IJ placed on [**10-15**] right IJ placed on [**10-27**] Picc line (left) Art line x 2 (right and left radials) History of Present Illness: The pt is a 74-yo woman w/ hypertension, hyperlipidemia, hypothyroidism, and a recent diagnosis of ovarian cancer vs. lymphoma, who presented to the ED for evaluation today for acute renal failure. The pt notes that she has been feeling increasingly SOB and weak over the last couple days, with an episode of dizziness / lightheadedness on the day prior to admission. The pt has not been eating well over the last few days and had an episode of nausea / vomiting on the day prior to admission as well. She had an abdominal ultrasound done on the day prior to admission for evaluation for paracentesis, and labs drawn that day showed worsening renal function, so she was called to come in to the ED today for evaluation. . On arrival in the ED: VS - Temp 97.5F, HR 100, BP 111/70, R 20, O2-sat 91% RA. Labs were significant for K 7.8, BUN 116 / Cr 7.2, WBC 14.3 w/ 92% PMNs, and lactate 2.0. CXR revealed a large left pleural effusion and ECG was low voltage. Pulsus was 10, so a bedside TTE was done to eval for tamponade, which revealed a mild pericardial effusion without tamponade physiology. She was treated with IVF, calcium gluconate, insulin w/ dextrose, Kayexelate, and albuterol nebs. She was also given levofloxacin x1 for ? pneumonia. She is being admitted to the MICU for evaluation and treatment of her hyperkalemia and acute renal failure. . The pt has a recent dx of ovarian cancer vs. lymphoma. Approx 6 weeks PTA, the pt started to feel tired and developed swollen legs and a distended abdomen. Evaluation revealed a mass on her right ovary that was to be removed, but CT scan prior to surgery also showed enlarged LNs, so the surgery was held off until a biopsy specimen could be taken of the lymph nodes. There is some thought that the cancer may be a lymphoma rather than primary ovarian. Past Medical History: - Hypertension - Gallstones - Hyperlipidemia - Hypothyroidism Social History: Occupation: Retired. Drugs: Denies. Tobacco: Denies. Alcohol: Denies. Other: Family History: sister w/ pancreatic cancer Physical Exam: Tmax: 37.9 ??????C (100.3 ??????F) Tcurrent: 37.3 ??????C (99.1 ??????F) HR: 119 (115 - 135) bpm BP: 80/30(46) {60/15(36) - 122/88(76)} mmHg RR: 22 (0 - 32) insp/min SpO2: 98% Heart rhythm: ST (Sinus Tachycardia) Wgt (current): 104.3 kg (admission) General Appearance: Sedated, unresponsive, intubated Eyes / Conjunctiva: Pupils mid, responsive to light. Head, Ears, Nose, Throat: Normocephalic, Endotracheal tube, NG tube Cardiovascular: (S1: Normal), (S2: Normal) Peripheral Vascular: (Right radial pulse: Not assessed), (Left radial pulse: Not assessed), (Right DP pulse: Not assessed), (Left DP pulse: Not assessed) Respiratory / Chest: (Expansion: Symmetric), (Breath Sounds: Rhonchorous: throughout) Abdominal: Rigid and distended Extremities: Right: 4+, Left: 4+ lower. Upper warm with 3+. Skin: Not assessed Neurologic: Responds to: Unresponsive, Movement: No spontaneous movement, Sedated, Tone: Not assessed, No response to sternal rub. Positive corneal reflex Pertinent Results: Abd u/s: Small amount ascites; Bilateral inguinal lymphadenopathy Echo: IMPRESSION: Suboptimal image quality. Normal global left ventricular systolic function with preserved ejection fraction. Small to moderate complex pericardial effusion with no obvious echocardiographic signs of tamponade. Dilated right ventricle with global hypokinesis. CXR: IMPRESSIONS: Large left pleural effusion with associated atelectasis. Given size and recent diagnosis of cancer, this may be a malignant effusion. The right lung is well aerated. Renal u/s: IMPRESSION: Moderate right-sided hydronephrosis. No renal calculi. Moderate amount of ascites. [**2138-10-29**] 03:49AM BLOOD WBC-30.1* RBC-3.26* Hgb-9.4* Hct-30.6* MCV-94 MCH-28.9 MCHC-30.7* RDW-18.6* Plt Ct-172 [**2138-10-29**] 03:49AM BLOOD Neuts-85* Bands-3 Lymphs-3* Monos-5 Eos-0 Baso-0 Atyps-2* Metas-2* Myelos-0 NRBC-2* [**2138-10-29**] 03:49AM BLOOD Hypochr-NORMAL Anisocy-1+ Poiklo-1+ Macrocy-1+ Microcy-NORMAL Polychr-OCCASIONAL Ovalocy-OCCASIONAL Schisto-OCCASIONAL Burr-OCCASIONAL Fragmen-OCCASIONAL [**2138-10-29**] 03:49AM BLOOD Plt Smr-NORMAL Plt Ct-172 [**2138-10-29**] 03:49AM BLOOD PT-46.4* PTT-54.8* INR(PT)-5.2* [**2138-10-29**] 03:49AM BLOOD Glucose-203* UreaN-79* Creat-2.5* Na-125* K-6.0* Cl-104 HCO3-12* AnGap-15 [**2138-10-20**] 01:44PM BLOOD LD(LDH)-261* [**2138-10-17**] 03:17AM BLOOD ALT-23 AST-34 LD(LDH)-257* AlkPhos-73 TotBili-0.3 [**2138-9-30**] 05:13AM BLOOD Lipase-24 [**2138-10-11**] 08:00PM BLOOD CK-MB-8 cTropnT-0.10* [**2138-10-29**] 03:49AM BLOOD Calcium-6.7* Phos-9.6*# Mg-1.9 [**2138-10-1**] 05:20AM BLOOD calTIBC-173* VitB12-1149* Folate-11.6 Ferritn-222* TRF-133* [**2138-10-16**] 03:01AM BLOOD Triglyc-404* HDL-27 CHOL/HD-8.3 [**2138-10-23**] 04:45PM BLOOD Osmolal-283 [**2138-10-28**] 03:56AM BLOOD TSH-2.4 [**2138-10-28**] 03:56AM BLOOD T4-2.9* T3-33* [**2138-9-27**] 04:23AM BLOOD Cortsol-30.8* [**2138-9-26**] 08:44AM BLOOD Cortsol-20.9* [**2138-10-24**] 03:53AM BLOOD CA125-43* [**2138-10-2**] 04:56AM BLOOD CA27.29-212* CA125-70* [**2138-9-16**] 04:00AM BLOOD CA27.29-574* [**2138-9-13**] 01:40PM BLOOD CEA-<1.0 AFP-3.0 CA125-203* [**2138-9-13**] 01:40PM BLOOD b2micro-27.8* [**2138-10-29**] 05:29AM BLOOD Type-MIX Temp-38.4 pO2-60* pCO2-37 pH-7.07* calTCO2-11* Base XS--19 Intubat-INTUBATED Comment-99.1 F AXI [**2138-10-29**] 05:29AM BLOOD Lactate-7.9* [**2138-10-16**] 03:18AM BLOOD freeCa-1.14 [**2138-10-29**] 05:29AM BLOOD O2 Sat-84 Brief Hospital Course: 74 yo F w/ Stage IV metastatic ovarian cancer, ARF on CVVH, and malignant pleural effusion. Course has been complicated by hypotension requiring pressors (levophed). Originally presented to ED [**2-22**] ARF and hyperkalemia. PMH includes hypothyroidism and HLD. #. Hypotension/shock. Has required Levophed for much of admission. Last 2-3 days prior to leaving the MICU for the [**Hospital Unit Name 153**] she tolerated several hours without pressors; however, she received albumin or blood during these periods. Differential dx for shock includes sepsis, metabolic causes, cardiogenic, hypovolemia. - [**Name (NI) 15305**] pt has a leukocytosis but has been afebrile. Started on empiric abx to cover for HAP. D/c abx on [**9-25**]: pt received 6 days of zosyn, 9 days of cipro, and 4 days of vanc. Line infections: changed HD cath over the wire on [**9-23**] and art line was d/c??????ed. Will monitor PICC line for signs of infection. - Metabolic- [**Last Name (un) 104**] stim was wnl so likely not adrenal insufficiency. Consulted ID for evaluation of whether hypothyroidism could cause shock. Increased dose of Synthroid and transitioned to IV but endocrinology that it is unlikely for hypothyroidism to be the cause. Endo also concerned because pt had one episode of paroxysmal a. fib on [**9-20**] and increased dose of synthroid may precipitate further episodes. Will continue to monitor, however, this episodes appears to be isolated. - Cardiogenic- Originally, was concerned for tamponade. Although they have been suboptimal studies, multiple echoes have only showed effusions without echocardiographic evidence of tamponade with one exception. Her echo from [**9-15**] showed impaired fillling/tamponade physiology. Most recent echo on [**9-24**] again did not show evidence of tamponade, just small effusion. Also, echo on [**9-24**] revealed normal RV size and motion which made PE less likely. Throughout her course in the MICU, have considered V/Q scan to r/o PE as a possible cause of hypotension however, given her echo findings, the pretest possibility remains equivocal. - On [**9-22**], SVV (from Vigileo) suggested intravascular depletion, and repleted pt with crystalloid and colloid. However, she did not require pressors for much of that day. For last few days prior to transfer to [**Hospital Unit Name 153**], have been running CVVH at a 0 balance. Gave albumin challenge again on [**9-25**] and her CVP bumped to 12 and was thus able to be off of leveophed for several hours. It appeared that she needs her CVP to be [**1-4**] to maintain her BP. Goal has been to wean levophed and have considered transitioning to midodrine as an oral pressor. - At time of transfer, the etiology of her hypotension remains elusive. Without an adequate explanation, team has hypothesized that this may be a possible paraneoplastic syndrome. # Bilat pleural effusions, cytology from left c/w malignancy. Final cytology from right effusion still pending at time of transfer but pH, cell counts, gluc, prot consistent with left effusion and anticipate that it will also be malignant. Prior to first thoracentesis, pt required BiPap but upon transfer, pt has been satting well on only 1.5L NC for several days. Underwent both chest tube and pigtail placement for left sided effusion. Chest tube was removed early in course of stay because it was extrathoracic and not draining but pigtail (placed by IP) continues to drain serosang fluid. Was placed to water seal by IP on [**9-25**]. A repeat CT on [**9-22**] showed increased right sided effusion which was tapped on [**9-24**]. IP is considering either Pleurodesis vs pleurex when stable. Has also used bronchodilators for wheezing. On [**10-3**], chest tube fell out. Per IP, Ok to leave out, re-image if symptomatic. Pleural effusion should be responsive to chemo if tumor is. However, if reaccumulates, will need pleurex catheter v pleurodesis. Should follow-up with IP in [**Hospital 3782**] clinic with Dr. [**Last Name (STitle) **], [**Telephone/Fax (1) 3020**] two weeks post-discharge or immediately if SOB. #. Acute renal failure ?????? Persistent volume overload and anasarca. Originally admitted with K of 7.8 and Cr of 7.2. Hyperkalemia resolved quickly (see below). Held on dialysis for a few days but CVVH was started on [**9-16**] but had to be stopped temporarily on [**9-20**] [**2-22**] poor access. Line changed over the wire by renal on [**9-23**] and restarted CVVH. Initial and repeat imaging of kidneys has showed continued right hydronephrosis. Plan is to transfer from MICU ([**Hospital Ward Name **]) to [**Hospital Unit Name 153**] in order to go to the OR with urology on [**9-26**]. Urology will place a stent in the right ureter. Goal of stenting is to relieve the obstruction with the hope of regaining some kidney function. Acutely on [**9-24**], she developed hyponatremia and hyperglycemia. Unclear etiology but hyponatremia may be related to the ultrafiltrate bath having a Na concentration of 130. Na corrected slightly following initiation of insulin sliding scale for hyperglycemia. Also, hyperglycemia seems to have occurred acutely. No prior episodes of hyperglycemia during this admission. Also, [**Name8 (MD) **] RN, finger sticks are consistently lower than serum glucose. Could be related to diffuse extravascular volume. Pt was placed on insulin sliding scale for the elev glucose. Initially, pt was hyperphosphatemic but on the day of transfer pt required repletion of phos. Used Na-Phos for added sodium benefit. Have held home Lasix and ACE-I in setting of ARF. # Metastatic ovarian cancer: cardiopulmonary status has been too tenuous for treatment during this admission. Obtained tumor markers which revealed borderline high CA-125 and elevated CA27,29, but were overall non-specific. Heme onc is following closely and feel that pt will require inpt palliative chemotherapy, most likely carboplatinum. Family has been supportive of continuing more aggressive means of treatment. Have discussed transfer to OMED when stable and off pressors. Gyn onc originally saw the pt but have not been following daily. Also, on allopurinol to prevent tumor lysis syndrome. #. Hypothyroidism ?????? Was diagnosed with hypothyroidism approx 2 weeks prior to admission and had been started on a low dose of Synthroid. Consulted endocrinology to help elucidate if hypothyroidism could be cause of persistent hypotension. Preliminary thought is no, but increased dose to 100 mcg on [**9-25**]. Per endo, should re-check a Free T4 level in 3 to 4 days. Anti-TPO ab < 10. Also, changed from oral to IV Synthroid to ensure proper absorption despite this one episode of questionable a. fib. #. Hyperkalemia, resolved: Was most likely due to worsening renal function, esp in setting of the medications she was taking, including Lasix and ACE-I. Pt had K 7.8 on arrival to ED, without ECG changes. Treated w/ Ca gluconate, insulin / dextrose, albuterol nebs, and Kayexelate. Potassium has appropriately responded to treatment and has remained wnl. #. Hyperlipidemia - Taking home statin dose. #. [**Name (NI) 8410**] Pt remains full code at time of transfer to [**Hospital Unit Name 153**]. [**Hospital Unit Name 153**] course: #. Hypotension and Sepitc shock: the patient had been on-and-off pressors for the length of her ICU admissions. She responded well to albumin and IV fluids however the response was short-lived. She was eventually weaned off pressors and started on corticosteroids which improved her pressure significantly. However, during her ICU stay she began to deteriorate and her course was complicated by C. diff colitis tx with IV flagyl po/pr vancomycin. Additionally, she developed a VAP w/ pseudomonas and was treated with ceftazidime. The patient's [**Female First Name (un) **] fungemia was treated with caspofungin. The patient was maintained and three pressors and remained intubated. Maximal treat was administered, but the patients status continued to decline and she remained pressor dependent. The family decided to stop pressors on [**2138-10-29**] and the patient passed away at 7:50pm. # Renal failure: Post stent placement by urology the patient's urine output did not improve significantly. Due to patient's labile blood pressure and tendency towards hypotension she was started CVVH. She was subsequently tried on HD, given albumin and fluids for volume, and eventually maintained a low but steady blood pressure with concominant tachycardia. However, as the patient's clincal course declined as did her renal function. She was no longer a candidate for CVVH due to her hypotension and worsening clincal picture. Her creatinine continued to trend upwards and she had multiple electrolyte abnormalities including continued hyperkalemia that was refractory to treatment. The patient was essentially anuric and passed away when her pressors were stopped. # Tachycardia: the patient had several episodes of tachycardia to 130-140s, with transition to NSVT. Cardiology consult felt this was consistent with NSVT, started patient on amiodarone IV overnight with good response. However since this was an isolated episode it was not felt that keeping her on amiodarone was necessary at this time. #Pleural effusions: Patient had chest tube placement with initial high output which eventually tapered off. This was thought likely due to her malignancy. Several days post admission to ICU the patient's chest tube fell out while moving from chair to bed. IP was consulted but did not feel the tube needed to be replaced at that time and serial CXR were indicated to r/o PTX. The patient's chest tubes were removed on [**10-24**]. She continued to have signifcant pleural effusions. # Metastatic ovarian cancer: Patient was followed by the OMED service. The option of chemotherapy was discussed which the patient agreed to a trial of carboplatin. Steroids and antiemetics were given as per oncology protocol during her chemotherapy. Her WBC and fever curve were monitored. She tolerated the course well and was maintained on HD throughout. Tumor lysis labs were followed and allopurinol was started prophylactically. However, given her clinical decline and infections she no longer could tolerate additional treatment. #Code Status: The patient was maintained on 3 pressors. After a multiple family meets and discussions it was decided to withdraw the pressors on [**2138-10-29**]. The patient passed away shortly after at 7:50pm. Medications on Admission: - enalapril 20mg daily - lorazepam 1-2mg QHS PRN - simvastatin 20mg QHS - oxycodone-acetaminophen 1-2tabs Q4hrs PRN - furosemide 20mg daily - trazodone 50mg QHS PRN - levothyroxine 0.05mg daily Discharge Disposition: Expired Discharge Diagnosis: Cardiac Arrest Sepsis C. Diff Colitis VAP Metastatic Ovarian Cancer Discharge Condition: Death [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**Name8 (MD) **] MD [**MD Number(1) 292**] Completed by:[**2138-10-29**] ICD9 Codes: 5845, 5180, 2762, 2761, 4280, 2449, 4019, 2720, 2767, 4589
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Medical Text: Admission Date: [**2109-3-20**] Discharge Date: [**2109-3-29**] Date of Birth: [**2051-5-21**] Sex: M Service: CARDIOTHORACIC Allergies: Lisinopril Attending:[**First Name3 (LF) 1283**] Chief Complaint: Dyspnea on exertion. Major Surgical or Invasive Procedure: Mitral valve repair with resection of posterior leaflet [**2109-3-20**]. History of Present Illness: This is a 57 year old male patient with known heart murmurs who has been followed by serial echos since [**2093**]. In [**8-27**] he saw his primary care physician with the complaint of progressive dyspnea. A Cardiac catheterization in [**11-28**] showed severe mitral regurgitation, an ejection fraction of 66% and a right coronary artery with a 70% lesion which was stented. He was subsequently referred for a minimally invasive mitral valve repair Past Medical History: Hypertension. Addison's disease. Hypothyroidism. Melanoma. BPH. Social History: Works as mechanical engineer. Lives with wife. [**Name (NI) 58972**] tobacco use, reports [**12-27**] drinks of alcohol per week. Family History: Noncontributory Physical Exam: BP: (R) 135/76 (L) 149/79 HR 68 Weight 225 Gen: Tall young lad in no acute distress Skin: well healed right shoulder incision HEENT: EOMI intact, nl buccal mucosa, anicteric, oropharynx benign. Neck: supple, murmur transmitted, No JVD Chest: Clear Heart: RRR, III/VI systolic murmur. Abdomen: Soft, Nontender, nondistended Ext: warm and well perfused Neuro: grossly intact Pertinent Results: [**2109-3-26**] 08:50AM BLOOD WBC-10.8 RBC-2.60* Hgb-8.0* Hct-23.3* MCV-90 MCH-30.9 MCHC-34.5 RDW-15.0 Plt Ct-203 [**2109-3-26**] 08:50AM BLOOD Plt Ct-203 [**2109-3-21**] 03:04AM BLOOD PT-12.9 PTT-30.5 INR(PT)-1.1 [**2109-3-26**] 08:50AM BLOOD Glucose-81 UreaN-15 Creat-0.9 Na-133 K-3.7 Cl-95* HCO3-28 AnGap-14 [**2109-3-25**] 04:46AM BLOOD Calcium-8.0* Phos-3.9 Mg-1.9 [**2109-3-28**] 11:30AM BLOOD WBC-9.8 RBC-4.04* Hgb-12.1* Hct-36.4* MCV-90 MCH-30.0 MCHC-33.3 RDW-15.3 Plt Ct-407# [**2109-3-28**] 11:30AM BLOOD Plt Ct-407# [**2109-3-28**] 11:30AM BLOOD Glucose-102 UreaN-19 Creat-1.0 Na-136 K-4.6 Cl-96 HCO3-27 AnGap-18 [**2109-3-25**] 04:46AM BLOOD Calcium-8.0* Phos-3.9 Mg-1.9 [**2109-3-22**] CXR No evidence of pneumothorax, no significant CHF but bilateral moderate amount of pleural effusions as seen on single view chest examination. [**Last Name (NamePattern4) 4125**]ospital Course: Mr. [**Known lastname 58973**] was admitted the morning of [**3-20**] and proceeded directly to the operating room. He underwent a mitral valve repair with resection of the posterior leaflet with a 28 mm [**Doctor Last Name 405**] band with Dr. [**Last Name (Prefixes) **]. Please see OP note for full details. He was successfully weened and extubated on his operative evening and was placed on a steroid taper with the help of endocrinology given his addisons disease. On postoperative day two he was transferred to the inpatient telemetry floor for ongoing management and rehabilitation. On postoperative day four he had a burst of atrial fibrillation -- converted spontaneously and was noted to have a first degree AV-block. Due to this AV block, his beta blockade was held. On postoperative day five, with no furtehr episodes of afib but with elevated BP and HR, a low dose beta-blocker was added with no change in his AV block. He also continued to be significantly edamatous, nearly 14 kg up from his pre-op weight and he was actively diureses with lasix. On postoperative days six and seven, we continued to diurese him heavily. Endocrine also continued to follow with regards for his steroid taper. On postoperative eight, he cleared physical therapy and was discahrged home with a visiting nurse to follow. Medications on Admission: Plavix 75 daily. Prednisone 12.5 mg daily. Flurinef 0.1 mg daily. Levoxyl 0.025 mg daily. Enalapril 10 mh [**Hospital1 **]. Lipitor 20 mg daily. Aspirin 325 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. Atorvastatin Calcium 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 4. Levothyroxine Sodium 25 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 5. Clopidogrel Bisulfate 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 6. Fludrocortisone Acetate 0.1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 7. Enalapril Maleate 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 8. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* 9. Polysaccharide Iron Complex 150 mg Capsule Sig: One (1) Capsule PO DAILY (Daily). Disp:*30 Capsule(s)* Refills:*0* 10. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). Disp:*30 Tablet(s)* Refills:*0* 11. Oxycodone HCl 5 mg Tablet Sig: 1-2 Tablets PO every [**2-27**] hours as needed. Disp:*40 Tablet(s)* Refills:*0* 12. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig: Two (2) Tab Sust.Rel. Particle/Crystal PO Q12H (every 12 hours) for 2 weeks. Disp:*56 Tab Sust.Rel. Particle/Crystal(s)* Refills:*0* 13. Lasix 40 mg Tablet Sig: One (1) Tablet PO twice a day for 2 weeks. Disp:*28 Tablet(s)* Refills:*0* 14. Prednisone 5 mg Tablet Sig: 1.5 Tablets PO QAM (once a day (in the morning)): 5 mg on the PM. Disp:*45 Tablet(s)* Refills:*2* 15. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* Discharge Disposition: Home With Service Facility: [**Hospital1 1474**] VNA Discharge Diagnosis: Mitral regurgitation. Hypertension. Addison's disease. Hypothyroidism. Discharge Condition: Stable. Discharge Instructions: Shower daily with soap and water. Rinse well. [**Male First Name (un) **] not apply any creams, lotions, powders, or ointments. Take all new medications as prescribed. Make follow-up appointments as directed. No heavy lifting, greater than 10 pounds. No driving x 6 weeks. [**Last Name (NamePattern4) 2138**]p Instructions: Call to schedule appointment with Dr. [**Last Name (Prefixes) **]. Call to schedule appointment with Dr. [**Last Name (STitle) **]. Completed by:[**2109-3-29**] ICD9 Codes: 4240, 9971, 2761, 4019, 2449
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Medical Text: Admission Date: [**2108-4-24**] Discharge Date: [**2108-5-10**] Date of Birth: [**2030-11-10**] Sex: M Service: SURGERY Allergies: Penicillins Attending:[**First Name3 (LF) 4748**] Chief Complaint: Excruciating right foot pain Major Surgical or Invasive Procedure: [**2108-4-25**] 1. Angiogram: Abdominal aortogram, Serial arteriogram of the right lower extremity, Angioplasty of right above-knee popliteal artery, angioplasty of right superficial femoral artery, StarClose closure of left common femoral arteriotomy. [**2108-4-27**] 1. Angioscopy 2. Right superficial femoral artery to distal anterior tibialis artery bypass with nonreversed cephalic vein. History of Present Illness: Patient is a 77 year old male seen on day of admission by Dr [**Last Name (STitle) 1391**] in clinic who told patient to come to ED for hospital admission. He reports right foot pain starting back in [**Month (only) 404**] when podiatrist diagnosed him with plantar faucitis and prescribed unknown medication which made the patient nauseous prompting discontinuation. The pain persisted while living in [**State 108**] for the winter causing difficulty ambulating while playing golf. He takes Advil regularly with some relief and reports that hanging leg off bed, dependency, improves symptoms. On [**4-19**] worsening pain and concern for toe infection prompted podiatry visit where paronychia of the right hallux nail was noted, started on Levaquin antibiotic and told to meet with Dr [**Last Name (STitle) 1391**] in consult. Patient reports increasing in pain over last week sharp, achy in nature. He reports no fever, chills however has nausea and emesis 3-4x per week. Past Medical History: PMH: DMII requiring insulin, HTN, hyper cholesterol, Thrombocythemia, history of shingles. PSH: Fracture left elbow [**2055**], Appendectomy, Ulnar nerve repair left elbow, carpal tunnel repair, right inguinal hernia. All: Penicillin for which he has anaphylaxis Social History: Posting 1PPD tobacco hx quit 40 year ago, EtOH 1 vodka/day, no ilicit drugs. Married with 5 children, retired registrar at [**University/College 31355**]now gold coach. Physical Exam: on Admission 99.2 HR:65 BP:124/46 Resp:17 100%ra GEN: NAD, AA0x3, clean well groomed man Neuro: CNII-X11 grossly intact, equal motor strength CV: RRR, possible carotid bruits, Notable systolic murmur PUl: CTA, no respiratory distress Abd: Apear distended-reports baseline, soft, NT, ND, umbilical hernia noted. Ext: Upper radial pulses palpable ......Fem.....[**Doctor Last Name **].....DP....PT Lt.....Palp....Dop....Palp..Dop Rt.....Palp....Dop....none...DopFaint Right foot notable cold to touch, decreased hair growth in lower extremities bilaterally, Rt first phalanx with mild swelling erythema of lateral toe nail bed with minimal purulent discharge. Pertinent Results: On addmision 137 100 43 -------------<213 4.1 24 2.5 102 28.7 > 11.3< 474 35.1 PT: 14.4 PTT: 38.3 INR: 1.2 On Discharge [**2108-5-10**] 141 105 85 --------------<111 4.4 24 3.9 Ca: 8.5 Mg: 2.2 P: 4.6 96 39.3 > 9.4 < 346 28.7 Imaging: [**2108-4-28**] Renal Ultrasound 1. No hydronephrosis 2. Parvus tardus waveform on the left kidney can represent a more proximal stenosis. 3. Complex 1.9 cm cyst arising from the upper pole of the left kidney, likely a hemorrhagic or proteinaceous cyst. [**2108-4-25**] Arterial non-invasive studies Severe outflow arterial disease in the right lower extremity. Disease is likely located at the right superficial femoral artery as well as distal to it. 2. Mild outflow arterial disease in the left lower extremity. Disease is likely located distal to the popliteal artery. Micro WOUND CULTURE (Final [**2108-4-27**]): CORYNEBACTERIUM SPECIES (DIPHTHEROIDS). SPARSE GROWTH. URINE CULTURE (Final [**2108-5-4**]): YEAST. >100,000 ORGANISMS/ML. Blood Culture, Routine (Final [**2108-4-30**]): NO GROWTH. Brief Hospital Course: The patient was admitted to the Dr[**Name (NI) 1392**] Vascular Surgical Service for evaluation and treatment. On [**2108-4-25**] the patient underwent angiography and on [**2108-4-27**] he underwent Angioscopy and Right superficial femoral artery to distal anterior tibialis artery bypass with nonreversed cephalic vein. (Please refer to Operative Notes for details). The patient tolerated the procedure well. After a brief, uneventful stay in the PACU, the patient arrived to the VICU NPO, on IV fluids and antibiotics, narcotic medication for pain control. The patient was closely monitored throughout out his hospital stay which can be summarized by following systems: Neuro: The patient received IV narcotic medication with good effect and adequate pain control. When tolerating oral intake, the patient was transition ed to oral pain medications. CV: The patient remained stable from a cardiovascular standpoint; vital signs were routinely monitored. Pulmonary: The patient remained stable from a pulmonary standpoint; vital signs were routinely monitored. Good pulmonary toilet, early ambulation and incentive spirometry were encouraged throughout hospitalization. GI:Post-operatively, the patient initially NPO with IVFs. Patient had nausea with diet advancement for which he was closely monitor. He was encouraged to maintain his PO intake in spite of decrease appetite at time. He was tolerating a regular diet prior discharge. was advanced appropriately and was well tolerated. Post-operatively, GU/FEN: Post-operatively, the patient initially was on IVFs and foley in place. Patient's intake and output were closely monitored, and IV fluid was adjusted when necessary. Electrolytes were routinely followed and repeated when necessary. Due to an increase in Creatinine and the patients baseline stage III CKD caused by DM, nephrology was consulted to help manage acute on chronic kidney insufficiencies. Patient suffered from acute on chronic renal insufficiency during his hospital stay which prolonged the hospital course and for which he is deconditioned. On renal ultrasound, there was no evidence of hydronephrosis. The patient creatinine, fluid balance and electrolytes were closely monitored, his antibiotics and hydroxyurea medication were appropriate changed or adjusted and his renal insufficiency improved over time. He did not require hemodialysis.His Creatinine plateau ed at 6.1 and at time of discharge is 3.9. Due to renal insufficiency patient required prolonged use of a foley catheter which was definitively discontinued on [**2108-5-9**] at midnight. On day of discharge he was unable to void and was straight cathed for 375cc. On discharge he is due to void at 6pm. If patient unable to void please bladder scan patient and consider foley placement and follow-up with a urologist. Of note, his home dose Atenolol was discontinue per Nephrology consult as desired SBP goal is >120 to facilitate renal perfusion. When re-ignition of beta-blocker is deemed appropriate, it is advised that his PCP consider metoprolol as oppose to Atenolol as it is cleared more effectively from the kidneys. He will need to follow up with long term kidney physician [**Last Name (NamePattern4) **]. [**First Name (STitle) 10083**] at [**Last Name (un) **] as well as with his PCP. ID: The patient's white blood count and fever curves were closely watched for signs of infection. He was started on broad spectrum antibiotics Vanc/levo/Flagyl with admission which was changed to Bactrim post operatively on [**5-1**] and subsequently changed to Cipro [**5-3**] secondarily to Cipro ability to falsely elevate creatinine. He is being discharged on 7 days PO Cipro to complete course. Endocrine: The patient's blood sugar was monitored throughout his stay; insulin dosing was adjusted accordingly. Hematology: The patient's complete blood count was examined routinely; the patient received 4 non reactive blood transfusions during this hospitalization. He was noted to have leukocytosis on admission and with his history of thrombocythemia, hematology was consulted to facilitate proper management. His hydroxyurea was decreased from 5x/week to 2x/week secondary to renal insufficiency. He is to follow with his long term hematologist Dr [**Last Name (STitle) 17881**] on discharge. Prophylaxis: The patient received subcutaneous heparin, asa, Plavix and venodyne boots on non affected leg were used during this stay; was encouraged ambulate when appropriate with the assistance of physical therapy. At the time of discharge, the patient had improved significantly. From a surgical perspective he was doing very well but was deconditioned secondary to recovering renal insufficiency. He has been afebrile with stable vital signs, tolerating a regular diet, ambulating minimally with much assistance, patient is due to void and may require foley and urology fup if unable and his pain was well controlled. At time of discharge the patient, physicians, physical therapist and nursing staff agreeded that he was safe for discharge to a rehabilitative center. The patient received discharge teaching and follow-up instructions with understanding verbalized and was in agreement with the discharge plan. Medications on Admission: Insulin Before Breakfast Humalog 5 and NPH 25, Before Dinner: Humalog 5 and NPH 20, Cilostazol 100mg [**Hospital1 **], Hydroxyurea 500mg 5x/wk, hydrocholrothiazide 25mg Q otherver day with 2pill (50mg) Q other day alternating, Pravachol 20mg QHS, Viagra 100mg PRN, Diovan 160mg', enalapril 20mg [**Hospital1 **], Atenolol 25mg', Prazosin 12mg in am and 10mg in pm, Actos 30 mg', Vitamin D 1000 Unit Fish oil, Asairin 325mg', Glucosamine 500mg [**Hospital1 **],Philostazol 100mg [**Hospital1 **], Levaquin 500mg daily since [**4-19**]. Discharge Medications: 1. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily) for 30 days. 3. Insulin and sliding scale Breakfast Dinner Humalog 5 Units NPH 25 Units Humalog 5 Units NPH 20 Units Insulin SC Sliding Scale Breakfast Lunch Dinner Bedtime Regular Regular Regular Regular Glucose Insulin Dose Insulin Dose Insulin Dose Insulin Dose 0-70 mg/dL Proceed with hypoglycemia protocol Proceed with hypoglycemia protocol Proceed with hypoglycemia protocol Proceed with hypoglycemia protocol 71-119 mg/dL 0 Units 0 Units 0 Units 0 Units 120-159 mg/dL 2 Units 2 Units 2 Units 2 Units 160-199 mg/dL 4 Units 4 Units 4 Units 4 Units 200-239 mg/dL 6 Units 6 Units 6 Units 6 Units 240-279 mg/dL 8 Units 8 Units 8 Units 8 Units 280-319 mg/dL 10 Units 10 Units 10 Units 10 Units 320-359 mg/dL 12 Units 12 Units 12 Units 12 Units 4. Pravastatin 10 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 5. Pioglitazone 15 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 6. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 7. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 8. Bisacodyl 5 mg Tablet Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for Constipation. 9. Furosemide 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily): Until patient appropriately euvolemic. 10. Tamsulosin 0.4 mg Capsule, Sust. Release 24 hr Sig: One (1) Capsule, Sust. Release 24 hr PO HS (at bedtime). 11. Nystatin 100,000 unit/g Cream Sig: One (1) Appl Topical [**Hospital1 **] (2 times a day): to affected areas. 12. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO Q6H (every 6 hours) as needed for Constipation. 13. Hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for Pain: Do not drive while taking this medication. 14. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). 15. Prazosin 5 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 16. Hydroxyurea 500 mg Capsule Sig: One (1) Capsule PO 2X/WEEK (TU,FR). 17. Metoclopramide 10 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 18. Ciprofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours) for 7 days. Discharge Disposition: Extended Care Facility: [**Hospital 31356**] health care center-[**Location (un) **] Discharge Diagnosis: 1) Right lower extremity critical limb ischemia with rest pain 2) Acute on Chronic kidney 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: Division of Vascular and Endovascular Surgery Lower Extremity Bypass Discharge Instructions ACTIVITIES: - ambulate essential distances untill FU with Dr. [**Last Name (STitle) 1391**] - Ace wrap leg from foot-knee when ambulating, to prevent swelling - Your operated leg is expected to have some swelling and will resolve over time - Elevate leg when sitting - no driving till FU - may shower, pat dry your incisions, no tub baths WOUND: - Keep wound dry and clean, call if noted to have redness, excess draining, swelling, or if temp is greater than 101.5 - Your staples have been removed and replaced with steri strips. Leave seri strips in place, they will come off on [**Last Name (un) 1292**] own or will be removed at FU. Ok to use dry guaze dressin if need for ozzing. - Pleaese use heal protection (waffle boot) on both legs while in bed - Use ace wrap foot to knee while ambulating to prevent swelling DIET: - Diet as tolerated eat a well balanced meal - Your appetite will take time to normalize - Prevent constipation by drinking adequate fluid and eat foods [**Doctor First Name **] in fiber, take stool softener while on pain medications MEDICATIONS: - Continue all medications as directed - Please follow up with your PCP regarding restarting beta blocker- It is recommended that you take Metoporol inplace of Atenolol for purposes of renal clearance. Ask your PCP to address. - Take your pain medications conservatively - Your pain will get better over time FU APPOINTMENTS: - keep all FU appointments - Call Dr.[**Name (NI) 1392**] office for FU appointment. Phone [**Telephone/Fax (1) 1393**] - Follow-up with your Nephrologist Dr. [**First Name (STitle) 10083**] at [**Last Name (un) **] - Follow-up with your hematology Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 17881**]. ([**Telephone/Fax (1) 31357**] - Follow-up with your Primary Care Physician Followup Instructions: 1) Please follow-up with Dr [**Last Name (STitle) 1391**] in 3 weeks. Call [**Telephone/Fax (1) 1393**] to schedule an appointment. 2) Follow-up with your Nephrologist Dr. [**First Name (STitle) 10083**] at [**Last Name (un) **] 3) Follow-up with your hematology Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 17881**]. ([**Telephone/Fax (1) 31357**] 4) Follow-up with your Primary Care Physician Completed by:[**2108-5-10**] ICD9 Codes: 5849, 2724
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Medical Text: Admission Date: [**2119-5-13**] Discharge Date: [**2119-5-16**] Date of Birth: [**2059-6-26**] Sex: M Service: MEDICINE Allergies: Morphine Attending:[**First Name3 (LF) 1253**] Chief Complaint: Bradycardia Major Surgical or Invasive Procedure: None History of Present Illness: Mr. [**Known lastname 32458**] is a 59 year old male with a history of major depression, ethanol dependence and chronic suicidality who was admitted for alcohol withdrawal. Pt first presented to the emergency room on [**2119-5-12**] seeking inpatient admit for alcohol detox and increasing suicidal ideation. He was evaluated by psychiatry, placed under section 12, and transferred to an inpatient detox center ([**Last Name (un) 4199**]). Pt was sent back to the ED for bradycardia. Pt reports his HR was in the 30s but there was no documentation provided. In the emergency room his inital vitals were T: 98.1 BP: 151/89 HR: 94 RR: 16 O2: 98% on RA. He received levofloxacin 750 mg IV x 1 and valium 20 mg IV. He was admitted to the medical floor for alcohol withdrawal and possible pneumonia. . On the floor, BP ranged 150/102 to 142/54, HR in 90s, RR 22, O2 sat 96% on 3L. He received 1L NS. For CIWA consistently at 28, pt received 115 mg of valium (IV and PO) while on the floor. . The pt was transfered to the MICU for further management of acute alcohol withdrawal. In the MICU the pt received Valium 50mg IV and 60 mg PO. Past Medical History: Depression, followed by Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], h/o SI attempt Hypothyroidism Bigemeny and Trigemny Idiopathic L hemidiaphragm paralysis . Social History: Pt is married with 4 children; formerly worked as a radiologist and lost his medical license. Drinks 6 gin & tonics daily, increased from 3 drinks daily 2 weeks ago, reports hx of blackouts, denies w/d seizures or DTs until today, alcoholic for 15 years. Recreational drugs: h/o prescription drug abuse inc. Vicodin, Percocet and Xanax. He has been clean for 2 years. He denies use of IVDs. Tobacco: Denies use. Family History: Mother and son with depression. Per OMR first degree relatives with [**Name (NI) **], but pt denies this. Physical Exam: VS: T97.6, P 87 (P 100's), 140/73, 97% on RA GENERAL: Pleasant, fatigued man in NAD HEENT: Normocephalic, atraumatic. No conjunctival pallor. No scleral icterus. PERRLA/EOMI. MMM. OP clear. Neck Supple, No LAD, No thyromegaly. CARDIAC: Regular rhythm, normal rate. Normal S1, S2. No murmurs, rubs or [**Last Name (un) 549**]. LUNGS: CTAB, good air movement biaterally. ABDOMEN: NABS. Soft, NT, ND. No HSM EXTREMITIES: No edema or calf pain, 2+ dorsalis pedis/ posterior tibial pulses. SKIN: No rashes/lesions, ecchymoses. NEURO: A&Ox3. Appropriate. CN 2-12 grossly intact. Preserved sensation throughout. 5/5 strength throughout. [**2-3**]+ reflexes, equal BL. Normal coordination. Gait assessment deferred. No asterixis. PSYCH: Listens and responds to questions appropriately, pleasant . Pertinent Results: [**2119-5-12**] 02:10PM BLOOD WBC-8.8 RBC-5.36 Hgb-16.6 Hct-47.5 MCV-89 MCH-31.0 MCHC-35.0 RDW-15.6* Plt Ct-296 [**2119-5-15**] 06:45AM BLOOD WBC-5.4 RBC-4.62 Hgb-14.4 Hct-41.2 MCV-89 MCH-31.1 MCHC-34.9 RDW-15.5 Plt Ct-163 [**2119-5-15**] 06:45AM BLOOD Plt Ct-163 [**2119-5-12**] 02:10PM BLOOD Plt Ct-296 [**2119-5-12**] 02:10PM BLOOD Glucose-110* UreaN-11 Creat-0.9 Na-135 K-3.7 Cl-95* HCO3-21* AnGap-23* [**2119-5-15**] 06:45AM BLOOD Glucose-96 UreaN-12 Creat-0.8 Na-141 K-3.4 Cl-106 HCO3-24 AnGap-14 [**2119-5-13**] 12:05PM BLOOD TSH-9.4* [**2119-5-14**] 01:32AM BLOOD Free T4-1.0 [**2119-5-13**] 12:05PM BLOOD Osmolal-300 [**2119-5-12**] 02:10PM BLOOD ASA-NEG Ethanol-295* Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG . . CXR: Elevated left lung base, which could be an elevated hemidiaphragm of uncertain chronicity. Correlation with clinical history or prior imaging will be very helpful. . EKG: normal sinus rhythm, normal axis, normal intervals, frequent PVCs, no acute ST segment changes. No change from prior dated [**2117-1-7**]. . . Brief Hospital Course: Mr [**Known lastname 32458**] is a 59 year old man with alcohol abuse and major depressive disorder with a history of a suicide attempt who presented with alcohol withdrawal and suicidality. . # Alcohol withdrawal: The pt was placed on a CIWA scale with q4h valium initially. The pt was requiring ample nursing attention on the floor and was sent to the medical ICU where he received q1h valium which led to an improvement in the pt's CIWA scores, which had been in the 20's while on the floor. On transfer back to the floor on [**2119-5-15**] the pt's CIWA scores were [**11-14**] and the pt was tolerating q4h valium 10mg po. . # Depression: The pt was continued on his outpatient effexor, and his seroquel was restarted. The psychiatry consult service saw the pt and recommended inpatient psychiatric treatment for his suicidal ideation. On discharge the pt had passive suicidal ideation and was transfered to an inpatient psychiatry team. . # Bradycardia: During this admission the pt was not bradycardic, and his pulse remained in the 70's, except while withdrawing from alcohol, when the pt's pulse was in the 100's. The pt's home metoprolol was held during this admission, and the pt was instructed to hold metoprolol until he saw his primary care doctor. The pt's potassium and magnesium were repleted. Medications on Admission: Per [**Company 25795**] pharmacy: ([**Telephone/Fax (1) 70215**] Levothyroxine 200mcg daily Metoprolol tartrate 50mg [**Hospital1 **] Seroquel 400mg [**Hospital1 **] (ran out 4 days ago) Geodon 80mg [**Hospital1 **] (ran out 1 week ago) Klonopin 1 mg [**Hospital1 **] prn Ambien 10 mg qhs prn Simvastatin 10 mg daily (denied taking) Discharge Medications: 1. Thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Venlafaxine 75 mg Capsule, Sust. Release 24 hr Sig: Three (3) Capsule, Sust. Release 24 hr PO DAILY (Daily). 5. Levothyroxine 100 mcg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 6. Quetiapine 200 mg Tablet Sig: Four (4) Tablet PO HS (at bedtime). 7. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection TID (3 times a day). 8. Diazepam 10 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for PRN CIWA > 10 . Discharge Disposition: Extended Care Facility: deaconness 4 Discharge Diagnosis: Primary: Alcohol withdrawal. Secondary: Major depressive disorder, hypothyroidism Discharge Condition: Breathing comfortably on room air, CIWA of 11. Discharge Instructions: Mr [**Known lastname 32458**]: You were admitted with a slow heart rate. Your heart rate was found to be normal when you were evaluated in the emergency department. Your heart rate remained normal during the length of the hospitalization. You were also found to be in alcohol withdrawal, which we treated you for with medications. . Your home medications remain the same. Please continue to take your home medications as directed. . If you develop chest pain, shortness of breath, nausea and vomiting, palpitations, or any other concerning symptom, please call your doctor or return to the emergency room. Followup Instructions: Please call Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 70216**] [**Telephone/Fax (1) 40799**] to make a follow up appointment within the next two weeks, or after you are discharged from your psychiatric hospitalization. ICD9 Codes: 2449
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Medical Text: Admission Date: [**2133-6-12**] Discharge Date: [**2133-7-1**] Date of Birth: [**2073-11-10**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 9569**] Chief Complaint: Lower Back Pain with LE weakness beginning [**2133-6-8**] Major Surgical or Invasive Procedure: Laminectomy T12-L2 Single wire pacemaker placed History of Present Illness: Pt is a 59 y/o Cantonese female with a h/o Atrial fibrillation and mechanical MVR (Bjork-Shiley) secondary to RHD experienced low back pain and LE weakness beginning on [**2133-6-8**]. MRI of the lumbar spine revealed a cystic mass at the T12-L2, which was found to be a hematoma upon surgical exploration on [**2133-6-12**] and was subsequently evacuated. Pt has been on Coumadin and digoxin due to her cardiac hx and initially her INR was 3.5. During the operation the pt experienced episodes of bradycardia with right neck manipulation and swan-ganz catheter placement c/w vagal etiology, however bradycardia and pauses continued for following the surgery. Permanent v-lead pacemaker was placed on [**2133-6-14**]. Pt demonstrated NSVT believed to be d/t digoxin toxicity (1.1). Currently pt c/o pain in right leg from the buttock down to the ankle on the lateral calf, diminishing distally. No c/o CP other than at the incision site for the pacemaker, no SOB, no LH. Difficulty with using bedside commode due to pain and reports no BM, but positive flatus. Past Medical History: MVR secondary to RHD with Bjork-Shiley valve in [**3-/2108**] Atrial fibrillation HTN Social History: Visiting brother in US, lives in [**Name (NI) 651**], speaks predominantly Cantonese and some English. No tobacco, alcohol, or recreational drugs. Family History: Mother with HTN. Physical Exam: VS: HR - 103 RR - 20 T - 98.8 BP - 124/78 O2 sat - 95% on RA Pain - [**4-21**] Gen: WN, WD thin woman who appears her age. Appears to be uncomfortable and is diaphoretic. HEENT: EOMI NECK: JVP noted b/l, no JVD CV: Irregularly irregular, tachycardic; Loud S1, S2, no M/R/G/C noted; heart beat noted visibly across the chest and by palpation. No carotid bruits. Resp: CTA b/l A/P, no W/R/R Abd: +BSx4, soft, NT/ND, no HSM Ext: PP present and symmetric, except dorsalis pedis R>L. Ext warm, with no cyanosis or edema. No right leg tenderness. Neuro: AOx3; observed exam by Dr. [**First Name (STitle) 1022**] (ortho) - weakness in right hallux extension; left LE weakness improving, left knee extension at 2/5 strength. Pertinent Results: [**2133-6-12**] 12:20AM DIGOXIN-1.1 [**2133-6-12**] 12:20AM PT-23.0* PTT-31.6 INR(PT)-3.5 [**2133-6-12**] 12:20AM WBC-8.8 RBC-4.13* HGB-13.6 HCT-39.2 MCV-95 MCH-33.0* MCHC-34.8 RDW-13.4 [**2133-6-12**] 12:20AM GLUCOSE-137* UREA N-18 CREAT-0.6 SODIUM-135 POTASSIUM-3.8 CHLORIDE-96 TOTAL CO2-28 ANION GAP-15 MRI L-Spine [**2133-6-12**]: IMPRESSION: Extramedullary hematoma, which may be intradural or epidural, compressing the conus and cauda equina from T11/12 through L1/2. Associated large veins are suggestive of a vascular malformation. If the hematoma is intradural, a spinal cord arteriovenous malformation is likely. A conventional angiogram is recommended for assessment of vascular malformation. Follow-up lumbar spine MRI is also recommended to evaluate the surgical decompression. MRI L-Spine [**2133-6-13**]: IMPRESSION: Status post decompression of a large dorsal epidural hematoma, there is soft tissue swelling which continues to impress the distal cord and proximal cauda equina. CXR [**2133-6-15**]: IMPRESSION: 1. Pacing leads in the expected position of the right ventricle. No evidence of pneumothorax. 2. Massive enlargement of the left atrium Echo [**2133-6-16**]: IMPRESSION: Normal functioning mitral valve prosthesis. Mild aortic stenosis. Mild aortic regurgitation. Severe biatrial enlargement. Preserved biventricular systolic function. Pulmonary artery hypertension. PM Interrogation [**2133-6-24**]: PM functioning properly Brief Hospital Course: 59 yo Cantonese F with history of Atrial fibrillation, Mitral valve replacement presented with epidural hematoma and lower extremity weakness. Patient is s/p epidural hematoma evacuation on [**2133-6-12**] and s/p single wire pacer placement on [**2133-6-14**] sceondary to periop brady/pause. Patient was found to have NSVT/?junctional tachycardia likely secondary to digoxin toxicity. . The patient p/w spontaneous epidural hematoma and LE weakness on [**2133-6-12**]. Following diagnositic evaluation, the patient was taken to surgery for a T12-L2 laminectomy and subsequent evacuation of the hematoma. At the time of admission the patient's INR was 3.5 as she was taking 3.5mg coumadin PO Qhs for prophylactic anticoagulation due to her h/o afib and MVR. Her coumadin was held and her INR monitored following surgery. She was placed on coumadin 3.0mg Qhs once her INR dropped below 2.0 and she was bridged with a heparin drip. Coumadin was increased to 4.0mg on [**2133-6-17**] and as her INR rose to 2.8 on [**6-22**], decreased to 3.0mg. Subsequent to her INR dropping from 2.5 to 2.1 on [**6-25**] and then to 1.9 on [**6-26**] the coumadin dose was increased to 4.0mg and 5.0mg repectively. Coumadin continued to be titrated to a dose of 3.5mg (her dose PTA) giving an INR of 2.4 at discharge. In the perioperative period the patient began having episodes of bradycardia and pauses for which a single wire pacemaker was placed on [**2133-6-14**], with confirmation of proper lead placement by CXR. The PM was interrogated on [**2133-6-24**] and found to be functioning properly. Additionally in this time she developed mild anemia likely due to the spontaneous hematoma and surgical blood loss for which she received a total of 2 units of PRBCs and has since resolved. During this time the patient was continued on Lanoxin for her atrial fibrillation and developed a NSVT/? junctional tachycardia likely due to digoxin toxicity. Her digoxin was discontinued and per EP's recommendations was not restarted and will be held indefinitely. In order to maintain K levels above 4.0 to avoid potential dysrhytmias from hypokalemia, spironolactone 25mg PO daily was started. On this regimen the patient required 40mEq of KCl PO daily to maintain her K levels and this was reduced to 20mEq daily as the K level on the day prior to discharge was 4.5. On discharge the K level was 4.3. For heartrate control metoprolol was increased over time to an eventual dose of 75mg PO BID the day prior to discharge, during which time the patient's BP was stable at SBP=110s to 130s. On the day of discharge metoprolol 75mg [**Hospital1 **] was increased to Toprol XL 200mg to help control SBP that were in the upper 120s. Following evacuation of her epidural hematoma she developed right LE pain, which was attributed to a radiculpathy and was successfully treated with Neurontin 100mg TID. Due to predominately left LE weakness, PT was consulted and recommended that the pt be discharged to an extended care factility where she could receive further care from PT. The patient continued to improve during the course of her stay, but was it was still considered necessary that the pt receive rehab upon d/c. Prior to discharge the patient was prescribed an AFO left foot splint. In addition she spiked a temperature to 100.3, for which an infection work-up was began. Urine Cx showed Proteus Mirabilis, Bld Cx negative. She was treated impirically on Vacnomycin, which was d/c after the Bld Cx came back negative, and Ciprofloxacin. P. mirabilis was found to be intermediately sensitive to ciprofloxacin and Tx was switched to a sensitive antibiotic, Ceftriaxone 500mg po Q12H for 10 days. Ceftriaxone was stopped on [**2133-6-29**] and the patient remained afebrile and asymptomatic. Both incisions healed well without current drainage, erythema, edema, or tenderness. Lastly during her hospital course she developed some bladder irritation/spasms and hematuria likely due to foley catheter trauma. The catheter was d/c'ed and she was treated with Detrol for a couple of days. She has since been asymmptomatic and without hematuria. Medications on Admission: Lanoxin 0.25mg po daily Coumadin Flexeril Vicodin Mehtylprednislone dose back Apo-amilizide 50/5 mg po daily Tensiomin (Chinese med) 25 mg po daily Take chinese herbs and teas Discharge Medications: 1. Spironolactone 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Warfarin Sodium 1 mg Tablet Sig: 3.5 Tablets PO HS (at bedtime). 3. Gabapentin 100 mg Capsule Sig: One (1) Capsule PO Q8H (every 8 hours). 4. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed for pain. 5. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day) as needed for Constipation. 6. Potassium Chloride 20 mEq Packet Sig: One (1) packet PO once a day. 7. Toprol XL 200 mg Tablet Sustained Release 24HR Sig: One (1) Tablet Sustained Release 24HR PO once a day. Discharge Disposition: Extended Care Facility: [**Hospital6 85**] - [**Location (un) 86**] Discharge Diagnosis: Epidural hematoma s/p evacuation, periop brady/pause s/p single wire pacemaker placement, non-sustained ventricular tachycardia secondary to digoxin toxicity Discharge Condition: Stable Discharge Instructions: Please take all medications as prescribed. Contact primary care physician or return to hospital if experience chest pain, shortness of breath, palpitations, worsening lower extremity weakness, or other concerns. Followup Instructions: The following appointments have been scheduled for you: 1. [**Company 191**] Provider: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] [**Name12 (NameIs) **], MD Where: [**Hospital 273**] [**Hospital3 249**] Phone:[**Telephone/Fax (1) 250**] Date/Time:[**2133-7-24**] 3:00 2. Provider: [**Name10 (NameIs) 900**] [**Name8 (MD) 901**], M.D. Where: [**Hospital6 29**] CARDIAC SERVICES Phone:[**Telephone/Fax (1) 902**] Date/Time:[**2133-8-10**] 11:30 Completed by:[**2133-7-1**] ICD9 Codes: 2768, 2859, 4019, 9971, 5990
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Medical Text: Admission Date: [**2154-11-20**] Discharge Date: [**2154-11-22**] Date of Birth: [**2087-6-12**] Sex: F Service: MEDICINE Allergies: Plavix Attending:[**First Name3 (LF) 5119**] Chief Complaint: Chest pain, shortness of breath Major Surgical or Invasive Procedure: None History of Present Illness: Mrs. [**Known lastname 22833**] is a 67 year old female with a history of CAD s/p LAD stents in [**2145**], type II diabetes, hypertension and hyperlipidemia who presents with one day of dyspnea on exertion and subscapular pain. Patient was in her usual state of health until one day prior to admission. On the morning of presentation she took her husband to the doctor for a routine visit. On the way into the building she had to walk up a ramp and noticed that she was short of breath. She stopped and caught her breath and felt somewhat better. The sensation returned when they got home and she had to climb the 7 stairs into her house. She got to the top and had to reset. At this time she also noticed pain between her shoulder blades which reminded her of the pain she felt 10 years ago when she had her myocardial infarction. The pain was not pleuritic. It was associated with exertion and dyspnea. It was not associated with lightheadedness, dizziness, diaphoresis and did not radiate. It resolved with rest. It returned later in the evening and was more severe. She recalls feeling as if she were going to die. She had her daughter call EMS. In the ambulance she received aspirin 325 mg and SL nitroglycerin x 1 which she says resolved her pain. In the emergency room her initial vitals were T: 98.1 BP: 129/79 HR: 118 RR: 20 O2: 77% on RA which improved to 93% on 15L. She had a CXR which showed no acute process. Her initial EKG showed sinus tachycardia at 108 with left axis deviation, normal intervals, no acute ST segment changes. Her first troponin was 0.05 with CK of 186. Cardiology was consulted who felt her picture not consistent with acute coronary syndrome. Her d-dimer was elevated at 1143 and she underwent a CTA which showed bilateral subsegmental pulmonary emboli. She received one liter normal saline and was started on IV heparin with a bolus. She was admitted to the [**Hospital Unit Name 153**] for further management. On arrival to the [**Hospital Unit Name 153**] she is awake, alert and speaking in full sentences. She denies lightheadedness, dizziness, chest pain. She continues to have dyspnea but this is improved with supplemental oxygen. She denies nausea, vomiting, abdominal pain, dysuria, hematuria, diarrhea, constipation, melena, hematochezia, leg pain or swelling. She denies recent travel or immobilziation. No recent surgeries. She is up to date on her mammograms. No PAP smear in last 10 years. Due for colonoscopy. While in the [**Hospital Unit Name 153**] she was continued on IV heparin and started on coumadin. She was initially requiring 6L nasal cannula and this was weaned to 3L by hospital day two. She had an echocardiogram which showed mild right ventricular cavity enlargement with mild free wall hypokinesis and mild pulmonary artery systolic hypertension. She had bilateral lower extremity ultrasounds which were negative for DVT. At no time was she hemodynamically unstable. She is transferred to the floor for further management. Past Medical History: Type II Diabetes Coronary Artery Disease s/p NSTEMI with 2 LAD stents placed in [**2145**] with additional stent placed for acute thrombotic occlusion Hypertension Type II Diabetes Hyperlipidemia Social History: Patient lives with her husband and two grown children. She has a remote smoking history and quit as a teenager. Occassional alcohol use. No illicits. Family History: Mother died suddenly at age 66 when she collapsed. Father died of a traumatic accident at age 59. She has 12 siblings, 8 are still living. One sister had a lower extremity DVT. Physical Exam: Vitals: T: 98.1 HR: 104 BP: 138/84 RR: 15 O2: 93% on 6L NC General: Awake, alert, speaking in full sentences HEENT: PERRL, sclera anicteric, MMM, oropharynx clear Neck: supple, no LAD, JVP not elevated Cardiac: tachycardic, s1 + s2, no murmurs, rubs, gallops Lungs: Clear to ausculatation bilaterally without wheezes, rales, ronchi GI: soft, non-tender, non-distended, +BS, no organomegaly appreciated GU: no foley Ext: WWP, 2+ pulses, no clubbing, cyanosis or edema Rectal: guaiac negative in ER Pertinent Results: Chemistries: [**2154-11-19**] 10:14PM GLUCOSE-270* UREA N-16 CREAT-1.5* SODIUM-136 POTASSIUM-4.2 CHLORIDE-100 TOTAL CO2-21* ANION GAP-19 [**2154-11-20**] 04:14AM CALCIUM-8.9 PHOSPHATE-3.0 MAGNESIUM-1.6 [**2154-11-19**] 10:14PM D-DIMER-1143* Hematology: [**2154-11-19**] 10:14PM WBC-10.5 RBC-4.37 HGB-11.0* HCT-33.5* MCV-77* MCH-25.2* MCHC-32.8 RDW-16.2* [**2154-11-19**] 10:14PM NEUTS-64.9 LYMPHS-26.5 MONOS-5.0 EOS-2.7 BASOS-0.8 [**2154-11-19**] 10:14PM PT-13.4 PTT-21.8* INR(PT)-1.1 Cardiac Enzymes: [**2154-11-19**] 10:14PM BLOOD CK-MB-5 cTropnT-0.05* CK(CPK)-186* [**2154-11-20**] 04:14AM BLOOD CK-MB-6 cTropnT-0.07* CK(CPK)-161* [**2154-11-20**] 03:15PM BLOOD CK-MB-5 cTropnT-0.03* CK(CPK)-135 Urine Studies: [**2154-11-20**] 10:16AM URINE Osmolal-407 [**2154-11-20**] 10:16AM URINE Hours-RANDOM Creat-64 Na-100 K-28 Cl-96 EKG: sinus tachycardia at 108 with left axis deviation, normal intervals, no acute ST segment changes. Imaging: Chest XRAY [**2154-11-19**]: Single portable view of the chest in upright position was obtained. The cardiac silhouette is enlarged. There is no pneumothorax, consolidation, or large pleural effusions. The pulmonary vasculature is normal. The osseous structures demonstrate degenerative changes of the thoracic spine. CTA Chest [**2154-11-19**]: There are multiple bilateral filling defects involving the lobar branches of the pulmonary artery consistent with pulmonary embolism. The central airways are patent to the segmental levels, bilaterally. There is motion artifact which limits the study. There is no pneumothorax or consolidation. The heart is normal in size and demonstrates right ventricular strain. A coronary artery stent is seen in the LAD. There is no mediastinal, hilar, or axillary lymphadenopathy. The visualized portions of the upper abdomen demonstrate vascular calcifications. Atherosclerotic changes of the aorta without evidence of aneurysm. Echocardiogram [**2154-11-20**]: The left atrium and right atrium are normal in cavity size. The estimated right atrial pressure is 0-10mmHg. There is mild symmetric left ventricular hypertrophy with normal cavity size. Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. Overall left ventricular systolic function is low normal (LVEF 50%). The right ventricular cavity is mildly dilated with mild global free wall hypokinesis. 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 appears structurally normal with trivial mitral regurgitation. There is mild pulmonary artery systolic hypertension. There is no pericardial effusion. Brief Hospital Course: Mrs. [**Known lastname 22833**] is a 67 year old female with coronary artery disease, hypertension, and diabetes who presents with subscapular chest pain and shortness of breath found to have bilateral segmental pulmonary emboli with evidence of right heart strain. . Pulmonary Embolism: Diagnosed by CT chest. She was started on IV heparin in the emergency room and coumadin on arrival to the [**Hospital Unit Name 153**]. Her echocardiogram showed evidence of mild right heart strain but at no time was she hemodynamically unstable. She was initially requiring 6L of supplemental oxygen and upon transfer to the floor she was requiring 3L. It was weaned off by discharge. The etiology of her pulmonary emboli are unclear. She had bilateral lower extremity ultrasounds whcih were negative for DVT. She is up to date on her mammograms. She has not had a recent PAP smear or colonoscopy. She has one sister with a history of a DVT but no other history of clotting disorders in her family. Patient will follow up with her PCP for age appropriate cancer screening and consideration of hypercoaguable workup. Patient was on heparin gtt until her INR was within therapeutic range. The patient will follow up with her PCPs office on Mon to check another INR. . Acute Renal Failure: On arrival to the [**Hospital Unit Name 153**] her creatinine was elevated at 1.5 from a baseline in [**2145**] of 0.8. Urine electrolytes were equivocal. Her creatinine improved to 1.2 with IVF administration. Her urine output has been good. Will continue to monitor. . Hypertension: She has been hemodynamically stable during her ICU course. Metoprolol was continued given her CAD history but her other antihypertensive medications were held due to low normal blood poressures. Patient was instructed to not continue her benicar/HCTZ for now. She will follow up with her PCP to determine if it needs to be restarted in the future. . Type II Diabetes: Patient was monitored on insulin sliding scale. Her home oral agents were initially held but restarted at discharge. . Coronary Artery Disease: s/p MI and LAD stents in [**2145**]. EKG on admission without without ischemic changes. She had three sets of negative cardiac enzymes and no arrythmias were noted on telemetry. She was continued on her home aspirin, statin and metoprolol as above. Her home statin and fibrate were continued. . FEN: Cardiac/Diabetic diet, monitor electrolytes, no standing IVF . Code: Full . Communication: Husband [**Name (NI) **] [**Name (NI) 22833**] [**Telephone/Fax (1) 31750**] . Disposition: Patient was cleared by PT to go home without services. Medications on Admission: Aspirin 325 mg daily Metformin 850 QAM and 1350 QPM Toprol XL 100 mg daily Benicar/HCTZ 40-12.5 mg daily Tricor 145 mg daily Glimepiride 2 mg daily Lisinopril 40 mg daily Lipitor 40 mg daily Discharge Medications: 1. Metformin 850 mg Tablet Sig: One (1) Tablet PO qam. 2. Metformin 850 mg Tablet Sig: 1.5 Tablets PO at bedtime. 3. Glimepiride 2 mg Tablet Sig: One (1) Tablet PO once a day. 4. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Toprol XL 100 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO once a day. 6. Fenofibrate Micronized 145 mg Tablet Sig: One (1) Tablet PO daily (). 7. Lipitor 40 mg Tablet Sig: One (1) Tablet PO once a day. 8. Warfarin 5 mg Tablet Sig: One (1) Tablet PO Once Daily at 4 PM. Disp:*30 Tablet(s)* Refills:*2* 9. Lisinopril 40 mg Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Home Discharge Diagnosis: Pulmonary embolisms Discharge Condition: Good. Discharge Instructions: -Continue Coumadin to treat your blood clots. -Go to your PCPs office on Monday to obtain a lab slip to have your blood drawn to check your coumadin levels. -On monday when you get the lab slip you should arrange a hospitalization follow up appointment with your PCP [**Name Initial (PRE) **] [**12-19**] weeks from now. -Your PCP should facilitate further age appropriate cancer screeening such as pap smear and colonoscopy. -Do not take benicar/HCTZ for now as your blood pressure has been running on the lower side. Discuss with your PCP about whether or not to restart this medication in the future. -Take all other medications as prescribed. -Call your PCPs office or return to ED if you experience worsening shortness of breath, chest or scapulaar pain, fevers/chills or other worrisome signs/symptoms. Followup Instructions: Follow up with PCP 1-2 weeks [**First Name7 (NamePattern1) 1569**] [**Initial (NamePattern1) **] [**Name8 (MD) **] MD [**MD Number(2) 5122**] Completed by:[**2154-11-25**] ICD9 Codes: 5849, 412, 4019, 2724
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Medical Text: Admission Date: [**2187-2-17**] Discharge Date: [**2187-2-25**] Date of Birth: [**2148-11-12**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2160**] Chief Complaint: Cellulitis/fever Major Surgical or Invasive Procedure: None History of Present Illness: 38 yo with known hypertension/hyperlipidemia/Diabetes Mellitus presents with a 4 day history of cellulitis RLE, started cephalexin and bactrim the day prior to presentation without improvement. On the day of admission, the temperature increased to 101.4 at home and he called PCP who advised to go to ER. Temperature at ED: 101, wbc 24, creat 2.7 (baseline 1.7). Pan cultured, started iv vanco and unasyn, iv rehydration. u/s and xray of RLE prelim were negative. The patient was admitted after discussion with Dr [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **]. . ROS Denied any precipitant of cellulitis; no falls/abrasion, trauma. No other complaints: No CP, SOB, palpitations. No GI/GU complaints. Past Medical History: DIABETES TYPE 2 ([**First Name8 (NamePattern2) **] [**Last Name (un) **]; in [**Last Name **] problem list says type 1) HYPERCHOLESTEROLEMIA HYPERTENSION OBESITY ASTHMA; never been intubated TOBACCO ABUSE S/P APPY TO THE ER Chronic RENAL INSUFFICIENCY OTITIS Obesity Social History: He lives in [**Location 686**] with his wife, their 11 [**Name2 (NI) **] son and two step sons. Pt states he is a long-time smoker, but has quit several times in the past and does not see smoking as a problem for him. Occasional EtOH at parties, no IVDU. Family History: Diabetes Physical Exam: T: 98.0 BP: 126/72 P: 86 RR: 22 O2 sats: 92RA FS: 181 Gen: NAD HEENT: NC/AT, EOMI Neck: supple, no [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) **]: RRR, no m/r/g Resp: CTAB Abd: obese, soft, NT/ND Ext: - RLE with areas of blanching erythema bordered with pen on anterior aspect. No erythema over posterior aspect. Warm and tender on palpation. Proximal leg with trace erythema/swelling. - LLE wnl. Neuro: grossly wnl Sensation: wnl Strength: [**2-22**] dorsi/plantar flexion of R foot; 5/5 strength on L Reflexes: 1+ b/l DTR Pertinent Results: [**2187-2-16**] 03:45PM BLOOD WBC-12.9* RBC-4.83 Hgb-13.1* Hct-38.9* MCV-81* MCH-27.1 MCHC-33.7 RDW-13.8 Plt Ct-308 [**2187-2-17**] 01:30PM BLOOD WBC-23.6*# RBC-4.48* Hgb-12.4* Hct-35.7* MCV-80* MCH-27.7 MCHC-34.8 RDW-14.5 Plt Ct-256 [**2187-2-18**] 06:55AM BLOOD WBC-15.9* RBC-4.04* Hgb-11.0* Hct-32.4* MCV-80* MCH-27.3 MCHC-34.1 RDW-14.5 Plt Ct-261 [**2187-2-19**] 07:35AM BLOOD WBC-15.8* RBC-4.00* Hgb-10.4* Hct-32.4* MCV-81* MCH-26.0* MCHC-32.1 RDW-14.4 Plt Ct-262 [**2187-2-17**] 01:30PM BLOOD Neuts-83.7* Lymphs-11.4* Monos-4.4 Eos-0.3 Baso-0.2 [**2187-2-19**] 01:05PM BLOOD PT-12.0 PTT-45.7* INR(PT)-1.0 [**2187-2-17**] 01:30PM BLOOD Glucose-186* UreaN-37* Creat-2.7* Na-135 K-4.1 Cl-96 HCO3-30 AnGap-13 [**2187-2-18**] 06:55AM BLOOD Glucose-172* UreaN-48* Creat-3.7* Na-136 K-4.1 Cl-97 HCO3-27 AnGap-16 [**2187-2-19**] 07:35AM BLOOD Glucose-133* UreaN-59* Creat-4.0* Na-137 K-4.3 Cl-100 HCO3-27 AnGap-14 [**2187-2-18**] 06:55AM BLOOD Calcium-8.3* Phos-4.3 Mg-1.9 Cholest-207* [**2187-2-19**] 07:35AM BLOOD calTIBC-225* VitB12-440 Ferritn-269 TRF-173* [**2187-2-18**] 06:55AM BLOOD Triglyc-201* HDL-42 CHOL/HD-4.9 LDLcalc-125 [**2187-2-19**] 07:35AM BLOOD Vanco-8.8* [**2187-2-19**] 03:59AM BLOOD Type-ART pO2-62* pCO2-56* pH-7.34* calTCO2-32* Base XS-2 Intubat-NOT INTUBA Comment-NON-REBREA [**2187-2-17**] 01:32PM BLOOD Lactate-1.1 - UNILAT LOWER EXT VEINS RIGHT [**2187-2-17**] 3:48 PM FINDINGS: Color Doppler son[**Name (NI) 1417**] of the right common femoral, superficial femoral, and popliteal veins were performed. There was normal flow, augmentation, and waveforms demonstrated. There was no intraluminal thrombus identified. Due to the patient body habitus, compression images of the common and superficial femoral arteries could not be obtained. IMPRESSION: No evidence of right lower extremity deep vein thrombosis. Somewhat limited study. - RADIOLOGY TIB/FIB (AP & LAT) RIGHT [**2187-2-17**] FINDINGS: There is a marked soft tissue edema and density, in the proximal right lower extremity. There is no gas noted in the subcutaneous tissue. There is no sign of fracture or dislocation or degenerative change. There is no underlying cortical reaction. There are no radiopaque foreign bodies. IMPRESSION: Marked density and edema of soft tissues of the proximal right lower extremity. Please note that absence of gas does not rule out necrotizing fasciitis. - RADIOLOGY CHEST (PA & LAT) [**2187-2-17**] PA AND LATERAL CHEST RADIOGRAPH: The lung volumes are low. Cardiomediastinal silhouette is unchanged. There is no evidence of central lymphadenopathy. Lungs are clear, with the exception of bibasilar atelectasis. There is no pleural effusion. Pulmonary vascularity is normal. IMPRESSION: No acute cardiopulmonary process - RADIOLOGY Final Report CHEST (PORTABLE AP) [**2187-2-18**] IMPRESSION: Stable appearance to the chest with no acute process seen. - RENAL U.S. [**2187-2-18**] FINDINGS: Study is very limited secondary to large body habitus. The left kidney measures 11.9 cm. The right kidney measures 10.7 cm. No hydronephrosis identified within the kidneys. No definite mass lesion or stones identified. IMPRESSION: Limited study secondary to increased body habitus. No hydronephrosis identified and no definite mass lesion or renal stones identified. - LUNG SCAN [**2187-2-19**] INTERPRETATION: Ventilation images obtained with Tc-[**Age over 90 **]m aerosol in 8 views demonstrate mild decrease in tracer uptake in the posterobasilar segment of the right lower lobe. Perfusion images in the same 8 views show a matched defect in the posterior right lower lobe. No other perfusion defects are identified. Chest x-ray shows an air space opacity in the right lower lobe corresponding to the area of matched tracer defect. IMPRESSION: Decreased perfusion and ventilation in the posterior right lower lobe corresponding to an infiltrate on CXR. These findings would be entirely compatible with air space disease, but in the face of CXR findings, the possibility of pulmonary embolism can not be fully excluded. No other segmental perfusion defects are present. - BILAT LOWER EXT VEINS [**2187-2-19**] BILATERAL LOWER EXTREMITY ULTRASOUND: Compared to DVT study of just two days prior. Grayscale and Doppler son[**Name (NI) 867**] were performed of the bilateral lower extremity veins including the greater saphenous, common femoral, superficial femoral, popliteal, and deep tibial veins. Venous structures demonstrate normal compression, flow, waveforms, and augmentation without intraluminal thrombus. Note is made of large right groin lymph nodes measuring up to 2.8 cm in long axis, demonstrating a benign-appearing fatty hila, likely reactive given history of cellulitis. IMPRESSION: 1) No evidence of DVT. 2) Right groin adenopathy, likely reactive. - CHEST (PORTABLE AP) [**2187-2-19**] PORTABLE AP CHEST RADIOGRAPH: There is a new area of faint opacity within the right lower lobe in comparison to the prior study. The cardiac and mediastinal contours are stable. The remainder of lungs are clear. There is no pulmonary vascular congestion. No pleural effusions or pneumothorax seen. IMPRESSION: New faint opacity in the right lower lobe may represent an area of aspiration and/or consolidation. LIVER OR GALLBLADDER US (SINGLE ORGAN) [**2187-2-24**] 3:52 PM LIVER OR GALLBLADDER US (SINGL; DUPLEX DOP ABD/PEL LIMITED Reason: evaluate for evidence of hepatitis, gallbladder disease, por [**Hospital 93**] MEDICAL CONDITION: 38 year old man with diabetes, hypercholesterolemia, HTN, CRI admitted for PE and ? cellulitis, now with elevated LFTs (new since [**2187-2-15**]). REASON FOR THIS EXAMINATION: evaluate for evidence of hepatitis, gallbladder disease, portal vein thrombosis INDICATION: Diabetes, chronic renal failure, and admitted for PE. Now with elevated LFTs. Evaluate for hepatitis, gallbladder disease, portal vein thrombosis. COMPARISON: [**2185-6-17**]. ABDOMINAL ULTRASOUND: The liver is diffusely echogenic consistent with fatty infiltration. No focal lesions are seen. The gallbladder is unremarkable with no stones or wall thickening. The common hepatic duct measures 4 mm. There is no intrahepatic biliary dilatation. The portal vein is patent with anterograde flow. There is no ascites. The pancreas was not well visualized due to overlying bowel gas. Limited views of the right kidney demonstrate no hydronephrosis. IMPRESSION: Echogenic liver consistent with fatty infiltration. Other forms of liver disease including significant fibrosis/cirrhosis cannot be excluded. Additionally, ultrasound is not very sensitive for detection of hepatitis. Please correlate clinically. TIB/FIB (AP & LAT) RIGHT [**2187-2-24**] 1:39 PM TIB/FIB (AP & LAT) RIGHT Reason: eval for evidence of osteomyelitis [**Hospital 93**] MEDICAL CONDITION: 38 year old diabetic male with cellulitis, pain on RLE (anterior shin). REASON FOR THIS EXAMINATION: eval for evidence of osteomyelitis EXAMINATION: Tibia and fibular, right. INDICATION: Diabetes. Pain. Possible osteomyelitis. Views of the right tibia and fibula show normal bony alignment with no acute bony injury. No plain film findings are seen to suggest osteomyelitis. No soft tissue gas or foreign material is visualized. There is mild soft tissues swelling anterior to the proximal tibia. IMPRESSION: No plain final film findings to suggest osteomyelitis. If this remains a clinical concern, then a nuclear medicine study or MRI would be more sensitive. Brief Hospital Course: # Cellulitis Pt was started on keflex and bactrim as an outpatient on the day prior to admission, but had called PCP because of fevers on day of admission. On arrival to [**Name (NI) **], pt had LENIs, R TIB/FIB XR, and CXR performed, which were all negative. He received vanco and unasyn in ED and continued on floor. Temperatures were monitored, and noted to spike despite antibiotics. Blood cultures were drawn for each spike. His wbc trended downwards from 26->15. Pt received dilaudid for pain control. Subsequently he was switched to a regimen of vancomycin, levofloxacin and flagyl. He was discharged on keflex x one week and asked to finish his course of levo and flagyl. # Hypoxia Pt had desaturated to the 66% on RA while sleeping on routine vital sign check on HD#2. Pt's lungs were clear, without wheeze/rales/crackles. Given his asthma hx, albuterol/atrovent nebs were provided. An EKG and CXR were also performed which showed no change from prior. His temperature was also elevated at the time, and thus another set of blood culture was sent. Blood cultures from [**2-19**] were again negative, and ASO negative as well. The patient then had an episode of shortness of breath early morning of HD#3. Pt was noted to be saturating at 76% on RA when he ambulated to the use the bathroom. Pt was placed on NC, and was 85%. Thus, was placed on NRB and saturating 93%. He was without CP, palpitations, or any other complaints. SOB was improved on NRB. His vitals at the time of incident was: 102.3 108 118/70 22. Another CXR and LENIs were ordered, which were negative, ABG was done: 7.34/56/62. Repeat EKG showed no acute changes. Moreover, his creatinine had increased up to 4.0. On exam, the patient's lungs had crackles, and thus lasix was given with renal consult. Pt had a V/Q scan performed and he was found to have decreased perfusion and ventilation in the posterior right lower lobe corresponding to an infiltrate on CXR. These findings would be entirely compatible with air space disease, but in the face of CXR findings, the possibility of pulmonary embolism could not be fully excluded. No other segmental perfusion defects were present. Pt remaind on NRB and was achieving low 90s. MICU consult was obtained, and the patient was transferred to the MICU for persistent hypoxia. Because the patient had remained relatively immobile with his cellulitis, clinical suspicion for PE warranted the initiation of anticoagulation with heparin bridge to coumadin. Heparin was d/c on [**2-23**]. Coumadin was initially given at 7.5 mg, then 5 mg, and he was discharged on 3 mg with instructions to see his PCP within [**Name Initial (PRE) **] day or two to address the need for continued anticoagulation. The patient was put on BIPAP for OSA in the ICU, and prior to discharge it was arranged that he would get a BIPAP machine that same day. He did not like the BIPAP but it was explained to him that he required it for sleep apnea. Prior to discharge, he ambulated on the floor and maintained his oxygen sats >95% at all times. . # Acute renal failure The patient has known chronic renal insufficiency with bsl creatinine of 1.7-2.1. On admission at [**Name (NI) **], pt's creatinine was elevated to 2.7. It was remeasured on the following day and showed an increase to 3.7. Urinary Na, creatinine, osm, protein, eos were measured, and results were suggestive of prerenal picture. Renal U/S was performed, which was a limited study secondary to increased body habitus, but no hydronephrosis identified and no definite mass lesion or renal stones identified. IVF was started overnight of HD#2. Renal consult was obtained. Recommendations included: Holding ACE-I, continuing to Vanco dose was obtained was 8.8. Vancomycin was continued until the day of discharge, at which time he was put on Keflex for one week. # DIABETES TYPE II, followed at [**Last Name (un) **], the patient's sugars were well controlled on sliding scale insulin. . # HYPERCHOLESTEROLEMIA - Stable; Pt was continue on Lipitor. Fasting lipids were drawn which were reasonable. . # HYPERTENSION - Stable; Pt was initiated on HCTZ, Cardia, Lisinopril. Lisinopril was later held. . # TOBACCO ABUSE - offer nicotine patch prn . #. # FEN: The patient was maintained on a regular - diabetic diet. . # PPX: SC hep . # CODE: FC Medications on Admission: Bupropion 100" keflex, bactrim insulin NPH - 62u in AM, 52 in PM HCTZ 50' Cartia 180' Lisinopril 40' question other meds? Discharge Medications: 1. Bupropion 100 mg Tablet Sustained Release Sig: One (1) Tablet Sustained Release PO BID (2 times a day). 2. Diltiazem HCl 180 mg Capsule, Sustained Release Sig: One (1) Capsule, Sustained Release PO DAILY (Daily). 3. Metronidazole 500 mg Tablet Sig: One (1) Tablet PO TID (3 times a day) for 5 days: Last doses on [**3-1**]. Disp:*14 Tablet(s)* Refills:*0* 4. Albuterol 90 mcg/Actuation Aerosol Sig: 1-2 Puffs Inhalation Q6H (every 6 hours) as needed for shortness of breath or wheezing. 5. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 6. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours) for 4 days: Last dose 4/12. Disp:*4 Tablet(s)* Refills:*0* 7. Coumadin 3 mg Tablet Sig: Three (3) Tablet PO at bedtime: Please take 3 mg daily, follow-up with your PCP on [**Month/Year (2) 3816**] for dose adjustment. . Disp:*5 Tablet(s)* Refills:*0* 8. Keflex 500 mg Tablet Sig: One (1) Tablet PO every six (6) hours for 7 days: Last doses on [**2187-3-3**]. Disp:*28 Tablet(s)* Refills:*0* 9. Please continue to take insulin as you were prior to admission Discharge Disposition: Home Discharge Diagnosis: Primary Diagnosis: Acute respiratory failure - Possible Pulmonary Embolism/ pneumonia Right Lower Extremity Cellulitis Acute on Chronic Renal Failure Secondary Diagnosis: DM type II Hypercholesterolemia Hypertension Obesity Asthma Discharge Condition: Good. Ambulatory and no need for oxygen. Discharge Instructions: You were in the hospital for an infection in your right leg. We also were unable to exclude a blood clot in your lungs, and are treating you for this condition. You were given medicine to make your blood thinner and antibiotics. It is ESSENTIAL that you see your doctor [**First Name (Titles) **] [**Last Name (Titles) 3816**] [**2-27**] at the latest as your blood can get too thin and not thin enough and this can cause very serious health problems. You need to complete the course of antibiotics as prescribed. Flagyl and Levofloxacin until [**3-1**], and Keflex until [**3-4**]. You need to use a CPAP machine at home for your obstructive sleep apnea (breathing problems at home). You also need to discuss this problem with your PCP during your next visit. Please note that we have stopped hydrochlorothiazide, and started a new blood pressure medication called Metoprolol. Please take it as prescribed. Please note that we have also stopped Lisinopril. Please discuss this with your PCP when you see him on [**Month/Year (2) 3816**]. Followup Instructions: With Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 5377**], MD Phone:[**Telephone/Fax (1) 250**]. Please call and schedule an appointment with him for Monday or [**Telephone/Fax (1) 3816**] ([**2-27**]) at the latest. Should he not be available, please schedule an appointment with a different provider in the clinic (episodic), but it is ESSENTIAL that you be seen within the next two days. ICD9 Codes: 5849, 486, 2720
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6592 }
Medical Text: Admission Date: [**2192-11-8**] Discharge Date: [**2192-11-11**] Date of Birth: [**2151-4-20**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 12174**] Chief Complaint: EtOH Withdrawal Abdominal pain Major Surgical or Invasive Procedure: Diagnostic paracentesis History of Present Illness: 41yF with alcoholic cirrhosis who presented from OSH with 3d of RUQ pain nausea/vomiting. Her abdominal pain was made worse with eating or laying flat. She denies fevers/chills. RUQ US at OSH demonstrates GB wall thickening 7mm without pericholecystic fluid. Her wt ct was 16.7 at OSH with TBili 5. She was transferred to [**Hospital1 18**] for management of putative acute cholecystitis. . At [**Hospital1 **], pt started on unasyn, but U/S and CT [**Last Name (un) 103**] showed no evidence of acute chole, but rather GB wall edema c/w cirrhosis. Was admitted to SICU with plan for diagnostic para and HIDA scan, but plan for HIDA was dropped. Meanwhile, patient was feeling more agitated c/w previous <24 hour periods w/o EtOH. Patient reported last EtOH intake on [**11-7**], with a decades-long history of 1bottle of wine or vodka daily hx of EtOH use. . In the SICU, patient was thought to be showing some increased signs of agitation, and so was transferred to the MICU for possible EtOH w/d. Past Medical History: - Cirrhosis (dx day of admission) - EtOH Abuse - Bilateral carpal tunnel release 2y ago - Breast augmentation 14 years ago - C-section x 2 Social History: Former dialysis RN. ETOH abuse x 20 years 6 cocktails/day. 1 bottle of wine/day. Prefers merlot and vodka. No IVDU or other illicit drug use. Tobacco 1.5ppd x 30 years. Family History: father with stomach CA. Mother with HTN Physical Exam: Physical exam on discharge: Vitals: T:97 BP:98/60 P:92 R: 18 O2:96% RA General: Alert, anxious, NAD HEENT: 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, mild abdominal tenderness, full belly, 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: 1. Labs on admission: [**2192-11-7**] 09:30PM BLOOD WBC-13.6* RBC-2.26* Hgb-8.7* Hct-26.4* MCV-117* MCH-38.6* MCHC-33.0 RDW-15.6* Plt Ct-212 [**2192-11-7**] 10:57PM BLOOD PT-16.4* PTT-30.6 INR(PT)-1.5* [**2192-11-7**] 09:30PM BLOOD Glucose-115* UreaN-3* Creat-0.5 Na-139 K-2.6* Cl-100 HCO3-26 AnGap-16 [**2192-11-7**] 09:30PM BLOOD ALT-40 AST-177* AlkPhos-268* TotBili-4.7* DirBili-3.4* IndBili-1.3 [**2192-11-7**] 09:30PM BLOOD Lipase-21 [**2192-11-7**] 09:30PM BLOOD Albumin-3.0* Calcium-8.2* Phos-2.6* Mg-1.2* [**2192-11-7**] 09:59PM BLOOD K-2.4* . 2. Labs on discharge; [**2192-11-11**] 05:35AM BLOOD WBC-10.3 RBC-2.01* Hgb-7.7* Hct-24.4* MCV-121* MCH-38.1* MCHC-31.5 RDW-15.7* Plt Ct-261 [**2192-11-11**] 05:35AM BLOOD PT-16.0* PTT-32.9 INR(PT)-1.4* [**2192-11-11**] 05:35AM BLOOD Glucose-108* UreaN-5* Creat-0.4 Na-140 K-4.1 Cl-112* HCO3-20* AnGap-12 [**2192-11-11**] 05:35AM BLOOD ALT-38 AST-196* AlkPhos-221* TotBili-2.7* [**2192-11-11**] 05:35AM BLOOD Calcium-7.7* Phos-2.2* Mg-1.9 [**2192-11-9**] 11:30AM BLOOD calTIBC-107* VitB12-741 Folate-11.8 Ferritn-782* TRF-82* [**2192-11-8**] 10:27AM BLOOD HBsAg-NEGATIVE HBsAb-POSITIVE HBcAb-NEGATIVE HAV Ab-POSITIVE [**2192-11-9**] 11:30AM BLOOD IgG-952 IgA-253 IgM-134 [**2192-11-8**] 10:27AM BLOOD HCV Ab-NEGATIVE [**2192-11-9**] 10:56AM BLOOD freeCa-0.96* . 3. Imaging/diagnostics: - CXR: Normal chest. - Abdominal u/s: 1. Heterogeneous nodular echotexture of the liver with increased echogenicity that is compatible with provided history of cirrhosis. 2. Moderate amount of simple intra-abdominal ascites. 3. Main portal vein is patent. 4. Gallbladder sludge. No evidence of cholecystitis. 5. Mild splenomegaly measuring up to 14.3 cm. - CT abdomen/pelvis: 1. No evidence of acute cholecystitis. Diffuse fatty liver infiltration/heterogeneity and a moderate amount of abdominal and pelvic ascites and varices c/w cirrhosis. 2. The patient has diverticulosis with colonic wall hypertrophy; however, there are no surrounding changes to suggest acute diverticulitis. . ================================================== Pending labs on discharge (to be followed up: [**2192-11-9**] 09:30PM BLOOD AMA-PND Smooth-PND [**2192-11-9**] 09:30PM BLOOD [**Doctor First Name **]-PND [**2192-11-9**] 09:30PM BLOOD CERULOPLASMIN-PND [**2192-11-9**] 09:30PM BLOOD ALPHA-1-ANTITRYPSIN-PND =================================================== Brief Hospital Course: 41 yo F with history of alcohol abuse, initially admitted for concern of acute cholecystitis and alcohol withdrawal, found to have cirrhosis. . # EtOH Withdrawal: No prior history of DTs or active withdrawal however concern given high daily EtOH intake. No hallucinations. CIWA < 10 throughout hospitalization. Thiamine, folate, multivitamins given and a social work consult was ordered. Patient declined social work consult. Patient instructed to attend AA meeting or join support group to help alcohol cessation. Patient declined. . # Abdominal Pain/Nasea/Vomiting: Exam negative for acute abdomen. Mild diffuse abdominal tenderness but non-localizable. CT scan without evidence of acute process and RUQ US at OSH with GB wall thickening 7mm but without pericholecystic fluid. Transaminitis remained stable, likely chronic. Transitioned to oral diet. Weaned off pain medication. . # Cirrhosis: New diagnosis on on transfer from OSH ([**2192-11-7**]). Transaminitis and cholestatic picture noted on labs, unclear past history but pt reports heavy drinking and AST/ALT ratio > 4, which remained stable. Viral hepatitis panel negative for acute infection. Autoimmune panel and wilson's disease labs pending at the time of discharge. Diagnostic paracentesis negative for spontaneous bacterial peritonitis. Serum-ascites albumin gradient 2.6, consistent with ascites due to portal hypertension. . ================================================== Pending labs on discharge (to be followed up: [**2192-11-9**] 09:30PM BLOOD AMA-PND Smooth-PND [**2192-11-9**] 09:30PM BLOOD [**Doctor First Name **]-PND [**2192-11-9**] 09:30PM BLOOD CERULOPLASMIN-PND [**2192-11-9**] 09:30PM BLOOD ALPHA-1-ANTITRYPSIN-PND =================================================== Medications on Admission: None Discharge Medications: 1. multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 2. thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 3. folic acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Cirrhosis Transaminitis Alcohol abuse Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Ms. [**Known lastname 5395**], you were admitted to [**Hospital1 1170**] ([**Hospital1 18**]) because you had abdominal pain. We found that you have fibrosis of the liver called cirrhosis, most likely from your alcohol use. Your liver enzymes were elevated but remained stable. You had withdrawal from alcohol and we treated you for that. We tapped the fluid in your abdomen which did not show an infection. . It is VERY important that you call the liver clinic at [**Hospital1 18**] to make a follow-up appointment on Monday [**2192-11-12**]. The phone number is listed below. You should join a support group and stop alcohol consumption to prevent progression of your liver disease. . We made the following changes to your medications: STARTED: - Folic Acid 1 mg by mouth daily - Thiamine 100 mg by mouth daily - Multivitamins 1 tab by mouth daily Followup Instructions: Please call the Liver Center at [**Hospital1 1170**] at ([**Telephone/Fax (1) 1582**] on [**2192-11-12**] to schedule a follow-up appointment within the next 2 weeks. Completed by:[**2192-11-11**] ICD9 Codes: 2768, 2859
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Medical Text: Admission Date: [**2144-3-16**] Discharge Date: [**2144-3-17**] Date of Birth: [**2097-12-21**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**Last Name (NamePattern4) 290**] Chief Complaint: AMS Major Surgical or Invasive Procedure: none History of Present Illness: 46 yo f with hx of EtOH abuse, who presented at ER after being found down at a McDonald's appearing intoxicated. Pt was unresponsive in [**Last Name (un) 8491**] and brought to ER. She had a bottle of trazadone that was Rx early in [**Month (only) 404**] with the appropriate amount of tabs remaining. Pt smelled of etoh. She does not remember what happen today, but states she usually drinks about a pint of vodka a day. She denies other drug use. She does report a recent productive cough, but is unclear about the details. She c/o chronic LBP. She denies CP, SOB, and GI sx. . On arrival to the ER pt VS were reported 96.7 90 89/63 12 94; however [**Name8 (MD) **] MD pt was not hypotensive and BP was in 110s. Pt had a CXR concerning for a RML infiltrate and was given levo 750mg, and flagyl. Also given thiamine, folate, and MV. Pt started to awake and was responsive to verbal stimuli. 3 liters of NS was given including banana bag. Initially pt was low 90s% sats on [**Last Name (LF) **], [**First Name3 (LF) **] a nasal trumpet was placed and pt was 100% on 4 liters. Pt was admitted to MICU for observation and concern for continued AMS. VS at transfer were 98.1 89 103/65 20 100% on 4 liters. . On the floor, pt is more awake but confused and a poor historian. Past Medical History: -etoh use -low back pain, s/p surgery Social History: Pt is homeless, lives at a shelter. Is single, reports a 12 yo child, but unclear where the child is. Reports drinking a pint of vodka a day. +tobacco use, but unclear on amount. Denies drug use. Family History: NC Physical Exam: Vitals: 98.2 98 102/66 15 90% on RA General: Alert, not oriented except to person and season HEENT: Sclera anicteric, MMM, oropharynx with secretions Neck: supple, no LAD Lungs: diffuse rhonchi, + wheezes, bronchial breath sounds CV: Regular rate and rhythm, no M, 2+ pulses Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly GU: foley removed Ext: warm, no edema, no clubbing at time of leaving AMA, pt was orientated and had capacity Pertinent Results: [**2144-3-17**] 01:43AM BLOOD WBC-5.0 RBC-3.70* Hgb-12.0 Hct-37.7 MCV-102* MCH-32.5* MCHC-31.9 RDW-14.9 Plt Ct-460* [**2144-3-16**] 07:50PM BLOOD WBC-6.7# RBC-3.82* Hgb-12.7 Hct-38.7 MCV-101* MCH-33.2* MCHC-32.8 RDW-14.7 Plt Ct-495* [**2144-3-17**] 01:43AM BLOOD Neuts-56.1 Lymphs-39.3 Monos-3.8 Eos-0.4 Baso-0.3 [**2144-3-16**] 07:50PM BLOOD Neuts-52 Bands-2 Lymphs-36 Monos-7 Eos-0 Baso-0 Atyps-3* Metas-0 Myelos-0 [**2144-3-16**] 07:50PM BLOOD Hypochr-2+ Anisocy-2+ Poiklo-1+ Macrocy-2+ Microcy-NORMAL Polychr-OCCASIONAL Schisto-OCCASIONAL Burr-OCCASIONAL [**2144-3-17**] 01:43AM BLOOD Glucose-75 UreaN-6 Creat-0.5 Na-146* K-3.8 Cl-115* HCO3-22 AnGap-13 [**2144-3-16**] 07:50PM BLOOD Glucose-97 UreaN-6 Creat-0.6 Na-143 K-4.0 Cl-110* HCO3-23 AnGap-14 [**2144-3-17**] 01:43AM BLOOD ALT-95* AST-172* LD(LDH)-236 AlkPhos-74 TotBili-0.2 [**2144-3-16**] 07:50PM BLOOD ALT-105* AST-172* AlkPhos-80 TotBili-0.2 [**2144-3-17**] 01:43AM BLOOD Calcium-6.9* Phos-3.1 Mg-1.6 [**2144-3-16**] 07:50PM BLOOD ASA-NEG Ethanol-568* Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG [**2144-3-16**] 07:56PM BLOOD Glucose-94 Lactate-2.2* [**2144-3-16**] 08:00PM URINE Color-Yellow Appear-Clear Sp [**Last Name (un) **]-1.013 [**2144-3-16**] 08:00PM URINE Blood-NEG Nitrite-NEG Protein-NEG Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-NEG pH-5.0 Leuks-NEG [**2144-3-16**] 08:00PM URINE Hours-RANDOM [**2144-3-16**] 08:00PM URINE bnzodzp-NEG barbitr-NEG opiates-NEG cocaine-NEG amphetm-NEG mthdone-NEG [**2144-3-17**] 1:43 am SPUTUM Site: EXPECTORATED **FINAL REPORT [**2144-3-17**]** GRAM STAIN (Final [**2144-3-17**]): >25 PMNs and >10 epithelial cells/100X field. Gram stain indicates extensive contamination with upper respiratory secretions. Bacterial culture results are invalid. PLEASE SUBMIT ANOTHER SPECIMEN. RESPIRATORY CULTURE (Final [**2144-3-17**]): TEST CANCELLED, PATIENT CREDITED. cxr AP UPRIGHT BEDSIDE RADIOGRAPH OF THE CHEST: There is a hazy opacity with a central more dense consolidation in the right lower lobe. Linear left lower lobe opacity is also present, the configuration of the latter however favors atelectasis. There is no pleural effusion or pneumothorax. There is no pulmonary edema. Heart size is upper limits of normal. Hilar contours are unremarkable. IMPRESSION: Right lower lobe opacity, could reflect pneumonia or perhaps aspiration. Differential considerations include atelectasis and clinical correlation is advised. The study and the report were reviewed by the staff radiologist. CT head FINDINGS: There is no intra- or extra-axial hemorrhage, mass effect, or shift of normally midline structures. The ventricles and sulci are normal in size and configuration and the [**Doctor Last Name 352**] and white matter differentiation is well preserved. There is no acute major vascular territorial infarct. The basilar cisterns appear preserved. There is no herniation. There is mucosal thickening in bilateral ethmoid air cells and in the right maxillary sinus. No acute fracture is seen. IMPRESSION: No acute intracranial process. Brief Hospital Course: 46 yo f with hx of etoh abuse, presented to ER after being found unresponsive at a McDonald's, with suspected etoh intoxication. # Etoh intoxication: pt has known hx of etoh use, on admission alcohol level was 568. This is likely the cause of the pt's AMS, since it improved after staying in the ICU overnight. Serum and urine tox were only positive for etoh. Pt was given a banana bag and 2 liters NS in ER. During the night pt became combative and required a code purple while still intoxicated. She briefly was in 4 point restraints since she still had an AMS. She was given Ativan and improved. In the morning, pt did not want to go to a detox center and once her MS had cleared she requested to leave AMA. Pt was able to understand the risks and benefits of leaving 10:30AM. # Aspiration PNA: on exam had diffuse rhonchi and some wheezing. Pt was producing thick white sputum. CXR was concerning for aspiration, which pt is at risk for due to intoxication. She was given levo and Flagyl while admitted. She refused to stay for further tx. She stated she would go to her homeless clinic today. At time of leaving the sputum cx was contaminated and the blood cx were pending. She remained afebrile and no longer was hypoxic. # Transaminitis: Mild elevation, likely [**3-10**] to etoh # Bandemia: 2% bands, concerning for infection. Pt likely has a PNA. UA was negative. This may also explain mild elevation of lactate. However, pt also had some atypical cells initially. However on repeat labs and bands and atypical cells were not seen. Attending and fellow were notified that pt left. Medications on Admission: trazadone tramadol (currently off) Discharge Medications: none Discharge Disposition: Home Discharge Diagnosis: left AMA Discharge Condition: left AMA Discharge Instructions: left AMA Followup Instructions: left AMA [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**Name8 (MD) **] MD [**MD Number(1) 292**] Completed by:[**2144-3-17**] ICD9 Codes: 5070
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6594 }
Medical Text: Admission Date: [**2167-6-2**] Discharge Date: [**2167-6-10**] Date of Birth: [**2116-3-29**] Sex: M Service: NEUROLOGY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2569**] Chief Complaint: Confusion, head trauma, unsteady gait, multiple hemorrhagic lesions on head CT Major Surgical or Invasive Procedure: MR HEAD W & W/O CONTRAS CHEST (PORTABLE AP) CT CHEST W/CONTRAST CT ABD W&W/O C CT PELVIS W/CONTRAST MRA BRAIN W/O CONTRAST MR HEAD W/O CONTRAST Cardiology ECHO Neurophysiology EEG Cardiology ECG CHEST (PA & LAT) CT HEAD W/O CONTRAST CT C-SPINE W/O CONTRAST History of Present Illness: Pt is a 51 yo with h.o HTN, hyperlipidemia, anxiety, and alcoholism who is sent in from his PCP after being brought there by his father for confusion, head trauma, and gait problems. The history is sparse as the pt is unable to relate one and his father is currently unreachable. From talking to his PCP and the records, it appears that his father was unable to contact him for several days this week so he finally went to his house to check on him. It is unclear if this was yesterday or today. He found his house to be disheveled and many things broken/dirty. The pt was confused and apparently was having trouble walking. He would not eat unless food was brought to him. He was disoriented. His father thought he has had nothing to drink since Friday, but unclear how he knows this. Also reportedly he has not taken his meds for 1 week(again not sure how we know this). He was taken to his PCP who agreed he was confused and thought he had some possible right sided weakness. He was sent here. A head CT here shows ~8 hemorrhagic lesions in his cerebral hemispheres with some edema, but no mass effect or shift. No blockage of CSF flow is obviously seen. When asked why he is here the pt says he needed to get his BP checked and that he is otherwise ok. He has clear evidence of head trauma on exam though. He is unable to give any more substantial history and on ROS, changes his answers to the same questions if he answers them at all. ROS: Patient denies any HA, diplopia(although holds 1 eye shut constantly), fevers, weakness, numbness, or tingling. Past Medical History: hypertension hyperlipidemia anxiety alcoholism h/o MVA with possible TBI Social History: Lives alone but father checks in on him. He is an alcoholic. He smokes. Family History: Unknown Physical Exam: Vitals:98.5, 80, 143/87, 16, 97% on RA Gen:NAD. Holds eyes closed HEENT:MMM. Sclera clear. OP clear. Brusing over his face and head as well as laceration of his forehead. Neck: C-collar in place CV: RRR, Nl S1 and S2, no murmurs/gallops/rubs Lung: Clear to auscultation bilaterally Ext:No cyanosis/edema Neurologic examination: Mental status: Awake and alert but holds eyes closed, moderately cooperative with exam Orientation: Oriented to person. Thinks he is in LA. Then says he is at [**Hospital **] Clinic. Year is variably "[**2062**] or [**2166**]". Says it is "harvest time". Knows father lives in JP. Says he personally lives "1 house from here". Attention: Unable to do DOWF or B Registration: Not tested Language: Fluent with moderate comprehension and normal repetition. Naming impaired to low freq objects. No dysarthria or paraphasic errors No apraxia, no neglect or ext to DSS. [**Location (un) **] intact with slight trouble. Calculation intact to simple addition. can't do quarters in 1.75. Cranial Nerves: I: not tested II: Pupils equally round and reactive to light, 4 to 3mm bilaterally. Visual fields are full to confrontation grossly. Fundi normal bilaterally. III, IV, VI: Extraocular movements hard to assess as he is poorly cooperative, but ? limitation of upgaze and possible decrease in right eye abduction. V, VII: Facial strength and sensation intact and symmetric. VIII: Hearing intact to finger rub bilaterally. IX, X: Palatal elevation symmetrical [**Doctor First Name 81**]: Sternocleidomastoid and trapezius normal bilaterally. XII: Tongue midline without fasciculations, intact movements Motor: Normal bulk and tone bilaterally No tremor Full strength throughout No pronator drift Sensation: Intact to light touch, pinprick, temperature (cold) throughout all extremities, although MS makes this unreliable. Reflexes: B T Br Pa Ankle Right 2 t t 1 0 Left 1 t t 1 0 Toes were up on right and mute to up on left. Coordination: Significant ataxia/dysmetria on left and less severe, but still present on right. Fairly good with FFM and [**Doctor First Name **]. Gait: Unable as C-spine not cleared Pertinent Results: WBC-8.7# RBC-5.11# Hgb-16.8# Hct-49.7# MCV-97 MCH-32.9* MCHC-33.8 RDW-13.2 Plt Ct-303# Neuts-70.7* Lymphs-20.6 Monos-6.6 Eos-0.5 Baso-1.6 PT-12.5 PTT-26.9 INR(PT)-1.1 Glucose-107* UreaN-24* Creat-0.9 Na-141 K-4.2 Cl-102 HCO3-25 AnGap-18 Calcium-9.8 Phos-3.8 Mg-2.8* ALT-29 AST-24 AlkPhos-78 TotBili-0.9 Lipase-32 Albumin-4.2 Lactate-2.1* [**2167-6-2**] 01:30PM BLOOD CK(CPK)-89 CK-MB-NotDone cTropnT-<0.01 TSH-1.0 BLOOD ASA-NEG Ethanol-NEG Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG URINE Color-Amber Appear-Clear Sp [**Last Name (un) **]-1.024 Blood-NEG Nitrite-NEG Protein-NEG Glucose-NEG Ketone-15 Bilirub-SM Urobiln-4* pH-7.0 Leuks-NEG bnzodzp-NEG barbitr-NEG opiates-NEG cocaine-NEG amphetm-NEG mthdone-NEG Bld cxs [**Date range (1) 14706**] x6 NGTD [**6-2**] UCx neg [**2167-6-7**] 11:30 am URINE Source: CVS. URINE CULTURE (Preliminary): ESCHERICHIA COLI. >100,000 ORGANISMS/ML.. PRESUMPTIVE IDENTIFICATION. Trimethoprim/Sulfa sensitivity testing confirmed by [**First Name8 (NamePattern2) 3077**] [**Last Name (NamePattern1) 3060**]. ENTEROCOCCUS SP.. 10,000-100,000 ORGANISMS/ML.. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ ESCHERICHIA COLI | AMPICILLIN------------ =>32 R AMPICILLIN/SULBACTAM-- 8 S CEFAZOLIN------------- 16 I CEFEPIME-------------- <=1 S CEFTAZIDIME----------- <=1 S CEFTRIAXONE----------- <=1 S CEFUROXIME------------ 8 S CIPROFLOXACIN---------<=0.25 S GENTAMICIN------------ <=1 S IMIPENEM-------------- <=1 S MEROPENEM-------------<=0.25 S NITROFURANTOIN-------- <=16 S PIPERACILLIN/TAZO----- <=4 S TOBRAMYCIN------------ <=1 S TRIMETHOPRIM/SULFA---- <=1 S IMAGING: [**2167-6-2**] CT C-SPINE W/O CONTRAST: No evidence of acute fracture or dislocation. [**2167-6-2**] CT HEAD W/O CONTRAST: Multiple hemorrhages in the cerebral hemispheres, with questionable intraventricular v. subepndymal extension. [**2167-6-2**] CHEST (PA & LAT): 1) No acute cardiopulmonary process. 2) Elevation of the left hemidiaphragm. Correlation with old films is recommended to document stability. [**2167-6-2**] Cardiology ECG: Sinus rhythm. Findings are within normal limits. Compared to the previous tracing of [**2166-6-3**] no significant diagnostic change. Intervals Axes Rate PR QRS QT/QTc P QRS T 78 166 80 396/429 59 45 67 [**2167-6-3**] Neurophysiology EEG: Largely normal EEG for drowsiness. There were no areas of prominent focal slowing, and there were no epileptiform features. [**2167-6-3**] Cardiology ECHO: There is 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 mildly depressed. Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets (3) are mildly thickened. There is no aortic valve stenosis. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Physiologic mitral regurgitation is seen (within normal limits). There is no pericardial effusion. No LV thrombus visualized (cannot exclude). No vegetation seen (cannot definitively exclude). [**2167-6-4**] MRI AND MRA OF THE BRAIN: Multiple T1 bright lesions in the cerebrum, vermis, possibly an intraventicular lesion, and a scalp lesion. [**2167-6-4**] Radiology MR HEAD W & W/O CONTRAST: There are multiple bilateral hemorrhagic lesions within the cerebral hemispheres as previously demonstrated on CT and MRI. These lesions are markedly T1 hyperintense before contrast administration, making it difficult to assess if there is any enhancement, as these lesions appear similar on the pre- and post- contrast images. No other enhancing lesions are visualized on the post- contrast images that were not already T1 hyperintense on the pre- contrast images. There is no evidence of intraventricular extension of lesions, as was questioned on the prior CT. Gradient echo sequences do demonstrate many other smaller punctate areas of susceptibility artifact concerning for smaller lesions which do not enhance demonstrably on the gadolinium sequences. In addition to the larger lesions previously described on prior studies, there are many smaller lesions which appear to involve the cerebellar vermis on the right. The diffusion-weighted images demonstrate no restriction outside of the previously described lesions to suggest acute infarction. Surgical hardware in the posterior elements of the upper cervical spine obscures evaluation of the cervical cord and marrow of the upper cervical spine. [**2167-6-7**] CHEST (PORTABLE AP): IMPRESSION: Subsegmental atelectasis, left base. Brief Hospital Course: 51 yo with h.o HTN, hyperlipidemia, anxiety, and alcoholism who is sent in from his PCP after being brought there by his father for confusion, head trauma, and gait problems. His exam is significant for disorientation, inattention, frontal dysfunction, possible eye movement abnormalities (denies diplopia, but holds one eye shut constantly. He also has possible upgoing toes and incoordination L>R. NEURO: Patient was admitted to the ICU for close neuro monitoring. CT C-spine was negative for fracture and patient was clinically cleared in the ED. MRI/A of the head with and without gado showed numerous T1 bright lesions involving both frontal, parietal, and right temporal, and left occipital regions, as well as the vermis on the right, normal intracranial vessels and no arteriovenous malformations. Patient was loaded on Dilantin and maintained on maintenance to achieve a therapeutic level of Dilantin between [**10-10**]. EEG showed irregular heart rate, mostly sleepy, no focal/epileptiform features. Paient was called out to the floor on [**6-4**], screened by physical therapy and then discharged to rehab. The cause for his presentation is not clear as patient lives alone and cannot recall the events surrounding his presentation. He clearly had external head trauma and either fell multiple times or was perhaps assaulted. Blood cultures and echocardiogram were performed to exclude endocarditis and a possible etiology of septic emboli. Torso CT was also performed to exclude a primary malignancy and etiology of metastatic lesions that bled in the brain. It was thought most likely etiology of intracranial hemorrhages were from trauma. With regards to patient's confusion possibilities included seizures causing post-event confusion, infection, EtOH withdrawal, or Wernicke's encephalopathy. It was thought to be most consistent with the latter given the associated findings of confabulation, gait problems and ophthalmoplegia that improved with IV thiamine and folate repletion. Patient will follow-up in [**Hospital 4038**] Clinic as an outpatient and have a repeat MRI brain with contrast at that time to assess for interval change. CV: Surface echocardiogram was negative for apical hypokinesis or low EF, ASD/PFO, clot or valvular vegetations. Continued Lisinopril, Lovastatin and Zetia. Resumed Lisinopril and Hydrochlorothiazide. Held Atenolol which can be resumed as tolerated as an outpatient. Continued Lovastatin and Zetia. PULM: Continued Fluticasone-Salmeterol INH. GI: Heart healthy diet. PPI. END: Multivitamin, thiamine, folate. Covered with insulin sliding scale. ID: Ciprofloxacin PPX: Alcohol withdrawal prophylaxis with PRN Ativan for CIWA>10 per protocol every 4 hours. H2B, Tylenol PRN for fevers or pain. Medications on Admission: (unclear compliance, but he is prescribed the following): Lovastatin 40 daily Atenolol 100 daily HCTZ 25 daily Lisinopril 5 daily Zetia 10 daily Advair 100-50 daily Neurontin 300 [**Hospital1 **] Valium 2 prn Ultram 50 prn Discharge Medications: 1. Lovastatin 20 mg Tablet Sig: Two (2) Tablet PO daily (). 2. Hydrochlorothiazide 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Ezetimibe 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Fluticasone-Salmeterol 100-50 mcg/Dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). 5. Lisinopril 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Hexavitamin Tablet Sig: One (1) Cap PO DAILY (Daily). 7. Famotidine 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 8. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 9. Phenytoin Sodium Extended 100 mg Capsule Sig: [**12-23**] Capsules PO three times a day for 1 weeks: Take 1 cap (100mg) QAM and QNOON. Take 2 caps (200mg) QPM. Start [**6-10**]. Discontinue on [**6-19**]. 10. Phenytoin Sodium Extended 100 mg Capsule Sig: One (1) Capsule PO three times a day for 1 weeks: Start on [**6-19**]. Discontinue on [**6-26**]. 11. Phenytoin Sodium Extended 100 mg Capsule Sig: One (1) Capsule PO twice a day: Starting [**6-26**]. Discontinue [**7-3**]. 12. Phenytoin Sodium Extended 100 mg Capsule Sig: One (1) Capsule PO once a day: Start [**7-3**]. Discontinue on [**7-10**]. 13. Ciprofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours) for 4 days: Dc on [**6-14**]. 14. Folic Acid 5 mg/mL Solution Sig: One (1) mg Injection DAILY (Daily). 15. Thiamine HCl 100 mg/mL Solution Sig: One Hundred (100) mg Injection DAILY (Daily). Discharge Disposition: Extended Care Facility: [**First Name4 (NamePattern1) 3504**] [**Last Name (NamePattern1) **] Rehabilitation & Nursing Center - [**Location (un) 538**] Discharge Diagnosis: primary diagnosis: Hemorrhagic brain lesions bilaterally E. coli urinary tract infection secondary diagnosis: Hypertension Hyperlipidemia Anxiety Alcoholism h/o MVA with possible TBI Discharge Condition: Awake alert oriented only to self. Speech is clear but confabulates when he does not know the answer to questions. Incomplete adduction of left eye and dysconjugate gaze. Discharge Instructions: You have bled into your brain. You will need to follow-up with a stroke neurologist. You will need a repeat MRI brain with contrast in month's time. Please use an eye patch while awake alternating eyes every 4 hours to help with your diplopia. Please take medications as prescribed and keep your follow-up appointments. Do not take motrin or aspirin. Followup Instructions: Neurologist: [**First Name8 (NamePattern2) **] [**Name8 (MD) 162**], MD Phone: [**Telephone/Fax (1) 2574**] Date/Time: [**2167-8-18**] 9:00am MRI with contrast: Friday [**2167-7-10**] 2:25pm Phone: [**Telephone/Fax (1) 327**] Location: [**Hospital Ward Name 23**] [**Location (un) 861**] [**First Name8 (NamePattern2) **] [**Name8 (MD) 162**] MD [**MD Number(2) 2575**] Completed by:[**2167-6-10**] ICD9 Codes: 5990, 4019, 2724
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Medical Text: Admission Date: [**2160-11-12**] Discharge Date: [**2160-11-16**] Date of Birth: [**2081-5-5**] Sex: M Service: NEUROLOGY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 8747**] Chief Complaint: Slurred speech Major Surgical or Invasive Procedure: None History of Present Illness: 79yo RH M h/o DM2, hyperlipidemia who went to bed in USOH neurologically normal and awoke so at 6:30am and went to the bathroom. he was standing at the sink when he "lost coordination and lost balance" and he slumped to the ground, feeling woozy. He denied weakness, vertigo or light-headedness at this time and pulled himself up, walked downstairs, and told his wife what happened. His speech was clear and without errors at this time. He did not have a headache. He complained, though, of right hand numbness and EMS was called. By the time of their arrival, he was neurologically normal. However, at 9:50am, he became acutely dysarthric and was seen by neurology at the OSH, with his NIHSS of 4, presumably due to a right facial droop, which is still present. CT revealed no bleed and the patient was given tPA at 11:40am. He is transferred here for post-tPA care. He denies blurry vision, diplopia, problems with understanding or communicating language aside from dysarthria. No hoarseness. No headache. No weakness or numbness in his limbs. No incoordination or trouble walking. Past Medical History: DM2 Hyperlipidemia Glaucoma s/p b/l knee replacement BPH with recent UTI/sepsis L rotator cuff injury (limits pronation/supination) Social History: SH: lives at home with his wife, independent with ADLs. Retired insurance worker. No etoh, drugs. Quit smoking 35yrs ago. Family History: FH: negative for HTN, strokes, DM Physical Exam: 98.4 96 150/88 12 99% Gen lying in bed in NAD HEENT Neck supple CV rrr pulm ctab Abd soft nt/nd +BS Ext no edema NEURO NIH SS: 1a. Level of Consciousness: 0 1b. LOC questions: 0 1c. LOC commands: 0 2. Best gaze: 0 3. Visual: 0 4. Facial palsy: 2, right lower face 5a. Motor arm, left: 0 5b. Motor arm, right: 0 6a. Motor leg, left: 0 6b. Motor leg, right: 0 7. Limb ataxia: 0 8. Sensory: 0 9. Best language: 0 10. Dysarthria: 2 11. Extinction and inattention: 0 MS: awake and alert, fully oriented. Recites [**Doctor Last Name 1841**] backwards. Speech dysarthric, esp for labials but also somewhat for dentals, linguals and guttarals. Otherwise, speech is fluent with intact comprehension, [**Location (un) 1131**] and naming. No neglect to cookie jar. No apraxia. CN VFF without extinction. Acuity normal. Pupils 4->2 b/l. EOM full no diplopia or nystagmus, in all directions. Facial sensation intact to LT, PP. Upper facial strength full, lower face droops on attempted smile on the right, the right NLF is decreased and the cheek puffs out on attempted closure. Hearing intact b/l. Palate rises symmetrically. Shrug [**6-13**]. Tongue midline. Motor: normal bulk and tone throughout. No pronator drift (L arm does not suppinate fully due to rotator cuff injury) D B T WE FE FF FAbd IP Q H DF PF TE TF Sensory: intact to LT, PP, JPS, vibration throughout, no extinction. Coord: FTN, HTS intact b/l. RAMs equal and rhythmic. Reflexes: 2+ throughout, toes down b/l Gait: deferred Brief Hospital Course: The patient was transferred here after receiving tPA and admitted to the ICU for post-tPA care. He sustained no complications from tPA and MRI/A one day after receiving it showed a left corona radiata stroke. He was transferred to the floor and started on aggrenox. He should have fasting lipid panel and hemoglobin A1c drawn by his primary care physician, [**Name10 (NameIs) **] minimize stroke risk factors, as well as for blood pressure control. Carotid U/S was normal. Echo showed no source of emboulus, PFO or ASD. He will be seen in neurology stroke clinic for follow-up. At discharge, his speech had improved and he only had a mild drift of the right arm. He had good strength in the legs. Medications on Admission: Glipizide 5mg po BID Lipitor 40mg po daily Discharge Medications: 1. Atorvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 2. Dipyridamole-Aspirin 200-25 mg Cap, Multiphasic Release 12 HR Sig: One (1) Cap PO BID (2 times a day). Disp:*60 Cap(s)* Refills:*2* 3. Outpatient Physical Therapy Home safety evaluation. Gait training. Discharge Disposition: Home With Service Facility: [**Location (un) 86**] VNA Discharge Diagnosis: Left corona radiata stroke Discharge Condition: Improved Discharge Instructions: Please continue to take all medications as prescribed. Return to ER with any new neurologic symptoms Followup Instructions: Please call ([**Telephone/Fax (1) 7394**], Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], to schedule an outpatient neurology appointment. Completed by:[**2160-11-16**] ICD9 Codes: 2724
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Medical Text: Admission Date: [**2146-7-21**] Discharge Date: [**2146-7-26**] Date of Birth: [**2071-5-3**] Sex: M Service: CARDIOTHORACIC Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 1505**] Chief Complaint: severe aortic stenosis Major Surgical or Invasive Procedure: redo sternotomy/AVR(#23mm St.[**Male First Name (un) 923**] porcine) on [**2146-7-22**] History of Present Illness: 76yo well developed male with history of Parkinson's disease seeking deep brain stimulator device. Elective procedure on hold due to severe aortic stenosis elevating risk. Past medical history of CAD s/pCABG x 3 ([**2137**]), hyperlipidedmia. Patient admits to noticing increasing fatigue over the last year, now requiring daily naps. Reports lightheadedness when getting out of bed in the morning, and dizziness after 2-3 minutes of pulling weeds. He can climb a flight of stairs but must pace himself, ambulates 2 blocks before needing to stop due to shortness of breath. He denies chest pain or syncope. Echocardiogram reveals aortic valve area 0.8cm2, peak gradient 66mmhg, EF>60%. NYHA Class: II Past Medical History: -aortic stenosis -CAD, s/p CABG x 3 ([**2137**]) -hyperlipidemia -sick sinus syndrome -Parkinson's (rt hand tremors, RLE weakness, speech hesitancy) -[**Year (4 digits) 499**] Ca s/p [**Year (4 digits) 499**] resection - exlap for twisted bowel -vein ligation -vertebral fracture T5-6-7 secondary to fall, s/p fusion -right arm fracture -tonsillectomy -left ankle fracture -varicella zoster rt torso [**6-2**] Previous Cardiac Surgery: [**2137**] CAGGx3- LIMA-LAD, SV-PDA,SV-OM1 Social History: Retired to [**State 1727**]. Supportive friends. Usually walks the neighbors labrador several times a week, none recent. contact: [**Name (NI) **] [**Name (NI) 91288**] (brother) [**Telephone/Fax (1) 91289**] Family History: Father deceased age 70's, stomach Ca. Mother deceased age [**Age over 90 **], CAD/CVA. Two brothers deceased, [**Name2 (NI) 499**] Ca. Brother 82yo alive. Widowed, 3 adopted children. Physical Exam: Physical Exam on Admission Pulse:68 Resp:14 O2 sat:96% on RA B/P Right:128/56 Left: General:well appearing in NAD Skin: Dry [x] intact [x] HEENT: PERRLA [x] EOMI [x] Neck: Supple [x] Full ROM [x] Chest: Lungs clear bilaterally [x] Heart: RRR [x] Irregular [] Murmur [x] grade _4/6_____ Abdomen: Soft [x] non-distended [x] non-tender [x] +BS [x] Extremities: Warm [x], well-perfused [x] Edema none Varicosities: None [x] Neuro: Grossly intact [x] Pulses: Femoral Right: cath site without hematoma Left:2+ DP Right: 1+ Left:1+ PT [**Name (NI) 167**]: 1+ Left:1+ Radial Right:2+ Left:2+ Carotid Bruit Right: radiating murmur Left: radiating murmur Discharge Exam: VS 99.1 73 106/54 18 97%-RA Gen: NAD Neuro: A&O x3, MAE-nonfocal exam CV: RRR no murmur. Sternum stable-incision CDI Pulm: clear-slightly diminished in bases bilat Abdm: soft, NT/ND/+BS Ext: warm, well perfused. trace pedal edema bilat Pertinent Results: Admission labs: [**2146-7-21**] 08:34PM URINE BLOOD-NEG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-7.5 LEUK-NEG [**2146-7-21**] 08:53PM PT-11.4 PTT-31.9 INR(PT)-1.1 [**2146-7-21**] 08:53PM PLT COUNT-245 [**2146-7-21**] 08:53PM WBC-7.5 RBC-4.33* HGB-14.6 HCT-42.7 MCV-99* MCH-33.8* MCHC-34.3 RDW-12.9 [**2146-7-21**] 08:53PM ALBUMIN-4.5 [**2146-7-21**] 08:53PM proBNP-303 [**2146-7-21**] 08:53PM ALT(SGPT)-6 AST(SGOT)-25 CK(CPK)-141 ALK PHOS-64 TOT BILI-0.9 [**2146-7-21**] 08:53PM GLUCOSE-124* UREA N-13 CREAT-0.9 SODIUM-138 POTASSIUM-3.7 CHLORIDE-107 TOTAL CO2-23 ANION GAP-12 Discharge labs: [**2146-7-26**] 05:55AM BLOOD WBC-11.0 RBC-2.87* Hgb-9.1* Hct-27.8* MCV-97 MCH-31.7 MCHC-32.7 RDW-14.2 Plt Ct-196 [**2146-7-26**] 05:55AM BLOOD Plt Ct-196 [**2146-7-24**] 02:32AM BLOOD PT-13.6* PTT-30.2 INR(PT)-1.3* [**2146-7-26**] 05:55AM BLOOD Glucose-115* UreaN-19 Creat-0.8 Na-135 K-3.5 Cl-102 HCO3-26 AnGap-11 [**2146-7-26**] 05:55AM BLOOD Mg-2.0 [**Hospital1 18**] ECHOCARDIOGRAPHY REPORT Echocardiographic Measurements Results Measurements Normal Range Left Ventricle - Ejection Fraction: >= 55% >= 55% Left Ventricle - Stroke Volume: 99 ml/beat Aorta - Annulus: 2.3 cm <= 3.0 cm Aorta - Sinus Level: 3.2 cm <= 3.6 cm Aorta - Sinotubular Ridge: 2.8 cm <= 3.0 cm Aorta - Ascending: 3.4 cm <= 3.4 cm Aorta - Descending Thoracic: 2.5 cm <= 2.5 cm Aortic Valve - Peak Velocity: *3.5 m/sec <= 2.0 m/sec Aortic Valve - Peak Gradient: *50 mm Hg < 20 mm Hg Aortic Valve - Mean Gradient: 33 mm Hg Aortic Valve - LVOT pk vel: 0.[**Age over 90 **] m/sec Aortic Valve - LVOT VTI: 26 Aortic Valve - LVOT diam: 2.2 cm Aortic Valve - Valve Area: *1.0 cm2 >= 3.0 cm2 Findings RIGHT ATRIUM/INTERATRIAL SEPTUM: No ASD by 2D or color Doppler. LEFT VENTRICLE: Mild symmetric LVH. Moderately dilated LV cavity. Normal regional LV systolic function. Overall normal LVEF (>55%). RIGHT VENTRICLE: Mildly dilated RV cavity. AORTA: Normal ascending aorta diameter. Normal descending aorta diameter. AORTIC VALVE: Severely thickened/deformed aortic valve leaflets. Severe AS (area 0.8-1.0cm2). Mild (1+) AR. MITRAL VALVE: Mildly thickened mitral valve leaflets. Mild to moderate ([**11-22**]+) MR. TRICUSPID VALVE: Normal tricuspid valve leaflets with trivial TR. PULMONIC VALVE/PULMONARY ARTERY: Physiologic (normal) PR. GENERAL COMMENTS: Informed consent was obtained. A TEE was performed in the location listed above. I certify I was present in compliance with HCFA regulations. The patient was under general anesthesia throughout the procedure. No TEE related complications. REGIONAL LEFT VENTRICULAR WALL MOTION: N = Normal, H = Hypokinetic, A = Akinetic, D = Dyskinetic Conclusions PREBYPASS No atrial septal defect is seen by 2D or color Doppler. There is mild symmetric left ventricular hypertrophy. The left ventricular cavity is moderately dilated. Regional left ventricular wall motion is normal. Overall left ventricular systolic function is normal (LVEF>55%). The right ventricular cavity is mildly dilated The aortic valve leaflets are severely thickened/deformed. There is severe aortic valve stenosis (valve area 0.8-1.0cm2). Mild (1+) aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Mild to moderate ([**11-22**]+) mitral regurgitation is seen. POSTBYPASS There is preserved biventricular systolic function. There is a well seated, well functioning bioprosthesis in the aortic position. No perivalvular AI is visualized. The MR is now trace. The study is otherwise unchanged from prebypass. I certify that I was present for this procedure in compliance with HCFA regulations. Electronically signed by [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 168**], MD, Interpreting physician [**Last Name (NamePattern4) **] [**2146-7-22**] 12:38 Radiology Report CHEST (PORTABLE AP) Study Date of [**2146-7-25**] 8:59 AM Final Report: There is no evident pneumothorax. Moderate cardiomegaly is stable. Widened mediastinum is unchanged. Pulmonary edema has improved, now mild. Bibasilar atelectases have markedly improved. If any, there is a small left pleural effusion. Sternal wires are aligned. DR. [**First Name (STitle) 3901**] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 3902**] . [**2146-7-26**] 05:55AM BLOOD WBC-11.0 RBC-2.87* Hgb-9.1* Hct-27.8* MCV-97 MCH-31.7 MCHC-32.7 RDW-14.2 Plt Ct-196 [**2146-7-25**] 06:05AM BLOOD WBC-10.2 RBC-2.89* Hgb-9.3* Hct-27.8* MCV-96 MCH-32.2* MCHC-33.5 RDW-14.2 Plt Ct-138* [**2146-7-26**] 05:55AM BLOOD Glucose-115* UreaN-19 Creat-0.8 Na-135 K-3.5 Cl-102 HCO3-26 AnGap-11 [**2146-7-25**] 06:05AM BLOOD Glucose-100 UreaN-16 Creat-0.7 Na-137 K-3.7 Cl-104 HCO3-26 AnGap-11 [**2146-7-26**] 05:55AM BLOOD Mg-2.0 Brief Hospital Course: On [**2146-7-22**] Mr. [**Known lastname 69467**] was taken to the operating room and underwent a redo sternotomy/Aortic Valve Replacement (#23mm St.[**Male First Name (un) 923**] Porcine) with Dr.[**Last Name (STitle) **]. Please see opeartive report for further details. He tolerated the procedure well and was transferred to the CVICU for invasive monitoring in critical but stable condition. He awoke neurologically intact and extubated on the day of surgery. He weaned off pressor support on POD1. All lines and drains were removed per cardiac surgery protocol withoout complication. No Beta-blocker were initiated due his history of sick sinus syndrome and postoperative accelerated junctional rhythm. Statin/ASA/and diuresis were intiated along with resuming preoperative meds before transfer from ICU on POD#1. Physical Therapy was consulted to work on stregnth and mobility. The remainder of his postop course was essentially uneventful. He continued to progress and was ready for discharge to rehabilitation at Clipper [**Hospital1 **] Health in [**Location (un) 12017**], NH on POD 4. At the time of discharge he was ambulating with assistance, incisions are healing well. All follow up appointments were advised. Medications on Admission: CARBIDOPA-LEVODOPA - 25 mg-100 mg tablet - two Tablet(s) by mouth 4 times per day CITALOPRAM - 20 mg tablet - one Tablet(s) by mouth once at night RAMIPRIL [ALTACE] - (Prescribed by Other Provider) - Dosage uncertain SIMVASTATIN - (Prescribed by Other Provider) - Dosage uncertain TAMSULOSIN - 0.4 mg capsule,extended release 24hr - one Capsule(s) by mouth once per day ZONISAMIDE - 25 mg capsule - 1 Capsule(s) by mouth twice a day ZONISAMIDE - 50 mg capsule - 1 Capsule(s) by mouth twice per day increase to twice a day after 1 week Medications - OTC ASPIRIN - (Prescribed by Other Provider) - Dosage uncertain Discharge Medications: 1. Aspirin EC 81 mg PO DAILY 2. Carbidopa-Levodopa (25-100) 2 TAB PO QID 3. Citalopram 20 mg PO DAILY 4. Simvastatin 40 mg PO DAILY 5. Tamsulosin 0.4 mg PO HS 6. Zonisamide 100 mg PO DAILY 7. Acetaminophen 650 mg PO Q4H:PRN fever, pain 8. Docusate Sodium 100 mg PO BID 9. Milk of Magnesia 30 ml PO HS:PRN constipation 10. Oxycodone-Acetaminophen (5mg-325mg) [**11-22**] TAB PO Q4H:PRN pain 11. Ranitidine 150 mg PO BID Duration: 1 Months 12. Furosemide 40 mg PO DAILY Duration: 10 Days 13. Potassium Chloride 20 mEq PO DAILY Duration: 10 Days Discharge Disposition: Extended Care Facility: clipper [**Hospital1 **] of [**Location (un) **] care and rehabilitation center Discharge Diagnosis: aortic stenosis -redo sternotomy/AVR(#23mm St.[**Male First Name (un) 923**] porcine) on [**2146-7-22**] -CAD, s/p CABG x 3 ([**2137**]) -hyperlipidemia -sick sinus syndrome -Parkinson's (rt hand tremors, RLE weakness, speech hesitancy) -[**Year (4 digits) 499**] Ca s/p [**Year (4 digits) 499**] resection - exlap for twisted bowel -vein ligation -vertebral fracture T5-6-7 secondary to fall, s/p fusion -right arm fracture -tonsillectomy -left ankle fracture -varicella zoster rt torso [**6-2**] Previous Cardiac Surgery?: [**2137**] CAGGx3- LIMA-LAD, SV-PDA,SV-OM1 Discharge Condition: Alert and oriented x3 nonfocal Ambulating, deconditioned Incisional pain managed with Percocet Incisions: Sternal - healing well, no erythema or drainage Leg Right/Left - healing well, no erythema or drainage. Edema -trace bilat LE 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 one month or while taking narcotics. Driving will be discussed at follow up appointment with surgeon. No lifting more than 10 pounds for 10 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** Followup Instructions: You are scheduled for the following appointments Surgeon: [**Last Name (LF) **], [**First Name3 (LF) **] [**Telephone/Fax (1) 1504**] on [**8-17**] @1:30PM Cardiologist: [**Last Name (LF) **], [**Name8 (MD) **] MD ([**Location (un) 34004**] cardiology, ME)on [**9-30**] @11:20AM Please call to schedule appointments with your Primary Care Dr. [**Last Name (STitle) **],[**First Name3 (LF) **] M [**Telephone/Fax (1) 35326**] in [**11-22**] 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:[**2146-7-26**] ICD9 Codes: 4241, 2762, 2724
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Medical Text: Admission Date: [**2117-12-30**] Discharge Date: [**2118-1-4**] Date of Birth: [**2054-1-6**] Sex: F Service: NEUROSURGERY Allergies: Penicillins Attending:[**First Name3 (LF) 2724**] Chief Complaint: Neurogenic claudication Major Surgical or Invasive Procedure: [**2117-12-30**] PLIF L4-5 History of Present Illness: 63-year-old woman who complains of bilateral lower extremity symptoms that are exacerbated by walking. She receives some amelioration with rest. She denies difficulty with bowel or bladder function. Past Medical History: HTN Diabetes Angina Social History: NC Family History: NC Physical Exam: Pre-Op on clinic visit: On examination, her motor strength was [**3-30**] in hip flexion, extension, quadriceps, hamstrings, dorsiflexion, and plantar flexion bilaterally. Her sensory examination was intact with respect to the modality of light touch. Her reflexes were normal and symmetric in the patellar and absent in the Achilles bilaterally. Her pulses were palpable bilaterally. [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] sign was positive on the left and not on the right, but weekly so. Upon Discharge: A&OX3 PERRL EOMs: intact Motor: IP [**Initials (NamePattern5) 12643**] [**Last Name (NamePattern5) **] AT [**Last Name (un) 938**] R 5 5 5 5 4 4 L 5 5 5 5 5 5 Incision: c/d/i- STAPLES Pertinent Results: CT L-SPINE W/O CONTRAST [**2118-1-1**] 1. Postoperative changes in the lumbar spine including posterior fusion of L4-L5. Grade 1 anterolisthesis of L4 on L5. 2. Drain is identified within the postoperative bed. No evidence of immediate hardware complication. LUMBO-SACRAL SPINE (AP & LAT) [**2118-1-1**] Status post L4-L5 stabilization. The stabilization material is in correct position. No evidence of complications. Brief Hospital Course: [**2117-12-30**] s/p PLIF L4-5 with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 548**]. Surgery was uneventful and immediately post-operatively she remained stable. POD 1 [**12-31**] she had an episode of stridor and feeling like she could not breath, desat to 84-86% - she received an albuterol and racemic neb with good effect, CXR was negative. Later that morning she experienced a second episode of stridor and feeling like she could not breath but OS sat was 100% and was transferred to the ICU for observation. Etiology is unclear but appeared to be upper respiratory. SQ Heparin was started on [**2117-12-31**]. On [**1-1**] she was transferred to the floor and her JP drain was discontinued. On [**1-3**], patient complained of pain in her back that radiated down both legs. Her R IP and [**Last Name (un) 938**] were both [**2-28**] on exam. She was started on neurontin and a medrol dose pack to help alleviate pain. PT is working with patient to determine if she needs to go to a rehab facility. On [**1-4**], patient reported that her pain was much more controlled. Her exam is improved with her R IP [**3-30**], but [**Last Name (un) 938**] is [**2-28**]. Patient will be discharged to [**Location (un) 86**] Center for rehabilitation. Medications on Admission: Atenolol Metformin Lisinopril Nortriptyline Hydroxychloroquine [Plaquenil] Discharge Medications: 1. Acetaminophen 325 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for fever > 100.4, pain. 2. Nortriptyline 10 mg Capsule Sig: One (1) Capsule PO HS (at bedtime). 3. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) Inhalation Q6H (every 6 hours) as needed for SOB. 4. Atenolol 50 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO Q3H (every 3 hours) as needed for Pain. 6. Methocarbamol 500 mg Tablet Sig: 1.5 Tablets PO TID (3 times a day). 7. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for constipation. 8. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO Q6H (every 6 hours) as needed for constipation. 9. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection TID (3 times a day). 10. Metformin 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 11. Insulin Regular Human 100 unit/mL Solution Sig: One (1) Injection ASDIR (AS DIRECTED). 12. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for anxiety. 13. Gabapentin 300 mg Capsule Sig: One (1) Capsule PO TID (3 times a day). 14. Methylprednisolone 8 mg Tablet Sig: One (1) Tablet PO breakfast/lunch/dinner () for 1 days. 15. Methylprednisolone 8 mg Tablet Sig: Two (2) Tablet PO bedtime () for 1 days. 16. Methylprednisolone 8 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) for 1 days: start on [**2118-1-5**]. 17. Methylprednisolone 8 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours) for 1 days: start on [**2118-1-6**]. 18. Methylprednisolone 8 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours) for 1 days: start on [**2118-1-7**]. 19. Methylprednisolone 8 mg Tablet Sig: One (1) Tablet PO QD () for 1 days: start on [**2118-1-8**]. 20. Senna 8.6 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 21. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO TID (3 times a day). 22. Magnesium Citrate 1.745 g/30mL Solution Sig: Three Hundred (300) ML PO ONCE (Once) as needed for constipation. Discharge Disposition: Extended Care Facility: [**Location (un) 86**] Center - [**Location (un) 2312**] Discharge Diagnosis: Lumbar Spondylolisthesis 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: DISCHARGE INSTRUCTIONS FOR SPINE CASES ?????? Do not smoke ?????? Keep wound clean / No tub baths or pools until seen in follow up/ begin daily showers [**2118-1-3**] ?????? No pulling up, lifting> 10 lbs., excessive bending or twisting for two weeks. ?????? Limit your use of stairs to 2-3 times per day ?????? Have a family member check your incision daily for signs of infection ?????? Take pain medication as instructed; you may find it best if taken in the a.m. when you wake if you experience muscle stiffness and before bed for sleeping discomfort ?????? Do not take any anti-inflammatory medications such as Motrin, Advil, aspirin, Ibuprofen etc. for 3 months. ?????? Increase your intake of fluids and fiber as pain medicine (narcotics) can cause constipation ?????? 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: ?????? Pain that is continually increasing or not relieved by pain medicine ?????? Any weakness, numbness, tingling in your extremities ?????? Any signs of infection at the wound site: redness, swelling, tenderness, drainage ?????? Fever greater than or equal to 101?????? F ?????? Any change in your bowel or bladder habits Followup Instructions: PLEASE RETURN TO THE OFFICE IN [**6-4**] DAYS FOR REMOVAL OF YOUR STAPLES PLEASE CALL [**Telephone/Fax (1) **] TO SCHEDULE AN APPOINTMENT WITH DR. [**Last Name (STitle) **] TO BE SEEN IN 6 WEEKS. YOU WILL NEED XRAYS PRIOR TO YOUR APPOINTMENT Completed by:[**2118-1-4**] ICD9 Codes: 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6598 }
Medical Text: Admission Date: [**2106-6-26**] Discharge Date: [**2106-7-11**] Date of Birth: [**2039-6-30**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 905**] Chief Complaint: Altered mental status Major Surgical or Invasive Procedure: Ventricular peritoneal shunt placement [**2106-6-28**] History of Present Illness: Pt is a 66 yo male w/ PMHx sig for who was recently admitted to [**Hospital1 18**] from [**5-18**] - [**6-9**] for hospitalization related to a non-aneurysmal SAH with complicated hospital course now readmitted for altered mental status and CT scan from [**6-24**] that showed marked hydrocephalus. The patient initially presented to [**Hospital1 18**] on [**5-18**] for altered mental status and gait difficulties. CTA of the end showed SAH in the basilar cisterns, with no evidence of aneurysm by CT and conventional angiogram. The patient's initial CT scan from [**5-18**] showed evidence of hydrocephalus that resolved on the following CT from [**5-19**]. The patients hospital course was complicated respiratory distress requiring intubation, pneumonia, and fluctuating mental status. Neurology saw the patient and felt that b/l SDH could be causing the impaired mental status. The patient then went for b/l frontal burr holes. Eventually he was transferred to step down and eventually to a rehab unit. At rehab, the patient continued to have difficulty with attention and orientation. He had a head CT on [**6-24**] that showed marked hydrocephalus. As a result, he was transferred back to [**Hospital1 18**] for planned VP shunt. Past Medical History: DIABETES MELLITUS [**2053**] COLONIC POLYPS [**2099**] CORONARY ARTERY DISEASE [**2093**] HYPERTENSION UMBILICAL HERNIA ELEVATED PSA [**12/2103**] Social History: He lives alone and has sister who lives in [**Name (NI) 108**]. Family History: 3 brothers died of MIs, father died of MI, no history of aneurysms. Physical Exam: Vitals: T 98.1; BP 137/76; P 89; RR 18; O2 sat 97% RA General: lying in bed NAD HEENT: NCAT, moist mucous membranes Neck: supple Pulmonary: CTA but shallow breaths Cardiac: regular rate and rhythm, with no m/r/g Abdomen: soft, nontender, non distended, normal bowel sounds Extremities: no c/c/e. Neurological Exam: Mental status: Lethargic but opens eyes to stimulation. States name. Shows thumb, raises arms. Year - [**2103**], month - [**Month (only) **] hospital - [**Hospital1 18**]. Fluent speech with no paraphasic or phonemic errors. Drifts off without repeated stimulation. Cranial Nerves: I: Not tested II: PERRL, 4-->2mm with light. III, IV, VI: EOMI. V, VII: facial sensation intact, facial strength symm. IX, X: Palatal elevation symmetrical. [**Doctor First Name 81**]: SCM [**5-5**] XII: Tongue midline without fasciculations. Motor/[**Last Name (un) **]: Normal bulk. Normal tone. Does not comply with formal strength testing but moves arms purposefully and withdraws in all four extremities to painful stimuli. Sensation: intact to pinprick, light touch, vibration, and position sense. Does not extinguish to double simultaneous stimulation Reflexes: Bic T Br Pa Ac Right 2 2 2 0 0 Left 2 2 2 0 0 Toes downgoing bilaterally. Pertinent Results: CT HEAD W/O CONTRAST [**2106-6-28**] 1. Interval right frontal ventriculostomy catheter with persistent unchanged moderately severe hydrocephalus. 2. Minimally larger right frontal subdural collection measuring up to 10 mm compared to prior 9 mm. Unchanged left frontal subdural collection. BILAT LOWER EXT VEINS [**2106-6-29**] No evidence of deep vein thrombosis in either leg NECK,SOFT TISSUE US [**2106-6-26**] Small hypoechoic nodules as described above within the right and left lobes of thyroid without aggressive features. No definitive mass seen in the midline region of the neck, underlying region of palpable concern. If clinical concern persists, recommend CT of the neck for further evaluation. Series of CT HEAD w/o contrast: [**7-2**] IMPRESSION: 1. Increased hypodense bilateral frontal subdural collections, more prominent on the right with new small amount of blood layering along the right frontal convexity. These findings could be related to marked decrease in ventricular size and re-expansion of bilateral subdural spaces. Close followup is recommended. 2. Right frontal ventriculostomy catheter in the right lateral ventricle is unchanged . [**7-6**] IMPRESSION: 1. Marked interval increase in ventriculomegaly compared to [**7-2**], with unchanged configuration of the VP shunt catheter in the right lateral ventricle. 2. Stable bilateral subdural collection, without evidence of new bleeding. [**7-7**] IMPRESSION: 1. Persistent ventriculomegaly with right frontal VP shunt in unchanged configuration, compared to [**7-6**], but overall worsened compared to [**7-2**]. Some narrowing of the suprasellar cistern due to enlargement of the third ventricle is also unchanged. 2. Stable bilateral subdural collections. 3. No new intracranial hemorrhage. [**7-9**] IMPRESSION: 1. No interval change since yesterday's exam, with persistent ventriculomegaly and stable bilateral subdural collections. 2. Unchanged scattered mastoid air cell opacification. CT CHEST [**7-6**]: Slightly suboptimal bolus timing. Bilateral small segmental PE, non occlusive, predominantly in the left and right lower lobe and in the right upper lobe. Mild right pleural effusion, bilateral atelectasis. No evidence of right heart strain. No other lung parenchymal changes. Brief Hospital Course: 67M s/p nonaneurysmal SAH and external hydrocephalus presented from rehab with altered mental status. Outpatient head CT showed an increase in hydrocephalus and the patient was admitted to the neurosurgical service for VP shunt placement. VP shunt was placed without complication on [**6-28**]. Patient was transferred to the MICU on HD#4 for respiratory distress due to aspiration pneumonitis. The patient was stable for transfer to the medical floor on HD#6. Additional hospital course was complicated by aspiration pneumonia treated with broad-spectrum antibiotics. Nasogastric tube feeding was initiated. Frequent adjustments to the VP shunt were made by the neurosurgery team. Heparin IV was started to treat pulmonary emboli diagnosed on [**7-6**] after discussing the risks and benefits of anticoagulation with the neurosurgery team. On [**7-9**] a meeting was held with the primary medical team, palliative care team (Dr. [**First Name (STitle) 9305**] [**Name (STitle) 4261**] and [**First Name4 (NamePattern1) 501**] [**Last Name (NamePattern1) 23636**], NP), the patient's sister (and healthcare proxy) and the patient's brother-in-law. We discussed Mr. [**Known lastname 23637**] strong religious beliefs and advanced directives about end-of-life care. These preferences were reinforced via communication with his primary care physician who had spoken openly with the patient about his beliefs on a prior occasion. Despite an unclear prognosis, the patient's sister stated clearly that Mr. [**Known lastname **] would not favor having a gastrostomy tube placed for a more permanent means of delivering nutrition, nor would he favor transfer to a rehabilitation facility. His family stated unequivocally that Mr. [**Known lastname 23637**] preference would be a comfort-based approach to his care. Comfort measures only were instituted that day and he was transferred to inpatient hospice on [**7-10**]. He passed away at 12:24 AM on [**2106-7-11**]. Medications on Admission: Keppra 500 mg [**Hospital1 **] Colace 200 mg [**Hospital1 **] Amantadine HCL 50 mg q day Glimepiride 2 mg Metoclopramide 5 mg tid Metformin 500 mg q 8 Lisinopril 10 mg daily Lactulose 30 ml [**Hospital1 **] Atenolol 25 mg daily MVI Trazadone 25 mg qhs Omeprazole 40 mg qhs Insulin Glargine 44 units qhs Folate Lipitor 80 mg q day Insulin Regular Heparin 5000 sc tid Ipatropium Albuterol Discharge Medications: none. Discharge Disposition: Expired Discharge Diagnosis: External Hydrocephalus Hyperkalemia Resp alkalosis Hyperglycemia Acute Gastritis with hematemesis Tachypnea Submandibular mass Chemical pneumonitis from aspiration Hypocarbia Acute renal failure Dehydration Hypertension Leukocytosis Pulmonary emboli Subdural fluid collections Discharge Condition: N/A Discharge Instructions: N/A Followup Instructions: N/A [**Name6 (MD) 251**] [**Name8 (MD) **] MD [**MD Number(1) 910**] Completed by:[**2106-7-14**] ICD9 Codes: 5070, 5849, 4019, 2859, 2767
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6599 }
Medical Text: Admission Date: [**2105-1-26**] Discharge Date: [**2105-2-4**] Date of Birth: [**2047-2-3**] Sex: F Service: MEDICINE Allergies: Ambien / Percocet Attending:[**First Name3 (LF) 134**] Chief Complaint: admitted for pre-op cath Major Surgical or Invasive Procedure: Cardiac Catheterization History of Present Illness: 57 y/o F w/CAD s/p CABG [**2098**] (at [**Hospital1 112**], LIMA->LAD, SVG->RCA, SVG->OM3), CHF [**1-28**] diastolic dysfxn w/EF 50%, and aortic stenosis, admitted today for pre-op cath, prior to possible redo CABG and possible AVR. She was noted to have aortic stenosis on a TTE from an OSH in [**7-30**], with a valve area 1.0 cm2, peak gradient 59 mm Hg, 1+ MR, and mod pulm htn. Her most recent adm to the [**Hospital1 **] was [**8-30**], when she presented w/resting CP. EKG at that time demonstrated old lat TWI. She underwent cath which revealed patent LIMA->LAD, 80% mid LAD, 80% OM1, and 100% OM3 occlusions. Her EF was noted to be 55%. She had a PTCA of OM1, c/b dissection with resulting overlying cypher stents placed. Since that intervention, she has noted no improvement in her anginal symptoms, and has been having 3-6 episodes of angina daily both at rest and with exertion (episodes resolve w/nitro spray). She also c/o orthopnea and increasing LE edema, but no PND. Prior to her cath today, she became hypotensive in the holding area (72/41, pulse 61). She received 2 L NS, 1 mg atropine, with a pressure that responded to 108/52. She was also somewhat hypotensive during her cath, systolics 80s. Today, she underwent a cath which revealed patent LIMA->LAD, totally occluded RCA/SVGs, 3+MR, posterobasal/inferior akinesis, and EF 40%. Her CO was 6.3, CI 3.2, PA 44/20, wedge 23, and RA mean 30. Aortic valve area 1.1 cm2, peak gradient 40 mm Hg (mean 28 mm Hg). She also had posterobasal and inferior akinesis on left ventriculography. Past Medical History: 1. CAD 2. Mitral regurg 3. Aortic stenosis 4. rheumatoid arthritis 5. osteoarthritis 6. fibromyalgia 7. hypothyroidism 8. htn 9. hypercholesterolemia 10. depression 11. iron def. anemia 12. s/p appy 13. s/p TAH Social History: single, has daughter, denies EtOH or tobacco Family History: Mother had CABG at age 48, died of CAD at age 68 Father had DM, CAD, died of MI Physical Exam: T: 97.2 P: 67 BP: 127/53 RR: 12 O2 sat: 97% Gen: alert & oriented anxious female, in NAD HEENT: NCAT. no conjunct. pallor. MMM. Lungs: CTA bilaterally CV: RRR, III/VI mid-peaking systolic murmur heard throughout, radiating to carotids Abd: obese, nontender, nondistended. normoactive bowel sounds. Ext: no edema. 1+ dorsalis pedis pulses bilaterally. Pertinent Results: Admit ECG: NSR, q waves in II, III, avF, and TWI in V4-6. Cardiac Cath: COMMENTS: 1. Selective coronary angiography demonstrated native three vessel coronary artery disease in this right dominant circulation. The LMCA was a short vessel without flow limiting disease. The LAD was totally occluded after the first septal branch. The distal LAD filled via a patent LIMA graft. The LCX had a 50% tubular proximal stenosis. The OM2 had a 70% ostial stenosis and was a large vessel. A patent stent was seen between OM2 and OM3. OM3 was a large vessel without flow limiting disease. The RCA was totally occluded in the proximal vessel with left to right collaterals seen filling the distal vessel. 2. Graft angiography demonstrated a widely patent LIMA-LAD. The SVG-RCA and SVG-OM3 were known to be occluded and not engaged. 3. Resting hemodynamics from right and left heart catheterization revealed markedly elevated right and left sided filling pressures (RVEDP=28mmHg and LVEDP=26mmHg). Cardiac output and index were preserved at 6.3L/min and 3.2L/min/m2. There was a 40mmHg peak gradient and 28mmHg mean gradient across the aortic valve with calculated aortic valve area of 1.1cm2. Moderate pulmonary systolic pressures was seen. 4. Left ventriculography demonstrated posterobasal and inferior akineses with LVEF of 40%. 3+ mitral regurgitation was seen. FINAL DIAGNOSIS: 1. Native three vessel coronary artery disease. Patent LIMA-LAD. 2. Moderate aortic stenosis. 3. Moderate to severe mitral regurgitation. 4. Focal LV systolic dysfunction. 5. Severe biventricular diastolic dysfunction. TTE [**2105-1-29**]: Left ventricular wall thicknesses are normal. The left ventricular cavity size is normal. Overall left ventricular systolic function is mildly depressed (ejection fraction 40-50 percent) secondary to hypokinesis of the inferior free wall. No masses or thrombi are seen in the left ventricle. There is no ventricular septal defect. The aortic valve is bicuspid. There is moderate aortic valve stenosis, with mild aortic regurgitation. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. At least mild mitral regurgitation is seen. There is no pericardial effusion. Compared with the findings of the prior study (tape reviewed) of [**2105-1-27**], the transaortic valvular gradient is somewhat lower; however, moderate aortic stenosis is still present; otherwise no major change is evident (inferior hypokinesis present on prior study). Pertinent lab results: [**2105-1-26**] 01:45PM BLOOD WBC-3.1* RBC-3.70* Hgb-7.9* Hct-25.9* MCV-70* MCH-21.4* MCHC-30.5* RDW-13.8 Plt Ct-215 [**2105-1-26**] 06:43PM BLOOD Hct-27.1* [**2105-1-27**] 05:05AM BLOOD WBC-4.5 RBC-3.85* Hgb-8.1* Hct-27.2* MCV-71* MCH-21.1* MCHC-29.9* RDW-14.2 Plt Ct-231 [**2105-1-28**] 06:02AM BLOOD WBC-5.7 RBC-3.81* Hgb-8.3* Hct-26.8* MCV-70* MCH-21.8* MCHC-31.0 RDW-14.1 Plt Ct-211 [**2105-1-29**] 06:30AM BLOOD WBC-4.9 RBC-4.32 Hgb-9.6* Hct-30.6* MCV-71* MCH-22.3* MCHC-31.4 RDW-15.3 Plt Ct-209 [**2105-1-30**] 06:10AM BLOOD Hct-29.2* [**2105-1-31**] 06:50AM BLOOD Hct-29.7* [**2105-2-1**] 06:40AM BLOOD Hct-30.8* [**2105-2-2**] 07:00AM BLOOD Hct-30.8* [**2105-1-26**] 01:45PM BLOOD Glucose-111* UreaN-17 Creat-0.9 Na-140 K-4.5 Cl-111* HCO3-25 AnGap-9 [**2105-1-26**] 06:43PM BLOOD Glucose-143* UreaN-15 Creat-0.8 Na-141 K-4.4 Cl-111* HCO3-26 AnGap-8 [**2105-1-27**] 05:05AM BLOOD Glucose-107* UreaN-12 Creat-0.8 Na-138 K-4.4 Cl-107 HCO3-24 AnGap-11 [**2105-1-28**] 06:02AM BLOOD Glucose-87 UreaN-15 Creat-0.9 Na-139 K-4.3 Cl-108 HCO3-23 AnGap-12 [**2105-1-29**] 06:30AM BLOOD Glucose-78 UreaN-15 Creat-0.7 Na-141 K-3.9 Cl-104 HCO3-26 AnGap-15 [**2105-1-26**] 01:45PM BLOOD ALT-22 AST-22 AlkPhos-108 TotBili-0.3 [**2105-1-29**] 06:30AM BLOOD Mg-1.7 Cholest-232* [**2105-1-29**] 02:02PM BLOOD %HbA1c-6.4* [**2105-1-28**] 06:02AM BLOOD TSH-1.5 Brief Hospital Course: 1. Cardiac: -coronaries: She was continued on ASA, plavix, statin. She was evaluated by the CT surgery team regarding the possibility of CABG/valve replacement, and they felt she could follow-up with them as an outpatient. It was not felt to be an urgent inpatient matter and f/u was arranged with Dr. [**Last Name (STitle) **]. Throughout her stay, she had numerous episodes of chest pain which she states were the typical chest pain she has at home that wake her up at night. EKGs were done for all of these episodes, and never showed any signs of ischemia. The pain would resolve on its own or with sublingual nitroglycerin. It was unclear whether this pain represented angina or not, however given the lack of EKG changes it seemed unlikely to be angina. -pump: She has an EF of 40%. Because of her AS, she is preload-dependent and so was not aggressively diuresed. Her bp was difficult to control and several medication adjustments were made throughout her admission. She was eventually discharged on lisinopril, toprol, isosorbide mononitrate, and HCTZ. -rhythm: remained in sinus throughout. 2. Hypotension: She was admitted to the CCU for post-cath hypotension, which resolved by the night of admission. This was felt to be most likely related to medications, as the patient was given her meds on a different schedule than her home regimen (she usually only takes her meds at night). 2. Heme: She has a hx of iron-def anemia and was kept on her iron supplementation. She was transfused to a hematocrit of 30 given her CAD. 3. Hypothyroidism: continued on levoxyl. 4. Fibromyalgia/Osteoarthritis: She was continued on her home pain regimen (duragesic, hydrocodone, nambutone). She was also given prn percocet. However, this was attempted to be limited, as the pt often appeared to be overly medicated on narcotics (falling asleep during conversations, etc.) 5. PT: The patient had difficulty ambulating secondary to her chronic back/leg pain. She was evaluated by PT, who felt she was safe to go home w/home PT, which was arranged. Medications on Admission: crestor 10 mg po daily nambutone 500 mg po bid levoxyl 150 mcg po daily imdur 120 mg po daily norvasc 50 mg po tid plavix 75 mg po daily lopid 600 mg po daily toprol XL 100 mg po daily lisinopril 40 mg po daily effexor XR 150 mg po daily hydrocodone 7.5-750 2 tabs q4-6 hrs prn duragesic patch 125 mcg q48hrs trazodone 150-200mg po qhs nitro sublingual prn ASA 325 po daily iron 325 mg po tid Discharge Medications: 1. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 2. Hydrocodone-Acetaminophen 5-500 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 3. Nabumetone 500 mg Tablet Sig: Two (2) Tablet PO QHS (once a day (at bedtime)). 4. Gemfibrozil 600 mg Tablet Sig: One (1) Tablet PO QHS (once a day (at bedtime)). 5. Aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO QHS (once a day (at bedtime)). 6. Levothyroxine Sodium 150 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. Venlafaxine HCl 75 mg Capsule, Sust. Release 24HR Sig: Two (2) Capsule, Sust. Release 24HR PO QHS (once a day (at bedtime)). 8. Clopidogrel Bisulfate 75 mg Tablet Sig: One (1) Tablet PO QHS (once a day (at bedtime)). 9. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO QHS (once a day (at bedtime)). Disp:*30 Tablet(s)* Refills:*2* 10. Trazodone HCl 50 mg Tablet Sig: 1-3 Tablets PO HS (at bedtime) as needed. 11. Ferrous Sulfate 325 (65) mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 12. Lisinopril 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Disp:*60 Tablet(s)* Refills:*2* 13. Fentanyl 100 mcg/hr Patch 72HR Sig: One (1) Patch 48HR Transdermal Q48HRS (). 14. Fentanyl 25 mcg/hr Patch 72HR Sig: One (1) Patch 48HR Transdermal Q48HRS (). 15. Rosuvastatin Calcium 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 16. Metoprolol Succinate 100 mg Tablet Sustained Release 24HR Sig: 1.5 Tablet Sustained Release 24HRs PO DAILY (Daily). Disp:*60 Tablet Sustained Release 24HR(s)* Refills:*2* 17. Isosorbide Mononitrate 60 mg Tablet Sustained Release 24HR Sig: One (1) Tablet Sustained Release 24HR PO DAILY (Daily). Disp:*30 Tablet Sustained Release 24HR(s)* Refills:*2* 18. Hydrochlorothiazide 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* Discharge Disposition: Home With Service Facility: [**Hospital1 1474**] VNA Discharge Diagnosis: Coronary Artery Disease Aortic Stenosis Mitral Regurgitation Discharge Condition: stable Discharge Instructions: Please call your doctor or return to the emergency room for worsening chest pain, chest pain that does not resolve with 5 minutes, shortness of breath, nausea, vomiting, abdominal pain, lightheadedness, or any other concerns. Please take all of your medications as prescribed. If some of your medications are supposed to be taken at intervals during the day, it is important that you take them at those times. Do not just take all of your daily dose at night for medications that are dosed more than once per day. Followup Instructions: Provider: [**Name10 (NameIs) **],[**Last Name (Prefixes) 413**] CARDIAC SURGERY LMOB 2A Where: CARDIAC SURGERY LMOB 2A Date/Time:[**2105-2-5**] 1:00 f/u with your PCP within one week You have anemia, which we discussed. You should talk with your primary care physician about pursuing an upper endoscopy and a colonoscopy. ICD9 Codes: 2449, 4019