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{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6600 }
Medical Text: Admission Date: [**2162-8-17**] Discharge Date: [**2162-8-23**] Date of Birth: [**2092-10-8**] Sex: F Service: MEDICINE Allergies: Penicillins / Sulfa (Sulfonamides) Attending:[**First Name3 (LF) 348**] Chief Complaint: Dyspnea. Major Surgical or Invasive Procedure: Bronchoscopy. History of Present Illness: This is a 70 year old woman with past medical history significant for COPD (0.55 FEV1/FVC 38% of predicted on home O2), status post left upper lobe endobronchial lung reduction, CAD, CHF, PVD status post multiple bypass surgeries, on chronic anticoagulation who presented with worsened dyspnea over the past 4 weeks associated with hoarseness of voice since 2 weeks. On admission, she was noted to have INR 8.1 in her PCP's office. She was also found to have a CXR which showed left lung collapse with tracheal deviation to the left, and was referred to our ED for this, where she received a combivent nebulizer prior to transfer. On presentation to the ED, the patient was complaining of dyspnea and was tachypneic with respiratory rate to 25 with O2 sat 95% on 5L. Otherwise, her systolic blood pressure was in the 110 range and pulse in 80-90 range. Her admission labs were remarkable for WBC of 22.7 and INR of 11.7. In the ED, she received two combivent nebulizers and 10 mg SC vitamin K and was then transferred to the MICU. There, she was given 60 mg prednisone but she refused this citing history of steroid induced psychosis; she is currently on a prednisone taper (20 mg a day currently). She denies any recent chest pain, fever or chills, abdominal pain, nausea or vomiting, headache, dysuria and polyuria. . Since presenting to the MICU, she has undergone emergent rigid bronchoscopy which demonstrated a mass in the left bronchus which has subsequently been shown to be non small cell carcinoma, likely squamous cell. Oncology is setting up a complete outpatient workup for this patient, including Pet CT. She was also seen by ENT for evaluation of hoarseness. She is on aspiration precautions for a paralyzed vocal cord and will follow up with Dr. [**Last Name (STitle) 33748**] as an outpatient. Two nights prior to moving out of the MICU, the patient was found to be in asymptomatic atrial fibrillation with RVR. She was started on an amiodarone drip and converted back to sinus. Then, she had another episode the night prior to transfer and converted on IV amiodarone. She was switched from IV to PO amiodarone on [**8-21**] and has been in sinus rhythm since the night prior to transfer. . At the present time, the patient feels at her baseline. She denies any shortness of breath that is worse than her usual. She denies any pain and states that she is "ready to get out" of the hospital. She denies palpitations and chest pain. Past Medical History: 1) COPD, FEV1 0.55, FEV1/FVC 38% of predicted 2) Status post LUL endobronchial lung reduction surgery [**12/2159**] 3) CAD status post remote MI (no history of cath) 4) CHF, previous EF 35% but most recent echo in [**2160**] with EF 55% 5) Mobile mass in mitral valve, unknown etiology 6) Peripheral vascular disease s/p multiple bypass surgeries 7) Prior history of DVT's 8) History of small bowel obstruction s/p exp. lap. Social History: Lives with husband who is health care proxy. 50 pk year history, quit 5 years ago, rare alcohol use. Family History: Non-contributory. Physical Exam: T 97.9 BP 109/55 P 105 RR 24 O2 94 on 4L Gen: Elderly thin female Caucasian, NAD, somewhat anxious--speaking in full sentences, some accessory muscle use. Eyes: PERRL, EOMi, sclerae anicteric Mouth: MM somewhat dry, no bruising/bleeding Neck: No bruits, supple, no LND Chest: Decreased breath sounds in both fields, no wheezes appreciated Heart: Tachycardic regular distant heart sounds. Abdomen: Flat, NT/ND, hypoactive bowel sounds. Ext: Warm well perfused, weak pulses in feet, nl in hands. Pertinent Results: Admission Labs: ============== [**2162-8-17**] 07:30PM WBC-22.7*# RBC-4.83# HGB-13.4 HCT-39.1 MCV-81 [**2162-8-17**] 07:30PM NEUTS-96.3* BANDS-0 LYMPHS-2.5* MONOS-1.0* EOS-0.1 [**2162-8-17**] 07:30PM PT-87.1* PTT-44.0* INR(PT)-11.7* [**2162-8-17**] 07:30PM TSH-0.47 [**2162-8-17**] 07:30PM ALBUMIN-3.6 [**2162-8-17**] 07:30PM ALT-19 AST-21 LD(LDH)-221 ALK PHOS-83 T BILI-0.2 [**2162-8-17**] 07:30PM GLUCOSE-162* UREA N-15 CREAT-0.7 SODIUM-136 POTASSIUM-4.4 CHLORIDE-96 TOTAL CO2-29 ANION GAP-15 . RADIOLOGY: ========= CXR [**2162-8-17**]- 1. Left lung atelectasis with associated leftward mediastinal shift. CT scan can be performed for further evaluation to assess etiology. 2. Emphysema. . CT [**2162-8-17**]- Nearly complete collapse of the left lung, accelerated over several hours. Heavy secretions throughout left bronchial tree, could be disguising an endobronchial mass. Severe emphysema. Ground glass peribronchial opacities in the right lung, likely infectious, warranting CT. Mediastinal lymphadenopathy, presumably reactive . CT [**2162-8-20**]- 1. Extensive intrathoracic malignancy, left lower lobe primary mass with hilar adenopathy obstructing left upper lobe bronchus and mediastinal extension crossing the midline in both the subcarinal and lower paratracheal stations. 2. Severe emphysema. Endobronchial reduction valves, left upper lobe. Left upper lobe fully collapsed. 3. Embolic occlusion proximal left subclavian artery, not due to tumor invasion. . STUDIES: ======= [**2162-8-18**] Bronchial washing: ATYPICAL. Rare atypical squamous cells. Squamous cells, inflammatory cells and bacteria . PATHOLOGY- SPECIMEN SUBMITTED: LEFT MAIN STEM TUMOR FOR F/S, LEFT MAIN STEM TUMOR (RUSH). [**2162-8-19**] DIAGNOSIS: A). "Left main stem tumor biopsy for frozen": Non-small cell carcinoma, favor squamous cell, focus suspecious for lymphatic vascular invasion. B)."Left main stem tumor (fresh)": Non-small cell carcinoma, favor squamous cell . CXR ([**8-20**]): Left lower lobe has been substantially reexpanded. Left upper lobe remains collapsed and left hilus enlarged. New bronchial stent extends from the carina to just before the anticipated location of the left upper lobe takeoff. Left pleural thickening, unchanged. Leftward mediastinal shift stable. Severe emphysema in the right lung, otherwise clear. . Labs at discharge: Brief Hospital Course: Mrs. [**Known lastname 47011**] is a 69 year old female with a history of COPD on home oxygen (4L NC), status post left upper lobe reduction, CAD, CHF, peripheral vascular disease on chronic anticoagulation who presented with dyspnea secondary to left lung collapse and associated tracheal deviation. On bronchoscopy, the patient had a mass seen with biopsies taken which were consistent with squamous cell lung cancer; a subsequent CT chest confirms extensive intrathroacic malignancy. . #) Left lung collapse/atelectasis: On bronchoscopy, a mass was seen with biopsies taken which were consistent with squamous cell lung cancer. A subsequent CT chest confirms extensive intrathroacic malignancy. The patient's left lung collapse improved with stenting by IP. She has follow-up scheduled with hematology/oncology and is scheduled for outpatient staging PET scan. Oncology will call patient at home with appointments, PET scan A social work consult for new diagnosis was obtained. According to ENT & S&S recs, we will discharge patient home on aspiration precautions with [**Hospital1 **] PPI, regular diet, medications given in purees . #) Coagulalopathy: The patient did have a supratherapeutic INR on admission on coumadin. At that time, her coumadin was held, and her INR improved with vitamin K. Heparin was started for bridge to coumadin prior to discharge, and transitioned to lovenox 50mg [**Hospital1 **] until her INR becomes therapeutic. On day of discharge, INR was 1.6 today, we therefore increased coumadin to 2mg po daily today, and discharged home on lovenox 50mg SC BID (to treat embolic occlusion of left subclavian artery), while waiting for INR to become therapeutic. Pt was aware, and amenable to this plan. She will have home VNA check INR daily and fax results to PCP ([**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], [**Telephone/Fax (1) **], fax [**Telephone/Fax (1) **]). . #) Hematocrit drop: The patient's drop in hematocrit was most likely dilutional. She has no signs or symptoms of active bleeding. Her hematocrit was otherwise stable throughout admission. . #) Atrial fibrillation: Following her first episode of atrial fibrillation, the patient was loaded with amiodarone IV with conversion to normal sinus rhythm. She reverted back to atrial fibrillation subsequently and was restarted on an amiodarone drip. She was transitioned to PO amiodarone on [**8-21**] and will be discharged on amiodarone 400 mg po daily. She will discharged with anticoagulation as above (lovenox bridge to coumadin, f/u with PCP for INR). . # CAD: On beta blocker, statin, ACEi. Will continue these medications. . #) COPD: Prior to admission, the patient was on home O2 4L. Her most recent PFTs demonstrate FEV1/FVC 38%. Therefore, her underlying lung disease could be contributing to her dyspnea. She was begun on prednisone for presumed COPD exacerbation, and will be discharged home with a 3 day taper (2 more days on 20mg then 3days on 10mg po qdaily). . #) Leukocytosis: This is perhaps secondary to steroids and the stress of lung collapse. She is being treated for post-obstructive pneumonia. Initially, she was trated with vancomycin/ceftriaxone and then transitioned to PO levo/flagyl to complete 7 day course. Cultures are all negative at time of discharge, albeit contaminated. WBC was 12 on day of discharge, felt [**12-31**] steroid use. Her antibiotic course was completed on day of discharge. . #) Peripheral vascular disease - Pt was dicharged on aspirin and pentoxyfilline. . #) Depression/anxiety--continued SSRI, PRN ativan for sleep per home regimen. SW consulted for coping with new diagnoses of lung ca. . # FEN: Regular diet with thin liquids and regular solids per Speech & Swallow. The patient should take her pills with purees. . # Code status: Patient states that she does not want to have any shocks or chest compressions. She does not object to intubation, but would not want to be kept alive on ventilator for lengthy period at the discretion of her husband (her healthcare proxy). . # Communication: Comm: [**Name (NI) 4906**], [**Name (NI) 382**] ([**Telephone/Fax (1) 47012**] Medications on Admission: 1) Captopril 12.5 TID 2) Metoprolol 25 [**Hospital1 **] 3) Pentoxyfilline 400 TID 4) Lipitor 40 daily 5) ASA 81 daily 6) Advair 500/50 [**Hospital1 **] 7) Spiriva 1 puff daily 8) Ativan prn qHS 9) Warfarin 3mg qOD,4mg qOD 10) Oxazepam prn 11) Fluoxetine 20 mg daily Discharge Medications: 1. Albuterol Sulfate 0.083 % Solution Sig: One (1) neb Inhalation Q4H (every 4 hours) as needed. 2. Captopril 12.5 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 3. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 4. Pentoxifylline 400 mg Tablet Sustained Release Sig: One (1) Tablet Sustained Release PO TID (3 times a day). 5. Atorvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Aspirin EC 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. 7. Advair Diskus 500-50 mcg/Dose Disk with Device Sig: One (1) inhalation Inhalation twice a day. 8. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) as needed for anxiety. 9. Warfarin 2 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 10. Amiodarone 200 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Disp:*60 Tablet(s)* Refills:*2* 11. Cepacol 2 mg Lozenge Sig: One (1) Lozenge Mucous membrane PRN (as needed) as needed for throat pain. Disp:*50 Lozenge(s)* Refills:*0* 12. Fluoxetine 20 mg Capsule Sig: One (1) Capsule PO DAILY (Daily). 13. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 14. Prednisone 10 mg Tablet Sig: 1-2 Tablets PO once a day for 7 doses: please take 20 mg (two tablets) once daily x 2 days (last day [**8-25**]) then take 10mg (1 tablet) once daily for 3 more days (last day [**8-28**]). . Disp:*8 Tablet(s)* Refills:*0* 15. Warfarin 2 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily): please have INR checked by home VNA daily and sent to your PCP. . Disp:*28 Tablet(s)* Refills:*0* 16. Enoxaparin 60 mg/0.6 mL Syringe Sig: One (1) Subcutaneous Q12H (every 12 hours) for 7 days. Disp:*14 injections* Refills:*0* 17. Outpatient Lab Work please have home VNA draw labs DAILY to check INR and send the results to your PCP [**Last Name (NamePattern4) **]. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] ([**Telephone/Fax (1) 3070**], fax [**Telephone/Fax (1) **]). Discharge Disposition: Home With Service Facility: [**Location (un) 932**] VNA Discharge Diagnosis: Lung cancer, squamous cell COPD CAD Peripheral vascular disease Discharge Condition: Hemodynamically stable and on 4L NC (home regimen) Discharge Instructions: Please take all medications as prescribed. . Please take lovenox injections twice daily until your INR is between [**1-1**] (please ask home VNA draw labs DAILY to check INR and send the results to your PCP [**Last Name (NamePattern4) **]. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] ([**Telephone/Fax (1) 3070**], fax [**Telephone/Fax (1) **]). If your INR is not between [**1-1**] within 7d please call your PCP to obtain refill of lovenox perscription. . Please call your doctor or return to the emergency room should you experience any of the following symptoms: chest pain, increasing shortness of breath, fever or chills, easy bruising, blood in your urine or stools, bleeding gums, increasing hoarseness of voice, or any other concerns. Followup Instructions: The oncologists will call you with a follow up appointment as well as a date/time for your PET scan. Otherwise, please keep these already-scheduled appointments: Provider: [**Name10 (NameIs) 1571**] BREATHING TEST Phone:[**Telephone/Fax (1) 612**] Date/Time:[**2162-9-2**] 1:40 Provider: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], MD Phone:[**Telephone/Fax (1) 612**] Date/Time:[**2162-9-2**] 2:00 Provider: [**Name10 (NameIs) 1570**],[**Name11 (NameIs) 2162**] [**Name12 (NameIs) 1570**] INTEPRETATION BILLING Date/Time:[**2162-9-2**] 2:00 ICD9 Codes: 496, 4280, 5180
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6601 }
Medical Text: Admission Date: [**2191-4-19**] Discharge Date: [**2191-4-21**] Service: [**Doctor Last Name 1181**] HISTORY OF PRESENT ILLNESS: The patient is an 85 year-old male with a history of coronary artery disease and radiation proctitis who presents with bright red blood per rectum on the morning of admission. The patient had a bloody bowel movement in his diaper at his nursing home and needed to be changed four times since that morning. His blood pressure was 110/60 and a heart rate of 70 in the field. The patient was transferred to the [**Hospital1 69**] for further evaluation. In the Emergency Department the patient was given two large bore intravenouses and he was given intravenous fluids. Gastrointestinal bleed scan was attempted and there was no clear evidence of a gastrointestinal bleed. Of note during the bleeding scan the patient's blood pressure dropped to the 70s and 80s and the patient was transferred back to the Emergency Department before the scan could be officially completed. The patient was asymptomatic throughout. PAST MEDICAL HISTORY: 1. Coronary artery disease status post anterior myocardial infarction, status post coronary artery bypass graft in [**2182**], status post percutaneous transluminal coronary angioplasty in [**2186**]. 2. Congestive heart failure with an EF of 25% according to a [**2186**] echocardiogram with mild AS and aortic regurgitation and moderate mitral regurgitation. 3. Prostate cancer status post radiation therapy in [**2183**], complicated by radiation proctitis and bleeding. 4. Dementia secondary to Alzheimers. 5. Anemia. ALLERGIES: Bee stings. MEDICATIONS ON ADMISSION: 1. Atenolol 25 q.d. 2. Sorbitol 30 q.d. 3. Ambien 5 q.d. 4. Hydrocortisone 1% to scalp. SOCIAL HISTORY: The patient is a retired postal clerk. He lives at [**Hospital 100**] Rehab Facility since [**2188**]. He is married with three children. Health care proxy is [**Name (NI) **] [**Name (NI) 7692**]. PHYSICAL EXAMINATION: On examination the patient's temperature is 96.9, pulse 82, blood pressure 126/38 that fell to 88/60 over the course of the day. Respiratory rate 18. Satting 97% on room air. In general, he was an elderly man sitting, awake, alert, but not oriented to person, place or time. Head and neck examination extraocular movements intact. Mucous membranes are moist. Conjunctiva were well perfuse with no cervical lymphadenopathy. Cardiac examination he had a 4 out of 6 systolic ejection murmur and a 2 out of 6 diastolic murmur at the left upper sternal border. His lung examination was limited due to lack of cooperation, but it seemed that he had decreased breath sounds at the bases. Abdomen was soft, nontender, nondistended with normoactive bowel sounds. Extremities had no clubbing, cyanosis or edema. LABORATORY DATA: White blood cell count of 7.5 with a normal differential. Hematocrit 34.0 and platelets 236. His chem 7 showed a sodium of 142, potassium 4.9, chloride 106, bicarb 30, BUN 28, creatinine 1.0, glucose 107. His PTT was 24.8, INR 1.0, urinalysis negative. He had an electrocardiogram that was done that showed Q waves in 2, 3, F and Qs in V1 through V6 with left bundle branch block and PR prolongation. There was no substantial change from previous electrocardiograms. Chest film was performed, which showed no acute cardiopulmonary disease. HOSPITAL COURSE: 1. Gastrointestinal bleed: The patient's gastrointestinal bleed was felt likely due to radiation proctitis since the presentation was less consistent with diverticular bleed or an AVM. The patient was admitted to the Medical Intensive Care Unit for close hemodynamic monitoring and serial hematocrits. The patient's hematocrit did trend down over the course of the day and was given one unit of packed red blood cells over the entire course of his admission with an appropriate bump in his hematocrit and no further bleeding. The patient had a sigmoidoscopy, which showed an ulcer in the rectum, but was limited by poor prep. The patient was kept overnight in the Intensive Care Unit and was transferred out to the floor the following day without complications. The patient denies any further evidence of gastrointestinal bleeding. Follow up flexible sigmoidoscopy showed the ulcer in the rectum, but was otherwise normal and these were biopsied. This will be followed up as an outpatient the differential being benign ulcers versus malignancy. 2. Cardiac: The patient has a history of congestive heart failure, but he tolerated the packed red blood cells and fluid boluses well. His Atenolol was held out of concern for hypotension. There were no ill effects from a congestive heart failure standpoint. The patient remained satting well on room air and he did not have any evidence for congestive heart failure. In addition, the patient has a history of coronary artery disease, however, there was no evidence of ischemia on electrocardiogram. 3. Code: The patient is DNR/DNI. CONDITION ON DISCHARGE: Stable. DISCHARGE STATUS: To [**Hospital 100**] Rehab Facility. DISCHARGE DIAGNOSES: 1. Rectal ulcer. 2. Lower gastrointestinal bleed. 3. Radiation proctitis. DISCHARGE MEDICATIONS: 1. Sorbitol 30 q.d. 2. Ambien 5 q.h.s. 3. Hydrocortisone 1% to scalp. 4. Atenolol 25 q day, which should only be started once the patient's blood pressure has normalized back to his baseline. FOLLOW UP PLANS: The patient should follow up with his primary care physician within one to two weeks. The biopsy will be sent to his primary care physician and further evaluation and treatment can be decided at that time. [**Name6 (MD) 1592**] [**Name8 (MD) 1593**], M.D. [**MD Number(2) 1594**] Dictated By:[**Last Name (NamePattern1) 7693**] MEDQUIST36 D: [**2191-4-21**] 11:05 T: [**2191-4-21**] 11:08 JOB#: [**Job Number 7694**] ICD9 Codes: 5789, 4280, 2859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6602 }
Medical Text: Admission Date: [**2156-12-30**] Discharge Date: [**2157-1-7**] Date of Birth: [**2086-3-10**] Sex: M Service: CARDIOTHORACIC Allergies: Actos Attending:[**First Name3 (LF) 1406**] Chief Complaint: chest pain Major Surgical or Invasive Procedure: coronary artery bypass graft x3- LIMA-LAD, SVG to diagonal, obtuse marginal, PDA History of Present Illness: This is a 70-year-old male who presented with chest pain at rest. He has a stress test which was abnormal. He underwent a cardiac catheterization and this demonstrated 3-vessel coronary artery disease with a totally occluded right coronary artery. He had an echocardiogram performed which showed that he had a left ventricular ejection fraction of 30-40%. There was global left ventricular hypokinesis. It was recommended he undergo coronary bypass grafting and after the risks and benefits were explained to him he agreed to proceed. Past Medical History: diabetes mellitus hypertension chronic kidney disease (Cr 1.5-1.7) h/o inferior myocardial infarction with EF 40% coronary artery disease- stent to cx [**2143**] hyperlipidemia Past Surgical History right carotid endarterectomy Social History: Lives with wife [**Name (NI) 595**] speaking retired college professor tobacco: quit 5 years ago; prior 2 cigarettes/day on and off for 20 years. Family History: non contributory Physical Exam: Pulse: 52 SR Resp: 12 O2 sat: 98%RA B/P Right: Left: 145/54 Height: 5'6" Weight: 252lb General: Skin: Dry [x] intact [x] HEENT: PERRLA [x] EOMI [x] Neck: Supple [x] Full ROM [x] Chest: Lungs clear bilaterally [x] Heart: RRR [x] Irregular [] Murmur Abdomen: Soft [x] non-distended [x] non-tender [x] bowel sounds + [x] obese Extremities: Warm [x], well-perfused [x] Edema Varicosities: None [] 1+edema b/l LEs, small varicosities bilaterally Neuro: Grossly intact x Pulses: Femoral Right: cath site Left: 1+ DP Right: 1+ Left: 2+ PT [**Name (NI) 167**]: Left: not palpable Radial Right: 2+ Left: 2+ Carotid Bruit Right: Left: no bruits Pertinent Results: [**Hospital1 18**] ECHOCARDIOGRAPHY REPORT [**Known lastname 27594**], [**Known firstname **] [**Hospital1 18**] [**Numeric Identifier 27595**] (Complete) Done [**2156-12-30**] at 9:31:09 AM PRELIMINARY PREBYPASS No atrial septal defect is seen by 2D or color Doppler. There is mild symmetric left ventricular hypertrophy. The left ventricular cavity is mildl-moderately dilated. There is mild regional left ventricular systolic dysfunction with mild global hypokinesis with more hypokinesis in the distal anterior and anteroseptal walls.. Right ventricular chamber size and free wall motion are normal. There are simple atheroma in the descending thoracic aorta. The aortic valve leaflets (3) are mildly thickened. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Mild (1+) mitral regurgitation is seen. POSTBYPASS There is marginal improvement in LV systolic function. LVEF ~ 50-55%. RV systolic function remains preserved. The study is otherwise unchanged from prebypass. I certify that I was present for this procedure in compliance with HCFA regulations. Interpretation assigned to [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 168**], MD, Interpreting physician [**2157-1-7**] 05:45AM BLOOD WBC-13.0* RBC-3.75* Hgb-10.0* Hct-30.6* MCV-82 MCH-26.6* MCHC-32.6 RDW-13.8 Plt Ct-561* [**2157-1-7**] 05:45AM BLOOD PT-14.3* INR(PT)-1.2* [**2157-1-6**] 06:05AM BLOOD PT-14.1* INR(PT)-1.2* [**2157-1-6**] 06:05AM BLOOD Glucose-169* UreaN-34* Creat-1.6* Na-140 K-4.2 Cl-99 HCO3-31 AnGap-14 [**2157-1-7**] 05:45AM BLOOD UreaN-43* Creat-1.9* K-4.0 [**2157-1-7**] 05:45AM BLOOD Mg-2.3 Brief Hospital Course: On [**2156-12-30**] Mr. [**Known firstname 1975**] [**Known lastname **] underwent a coronary artery bypass grafting times four. This procedure was performed by [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], please see the operative note for details. He tolerated this procedure well and was transferred in critical but stable condition to the surgical intensive care unit. He was extubated and weaned from his drips. He had atrial fibrillation which resolved with amiodarone boluses and beta blockade. He was transferred to the surgical step down floor and his chest tubes were removed. [**Last Name (un) **] was asked to consult secondary to high insulin requirements and a pre-operative HgbA1C of 7.8. He was placed on U-500 concentrated insulin and an aggressive sliding scale. His epicardial wires were removed. Keflex was initiated for mediastinal incision erythema without drainage. A sleep apnea consult was requested secondary to nocturnal desaturations without bradycardia. Sleep study revealed a mixed sleep apnea. Recommendation is to follow up as an outpatient, and use home oxygen while sleeping in the meantime. Atrial fibrillation/flutter returned. Cardizem was resumed and the patient was started on coumadin. By the time of discharge on POD 8, the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. He was discharged to home in good condition with appropriate follow up instructions. Medications on Admission: cardizem cd 300 daily,tricor 145 daily,lasix 60 daily,imdur 60daily,humalog 20 before dinner,RISS,avapro 150 daily,lipitor 80daily,toprol xl 50 daily,NTG prn plavix 75 daily,terazosin 2daily hs,dyazide 37.5/25 daily ,asa 81 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. Fenofibrate Micronized 145 mg Tablet Sig: One (1) Tablet PO daily (). 3. Irbesartan 150 mg Tablet Sig: One (1) Tablet PO daily (). 4. Terazosin 1 mg Capsule Sig: Two (2) Capsule PO HS (at bedtime). 5. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 6. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO HS (at bedtime) as needed for constipation. 7. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4 hours) as needed for pain. 8. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 9. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*40 Tablet(s)* Refills:*0* 10. Metoprolol Succinate 100 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO DAILY (Daily). Disp:*30 Tablet Sustained Release 24 hr(s)* Refills:*2* 11. Hydrochlorothiazide 12.5 mg Capsule Sig: Two (2) Capsule PO DAILY (Daily). Disp:*30 Capsule(s)* Refills:*2* 12. Cephalexin 500 mg Capsule Sig: One (1) Capsule PO Q6H (every 6 hours) for 7 days: sternal wound erythema. Disp:*28 Capsule(s)* Refills:*2* 13. Lasix 20 mg Tablet Sig: Three (3) Tablet PO once a day: total of 60mg daily. Disp:*90 Tablet(s)* Refills:*2* 14. Insulin Regular Hum U-500 Conc 500 unit/mL Solution Sig: Fifteen (15) units Injection three times daily with meals: titrate up insulin dose every two days to a goal fasting blood sugar of <120 and pre-meal blood sugar of <160 per instructions of the [**Hospital **] clinic. Disp:*qs * Refills:*2* 15. Insulin Regular Human 300 unit/3 mL Insulin Pen Sig: per sliding scale Subcutaneous four times a day. Disp:*qs * Refills:*2* 16. Cardizem CD 300 mg Capsule, Sust. Release 24 hr Sig: One (1) Capsule, Sust. Release 24 hr PO once a day. Disp:*30 Capsule, Sust. Release 24 hr(s)* Refills:*2* 17. Warfarin 5 mg Tablet Sig: One (1) Tablet PO once a day: dose will change daily for goal INR [**1-19**]. Disp:*30 Tablet(s)* Refills:*2* 18. Outpatient Lab Work serial PT/INR dx: atrial fibrillation results to Dr. [**Last Name (STitle) **] [**Telephone/Fax (1) 62**] 19. home oxygen oxygen 2Lpm continuous for portability pulse dose system Discharge Disposition: Home With Service Facility: [**Hospital6 1952**], [**Location (un) 86**] Discharge Diagnosis: diabetes mellitus hypertension chronic kidney disease (Cr 1.5-1.7) h/o inferior myocardial infarction with EF 40% coronary artery disease- stent to cx [**2143**] hyperlipidemia Past Surgical History right carotid endarterectomy Discharge Condition: Alert and oriented x3 nonfocal Ambulating, gait steady Sternal pain managed with percocet prn Discharge Instructions: Discharge Instructions: Please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your 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**] Followup Instructions: Recommended Follow-up:Please call to schedule appointments Surgeon Dr. [**Last Name (STitle) **] in 4 weeks [**Telephone/Fax (1) 170**] [**1-26**] at 1:00 PM Primary Care Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] in [**12-18**] weeks [**Telephone/Fax (1) 250**] Cardiologist Dr. [**Last Name (STitle) **] in [**12-18**] weeks [**Telephone/Fax (1) 62**] ***[**First Name8 (NamePattern2) 6480**] [**Last Name (NamePattern1) 2716**], RN- will follow INR/Coumadin dosing for Dr.[**Last Name (STitle) **], Please call daily for INR/Coumadin dosing [**Hospital **] Clinic Dr. [**Last Name (STitle) 3617**] [**2157-3-4**] at 1:30 PM ([**Telephone/Fax (1) 20881**] Wound check appointment - [**Hospital Ward Name 121**] 6 ([**Telephone/Fax (1) 3071**]) - your nurse will schedule Sleep Center: Thursday, [**2157-1-27**] 3pm, Dr. [**First Name8 (NamePattern2) **] [**Name (STitle) **] [**Telephone/Fax (1) 612**] Completed by:[**2157-1-7**] ICD9 Codes: 5119, 5180, 4240, 5859, 2724, 412
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6603 }
Medical Text: Admission Date: [**2191-3-27**] Discharge Date: [**2191-3-30**] Date of Birth: [**2131-6-20**] Sex: M Service: MEDICINE Allergies: Tapazole Attending:[**Last Name (NamePattern1) 1167**] Chief Complaint: STEMI Major Surgical or Invasive Procedure: cath lab for urgent intervention: stenting of OM1 with bare metal stent History of Present Illness: Mr. [**Known lastname 101177**] is a 59M letter carrier who was working the night shift when he had chest pressure, b/l jaw pain, diaphoresis, and nausea. He went to [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) 101178**] where he had an EKG that showed II>III STE. No RV or posterior leads were started. A nitro gtt was briefly started but discontinued abruptly prior to transfer at the reccomendations of our cardiology fellow. He was given ASA, Plavix load, G32B inhibitor and heparin. He had some bradycardia to the 30's. He was transferred to [**Hospital1 18**] cath lab for urgent intervention. . He was found to have 100% occlusion of large OM1. A BMS was deployed with some mild STE without chest pain felt to be reperfusuion. He is currently CP free. He did get bivalirudin during the case. On the CCU, he says he feels "great" and denies CP, HA, SOB, abdom pain, chest pressure. At baseline, he does cardio exercise 3-4x/wk doing stairmaster or spinning Past Medical History: ??Inflammatory arthritis (lupus per pt) [**Name (NI) 101179**] Social History: The patient works in the post office. No tobacco use since early [**2158**]. No alcohol use. Family History: - No family history of early MI, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. - Mother: still alive, no cardiac Hx - Father: still alive at 83, had CABG in 60s Physical Exam: ADMISSION EXAM: GENERAL: NAD. Oriented x3. Mood, affect appropriate. HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. No xanthalesma. NECK: Supple with JVP of 6-7cm. No carotid bruits. CARDIAC: RR with occasional PVC, 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. EXTREMITIES: No c/c/e. No femoral bruits. NEURO: AAOx3, CNII-XII intact PULSES: Right: DP 2+ PT 2+ Left: DP 2+ PT 2+ . DISCHARGE EXAM: 98.2 105/62 62 18 99%RA GENERAL: NAD. Oriented x3. Mood, affect appropriate. HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. No xanthalesma. NECK: Supple with JVP of 6-7cm. No carotid bruits. CARDIAC: RR with occasional PVC, 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. EXTREMITIES: No c/c/e. No femoral bruits. NEURO: AAOx3, CNII-XII intact PULSES: Right: DP 2+ PT 2+ Left: DP 2+ PT 2+ Pertinent Results: ADMISSION LABS: [**2191-3-27**] 03:16PM BLOOD WBC-5.3 RBC-3.55* Hgb-12.2* Hct-36.2* MCV-102* MCH-34.3* MCHC-33.7 RDW-13.2 Plt Ct-198 [**2191-3-27**] 03:16PM BLOOD PT-11.2 PTT-44.9* INR(PT)-1.0 [**2191-3-27**] 03:16PM BLOOD Glucose-98 UreaN-20 Creat-1.3* Na-136 K-4.3 Cl-102 HCO3-26 AnGap-12 [**2191-3-27**] 09:04PM BLOOD CK(CPK)-2123* [**2191-3-27**] 09:04PM BLOOD CK-MB-GREATER TH cTropnT-8.00* [**2191-3-28**] 05:55AM BLOOD CK-MB-244* MB Indx-18.4* cTropnT-4.74* [**2191-3-28**] 05:55AM BLOOD Calcium-9.0 Phos-3.6 Mg-2.1 Cholest-220* [**2191-3-28**] 05:55AM BLOOD Triglyc-107 HDL-68 CHOL/HD-3.2 LDLcalc-131* LDLmeas-148* [**2191-3-28**] 05:55AM BLOOD %HbA1c-5.6 eAG-114 PERTINENT INTERVAL LABS: [**2191-3-27**] 09:04PM BLOOD WBC-4.7 RBC-3.41* Hgb-11.4* Hct-35.2* MCV-103* MCH-33.5* MCHC-32.5 RDW-13.5 Plt Ct-208 [**2191-3-28**] 05:55AM BLOOD WBC-3.8* RBC-3.52* Hgb-12.0* Hct-35.9* MCV-102* MCH-34.1* MCHC-33.5 RDW-13.3 Plt Ct-199 [**2191-3-29**] 04:33AM BLOOD WBC-3.9* RBC-3.64* Hgb-12.2* Hct-37.3* MCV-103* MCH-33.5* MCHC-32.7 RDW-13.1 Plt Ct-177 [**2191-3-30**] 04:27AM BLOOD WBC-3.6* RBC-3.90* Hgb-13.3* Hct-40.6 MCV-104* MCH-34.0* MCHC-32.7 RDW-13.2 Plt Ct-205 [**2191-3-28**] 05:55AM BLOOD PT-9.2* PTT-25.3 INR(PT)-0.8* [**2191-3-27**] 09:04PM BLOOD Glucose-113* UreaN-20 Creat-1.4* Na-138 K-4.7 Cl-104 HCO3-26 AnGap-13 [**2191-3-28**] 05:55AM BLOOD Glucose-91 UreaN-17 Creat-1.2 Na-140 K-4.8 Cl-105 HCO3-25 AnGap-15 [**2191-3-29**] 04:33AM BLOOD Glucose-91 UreaN-19 Creat-1.2 Na-139 K-5.1 Cl-104 HCO3-24 AnGap-16 [**2191-3-30**] 04:27AM BLOOD Glucose-90 UreaN-21* Creat-1.7* Na-137 K-4.6 Cl-101 HCO3-25 AnGap-16 [**2191-3-28**] 05:55AM BLOOD CK(CPK)-1328* [**2191-3-30**] 04:27AM BLOOD ALT-43* AST-79* LD(LDH)-533* AlkPhos-93 TotBili-0.9 [**2191-3-27**] 09:04PM BLOOD CK-MB-GREATER TH cTropnT-8.00* [**2191-3-28**] 05:55AM BLOOD CK-MB-244* MB Indx-18.4* cTropnT-4.74* [**2191-3-27**] 09:04PM BLOOD Calcium-8.8 Phos-3.8 Mg-2.3 [**2191-3-28**] 05:55AM BLOOD Calcium-9.0 Phos-3.6 Mg-2.1 Cholest-220* [**2191-3-29**] 04:33AM BLOOD Calcium-9.4 Phos-3.1 Mg-1.7 [**2191-3-30**] 04:27AM BLOOD Albumin-4.4 Calcium-9.8 Phos-4.0 Mg-1.7 [**2191-3-27**] 03:16PM BLOOD TSH-4.0 [**2191-3-28**] 05:55AM BLOOD Triglyc-107 HDL-68 CHOL/HD-3.2 LDLcalc-131* LDLmeas-148* [**2191-3-28**] 05:55AM BLOOD %HbA1c-5.6 eAG-114 STUDIES: ECG [**2191-3-27**]: rate 62. Sinus rhythm with a ventricular premature beat. Inferior ST segment elevation with Q waves suggesting an inferior myocardial infarction which could be acute. RSR' pattern in lead V1. Low QRS voltage in the precordial leads. No previous tracing available for comparison. TRACING #1 Cardiac Catheterization [**2191-3-27**]: COMMENTS: 1) Selective angiography of this right-dominant system demonstrated significant one-vessel coronary artery disease. The LMCA had no angiographically-apparent flow-limiting stenoses. The LAD had a 50% mid-vessel stenosis. The RCA had serial 70% mid- and distal-vessel stenoses. The LCx system had a totally-occluded large obtuse marginal branch. 2) Limited resting hemodynamics revealed systemic arterial hypertension, with a central aortic pressure of 172/90 mmHg. ADDENDUM: INTERVENTION COMMENTS: Initial angiography revealed an occlusion of OM which we planned to treat with PTCA and stenting. A 6 Fr XB 3.0 guiding catheter provided good support throughout the procedure. Bivalirudin bolus was administered and infusion started. A Prowater wire was used to successfully cross the occlusion and was positioned in the distal vessel. An Apex OTW 2.0 x 8 mm balloon was used to pre-dilate the lesion, restoring flow to the vessel. This was then stented using an Integrity 3.0 x 22 mm bare metal stent deployed at 18 atm. Final angiography revealed an excellent result with 0% residual stenosis in the stented segment, TIMI 3 flow within the vessel and no apparent dissection. Hemostasis achieved at the right femoral arterial access site using Angioseal vascular closure device. FINAL DIAGNOSIS: 1. Significant one-vessel coronary artery disease. 2. Primary PCI of obtuse marginal occlusion with bare metal stent. . ECHO [**2191-3-28**]: The left atrium is normal in size. No atrial septal defect is seen by 2D or color Doppler. There is mild symmetric left ventricular hypertrophy with normal cavity size. There is mild regional left ventricular systolic dysfunction with hypokinesis of the basal half of the basal half of the inferior and inferolateral walls. The remaining segments contract well (LVEF 50%). Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No aortic regurgitation is seen. The mitral valve leaflets are structurally normal with trivial mitral regurgitation. There is no mitral valve prolapse. The pulmonary artery systolic pressure could not be determined. There is an anterior fat pad. IMPRESSION: Mild symmetric left ventricular hypertrophy with normal cavity size and regional systolic dysfunction c/w CAD (PDA distribution). Brief Hospital Course: BRIEF CLINICAL SUMMARY: Mr. [**Known lastname 101177**] is a 59M h/o hypothyroidism and unspecified MSK disease (per pt, is lupus), p/w classic ACS symptoms, found to have a STEMI, s/p BMS to OM1. ISSUES: # STEMI: Patient presented with classic ACS symptoms, including substernal chest pressure, arm and jaw pain. Patient had a demonstrable STEMI, culprit lesion is OM1 s/p BMS PCI. He remained hemodynamically stable throughout hospitalization. He has had a few occasional runs of PVC's on telemetry, no other complications. The patient was discharged on aspirin, plavix, atorvastatin 80mg, metoprolol succinate 50mg qd. Lisinopril was held because of [**Last Name (un) **]. The patient was discharged to home with PCP [**Name9 (PRE) 702**] and cardiology follow-up, and was recommended to pursue cardiac rehab. # [**Last Name (un) **]: Admission Cr 1.3. Cr increased to 1.7 on [**2191-3-30**] (from 1.2), likely secondary to dye load from catheterization. The patient was urged to drink plenty of fluids. The patient was very anxious to be discharged, so we sent patient with a prescription to have chem 7 checked tomorrow at his PCP's office. We held his lisinopril in the setting of worsening renal function. . # Hypothyroidism: continue home levothyroxine . # Unspecified MSK Dx (per pt, is lupus involving b/l hand joints, and he has been taking 5mg prednisone qd-[**Hospital1 **] for 1 month PTA). We held the patient's prednisone throughout his hospital course. . TRANSITIONS OF CARE: - repeat lipid panel as outpatient to ensure LDL at goal - start lisinopril when Cr normalizes Medications on Admission: HOME MEDICATIONS: Prednisone 10mg daily for past month Levothyroxine, unknown dose . Discharge Medications: 1. aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 2. clopidogrel 75 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*0* 3. atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 4. levothyroxine 50 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Toprol XL 50 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* 6. Outpatient Lab Work ICD-9 code: acute kidney injury Check Chem 7 panel on [**2191-3-31**] Please fax results: [**Last Name (LF) **],[**First Name3 (LF) **] B. [**Hospital3 **] MEDICINE Phone: [**Telephone/Fax (1) 4475**] / Fax: [**Telephone/Fax (1) 29683**] Discharge Disposition: Home Discharge Diagnosis: ST- elevated myocardial infarction Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Dear Mr. [**Known lastname **], You were admitted to the [**Hospital1 18**] for chest pain. You were found to have a heart attack. You had a bare metal stent placed in one of your coronary arteries. It is very important for you to follow up with your new cardiologist and your primary care physician. You also had some kidney injury while you were in the hospital. It is very important that you drink plenty of water at home and you need to have a laboratory test tomorrow to evaluate your renal function. If you have any chest pain, shortness of breath or any other symptoms that worry you, you should call your PCP or present to the emergency department as soon as possible. Continue to take all of your medications as you previously had, EXCEPT: ADD aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) by mouth DAILY (Daily). ADD clopidogrel 75 mg Tablet Sig: One (1) Tablet by mouth once a day. ADD atorvastatin 80 mg Tablet Sig: One (1) Tablet by mouth DAILY (Daily). ADD Toprol XL 50 mg Tablet Extended Release 24 hr Sig: One (1) Tablet Extended Release 24 hr by mouth once a day. ADD levothyroxine 50 mcg Tablet Sig: One (1) Tablet by mouth DAILY Followup Instructions: Name: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 101180**], MD When: Wednesday [**4-6**] at 3:15pm Location: [**Hospital3 **] INTERNAL MEDICINE Address: [**Street Address(2) 4472**], [**Apartment Address(1) 4473**], [**Hospital1 **],[**Numeric Identifier 9331**] Phone: [**Telephone/Fax (1) 4475**] Name: [**Doctor First Name **] [**First Name8 (NamePattern2) **] [**Name8 (MD) **], MD Specialty: Cardiology When: Thursday [**4-14**] at 1:45pm Location: [**Hospital3 **] INTERNAL MEDICINE ASSOCIATES Address: [**Street Address(2) 4472**], [**Apartment Address(1) 4473**], [**Hospital1 **],[**Numeric Identifier 4474**] Phone: [**Telephone/Fax (1) 4475**] ICD9 Codes: 5849, 2449
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6604 }
Medical Text: Admission Date: [**2120-2-3**] Discharge Date: [**2120-2-26**] Date of Birth: [**2049-2-9**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 7591**] Chief Complaint: Hemoptysis Major Surgical or Invasive Procedure: Bronchoscopy History of Present Illness: Mr. [**Known lastname **] is a 70 year old man with CLL, known lung masses and recent brochial artery bleed, s/p embolization of LLL bronchial artery [**1-17**], who presents with hemoptysis. He was recently discharged from [**Hospital1 18**] to [**Hospital 100**] Rehab [**2-1**] after an extended admission for hemoptysis during which he underwent rigid broncoscopy demonstrating no endobronchial source followed by angiography showing a bleeding LLL bronchial artery, which was successfully embolized. He was also diagnosed with HAP during that admission, and treatment with vanc/cefepime was begun [**1-28**]. Hemoptysis and infectious symptoms resolved, and he was discharged to [**Hospital 100**] Rehab. The day of transfer, he again developed hemoptysis of unclear volumes. EMS was activated. . On arrival of EMS, VS 98.2, HR 93, BP 140/90, RR 20, O2 93% on RA. and he was intubated in the field by EMS, went to [**Hospital1 **]. From there he was transferred to [**Hospital1 18**] ED where BRB was still coming from the ET tube. She was placed L side down. IP saw him in the ED and felt that, given no visualization of endobronchial source at the time of recent scope, it would be more useful to go directly to IR for repeat guided embolization. They also recommended advanced ET tube to R side to protect his lung, which was done. He was reportedly hypotensive to 80/50, femoral line was placed, and levophed gtt was started with improvement in BP to systolic in the low 100s. He received 2 Units pRBC and 2L 2S. He was transferred to the MICU on AC at 100% FiO2, 20, 550, PEEP 5. . PAST MEDICAL HISTORY: Past Medical History: CLL x 20 yrs -s/p fludarabine and Cytoxan ([**7-14**]) with good response -auto-immune hemolytic anemia on chronic steroids -mediastinal lymphadenopathy -h/o bilat pleural effusions with + cytology ([**6-13**]) RCC s/p Left nephrectomy [**2106**] CKD: prior baseline CR 1.5, most recently 1.1-1.2 BPH vs Prostate cancer - h/o multiple prostate biopsies with only 1 c/w adenocarcinoma ([**Doctor Last Name **] 3+3) GERD Type II DM: -recently started insulin R-sided Exotropia Gallstone pancreatitis [**12-10**]; s/p lap chole Hyperlipidemia CAD s/p cath [**4-13**] with diffuse 2 vessel dz - 70% RCA/PDA, 60%prox/mid LAD) HTN Hypogammaglobumenia, recurrent URI/PNA, on IVIG X 2years, good response (last dose [**2118-11-11**]) Allergic rhinitis Gilberts disease Hypotesteronemia R humeral fracture ([**12-16**]) Enlarged spleen secondary to CLL vs portal hypertension. Social History: Married, lives with wife [**Name (NI) **] in [**Location (un) **]. Is a retired rabbi working in academics/think tank with 30 year history prior to that of congregation work in [**State 760**]. They have two adult children in [**Location (un) 9012**] and LA and three grandchildren. Life-time [**Location (un) 24233**], rare EtOH, no illicit drug use. Family History: Father w/ [**Name2 (NI) 499**] cancer and coronary artery disease. Multiple relatives with DM. Physical Exam: GEN: NAD, lying in bed, restrained VS: T 100 axillary, BP 120/54, HR 114, RR 18, 100% RA HEENT: PERRL, limited exam of oropharynx due to patient sedation, but no signs of active hemoptysis, sclera anicteric CV: tachycardic, regular rate, no m/g/r PULM: decreased BS at left posterior lung base and right apice, +occasional rhonchi in LLL, o/w CTAB. no wheezes. ABD: soft, NT/ND, +BS, no guarding or rebound tenderness LIMBS: no c/c/e, DP pulses palpable and equal bilaterally NEURO: arousable, oriented x 1 (self), normal muscle tone, spontaneously moves all extremities, follows simple commands such as "open eyes", Pertinent Results: LABS ON ADMISSION: [**2120-2-3**] 03:10AM BLOOD WBC-4.2# RBC-3.10* Hgb-8.5* Hct-24.8* MCV-80* MCH-27.5 MCHC-34.3 RDW-16.6* Plt Ct-55* [**2120-2-3**] 03:10AM BLOOD Neuts-86.6* Lymphs-7.0* Monos-4.7 Eos-1.4 Baso-0.2 [**2120-2-3**] 03:10AM BLOOD PT-16.7* PTT-29.0 INR(PT)-1.5* [**2120-2-3**] 03:10AM BLOOD Glucose-204* UreaN-34* Creat-1.4* Na-136 K-4.5 Cl-105 HCO3-22 AnGap-14 [**2120-2-3**] 03:10AM BLOOD ALT-45* AST-35 CK(CPK)-76 AlkPhos-101 TotBili-0.8 [**2120-2-3**] 03:10AM BLOOD Lipase-47 [**2120-2-3**] 03:10AM BLOOD cTropnT-0.68* [**2120-2-3**] 03:10AM BLOOD Albumin-2.9* Calcium-7.6* Phos-4.7*# Mg-1.8 [**2120-2-3**] 07:34AM BLOOD Cortsol-18.3 [**2120-2-3**] 03:10AM BLOOD ASA-NEG Ethanol-NEG Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG [**2120-2-3**] 03:41AM BLOOD Type-ART Rates-20/ Tidal V-450 PEEP-5 FiO2-100 pO2-194* pCO2-44 pH-7.34* calTCO2-25 Base XS--2 AADO2-494 REQ O2-81 -ASSIST/CON Intubat-INTUBATED STUDIES: Chest X-ray [**2120-2-3**] - 1. Multiple masses, unchanged. 2. Small left pleural effusion and increased atelectasis. CT Head [**2120-2-9**] - There is no intracranial hemorrhage, edema, shift of normally midline structures, or evidence of acute major vascular territorial infarct. Ventricles and sulci are normal in size and configuration, for the patient's age. The [**Doctor Last Name 352**]-white matter differentiation is preserved. The basilar cisterns are symmetric. Paranasal sinuses and mastoid air cells are well aerated. CT Chest [**2120-2-9**] - Interval increase in bilateral pleural effusions, small bilaterally, but left greater than right. New heterogeneous opacities at the right lung base could represent atelectasis or the sequela of aspiration. No lobar consolidation. Unchanged appearance of large mediastinal and perihilar masses bilaterally, with attenuation of the adjacent airways. No new masses. Splenomegaly. CT Head [**2120-2-17**] - This study is slightly limited due to patient motion. There is no intracranial hemorrhage, edema, mass effect, shift of normally midline structures, or acute major vascular territorial infarction. The ventricles and sulci are prominent, compatible with age-related volume loss. Visualized paranasal sinuses are normally aerated. Inferior right mastoid air cells are partially opacified. Mastoid air cells are otherwise normally aerated. Osseous structures are unremarkable. 2D ECHO [**2120-2-19**] - Compared with the prior study (images reviewed) of [**2120-1-15**], LV systolic function is more impaired (35-40%). There is global hypokinesis. The prior echo images were also suboptimal - the ejection fraction may have been OVERestimated on the prior study. Brief Hospital Course: 70 year old male with known CLL presents with hemoptysis in setting of known LLL mass; now s/p embolization of bronchial artery with recurrent hemoptysis. # Goals of Care - After prolonged hospitalization and no clear clinical response to treatment, discussion of goals of care were initiated with the family of Rabbi [**Known lastname **]. [**Name2 (NI) **] was initially made DNR/DNI with no escalation of care, then placed on morphine for comfort and control of his tachypnea, finally antibiotics were discontinued. IV hydration and nutrition was continued throughout admission until Rabbi [**Known lastname **] passed away on the morning of [**2120-2-26**]. # Hemoptysis - Mr. [**Known lastname **] was admitted to the hospital for hemoptysis noted while at [**Hospital 100**] Rehab facility. He was intubated in the field by EMS. Due to hypotension, he was started on pressors on arrival in the ED at [**Hospital1 18**]. He was directly admitted to the ICU. While in the ICU, he underwent flexible bronchoscopy that showed recurrent massive hemoptysis from left lower lobe which had subsided with no signs of active bleeding. Due to previous embolization, IR was contact[**Name (NI) **] and felt that since hemostasis was alrady obtained, there was no indication for IR intervention. He was extubated without event. After completing stabilization in the ICU, he was transferred to the BMT (bone marrow transplant/heme malignancy) unit for further management. Rad-Onc was consulted and decision was made to undergo radiation therapy to left lower lobe and mediastinal masses for definitive treatment of hemoptysis. He underwent XRT without complications. He had no repeat hemoptysis during his admission. # Acute Hypoxic Respiratory Failure (x 2): Patient was transferred to the [**Hospital Unit Name 153**] on [**2120-2-14**] for respiratory failure. Differential included flash pulmonary edema vs. acute intrapulmonary hemorrhage vs compressive pathology of airways from mediastinal lymphadenopathy/inflammation from XRT vs. mucous plugging. HCT remained stable, no evidence of hemoptysis. No evidence of worsening infection. PE less likely given rapid response of 15 mins to mask ventilation. The patient was diuresed, given pulmonary toilet with albuterol/ipratropium, and was continued on vanc/zosyn. After transfer from ICU to BMT service floor, Rabbi [**Known lastname **] had repeat episode of acute hypoxic respiratory failure associated with SBP=200. He was transferred to the unit with quick resolution of symptoms once placed on BiPAP. He was monitored in the ICU prior to being transferred back to the BMT floor. # Altered Mental Status: Rabbi [**Known lastname **] was sedated in the ICU due to being intubated. After discontinuation of all sedating medications, he was noted to only be oriented to self, intermittantly agitated as well as difficulty verbally expressing himself. Initially felt to be delirium and drug side effects, however altered mental status continued despite no sedating medications. Neurology consult felt possible delirium vs. intracranial process (mets, annoxic injury, infection, seizure). MRI and LP were deferred out of request of family not to use sedating medications. After initial hypoxic respiratory failure prompting transfer to ICU, patient underwent EEG which showed mild to moderate encephalopathy. CT head was negative for acute intracranial process x 2. Prior to Rabbi [**Known lastname 24239**] passing, there was no clear determination of the etiology of his altered mental status. # Tachypnea - Rabbi [**Known lastname **] started to have tachypnea approximately 7-10 days into his hospitalization. ABG were consistent with primary respiratory alkalosis. He was not hypoxic, however tachypnea was in the 30-40 range at times. Pulmonary consult was obtained out of concern for effusions as etiology of tachypnea, however, felt more likely [**1-9**] CNS etiology and deferred thoracentesis. Rabbi [**Known lastname 24239**] antibitoics were continued until the day prior to his passing to treat any residual pneumonia. # CLL: After hemoptysis stopped and patient extubated, he a was transferred to the BMT service for further treatment. Rabbi [**Known lastname 24239**] CLL was not actively treated during admission, however, he did recieve XRT for definitive treatment of his hemoptysis. During these treatments, he had XRT to the large mediastinal CLL mass as well. Neupogen was given on prn basis. #CAD: ECG not significantly changed from prior. Metoprolol was held during intial hypotensive episode. Metoprolol was restarted on transfer to the floor and titrated as tolerated. Mr. [**Known lastname **] was noted to have troponin leak during his initial presentation as well as during his acute hypoxic respiratory failure episodes. There was concern that he was volume overloaded during his first hypoxic episode and was diuresed, however on second hypoxic episode he had no sign of total body volume overload. EKG remained unchanged. Echo was done and showed ..... # Hypotension: He briefly required pressors. Hypotension was likely due to a combination of positive pressure ventilation and medication effect, less likely significant hemodynamic loss into thorax or adrenal infufficiency given relatively low (physiologic) home dose of prednisone. Random cortisol was normal. Pressors were quickly weaned. # Recent HAP: Vancomycin and cefepime were continued on admission until [**2-5**] to complete antibiotic course for hospital acquired pneumonia from previous admission. # [**Last Name (un) **]: Cr elevated to 1.4 (baseline 1.0-1.2) on admission, likely secondary to hypotension. # Anemia: Patient has known AIHA related to CLL and HCT 25 from baseline 28-30. Transfused 2 unit PRBCs in ED. Prednisone was continued. Hct was subsequently stable. # Diabetes Mellitus Type II - Mr. [**Known lastname **] was placed on QID fingersticks and sliding scale insulin. Medications on Admission: Albuterol 90 mcg 2 puffs PRN Allopurinol 100mg PO Daily Folic Acid 2mg PO Daily Insulin Lispro Protam & Lispro As Directed Metoprolol Succinate 25mg PO BID Nitroglycerin [NitroQuick] 0.3mg SL PRN Prednisone 2mg PO daily Rosuvastatin 5mg PO daily Docusate Sodium [Colace] 100mg PO BID Senna 8.6 PO BID PRN Discharge Medications: None - Expired Discharge Disposition: Expired Discharge Diagnosis: 1. Massive Hemoptysis 2. Tachypnea 3. Altered Mental Status 4. Pneumonia 5. Acute hypoxic respiratory Failure 6. CLL 7. Anemia 8. Acute on Chronic renal Failure Discharge Condition: Expired Discharge Instructions: None. Followup Instructions: None. ICD9 Codes: 5849, 5070, 2762, 5859, 2875
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Medical Text: Admission Date: [**2158-6-7**] Discharge Date: [**2158-6-14**] Service: CME CHIEF COMPLAINT: Dyspnea and painful right foot. HISTORY OF PRESENT ILLNESS: This is a 79-year old female admitted to [**Hospital6 10353**] on [**5-26**] with a chief complaint of dyspnea. The patient also complained of a painful right foot. The patient stated that she had a one week history of increased dyspnea. At the outside hospital, she had a BNP of 1700. The patient was felt to be in congestive heart failure. She was ruled out for a myocardial infarction and was diuresed. The patient was started on antibiotics for cellulitis. Her foot was debrided and grew out Staphylococcus aureus as well as a group B Streptococcus. The patient was treated with vancomycin and then a cephalosporin. The patient was also maintained on Coreg and lisinopril as well as intermittent Lasix. An echocardiogram was performed which revealed LVH, akinesis of the inferior and posterior walls, anterolateral wall hypokinesis, with an ejection fraction of 30 percent, and severe mitral regurgitation. The left atrium was moderately dilated. The aortic valve was calcified with restricted movement, peak and mean gradients of 80 and 40; respectively. There was a valve area of 0.6 percent; felt to be consistent with severe aortic stenosis. The patient also had evidence of mild aortic insufficiency and moderate-to- severe tricuspid regurgitation. The patient's pulmonary artery systolic pressure was 63. The patient was transferred to the Transitional Care Unit at which time she developed oliguria with an increased creatinine to 4.5. The patient was transferred to the hospital again. She was found to be hypotensive as well as in renal failure. An echocardiogram was repeated, and the findings were similar to prior echocardiogram. The patient was placed on dopamine and intravenous fluids. Her blood pressure increased, and she also had increased urine output with her creatinine decreasing from 4.5 to 1.3. The patient was then transferred here for possible aortic valve replacement, mitral valve replacement, and coronary artery bypass grafting. PAST MEDICAL HISTORY: Significant for type 2 diabetes complicated by peripheral neuropathy. Coronary artery disease. Ventricular aneurysm in [**2150**]; status post surgical repair. History of inferior posterior myocardial infarction 10 years ago complicated by LV free wall rupture and pseudoanuerysm repaired at [**Hospital1 18**]. History of hypertension. History of myeloproliferative disorder. History of anemia. History of gout. History of degenerative joint disease. History of chronic renal insufficiency (with a baseline creatinine of 1.3 to 1.7). History of peripheral vascular disease. Ischemia right medial hallux. ALLERGIES: The patient has no known drug allergies. MEDICATIONS ON ADMISSION: 1. Hydrea. 2. Regular insulin sliding scale. 3. Lisinopril. 4. One-half normal saline with 40 of potassium chloride. 5. Vancomycin REVIEW OF SYSTEMS: The patient's constitutional, ophthalmologic, ear/nose/throat, gastrointestinal, endocrine, hematologic, genitourinary, and musculoskeletal systems were all within normal limits. On review of systems, the patient had no chest pain. She did have dyspnea on exertion with increasing lower extremity edema. No paroxysmal nocturnal dyspnea. No orthopnea. Increased shortness of breath with exertion. No palpitations, syncope, or presyncope. SOCIAL HISTORY: The patient lives by herself in [**Hospital1 42377**]. She has a very supportive and close family and a son that is very involved in her care. No tobacco. No ethanol. No illicit substances. PERTINENT LABORATORY VALUES ON PRESENTATION: Her temperature was 97.5, her blood pressure was 119/70, her heart rate was 90, and the patient was saturating at 97 percent on 2 liters by nasal cannula. Generally, the patient appeared her stated age. She was sitting in bed. She appeared in no acute distress. Head, eyes, ears, nose, and throat examination was significant for normocephalic and atraumatic. The extraocular movements were intact bilaterally. The sclerae were anicteric. The oropharynx was clear with moist mucous membranes. There was no evidence of thyromegaly on examination. Heart was regular in rate and rhythm with a 3/6 systolic murmur at the left and right upper sternal borders as well as the left lower sternal border with radiation to the axilla. Jugular venous pressure was noted to be 9 cm. The lungs were clear to auscultation with crackles at the bases. No wheezes or rales were noted. The abdomen was soft, nontender, and nondistended with normal active bowel sounds. No evidence of hepatosplenomegaly. No masses were palpated. Extremities were significant for no clubbing or cyanosis but trace edema that was nonpitting. On the patient's right foot there is an open wound adjacent to the first big toe with no active drainage, no erythema, and no edema. There was also a stage 1 decubitus ulceration on the patient's coccyx. On neurologic examination, cranial nerves II through XII were intact. Strength was [**5-31**] and symmetric. The toes were downgoing. Pulses were dopplerable; that is, both dorsalis pedis and posterior tibialis pulses bilaterally. The patient's femoral pulses were palpable bilaterally. PERTINENT RADIOLOGY-IMAGING: On electrocardiogram, the patient had evidence a right bundle branch block, a normal sinus rhythm at a rate of 87. No acute ST changes. The patient had T wave inversions in V1 through V4 as well as in II and III. On telemetry, the patient had evidence of a normal sinus rhythm with no ectopy. PERTINENT LABORATORY VALUES ON PRESENTATION: White blood cell count was 26.2, her hematocrit was 34.8, and her platelet count was 510. Differential with neutrophils of 90 percent, bands of 4 percent, lymphocytes of 4 percent, and monocytes of 2 percent. Her prothrombin time was 19, her partial thromboplastin time was 33.9, and her INR was 2.4. Her fibrinogen was 343. D-dimer was 1040. Erythrocyte sedimentation rate was 13. Sodium was 146, potassium was 4.3, chloride was 110, bicarbonate was 24, blood urea nitrogen was 49, creatinine was 1.3, and her blood glucose was 125. Her calcium was 8.6, her magnesium was 1.9, and her phosphate was 2.7. Thyroid stimulating hormone was 2. High- density lipoprotein was 23, her low-density lipoprotein was 58, and her triglycerides were 182. Her C-reactive protein was 2.47. Urine culture was consistent with yeast. Urinalysis was negative. Further data throughout her admission revealed Gram stain of wound culture obtained on [**2158-6-12**] revealed there were no microorganisms with only 2 plus polymorphonuclear neutrophils. Tissue no growth. Aerobic culture was no growth. Wound culture from [**6-12**]; again, Gram stain was significant 1 plus polymorphonuclear neutrophils and no microorganisms. Wound culture with no growth. Aerobic culture with no growth. Blood cultures from [**2158-6-10**] were no growth. Blood cultures from [**6-7**] were no growth. The patient's peak creatine kinase was 54, and her troponin was 0.43. SUMMARY OF HOSPITAL COURSE BY ISSUES-SYSTEMS: CONGESTIVE HEART FAILURE ISSUES: The patient had a Swan-Ganz catheter placed, and her central venous pressure transduced at 20 with a pulmonary artery pressure of 66/32. The decision was made that the patient should not initially be diuresed given that she was preload dependent. Additionally, the patient was stable on minimal oxygen to stable on room air. The patient was maintained on her Coreg and lisinopril. Throughout her hospitalization, the patient received as needed Lasix intermittently. She had a good response to intravenous Lasix, but diuresis was kept to a minimum given the patient's aortic stenosis. The patient had a transthoracic echocardiogram on [**2158-6-8**] which revealed long axis dimension at 5.9, a four chamber length of 6.4, ejection fraction of 20 percent, a TR gradient of 38 to 42, E:A ratio of 1.3, left atrium that was moderately dilated, right atrium that was moderately dilated, and moderate symmetric LVH. The left ventricular cavity was mildly dilated. Overall left systolic ejection fraction was severely depressed. The right ventricular cavity was dilated. There was severe global right ventricular free wall hypokinesis. The aortic root was normal in diameter. The aortic valve leaflets were 3 and mildly thickened. There was moderate aortic valve stenosis. There was 1 plus atrial regurgitation was seen. The mitral valve leaflets were thickened. Mild 1 plus mitral regurgitation was seen. The mitral regurgitation is eccentric. The tricuspid valve leaflets were normal. Moderate-to-severe 3 plus tricuspid regurgitation was seen. Moderate pulmonary artery systolic hypertension was seen. Physiologic pulmonary regurgitation was seen. No pericardial effusion. The patient underwent cardiac catheterization on [**2158-6-9**] which revealed the following. Coronary angiography of a right-dominant system revealed moderate two vessel disease. The left main coronary artery was not obstructed. The left anterior descending artery and its major branches had no significant disease. The left circumflex had minimal distal vessel 70 percent stenosis. The right coronary artery had moderate luminal irregularities distally, up to 40 percent stenosed. Resting hemodynamic measurements demonstrated elevated right heart filling pressures. Right right atrial mean was 29 mmHg. The right ventricular end-diastolic pressure was 19 mmHg. Pulmonary arterial hypertension was noted with pulmonary artery pressure of 16/14 mmHg with a calculated peripheral vascular distance of 363 dynes seconds per cm5, and mildly elevated left heart filling pressures, with a mean capillary wedge pressure of 15 mmHg, and a left ventricular end-diastolic pressure of 14 mmHg. There was approximately 43 mmHg peak, and 36 mm mean gradient across the aortic valve, and mildly diminished cardiac output, an index of 3.9 liters per minute, and 2.4 liters per minute m2; respectively, for a calculated valve area of approximately 0.6 cm2. Left ventriculography revealed severe regional systolic ventricular dysfunction. There was severe anterior and apical hypokinesis and dyskinesis of the inferior wall with prominent aneurysm of the inferior basal segment. There was moderate 1 plus to 2 plus mitral regurgitation. Final diagnoses included noncritical two vessel coronary artery disease, severe aortic stenosis, moderate mitral regurgitation, and severe regional systolic ventricular dysfunction. It was felt that given these findings that the patient would be a candidate for aortic valve replacement. The case was discussed with Cardiothoracic Surgery, and it was felt that given the patient's active infection in the right foot that aortic valve replacement should be deferred until a later time after the patient has been on antibiotics for an adequate amount of time. CORONARY ARTERY DISEASE ISSUES: The patient was maintained on aspirin. INFECTIOUS DISEASE ISSUES: The patient was initially maintained on vancomycin for a presumed right foot osteomyelitis. The patient underwent x-rays of her right foot which revealed no fracture, evidence of bony destruction involving the head of the right first metatarsal consistent with osteitis. There has been an amputation through the base of the proximal phalanx of the second digit. No radiopaque foreign bodies were seen. The left foot views revealed that there was a hallux valgus deformity. There was resumption involving the head of the second metatarsal with metatarsal phalangeal subluxation at this location, and there could be bony resorption of the head and the base of the proximal phalanx of the second digit. No fracture. No radiopaque foreign bodies noted. Infectious Disease was consulted and they recommended oxacillin intravenously for osteomyelitis. The length of antibiotics was discussed with Infectious Disease, and it was recommended that the patient would need at the very minimum six weeks of intravenous antibiotics following right foot debridement, and up to eight week total of intravenous oxacillin depending upon how the patient's right foot looked at follow-up appointments with both Podiatry and Infectious Disease. Infectious Disease also stated that should an aortic valve replacement be necessitated prior to six weeks of intravenous antibiotics, at least two weeks of intravenous antibiotics are recommended and that the ptient should have surveillance blood cultures after this date, and if the patient's blood cultures are negative that the patient could then proceed with aortic valve replacement should it be necessitated before six weeks of antibiotics could be completed. Podiatry was also consulted, and they debrided the patient's wounds. As stated above, the patient's wound cultures were negative with no growth final. PERIPHERAL VASCULAR DISEASE ISSUES: The patient also underwent magnetic resonance imaging/magnetic resonance angiography of her lower extremities to assess for peripheral vascular disease and to see if she could possibly be a candidate for stenting. She had a magnetic resonance imaging/magnetic resonance angiography performed on [**2158-6-9**] which revealed the following. Mild atherosclerotic changes were present in the infrarenal abdominal aorta without evidence of aneurysm or dilatation. The assessment of the first station was limited due to technical factors and venous contamination; however, the iliac vessels appeared grossly normal to the level of the femoral arteries with no hemodynamically significant stenosis. The superficial femoral artery on the right leg had minimal atherosclerotic changes at the adductor canal. The right superficial femoral artery was of normal caliber and provided adequate flow to the lower right leg. The right profunda femoral appear appeared normal. The anterior tibial artery appeared normal throughout its course and as it enters the dorsalis pedis artery there was mild narrowing at the tibiofemoral trunk. The posterior tibial artery appeared normal at it enters the posterior foot. There was mild proximal narrowing. The plantar arch appeared normal. In the left leg, there was a surgical clip in the proximal superficial femoral artery which obscured evaluation of a very focal region of this area. The superficial femoral artery appeared normal. The profunda artery was diffusely diseased. The popliteal artery appeared normal. The anterior tibial artery had mild narrowing in its distal third but remains normal in caliber as it enters a normal-appearing dorsalis pedis. The tibiofemoral trunk appeared normal. The posterior tibial artery becomes diffusely atherosclerotic distally and was not identified at the ankle. The proximal peroneal artery appeared normal with diffuse disease distally. The plantar arch was not well visualized. The final impression was no significant aortoiliac disease, mild narrowing at the right tibioperoneal trunk, and of the distal peroneal artery, and diffuse disease of the left profunda femoral artery, mild narrowing of the mid segment of the anterior tibial artery, and diffuse disease of the distal posterior tibial and peroneal arteries with apparent occlusion of the these two vessels at the ankle. Given that the patient had good distal arterial flow, it was felt that the patient would not need stenting at this time. CHRONIC RENAL INSUFFICIENCY ISSUES: The patient's creatinine remained at her baseline. Her urine was sent, and urine culture was negative. Additionally, the patient had no evidence of urine eosinophils. FLUIDS/ELECTROLYTES/NUTRITION ISSUES: The patient was maintained on a 2-gram cardiac diet as well as a diabetic diet. Her electrolytes were followed and repleted as needed. PROPHYLAXIS ISSUES: The patient was maintained on subcutaneous heparin and a bowel regimen. COMMUNICATION ISSUES: Communication was with her son throughout. Additionally, the patient's primary care physician was [**Name (NI) 653**] prior to the patient's discharge. CODE STATUS ISSUES: The patient remained a full code. MYELOPROLIFERATIVE DISORDER ISSUES: The patient was maintained on her outpatient dose of Hydrea with a good response. The patient did have elevated platelet counts in the range of 500s; however, there was no evidence of thrombo occlusive events. Prior to discharge, the patient had a peripherally inserted central catheter line placed for the purpose of extended intravenous antibiotics. This occurred without event. DISCHARGE INSTRUCTIONS: The patient was to take all medications as prescribed. The patient was to be weighed daily, and if greater than a 3- pound weight gain, as needed Lasix was to be considered. The patient also needs every 2-week liver function tests given that she was on oxacillin. Her liver function tests at the [**Hospital1 69**] were within normal limits except a mildly elevated alkaline phosphatase at 130. It was requested that the outside facility follow her liver function tests while the patient was on oxacillin for right osteomyelitis. FINAL DISCHARGE DIAGNOSES: Severe aortic stenosis. Congestive heart failure. Chronic renal insufficiency. Myeloproliferative disorder. Diabetes. Degenerative joint disease. Peripheral vascular disease. Hypertension. DISCHARGE FOLLOW UP: [**Hospital **] Clinic on [**Last Name (LF) 2974**], [**2158-6-23**] at 3 p.m. with Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **]. Infectious Disease by Dr. [**First Name8 (NamePattern2) 2048**] [**Last Name (NamePattern1) 3640**] at the [**Last Name (un) 2577**] Building (telephone number [**Telephone/Fax (1) 457**]) on [**2158-7-17**] at 10:30 a.m. Cardiothoracic Surgery with Dr. [**First Name (STitle) **] [**Last Name (Prefixes) **] on [**2158-7-6**]. MAJOR SURGICAL-INVASIVE PROCEDURES PERFORMED: Status post pulmonary catheter placement. Status post cardiac catheterization. Status post right foot debridement [**2158-6-11**]. CONDITION ON DISCHARGE: Stable. She was stable on room air. She was mentating appropriately. Had no ectopy on telemetry. No chest pain. She was not in congestive heart failure. DISCHARGE STATUS: She was to be discharged to [**Hospital1 392**] Transitional Care Unit. MEDICATIONS ON DISCHARGE: 1. Regular insulin sliding scale. 2. Hydroxyurea. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] [**Last Name (NamePattern1) **], MD [**MD Number(2) 15194**] Dictated By:[**Last Name (NamePattern1) 18827**] MEDQUIST36 D: [**2158-7-4**] 16:41:36 T: [**2158-7-4**] 18:58:31 Job#: [**Job Number 42378**] ICD9 Codes: 3572
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Medical Text: Admission Date: [**2120-8-1**] Discharge Date: [**2120-8-9**] Date of Birth: [**2040-6-6**] Sex: M Service: NEUROSURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2724**] Chief Complaint: Perimesencephalic subarachnoid bleed after falling out of bed Major Surgical or Invasive Procedure: None History of Present Illness: 78M s/p R CVA with trach who presented to outside hospital after wife heard thump in his room and went in to find him on the floor. Had left top of head laceration stapled at OSH. CT there showed ICH. Transferred to [**Hospital1 18**] ED. Past Medical History: HTN stomach CA CVA 5 yr ago w/ trach Social History: no tob, no EtOH, lives with wife Family History: Non contributory Physical Exam: T: 100.1 BP:98 / 61 HR:103 R18 O2Sats100 Gen: WD/WN, comfortable, NAD, in hard collar, staples in left top of head with dried blood HEENT: Pupils: 3mm ERRLA EOMs appear full but pt not cooperative Neck: in hard collar Extrem: Warm and well-perfused. No C/C/E. Neuro: Mental status: Awake not cooperative with exam Orientation: nonverbal Cranial Nerves: I: Not tested II: Pupils equally round and reactive to light, 3mm bilaterally. III, IV, VI: Extraocular movements appear intact bilaterally without nystagmus. V, VII: Facial strength and sensation intact and symmetric. VIII: Hearing difficult to assess IX, X: Palatal elevation symmetrical. [**Doctor First Name 81**]: Sternocleidomastoid and trapezius normal bilaterally. XII: Tongue midline without fasciculations. Motor: Normal bulk bilaterally. Increased tone in [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) **] abnormal movements, tremors. Strength: no obvious deficits throughout. Reflexes: Pa Ac Right 3 0 Left 2 0 Toes downgoing left, upgoing right Pertinent Results: [**2120-8-1**] 06:50AM URINE BLOOD-NEG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-TR BILIRUBIN-NEG UROBILNGN-NEG PH-8.0 LEUK-NEG [**2120-8-1**] 06:50AM URINE COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.011 [**2120-8-1**] 06:50AM FIBRINOGE-165 [**2120-8-1**] 06:50AM PT-12.1 PTT-23.3 INR(PT)-1.0 [**2120-8-1**] 06:50AM PLT COUNT-194 [**2120-8-1**] 06:50AM WBC-15.8* RBC-3.78* HGB-13.3* HCT-36.8* MCV-97 MCH-35.3* MCHC-36.2* RDW-13.2 [**2120-8-1**] 06:50AM URINE bnzodzpn-NEG barbitrt-NEG opiates-NEG cocaine-NEG amphetmn-NEG mthdone-NEG [**2120-8-5**] 06:15AM BLOOD WBC-8.9 RBC-4.04*# Hgb-13.8* Hct-39.7*# MCV-98 MCH-34.0* MCHC-34.6 RDW-13.0 Plt Ct-228# [**2120-8-4**] 03:40AM BLOOD WBC-8.0 RBC-3.16* Hgb-11.1* Hct-30.6* MCV-97 MCH-35.0* MCHC-36.1* RDW-13.0 Plt Ct-148* [**2120-8-5**] 06:15AM BLOOD Plt Ct-228# [**2120-8-5**] 06:15AM BLOOD Glucose-119* UreaN-7 Creat-0.8 Na-139 K-3.9 Cl-99 HCO3-30 AnGap-14 Brief Hospital Course: Mr [**Known lastname 12330**] was admitted to the ICU for close neurological and hemodyamic monitoring given his obtunded exam initially on arrival. He underwent a CTA of his brain to rule out source of perimesencephalic bleed which was negative for any aneurysm or AVM. He was seen by cardiology to rule out whether his fall was related to a syncopal episode. They felt it may be related to his afib/aflutter and his rate should be better controlled he was placed on metropolol 25mg [**Hospital1 **]. Neurologically he became more arrousable on a daily basis. By hospital day three he was following commands and moving all extremities with full strenght. On hospital day number 4 he was transferred to the surgical floor. On the evening of his transfer he began to have episodes of agitation/sundowning. He was started on a regiman of various atypical antipsychotics finally finding Seroquel at 12.5mg HS worked well and had no further episodes of agitation. Geriatrics consult service helped us manage his behavioral issues. Speech therapy saw the patient he was cleared to eat a regular diet and recommended the following with regards to his speech: . Speak VERY LOUD while looking directly at the patient 2. Help him depress the voicing button on the [**Doctor Last Name **]-[**Doctor Last Name **] artificial larynx 3. Help him to place the intra-oral tube [**12-4**] way into his mouth so that the sound can be shaped into audible/intelligible speech and he can be understood 4. It is impossible to understand all the words produced with an artificial larynx because it voices all sounds. (Many sounds such as P, T, K, f, S, etc. are produced without voice) So, it is easier to understand someone if: A. You know the subject of conversation B. He speaks in short phrases (it can be harder to understand single words) 5. Watch his lips when he speaks, and if you don't understand, A. Ask him to say it again more slowly B. Put the tube further in his mouth c. Clarify the topic On discharge he was alert, orientated following commands with no neurological deficits. His last CT was on [**8-2**] and it showed no new blood. Medications on Admission: simvastatin, folic acid, plavix, prozac, neurontin Discharge Medications: 1. Levothyroxine 112 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Cyanocobalamin 500 mcg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 3. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Fluoxetine 20 mg Capsule Sig: Two (2) Capsule PO DAILY (Daily). 5. Folic Acid 1 mg Tablet Sig: One (1) 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) as needed. 8. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 9. Bacitracin Zinc 500 unit/g Ointment Sig: One (1) Appl Topical [**Hospital1 **] (2 times a day) as needed for scalp lac. 10. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 11. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection TID (3 times a day). 12. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: One (1) Tablet PO Q4-6H (every 4 to 6 hours) as needed. 13. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 14. Quetiapine 25 mg Tablet Sig: 0.5 Tablet PO QHS (once a day (at bedtime)). Discharge Disposition: Extended Care Facility: [**Hospital3 245**] [**Hospital6 **], Satellite as [**Hospital1 **] Hospitals, Hunt Center Discharge Diagnosis: Perimesencephalic SAH after fall Discharge Condition: Neurologically stable Discharge Instructions: Return to ER or call Dr[**Name (NI) 2845**] office if you develop any neurologic changes such as headache, weakness or mental status changes. Followup Instructions: Follow up in 6 weeks with Head CT in 6 weeks with Dr [**Last Name (STitle) 548**], call for an appointment [**Telephone/Fax (1) 2992**] Completed by:[**2120-8-9**] ICD9 Codes: 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6607 }
Medical Text: Admission Date: [**2187-10-5**] Discharge Date: [**2187-10-9**] Date of Birth: [**2120-3-30**] Sex: M Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 473**] Chief Complaint: Hypotension Fevers Major Surgical or Invasive Procedure: None History of Present Illness: 67M s/p Whipple procedure [**2187-7-3**] for ampullary adenoma who was readmitted post-op intra-abdominal fluid collections [**2187-7-25**], and again on [**8-16**] for fevers and hypotension and E.Coli bacteremia, who presents again after transfer from an outside hospital with fevers and hypotension. Fevers at the OSH were 102. The patient was discharged on his last admission with PO antibiotics for 6 weeks (augmentin). His antibiotic course was stopped just prior to this admission. Feeding as an outpatient was continued with a dobhoff tube feeds. The patient was seen in clinic 5 days prior to admission and reported good progress with weight gain, and was afebrile since his last admission. Past Medical History: Past Medical History: ampullary adenoma, likely diagnosis of familial adenomatous polyposis, ypertension, coronary artery disease, chronic obstructive pulmonary disease (COPD), arthritis and peripheral vascular disease PSH: Whipple procedure, coronary artery bypass graft (CABG) and carotid endarterectomy, total abdominal colectomy and end ileostomy, ex-lap's for SBO, EVAR Social History: His social history is significant for positive tobacco. He smokes half pack per day, no alcohol and no IV drugs use, and no intranasal cocaine use. Family History: Family History: His family history is significant for his maternal grandfather that was affected with colorectal cancer, mother that was affected with polyposis, brother that was affected with colorectal cancer, 2 daughters that are affected with polyposis, a grandson that is affected with polyposis, a brother that was lost to colorectal cancer and a son that is also affected with polyposis. Physical Exam: Vitals- 97.4 97.4 75 100/52 15 97% 2L Gen- NAD, alert Head and neck- NC/AT, No JVD Heart-RRR, SEM at LSB, II/VI Lungs-clear bilaterally Abd-soft, osteomy pink, dark green watery stool Ext-no edema Pertinent Results: [**2187-10-6**] 12:12AM BLOOD WBC-7.7 RBC-3.43* Hgb-10.5* Hct-30.4* MCV-89 MCH-30.6 MCHC-34.5 RDW-16.1* Plt Ct-146* [**2187-10-7**] 01:12AM BLOOD WBC-5.0 RBC-3.38* Hgb-10.3* Hct-29.2* MCV-86 MCH-30.5 MCHC-35.3* RDW-16.2* Plt Ct-145* [**2187-10-7**] 01:12AM BLOOD Glucose-145* UreaN-9 Creat-0.5 Na-137 K-3.8 Cl-110* HCO3-21* AnGap-10 [**2187-10-8**] 06:00AM BLOOD ALT-55* AST-29 LD(LDH)-152 AlkPhos-157* TotBili-0.4 [**2187-10-6**] 12:12AM BLOOD Lipase-61* [**2187-10-7**] 01:12AM BLOOD Albumin-2.9* Calcium-7.8* Phos-2.1* Mg-1.9 [**2187-10-8**] 06:00AM BLOOD Albumin-3.2* Mg-1.7 . Blood Cultures OSH E.coli pan-sensitive . Brief Hospital Course: This is a 67 readmitted for hypotension, fevers, in the context of prior fluid collection, E.coli sepsis. He was sent from OSH for 1 day of rigors and malaise. Was reportedly hypotensive at OSH ED, given 4 liters crystalloids w/ transient improvement. BP 90s/50-110/60s on arrival. CT abdomen @ OSH - per ED report no free air or acute process. It was reviewed by Gold surgery as having no acute issue/cause for sepsis. He was admitted to the SICU. He was Pan culture and started on Vanc/zosyn. He responded to IVF and his BP was stable. Pain - minimal, continue to monitor CARDIOVASCULAR: Hypotension - low CVP, most likely vasodilatory [**1-6**] ?infection, given bolus to maintain SBP and responded well. GI / ABD: He was restarted on PO's and tube feeds HEMATOLOGY: Stable anemia, follow ID: OSH blood cultures were pan-sensitive E.coli. He was discharged home with 2 weeks of Levofloxacin He was stable at time of discharge and will follow-up with Dr. [**Last Name (STitle) 468**] in a few weeks. Medications on Admission: Simvastatin 10', Aspirin 325', Lopressor 50'', Omeprazole 20', reglan 10"", dilaudid 1-2q4hp, colace 100" Discharge Medications: 1. Simvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 4. Metoclopramide 10 mg Tablet Sig: One (1) Tablet PO QIDACHS (4 times a day (before meals and at bedtime)). 5. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 6. Vytorin 10-40 10-40 mg Tablet Sig: One (1) Tablet PO once a day. 7. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours) for 2 weeks. Disp:*14 Tablet(s)* Refills:*0* 8. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO twice a day. Discharge Disposition: Home With Service Facility: [**Location (un) **] visiting nurses Discharge Diagnosis: E.Coli bacteremia hypotensive febrile 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. . * Take all 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 * Continue with tubefeedings as directed Followup Instructions: Provider: [**First Name8 (NamePattern2) 251**] [**Name11 (NameIs) **], MD Phone:[**Telephone/Fax (1) 476**] Date/Time:[**2187-11-12**] 11:00 Completed by:[**2187-10-9**] ICD9 Codes: 7907, 4589, 4019, 496, 4439
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6608 }
Medical Text: Admission Date: [**2153-4-19**] Discharge Date: [**2153-4-24**] Service: NEUROLOGY Allergies: Penicillins / Codeine / Sulfonamides / Aspirin / Valium / Erythromycin Base / Ciprofloxacin / Biaxin / Acyclovir / Zestril / Egg / Oxycontin Attending:[**First Name3 (LF) 2569**] Chief Complaint: Right sided weakness, speech difficulties-CODE STROKE Major Surgical or Invasive Procedure: tPA [**2153-4-19**] History of Present Illness: 92W h/o afib not on AC presents as CODE STROKE after acute onset of garbled speech, right sided weakness and left gaze preference. Last seen well @ 1:20pm by driver. Onset of symptoms @ 1:20pm noted by driver that patient began to have garbled speech. Driver subsequently called for an ambulance which brought pt to [**Hospital1 18**] ED. NIHSS 1a. alert 0 1b. LOC questions 2 1c. LOC commands 2 2. Gaze 1 3. Visual 0 (chronically blind) 4. Facial palsy 2 5. Motor L arm 0 5. Motor R arm 2 6. Motor L leg 0 6. Motor R leg 3 7. Limb ataxia 0 8. Sensory 0 9. Best language 2 10. Dysarthria 1 11. Extinction 2 NIHSS Total 17 Head and neck CTA showed ?LMCA distal division occlusion. Labs INR 1.1, Cr 1.1 and FS 114. Past Medical History: -- CAD: s/p MI x2; s/p Cypher stent to RCA in [**2148**]; [**12-11**] P-MIBI: Normal pharmacologic stress myocardial perfusion with normal left ventricular cavity size and wall motion. -- Chronic diastolic CHF: Echo [**2151-3-4**] EF >55%, 1+MR, 1+ TR, mild PA systolic pressure -- Hypertension -- Diabetes mellitus -- Atrial fibrillation - per history but currently in sinus. Not on coumadin -- Sjogren's syndrome / scleroderma. -- squamous cell carcinoma -- Interstitial lung disease -- osteoporosis, with vertebral compression fractures. -- GERD / esophageal dysmotility / peptic ulcer disease. -- Macular degeneration -- h/o DVT -- s/p colectomy -- s/p strokes x4 -- s/p TAH/RSO -- s/p post appendectomy -- h/o femoral hernia repair -- Pancreatic lesion that needs follow up -- influenza [**2-/2153**] Reportedly no h/o seizures. Social History: Patient was a [**Hospital1 18**] employee x 36 years, widowed. She has 2 children, one in [**State **] and [**State 4565**]. Patient walks with a cane. Patient lives in [**Location **] Place [**Hospital3 **]. Patient reports she walks with cane assist only although she is legally blind. Tobacco: 15 pk-yr, quit 65 yrs ago ETOH: None Illicts: None Son [**Name (NI) **] [**Name (NI) **] (HCP) [**Telephone/Fax (1) 96979**] in [**State **] but will be coming into town this weekend. Family History: One child died at age 60 of CAD/cancer Father died at 52 of MI Physical Exam: T- 99.4 BP- 143/77 HR- 102 RR- 38 100 O2Sat NC FS 104 Gen: Lying in bed, tremulous and mild distress HEENT: NC/AT, moist oral mucosa Neck: supple, no carotid or vertebral bruit CV: sinus tachycardia, Nl S1 and S2, no murmurs/gallops/rubs Lung: Clear to auscultation bilaterally but tachypneic aBd: +BS soft, nontender ext: no edema Neurologic examination: Mental status: Awake and alert but not coherent. Rambling speech with incoherent content. Does not answer questions or follow commands. Cranial Nerves: Pupils equally round and reactive to light, 4 to 2 mm bilaterally. Left gaze preference but intact extraocular movements with OCMs. R UMN facial droop. Palate elevation symmetrical. Tongue midline, movements intact Motor/Sensory: Decr'd bulk throughout and tone decr'd on the right. Does not cooperate with formal resistance testing but moves left arm purposefully and leg spontaneously. Much fewer spontaneous movement from the right side but will withdraw to noxious stim bilaterally, again less on the right. Reflexes: +2 symm throughout. Right toe upgoing and left toe downgoing. Coordination/Gait/Romberg: Unable. Pertinent Results: Trop-T: <0.01 138 102 19 114 AGap=18 ----------------- 4.3 22 1.1 estGFR: 46/56 (click for details) CK: 30 MB: Notdone Ca: 9.6 Mg: 1.9 P: 2.6 ALT: 14 AP: 77 Tbili: 0.8 Alb: AST: 23 LDH: Dbili: TProt: [**Doctor First Name **]: Lip: 42 Serum ASA, EtOH, Acetmnphn, Benzo, Barb, Tricyc Negative MCV 93 7.6 D > 12.2 < 261 D 37.3 N:46.1 L:41.0 M:8.5 E:3.1 Bas:1.3 PT: 12.5 PTT: 25.6 INR: 1.1 UA neg CT ABDOMEN/PELVIS [**4-19**] CT OF THE ABDOMEN: Chronic interstitial lung changes at the bases of the lungs bilaterally are again identified, similar in appearance. Mild cardiomegaly is again identified. Coronary artery calcifications are again identified. Extensive calcification of the aorta and its branches is also noted. The patency of these vessels cannot be evaluated due to lack of contrast. However, within the limitations of a non- contrast scan, the small bowel loops are unremarkable. There is no wall thickening or bowel dilatation. The spleen is unremarkable. Within the liver, multiple low- attenuation lesions (2, 24 and 2, 29) are identified and not completely evaluated on this single phase study. Within the pancreas, there are two hypodense lesions (2, 27 and 2, 29). These are incompletely characterized on this non- contrast study. Multiple bilateral renal cysts are again identified, most of which have increased in size when compared to the prior exam. Contrast from prior CAT scan is seen within the collecting system of the right kidney, however, minimal contrast appears to fill the right ureter. There has been interval development of right- sided hydronephrosis due to a right- sided [**Month/Year (2) 96980**] obstruction. The left kidney demonstrates normal excretion of contrast. Scattered mesenteric and retroperitoneal lymph nodes are again identified, none of which meet CT criteria for pathological enlargement. Patient is status post right hemicolectomy. There is no free fluid or free air. CT OF THE PELVIS: The rectum and sigmoid colon are unremarkable. There is diverticulosis without evidence of diverticulitis. There is a Foley catheter within the bladder. Contrast is seen within the bladder lumen. There is no pelvic or inguinal lymphadenopathy. Extensive diverticulosis without evidence of diverticulitis is noted. Numerous phleboliths are seen within the pelvis. BONE WINDOWS: Multiple old right-sided rib fractures are identified, with delayed/non-[**Hospital1 **] of right tenth rib. No suspicious lytic or sclerotic lesions are noted. IMPRESSION: Please note there is a change from the initial wet read; the presence of right sided hydronephrosis is now added.. 1. There has been interval development of right-sided hydronephrosis and right- sided [**Hospital1 96980**] obstruction. 2. Interval increase in size of numerous bilateral renal cysts. 3. Multiple hepatic cysts. 4. Pancreatic hypodense lesions, incompletely characterized. 4. Extensive calcifications of the aorta and its branches. 5. Diverticulosis without evidence of diverticulitis. 6. Right-sided rib fractures with possible delayed/nonunion of the right tenth rib (300B, 7). ECHO: The left atrium is mildly dilated. No left atrial mass/thrombus seen (best excluded by transesophageal echocardiography). The estimated right atrial pressure is 0-10mmHg. Left ventricular wall thickness, cavity size and regional/global systolic function are normal (LVEF >55%) No masses or thrombi are seen in the left ventricle. The right ventricular cavity is moderately dilated with mild global free wall hypokinesis. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. Trace aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Mild to moderate ([**12-6**]+) mitral regurgitation is seen. The tricuspid valve leaflets are mildly thickened. Moderate to severe [3+] tricuspid regurgitation is seen. There is moderate pulmonary artery systolic hypertension. There is no pericardial effusion. IMPRESSION: Dilated right ventricle with mild systolic dysfunction. Preserved left ventricular systolic function. Mild-moderate mitral regurgitation. Moderate-to-severe tricuspid regurgitation. Moderate pulmonary hypertension. NON-CONTRAST HEAD CT: There is no acute intracranial hemorrhage, edema, or major vascular territorial infarction evident on this non-contrast head CT. No change since [**2153-2-3**]. Again seen is prominence of the ventricles and sulci consistent with age-related involutional changes. [**Doctor Last Name **]-white matter differentiation is preserved. Again seen is chronic wall thickening and atelectasis of the left maxillary sinus. The eyes deviated leftward. CTA OF THE HEAD AND NECK: The vertebral and carotid arteries are seen from the origin, intracervical courses, with no significant stenosis. The cavernous carotids are mildly calcified and tortuous, nearly kissing at the center. The major vessels of the circle of [**Location (un) 431**] and its major branches are patent, with no flow-limiting stenosis or aneurysm detected. The vertebrobasilar system is also patent, with no stenosis. CT PERFUSION: There is an area of abnormal perfusion with increased mean transit time and decreased cerebral blood flow and blood volume, which is mild to moderate in extent, in the left posterior cerebral artery circulation distribution, concerning for an area of ischemia or infarction. EKG: Sinus rhythm. Frequent atrial premature beats. Left axis deviation. Probable old anteroseptal myocardial infarction. Non-specific inferolateral ST-T wave changes. Compared to the previous tracing of [**2153-4-19**] frequent atrial premature beats are new. Left bundle-branch block has resolved. Clinical correlation is suggested. Brief Hospital Course: A/P 92W h/o afib not on AC presents as CODE STROKE after onset of garbled speech, right sided weakness and left gaze preference and arrived to ED within 3 hours of time of onset and was given TPA for NIHSS 17 and concern for left MCA occlusion on CTA head nonreformatted. Rec'd TPA at 3:35pm and then admitted to neuroICU. On Vanc, Aztreonam, Flagyl for fever 102 emp pulm coverage d/t tachypnea on presentation. NEURO: Admitted to the ICU for close observation and post-tPA care. Neurologically she fared well throughout the entire hospitalization, with gradual near-full recovery. An EEG showed only some mild diffuse intermittent theta-range slowing (formal report pending at time of discharge). Since she's has such remarkable recovery and the initial imaging studies, including CT/CTA/perfusion did not reveal a LMCA stroke, and MRI was done to assess for older strokes or signs of this recent stroke. It revealed no DWI abnormalities, mild white matter microangiopathic changes, and intact vessels intracranially (formal read pending) . She was started on Plavix in lieu of Aspirin [**1-6**] allergy. Given the previous admission where she had altered mental status and speech resolved with resolution of the fever, it is a possibility that she had the same issue now. CARDIO Recurrent episodes of CP reported upon Tx out of unit to floor. Serial EKGs (3) and serial enzymes ruled out MI. Bloodpressure was allowed to autoregulate. No further issues during hospitalization. She was restarted on her home-meds gradually. RESP CXR as outlined under results, no PNA. No respiratory issues during admission. GI/ABD/UG An abdominal scan was done for a high lactate and fever, revealing no soource of infection but a it did reveal right-sided hydronephrosis and right- sided [**Month/Day (2) 96980**] obstruction. There also was extensive diverticulosis without evidence of diverticulitis, multiple hepatic cysts, bilateral renal cysts that had increased in number and hypodensities in the pancreas that were anticipated. Urology was [**Month/Day (2) 653**] for the hydronephrosis and [**Name (NI) 96980**] stenosis, and after reviewing the images they said it was OK to follow it over time as long as she was asymptomatic . ID High grade fever on admission, empirically treated with broad spectrum ABx. D/C'd on day 3. No growth all cultures (urine, blood), CXR negative). ENT She complained of a fullness of her L ear on day 3, on the floor, and of earpain bilaterally on day 4, both self-resolved with negative bedside otoscopy. HEME/ONC The PCP was [**Name (NI) 653**] regarding the issues above, and in his notes it is outlined that no further workup for her pancreatic lesion was to be done. He is aware of the hydrouretero-nephrosis. Also, Coumadin should be considered given her atrial fibrillation. Medications on Admission: ALBUTEROL - 90 mcg Aerosol - 2 puffs inhaled every 12 hours as needed for shortness of breath ATORVASTATIN - 10 mg Tablet - 1 once a day CLONAZEPAM - 0.5 mg Tablet - [**12-6**] Tablet(s) by mouth twice a day ESCITALOPRAM [LEXAPRO] - 10 mg Tablet - 1 Tablet(s) by mouth once a day ISOSORBIDE MONONITRATE - 120 mg Tablet Sustained Release 24 hr - 1 Tablet(s) by mouth 1 LORAZEPAM - 0.5 mg Tablet - 1 Tablet(s) by mouth four times a day as needed METOPROLOL TARTRATE [LOPRESSOR] - 50 mg Tablet - [**12-8**] Tablet(s) by mouth twice a day NITROGLYCERIN - 0.3MG Tablet, Sublingual - USE AS DIRECTED RISEDRONATE [ACTONEL] - 35 mg Tablet - 1 Tablet(s) by mouth a week Medications - OTC ASPIRIN [ASPIRIN EC] - 81 mg Tablet, Delayed Release (E.C.) - 1 Tablet, Delayed Release (E.C.)(s) by mouth once a day CALCIUM - (Prescribed by Other Provider) - 500 mg Tablet - 1 Tablet(s) by mouth three times a day OMEPRAZOLE - 20 mg Tablet, Delayed Release (E.C.) - 1 Tablet(s) by mouth once a day ALL: Penicillins / Codeine / Sulfonamides / Aspirin / Valium / Erythromycin Base / Ciprofloxacin / Biaxin / Acyclovir / Zestril / Egg / Oxycontin Discharge Medications: 1. Albuterol 90 mcg/Actuation Aerosol Sig: Two (2) puffs Inhalation every twelve (12) hours as needed for shortness of breath or wheezing. 2. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO once a day. 3. Escitalopram 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Clonazepam 0.5 mg Tablet Sig: half Tablet PO twice a day as needed for anxiety. 5. Isosorbide Mononitrate 120 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO once a day. 6. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 7. Nitroglycerin Oral 8. Alendronate 35 mg Tablet Sig: One (1) Tablet PO once a week. 9. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO TID W/MEALS (3 TIMES A DAY WITH MEALS). 10. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day. 11. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: Possible stroke Discharge Condition: Improved. No pronator drift, perhaps only mild 'cupping' of the R hand but no paresis. Neurological exam has returned to pre-admission baseline, no focal findings. Discharge Instructions: You have been admitted with an altered mental status and fever, and there were signficant concerns for stroke. You have received iv tPA, a strong medication that resolves clot. You have recovered well with antibiotics as well. You have also been started on Plavix. Please take all your medications excactly as directed and please attend all your follow-up appointments. Please report to the nearest ER or call 911 or your PCP immediately when you experience recurrence of weakness, numbness, tingling, problems with speech, language, walking, thinking, headache, or difficulties arousing, or any other signs or symptoms of concern. Followup Instructions: 1 Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 33176**], M.D. Phone:[**Telephone/Fax (1) 96976**] Date/Time:[**2153-5-2**] 10:30 2 Provider: [**Name10 (NameIs) **] [**Name10 (NameIs) **], RNC Date/Time:[**2153-5-15**] 10:20 3 NEUROLOGY - Provider: [**First Name8 (NamePattern2) **] [**Name11 (NameIs) 162**], MD Phone:[**Telephone/Fax (1) 44**] Date/Time:[**2153-6-11**] 1:30 [**First Name8 (NamePattern2) **] [**Name8 (MD) 162**] MD [**MD Number(2) 2575**] Completed by:[**2153-4-24**] ICD9 Codes: 4280, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6609 }
Medical Text: Admission Date: [**2144-9-10**] Discharge Date: [**2144-9-30**] Date of Birth: [**2144-9-10**] Sex: M Service: NEONATOLOGY HISTORY OF PRESENT ILLNESS: Patient is a 34 and 6/7ths week gestational age, 2475 gram male admitted from the Newborn Nursery for respiratory distress at approximately four hours of life. G6, P2 now 3 mother. She is status post spontaneous abortion times two, intrauterine fetal demise times one at 33 weeks and also has two full term children. MATERNAL PRENATAL SCREENS: O positive, antibody negative. RPR nonreactive. Hepatitis surface antigen negative. GDS unknown. Estimated date of consignment is [**2144-10-16**]. By report this has been an unremarkable pregnancy until the mother experienced premature rupture of membranes at 8 o'clock the day prior to delivery. There was no fever. There was no antibiotics until a dose of Clindamycin given at the time of Cesarean section. The Cesarean section was performed due to a history of previous Cesarean section. DELIVERY HISTORY: Patient emerged vigorous. Apgar's were [**8-10**]. He looked well and was transferred to the Newborn Nursery. In the Newborn Nursery, the patient was noted to be persistently grunting, flaring and retracting. He was transferred to the NICU for further evaluation and management. PHYSICAL EXAMINATION: On admission birth weight is 2475 grams at 50th percentile. Length is 45.5 cm, 50th percentile. Head circumference is 32 cm, 75th percentile. The patient is an AGA male in moderate respiratory distress. He has grunting, flaring and retraction. Respiratory rates are in the 80s to 100s. Room air saturations are 90 to 92%. Heart rate is 140s to 150s. The blood pressure ranged in the mid 30s. His rectal temperature was 98.5 F. Anterior fontanelle was soft, open and flat. He had non-dysmorphic faces. The lungs were inconsistently well aerated as there were intercostal and subcostal retractions. Cardiovascular exam revealed regular rate, no murmurs. Normal pulses. The abdomen had active bowel sounds and was soft without masses. The GU exam was normal. Hips are stable. The tone was somewhat decreased, but otherwise a normal neurologic exam. LABORATORY: Blood glucose on admission was 80. CBC and blood culture was sent. HOSPITAL COURSE BY SYSTEMS: 1. RESPIRATORY: Patient's initial respiratory distress actually resolved within several hours and he only briefly required nasal cannula supplemental O2. By day of life #4, he had weaned entirely to room air and has remained there. 2. CARDIOVASCULAR: Patient had normal cardiovascular exam on admission and throughout his hospitalization. He did develop apnea and bradycardia of premature at approximately day of life #6. He had intermittent spells, but never required caffeine. His last spell was on [**9-25**]. He has no had no spells for over five days. 3. FLUIDS, ELECTROLYTES AND NUTRITION: The patient's briefly required intravenous fluids, but these were quickly weaned as patient advanced on enteral feeds. He initially required gavage feeding, but by approximately two weeks of age, was taking full p.o. feeds and has continued to do so with adequate weight gain. As mentioned his birth weight was 2475 and his discharged weight is 2695 grams. 4. GI: Patient tolerated enteral feeds without difficulty. 5. HEMATOLOGY: Patient's CBC on admission was as follows with a white blood cell count of 14.3, 68 polys, 2 bands. His hematocrit was 47 and platelet count was 285,000. He was started on iron when he obtained full p.o. feeds. Also from a hematological standpoint, the patient developed physiological hyperbilirubinemia for which he received further therapy for day of life #4 to 6. His peak bilirubin was 14. 6. INFECTIOUS DISEASE: Patient, given his respiratory distress, as initially started on ampicillin and gentamicin, however given his benign CBC, quick resolution of his respiratory distress and the fact that blood cultures remained sterile after 48 hours, the antibiotics were discontinued after 48 hours. 7. GU: Patient had a circumcision performed on [**2144-9-24**]. 8. SENSORY: Audiology hearing screening was performed through automated auditory brainstem responses and the patient passed in both ears. 9. PSYCHOSOCIAL: A social worker was involved with the family. The contact social worker can be reached at [**Telephone/Fax (1) **]. CONDITION ON DISCHARGE: Good. DISCHARGE DISPOSITION: To home. PRIMARY CARE PEDIATRICIAN: Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 45058**] at [**Hospital **] Pediatrics, [**Telephone/Fax (1) 45059**]. CARE AND RECOMMENDATIONS: 1. Feeds at discharge: Enfamil 20 and breast milk p.o. ad lib. 2. Medications: Fer-In-[**Male First Name (un) **] 0.2 cc p.o. q.d. 3. Car seat position screening: Passed. 4. State newborn screening: Two week test sent and is pending. 5. Immunizations: Hepatitis B vaccine given on [**2144-9-11**]. 6. Immunizations recommended: Synagis RSV prophylaxis should be considered from [**Month (only) 359**] through [**Month (only) 547**] for infants who meet any of the following criteria: 1) Born at less than 32 weeks; 2) born at 32 and 35 weeks with plans for DayCare during RSV season with a smoker in the household or with preschool siblings; and 3) with chronic lung disease. Baby boy [**Known lastname 28708**] did receive Synagis on [**2144-9-25**]. FOLLOW UP APPOINTMENTS: Patient is to see Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 45058**] at the end of this week. DISCHARGE DIAGNOSES: 1. Prematurity. 2. Transient tachypnea of a newborn. 3. Rule out sepsis. 4. Apnea and bradycardia of prematurity. 5. Status post circumcision. [**First Name11 (Name Pattern1) 37693**] [**Last Name (NamePattern4) 37927**], M.D. [**MD Number(1) 37928**] Dictated By:[**Last Name (NamePattern1) 44694**] MEDQUIST36 D: [**2144-9-30**] 11:07 T: [**2144-9-30**] 11:21 JOB#: [**Job Number 45060**] ICD9 Codes: V290, V053
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Medical Text: Admission Date: [**2197-1-13**] Discharge Date: [**2197-2-3**] Service: CARDIOTHORACIC Allergies: Penicillins Attending:[**First Name3 (LF) 922**] Chief Complaint: chest discomfort and fatigue Major Surgical or Invasive Procedure: Aortic valve replacement (27mm [**Company 1543**] Mosaic),coronary artery bypass x3(Lima-LAD,SVG-ramus, SVG-OM) and ligation of left atrial appendage [**2197-1-17**] History of Present Illness: Mr. [**Known lastname 84178**] is an 86 year old man who has been experiencing increasing episodes of chest discomfort and fatigue over the past month. A recent echocardiogram revealed an EF of 45% with modest aortic stenosis ([**Location (un) 109**] 1.2) and moderate aortic regurgitation and 2+ mitral regurgitation and modest tricuspid regurgitation. A subsequent cath revealed 90% LM and RCA, LCX, and Ramus lesions. He is admitted for surgical revasularization and aortic valve replacement. Past Medical History: Past Medical History: PAF, HTN, Meniere's, Aortic stenosis, Aortic insufficiency, non-STEMI [**12-14**], TIA (two episodes ten years ago), AFib Social History: Race:caucasian Last Dental Exam:2 yrs ago Lives with:alone Occupation:retired Tobacco:never ETOH:never Family History: non contributory Physical Exam: Pulse: 77 Resp: 18 O2 sat: 100% RA B/P 137/71 Height: 5'[**97**]" Weight:150 lbs General: Skin: Dry [x] intact [x] HEENT: PERRLA [x] EOMI [x] Neck: Supple [x] Full ROM [x] Chest: Lungs clear bilaterally [x] Heart: RRR [] Irregular [x] Murmur IV/Vi SEM Abdomen: Soft [x] non-distended [x] non-tender [x] bowel sounds + [x] Extremities: Warm [x], well-perfused [x] Edema Varicosities: superficial veins b/l None [] Neuro: Grossly intact 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: transmitted murmur Pertinent Results: [**Hospital1 18**] ECHOCARDIOGRAPHY REPORT [**Known lastname **], [**Known firstname **] [**Hospital1 18**] [**Numeric Identifier 84179**] (Complete) Done [**2197-1-17**] at 1:08:20 PM FINAL Referring Physician [**Name9 (PRE) **] Information [**Name9 (PRE) **], [**First Name3 (LF) 177**] C. [**Hospital Unit Name 927**] [**Location (un) 86**], [**Numeric Identifier 718**] Status: Inpatient DOB: [**2110-1-20**] Age (years): 86 M Hgt (in): 70 BP (mm Hg): 110/70 Wgt (lb): 150 HR (bpm): 50 BSA (m2): 1.85 m2 Indication: Coronary artery disease, aortic valve disease ICD-9 Codes: 424.1, 424.0 Test Information Date/Time: [**2197-1-17**] at 13:08 Interpret MD: [**Name6 (MD) 3892**] [**Name8 (MD) 3893**], MD Test Type: TEE (Complete) Son[**Name (NI) 930**]: [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 3893**], MD Doppler: Full Doppler and color Doppler Test Location: Anesthesia West OR cardiac Contrast: None Tech Quality: Adequate Tape #: 2010AW01-: Machine: Echocardiographic Measurements Results Measurements Normal Range Left Atrium - Long Axis Dimension: *6.2 cm <= 4.0 cm Left Atrium - Four Chamber Length: *6.2 cm <= 5.2 cm Left Ventricle - Septal Wall Thickness: *1.2 cm 0.6 - 1.1 cm Left Ventricle - Inferolateral Thickness: *1.2 cm 0.6 - 1.1 cm Left Ventricle - Diastolic Dimension: *5.7 cm <= 5.6 cm Left Ventricle - Ejection Fraction: 40% >= 55% Aorta - Sinus Level: 3.4 cm <= 3.6 cm Aorta - Ascending: *3.6 cm <= 3.4 cm Aortic Valve - LVOT diam: 2.3 cm Aortic Valve - Valve Area: *1.1 cm2 >= 3.0 cm2 Findings LEFT ATRIUM: Dilated LA. Moderate to severe spontaneous echo contrast in the LAA. Depressed LAA emptying velocity (<0.2m/s) RIGHT ATRIUM/INTERATRIAL SEPTUM: Normal RA size. No ASD by 2D or color Doppler. RIGHT VENTRICLE: Normal RV chamber size and free wall motion. AORTA: Normal aortic diameter at the sinus level. Focal calcifications in aortic root. Normal ascending aorta diameter. Focal calcifications in ascending aorta. Normal aortic arch diameter. Focal calcifications in aortic arch. Simple atheroma in descending aorta. AORTIC VALVE: Moderately thickened aortic valve leaflets. Moderate AS (area 1.0-1.2cm2) Mild (1+) AR. MITRAL VALVE: Mildly thickened mitral valve leaflets. Mild (1+) MR. TRICUSPID VALVE: Normal tricuspid valve leaflets. Mild [1+] TR. PULMONIC VALVE/PULMONARY ARTERY: Normal pulmonic valve leaflet. No PS. Physiologic PR. PERICARDIUM: No pericardial effusion. GENERAL COMMENTS: A TEE was performed in the location listed above. I certify I was present in compliance with HCFA regulations. The patient was under general anesthesia throughout the procedure. The TEE probe was passed with assistance from the anesthesioology staff using a laryngoscope. No TEE related complications. The rhythm appears to be atrial fibrillation. patient. REGIONAL LEFT VENTRICULAR WALL MOTION: N = Normal, H = Hypokinetic, A = Akinetic, D = Dyskinetic Conclusions PRE-BYPASS: The left atrium is dilated. Moderate to severe spontaneous echo contrast is present in the left atrial appendage. The left atrial appendage emptying velocity is depressed (<0.2m/s). No atrial septal defect is seen by 2D or color Doppler. Right ventricular chamber size and free wall motion are normal. There are focal calcifications in the aortic arch. There are simple atheroma in the descending thoracic aorta. The aortic valve leaflets are moderately thickened. There is moderate aortic valve stenosis (valve area 1.0-1.2cm2). Mild (1+) aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Mild (1+) mitral regurgitation is seen. There is no pericardial effusion. Dr. [**Last Name (STitle) 914**] was notified in person of the results on Mr.[**Known lastname 84178**] before surgical incision. Post_Bypass: Normal RV systolic function. LVEF 40%. Intact thoracic aorta. The bioprosthetic aortic valve is stable and functioning well. NO periprosthetic leaks. Residual mean gradient is 4mm of Hg. I certify that I was present for this procedure in compliance with HCFA regulations. . Brief Hospital Course: Mr. [**Known lastname 84178**] was admitted and taken tot he operating room for the following:(see operative note for details) 1. Aortic valve replacement with a 27-mm [**Company 1543**] Mosaic ULTRA Bioprosthesis. 2. Coronary bypass grafting x3 with the left internal mammary artery, left anterior descending coronary; reversed after sustaining a single graft from the aorta to ramus intermedius coronary artery; as well as reverse saphenous vein single-graft from the aorta to the first obtuse marginal coronary artery. 3. Resection of left atrial appendage. 4. Endoscopic left greater saphenous vein harvesting. Post operatively he remained intubated and was admitted to the CVICU for invasive hemodynamic monitoring and care. He awoke neurologically intact and was weaned from the ventilator and extubated without difficulty. Mr. [**Known lastname 84180**] chest tubes and temporary pacing wires were removed per protocol. He was started on betablockers, statins and diuresed toward his pre-operative weight however he continues to have 2+ LE edema bilateral which is being treated with IV lasix and zaroxyln. He remains in rate controlled atrial fibrillation. Mr. [**Known lastname 84178**] was anticoagulated with coumadin. He was evaluated and treated by physical therapy for strength and conditioning. He was noted to have endo-vein harvest site cellulitus on POD 8 and was placed on Vancomycin. Leukocytosis was persistent, and ID was consulted and agreed with vancomycin treatment. He developed loose stools and his laxatives were tapered and C-diff toxin would return negative twice. Cellulitis did improve on vancomycin. Rehab was recommmended upon discharge. Mr. [**Known lastname 84178**] was discharged to rehab on POD #17 after being cleared for discharge by Dr. [**Last Name (STitle) 914**]. Medications on Admission: ASA 81mg daily, plavix 75mg daily, lopressor 50mg [**Hospital1 **], zocor 20mg daily Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 3. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4 hours) as needed for fever/pain. 4. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal DAILY (Daily) as needed for constipation. 5. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO HS (at bedtime) as needed for constipation. 6. Simvastatin 10 mg Tablet Sig: Two (2) Tablet PO QHS (once a day (at bedtime)). 7. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 8. Tramadol 50 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for pain. Tablet(s) 9. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 10. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: One (1) Tablet PO DAILY (Daily). 11. Zinc Sulfate 220 mg Capsule Sig: One (1) Capsule PO DAILY (Daily). 12. Warfarin 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily): Take as directed for INR Goal 2-2.5 for afib. 13. Vancomycin 500 mg Recon Soln Sig: One (1) Recon Soln Intravenous Q 12H (Every 12 Hours): last dose pm on [**2197-2-9**]. 14. Metoprolol Tartrate 50 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 15. Amiodarone 200 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 16. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig: Two (2) Tab Sust.Rel. Particle/Crystal PO twice a day: while on lasix check potassium daily. 17. Metolazone 2.5 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily): continue diuresis until lower extremity. 18. Furosemide 10 mg/mL Solution Sig: Forty (40) mg Injection [**Hospital1 **] (2 times a day): until lower extremity edema resolves. 19. picc picc line care and flushes per facility protocol 20. Outpatient Lab Work check INR daily until stablizes and follow bun/creat and lytes daily while on lasix and vanco Discharge Disposition: Extended Care Facility: [**Last Name (NamePattern1) **]Nursing Facility Discharge Diagnosis: post operative left lower extremity cellulitis from saphenous vein graft site Aortic stenosis coronary artery disease s/p aortic valve replacement, coronary artery bypass grafts and ligation of left atrial appendage [**2197-1-17**] Meniere's disease hypertension hyperlipidemia paroxysmal atrial fibrillation cerebrovascular disease Discharge Condition: Alert and oriented x3 nonfocal Ambulating, gait steady Sternal pain managed with tylenol and ultram prn Discharge Instructions: 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**] When to Call Your Surgeon Call your surgeon ([**Telephone/Fax (1) 1504**] (24 hours a day, seven days a week) if any of the following occur: * Your incision is warm, red or swollen or there is increased tenderness or pain * Any of your incisions have ANY fluid or drainage coming out * You have a fever of 100.5 degrees Fahrenheit or higher * Your weight has gone up more than two pounds in one day or five pounds in a week * You have severe pain or increased swelling in either leg * You have palpitations * You feel dizzy or weak (if severe, call 911) * You notice any of the following, especially if you are on warfarin (Coumadin) o A lot of dark, large bruises o Black or dark bowel movements o Pain, discomfort or swelling in any area, especially after an injury o Severe or unusual headache (if symptoms are severe, please call 911) Followup Instructions: Dr. [**Last Name (STitle) 914**] in 4 weeks ([**Telephone/Fax (1) 170**]) [**2197-2-28**] at 1pm Dr. [**First Name11 (Name Pattern1) 2174**] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 656**] (primary care) [**2-21**] at 130 pm plaese call and schedule the following appointments: Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 4610**] (cardiologist) in 2 weeks Completed by:[**2197-2-3**] ICD9 Codes: 4280, 4241, 4168, 412, 2724
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Medical Text: Admission Date: [**2172-1-31**] Discharge Date: [**2172-2-2**] Date of Birth: [**2099-2-10**] Sex: M Service: MEDICINE Allergies: A.C.E Inhibitors Attending:[**First Name3 (LF) 1070**] Chief Complaint: SOB Major Surgical or Invasive Procedure: None History of Present Illness: History obatined from NH notes, [**Name8 (MD) **] MD, and Patient. Patient is poor historian. The pt. is a 72 year-old male with PMH of SCC of the tongue s/p XRT, and NSCLC of s/p RML and LUL resection, COPD on chronic O2 (2L NS), and current smoker, p/w 3 days of increased SOB with productive cough from his NH (Bengamin Center [**Telephone/Fax (1) 110311**]). Has been treated with nebs and levo for presumptive PNA over the past 13 days. + Fevers at home, no shaking chills, no CP, N/V. Is NPO [**2-20**] neck SCC but is able to swallow sercretion. No odynophagia or dysphagia. Per NH records, patient was noted to be 88% on usual 2l NC. On EMS arrival, 100% on NRB, tachypnic 26-28. Per NH sheets, has refused pneumovax in the past. He was admitted to the medical intensive care unit. In the MICU, the patient was started on vanco/zosyn for presumed PNA. Was maintained on oxygen mask with sating in the low 90's. Past Medical History: COPD on home O2 (2L) Dementia Squamous cell of the tongue s/p XRT CHF with EF 20% 2/2 EtOH CM PUD NSCLC s/p RML,LUL resection; status post video assisted left upper lobectomy in [**2159**] and laser ablation, plus radiotherapy in '[**63**]. Peptic ulcer disease Status post appendectomy. History of alcohol (now sober per patient) +++ tobacco use; 1-2ppd, currently [**Date range (1) 61126**] PPD Social History: Homeless, was transferred here from the [**Hospital **] Health Care facility. He has a 40 pack/year history of smoking and continues to smoke. He no longer uses alcohol. The patient was seen [**8-18**] status post a successful PEG placement with no complications. Family History: Non-Contributory Physical Exam: Vitals: T:96 P:107 R:21 BP:116/76 SaO2:95 General: awake, nodding to questions HEENT: PERRLA, EOMI without nystagmus, no scleral icterus noted, mucous membranes very dry Neck: no JVP or carotid bruits appreciated. XRT skin hyperpigmentation. No tracheal deviation noted. no palpable masses appreciated. Pulmonary: Poor air movment throughout; prolonged exp phase with end exp wheeze. + upper airway sounds Cardiac: Tachy, regular, no M/R/G noted Abdomen: soft, NT/ND, normoactive bowel sounds, no masses or organomegaly noted. PEG site is c/d/i Extremities: + clubbing; Atrophic limbs. DP and PT pulses b/l. Pertinent Results: EKG: ST 136, nl axis and intervals, PRWP, LAE, LVH by >35mm in precordial leads. STD in V5/V6. c/w [**5-/2166**], PRWP is new and LVH is more pronounced. Radiologic Data: left shirt of mediastinum with tracheal deviation. (unchanged from prior CXR), RUL and lLL new airspace disease. Small left pleura effusions. on PTX. Cultures: [**2172-1-31**] Blood - pending [**2172-1-31**] Urine - pending Brief Hospital Course: The patient was a 72 yo male with severe COPD, RML, LUL wedge resection,and neck XRT presented with a 2 history of increased SOB and cough. He had been on ceftriaxone from [**Date range (1) 90581**] and then levofloxicin for 10 more days. The patient was at risk for resistent organisms and also the risk of aspiration was great and given neck XRT, impaired ciliary clearnance increases risk of pseudomonas. On admission the patients ABG is remarkable for PaCO2 of 90, but with a pH of 7.39; for chronic resp, acidosis, expect his bicarb to be 39; thus he had a met alk as well. Patient does not give any history of nausea/emesis(as one might expect in Theoph toxicity). The patient had clearly documented DNR/DNI status at the nursing home and his signed forms were faxed over. The patient was initally admitted to the medical intensive care unit. He was started on vanco and zosyn for broad coverage and started on methylprednisolone q8 for management of his COPD flare. It was unclear if there was a superimposed PNA. The ICU team felt that BiPAP was not indicated as it could serve only be a bridge to intubation and intubation was against the patient's wishes. The patient was maintained on NC and fasemask O2. He was transferred to the medical floor there was no further intensive interventions. He continued to be tachypnic and require increasing amounts of oxygent to maintain O2>88%. He was given morphine for worsening SOB. Multiple attempts were made to contact family members, but none could be reached. The nursing home reported that the patient had not had contact with any family member in over 1 year. The patient expired on [**2172-2-2**] at 4:55PM. Further attempts were made to contact family members without success. No autopsy was performed. Medications on Admission: TF Jevity Plus Fluoxetine 20mg po qd Protonix 40mg po qd Prednisone 40mg po taper on [**1-19**] and completed this on the 11th; now on baseline 10mg po qd Trazodone 75mg po [**First Name9 (NamePattern2) 5910**] [**Last Name (un) **]-24 300mg po BID Lasix 40mg po BID Clonazepam 1mg po bid Percocet prn combivent INH 3puffs qid prn albuterol prn colace/senna/fleets prn Levo 500 from [**Date range (1) 35535**] CTX on [**11-18**] Allergies: LISINOPRIL WHICH CAUSES ANGIOEDEMA. Discharge Medications: Patient Expired on [**2172-2-2**] at 4:55 PM Discharge Disposition: Expired Discharge Diagnosis: Respiratory Failure Lung cancer Discharge Condition: Expired [**2172-2-2**] at 4:55 PM ICD9 Codes: 4280, 486, 4271
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Medical Text: Admission Date: [**2171-4-2**] Discharge Date: [**2171-4-16**] Service: CCU CHIEF COMPLAINT: Dyspnea, fatigue, diaphoresis. HISTORY OF PRESENT ILLNESS: Mr. [**Known lastname 104834**] is a 77-year-old male with a history of hypertension, alcoholism, and tobacco abuse who presented to the [**Hospital1 69**] Emergency Department on the afternoon of admission complaining of dyspnea earlier in the day. He had a feeling of indigestion accompanied by diaphoresis, chills, and nausea. He became progressively dyspneic throughout the afternoon and presented to the Emergency Room. In the Emergency Department, he was initially treated with Lasix and antibiotics. Despite these measures he remained tachypneic and was intubated for distress and worsening hypoxia. He received 3 liters of fluid in the Emergency Department over roughly six hours with no urine output. At the time of intubation, his blood pressure had dropped to a systolic of 80, and he was started on dopamine. There was a report of weight loss over the past three months along with malaise. There was no history of chest pain. No recent history of gastrointestinal illnesses. PAST MEDICAL HISTORY: 1. Hypertension. 2. Depression. 3. Alcoholism. 4. Tobacco use of one pack per day times 50 years. 5. Gout. 6. Peripheral vascular disease. 7. Non-insulin-dependent diabetes mellitus. 8. Chronic obstructive pulmonary disease. MEDICATIONS ON ADMISSION: 1. Micardis 20 mg p.o. q.d. 2. Lasix 20 mg p.o. q.d. 3. Effexor. SOCIAL HISTORY: The patient is married and retired. FAMILY HISTORY: Non-insulin-dependent diabetes in multiple family members. PHYSICAL EXAMINATION ON PRESENTATION: Admission physical examination with vital signs which revealed a temperature of 99.7, heart rate of 115, blood pressure of 96/41, ventilator setting of FVC of 500 X 14, FIO2 of 50%, positive end-expiratory pressure of 5. In general, intubated but alert. Answered questions. Head, eyes, ears, nose, and throat revealed pupils were equal, round, and reactive to light. Extraocular movements were intact. Neck revealed elevated jugular venous pressure. No bruits. Lungs revealed rhonchorous breath sounds throughout. Scattered bibasilar end-expiratory crackles. Abdomen was soft, nontender, and nondistended. Normal active bowel sounds. Extremities were thin, hairless, good pulses, no edema, cool. Skin revealed no rash. Neurologically, moved all extremities. PERTINENT LABORATORY DATA ON PRESENTATION: Admission laboratories with a white blood cell count of 15.1 (85% neutrophils and no bands), hematocrit of 33.7, platelets of 309, mean cell volume of 111. SMA-7 revealed a sodium of 145, potassium of 5, chloride of 108, bicarbonate of 26, blood urea nitrogen of 20, creatinine of 1.6, and glucose of 259. Calcium of 8.5, phosphorous of 7.5, magnesium of 2.1. Creatine kinase of 43, troponin of 2. Arterial blood gas status post intubation was 7.23/56/238 on 50% FIO2 and 5 of positive end-expiratory pressure. Hepatic enzymes revealed ALT of 17, AST of 42, alkaline phosphatase of 161, total bilirubin of 0.4, amylase of 113. RADIOLOGY/IMAGING: Chest x-ray revealed small right pleural effusion, diffuse interstitial alveolar infiltrates bilaterally (left greater than right); new compared to [**2171-3-19**]. Electrocardiogram revealed sinus tachycardia with a rate into the 120s, normal intervals, normal axis, Q waves in V2 and V3, poor R wave progression, ST elevations in V2 to V4 noted along with 1.5-mm ST depressions in V5 to V6. These changes were new compared to [**2167-12-25**] electrocardiogram. HOSPITAL COURSE: The patient was originally admitted to the Medical Intensive Care Unit for management of respiratory distress thought to be secondary to pneumonia. Over the course of the first 24 hours the patient started ruling in for a myocardial infarction, and he was emergently transferred to the [**Hospital Ward Name 517**] to undergo cardiac catheterization. The patient did undergo cardiac catheterization which revealed the following vascular abnormalities: The left main was calcified but okay, the left anterior descending artery had a 99% focal clot in the proximal region, and the left circumflex had a 95% large second obtuse marginal and a 70% distal circumflex lesion in the AV groove. The right coronary artery had a 90% middle and a diffusely diseased posterior descending artery. Stents were placed to the left anterior descending artery and large second obtuse marginal. The patient had elevations of his pulmonary capillary wedge pressure, and pulmonary artery pressure, along with borderline hypotension on high-dose Levophed; so an intra-aortic balloon pump was placed. The patient was then transferred to the Coronary Care Unit for further care. At the time of presentation, the patient had also been anuric for the first 24 hours of his admission. Over the next 72 hours, the patient continued to have progressive oliguria becoming increasingly refractory to diuretics. His creatinine was rising, and he became fluid overloaded. Though we were able to wean pressors and intra-aortic balloon pump was off for cardiac support, the fluid overload secondary to his worsening renal failure was refractory to medical therapy. Hemodialysis was initiated on [**2171-4-9**]. Prior to hemodialysis, the patient had multiple weaning trials which he had failed felt secondary to fluid overload in his lungs. Despite several rounds of hemodialysis, which the patient tolerated well, his weaning mechanics were still noted to be quite poor. After 16 days of intubation, the goals of the patient's care were revised and advance support was withdrawn. The patient was extubated on [**2171-4-15**] after getting his fourth round of dialysis; and over the next 18 hours, he was made comfortable as his cardiopulmonary parameters decompensated. The patient was pronounced dead at 6:20 a.m. on the morning of [**2171-4-16**]. DIAGNOSIS AT DEATH: 1. Intraseptal myocardial infarction leading to cardiogenic shock with subsequent multiorgan failure. 2. Inability to wean off ventilator despite successful diuresis. NOTE: The patient was notified of the patient's death, and voluntary postmortem examination was refused, and funeral home was to make arrangements. DR.[**Last Name (STitle) **],[**First Name3 (LF) **] 12-463 Dictated By:[**Name8 (MD) 2653**] MEDQUIST36 D: [**2171-4-16**] 06:52 T: [**2171-4-16**] 13:10 JOB#: [**Job Number **] ICD9 Codes: 5849, 486, 5990, 496
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Medical Text: Admission Date: [**2201-3-27**] Discharge Date: [**2201-4-1**] Date of Birth: [**2137-3-4**] Sex: M Service: CARDIOTHORACIC Allergies: Byetta Attending:[**First Name3 (LF) 922**] Chief Complaint: 64 yoM with known CAD complained of progressive angina, referred for cardiac catheterization Major Surgical or Invasive Procedure: CABG [**3-28**] Cardiac catheterization [**3-27**] History of Present Illness: 64yo man with history of HTN,^chol,DM, and known CAD s/p PCI of Cx(87) and RCA(99) free of angina after PCI know with recurrent angina at rest and with minimal exertion for last several weeks. EF by echo 60% Past Medical History: CAD s/p PCI(Cx and RCA), HTN, ^chol, DM2, BPH, Colon CA s/p colonoscopy and chemo, Tonsillectomy, Depression Social History: Divorced, lives with friend. Owns [**Name2 (NI) 27234**] shop. Occaisional ETOH, denies tobacco use Family History: non contributory Physical Exam: Admission: VS T 98 HR 66 BP 113/60 RR 14 O2sat Ht 5'7" Wt 165 lbs Gen NAd Neuro A&Ox3, nonfocal exam Chest CTA-bilat, well healed Porta-cath site Rt chest wall CV RRR no M/R/G Abdm soft, NT/ND/NABS Ext warm, well perfused. No edema. No varicosities Discharge Pertinent Results: [**2201-3-27**] 11:30AM URINE COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.000* [**2201-3-27**] 09:00AM GLUCOSE-137* UREA N-21* CREAT-0.9 SODIUM-136 POTASSIUM-4.6 CHLORIDE-104 TOTAL CO2-26 ANION GAP-11 [**2201-3-27**] 09:00AM ALT(SGPT)-22 AST(SGOT)-20 CK(CPK)-172 ALK PHOS-67 AMYLASE-72 TOT BILI-1.9* DIR BILI-0.3 INDIR BIL-1.6 [**2201-3-27**] 09:00AM ALBUMIN-4.1 CALCIUM-9.1 CHOLEST-139 [**2201-3-27**] 09:00AM %HbA1c-7.4* [Hgb]-DONE [A1c]-DONE [**2201-3-27**] 09:00AM WBC-7.3 RBC-4.08* HGB-12.3*# HCT-34.5* MCV-85 MCH-30.1 MCHC-35.6* RDW-14.8 [**2201-3-27**] 09:00AM PT-11.5 PTT-26.4 INR(PT)-1.0 C.CATH Study Date of [**2201-3-27**]: 1. Selective coronary angiography of this right dominant system demonstrated a three vessel CAD. The LAD and LCx had a common ostium. The LAD had a long proximal ulcerated lesion up to 90%. The LCx had a 70% proximal stenosis and diffuse disease elsewhere. The RCA had a 70% ostial stenosis; previously placed stent was patent. 2. Resting hemodynamics revealed a slightly elevated left sided filling pressure with an LVEDP of 15 mm Hg. 3. Left ventriclulography revealed no mitral regurgitation. The LVEF was preserved and was calculated to be 60% with a normal wall motion. CXR [**2201-3-30**]: S/P CABG. Heart size is within normal limits. There are small bilateral pleural effusions, left greater than right, with linear atelectases in the left lower lobe. No pneumothorax. ECHO Study Date of [**2201-3-28**]: PRE-BYPASS: The left atrium is normal in size. No spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. No atrial septal defect is seen by 2D or color Doppler. Left ventricular wall thicknesses and cavity size are normal. The right ventricular cavity is mildly dilated. Right ventricular systolic function is normal. There are simple atheroma in the descending thoracic aorta. The aortic valve leaflets (3)appear structurally normal with good leaflet excursion and no aortic regurgitation. There is no aortic valve stenosis. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Torn mitral chordae are present. Mild (1+)mitral regurgitation is seen. There is no pericardial effusion. POST CPB: Preserved biventricular systolic function. No change in valve structuer or function. Brief Hospital Course: Pt with progressive angina referred for cardiac catheterization which revealed native 3 vessel disease. Following catheterization patient was referred to CT surgery for consideration for CABG. Pt accepted for CABG and on [**3-28**] pt was brought to operating room where he had CABGx4. Please see OR report for details, in summary pt had LIMA-LAD, SVG-Diag, SVG-OM, SVG-RCA. His bypass time was 120 minutes with X-clamp time of 102 min. He did well in the immediate post-op period and was extubated on the day of surgery. On POD1 he was transferred to the step down floor. The remainder of his postop course was uneventful. On POD2 his chest tubes were removed and physical therapy was started. On POD3 his temporary pacing wires were removed. PT continued to work with the patient until on POD4, he was discharged home with VNA. Medications on Admission: ASA 81', Toprol XL 50", Lipitor 40', Altace 10', Lantus 17 QHS, MVI, Coenzyme Q10 Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 3. Atorvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 4. Hydromorphone 2 mg Tablet Sig: One (1) Tablet PO Q 3-4 hrs as needed. Disp:*50 Tablet(s)* Refills:*0* 5. Insulin Glargine 100 unit/mL Solution Sig: Seventeen (17) units Subcutaneous at bedtime. Disp:*1 bottle* Refills:*0* 6. Amiodarone 200 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day): 400mg [**Hospital1 **] x5 days then 400mg QD x 7 days then 200mg QD. Disp:*70 Tablet(s)* Refills:*0* 7. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). Disp:*90 Tablet(s)* Refills:*2* 8. Tamsulosin 0.4 mg Capsule, Sust. Release 24HR Sig: One (1) Capsule, Sust. Release 24HR PO HS (at bedtime). Disp:*30 Capsule, Sust. Release 24HR(s)* Refills:*0* 9. Furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day for 2 weeks. Disp:*14 Tablet(s)* Refills:*0* 10. Potassium Chloride 10 mEq Capsule, Sustained Release Sig: Two (2) Capsule, Sustained Release PO once a day for 2 weeks. Disp:*28 Capsule, Sustained Release(s)* Refills:*0* Discharge Disposition: Home With Service Facility: VNA Assoc. of [**Hospital3 **] Discharge Diagnosis: CAD s/p CABGx4(LIMA-LAD, SVG-Diag, SVG-OM, SVG-RCA)[**3-28**] PMH: CAD, Depression, HTN, ^chol, DM2, BPH, Colaon CA s/p colectomy/chemo, tonsillectomy Discharge Condition: good Discharge Instructions: keep wounds clean and dry. OK to shower, no bathing or swimming. Take all medications as prescribed. Call for any fever, redness or drainage from wounds Followup Instructions: [**Hospital 409**] clinic inn 2 weeks Dr [**Last Name (STitle) **] in [**3-21**] weeks Dr [**Last Name (STitle) 914**] in 4 weeks Follow up with urologist Completed by:[**2201-4-1**] ICD9 Codes: 4111, 4019, 2720
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Medical Text: Admission Date: [**2166-4-28**] Discharge Date: [**2166-5-6**] Date of Birth: [**2114-7-26**] Sex: M Service: NEUROSURGERY Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 78**] Chief Complaint: Worse headache Major Surgical or Invasive Procedure: [**2166-4-28**]: Diagnositic cerebral angiogram History of Present Illness: Mr. [**Known lastname 12967**] is a 51 y.o. RH male who presents to E.D. with sudden onset of headache last Wednesday. He states that he was using the bathroom and went to bed and felt sudden onset headache. He tried Tylenol and ibuprofen without relief. reports pain in neck going up toward scalp initially and now has progressed to global sharp headaches. He went to his PCP office and was seen by [**Name8 (MD) **] NP who sent her to ED for evaluation. Past Medical History: PMHx: none All: NKDA Medications: None Social History: SOCIAL HISTORY: He is a nonsmoker. He does not drink alcohol or use illicit drugs. He lives with his wife and their one child plus two [**Doctor Last Name **] children now. He denies having any criminal record. He works with hazardous chemical and using respiratory mask daily. Family History: Negative Physical Exam: PHYSICAL EXAM: Hunt and [**Doctor Last Name 9381**]: 1 [**Doctor Last Name **]: 1 GCS 15 O: AF bp 150/98, HR 98 RR 16 100% RA Gen: WD/WN, comfortable, NAD. HEENT: head: atraumatic, normocephalic, eyes clear, no papilledema Neck: Supple. Lungs: CTA bilaterally. Cardiac: RRR. S1/S2. Abd: Soft, NT, BS+ Extrem: Warm and well-perfused. No C/C/E. Neuro: Mental status: Awake and alert, cooperative with exam, normal affect. Orientation: Oriented to person, place, and date. Recall: [**3-1**] 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, 5to2 mm bilaterally. Visual fields are full to confrontation. no papilledema III, IV, VI: Extraocular movements intact bilaterally without nystagmus. 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. Motor: Normal bulk and tone bilaterally. No abnormal movements, tremors. Strength full power [**5-3**] throughout. No pronator drift Upon discharge: AOx3, PERRL, EOM intact, MAE [**5-3**], nonfocal exam Pertinent Results: CT/CTA Head and neck [**2166-4-28**]: 1. Normal intracranial vasculature without aneurysm. 2. Hyperdense lesion in the interpeduncular cistern extending into the prepontine cistern encases the distal basilar artery and may represent leptomeningeal disease such as lymphoma, primitive neuroectodermal tumor, metastatic disease or sarcoid. Followup MRI with and without contrast is recommended for further characterization. 3. Severe stenosis at the origin of the right vertebral artery. 4. Non-calcified atheroma of the left carotid bulb with 40% stenosis. Cerebral angiogram [**2166-4-28**]: FINDINGS: 1. Right internal carotid artery fills well along the cervical, petrous, cavernous and supraclinoid portions with brisk filling of the anterior and middle cerebral artery and normal distal runoff. There is no evidence of stenosis, occlusion, aneurysm or arteriovenous malformation. 2. Right external carotid artery and its branches are well outlined. There is no evidence of an arteriovenous malformation. 3. Right vertebral artery angiogram shows brisk filling of the right vertebral artery with reflux of contrast into the left vertebral artery. The basilar artery is well outlined and appears normal in caliber. There is no evidence of stenosis, occlusion, aneurysm or arteriovenous malformation in the posterior circulation. Dedicated angiographic images of the right and left vertebral angiograms for evaluation of intraspinal vessels in the cervical spine showed no evidence of a spinal arteriovenous fistula or vascular malformation. The anterior spinal artery was well outlined and appeared normal in caliber. 4. The right subclavian artery and its branches are well outlined. There is no evidence of an arteriovenous malformation. 5. Left subclavian artery and its branches are well outlined. There is no evidence of an arteriovenous malformation. 6. The left vertebral artery angiogram also shows brisk filling of the left vertebral artery with no evidence of stenosis, occlusion, aneurysm or arteriovenous malformation. Basilar artery is well outlined and appears normal. There is no evidence of any abnormal arteriovenous communication in the cervical spinal canal arising from the left vertebral artery. 7. Left internal carotid artery fills well along the cervical, petrous, cavernous and supraclinoid portions with brisk filling of the anterior and middle cerebral artery and normal distal runoff. There is no evidence of stenosis, occlusion, aneurysm or arteriovenous malformation. 8. Left external carotid artery and its branches are well outlined. There is no evidence of an arteriovenous malformation. 9. Right common femoral artery angiogram shows normal caliber of the right common femoral artery with good flow of contrast distal to the sheath. IMPRESSION: Mr. [**Known firstname 34077**] [**Known lastname 12967**] underwent diagnostic cerebral angiography which was unremarkable. There is no aneurysm or vascular malformation in the intracranial circulation or in the cervical spinal canal as described above. MRI Brain [**2166-5-5**]: IMPRESSION: 1. Small T1 and T2 hyperintense extra-axial lesion in the left side of the interpeduncular cistern. This has decreased in size since the prior study and likely represents an evolving hematoma. Non contrast CT head is advised to see for interval change. MRI head is advised after few weeks to confirm resolution. 2. Hypoenhancing lesion in the inferior aspect of the pituitary gland. This likely represents a pituitary adenoma. Dedicated pituitary imaging and correlation with laboratory values is advised. Head CT [**2166-5-6**]: IMPRESSION: 1. Resolved focus of subarachnoid hemorrhage in the interpeduncular cistern from prior CT of [**2166-4-28**]. No new intracranial hemorrhage. 2. Sinus disease as detailed above. Brief Hospital Course: Mr. [**Known lastname 12967**] was admitted to the neurosurgery service for intracranial hemorrhage. He underwent a Cerebral angiogram which was negative for an aneurysm. He remained in the ICU overnight for continued neurochecks and SBP control. His neurologic exam remained stable. His groin had no hematoma and he had good distal pulses. He was transferred to the SDU on [**4-29**] in stable condition. His SBP goals were liberalized to less than 160 and he was kept on nimodipine 60mg q4 hours. On [**4-30**], he reported headache which was treated adequately with pain medication. He was transferred to the floor and awaiting repeat angiogram. From [**5-1**] to [**5-5**], there were no changes to his exam. He was being prepped for his repeat Angiogram and prior imaging was being reviewed. Dr. [**First Name (STitle) **] thought this brain lesion could be a tumor and MRI was doen on [**2166-5-5**]. The MRI showed interval improvement in the hypodense lesion which correlates with a bleed vs. mass. There was also question of a pituitary macroadenoma, although a incidental finding, labs were sent for baseline measurement. A repeat head CT on [**5-6**] showed resolution of the bleed and he was discharged home. Medications on Admission: None Discharge Medications: 1. acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for HA. 2. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO twice a day. Disp:*60 Capsule(s)* Refills:*2* 3. butalbital-acetaminophen-caff 50-325-40 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for HA. Disp:*40 Tablet(s)* Refills:*0* Discharge Disposition: Home Discharge Diagnosis: Perimesencephalic SAH Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. 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, you may safely resume taking this when cleared by Neurosurgery. Followup Instructions: Please follow-up with Dr [**First Name (STitle) **] in 4 weeks with a MRI/MRA brain. Please call [**Telephone/Fax (1) 4296**] to make this appointment. Completed by:[**2166-5-6**] ICD9 Codes: 4019, 2724
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Medical Text: Admission Date: [**2201-4-20**] Discharge Date: [**2201-5-21**] Date of Birth: [**2201-4-20**] Sex: M Service: NB ADDENDUM: Discharge interim summary date of [**2201-5-19**]. HISTORY OF PRESENT ILLNESS: Baby boy [**Known lastname 61655**] is a 2150-gram product of a 33 and [**5-26**] week gestation born to a 34-year-old gravida 3/para 2 (now 3) mother. Maternal history is notable for celiac disease. Prenatal screens with blood type A negative, antibody screen negative, hepatitis B surface antigen negative, RPR nonreactive, GBS negative. She developed preterm labor at 32 and 5/7 weeks and completed a course with betamethasone. The infant was delivered by spontaneous vaginal delivery. There was meconium at delivery. The infant emerged vigorous with a good cry. Apgar's were 9 and 9. He was admitted to the NICU for prematurity. PHYSICAL EXAMINATION ON ADMISSION: Anterior fontanel open and flat. Palate and clavicles intact. Clear breath sounds with good aeration. A regular rate and rhythm. No murmur. Good femoral pulses. The abdomen was soft. No hepatosplenomegaly. He was pink and well perfused. He was a normal male with a patent anus. A small sacral dimple at the base visualized, and he moved all extremities well. HOSPITAL COURSE BY SYSTEM THROUGHOUT THIS INTERIM SUMMARY: 1. RESPIRATORY: He was on room air throughout his entire stay. He began having apneic and bradycardic spells all around feeding which resolved with mild-to-moderate stimulation. At the time of this dictation he is currently on day 3 of 5 of a spell countdown prior to his being able to be discharged home. 1. CARDIOVASCULAR: He has been cardiovascularly stable throughout his stay with no murmurs. His blood pressures have been normal, and he has had normal perfusion. 1. FLUIDS, ELECTROLYTES, AND NUTRITION: He was initially on IV fluids for the first 24 hours of his life with normal electrolytes, urine output, and glucoses. Enteral feedings were initiated on day of life 2 and slowly advanced. By day of life 4, he was breast feeding and taking at least a minimum of 80 cc/kg per day. His most recent weight is 2950 grams. He is on vitamins and iron. 1. GI: He had a bilirubin on day of life 4 that was 4.3. He was never on phototherapy. 1. HEMATOLOGY: His admission hematocrit was 46%, white blood cell count was 6.7, and platelets were 327,000 (with 50 polys and no bands). 1. INFECTIOUS DISEASE: He was placed on ampicillin and gentamicin for 48 hours after his delivery. These were discontinued when his blood culture was negative at 48 hours. 1. SENSORY: He passed his hearing screening on day of life 18. He did not meet criteria for a screening head ultrasound or screening for retinopathy of prematurity. He received his hepatitis B vaccination. He was also circumcised on day of life 8. CONDITION ON DISCHARGE: Good. NAME OF PRIMARY PEDIATRICIAN: Dr. [**First Name8 (NamePattern2) 553**] [**Last Name (NamePattern1) 38676**], [**First Name3 (LF) **] [**Hospital **] Pediatrics. FEEDINGS AT TIME OF INTERIM SUMMARY: Maternal breast milk or Similac 24 calories ad lib plus breast feeding. DISCHARGE DIAGNOSES: Prematurity at 33 and 6/7 weeks, hyperbilirubinemia, physiologic apnea and bradycardia of prematurity. [**First Name11 (Name Pattern1) 449**] [**Last Name (NamePattern1) **], [**MD Number(1) 54604**] Dictated By:[**Last Name (NamePattern1) **] MEDQUIST36 D: [**2201-5-19**] 16:37:26 T: [**2201-5-19**] 17:43:57 Job#: [**Job Number 61656**] ICD9 Codes: 7742, V290, V053
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Medical Text: Admission Date: [**2115-10-22**] Discharge Date: [**2115-10-24**] Date of Birth: [**2055-5-29**] Sex: F Service: CHIEF COMPLAINT: Malaise, nausea and vomiting. HISTORY OF PRESENT ILLNESS: Mrs. [**Known lastname 34331**] is a 60-year-old woman with a prior medical history of end stage renal disease secondary to polycystic kidney disease on hemodialysis with multiple graft clot and revisions secondary to non compliance with Coumadin, also with hypertension and chronic obstructive pulmonary disease, discharged from vascular surgery service yesterday after having been unable to underlie hemodialysis secondary to a thrombosed graft. The patient missed several Coumadin doses prior to the graft thrombosing. Subsequently she missed hemodialysis. On [**7-8**] she had a thrombectomy and she was discharged. She went to have hemodialysis on [**7-10**] but was unable to dialyze again as access was not obtained. She was readmitted to [**Hospital1 69**] for thrombectomy which was performed on [**2115-7-10**] and is now being transferred to medicine for complaint of malaise, nausea, vomiting, diarrhea. The patient is a poor historian but he reports 2-3 weeks of intermittent vomiting and nausea with subsequent decreased po intake, including her medications. She denies any abdominal pain, fever, chills, hematemesis, coffee ground or change in symptoms with food. She complains of diarrhea of loose brown stool, no melena, no blood or mucus. Stools are not clearly related to eating and she can have [**5-31**] bowel movements per day which vary in size. No recent history of travel, no sick contacts at home, no weight loss. The patient also complains of chronic cough which has been increased recently. She denies any shortness of breath, chest pain, changes in sputum color or hemoptysis. She uses inhalers more than usual but denies any wheezes or other upper respiratory infection symptoms. PAST MEDICAL HISTORY: Significant for end stage renal disease on hemodialysis secondary to polycystic kidney disease with multiple clotted graft followed by revision. Hypertension, depression, chronic obstructive pulmonary disease. ALLERGIES: Penicillin per patient report. MEDICATIONS: RenaGel 800 mg tid, Nephrocaps one q d, Albuterol as needed, Atrovent as needed, Coumadin. SOCIAL HISTORY: Lives with her husband and daughter. She has a positive tobacco history which consisted of two packs per day for 30 years. She quit one year ago, denies any alcohol use and reports that her family helps her with her medications. PHYSICAL EXAMINATION: Temperature 96.4, heart rate 92, blood pressure 115/50, respiratory rate 16 with an oxygen saturation of 98% on room air. General appearance, sleeping but arousable, in no acute distress with occasional congestive cough. HEENT: Anicteric, pupils are equal, round, and reactive to light, oropharynx clear. Neck supple without JVD. Chest, positive mild inspiratory plus expiratory wheezes with decreased air movement throughout, no rales. Heart, regular rate and rhythm, no murmurs, rubs or gallops. Abdomen soft, nontender, nondistended with positive bowel sounds, no right upper quadrant tenderness to palpation, no mass. Extremities, no clubbing, cyanosis or edema, Pneumo boots on. Neuro, alert and oriented times three, cranial nerves II through XII intact. Strength extremities not tested secondary to surgery today [**4-26**], left upper extremity and bilateral lower extremities. Babinski downgoing. LABORATORY DATA: WBC 8.8, hematocrit 34.4, platelet count 184,000, PT 13, PTT 27, INR 1.2, sodium 136, potassium 5.2, chloride 95, CO2 24, BUN 58, creatinine 9.2, glucose 82. Albumin 3.7, ALT 11, AST 15, alkaline phosphatase 117, total bilirubin 0.5, amylase 61, lipase 47. EKG on [**7-10**], sinus tachycardia at 105, no acute ST or T wave changes. C. diff negative. Radiology data: KUB, nonspecific bowel gas pattern, no dilated loops. Chest x-ray, hyperinflated lungs, no evidence of pneumonia or congestive heart failure. Urinalysis on [**10-6**] cloudy, large blood, positive nitrites and leukoesterase, 100 protein, PH 9.0, more than 50 RBC and WBC and many bacteria. HOSPITAL COURSE: Mrs. [**Known lastname 34331**] is a 60-year-old woman with end stage renal disease secondary to polycystic kidney disease on hemodialysis and also with chronic obstructive pulmonary disease, presenting with a few weeks of intermittent nausea and vomiting, diarrhea and decreased po intake. GI: Etiology of nausea and vomiting and diarrhea is unclear; could be related to renal function as the patient has missed dialysis sessions during the past weeks and her BUN and creatinine have been elevated. During her hospital course she also related that the nausea, vomiting and diarrhea had been occurring the past when she missed hemodialysis or her BUN and creatinine were particularly elevated. The nausea and vomiting resolved throughout her hospital stay right after she underwent dialysis but continued to appear in a milder form in between dialysis sessions. Renal failure: The patient requires hemodialysis. The patient presented to medicine status post AV graft thrombectomy with primary graft repair. Not withstanding the thrombectomy and despite the heparin drip, the graft remained non palpable but positive to Doppler. Heparin was increased to achieve a PTT between 60 and 90 and Coumadin was started. A Perma-cath was placed on [**2115-7-11**] to be used for dialysis until the graft would be cleared by vascular surgery. The patient received dialysis through the Perma-cath on [**2115-7-12**]. Meanwhile, the rate of the heparin drip had to be increased as the patient had difficulty in achieving PTT therapeutic range of 60-90. An arteriographic exploration of the graft was planned while the patient remained on heparin and Coumadin was titrated to achieve the therapeutic INR between 2.5 and 3.5. As arteriography could not be easily scheduled during the [**Hospital 228**] hospital stay, the procedure was scheduled as an outpatient for one week later. The patient continued to remain in hospital until [**2115-7-17**] in the attempt to achieve a therapeutic INR so that she could be discharged on Coumadin only. However, as this did not happen by [**7-17**] and the patient was eager to go home, she was discharged on Lovenox. Teaching was performed by a teaching nurse and her daughter appeared to be able to inject the patient with Lovenox. She was instructed to have her daughter inject her with Lovenox and have her INR checked at the local clinic where she had been going before. She would be returning to the hospital for an outpatient revision of the graft. [**Doctor First Name 4623**] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 4624**], MD [**MD Number(2) 4625**] Dictated By:[**Last Name (NamePattern1) 6831**] MEDQUIST36 D: [**2115-10-30**] 18:53 T: [**2115-11-4**] 19:30 JOB#: [**Job Number **] ICD9 Codes: 4019
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Medical Text: Admission Date: [**2200-8-3**] Discharge Date: [**2200-8-16**] Date of Birth: [**2169-3-15**] Sex: M Service: BLUE GENERAL SURGERY Attending:[**Last Name (NamePattern4) **] HISTORY OF PRESENT ILLNESS: The patient is a 31 year old male recently diagnosed with hepatocellular carcinoma and hepatitis B in [**2200-7-5**]. He presented to the Emergency sweats, headache and worsening right upper quadrant abdominal pain. It was unclear how high the patient's temperature was as he did not take his temperature at home. The patient denied nausea, vomiting, diarrhea or cough or cold symptoms. The patient denied having any sick contacts. Furthermore, the patient complains of new right lower quadrant abdominal pain at times radiating to his flank. He also complains of his abdominal pain. The patient also had a poor appetite. PAST MEDICAL HISTORY: 1. Hepatitis B. 2. Hepatocellular carcinoma diagnosed [**2200-7-5**]. PAST SURGICAL HISTORY: Status post appendectomy in [**2194**]. ALLERGIES: Optiray 320, CT scan intravenous contrast causes rash, itching. Levaquin causes itching and redness. MEDICATIONS ON ADMISSION: 1. Epivir HBV 100 mg once daily. 2. Famotidine 20 mg q.h.s. 3. Percocet q4-6hours p.r.n. for pain. SOCIAL HISTORY: The patient lives with his girlfriend in [**Name (NI) 1474**], [**State 350**]. He works as a custodian in a nursing home. He denied a history of tobacco, intravenous drug use and recreational drug use. He drinks alcohol socially. PHYSICAL EXAMINATION: On admission, the patient is a healthy appearing pleasant gentleman, appropriate for his stated age, in no apparent distress, laying on a stretcher. The head and neck examination showed extraocular movements are intact. The pupils are equal, round, and reactive to light and accommodation. He has oral thrush and cervical lymphadenopathy. There is no thyromegaly. His chest examination revealed bilaterally clear to auscultation. His heart has a regular rate and rhythm, normal heart sounds, no murmurs. His abdomen was soft, nondistended, right upper quadrant/epigastric/right lower quadrant abdominal tenderness. Bowel sounds active. Surgical scar from previous appendectomy. Burn scar infraumbilically. Rectal examination showed no masses with guaiac negative stools. He has no peripheral edema. His extremities were warm and well perfused. His neurologic examination was grossly intact. LABORATORY DATA: Pertinent laboratory results revealed a white count of 8.0, hematocrit 37.8, platelet count 150,000. His blood electrolytes were within normal limits. His liver function tests revealed AST of 155, ALT 226, alkaline phosphatase 167, total bilirubin 1.0, amylase 78 and lipase of 15. RADIOLOGIC STUDIES: Chest x-ray revealed clear lungs, no effusions. CT scan with p.o. contrast revealed large mass in the left hepatic lobe. In comparison to [**2200-7-18**], the mass was larger. No lesions in the right lobe. No biliary dilatation. Right upper quadrant ultrasound showed extension of portal venous clot to include the entire main portal vein to the level of the pancreatic head. The right portal vein remains preserved. There was a known 6.0 centimeter hepatic lobe mass consistent with hepatocellular carcinoma. HOSPITAL COURSE: The patient was admitted for scheduled hepatic lobectomy, cholecystectomy and removal of portal vein thrombosis. At the time of presentation, he noted to have two day history of fever and was found to have a temperature of 102.8. Blood culture was sent and failed to identify organism. A chest x-ray was negative. The patient was started on Ampicillin, Gentamicin and Flagyl for empiric treatment. A heparin drip was initiated in attempt to prevent further extension of the thrombus in the portal vein. Fever was thought to be of tumor origin and the patient was brought to the operating room on [**2200-8-8**]. He underwent a left hepatic lobectomy, cholecystectomy and removal of portal vein clot with placement of two [**Location (un) 1661**]-[**Location (un) 1662**] drains. Pathology report confirmed hepatocellular carcinoma with tumor thrombosis in the portal vein. Surgical margins were positive at the junction of the left portal vein and main portal vein. Because this was viewed as a palliative resection we did not consider resection of the entire portal vein with interposition graft. He received 18 units of packed red blood cells, three units of platelets and 11 units of fresh frozen plasma intraoperatively and postoperatively. The patient remained intubated postoperatively and was transferred to the Surgical Intensive Care Unit in stable condition with epidural in place for pain control. He required Propofol to maintain systolic blood pressure less than 180. The patient was weaned from Propofol and extubated postoperative day number one and transferred to the floor on postoperative day number two. The patient continued to spike fevers postoperatively despite antibiotic treatment. Blood, urine and sputum cultures were obtained on postoperative day number two. Sputum cultures were positive for pansensitive Klebsiella. Chest x-ray showed possible right middle lobe pneumonia. Gentamicin was discontinued when the patient began to experience ringing in his ears. Ampicillin and Flagyl were replaced with Ceftriaxone. Fevers resolved. The patient was discharged with one [**Location (un) 1661**]-[**Location (un) 1662**] drain in place. He was given a prescription for two weeks of Bactrim and instructed to follow-up with Dr. [**Last Name (STitle) **] within one week. MEDICATIONS ON DISCHARGE: 1. Bactrim DS one tablet p.o. twice a day times ten days. 2. Epivir HBV 100 mg p.o. once daily. 3. Percocet 5/325 one to two tablets p.o. q4-6hours p.r.n. for pain. 4. Famotidine 20 mg p.o. q.h.s. 5. Colace 100 mg p.o. twice a day. CONDITION ON DISCHARGE: Stable. DISCHARGE STATUS: To home without services. DISCHARGE DIAGNOSIS: Hepatocellular carcinoma, status post left hepatic lobectomy and portal vein thrombectomy. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 707**], M.D.,Ph.D. 02-366 Dictated By:[**Name8 (MD) 27821**] MEDQUIST36 D: [**2200-8-16**] 19:13 T: [**2200-8-19**] 19:49 JOB#: [**Job Number 42713**] ICD9 Codes: 2859
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Medical Text: Admission Date: [**2181-6-12**] Discharge Date: [**2181-6-26**] Date of Birth: [**2155-4-14**] Sex: F Service: OBSTETRICS/GYNECOLOGY Allergies: Penicillins Attending:[**First Name3 (LF) 76273**] Chief Complaint: left lower quadrant pain Major Surgical or Invasive Procedure: cesarean section hysterectomy History of Present Illness: Patient is a 26y/o G4P2012 at 34+4 weeks gestation with [**Last Name (un) **] [**2181-7-20**] by 6wk U/S. She presents to labor and delivery from the office with severe left lower quadrant pain. Pt reports pain [**7-17**] and describes it as sharp, localized to LLQ, and does not radiate. She was seen [**2181-6-7**] with similar complaints and had an evaluation including pelvic ultrasound. No acute process noted and she was discharged home on percocet. States she has been taking percocet but feels that it is not helping the pain. She denies any vaginal bleeding, leaking of fluid, fevers, chills, contractions. Patient has a known placenta accreta and a history of two prior c/s. She is scheduled for c-hyst on [**2181-6-22**]. Past Medical History: PRENATAL COURSE (1)EDC [**2181-7-20**] by LMP c/w first trimester U/S (2)Labs O pos, Ab neg, (3)U/S nl FFS, previa, cannot r/o accreta (4)Screening: Quad neg Issues * T2DM - poor control ([**5-14**]) EFW 2347g (>90%) was discharged NPH 28 qam, 38 qhs Humalog 34/30/36/- * Placenta previa/accreta - last vaginal bleed in [**Month (only) 404**] (slight spotting), stable; f/[**Initials (NamePattern4) **] [**Last Name (NamePattern4) 13675**] - ([**5-24**]) MRI neg for percreta, myometrium not clearly visualized * Short cervix - [**Doctor Last Name **] cerclage placed ([**2-13**]) * Asthma - albuterol prn, with hospitalization from [**3-14**]- [**3-16**] with steroid treatment PAST OBSTETRIC HISTORY G4P2012 - '[**75**] LTCS for suspected macrosomia, boy 9#8oz - '[**77**] rpt LTCS, boy 8#2oz, had cerclage - SAB 10wks - present, with cerclage PAST GYNECOLOGIC HISTORY - h/o abnl pap -> nl on rpt and since denies STIs PMH: - asthma - albuterol prn - migraine - T2DM, insulin PAST SURGICAL HISTORY - LTCS x2 - cerclage x2 Social History: married, lives in [**Location 669**] with husband, children and in-laws currently not working denies tobacco, alcohol, illicit drug use Family History: noncontributory Physical Exam: GENERAL: A&O x 3, NAD VITALS: T 97.2, BP 112/60, HR 98 LUNGS: CTAB HEART: RRR ABDOMEN: soft, tenderness with palpation no guarding or rebound, +BS EXTREMITIES: trace edema FHT: 130-140s and reactive TOCO: no contractions SVE: closed/50% Pertinent Results: [**2181-6-12**] FIBRINOGE-549 PT-12.1 PTT-30.5 INR-1.0 [**2181-6-12**] WBC-5.9 RBC-3.96 HGB-9.2 HCT-27.7 MCV-70 PLT-193 [**2181-6-12**] PELVIC MRI Low anterior placenta with findings concerning for placenta percreta with involvement of the anterior abdominal wall at the level of the lower uterine segment, and with unchanged questionable involvement of the bladder wall, but no definite evidence of mucosal penetration. Ultrasound could possibly be helpful in the evaluation of the anterior abdominal wall, particularly for planning of the surgical approach. For evaluation of the bladder, cystoscopy may be helpful as previously suggested. [**2181-6-20**] CT HEAD IMPRESSION: 1. No evidence of acute intracranial hemorrhage. 2. Slight asymmetry of the frontal horns of the lateral ventricles, however no definite mass lesions identified. If clinical suspicion remains high, an MR may be helpful. [**2181-6-19**] CT CHEST WITH INTRAVENOUS CONTRAST: IMPRESSION: 1. No evidence of pulmonary embolism. 2. Multifocal pneumonia, bilateral pleural effusions with atelectasis. [**2181-6-22**] CTA CHEST IMPRESSION: 1. Multiloculated pelvic fluid collection is likely hemoperitoneum in resolution, though superinfection is possible. The collection is amenable to percutaneous drainage. 2. Acute pulmonary embolus to apical segmental branch of right upper lobe pulmonary artery. 3. Worsening of multifocal pneumonia and bilateral now moderate pleural effusions. 4. Generalized anasarca. Brief Hospital Course: 26y/o G4P2012 with known placenta acreta admitted at 34+4 weeks with lower abdominal pain. . Mrs [**Known lastname 3095**] was admitted for close observation and bedrest. Fetal testing was reassuring. [**Last Name (un) **] followed her to assist in management of her diabetes. A repeat MRI on the day of admission revealed findings concerning for placenta percreta with involvement of the anterior abdominal wall at the level of the lower uterine segment, and with unchanged questionable involvement of the bladder wall, but no definite evidence of mucosal penetration. Due to the findings concerning for placenta percreta, in addition to her left lower quadrant tenderness, the decision was made to move up her delivery date to [**2181-6-15**]. Please see the operative report for further details. Briefly, her cesarean delivery was complicated by excessive hemorrhage requiring supracervical hysterectomy and abdominal packing. During this operation the patient received 15 units of packed red blood cells, 10 units of fresh frozen plasma, 1 unit of cryoprecipitate, 3 units of platelets. The patient was then taken to the operating room on [**2181-6-18**] for exploratory laparotomy, removal of pelvic packing, cystoscopy, removal of cerclage. . Patient was in the ICU from [**2181-6-15**] through [**2181-6-22**]. She was briefly called out to the floor on the evening of [**2181-6-22**] but returned to the ICU for respiratory distress in the setting of tachycardia and fever. Patient was transferred back to the floor on [**2181-6-25**]. Brief hospital course by organ system: *) NEURO: - Patient underwent CT head on [**2181-6-20**] for delirium and disconjugate gaze on exam, which was negative. Patient's pain was controlled with IV Toradol, oxycodone, and ibuprofen. The day prior to discharge, the patient expressed significant anxiety and urgency regarding going home. She was started on Lorazepam, and was seen by social worker. *) CARDIOVASCULAR: - Patient had persistent tachycardia immediately post operatively which was most pronounced with activity. Patient underwent two CTA chest studies. Initial study was negative for PE but showed multifocal pneumonia. The second study showed worsening multifocal, small segmental branch pulmonary embolism, and worsening pulmonary effusions with generalized anasarca. The patient was started on antibiotics and received diuresis. Her tachycardia resolved. *) RESPIRATORY: - Please see CV above - Briefly, the patient remained intubated post operatively, but was extubated without problems on [**2181-6-19**]. [**Name2 (NI) **] was persistently tachycardic and underwent CTA chest which revealed multifocal pneumonia. The patient initially received a 7 day course of Cipro/Vanco/Flagyl. However, the patient was noted to be febrile, with worsening respiratory status requiring transfer back to the ICU. Repeat CTA chest revealed worsening PNA and the patient was started on Cipro/Miropenem/Vanco after she underwent a miropenem desensitization protocol. The patient was also noted to have a pulmonary embolus and she was started on anticoagulation. Her respiratory status improved greatly. Upon discharge, she was treated with lovenox 90mg [**Hospital1 **]. *) HEME: - Throughout the hospitalization the patient received a total of 22u pRBC, 12u FFP, 2 units of cryo, and 4 units of platelets. At the time of discharge, patient's hematocrit and coags were WNL *) FEN/GI: - The patient was noted to have generalized anasarca and underwent diuresis both throughout the ICU stay as well as on the floor with IV lasix. - Patient was started on TPN briefly while awaiting return of her bowel function. - Patient's diet was slowly advanced. *) ID: - Please see CV / Resp above, but briefly, the patient was initially received a 7 day course of Cipro / Vanc / Flagyl for multifocal pneumonia, but continued spiking temperatures. An ID consultation was obtained and the patient's antibiotics were changed to Vancomycin, Ciprofloxacin, and Miropenem for 3 days. At the time of the discharge, multiple blood cultures are pending. Patient was also noted to have multiple loose bowel movements per day and C. diff was negative x 2. The patient was discharged home on Levo/Flagyl as she refused any further IV antibiotics. - Patient was noted to have a multiloculated pelvic fluid collection on CT abdomen and underwent an uncomplicated CT guided drainage on [**2181-6-22**]. At the time of discharge the culture of the pelvic fluid is pending. *) ENDOCRINE: - The patient has type II Dibetes mellitus. She was followed by [**Last Name (un) **] throughout her hospitalization. The patient was initially receiving insulin drip, but was transitioned to sliding scale. *) RENAL: - The patient received diurses with IV lasix and was euvolemic at the time of discharge. *) PPX: - The patient was receiving venodynes, heparin, and famotidine for prophylaxis Medications on Admission: insulin percocet Discharge Medications: 1. Albuterol 90 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation Q4H (every 4 hours) as needed. Disp:*1 * Refills:*5* 2. Metronidazole 250 mg Tablet Sig: Two (2) Tablet PO TID (3 times a day) for 14days days. Disp:*180 Tablet(s)* Refills:*0* 3. Lorazepam 1 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for anxiety / nausea. Disp:*30 Tablet(s)* Refills:*0* 4. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO once a day for 10 days. Disp:*10 Tablet(s)* Refills:*0* 5. Enoxaparin 100 mg/mL Syringe Sig: One (1) 90mg Subcutaneous Q12H (every 12 hours): Use as directed. Disp:*60 90mg * Refills:*2* 6. Insulin Glargine 100 unit/mL Solution Sig: One (1) 10u Subcutaneous at bedtime. Disp:*1 bottle* Refills:*2* 7. Insulin Lispro 100 unit/mL Solution Sig: Three (3) units Subcutaneous w/ breakfast, lunch and dinner: see sliding scale for additional insulin. Disp:*1 bottle* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: placenta eccreta pneumonia pulmonary embolus diabetes asthma Discharge Condition: stable Discharge Instructions: call for fever >100.5, vaginal bleeding, abdominal pain, nausea/vomiting, respiratory Symptoms, any questions or concerns. Followup Instructions: 2 days with Dr [**First Name (STitle) **] Completed by:[**2181-7-5**] ICD9 Codes: 2851, 5185, 486
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Medical Text: Admission Date: [**2118-6-17**] Discharge Date: [**2118-6-20**] Date of Birth: [**2065-12-12**] Sex: M Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 2736**] Chief Complaint: chest pain Major Surgical or Invasive Procedure: [**6-17**] cath lab: ballon angioplasty in his right coronary artery History of Present Illness: PCP: [**Name10 (NameIs) **],[**First Name3 (LF) **] M. . CHIEF COMPLAINT: chest pain . . HISTORY OF PRESENTING ILLNESS: 52 yo male with h/o poorly controlled hypertension and tobacco abuse presented to his PCP's office today with chest pain, seen in [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], and now transferred to [**Hospital1 18**] for STEMI. Patient reports he felt like he had an "attack" on Sunday (5 days PTA) while taking a shower, felt like his "whole lungs" hurt. Also had diaphoresis and dizziness at the time. Since then had been feeling short of breath and having chest pain. Finally presented to his PCP's office today for a medication refill and mentioned his pain. Pain at that time [**1-29**], ECG reportedly concerning for MI. He presented by car then to [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] (refused ambulance), where troponin I was 5.72 and EKG showed 1-[**Street Address(2) 1766**] elevations in inferior limb leads with reciprocal changes in lateral chest leads. Started on heparin gtt, loaded with 600mg [**Street Address(2) 4532**], given metoprolol and aspirin 325mg and transferred urgently to the cath. In the cath lab, he was found to have subtotal occlusion of RCA, 50-60% lesion in mid/prox LAD and 40-50% in LCx. RCA was a small [**Last Name (LF) 12425**], [**First Name3 (LF) **] lesion was POBA'd with good flow. He was started on integrillin with plan to continue this for 18 hours in the CCU. On arrival to the CCU, patient is chest pain free and comfortable. REVIEW OF SYSTEMS On review of systems, he denies any prior history of stroke, TIA, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. 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 presence of chest pain, dyspnea, diaphoresis. No orthopnea, ankle edema, palpitations, syncope or presyncope. Past Medical History: PAST MEDICAL HISTORY: Hypertension (poorly controlled) Depression Tobacco abuse ?Iron overload (pt reports needed therapeutic phlebotomy) COPD H/o asbestos exposure MEDICATIONS: Ibuprofen 800mg [**Hospital1 **] ALLERGIES: NKDA Social History: Works part-time as a mechanic. Lives alone, unmarried. -Tobacco history: 1ppd x 35 years -ETOH: ~18 beers per week (6 beers in one sitting) -Illicit drugs: denies Family History: Brother with CAD (s/p 5 stents) Physical Exam: VS: T=98.4 BP=141/68 HR=72 RR=18 O2 sat= 94% RA GENERAL: Obese middle aged male 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, elevated JVP 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. Bibasilar crackles, no wheezes or rhonchi. ABDOMEN: Soft, obese, NTND. No HSM or tenderness. EXTREMITIES: 2+ pitting edema of bilateral LEs, TR band in place over radial site. 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: [**2118-6-17**] 10:30PM SODIUM-140 POTASSIUM-4.0 CHLORIDE-105 [**2118-6-17**] 10:30PM CK-MB-5 [**2118-6-17**] 10:30PM PLT COUNT-171 EKG: NSR @72 bpm, NA/[**Last Name (LF) **], [**First Name3 (LF) **]-elevations in II,III,aVF and V1-V3, TWIs in V4-V6 CARDIAC CATH: LMCA: patent LAD: diffusely diseased, long mid 50-60% lesion LCx: large [**First Name3 (LF) 12425**] giving large OM, distal AV groove has a 40-50% lesion and OM has diffuse luminal irregularities RCA: totally occluded proximally just past the conus origin LVEDP 26 1. Successful POBA of totally occluded RCA 2. Moderate disease in the LAD and LCx system Brief Hospital Course: 52 yo M with history of poorly controlled hypertension and tobacco abuse who presented with chest pain, found to have STEMI, now s/p POBA of RCA. ACUTE ISSUES: # STEMI: s/p balloon angioplasty to the RCA. Troponin I 5.72 at OSH, however MB here is 5 (no MB at OSH). Event likely occurred 5 days prior to admission when he had severe pain, and he arrived to the [**Hospital1 18**] chest pain free. Echo showed likely preserved EF at >50% with no obvious wall motion abnormalities (however poor windows). He was started on [**Last Name (LF) 4532**], [**First Name3 (LF) **], atorvastatin, ACE-i. Beta blocker was also started at lower dose due to episodes of bradycardia (see below). We also encouraged smoking cessation and dietary changes # Bradycardia: Patient had several episodes of bradycardia with pauses lasting at longest 6.5 seconds. This was mainly at night and was asymptomatic. Episodes possibly a complication of his inferior MI with resultant ischemia to conduction system, however more likely they are vagal in nature. Beta blocker dose was decreased and he had no further episodes on telemetry. # Acute diastolic congestive heart failure: LVEDP elevated at 26 in the cath lab, volume overloaded on exam. EF found to be preserved at >50%, likely had diastolic dysfunction in setting of acute MI. Volume status mproved with IV lasix diuresis. CHRONIC ISSUES: # COPD: albuterol PRN # Tobacco abuse: He was given nicotine 21mcg patch We encouraged smoking cessation # Possible hemochromatosis: report h/o therapeutic phlebotomy. Hct and ferritin elevated, however no sign of cardiac involvement. TRANSITIONAL ISSUES: # Bradycardia: will follow up with cardiologist, will continue low dose metoprolol #STEMI: Will follow up with Dr. [**First Name (STitle) **] on [**2118-7-21**]. Discharged on metoprolol, lisinopril, aspirin, [**Date Range 4532**], and atorvastatin. #Hemochromatosis: follow up with heme/onc Medications on Admission: Ibuprofen 800mg [**Hospital1 **] Discharge Medications: 1. Aspirin 325 mg PO DAILY RX *aspirin 325 mg one tablet(s) by mouth daily Disp #*30 Tablet Refills:*2 2. Atorvastatin 80 mg PO DAILY RX *atorvastatin 80 mg one tablet(s) by mouth daily Disp #*30 Tablet Refills:*2 3. Clopidogrel 75 mg PO DAILY RX *clopidogrel 75 mg one tablet(s) by mouth daily Disp #*30 Tablet Refills:*2 4. Lisinopril 40 mg PO DAILY RX *lisinopril 40 mg one tablet(s) by mouth daily Disp #*30 Tablet Refills:*2 5. Metoprolol Succinate XL 25 mg PO DAILY hold for SBP<100, HR<50 RX *metoprolol succinate 25 mg one tablet(s) by mouth daily Disp #*30 Tablet Refills:*2 6. Nicotine Patch 21 mg TD DAILY RX *nicotine 21 mg/[**Street Address(2) **] one patch on arm daily Disp #*30 Transdermal Patch Refills:*2 7. TraMADOL (Ultram) 50 mg PO BID back pain RX *tramadol 50 mg one tablet(s) by mouth twice a day Disp #*60 Tablet Refills:*2 8. Nitroglycerin SL 0.4 mg SL PRN chest pain Take 1 tab under tongue, wait 5 min, then take up to 1 more tab. Call 911 if you still have chest pain after 2 tabs. RX *nitroglycerin 0.4 mg one tablet sublingually as directed Disp #*25 Tablet Refills:*2 Discharge Disposition: Home Discharge Diagnosis: Coronary Artery Disease ST elevation myocardial infarction Hypertension Acute systolic dysfunction Hemochromatosis Chronic Obstructive pulmonary disease Tobacco abuse Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: You were transferred from [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) 112375**] because you were having a heart attack. The cardiac catheterization showed blockages in several arteries but the blockage that was causing the heart attack was opened with a balloon procedure. You have been started on new medicines to help your heart recover from the heart attack and to prevent another heart attack. You will see Dr. [**First Name (STitle) **] in about a month to discuss your heart disease further. It is very important that you take all of your medicines and quit smoking, this is crucial to prevent further health problems. Followup Instructions: Name: [**Last Name (LF) **],[**First Name3 (LF) **] M. Location: COMMUNITY PHYSICIANS ASSOCIATES Address: [**Location (un) **], [**Location (un) **],[**Numeric Identifier 70678**] Phone: [**Telephone/Fax (1) 40833**] Appt: [**6-23**] at 12:15pm Department: CARDIAC SERVICES When: THURSDAY [**2118-7-21**] at 9:00 AM With: [**Name6 (MD) **] [**Name8 (MD) **], MD [**Telephone/Fax (1) 62**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage ICD9 Codes: 4280, 496, 311, 3051, 4019
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Medical Text: Admission Date: [**2116-4-17**] Discharge Date: [**2116-4-19**] Date of Birth: [**2062-10-30**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 7333**] Chief Complaint: PVI Major Surgical or Invasive Procedure: Pulmonary Vein Isolation Pericardial drain placement History of Present Illness: Mr. [**Known lastname **] is a 53 yo otherwise healthy man with lone atrial fibrillation who presented for elective pulmonary vein isolation. Following isolation of the first pulmonary vein, the pt became hypotensive and tachycardic. Echocardiography demonstrated evidence of a moderate pericardial effusion and evidence of earely tamponade physiology (RV diastolic collapse), and the pt underwent urgent pericardiocentesis with drainage of approximately 400 cc of blood. As he was anticoagulated with warfarin and heparin, he received protamine, Vitamin K and FFP. He was transiently on neosynephrine. A pericardial drain remains and continues to drain about 10 cc/hr. He was also DC cardioverted into junctional rhythm. Repeat echocardiogram demonstrated no pericardial effusion. . In the CCU, pt is hemodynamically stable, awake, and comfortable. He denies dizziness, lightheadedness, chest pain, palpitations or shortness of breath. He also denies nausea, abdominal pain, extremity pain, numbness or weakness Past Medical History: Atrial fibrillation - Diagnosed [**2116-11-15**], after a road bike competition in which he had become uncharacteristically short of breath. Pt was placed on warfarin and elected to attempt this definitive procedure given his active lifestyle and the associated risk of bleeding on anticoagulation therapy. He has previously defered antiarrhythmic medications due to concerns over long term side effects. . CARDIAC RISK FACTORS: - Diabetes, - Dyslipidemia, - Hypertension . Social History: Denies tobacco, EtOH or illicit drug use. Pt is an avid and competitive runner and biker (55 marathons, 3 triathalons) Family History: No family history of early MI, otherwise non-contributory Physical Exam: VS: HR 81 BP 99/62 RR 25 SpO2 100 GENERAL: NAD. Oriented x3. Mood, affect appropriate. HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were light pink, pallor of the oral mucosa is present. No xanthalesma. NECK: Supple with JVP of [**6-21**] cm. CARDIAC: PMI located in 5th intercostal space, midclavicular line. Regular rate, S3 and S4 present. No m/r/g. No thrills, lifts. LUNGS: Resp were unlabored, no accessory muscle use. CTAB, no crackles, wheezes or rhonchi. ABDOMEN: Soft, NTND. Abd aorta not enlarged by palpation. No abdominial bruits. EXTREMITIES: No c/c/e. No femoral bruits. SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. PULSES: Right: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ Left: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ Pertinent Results: Lab results: [**2116-4-17**] 06:45AM BLOOD WBC-3.4* RBC-4.63 Hgb-14.0 Hct-39.9* MCV-86 MCH-30.2 MCHC-35.0 RDW-13.6 Plt Ct-205 [**2116-4-18**] 06:33AM BLOOD WBC-5.9# RBC-3.54* Hgb-11.0* Hct-31.0* MCV-88 MCH-31.0 MCHC-35.5* RDW-13.9 Plt Ct-156 [**2116-4-19**] 02:53AM BLOOD WBC-5.5 RBC-3.51* Hgb-11.0* Hct-30.0* MCV-85 MCH-31.3 MCHC-36.7* RDW-13.8 Plt Ct-168 [**2116-4-17**] 06:45AM BLOOD Neuts-54.2 Lymphs-33.9 Monos-6.8 Eos-4.3* Baso-0.9 [**2116-4-17**] 06:45AM BLOOD PT-23.0* INR(PT)-2.2* [**2116-4-17**] 07:40PM BLOOD PT-19.9* PTT-28.3 INR(PT)-1.9* [**2116-4-18**] 06:33AM BLOOD PT-20.5* PTT-29.1 INR(PT)-1.9* [**2116-4-19**] 02:53AM BLOOD PT-16.9* PTT-26.9 INR(PT)-1.5* [**2116-4-17**] 06:45AM BLOOD Glucose-80 UreaN-16 Creat-1.0 Na-142 K-4.2 Cl-106 HCO3-28 AnGap-12 [**2116-4-18**] 06:33AM BLOOD Glucose-105 UreaN-13 Creat-0.9 Na-139 K-3.9 Cl-104 HCO3-29 AnGap-10 [**2116-4-19**] 02:53AM BLOOD Glucose-102 UreaN-13 Creat-0.9 Na-135 K-3.9 Cl-102 HCO3-27 AnGap-10 [**2116-4-18**] 06:33AM BLOOD Calcium-8.2* Phos-2.5* Mg-2.0 [**2116-4-19**] 02:53AM BLOOD Calcium-8.3* Phos-2.2* Mg-1.9 . TTE: [**2116-4-18**] The left atrium is elongated. The right atrium is moderately dilated. 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%). There is no ventricular septal defect. Right ventricular chamber size and free wall motion are normal. The aortic root is mildly dilated at the sinus level. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. The mitral valve leaflets are mildly thickened. Trivial mitral regurgitation is seen. The estimated pulmonary artery systolic pressure is normal. There is no pericardial effusion. Compared with the prior study (images reviewed) of [**2116-4-17**], no change. Brief Hospital Course: # Cardiac tamponade: [**2-17**] perforation of either pulmonary vein or right atrium. Patient remained stable in the ICU and pericardial drain output diminshed significantly. The tube was pulled the next day. Anticoagulation had been reversed during procedure but was restarted on discharge. Transient pressor requirement was weaned and patient remained hemodynamically stable on the floor. He was sent home with indomethacin for 5 days and coumadin and will follow up with his cardiologist regarding his atrial fibrillation. # Anemia: Baseline HCT of 39 now down to 29, likely secondary to acute blood loss. Hcts remained stable. He did not require a transfusion. # Atrial fibrillation: Not in sinus rhythm. Had only one PVI, and was in NSR s/p DC cardioversion upon arrival to the CCU. Initially all anticoagulants were held overnight given concern for bleeding and then restarted upon discharge. Pt continues to defer antiarrythmic medications, will readdress this issue if he reverts to atrial fibrillation while in the hospital. He will follow up with his outpatient cardiologist to address his options for treatment of AF. Medications on Admission: Warfarin (since [**2116-11-15**]) Magnesium MVI Discharge Medications: 1. Indomethacin 25 mg Capsule Sig: One (1) Capsule PO TID (3 times a day) for 5 days. Disp:*15 Capsule(s)* Refills:*0* 2. Warfarin 5 mg Tablet Sig: One (1) Tablet PO Once Daily at 4 PM. Disp:*30 Tablet(s)* Refills:*2* 3. Multiple Vitamin Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Home Discharge Diagnosis: Primary Diagnoses: Atrial fibrillation Cardiac tamponade, secondary to pericardial bleed during pulmonary vein isolation Discharge Condition: The patient is hemodynamically stable, with no evidence of cardiac tamponade on exam. Discharge Instructions: You were admitted to [**Hospital1 18**] for an elective procedure of pulmonary vein isolation for attempted ablation of your atrial fibrillation. You had a complication during the procedure which caused a small bleed into the pericardial space, the space around your heart. You had a drain placed to remove the fluid around your heart. Your symptoms improved, and it appears that the bleed has stopped. You should follow up with your cardiologist regarding this procedure and your atrial fibrillation. . You should restart coumadin 5mg to be taken every day. Please follow up in the coumadin clinic in 5 days for an INR check. . You will be given a prescription for a medication, Indomethacin, to help the pain from the procedure, to be taken for 5 days. . If you experience worsening chest pain, shortness of breath, lightheadedness, loss of consciousness, dizziness, fever, chills or any other worrisome symptoms please seek medical attention. Followup Instructions: Please follow up with your primary cardiologist regarding further therapy and possible repeat procedure. . Please follow up with the coumadin clinic in 5 days for an INR check. . Please follow up with your primary care physician, [**Last Name (NamePattern4) **]. [**First Name4 (NamePattern1) 1193**] [**Last Name (NamePattern1) 35663**], in the next 2-3 weeks to discuss your recent hospitalization. The phone number to the office is [**Telephone/Fax (1) 80692**] Completed by:[**2116-4-19**] ICD9 Codes: 2851
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Medical Text: Admission Date: [**2131-8-10**] Discharge Date: [**2131-8-15**] Date of Birth: [**2058-6-13**] Sex: F Service: CARDIOTHORACIC Allergies: Iodine; Iodine Containing Attending:[**First Name3 (LF) 165**] Chief Complaint: CP Major Surgical or Invasive Procedure: [**8-10**] CABG x 5 (LIMA->LAD, SVG->[**Last Name (LF) **], [**First Name3 (LF) **], RCA, PLV) History of Present Illness: 73 yo chinese woman with history of MI referreed for surgical revasculization Past Medical History: HTN hyperlipidemia Mi ([**6-28**]) Bilat cataract surgery "brain embolism" Social History: no tob no etoh lives with son and daughter in law Family History: sister with cad age 70 Physical Exam: NAD CV RRR Lungs CTAB Abd Benign Extrem no edema MSI healing well Pertinent Results: [**2131-8-14**] 06:35AM BLOOD WBC-8.3 RBC-3.46* Hgb-10.8* Hct-30.3* MCV-88 MCH-31.2 MCHC-35.5* RDW-14.9 Plt Ct-169 [**2131-8-14**] 06:35AM BLOOD Plt Ct-169 [**2131-8-15**] 06:55AM BLOOD Creat-0.4 K-4.1 [**2131-8-14**] 06:35AM BLOOD Glucose-106* UreaN-12 Creat-0.5 Na-143 K-3.5 Cl-104 HCO3-29 AnGap-14 Brief Hospital Course: Ms. [**Known lastname 1256**] was taken to the operating room on [**2131-8-10**] where she underwent a CABG x 5. She was transferred to the SICU in critical but stable condition on phenylephrine and propofol. She was extubated later that same day. He neo was weaned to off on POD #2, after she received 2 units of PRBCs for an HCT of 21.She was transferred to the floor on POD #3. She did well postoperatively, she had no problems with atrial fibrillation and was very easily diuresed. She was ready for discharge on POD #5. Medications on Admission: lopressor, fosinopril, zocor, norvasc, asa, indur 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. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* 3. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 4. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*40 Tablet(s)* Refills:*0* 5. Simvastatin 10 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 6. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* 7. Furosemide 20 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours) for 3 days. Disp:*6 Tablet(s)* Refills:*0* 8. Potassium Chloride 10 mEq Capsule, Sustained Release Sig: Two (2) Capsule, Sustained Release PO Q12H (every 12 hours) for 3 days. Disp:*12 Capsule, Sustained Release(s)* Refills:*0* Discharge Disposition: Home with Service Discharge Diagnosis: CAD PMH: CAD s/p MI, HTN, ^chol, s/p b/l cataracts, ? brain embolism that resolved with Chinese medicine Discharge Condition: Good. Discharge Instructions: Call with fever, redness or drainage from incision or weight gain more than 2 pounds in one day or five in one week. Shower, no baths, no lotions, creams or powders to incisions. No heavy lifting or driving until follow up with surgeon. Followup Instructions: Dr. [**First Name (STitle) **] 4 weeks Dr. [**Last Name (STitle) 9183**] 2 weeks Dr. [**First Name (STitle) 1075**] 2 weeks [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 173**] Completed by:[**2131-8-15**] ICD9 Codes: 4111, 4019, 2720
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Medical Text: Admission Date: [**2201-5-11**] Discharge Date: [**2201-5-26**] Service: MEDICINE Allergies: Morphine Sulfate / Ciprofloxacin / Demerol Attending:[**First Name3 (LF) 99**] Chief Complaint: Hip fracture Major Surgical or Invasive Procedure: OR [**5-14**]-- L hemi History of Present Illness: 89yoM with h/o CAD s/p 4vCABG, COPD on 2L home O2, CHF (EF 35%), Afib on coumadin, Parkinson's disease, myelodysplastic syndrome with anemia and thrombocytopenia, transferred from OSH with left hip fracture. History obtained from the patient and his daughter. The patient lives alone in an apartment downstairs from his daugther who helps with all ADLs. He walks with a walker. While alone in his apartment, he fell while walking backward from the kitchen with his walker. He called lifeline and was brought to [**Hospital3 1196**]. He reports hitting his head but no LOC. Head CT negative for hemorrhage at [**Hospital1 **]. C-spine cleared. . Per the patient's daughter, over the past week he has been somewhat short of breath. His weight was 170lbs, up from his dry weight of 160lbs. He normally does not wear his home O2 frequently but did so this past week. He was also found to be in ARF with creatinine elevated at 2.8 last week. His lasix dose was increased, and at the OSH today his creatinine was 2.5 (baseline 1.5-1.7). He sleeps with his head elevated in a hospital bed; denies PND. . Pt underwent L hemiarthoplasty of the hip for a L femoral head fx. Pt unable to wean from vent in PACU. Admitted to MICU for VAP, hypotension (briefly on levophed) and ATN thought to be [**3-12**] hypotension. Pt placed on lasix gtt with good u/o to this. Now continues to have altered MS but improved improved creat and treatment of presumed infection. Past Medical History: PMH Myelodysplasia - dx'd 2 [**2-9**] yrs ago Atrial fibrillation CAD s/p CABG/quadruple '[**89**], CHF-EF 40% in [**2198**] AI s/p valvuloplasty Aortic stenosis Melanoma or basal cell ca? - face, dx in '70s s/p radiation Acute pancreatitis - Cholelithiasis "Mild Parkinson's" Internal Hemorrhoids GERD Dyplastic polyps on colonscopy Social History: Lives in the same house as his adult daugher who appears supportive and actively involved in this care. He occupies the apt below hers and uses a baby [**Name (NI) **]-[**Name2 (NI) 18065**] to stay in constant communication with him. Uses a walker to ambulate at home. Family History: Family Hx: Daughter, Crohn's Disease Physical Exam: Pt died 1832 on [**5-26**] Pertinent Results: [**2201-5-11**] 11:00PM GLUCOSE-130* UREA N-57* CREAT-2.7* SODIUM-143 POTASSIUM-4.3 CHLORIDE-106 TOTAL CO2-21* ANION GAP-20 [**2201-5-11**] 11:00PM CALCIUM-10.2 PHOSPHATE-3.5 MAGNESIUM-2.3 [**2201-5-11**] 11:00PM WBC-7.5 RBC-3.00* HGB-10.7* HCT-33.1* MCV-111*# MCH-35.8*# MCHC-32.4 RDW-18.5* [**2201-5-11**] 11:00PM NEUTS-80.7* LYMPHS-14.1* MONOS-4.8 EOS-0.3 BASOS-0.1 [**2201-5-11**] 11:00PM HYPOCHROM-2+ ANISOCYT-2+ MACROCYT-3+ [**2201-5-11**] 11:00PM PLT COUNT-58* LPLT-2+ [**2201-5-11**] 11:00PM PT-22.8* PTT-32.9 INR(PT)-2.2* Brief Hospital Course: A/P: 89 yo M with h/o CAD s/p CABG, AS s/p valvuloplasty, CHF EF 35%, COPD, AF, CRI, Parkinson's Disease presenting with failure to extubate secondary to poor mental status after left hip hemiarthroplasty transferred to the MICU with hypoxic respiratory failure, hypotension. . # Respiratory/PEA arrest: Pt self-extubated [**5-23**]. CXR with mild vascular congestion, LLL collapse. s/p treatment w/ 8 day course of Vanco/Zosyn for VAP completed on [**5-22**]. Lasix gtt d/c'd [**5-24**] d/t hypotension. US did not show a large enough LLL effusion to tap. After transferred to the medical floor on [**5-26**], pt complained of acute shortness of breath. He became hypoxic and then had a PEA arrest. He was resuscitated with EPI and atropine. He was shocked x 3 for probable VT and bolused with amiodarone 300 mg IV x 1. On tranfer to the MICU, again had a PEA arrest with bradycardic rhythm x 2 unresponsive to multiple doses of Epi, atropine, bicarbonate, calcium chloride, transcutaneous pacing and maximum pressor support on Levophed, Dopamine and Neosynephrine. Laboratory results were significant for severe metabolic lactic acidosis. Discussions were made with the family regarding pt's poor prognosis despite maximal medical efforts. Time of death was 1832 on [**5-26**]. Possible etiology may have been acute PE, though patient had been anticoagulated x 2 weeks for his atrial fibrillation. CXR did not show signs of fluid overload/PNA/PTX. Pt's family declined a post-mortem. . # ID: Pt treated for VAP s/p 8 day Vanco and 7 day Zosyn on [**5-22**], MRSA in sputum. . # Acute on Chronic renal failure: Cr elevated from baseline of 1.5, peaked at 4.1, trending down to 2.9 likely from ATN. Renal had been following, HD had not been started. . # CV: > CAD: increased enzymes earlier in admission were c/w demand ischemia [**3-12**] hypotension. Was on ASA, statin, BB > Rhythm: atrial fibrillation- rate controlled, anticoagulated on heparin gtt. . # Anemia: s/p 1u PRBC [**5-17**]. Hct remained stable. . # Mental Status: Initial somnolence likely secondary to narcotics administered in the PACU. Slow improvement in MS likely from uremia. . # s/p Left hip hemiarthroplasty: Ortho had been following along with PT for mobilization. . # MDS: Anemia/thrombocytopenia at baseline. Had been on EPO/Iron. . # Parkinson's Disease: was on Sinemet . # Conjunctivitis: was on erythromycin ointment Medications on Admission: Outpt meds: Epogen 20,000/ml 1 ml SQ qwk Sinemet 25/100 1 tab [**Hospital1 **] Lasix 40mg 2 tabs qd Aldactone 25mg 1 tab qd Toprol XL 50mg tab qd Protonix 40mg 1 tab qd Lipitor 10mg 1 tab qd Paxil CR 12.5 mg qd Pepcid AC 10mg 2 tabs qd Coumadin 1.0 mg qd Alphagan 10ml one drop to left eye [**Hospital1 **] Xalatan 0.005% one frop to left eye qhs IC Erythromycin ointment tid prn Discharge Medications: Pt died [**5-26**] at 1832 Discharge Disposition: Expired Discharge Diagnosis: Time of death 1832, [**2200-5-26**] Discharge Condition: death Discharge Instructions: none Followup Instructions: none Completed by:[**2201-5-27**] ICD9 Codes: 5185, 0389, 5849, 5859, 4280, 496, 2875, 2859
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Medical Text: Admission Date: [**2157-5-26**] Discharge Date: [**2157-6-6**] Date of Birth: [**2084-11-28**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1505**] Chief Complaint: Chest Pain Major Surgical or Invasive Procedure: Cardiac Catheterization ([**5-27**]), Interventional Cardiology [**2157-6-1**]: Coronary artery bypass grafting x3, left internal mammary artery graft to left anterior descending, reverse saphenous vein up to the marginal branch and the posterior descending artery. History of Present Illness: 72yo man with HTN and DM who presented to ER with chest pain that occurred at rest. chest pain was associated with diaphoresis and mild shortness of breath. In the ED, patient's initial VS were 97.4 84 220/96 20 94% on Bipap. The patient was started on Bipap and was given NTG SL x 3 and started on NTG gtt. The patient was also given Lasix 20mg IV x 1. The patient's ECG was in NSR and showed diffuse ST depression with elevation in AVR. Patient was started on Hep gtt and plavix loaded. Past Medical History: coronary artery disease, Diabetes, Dyslipidemia, Hypertension, CRI(1.7), rt arm atrophy Social History: He smokes occasional cigars and does drink alcohol. Patient enjoys fishing Family History: Mother: DM Father: Died of unknown causes Physical Exam: VS: 112/63, 67, 20, 97RA Height: 5ft6in Weight:175lbs General: NAD Skin: Dry [x] intact [x] HEENT: PERRLA [x] EOMI [x] Neck: Supple [x] Full ROM [x] Chest: Lungs clear bilaterally [] rales bases bilat Heart: RRR [x] Irregular [] Murmur-no Abdomen: Soft [x] non-distended [x] non-tender [x] bowel sounds + [x] Extremities: Warm [x], well-perfused [x] Edema: none Varicosities: None [x] Neuro: Grossly intact, nonfocal exam Pulses: Femoral Right:2+(cath)Left:2+ DP Right:2+ Left:2+ PT [**Name (NI) 167**]:2+ Left:2+ Radial Right:2+ Left:2+ Carotid Bruit Right: no Left: no Pertinent Results: Labs on Admission: [**2157-5-25**] WBC-8.7 RBC-4.60 Hgb-13.8* Hct-42.8 MCV-93 Plt Ct-192 [**2157-5-25**] Neuts-54.5 Lymphs-39.4 Monos-4.3 Eos-1.3 Baso-0.6 [**2157-5-25**] PT-11.7 PTT-25.4 INR(PT)-1.0 [**2157-5-25**] Glucose-410* UreaN-20 Creat-1.7* Na-137 K-4.0 Cl-98 HCO3-30 [**2157-5-26**] CK(CPK)-408* [**2157-5-26**] %HbA1c-9.9* eAG-237* [**2157-5-25**] cTropnT-0.04* [**2157-5-26**] proBNP-424* [**2157-5-26**] cTropnT-0.04* [**2157-5-26**] CK-MB-39* MB Indx-9.6* cTropnT-0.97* [**2157-5-26**] CK(CPK)-408*[**2157-6-5**] 09:11AM BLOOD Hct-31.5* [**2157-6-4**] 04:46AM BLOOD WBC-13.4* RBC-3.63* Hgb-11.0* Hct-32.4* MCV-90 MCH-30.4 MCHC-34.0 RDW-14.7 Plt Ct-148* [**2157-6-5**] 09:11AM BLOOD Glucose-205* UreaN-21* Creat-1.0 Na-134 K-4.2 Cl-97 HCO3-32 AnGap-9 [**2157-6-6**] 04:56AM BLOOD UreaN-18 Creat-1.0 K-3.8 Reports: Cardiac Catheterization: 1. Coronary angiography in this right-dominant system demonstrated three-vessel disease. The LMCA had a 30% distal stenosis. The mid-LAD had serial 90% stenoses. The LCx was patent, but a large first obtuse marginal branch had serial 90% stenoses. The RCA had serial 90% stenoses in its proximal and middle portion. 2. Limited resting hemodynamics revealed normal systemic arterial blood pressure. FINAL DIAGNOSIS: 1. Three-vessel coronary artery disease. . CXR PA/LAT: Diffuse perihilar opacities and vascular congestion have resolved. The cardiomediastinal silhouette is normal. There are no pleural effusions. Chronic elevation of the right hemidiaphragm is stable since [**2148**]. . ECHO: Overall left ventricular ejection fraction is normal (LVEF 65%). However, the basal segment of the inferior wall and the apex are hypokinetic. Right ventricular chamber size and free wall motion are normal. The mitral valve appears structurally normal with trivial mitral regurgitation. There is no pericardial effusion. Intra-op echo [**2157-6-1**]: Prebypass No atrial septal defect is seen by 2D or color Doppler. Left ventricular wall thicknesses are 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 descending thoracic aorta. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. Trace aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Trivial mitral regurgitation is seen. There is no pericardial effusion. Dr. [**Last Name (STitle) **] was notified in person of the results on [**2157-6-1**] at 1030am. Post bypass Patient is on phenylephrine and is AV paced. Biventricular systolic function is unchanged. Mild mitral regurgitation present. Aorta is intact post decannulation. Brief Hospital Course: The patient is a 72yo gentleman who presented to the ED with a hypertensive emergency and ruled in for NSTEMI by EKG and enzymes. Cardiac cath revealed multi-vessel disease and cardiac surgery consultation was requested. The patient underwent the routine preoperative workup. He was taken to the operating room on [**2157-6-1**] where he underwent coronary artery bypass x3 LIMA-LAD, SVG to Oobtuse marginal and SVG to PDA. Overall the patient tolerated the procedure well and post-operatively was transferred to the CVICU in stable condition for recovery and invasive monitoring. Vancomycin was used for surgical antibiotic prophylaxis. POD 1 found the patient extubated, alert and oriented and breathing comfortably. The patient was neurologically intact and hemodynamically stable, weaned from inotropic and vasopressor support. Beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. He was restarted on his preoperative medication Lisinopril but at a lower dose given marginal systolic blood pressure in the 80's. The patient was transferred to the telemetry floor for further recovery. Chest tubes and pacing wires were discontinued without complication. The patient was evaluated by the physical therapy service for assistance with strength and mobility. [**Last Name (un) **] was consulted for blood sugar management and his insulin regimen was changed to Lantus. He is to follow up Dr. [**Last Name (STitle) 57318**] as an outpatient for further adjustments in insulin. By the time of discharge on POD #5 the patient was ambulating with assistance, the wound was healing and pain was controlled with oral analgesics. The patient was cleared for discharge to [**Hospital3 **] rehab in good condition with appropriate follow up instructions. Medications on Admission: Atenolol 100mg daily Lipitor 40mg daily HCTZ 25mg Twice Weekly Isosorbide 15mg daily Lisinopril 40mg daily Metformin ER 1000mg Once Daily Aspirin 81mg daily Novolog (70-30) 33/17 Discharge Medications: 1. Metformin 1,000 mg Tablet Extended Rel 24 hr Sig: One (1) Tablet Extended Rel 24 hr PO once a day. 2. Metoprolol Tartrate 50 mg Tablet Sig: Two (2) Tablet PO TID (3 times a day). Disp:*180 Tablet(s)* Refills:*2* 3. Lisinopril 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 4. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*65 Tablet(s)* Refills:*0* 5. 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* 6. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 7. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 8. Furosemide 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily) for 7 days. Disp:*7 Tablet(s)* Refills:*0* 9. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig: One (1) Tab Sust.Rel. Particle/Crystal PO every twenty-four(24) hours for 7 days. Disp:*7 Tab Sust.Rel. Particle/Crystal(s)* Refills:*0* 10. Insulin Glargine 100 unit/mL Solution Sig: One (1) 20 units Subcutaneous Q AM. Disp:*QS 1 month * Refills:*0* 11. Insulin Glargine 100 unit/mL Solution Sig: One (1) 10 units Subcutaneous Q BEDTIME. Disp:*QS 1 month * Refills:*0* Discharge Disposition: Extended Care Facility: [**Hospital3 2558**] - [**Location (un) **] Discharge Diagnosis: coronary artery disease PMH: Diabetes, Dyslipidemia, Hypertension, CRI(1.7), right arm atrophy Discharge Condition: Alert and oriented x3 nonfocal Ambulating, gait steady Sternal pain managed with oral analgesics sternal incision clean and dry Left leg harvest site clean and dry with intact steri strips. 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 cardiac surgery office with any questions or concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call person during off hours** Followup Instructions: Surgeon Dr. [**Last Name (STitle) **] [**Telephone/Fax (1) 170**] [**2157-6-30**] 1:15pm Please call to schedule appointments Primary Care Dr. [**Last Name (STitle) **],[**First Name3 (LF) 132**] C. [**Telephone/Fax (1) 133**] in [**2-12**] weeks Cardiologist Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] in [**2-12**] weeks Endocrinologist at [**Last Name (un) **] Dr [**Last Name (STitle) 57318**] Wed [**6-8**] at 11:00 AM Please call cardiac surgery if need arises for evaluation or readmission to hospital [**Telephone/Fax (1) 170**] Completed by:[**2157-6-6**] ICD9 Codes: 5119, 4280, 5859
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Medical Text: Admission Date: [**2120-9-26**] Discharge Date: [**2120-10-9**] Date of Birth: [**2080-8-6**] Sex: M Service: Plastic Surgery REASON FOR ADMISSION: The patient was transferred from [**Hospital3 418**] Hospital via med-flight, status post [**2080**]5 feet out of a tree with extensive facial fractures. HISTORY OF PRESENT ILLNESS: The patient is a 44-year-old gentleman who fell 25 feet four hours prior to arrival at [**Hospital1 69**] after an intermediate stop at an outside Emergency Department ([**Hospital3 417**] Hospital) who intubated the patient for airway protection and life-flighted him to the trauma unit here. PAST MEDICAL HISTORY: The patient's past medical history on presentation was negative (per report). The patient was intubated. REVIEW OF SYSTEMS: Review of systems was negative. PHYSICAL EXAMINATION ON PRESENTATION: The patient's blood pressure on arrival was 137/81. His heart rate was in the 80s. He was intubated at 99%. His pupils were equal, round, and reactive to light and accommodation. There was blood in his nares. A mobile hard palate was appreciated, and he had three lacerations on the left cheek. His tympanic membranes were clear. He had a chin laceration as well. He was placed in a cervical collar. No obvious deformity was appreciated. His lungs were clear to auscultation bilaterally. His abdomen was soft, nontender, and nondistended. A left upper quadrant abrasion was noted. His peritoneum was guaiac-negative. His prostate was okay. His extremities revealed a left shoulder contusion. Pulses were found in all distal extremities and in all upper extremities. He moved all extremities spontaneously. His back and spine revealed there was no deformity. He was on a back board on presentation. His [**Location (un) 2611**] Coma Scale on presentation was 7. PAST MEDICAL HISTORY: Further information was obtained from the family regarding the patient's past medical history of hypertension, high cholesterol, and gastroesophageal reflux disease. MEDICATIONS ON DISCHARGE: His medications were [**Doctor First Name **] and Lipitor. ALLERGIES: He had an allergy to PROTONIX (from which he got a rash). SOCIAL HISTORY: Occasional alcohol. A nonsmoker. PERTINENT LABORATORY VALUES ON PRESENTATION: His laboratories on presentation revealed his white blood cell count was 13.8, his hematocrit was 37.7, and his platelets were 245. His sodium was 144, potassium was 4.2, chloride was 108, bicarbonate was 24, blood urea nitrogen was 19, creatinine was 0.8, and blood glucose was 155. His amylase was 59. His prothrombin time was 12.7, partial thromboplastin time was 18.4, and his INR was 1.1. Toxicology screen was negative. Gas was 7.34/45/92/28 with a base deficit of -1. The patient was on synchronized intermittent mandatory ventilation at 700, 50% FIO2, and a positive end-expiratory pressure of 5. PERTINENT RADIOLOGY/IMAGING: A chest x-ray was negative. A pelvic x-ray was negative. A computed tomography of the abdomen and pelvis was negative. CONCISE SUMMARY OF HOSPITAL COURSE: The diagnosis at the time of presentation was loss of consciousness and maxillary fracture. The patient was admitted to the Trauma Surgical Intensive Care Unit. Cervical spine films, cervical collar, ACT, tetanus, antibiotics, and a Plastic Surgery was initiated. Plastic Surgery saw the patient the same evening. They arrived to find the patient sedated. The patient was intubated and sedated. Facial laceration of 5 cm and a chin laceration were sutured. Open mandible fracture, midline and open palate, and ecchymosis of the left eye. Tympanic membranes were clear bilaterally. No septal hematoma was appreciated. Facial bones were palpated. Stepoff was noted at palate. At this juncture, two coronal computed tomography scans were initiated for evaluation of facial fractures. Oral and Maxillofacial Surgery was initiated. An Ophthalmology consultation was initiated. The patient was placed on clindamycin and sutures of laceration for repair. On postoperative day one, the patient continued to be hemodynamically stable. His respiratory system was clear. His abdomen was soft with positive bowel sounds. Socially, his wife was updated on his status, as an Intensive Care Unit resident, and the patient was stable. On hospital day two, officially the cervical spine was cleared. The patient was evaluated by the Plastics attending. Le Fort I and Le Forte II palatal fracture. The plan was for open reduction/internal fixation of facial fractures after cervical spine clearance. On hospital day two, Ophthalmology came by. On computed tomography, there was already apparent, with a lateral orbital fracture nondisplaced with no evidence of globe rupture. The left lateral orbital wall fracture. Consensual pupil reflexes were intact. On hospital day three, the patient continued to be stable. He did spike a temperature with a temperature maximum of 101 degrees Fahrenheit. Urine cultures were initiated which turned out to be negative. On hospital day four, tube feeds were started. The patient's temperature maximum was 101.2 degrees Fahrenheit. The patient remained stable and intubated. On hospital day five, the patient continued to be stable. No events of significance. The patient was made nothing by mouth at midnight with a plan to take the patient to the operating room on hospital day six. The patient was taken to the operating room for open reduction/internal fixation of multiple facial fractures. Please see the Operative Report. The patient tolerated the procedure well. The patient was stable postoperatively with a patent airway and was kept intubated overnight. His head was elevated. The patient was placed in a maxillary mandibular fixation. On postoperative day one, hospital day seven, the patient continued to do well. The patient did spike a temperature to 103.1 degrees Fahrenheit. In addition to clindamycin, the patient was placed on levofloxacin. On hospital day seven, postoperative two, the patient continued to be intubated secondary to facial edema. A Dobbhoff tube was placed, and tube feeds were once again started. Maxillary computed tomography scan was taken again, and with input of Oral and Maxillofacial Surgery, the condylar displacement was once again evaluated and judged to be stable. Further evaluation will be determined through Oral and Maxillofacial Surgery. The patient's hematocrit, on hospital day seven, required a transfusion of 2 units of packed red blood cells with further hematocrit levels being ascertained. Input was once again given by Oral and Maxillofacial Surgery. All fractures were reduced. The patient was stable from a Plastic Surgery perspective; however, he remained intubated due to facial edema. Tube feeds were advanced. On [**2120-10-5**] there was decreasing facial edema. The sutures in the cheek were removed. The sutures under the chin were removed subsequently. The patient was in an extubation trial. The patient was appropriate and followed commands. The patient was extubated on hospital day ten, postoperative day four. The patient continued to do well. He was transferred to the floor. The facial swelling was decreasing. As the patient was transferred to the floor, he continued to improve. However, there was some question as to when the patient was out of bed and was evaluated by Physical Therapy; there was some question as to some unsteadiness on his feet. His Romberg sign was negative; however, that coupled with his mechanism injury prompted a head computed tomography which was negative for mass effect or for any old or new bleeds. The patient continued to improve. On hospital day 12, the patient was given a Panorex. His Foley catheter was discontinued. On hospital day 13, the patient was evaluated by Nutrition and given instructions on what kilocalories were needed to meet the patient's needs. The patient would need 9 cans to 10 cans of Boost per day. The patient continued to do well and was cleared by Neurology as to a normal neurologic examination. The patient was cleared by Physical Therapy to be able to go home with a cane for assistance until he regained stability in ambulation. Occupational Therapy cleared the patient from a neurologic perspective as well. DISCHARGE DISPOSITION: It was deemed that the patient would be appropriate to go home on [**2120-10-9**] after his continued improvement. DISCHARGE INSTRUCTIONS/FOLLOWUP: 1. The patient was instructed to follow up with Oral and Maxillofacial Surgery regarding maxillomandibular fixation. 2. The patient was instructed to follow up with Plastic Surgery regarding his facial fractures. CONDITION AT DISCHARGE: The patient was discharged on [**2120-10-9**] in stable condition. MEDICATIONS ON DISCHARGE: Discharge medications included resuming his home medications. DISCHARGE DIAGNOSES: 1. Complicated facial fractures (Le Forte I and Le Forte II). 2. Mandibular fracture. 3. Lateral and orbital wall fracture. 4. Status post open reduction/internal fixation of facial fractures. 5. Status post fall from a height of 20 feet. [**First Name11 (Name Pattern1) 1216**] [**Last Name (NamePattern4) 2612**], M.D. [**MD Number(2) 2613**] Dictated By:[**Name8 (MD) 2614**] MEDQUIST36 D: [**2120-10-8**] 19:52 T: [**2120-10-9**] 08:28 JOB#: [**Job Number 2615**] ICD9 Codes: 2720, 4019
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Medical Text: Admission Date: [**2106-4-5**] Discharge Date: [**2106-4-8**] Service: ORTHOPAEDICS Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 3190**] Chief Complaint: Back and leg pain Major Surgical or Invasive Procedure: Lumbar laminectomy L3-S1 History of Present Illness: Mr. [**Known lastname 34210**] has a long history of back and leg pain. He has attempted conservative therapy including physical therapy and has failed. He now presents for surgical intervention. Past Medical History: DM CRI CVA 3 years ago w/residual right sided weakness ?CAD Spinal stenosis Lower back pain and hip pain Social History: Lives with daughter and wife. Wife has stage IV breast cancer. Family History: Not obtained Physical Exam: NAD RRR CTA B Abd soft NT/ND BUE- good strength at biceps, triceps, wrist extension and flexion, finger extension and flexion and intrinsics on the left, decreased on the right 3-4/5; sensation intact in all dermatomes; reflexes intact at biceps, triceps and brachioradialis BLE- good strength at hip flexion and extension/abduction/adduction, knee flexion and extension, ankle dorsiflexion and plantar flexion, [**Last Name (un) 938**]/FHL on the left, decreased on the right [**3-22**]; sensation intact distally Pertinent Results: [**2106-4-8**] 06:25AM BLOOD WBC-17.4* RBC-3.84* Hgb-11.3* Hct-34.2* MCV-89 MCH-29.5 MCHC-33.2 RDW-13.7 Plt Ct-154 [**2106-4-7**] 09:30AM BLOOD Hct-36.0*# [**2106-4-7**] 12:46AM BLOOD WBC-14.2* RBC-3.16* Hgb-9.5* Hct-27.9* MCV-88 MCH-30.1 MCHC-34.1 RDW-13.7 Plt Ct-146* [**2106-4-6**] 02:12PM BLOOD WBC-12.1*# RBC-3.20* Hgb-9.6* Hct-28.3* MCV-89 MCH-29.9 MCHC-33.8 RDW-13.8 Plt Ct-167 [**2106-4-8**] 06:25AM BLOOD Glucose-98 UreaN-22* Creat-1.2 Na-137 K-4.4 Cl-99 HCO3-24 AnGap-18 [**2106-4-7**] 12:46AM BLOOD Glucose-105 UreaN-20 Creat-1.2 Na-137 K-4.3 Cl-105 HCO3-25 AnGap-11 [**2106-4-6**] 02:12PM BLOOD Glucose-123* UreaN-22* Creat-1.3* Na-139 K-4.4 Cl-105 HCO3-27 AnGap-11 [**2106-4-7**] 12:46AM BLOOD CK-MB-6 cTropnT-<0.01 [**2106-4-6**] 07:49PM BLOOD CK-MB-6 cTropnT-<0.01 [**2106-4-6**] 02:12PM BLOOD CK-MB-7 cTropnT-<0.01 Brief Hospital Course: Mr. [**Name14 (STitle) 41743**] was admitted to the service of Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 363**] for a laminctomy at L3-S1. He was informed and consented for the procedure and elected to proceed. Please see Operative Note for procedure in detail. Post-operatively he was administered antibiotics and pain medication. POD1 his blood pressure was noticed to be low and he was given 2 liters of fluid in addition to 1 unit of packed red blood cells. A medicine consult was obtained to evaulate the continue hypotension and it was recommended that he be transferred to the MICU. He was medically managed and given an additional 2 units of PRBCs with good effect on his blood pressure. He was transferred out to the floor when stable and was able to work with physical therapy. His incisions were clean and dry upon discharge. He was passing flatus but had not had a bowel movement. He was dischargeed from the hospital to an acute care facility where ther will monitor his bowel regimen. He was discharged in good condition. Medications on Admission: Cymbalta Simvastatin Lisinopril Glipizide Glargine Novalog Oxydodone Discharge Medications: 1. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 2. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed. 3. Simvastatin 10 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 4. Duloxetine 30 mg Capsule, Delayed Release(E.C.) Sig: Two (2) Capsule, Delayed Release(E.C.) PO 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. Oxycodone 5 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed. 7. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 8. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed. 9. Glipizide 10 mg Tab,Sust Rel Osmotic Push 24hr Sig: One (1) Tab,Sust Rel Osmotic Push 24hr PO once a day. 10. glargine Sig: Fourteen (14) units Subcutaneous qAM. 11. Novalog Sig: Eight (8) units Subcutaneous qPM. Discharge Disposition: Extended Care Facility: [**Hospital3 7665**] Discharge Diagnosis: Lumbar stenosis L3-S1 Post-operative anemia Post-operative hypotension Discharge Condition: Good Discharge Instructions: Please be sure to call your primary care physician to discuss the need for an outpatient colonoscopy to be sure you have no bleeding from your colon to explain your anemia. Please continue to take your pain medication with an over the counter laxative. Call the clinic if you notice any redness or discharge from the incision site. Call the clinic for any additional concerns. Physical Therapy: Activity: Activity as tolerated Lumbar corset for ambulation Treatments Frequency: Please continue to change the dressings daily with dry, sterile gauze. Followup Instructions: Please follow up in the Orthopedic Spine clinic during your previously scheduled appointments. Completed by:[**2106-4-8**] ICD9 Codes: 5859, 5180, 2851
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Medical Text: Admission Date: [**2119-6-11**] Discharge Date: [**2119-6-22**] Service: MEDICINE Allergies: amiodarone Attending:[**First Name3 (LF) 1515**] Chief Complaint: elective corevalve Major Surgical or Invasive Procedure: Percutaneous aortic valve replacement Endotracheal intubation Central line History of Present Illness: 86 year old woman with severe AS (valve area = 0.4, peak gradient 100), LVEF 55%, PAF, Amiodarone lung toxicity, pulmonary fibrosis, pacemaker for tachybrady syndrome, scleroderma/CREST syndrome and severe pulmonary hypertension. Patient was ADL independent at home untill her most recent admission to [**Hospital1 18**] in [**4-/2119**] with small bowel obstruction and pneumonia compicated by left basilic vein DVT from a PICC line which was replaced prior to her discharge on [**2119-5-25**]. She was started on Vanco + Cefepim [**5-21**], she had negative blood cultures and sputum grew MRSA, Cefepim was given for 5 days and Vanco for 10 days (last dose 5/11). Patient was worked up during her admission for aortic valve procedure to treat her critical AS. She is now readmited electively from rehab for the procedure. Antibiotics for pneumonia have been completed and patient is afebrile. Bowel obstruction has since resolved and patient is tolerating soft diet. Coumadin was discontinued on [**2119-6-7**] and switrched to fundaparinaux. She does report frequent loose stools, repeated assays for C. diff have been negative. . Untill her recent admission patient had been ADL independent and taking care of her demented [**Age over 90 **] year old husband at home. She dressed, cooked and shopped on her own and got cleaning help once weekly. She did have base-line DOE and was not able to walk more than 20 paces without stopping. She has had significant unintentional weight loss over the past 4-5 years. She was on oxygen at home for hypoxia attributed to her chronic pulmonary fibrosis. She has chronically low systolic blood pressure, running 70-90's. She had intermittent dizziness upon standing. She had orthopnea X 1 pillow. Nocturia X2. She denies leg swelling. At rehab she was able to walk upto 10 paces with walker and had to stop d/t SOB. She reports an episode of epigastic/lower anterior chest pain yesterday after a meal which she attributes to her scleroderma related GERD. Pain was continous for 2 hours and resolved with analgesia. ECG was checked and was reportedly unchanged. She denies any chronic angina. GU: voiding spontaneously, occasional inconteince. . Hct on [**6-8**] --27.7 . No evidence of bleeding. Hct initally was around 33 at rehab, but has trended down to 27-28 and has remained stable since [**6-1**]. . On review of systems, she denies prior history of stroke, TIA, pulmonary embolism, bleeding at the time of surgery, cough, hemoptysis, black stools or red stools. Denies recent fevers, chills or rigors. . Cardiac review of systems - notable for absence of paroxysmal nocturnal dyspnea, ankle edema, palpitations, syncope or presyncope Past Medical History: 1. Aortic stenosis (valve are = 0.8) 2. Left ventricular systolic dysfunction with ejection fraction of 45-55%. 3. Paroxysmal atrial fibrillation. 4. Amiodarone lung toxicity. 5. Pulmonary fibrosis, on home oxygen. PHTN (PAP = 80) 6. Tachybrady syndrome, status post permanent pacemaker. 7. History of breast cancer. 8. Gastroesophageal reflux disease. 9. Scoliosis. 10. Diverticulosis. 11. Hypothyroidism. 12. Basal cell carcinoma. 13. Left rotator cuff tendinitis and partial tear in [**2119**]. 14. Scleroderma with GI manifestations and lung manifestations, but without renal manifestations. 15. Severe pulmonary hypertension. 16. left basilic vein thrombosis, PICC induced [**5-/2119**]: Left basilic vein thrombosis: PICC induced during previous admission [**5-31**], considered superficial thrombosis. PICC on left pulled and no anticoagulation was indicated 17. s/p left shoulder injury with rotator cuff tear [**2119**] 18. partial SBO [**4-/2119**] Social History: Retired, a registered nurse [**First Name (Titles) **] [**Last Name (Titles) 88870**]. Until her previous admission in [**4-/2119**] patient reports she had been ADL independent and taking care of her demented [**Age over 90 **] year old husband at home. She dressed, cooked and shopped on her own and got cleaning help once weekly. She did have base-line DOE and was not able to walk more than 20 paces without stopping. She has been in rehab since her discharge on [**2119-5-25**], There she was able to walk up to 10 paces with walker. . Her 4 kids live in the area. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 20246**] (daughter) is her HCP (tel: [**Telephone/Fax (1) 88871**]). . . -Tobacco history: ~ 50 pack years, stopped in -ETOH: untill recently used to drink one vodka-[**Doctor Last Name 6654**] with olive per evening. -Illicit drugs: none Family History: Mother with breast CA. Physical Exam: On Admission: VS: T= 95.6...BP=109/49...HR=69...RR=20...O2 sat= 97% GENERAL: cachectic, frail appearing woman, NAD, tachypneic to 25 with speech dyspnea, A+OX3. Appropriate affect. HEENT: PERRLA, EOMI, sclerae anicteric, MMM, OP clear. NECK: Supple, no thyromegaly, no carotid bruits, JVD to the angle of the Jaw. HEART: Irregularly irregular, 3/6 SEM max at LUSB with out radiation to the carotids. no RG. LUNGS: faint crackles to the scapulas bilaterally, rare scattered exp wheezes. ABDOMEN: normal bowel sounds, Soft/NT/ND, no masses or HSM, no rebound/guarding mid lower abdomen, left knee, right sholder Skin: surgical scars EXTREMITIES: WWP, trace pre-tibial edema, no c/c, vertical surgical scar over left knee NEURO: Awake, A&Ox3, CNs II-XII grossly intact. motor 4-5/5 throughout, sensory intact except for loss of proprioception in 3rd through 5th toes of right foot. Lines: PICC right arm - no erythema, tenderness, discharge or swelling. Pulses r/l: radial -/-; brachial ++/+; TP +/+; DP -/- . On discharge: expired Pertinent Results: On admission: [**2119-6-11**] 04:40PM BLOOD WBC-5.7 RBC-3.05* Hgb-9.7* Hct-30.7* MCV-101* MCH-31.9 MCHC-31.8 RDW-15.5 Plt Ct-334 [**2119-6-11**] 04:40PM BLOOD PT-14.8* PTT-29.7 INR(PT)-1.3* [**2119-6-11**] 04:40PM BLOOD Glucose-100 UreaN-15 Creat-0.7 Na-141 K-5.2* Cl-106 HCO3-28 AnGap-12 [**2119-6-11**] 04:40PM BLOOD ALT-13 AST-14 LD(LDH)-230 AlkPhos-91 TotBili-0.4 [**2119-6-14**] 03:07AM BLOOD Lipase-28 [**2119-6-11**] 04:40PM BLOOD CK-MB-3 proBNP-[**Numeric Identifier 88872**]* [**2119-6-11**] 04:40PM BLOOD Albumin-3.0* Calcium-8.5 Phos-4.2 Mg-2.2 Iron-23* . [**6-14**] TTE: FOCUSED STUDY. Overall left ventricular systolic function is normal (LVEF>55%). An aortic CoreValve prosthesis is present. Mild (1+) aortic regurgitation is seen. There is no pericardial effusion. . [**6-20**] TTE: The left atrium is elongated. Left ventricular wall thickness, cavity size and regional/global systolic function are normal (LVEF >55%). The right ventricular cavity is markedly dilated with moderate global free wall hypokinesis. An aortic CoreValve prosthesis is present. The prosthetic aortic valve leaflets appear normal The transaortic gradient is normal for this prosthesis. A mild (1+) anterior paravalvular aortic valve leak is present. The mitral valve leaflets are mildly thickened. Moderate (2+) mitral regurgitation is seen. Moderate [2+] tricuspid regurgitation is seen. There is severe pulmonary artery systolic hypertension. There is no pericardial effusion. IMPRESSION: Normally-functioniong CoreValve aortic prosthesis with mild paravalvular regurgitation. Normal global and regional left ventricular systolic function. Severe pulmonary hypertension with dilated right ventricle with moderate global systolic dysfunction. Moderate mitral regurgitation. Compared with the prior study (images reviewed) of [**2119-6-15**], estimated PA pressures are higher still and RV appears slightly more dilated. The other findings are similar. . On [**2119-6-22**] [**2119-6-22**] 03:33AM BLOOD WBC-17.5* RBC-2.68* Hgb-8.3* Hct-25.5* MCV-95 MCH-30.8 MCHC-32.3 RDW-21.0* Plt Ct-89* [**2119-6-22**] 02:06AM BLOOD PT-20.1* PTT-90.9* INR(PT)-1.8* [**2119-6-22**] 03:33AM BLOOD Glucose-178* UreaN-94* Creat-4.8* Na-142 K-4.8 Cl-108 HCO3-14* AnGap-25* [**2119-6-22**] 02:06AM BLOOD ALT-62* AST-132* AlkPhos-109* Amylase-610* TotBili-0.5 [**2119-6-22**] 02:06AM BLOOD Lipase-1540* [**2119-6-20**] 04:16AM BLOOD proBNP-[**Numeric Identifier 4732**]* [**2119-6-22**] 06:14AM BLOOD Type-ART Temp-37.8 pO2-103 pCO2-34* pH-7.30* calTCO2-17* Base XS--8 Comment-AXILLARY T [**2119-6-22**] 06:14AM BLOOD Lactate-6.7* Brief Hospital Course: 86 year old woman with severe AS (valve area = 0.4, peak gradient 100), LVEF 55%, PAF, Amiodarone lung toxicity, pulmonary fibrosis, pacemaker for tachybrady syndrome, scleroderma/CREST syndrome and severe pulmonary hypertension who was admitted electively for core-valve placement, expired on [**2119-6-22**]. . # Critical AS: valve area = 0.4, peak gradient 100. Patient not deemed a surgical candidate for surgery due to her co-morbidities therefore scheduled for core-valve on [**6-13**]. Patient with uneventful pre-operative course. Intra-procedure patient plavix loaded. Procedure complicated by inability to pull right groin shealth necessitating open closure per vasculature. Patient extubated and transferred to the CCU. Follow-up TTE demonstrated stable, properly placed corevalve. . # PUMP: CHF, EF 45% per OSH. TTE prior to procedure 55%. Post-procedure, TTE demonstrated overall normal left ventricular systolic function, (LVEF>55%). An aortic CoreValve prosthesis is present. Mild (1+) aortic regurgitation is seen. There is no pericardial effusion. Patient was continued on metoprolol, digoxin. . #. ATRIAL FIBRILLATION: Pre-opertively patient had been on coumadin which had been transitioned to lovenox and subsequently switched to fondaparinaux. -- RATE CONTROL: Patient rate controlled with digoxin and metoprolol. -- ANTICOAGULATION: Pre-opertively patient had been on coumadin which had been transitioned to lovenox and subsequently switched to fondaparinaux Patient initially anticoagulated post-procedure with heparin IV however due to concern for HIT, heparin was stopped and argatroban started. HIT antibody returned negative and patient restarted on heparin gtt on [**6-20**]. . # Hypotension. Post-procedure patient noted to be hypotension with MAPS in 50s and SBPs in 80s necessitating pressure support. Initial hypotension attributed to fluid shifts s/p core valve and blood pressure augmented with neo. Neo resulted in pronounced peripheral vasoconstriction with resulting left extremity cyanosis. However patient persistently hypotension thought secondary to probable sepsis. Patient started on broad spectrum antibiotics and decision made to aggressively hydrate with IVF and transition pressure support to levophed and vasopression. On [**6-21**], the patient became increasingly hypotensive requiring pressor support with levophed, vasopressin, and dopamine. Despite pressors, lactate continued to climb into the 7 range until aggressive measures were withdrawn. . # Thrombocytopenia. Platlets with precipitous drop while hospitalized; ~300 pre-procedure with nadir in the 60s. Differential diagnosis at that time included sepsis, DIC medication side effect and HIT. DIC labs negative. Patients 4 T score ~6 (especially after UE US with evidence of new left brancial thrombosis). Concern for HIT prompted transition to argatroban and send out of the HIT antibody. On [**6-20**] HIT returned negative and patient transitioned back to IV heparin. Likely drop reflective of underlying infectious process as HIT ruled out and DIC labs negative. . # Acute Kidney Injury. Patient with elevation in creatinine and decrease in urine production post-corevalve. CT with evidence of renal infarct thought to have occurred intra-procedure. Etiology to [**Last Name (un) **] likely multifactorial in setting of renal infarct as well as hypovolemia in setting of hypotension. Patients kidney function was monitored daily, medications were renally dosed. The patient remained oliguric for several days and became net + 13L. Cr stabilized around 4.8 and urine output improved transiently on a lasix gtt before the patient began to deteriorate and urine output again declined. . # Peripheral vasoconstriction/left hand cyanosis. Post-procedure patient with complaints of numbness and tingling in left hand. Decision made to pull left axillary arterial line after which symptoms subsided. Patient with hypotension s/p procedure necessitating augmented pressure support with neo. Additional vasoconstriction in setting of neo in a patient with scleroderma likely resulted in aggravated peripheral vasoconstriction of left hand. Pressors transitioned from neo to vasopression with some improvement in perfusion. . # Elevated LFTS. Likely secondary to shocked liver in the setting of hypotension and sepsis. LFTs stabilized and began to slowly trend down after initiation of broad spectrum antibiotics and normalization of blood pressure. . #. CAD. Left cath undertaken in [**4-/2119**] as part of work-up for core-valve demonstarted left dominant system with singel vessel disease: ~50-70% lesion in OM1. Patient without complaints of chest pain in house. Continued on ASA 81 as well as BB. . # Lung disease. Pateint with history of extensive interstitial pulmonary fibrosis secondary to to amiodarone exposure vs scleroderma vs radiation injury (got radiation for breast cancer in the past. Per chart biopsy, baseline home oxygen 2-3L. Pre-procedure chest CT and severe pulmonary HTN on RHC which showed PA systolic pressure of 80mmHg in the presence of nopmal wedge pressure (16mmHg). Post-extubation patient continued on home nebulizer treatments. On [**6-21**], the patient acute desaturated to the 80s. She was deep suctioned with improvement in her sats. There was concern that the patient was not protecting her airway because of altered mental status and she was again intubated on [**6-21**]. . # Provoked Left basilic vein thrombosis. PICC induced during previous admission [**5-31**], considered superficial thrombosis. Monitored clinically in house . # Scleroderma: Clinically suspected on past admission on the basis of her ILD and chronic GERD complaints. Rheumatology were consulted and serology showed positive [**Doctor First Name **] + Anticentromere ab with neg SCL70, RNA ab and B2 glycoprotein. Impression was of CREST syndrome. No systemic therapy was started. Patient continued on PPI for treatment of GERD . # Nutrition. Post-procedure course complicated by extubation necessitating intubation. Of note patient is significantlly cachectic with hypoalbuminemia (Alb = 2.7 [**2119-5-21**]) likely [**2-22**] to her various chronic diseases and poor PO intake. There was concern for mesenteric ischemia post-procedure because of complaints of abdominal pain, and TPN was started. . # Hypothyroidism: TSH [**4-/2119**] = 2.6. Patient continued on home [**Year (4 digits) **] 75mcg . On [**6-22**], the patient was re-intubated for altered mental status and inability to protect her airway. The patient was noted to have oliguria, worsening lactic acidosis, evidence of pancreatitis and persistent respiratory failure. Discussions about goals of care were held with the patient's family - including her daughter who served as her HCP. The decision was made to transition the patient to comfort measures only. She passed away shortly after pressors were discontinued on the morning of [**2119-6-22**]. Medications on Admission: digoxin 125 mcg Tablet 1 Tablet(s) by mouth once a day levalbuterol HCl [Xopenex] 0.63 mg/3 mL Solution for Nebulization inh four times a day levothyroxine 75 mcg Tablet 1 Tablet(s) by mouth once a day metoprolol tartrate 25 mg Tablet 1 Tablet(s) by mouth q8hrs omeprazole 20 mg Capsule, Delayed Release(E.C.) 1 Capsule(s) by mouth twice a day potassium chloride 10 mEq Capsule, Extended Release 1 Capsule(s) by mouth once a day aspirin 81 mg Tablet, Delayed Release (E.C.) 1 Tablet(s) by mouth once a day cholecalciferol (vitamin D3) 2,000 unit Tablet 1 Tablet(s) by mouth once a day Arixtra SQ 2.5 mg QD Lidoqain patch was started in rehab on [**6-10**] Sucralfat 1g QID in rehab also got: Zolpidem, guiafenasine, maalox, glycolax, ondasternon Discharge Medications: N/A Discharge Disposition: Expired Discharge Diagnosis: Cardiopulmonary arrest Severe aortic stenosis s/p percutaneous aortic valve replacement Atrial fibrillation Pulmonary fibrosis Tachybrady syndrome Hypothyroidism Scleroderma Pulmonary hypertension Discharge Condition: Expired Discharge Instructions: Patient made comfort measures only on [**2119-6-22**] after developing cardiogenic shock and multi-system organ failure. This was in the setting of having received a percutaneous aortic valve replacement on [**2119-6-13**]. Followup Instructions: None ICD9 Codes: 4241, 0389, 5845, 4280, 2762, 5119, 2449, 4168, 2875, 496, 4275
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Medical Text: Admission Date: [**2198-1-13**] Discharge Date: [**2198-1-29**] Date of Birth: [**2129-7-30**] Sex: F Service: CARD. [**Doctor First Name 147**] CHIEF COMPLAINT: Shortness of breath. HISTORY OF PRESENT ILLNESS: Ms. [**Known lastname 45419**] is a 68-year-old female with cardiac risk factors including non-insulin-dependent diabetes mellitus, hypertension, hypercholesterolemia, and tobacco use, who was in her usual state of health until [**2198-1-10**], when she noted an acute onset of substernal chest pain while cooking which was associated with shortness of breath. This chest pain and shortness of breath lasted for approximately five to ten minutes and resolved with rest. She did not seek medical attention at that time. On [**2198-1-11**], she again had another episode of chest pain and shortness of breath while at rest, which was relieved with a baby aspirin. On [**2198-1-12**], she again noted acute onset of shortness of breath without chest pain while at rest and, upon informing her family, she was taken by ambulance to an outside hospital. It was noted that her shortness of breath was not positional or related to exertion. On the day of admission to the outside hospital she had sharp upper back pain between her shoulder blades which was relieved with Motrin. She at that time denied any other symptoms. She denied nausea, vomiting, chest pain, abdominal pain, lower extremity swelling, palpitations, paroxysmal nocturnal dyspnea, lightheadedness, dizziness, melena, diarrhea or constipation. Upon arrival to the outside hospital, she was found to be hypoxic to 92% on oxygen saturation on room air and was started on oxygen by nasal cannula which relieved her shortness of breath. She was also given 10 mg of Lasix intravenously as her chest x-ray at the time showed pulmonary edema. An EKG done at the outside hospital showed ST depressions in the lateral leads, and her initial cardiac enzymes were found to have a CK of 151 with an MB fraction of 10.5 and a troponin of 3.4. She was started on a nitroglycerin drip and subcutaneous Lovenox injections and was transferred to [**Hospital1 190**] for further management and evaluation. Upon arrival at the Emergency Department at [**Hospital1 190**] she was given 25 mg of Lopressor for hypertension, and admitted to the Cardiology service for treatment of acute coronary syndrome. PAST MEDICAL HISTORY: 1. Non-insulin-dependent diabetes mellitus for approximately two years. 2. Borderline hypertension. 3. Borderline hypercholesterolemia. 4. Melanoma status post resection from the chin times two. MEDICATIONS AT THE TIME OF ADMISSION: 1. Metformin 500 mg once per day. 2. She was also on a nitroglycerin drip from the outside hospital. ALLERGIES: No known drug allergies. SOCIAL HISTORY: The patient states that she smoked one-half pack per day for 20 years but had quit 15 years previously. She lives with her husband and has three healthy children. FAMILY HISTORY: There is no family history of coronary artery disease or cerebrovascular disease. There is an extensive history of cancer. Father died of prostate cancer at age 79, mother died of multiple myeloma at age 80. PHYSICAL EXAMINATION ON ADMISSION: The patient was found to have a temperature of 97.4, heart rate of 86 in sinus rhythm, blood pressure of 164/90 with an oxygen saturation of 96% on two liters nasal cannula. In general, she was an elderly female in no apparent distress. Her pupils were equally reactive to light and accommodation with extraocular muscles intact and anicteric sclerae. Her mucus membranes were dry. Her neck was supple with jugular venous pressure estimated at 8 cm, 2+ palpable carotid pulses, with a question of carotid bruit versus radiation of cardiac murmur. Her lung examination demonstrated rales up to one-third of her lung fields bilaterally with no wheezes. There was some left lung dullness, but no egophony or accessory muscle use. Her heart showed a regular rate and rhythm with normal S1, S2, and a grade [**2-22**] mid to late peaking crescendo-decrescendo systolic murmur heard best at the left upper sternal border and radiating to the carotids. She was found to have no rubs or gallops. Her abdomen was obese, soft, non-tender, non-distended, with no hepatosplenomegaly and no palpable masses. There were no periumbilical or femoral bruits. Her extremities showed [**1-18**]+ edema bilaterally up to the mid shin in the lower extremities. She had 1+ palpable dorsalis pedis and posterior tibial pulses bilaterally. On neurological examination, she was alert and oriented times three, with cranial nerves II through XII intact and no focal motor or sensory deficits. LABORATORIES ON ADMISSION: Showed a white count of 11.7 with hematocrit of 31.3 and platelet count of 267,000. Chem-7 showed a sodium of 135, potassium 4, chloride 102, bicarbonate of 20, BUN and creatinine of 15 and 0.5 and a blood glucose of 234. Her CK at this hospital was 117 with an MB fraction of 11. ELECTROCARDIOGRAM: EKG done at the time showed sinus rhythm at 68 beats per minute with T-wave inversions in leads V5, V6, 1 and aVL, as well as in 2, 3 and aVF. It was found to have poor R-wave progression. There were no ST elevations or depressions noted. In comparison with the EKG from the outside hospital, the ST depressions noted in the lateral leads had resolved. RADIOLOGY: On chest x-ray she was found to have bilateral effusions with interstitial edema and borderline cardiomegaly. There were no infiltrates noted. CT of the chest, abdomen and pelvis was also done which showed no dissection, no pericardial effusion, bilateral mild pleural effusions and bilateral increased septal thickening. The abdomen and pelvis were found to be unremarkable. HOSPITAL COURSE: Ms. [**Known lastname 45419**] was admitted to the hospital through the Emergency Department to the Cardiology service and was monitored for a period. During the next couple days she continued to have episodes of shortness of breath and chest pain, and a troponin which was continually monitored peaked at 21. Due to her continuing instability, she was taken to the Cardiac Catheterization Suite on hospital day three, and was found to have severe left main, left circumflex, and right coronary artery disease. She was also found to have mild left ventricular dysfunction, marked left ventricular diastolic dysfunction, moderate mitral regurgitation, and moderate pulmonary hypertension. Due to her catheterization results and continued instability and symptomatology, the patient was taken to the Operating Room on [**2198-1-16**], where she underwent coronary artery bypass graft times four. Please refer to the dictated operative note for full details of this procedure. She tolerated the procedure well and was transferred postoperatively to the Cardiac Surgical Intensive Care Unit. At the time of transfer, she was on a propofol drip at 10 mcg/kg/min. She was also on Neo-Synephrine and nitroglycerin drip to maintain her systolic blood pressure in an acceptable range. She was A-paced at 88 beats per minute and no ectopy was noted, with an underlying rhythm of 47 beats per minute. She was weaned from the ventilator and extubated late on the day of surgery which she tolerated well. On postoperative day one she continued to be A-paced at 88 beats per minute as her underlying rhythm was sinus bradycardia in the 40's. She was also continuing to require Neo-Synephrine drip to maintain her systolic blood pressure in the 130 to 140 range which was necessary due to her carotid artery disease. On postoperative day two, the patient was transfused one unit of packed red blood cells due to a hematocrit of 24.9 with a repeat hematocrit of 28.1. Her Neo-Synephrine drip was also weaned to off, as her systolic blood pressure remained in the 120 to 140 range without need for the drip. She did, however, remained A-paced, as her underlying rhythm ranged between 40 and 60 beats per minute. On postoperative day three, she was noted to have some low urine output for approximately two to three hours, at which time Lasix was started. She also demonstrated some lability of blood pressure, requiring Neo-Synephrine drip from time to time to maintain her systolic blood pressure greater than 110. She did also remain A-paced at this time. Though early in the day she was tolerating fluids by mouth, later in the day she began to have episodes of nausea and vomiting, which were treated using Reglan and Zofran as well as Phenergan. She continued to have a poor appetite and was unable to eat without vomiting. On postoperative day four she was actually found to be hypertensive with elevation as high as the 180 to 200 range of systolic blood pressure when in episodes of pain or retching associated with her nausea and vomiting. She was no longer needing to be A-paced, as her underlying rhythm was now in the 70's with normal sinus rhythm and no ectopy. Her Foley catheter was discontinued on postoperative day four as well. The patient continued to have active bowel sounds and was passing flatus on postoperative day five, however, she did continue to have severe episodes of vomiting and nausea. These episodes were associated with hypertension with systolic blood pressure as high as 200, and were very difficult to control. She was given intravenous labetalol and intravenous Haldol to help with her increasing agitation, which helped to improve her blood pressure. She at this time refused nasogastric tube placement despite continued vomiting. The nasogastric tube was finally placed on postoperative day five, and a Gastroenterology consult was obtained. Possibilities for her etiology of nausea and vomiting were thought to be gastritis with gastric outlet obstruction as opposed to gastroparesis or medication effect. It was recommended by the Gastroenterology service that she undergo examination by esophagogastroduodenoscopy. On postoperative day eight, the patient underwent EGD, which showed a normal esophagus and duodenum, with two benign-appearing linear ulcers without visible vessels, approximately 4 and 3 cm long respectively and 8 mm wide in the body of the stomach. It was felt by the Gastroenterology service that these ulcers likely represented the etiology of the patient's nausea and vomiting. The patient was continually treated on an oral proton pump inhibitor and on postoperative day eight, her nasogastric tube was clamped. She subsequently tolerated this well, and on postoperative day nine, the nasogastric tube was discontinued. In addition, on postoperative day nine, the patient on respiratory examination demonstrated decreased breath sounds at both bases, left greater than right. Chest x-ray done at the time showed a large sized pleural effusion on the left, and the patient underwent sterile insertion of a left-sided chest tube with 400 cc of serous drainage. The patient's nausea slowly began to improve on postoperative day ten, and she began to tolerate solid food for the first time. At this time, there was also some question of suicidal ideation on the part of the patient and a Psychiatry consult was obtained. At the time of the Psychiatric consultation, the patient denied any suicidal ideation, and it was felt by the psychiatric service that she was not a risk for self harm. Late on postoperative day ten, the patient was finally deemed ready and stable for transfer from the Intensive Care Unit to the regular patient floor. The patient had progressive improvement in her ability to tolerate oral foods, and decreases in her nausea and vomiting. She also showed improvement in her level of anxiety and expressed no further suicidal ideation. By postoperative day 13, she was tolerating p.o.'s easily, and showed a much improved mental state. At this time it was deemed that she was stable and ready for discharge home with visiting nurses to continue to do wound checks, blood pressure checks and to ensure that she was tolerating a regular diet. Her chest tube had been discontinued the day before without incident, and she reported no shortness of breath. At the time of discharge, the patient was afebrile with heart rate of 56 in sinus rhythm, and a blood pressure of 130/80. She did have a slightly unsteady gait, but she was cleared by the Physical Therapy service for discharge home with use of a cane. PHYSICAL EXAMINATION AT THE TIME OF DISCHARGE: Showed a regular rate and rhythm with a normal S1, S2 and 2/6 systolic murmur. Her lungs were clear to auscultation bilaterally. Her abdomen was soft, non-tender, non-distended with no hepatosplenomegaly. Her sternal incision was healing nicely. She had minimal lower extremity edema. DISCHARGE MEDICATIONS: 1. Lasix 20 mg twice per day times seven days. 2. Potassium chloride 20 mEq twice per day times seven days. 3. Enteric coated aspirin 325 mg once per day. 4. Percocet one to two tablets every four to six hours as needed for pain. 5. Lopressor 50 mg twice per day. 6. Captopril 75 mg three times per day. 7. Protonix 40 mg by mouth twice per day. 8. Metformin 500 mg once per day. 9. Ascorbic acid 500 mg twice per day. 10. Iron sulfate 325 mg once per day. 11. Colace 100 mg twice per day. CONDITION AT DISCHARGE: Stable. DISCHARGE DIAGNOSES: 1. Coronary artery disease status post myocardial infarction. 2. Status post coronary artery bypass graft times four. 3. Gastric ulcers times two. 4. Gastroesophageal reflux disease. 5. Non-insulin-dependent diabetes mellitus. 6. Hypertension. 7. Hypercholesterolemia. 8. Melanoma status post resection times two. FOLLOW UP: Follow up scheduled in the [**Hospital 409**] Clinic on _______ in two weeks' time. It was told to the patient that she should follow up with her cardiologist and primary care physician within the next one to two weeks. A follow-up appointment was scheduled with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 1537**] in approximately four weeks' time. [**First Name11 (Name Pattern1) 275**] [**Last Name (NamePattern4) 1539**], M.D. [**MD Number(1) 1540**] Dictated By:[**Name (STitle) 47509**] MEDQUIST36 D: [**2198-3-28**] 16:25 T: [**2198-3-28**] 17:52 JOB#: [**Job Number 47510**] ICD9 Codes: 4280, 4240, 5119, 4019
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Medical Text: Admission Date: [**2112-2-7**] Discharge Date: [**2112-2-12**] Date of Birth: [**2057-8-11**] Sex: M Service: [**Hospital1 **] Medicine HISTORY OF PRESENT ILLNESS: On presentation the patient is a 54 year old man with a history of hepatitis C, insulin dependent diabetes mellitus, osteomyelitis, status post recent surgery of his toe and a lengthy rehabilitation stay who eloped from rehabilitation and went home the day before admission to the Medicine Intensive Care Unit. The patient was relatively stable per family with talking, walking well at around 5 PM and the family then noticed that around 6 PM the patient was unresponsive and sleeping on the floor. The family called emergency medical services at that point and the patient was noted to be unresponsive with a fingerstick of 16. The patient was given 2 amps of D50 and Narcan 1 mg times two. The patient was then noticed to have agonal breathing with respiratory rates 4 to 6 and was intubated for that reason on the field and was brought into the Emergency Department for evaluation. The patient was started on low dose Propofol for sedation as the patient appeared agitation on the ventilator. He was moving all extremities but not responding to commands. Per the family, the patient had a recent problem with low fingersticks in the 50s. The patient usually takes care of his own medications and his family is unsure of his medication regimen. Per the family the patient did not have any fevers, chills, upper respiratory infection symptoms or gastrointestinal symptoms prior to admission. PAST MEDICAL HISTORY: 1. Hepatitis C. 2. Diabetes type 2 which is now insulin dependent. 3. History of endocarditis in the [**2068**]. 4. History of intravenous drug abuse which is current. 5. Hypertension. 6. Osteoarthritis. 7. Increased PSA. 8. Osteomyelitis. 9. Thyroid nodule. ALLERGIES: No known drug allergies. MEDICATIONS ON ADMISSION: Univasc, Ciprofloxacin, Percocet, Atenolol, Cimetidine, Oxazepam, Folic acid, Cyclobenzaprine, Clindamycin, Fluoxetine, Indomethacin and Novolin. SOCIAL HISTORY: History of intravenous drug abuse. Currently he uses cocaine. Smokes one pack per day of cigarettes. Alcohol, he drinks regularly. PHYSICAL EXAMINATION: Physical examination on admission, the patient's temperature was 95.3,blood pressure 102/82, heart rate 70s, respiratory rate 16, 100% on SIMV. General: Unresponsive, thin man intubated and sedated. Head, eyes, ears, nose and throat: Pupils were minimally reactive, no doll's eyes. Cardiovascular: Regular rate, no murmurs. Chest: Clear to auscultation bilaterally with equal breath sounds. Abdomen: Soft, nontender, nondistended, positive bowel sounds. Extremities: No cyanosis, clubbing or edema. 1+ bilateral pulses. LABORATORY DATA: Pertinent laboratory data on admission revealed lactate 7.9. Chest x-ray was significant for metal fragments in his right upper chest. Electrocardiogram with normal sinus rhythm at 80 with a normal axis. Head computerized tomography scan was negative for any masses or bleeds. Toxicology screen was positive for cocaine and Benzodiazepines. HOSPITAL COURSE: 1. Hypoglycemia - Most likely a fasting sugar of 15 was due to patient overdosing him on himself of his usual dose of Novolin. [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] consult was obtained during this admission. See medication list for [**Last Name (un) **] recommendations. 2. Unresponsiveness - The patient had a neurology consult during this admission and workup included electroencephalogram which showed mild encephalopathy but no seizures. An magnetic resonance imaging scan showed enlarged lateral ventricles which are old, otherwise no bleeds or masses. However, neurocognitive testing revealed that the patient was incompetent to care for himself. Testing showed that he had significant cognitive impairment, that interferes with the ability to care for himself with deficits in memory, planning and sustaining a task. The patient was maintained on a CIWA scale with prn Valium. However, the patient did not require any Valium. The CIWA was 1 to 2 during this admission. The patient was maintained on a 1:1 sitter because of his history of elopement and inability to care for himself. 3. Respiratory failure - The patient was intubated secondary to mental status and extubated one day after intubation. The patient has since then had good oxygen saturations with no problems in terms of respiratory status. 3. Hypertension - The patient in the Intensive Care Unit was started on a beta blocker and Hydralazine. On reaching the medical floor on the [**Hospital1 **] Team this regimen was changed to Captopril and Metoprolol which was titrated upwards for goal blood pressure of systolic around 130s. 4. Code status - The patient remained full code throughout this admission. 5. Smoking history - The patient was kept on a nicotine patch while in-house and was stopped on the nicotine patch on discharge. DISPOSITION: The patient was discharged to a rehabilitation institution. CONDITION ON DISCHARGE: Mentally incompetent to care for himself, however, medically was stable with good blood pressures and good fingersticks, all within the normal range 36 hours before discharge. DISCHARGE DIAGNOSIS: 1. Hypoglycemia. 2. Diabetes Type 2 which is now insulin dependent. 3. Hypertension. 4. Osteoarthritis. 5. History of intravenous drug abuse. 6. History of recent osteomyelitis. 7. Dementia. DISCHARGE MEDICATIONS: 1. Ranitidine 150 mg p.o. b.i.d. 2. Multivitamin one capsule p.o. q.d. 3. Thiamine one tablet p.o. q. day 4. Folic acid 1 tablet p.o. q. day 5. Docusate 100 mg p.o. b.i.d. 6. Reglan insulin sliding scale. See addendum for full insulin regimen. 7. Captopril 25 p.o. t.i.d. 8. Metoprolol 77.5 p.o. b.i.d. FOLLOW UP PLANS: The patient is to follow up with his primary care physician as appropriate from discharge. DR.[**Last Name (STitle) **],[**First Name3 (LF) **] 12-735 Dictated By:[**Name8 (MD) **] MEDQUIST36 D: [**2112-2-11**] 15:51 T: [**2112-2-11**] 16:39 JOB#: [**Job Number 23265**] ICD9 Codes: 2765
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Medical Text: Admission Date: [**2109-12-25**] Discharge Date: [**2109-12-26**] Date of Birth: [**2078-6-19**] Sex: M Service: EMERGENCY Allergies: Doxorubicin Hcl Liposomal Attending:[**First Name3 (LF) 2565**] Chief Complaint: Anaphylaxis to liposomal doxorubicin Major Surgical or Invasive Procedure: None History of Present Illness: 31M with history of cutaneous T cell lymphoma who had anaphylaxis to his first infusion of liposomal doxorubicin (around 5ml). He was seen by his oncologist in clinic this AM and then arranged to get first dose of lip dox. Few minutes into his infusion, patient developed shortness of breath and became stridorous with progressive facial swelling. He got benadryl 50, pepcid, sq epi 0.4, decadron 10 mg and nebulized epi. He was hemodynamically stable with O2 sat at 100% on NRB. He was transferred from to [**Hospital Unit Name 153**] for monitoring. Past Medical History: Cutaneous T-cell lymphoma RSV pneumonia- [**11-20**] Social History: Denied tobacco and illicit drug use. He drinks alcohol occasionally. He works for a financial company. He is married with 3 children. Family History: Denies family history of coronary artery disease, hypertension, diabetes or cancer Physical Exam: 97, 98, 144/73, 23, 100%/15L cool neb GEN: comfortable, NAD SKIN: diffuse hperpgmentation with multiple CTCL lesions, ulcerations from the lympoma NECK: occipital ulceration from CTCL, no supraclavicular or cervical lymphadenopathy, RESP: CTA b/l with good air movement throughout, no stridor CV: RR, S1 and S2 wnl, 1/6 systolic mumrur at LSB ABD: nd, +b/s, soft, nt, no masses or hepatosplenomegaly EXT: no c/c/e, warm, good pulses 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 Pertinent Results: [**2109-12-25**] 08:10AM GLUCOSE-104 UREA N-16 CREAT-1.4* SODIUM-137 POTASSIUM-3.7 CHLORIDE-102 TOTAL CO2-26 ANION GAP-13 [**2109-12-25**] 08:10AM estGFR-Using this [**2109-12-25**] 08:10AM ALT(SGPT)-22 AST(SGOT)-20 LD(LDH)-338* ALK PHOS-95 TOT BILI-0.3 DIR BILI-0.1 INDIR BIL-0.2 [**2109-12-25**] 08:10AM TOT PROT-7.8 ALBUMIN-3.9 GLOBULIN-3.9 CALCIUM-9.3 PHOSPHATE-3.9 MAGNESIUM-2.2 URIC ACID-2.9* CHOLEST-143 [**2109-12-25**] 08:10AM WBC-6.3# RBC-4.06* HGB-13.2* HCT-39.9* MCV-99* MCH-32.4* MCHC-33.0 RDW-12.9 [**2109-12-25**] 08:10AM NEUTS-52 BANDS-0 LYMPHS-14* MONOS-3 EOS-30* BASOS-0 ATYPS-1* METAS-0 MYELOS-0 [**2109-12-25**] 08:10AM HYPOCHROM-NORMAL ANISOCYT-1+ POIKILOCY-NORMAL MACROCYT-1+ MICROCYT-NORMAL POLYCHROM-NORMAL [**2109-12-25**] 08:10AM PLT SMR-NORMAL PLT COUNT-250 Brief Hospital Course: 31M with history of cutaneous T cell lymphoma who had anaphylaxis to his first infusion of liposomal doxorubicin. . # Anaphylaxis: Patient recieved IM epinephrine, diphenhydramine, ranitidine, and inhaled epinephrine for immediate treatment of his anaphylaxis reaction. Patient transiently developed stridor but never had desaturations and was never intubated. Patient was monitored overnight with stable vital signs, good oxygen saturations on room air, normal phonation, and tolerating po. A prednisone taper was initiated for 7 days. Standing benadryl and ranitidine were continued on discharge. . # Cutaneous T cell lymphoma: stable; discussed with Dr. [**Last Name (STitle) **], holding any further treatment for now. Patient to followup as scheduled with Dr. [**Last Name (STitle) **]. . # Acute Renal Failure: baseline around 1.2; increased to 1.4 on admission to the ICU, resolved with rehydration. . # F/E/N: IVF with NPO. Repleted lytes PRN. . # PPx: Ambulatory after initial treatment. . # Access: PIV . # Dispo: to Home . # Code Status: Full . # Communication: HCP Wife [**Name (NI) **] [**Name (NI) 1005**] (Phone: [**Telephone/Fax (1) 52195**]) Medications on Admission: Clobetasol 0.05 %--Apply to affected areas twice daily. TRIAMCINOLONE ACETONIDE 0.1 %--apply to affected areas [**Hospital1 **] BACTROBAN 2 %--Apply to wound twice daily [**Hospital1 **] Discharge Medications: 1. EpiPen 0.3 mg/0.3 mL Pen Injector Sig: One (1) injection Intramuscular PRN as needed for allergic reaction: GO TO THE EMERGENCY ROOM IMMEDIATELY UPIN USING THIS MEDICATION. Disp:*2 pens* Refills:*5* 2. Prednisone 5 mg Tablet Sig: 8,8,4,4,2,2,1,1 Tablets PO once a day for 8 days: Please take 8 pills on the first day, then 8 pills, then 4 pills for 2 days, then 2 pills for 2 days, then 1 pill for 2 days until you complete this course. Disp:*30 Tablet(s)* Refills:*0* 3. Diphenhydramine HCl 25 mg Tablet Sig: Two (2) Tablet PO every six (6) hours for 7 days. Disp:*56 Tablet(s)* Refills:*0* 4. Ranitidine HCl 300 mg Tablet Sig: One (1) Tablet PO twice a day for 7 days. Disp:*14 Tablet(s)* Refills:*0* Discharge Disposition: Home Discharge Diagnosis: Anaphylaxis Cutaneous T Cell Lymphoma Discharge Condition: Stable Discharge Instructions: During this admission you were treated for an allergic reaction. Please continue to take all medications as prescribed. Please come to the Emergency Department immediately if you develop any recurrent symptoms. Followup Instructions: Provider: [**Last Name (NamePattern4) **]. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **]/CUT. ONC. DERM. Phone:[**Telephone/Fax (1) 46583**] Date/Time:[**2110-1-8**] 9:00 Provider: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 4053**], RN Phone:[**Telephone/Fax (1) 22**] Date/Time:[**2110-1-8**] 10:00 ICD9 Codes: 5849
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Medical Text: Admission Date: [**2106-3-1**] Discharge Date: [**2106-3-10**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2745**] Chief Complaint: Status-post arrest Major Surgical or Invasive Procedure: none History of Present Illness: Mr. [**Known firstname **] [**Known lastname 724**] is a [**Age over 90 **] year male with past medical history of a traumatic subdural hematoma s/p craniectomy, HTN, and afib. Today while at his nursing home, he was noted to have tonic-clonic movements, then collapsed on the floor. Per report from the nursing home, no pulse was appreciated at that time. CPR was started, and portable defibrillator pads were placed, which advised no shock. He was reported to be asystolic. EMS arrived approximately 3 minutes later. Intravenous access was established and he was given 1 mg of epinephrine. The EMS team attempted to intubated the patient, at which time zucchini was noted in the airway above the vocal cords. This was removed and he was intubated. CPR was continued and he was transported to [**Hospital1 18**]. On route, he was noted to have return of spontaneous circulation, with atrial fibrillation at a rate of 140 was noted, with systolic blood pressure of 90. . Upon arrival to the ED, he was intubated, with a heart rate of 140 in atrial fibrillation and systolic blood pressure of 80. Levophed was started. He converted into sinus before he was able to be cardioverted, with improvement in his blood pressure. EKGs demonstrated left axis deviation, RBBB, and ST depressions in leads V3-V6. A right IJ was placed. He underwent a head CT which demonstrated bilateral small collections, with possible acute component. No trauma was apparent on examination. Neurosurgery evaluated the patient in the ED and concluded no surgical intervention was necessary. A chest x-ray was unremarkable and revealed appropriate CVL and ETT placement. . He was started on the Arctic Sun protocol 90 minutes after arrival and reached goal temp of 34C 150 minutes after arrival. His granddaughter arrived to the emergency room. He was transferred to the ICU for management. . Upon arrival to the ICU the patient is intubated, unresponsive, and cooled to 34C. Fentanyl, versed, and norephinepherine drips are running. Past Medical History: - Receives medical care at [**Hospital 3278**] Medical Center - Traumatic subdural hematoma s/p 3 drainage procedures ~18 months ago - Parkinsons Disease - HTN - Atrial fibrillation - Hyperlipidemia - Dysphagia - Worsening gait - Incontinence Social History: From [**Country 651**], has lived in the USA for >75 years. Lived independently until 18 months ago. Had a fall with subdural hematoma s/p 3 drainage procedures. Has since lived in a [**Hospital1 1501**] at [**Hospital6 **]. At baseline good mental status with "only a little" memory impairment. He walks with a walker, and requires help often with eating, hygeine and other ADLs and IADLs. Does not use tobacco, EtOH or other substances. Granddaughter [**Name (NI) **] is his health care proxy. Family History: Noncontributory. Parents lived into their 100s. Physical Exam: VS: T=33.8C (bladder), HR=57, BP=106/64, Intubated A/C 50% O2, 5 PEEP, 500cc Tv, 16 RR, 100% saturation. Gen: Appears younger than given age. Intubated, arctic sun cooling device in place, lying unresponsive. Neuro: Does not respond to voice. Does not withdraw to painful stimuli. R pupil unresponsive, L pupil 3->2.5mm sluggish response to light without apparent consensual R pupil reflex. No vestibuloocular reflex. Unable to access remaining cranial nerves. Limbs are atonic. Reflexes absent throughout, toes unresponsive on Babinski. HEENT: Head without any lesions. Moist occular mucosa, sclera noninjected, nonicteric. Nasogastric tube in place. Nasopharynx without exudate. Oropharynx difficult to access with endotrachael tube in place. No apparent lesions. Moist mucosa. Neck: Supple. No lymphadenopathy. No thyromegaly. R IJ in place, clean. CV: JVD not elevated. PMI in the midclavicular line. Heart sounds are soft. Regular rate. Preserved S1 and S2. No murmurs. No gallop. Pulm: Limited exam. Clear anteriorly and laterally with good air movement bilaterally. Abd: Exam limited by circumfirential cooling device. +BS. Soft. No masses appreciated. 60cc dark urine in foley. Ext: Cool. Present radial pulses. No pedal pulses. Good capillary refill. No edema. No cyanosis. Pertinent Results: [**2106-3-1**] 01:06PM FIBRINOGE-73* [**2106-3-1**] 01:06PM PT-28.8* PTT-117.3* INR(PT)-2.9* [**2106-3-1**] 01:06PM PLT SMR-VERY LOW PLT COUNT-42* [**2106-3-1**] 01:06PM WBC-2.2* RBC-0.84* HGB-2.7* HCT-9.0* MCV-106* MCH-31.7 MCHC-29.9* RDW-14.1 [**2106-3-1**] 01:06PM ASA-NEG ETHANOL-NEG ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**2106-3-1**] 01:06PM LIPASE-16 [**2106-3-1**] 01:06PM estGFR-Using this [**2106-3-1**] 01:06PM UREA N-17 CREAT-0.6 [**2106-3-1**] 01:19PM GLUCOSE-84 LACTATE-4.0* NA+-146 K+-1.2* CL--137* TCO2-6* [**2106-3-1**] 01:19PM TYPE-[**Last Name (un) **] COMMENTS-GREEN TUBE [**2106-3-1**] 01:34PM FIBRINOGE-263# [**2106-3-1**] 01:34PM PT-16.4* PTT-45.7* INR(PT)-1.5* [**2106-3-1**] 01:34PM PLT COUNT-165 [**2106-3-1**] 01:34PM WBC-13.5*# RBC-3.17*# HGB-10.5*# HCT-31.8*# MCV-100* MCH-33.2* MCHC-33.1# RDW-13.1 [**2106-3-1**] 01:34PM ASA-NEG ETHANOL-NEG ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**2106-3-1**] 01:34PM ALBUMIN-3.4 CALCIUM-8.0* PHOSPHATE-7.4* MAGNESIUM-2.5 [**2106-3-1**] 01:34PM CK-MB-NotDone [**2106-3-1**] 01:34PM cTropnT-0.01 [**2106-3-1**] 01:34PM ALT(SGPT)-40 AST(SGOT)-203* LD(LDH)-357* CK(CPK)-74 ALK PHOS-77 AMYLASE-251* TOT BILI-0.3 [**2106-3-1**] 01:34PM GLUCOSE-217* UREA N-42* CREAT-1.9*# SODIUM-144 POTASSIUM-4.4 CHLORIDE-110* TOTAL CO2-12* ANION GAP-26* [**2106-3-1**] 01:41PM K+-4.3 [**2106-3-1**] 01:41PM PO2-494* PCO2-37 PH-7.10* TOTAL CO2-12* BASE XS--17 [**2106-3-1**] 01:52PM GLUCOSE-200* LACTATE-9.1* NA+-145 K+-4.5 CL--113* TCO2-12* [**2106-3-1**] 05:12PM PT-14.9* PTT-33.7 INR(PT)-1.3* [**2106-3-1**] 05:12PM PLT COUNT-137* [**2106-3-1**] 05:12PM WBC-12.0* RBC-3.38* HGB-11.0* HCT-33.4* MCV-99* MCH-32.4* MCHC-32.8 RDW-13.0 [**2106-3-1**] 05:12PM ALBUMIN-3.4 CALCIUM-6.8* PHOSPHATE-3.8# MAGNESIUM-2.2 [**2106-3-1**] 05:12PM CK-MB-4 cTropnT-0.04* [**2106-3-1**] 05:12PM ALT(SGPT)-54* AST(SGOT)-255* LD(LDH)-437* CK(CPK)-102 ALK PHOS-73 TOT BILI-0.4 [**2106-3-1**] 05:12PM GLUCOSE-202* UREA N-42* CREAT-1.6* SODIUM-144 POTASSIUM-4.5 CHLORIDE-117* TOTAL CO2-17* ANION GAP-15 [**2106-3-1**] 05:48PM HGB-11.5* calcHCT-35 [**2106-3-1**] 05:48PM GLUCOSE-183* LACTATE-3.0* NA+-142 K+-4.6 CL--115* [**2106-3-1**] 05:48PM TYPE-ART PO2-129* PCO2-37 PH-7.24* TOTAL CO2-17* BASE XS--10 [**2106-3-1**] 10:45PM freeCa-1.22 [**2106-3-1**] 10:45PM HGB-12.8* calcHCT-38 [**2106-3-1**] 10:45PM GLUCOSE-121* LACTATE-3.0* NA+-143 K+-4.8 CL--115* [**2106-3-1**] 10:45PM TYPE-ART TEMP-34 PO2-141* PCO2-36 PH-7.23* TOTAL CO2-16* BASE XS--11 INTUBATED-INTUBATED [**2106-3-1**] 11:14PM URINE URIC ACID-RARE [**2106-3-1**] 11:14PM URINE GRANULAR-7* [**2106-3-1**] 11:14PM URINE RBC-52* WBC-6* BACTERIA-FEW YEAST-NONE EPI-0 [**2106-3-1**] 11:14PM URINE BLOOD-MOD NITRITE-NEG PROTEIN-30 GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-NEG [**2106-3-1**] 11:14PM URINE COLOR-Yellow APPEAR-Hazy SP [**Last Name (un) 155**]-1.013 [**2106-3-1**] 11:14PM URINE OSMOLAL-528 [**2106-3-1**] 11:14PM URINE HOURS-RANDOM UREA N-500 CREAT-114 SODIUM-32 CT head [**3-1**]: IMPRESSION: 1. Small mixed density bifrontal subdural collections, likely acute on chronic. 2. Bilateral ethmoidal mucosal thickening, left maxillary mucosal thickening and aerosolized secretions in the nasal cavity. Clinical correlation recommended. Echo [**3-2**]: The left atrium is normal in size. Left ventricular wall thicknesses are normal. The left ventricular cavity is small. Left ventricular systolic function is hyperdynamic (EF 70-80%). There is no ventricular septal defect. The right ventricular cavity is dilated with borderline normal free wall function. The ascending aorta is moderately dilated. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. Mild (1+) aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. Mild (1+) mitral regurgitation is seen. The left ventricular inflow pattern suggests impaired relaxation. The tricuspid valve leaflets are mildly thickened. There is mild pulmonary artery systolic hypertension. There is no pericardial effusion. IMPRESSION: dilated, borderline hypocontractile right ventricle; small, hyperdynamic left ventricle CT head [**3-3**]: CONCLUSION: Negligible interval change from prior study. Brief Hospital Course: [**Age over 90 **]yo M with chronic subdural hematoma, Parkinsons, and [**Hospital1 1501**] dependant at baseline who presented after cardiac arrest. The patient suffered severe anoxic brain injury and was made CMO by his family on the evening of [**3-9**] with plan for hospice care. The patient is to not receive IV fluids, any antibiotics, feeding tubes or dobhoffs nor is he to be rehospitalized for any reason. The patient is to be full hospice care. #) Arrest: Pt suspicious for asphyxiation leading to cardiopulmonary arrest with asystole given that he was found to have food at the vocal cords and he had an "non shockable" rhythm. His history does not support other common causes of PEA/asystole, and his lab abnormalities are likely a result and not cause of arrest. Pt did not have circulation for a total of 10min. He was started on the arctic sun cooling protocol w/ goal 34C. Pt remained on artic sun for 24h then rewarmed, electrolytes were monitered closely during rewarming. Pt did not have any hemodynamic compromise after this. #) Anoxic brain injury / AMS: Patient's neurologic exam is concerning for significant impairment secondary to cardiopulmonary arrest leading to anoxic brain injury. Neurology was consulted. Initially sz activity was also on the differential, but the EEG showed no epileptiform activity and no lateralizing areas. His myoclonic jerks were attributed to his anoxic brain injury. Pt did have intact pupillary reflex and weak OCR, but absent corneal reflex, and stereotypic posturing to pain in all extremities. His prognosis is very poor w/ little chance of meaningful recovery and very likely to stay in vegetative state. Family meeting was held and decided to attempt extubation, and not reintubate if pt declines. Family was against the idea of a trach/PEG, but are willing to have NG tube - for food/meds. TF started. Palliative care consulted. #) Respiratory Failure: There was no evidence on exam or CXR of respiratory failure or significant gas exchange abnormality and no evidence of further aspiration. Maintained on mandatory ventilation while cooling. Wean O2 as tolerated. His peak airway pressures have been in the 30s. This may be due to some obstructive airway disease at baseline/ elevated lung volumes. Pt was kept on vent because of his poor MS and inability to protect airway, at least until a decision was made on pt's goals of care. Pt was extubated and tolerated extubation well. #) Aspiration Pneumonitis: His CXR was concerning for aspiration PNA the next day and pt was started on Vanc/Zosyn. Pt's sputum and blood cx remained negative for G(+) and Vanc was d/c. Pt continues to have significant secretions even after extubation. Pt was continued on an 8 day course of Zosyn, currently on day [**6-23**]. #) Anion Gap: Patient has an anion gap with an elevated lactate, both of which are improving with IV fluids and improved hemodynamic status. This is secondary to cardiac arrest and resultant poor perfusion. #) Bifrontal subdural fluid collections - Patient with known chronic subdural hematomas. CT concerning for possible new acute progression in left frontal area. Seen by neurosurgery. No need for acute intervention. Reimaging did now show any chagnes. #) Acute Kidney Injury - Patient has an elevated creatinine likely due to prerenal azotemia. This could be strictly prerenal or may have progressed to ATN. It is reassuring that his creatinine is now trending down. Rhabdomyolsis is unlikely given the normal CK. Pt's prerenal failure resolveed. #) ST depressions - EKG shows precordial ST depressions and Troponin is elevated. This is likely secondary to arrest and CPR leading to cardiac myocyte damage. ACS is unlikely by history. Pt [**Name (NI) **]. Medications on Admission: Atenolol 25mg PO daily Lisinopril 2.5mg PO daily Prilosec 20mg PO daily Carbidopa/Levodopa 25/100 mg PO daily Colace 100mg PO BID Ipratropium-Albuterol neb QID PRN dyspnea Mirapex 0.125mg qac Discharge Medications: 1. Polyvinyl Alcohol-Povidone 1.4-0.6 % Dropperette Sig: [**12-18**] Drops Ophthalmic PRN (as needed). 2. Morphine Concentrate 20 mg/mL Solution Sig: 5-15 mg PO Q2H (every 2 hours) as needed. 3. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed. 4. Acetaminophen 160 mg/5 mL Solution Sig: 325-650 mg PO Q6H (every 6 hours) as needed for fever. 5. Acetaminophen 650 mg Suppository Sig: One (1) Suppository Rectal Q6H (every 6 hours) as needed. 6. Scopolamine Base 1.5 mg Patch 72 hr Sig: One (1) Patch 72 hr Transdermal PRN (as needed). Discharge Disposition: Extended Care Facility: [**Hospital6 **] Center Discharge Diagnosis: Anoxic Brain Injury Cardiopulmonary arrest Acute Renal Failure Elevated LFTs Atrial fibrillation Discharge Condition: Comfort Meausures Only. DNR/DNI, do not rehospitalize. No IVF, antibiotics. The goal of care is comfort. Discharge Instructions: The patient has been made CMO. DNR/DNI, do not rehospitalize. No IVF, antibiotics. The goal of care is comfort. Followup Instructions: Patient is CMO. Care at [**Hospital1 1501**]. ICD9 Codes: 4275, 5070, 5849, 496, 4019, 2724
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Medical Text: Admission Date: [**2160-1-17**] Discharge Date: [**2160-1-23**] Service: HISTORY OF PRESENT ILLNESS: The patient is an 82 year old man with end stage renal disease on peritoneal dialysis with a history of coronary artery disease, who presented with worsening shortness of breath. The patient was in his usual state of health until a few days prior to admission when he began to experience worsening shortness of breath, more than his baseline. He had experienced paroxysmal nocturnal dyspnea for some time but more frequently and progressively worse. At 4:00 a.m. the morning of admission, he awoke with extreme shortness of breath which improved when he sat up. He also reported dyspnea on exertion and occasional chest discomfort with exertion over the six months prior to admission, much worse over the week prior to admission. He reports that his chest pain improved with rest. The patient denied diaphoresis, nausea and vomiting. He reported that he could only walk down a [**Doctor Last Name **] until he experienced shortness of breath and needed to rest. PAST MEDICAL HISTORY: 1. Coronary artery disease, status post percutaneous transluminal coronary angioplasty to the D1 and right coronary artery. 2. End stage renal disease secondary to focal segmental glomerulosclerosis. The patient has been on chronic ambulatory peritoneal dialysis for two and one half years and has had two episodes of supraventricular tachycardia. 3. Chronic leukocytosis. 4. History of pulmonary embolus. 5. Chronic obstructive pulmonary disease. 6. Hypertension. 7. Hypercholesterolemia. 8. Congestive heart failure. 9. Gout. 10. Status post total hip replacement. 11. Status post right knee replacement. 12. Prostate cancer. 13. Status post cataract surgery. 14. History of adenomatous polyps. MEDICATIONS ON ADMISSION: 1. Digoxin 0.125 mg p.o. q.o.d. 2. PhosLo 2 mg p.o. three times a day. 3. Renagel 1500 mg p.o. three times a day. 4. Simvastatin 40 mg p.o. once daily. 5. Aspirin 81 mg p.o. once daily. 6. Lactulose 15 to 30 mg p.o. three times a day. 7. Metoprolol 2.5 mg p.o. once daily. ALLERGIES: Motrin. SOCIAL HISTORY: The patient quit smoking fifty years ago. He denies alcohol use. His primary cardiologist is Dr. [**Last Name (STitle) 121**]. PHYSICAL EXAMINATION: Vital signs revealed temperature 96.3, heart rate 89, blood pressure 134/72, oxygen saturation 99% on two liters, weight 200 pounds. Cardiovascular - The patient had distant heart sounds with a regular S1 and S2 and faint S3. Pulmonary - He had faint bibasilar crackles. Abdomen was obese, distended to percussion and nontender to palpation. Extremities showed no edema, palpable posterior tibial pulses and no femoral bruit. Neurologic examination was intact. LABORATORY DATA: On admission, white blood cell count was 14.7. Potassium 3.3. Blood urea nitrogen 33, creatinine 10.9. Liver function tests were normal. Digoxin level 0.88. HOSPITAL COURSE: The patient was admitted and initially was believed to rule in for myocardial infarction with a troponin of 5.0. Maximal CK was 157 with a MG of 13 and a positive MB index of 9.1. The patient was subsequently taken for cardiac catheterization where coronary angiography of the right dominant circulation revealed branch vessel coronary artery disease. Left main coronary artery had no significant stenoses. The left anterior descending had mild luminal irregularities. D1 totally occluded distally at the site of prior stenting. D2 no lesions. Left circumflex had mild luminal irregularities. Three OM branches free of disease. The right coronary artery was widely patent at the sites of prior stenting and otherwise free of significant stenoses. The right coronary artery supplied the posterior descending artery and PLV. Resting hemodynamics were measured at baseline and revealed a markedly impaired cardiac output of 3.6 liters per minute and a moderately elevated left ventricular filling pressures with a left ventricular end diastolic pressure of 25 mmHg. At rest, the gradient across the aortic valve was 21 mmHg with a calculated valve area of 0.97 square centimeters. Dobutamine was infused up to 10 mcg/kg/minute. The patient's systolic blood pressure fell to a level of 70 mmHg. During this time, the patient's cardiac output rose to 5.9 liters per minute. Aortic valve calculations revealed peak gradient of 34 mmHg and a valve area of 1.02 square centimeters. The patient was then started on Dopamine with no effect on the systemic arterial pressure. For this reason, an intra-aortic balloon pump was inserted with subsequent return of blood pressure to baseline and a cardiac output of 7.1 liters per minute. The patient was transferred to the Cardiac Care Unit where he was weaned off the balloon pump and Dopamine without difficulty. Electrophysiology service was consulted and evaluated the patient for biventricular pacemaker which was placed in addition to an ICD. The patient's symptoms of shortness of breath improved markedly after the biventricular pacer placement. He was transferred to the Cardiac Medicine floor for an additional day of monitoring. He had one episode of systolic blood pressure in the high 70s but otherwise was stable through the remainder of his hospital course. Renal - The patient was continued on his chronic ambulatory peritoneal dialysis throughout his hospital stay. He was closely followed by his primary nephrologist as well as the renal team. The patient's persistent leukocytosis was not felt to be a change, however, a sample of a diasolate was sent for culture with no growth by the time of discharge. Gram stain was negative. Per the renal team, the patient was instructed to continue his outpatient antihypertensive regimen with further fine tuning of his blood pressure through dialysis. DISCHARGE DIAGNOSES: 1. Status post biventricular pacer. 2. Congestive heart failure. MEDICATIONS ON DISCHARGE: 1. Digoxin 0.125 mg p.o. q.o.d. 2. PhosLo 2 mg p.o. three times a day. 3. Renagel 1500 mg p.o. three times a day. 4. Simvastatin 40 mg p.o. once daily. 5. Aspirin 81 mg p.o. once daily. 6. Lactulose 15 to 30 mg p.o. three times a day. 7. Metoprolol 2.5 mg p.o. once daily. FOLLOW-UP: Device Clinic [**2160-1-29**], at 1:00 p.m., Dr. [**Last Name (STitle) 121**] in two weeks after discharge, Dr. [**Last Name (STitle) 174**] as needed. [**Doctor First Name 900**] [**Name8 (MD) 901**], M.D. [**MD Number(1) 2144**] Dictated By:[**Last Name (NamePattern4) **] MEDQUIST36 D: [**2160-1-23**] 20:36 T: [**2160-1-27**] 11:34 JOB#: [**Job Number 21536**] ICD9 Codes: 4241, 496, 4254, 486
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Medical Text: Admission Date: [**2174-11-28**] Discharge Date: [**2174-12-1**] Date of Birth: [**2094-6-12**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2279**] Chief Complaint: Dyspnea (although patient non-verbal) Major Surgical or Invasive Procedure: None History of Present Illness: 80 YO nonverbal M with end-stage Alzheimer's and a well-documented h/o chronic aspiration p/w increased breath sounds. The patient's CC from the ED was initially dyspnea, but, per MICU resident discussions with the family, they were concerned about increased airway sounds described as "gurgling." The patient has failed a s/s eval in the past with frank aspiration. The family decided not to pursue a g-tube in the past despite documented aspiration given lack of likely benefit for the patient. The family normally will feed him yougerts at home and reports that he coughs with all PO intake. As the patient is non-verbal and only tracks to voice, please refer to the MICU history obtained from the family. . The patient was briefly admitted to the MICU due to persistent tachycardia despite having been given 3L of fluids in the ED. Upon review of prior EKGs, it appears the patient has been persistently tachycardic. A d-dimer was checked and was elevated so a CTA was ordered; the read is pending at this time. He has not been noted to be hypoxic while awake although sats did drop to the high 80s while sleeping. He did respond to 1L NC. In addition, the patient was reportedly suctioned by MICU nursing staff who produced whole pieces of food from his airways. Past Medical History: Recent hospitalization ([**Date range (2) 43948**]) with resp failure and resultant intubation requiring intubation Alzheimer's dementia- nonverbal at baseline h/o pneumonia requiring intubation 2 years ago h/o SBO [**1-29**] HTN Social History: Lives at home with wife and son. [**Name (NI) **] is his primary caregiver. [**Name (NI) **] is dependent for all ADLs. Pt is originally from [**Country 3587**]. He lived in [**Country 6257**] for 40 years, moved to US in [**2151**]. Formerly worked in construction, building maintenance. History of sniffing tobacco, but none for greater than 10 years. No history of smoking or EtOH use. Family History: non-contributory Physical Exam: Vitals - T: afebrile BP: 105/65 HR: 116 (low 100s to 120s) RR: 22 02: 93% on 1L while sleeping GENERAL: opens eyes, non verbal, tracks HEENT: NCAT, edentulous, PERRL CARDIAC: tachy, no MRG LUNG: diffuse rhonchi ABDOMEN: soft, NT/ND, NBS EXT: no CCE Pertinent Results: [**2174-11-28**] 07:40AM WBC-9.3 RBC-5.49 HGB-17.0 HCT-53.7*# MCV-98 MCH-30.9 MCHC-31.6# RDW-12.7 [**2174-11-28**] 07:40AM NEUTS-74* BANDS-2 LYMPHS-10* MONOS-7 EOS-0 BASOS-0 ATYPS-7* METAS-0 MYELOS-0 [**2174-11-28**] 07:40AM PLT SMR-NORMAL PLT COUNT-320 [**2174-11-28**] 07:40AM GLUCOSE-187* UREA N-15 CREAT-1.0 SODIUM-145 POTASSIUM-4.1 CHLORIDE-108 TOTAL CO2-25 ANION GAP-16 [**2174-11-28**] 07:40AM ALT(SGPT)-19 AST(SGOT)-17 LD(LDH)-209 CK(CPK)-64 ALK PHOS-70 TOT BILI-0.9 [**2174-11-28**] 07:40AM LIPASE-17 [**2174-11-28**] 07:40AM cTropnT-<0.01 [**2174-11-28**] 07:40AM CK-MB-NotDone [**2174-11-28**] 07:40AM ALBUMIN-4.1 CXR [**2174-11-28**]: 1. Decrease mild vascular congestion. Cleared pneumonia. 2. Mild right lower lobe atelectasis, unchanged. Chest CTA [**2174-11-28**]: 1. No evidence of central pulmonary embolism. 2. Findings most consistent with chronic or recurrent aspiration, including dependent bibasilar airspace opacities, peribronchiolar consolidation, and mild cylindrical bronchiectasis. 3. Possible tracheomalacia. If clinically indicated, further evaluation could be performed with dedicated CT airway study when the patient is clinically able. Brief Hospital Course: 80-year-old non-verbal man with end-stage Alzheimer's and chronic aspiration presented with increased airway secretions and tachycardia, concerning for aspiration pneumonia. # Aspiration pneumonia: patient has a long history of chronic aspiration, and his family was fully aware of the risks of PO intake. Even though he had no fever, his history of aspiration, his tachycardia and oxygen requirement on admission were concerning for aspiration pneumonia. Therefore, he was treated with clindamycin and levofloxacin and was discharged on these antibiotics to finish a 5-day course. By discharge, patient was breathing comfortably on room air. # Dysphagia: was seen by speech and swallow again during this admission, who recommended pureed diet. # Hematuria: seen on urinarlysis. Should be followed up as outpatient. # CODE: FULL Medications on Admission: Viatmin E 800units [**Hospital1 **] Albuter MDI 2 puffs PRN Zocor 20mg daily Ambien 5mg HS PRN Bisacodyl PR PRN Discharge Medications: 1. Clindamycin HCl 300 mg Capsule Sig: One (1) Capsule PO every six (6) hours for 3 days. Disp:*12 Capsule(s)* Refills:*0* 2. Levofloxacin 750 mg Tablet Sig: One (1) Tablet PO once a day for 3 days. Disp:*3 Tablet(s)* Refills:*0* 3. Albuterol Sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig: [**11-26**] inh Inhalation every 4-6 hours as needed for shortness of breath or wheezing. 4. Bisacodyl 5 mg Tablet Sig: One (1) Tablet PO once a day as needed for constipation. 5. Zolpidem 5 mg Tablet Sig: One (1) Tablet PO at bedtime as needed for insomnia. Discharge Disposition: Home With Service Facility: [**Location (un) 86**] VNA Discharge Diagnosis: Primary diagnosis: aspiration pneumonia Secondary diagnoses: Alzheimer's dementia, hypertension Discharge Condition: Stable. O2 saturation 97 on room air, not tachycardic or tachypneic. Discharge Instructions: You presented to [**Hospital1 69**] with increased gurgling. You were found to have a possible aspiration pneumonia and were started on antibiotics. By discharge, your respiratory status was stable, and you did not need supplemental oxygen. Please take these antibiotics, along with the rest of your medications, as instructed. Followup Instructions: MD: Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] Specialty: PCP [**Name Initial (PRE) 2897**]/ Time: [**Last Name (LF) 766**], [**12-5**] at 11:30am Location: [**Location **], [**Hospital1 **], [**Location (un) **],[**Numeric Identifier 12201**] Phone number: [**Telephone/Fax (1) 7976**] [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] MD [**MD Number(2) 2285**] ICD9 Codes: 5070, 4019
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Medical Text: Admission Date: [**2119-7-4**] Discharge Date: [**2119-7-8**] Date of Birth: [**2037-1-20**] Sex: M Service: MEDICINE Allergies: Phenytoin / Cefazolin Attending:[**First Name3 (LF) 2745**] Chief Complaint: Hypotension, fever, hypoxia Major Surgical or Invasive Procedure: [**2119-7-4**] s/p Left Knee Aspiration . [has Single lumen PICC, Right AC, placed [**2119-6-27**] @ [**Hospital1 2025**], placement confirmed by CXR @ [**Hospital1 18**]] History of Present Illness: HPI: This is a 82 year-old M with a history of rheumatoid arthritis S/P bilateral total knee replacements and recent admission to [**Hospital1 2025**] for left septic knee ([**Date range (2) 94427**], 7/22-29/08)(Coagulase negative Staph) who presents from rehab with episodes of "staring and unresponsiveness." After completing a physical therapy session on the day prior to admission, patient was noted by his wife to be unresponsive while lying in bed, with a gaze fixed to the left. She denied witnessing any myoclonic jerks, but does think he may have had urinary incontinence, without fecal incontinence. . Patient was transferred by EMS to [**Hospital3 417**] ED. On arrival to ED, he was noted to have fever to 103, BP 93/57, HR 98, RR 40, Sat 96% on 2L and he received 750 mg IV levofloxacin. Course was notable for frequent emesis, subsequent respiratory distress, and hypotension to 78/57 unresponsive to fluids, so he was started on Levophed gtt. He was transferred to [**Hospital1 18**] for further evaluation and management. . Of note, patient has had recurrent infectious complications related to knee hardware, and was most recently discharged on Vancomycin/Rifampin suppressive therapy, per ID recommendations. He also had recent episodes of diarrhea, but has been rule-out for C. difficile at [**Hospital1 2025**], and empiric metronidazole was discontinued. Past Medical History: #. Bilateral hip and knee replacements -L knee replaced [**2099**] c/b hardware dislocation and infection ?[**2113**], cultures grew coag negative staph and p. acnes, treated with vancomycin x6weeks followed by levofloxacin/rifampin suppressive therapy subsequently changed to doxycycline #. Septic L knee [**5-7**] - Arthrocentesis showed >35k WBC with 98% polys, s/p I+D and linear replacement but retained hardware - Culture grew Staph lugdunesis (Tet R, Ox/Vanc/Clinda/Bactrim S) - Initially treated with nafcillin/rifampin - Represented with diarrhea on [**6-4**] (workup negative), knee said to have some surround erythema, underwent repeat tap WBC 9700 72% polys. - Nafcillin changed to vancomycin [**6-21**] due to concern for ?naf related AIN #. Rheumatoid arthritis and OA #. Hypertension #. Hypercholesterolemia #. Prostate cancer s/p prostatectomy #. Spinal stenosis s/p laminectomy #. s/p wrist surgery, plate #. Polyneuropathy #. s/p TURP Social History: The patient is retired and usually lives with his wife although more recently in rehab. He is now retired, but previously worked in insurance Tobacco: None ETOH: None Illicits: None Family History: Noncontributory Physical Exam: D/C Physical Exam: ================= . T 98.2, P 72 BP 138/87 RR 18 O2 97% on RA General: elderly man sitting in [**Female First Name (un) 1634**] chair, alert, flat affect, somewhat lethargic HEENT: PERRL, EOMI, sclera white, conjunctiva pale, MMM Pulm: Bibasilar/posterior fine crackles which do not clear w/ DB&C. CV: RRR, s1 s2, 2/6 SEM RUSB Abd: Soft nontender +bowel sounds, no masses or organomegaly Extremities: bilat LE - warm, slight pitting ~[**11-30**] to knees L>R, hemesidern noted, DP 2+, cap refill ~ 3 secs, CSM intact, blanching erythema bilat heels. L knee with midline well approximatedly surgical wound, non-tender& non-erythemic but slightly warm to touch, more swollen compared to the right. Neuro: Alert, oriented to self (name & DOB), month "[**Month (only) 216**]", year "08", president "[**Last Name (un) 2450**]"; day "6" (is 9th), location "rehab", when corrected to hospital, can not say which one. Face symmetrical @ rest & with movement, tongue midline, resonds appropriately to requests. Derm: Erythemic rash in bilat buttocks region, hyperkeratosis noted bilat feet, skin tear left anterior upper chest w/ dsg D&I. Bruising noted right lateral flank just superior to illiac crest. Access: single lumen PICC, right AC.98.2 Pertinent Results: ADMISSION LABS: =============== [**7-4**]: Joint Aspirate ??????left knee ?????? WBC 8000, RBC [**Numeric Identifier 92903**], PMNs 77%, Lymph 2%, Mono 20%, Eos 0% -c/w inflammatory background but unlikely septic [**7-4**]: Gram stain joint fluid prelim ?????? 2+ PMNs, no microorganisms to date [**7-4**]: joint crystal analysis pending [**2119-7-4**] 05:16AM URINE RBC-2 WBC-5 BACTERIA-FEW YEAST-NONE EPI-0 [**2119-7-4**] 05:16AM URINE BLOOD-NEG NITRITE-NEG PROTEIN-TR GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.5 LEUK-TR [**2119-7-4**] 05:16AM PT-15.0* PTT-33.7 INR(PT)-1.3* [**2119-7-4**] 05:16AM GLUCOSE-158* UREA N-23* CREAT-1.7* SODIUM-137 POTASSIUM-4.0 CHLORIDE-100 TOTAL CO2-26 ANION GAP-15 [**2119-7-4**] 05:16AM ALT(SGPT)-11 AST(SGOT)-18 LD(LDH)-165 ALK PHOS-125* TOT BILI-0.5 [**2119-7-4**] 05:16AM proBNP-264 [**2119-7-4**] 05:16AM ALBUMIN-2.7* CALCIUM-9.6 PHOSPHATE-3.8 MAGNESIUM-1.6 [**2119-7-4**] 05:16AM WBC-18.8* RBC-2.91* HGB-8.7* HCT-25.8* MCV-89 MCH-29.9 MCHC-33.8 RDW-15.3 [**2119-7-4**] 05:16AM NEUTS-78.8* BANDS-0 LYMPHS-16.9* MONOS-3.7 EOS-0.3 BASOS-0.3 . IMAGING: ======= [**2119-7-5**] PELVIS (AP ONLY) PORT - FINDINGS: The patient is status post bilateral total hip arthroplasty with revision prosthesis on the right. There is no major hardware complication seen on the radiograph. Comparison with prior study will be helpful. There is severe osteoarthritic changes in the lower lumbar spine. IMPRESSION: No major hardware complication. Recommend comparison with prior study. [**2119-7-5**] CHEST (PORTABLE AP) - Since yesterday, lung volumes improved and bibasilar atelectasis slightly decreased. Left lower lobe alveolar opacity also slightly decreased but persists associated with unchanged patchy alveolar opacity in the right mid lung, worrisome for multifocal pneumonia which should be followed up. There is no vascular congestion. Heart size is top normal and the aorta is moderately tortuous. Right PICC line is in SVC in unchanged position. Blunting of the left costodiaphragmatic angle is unchanged. [**2119-7-4**] KNEE (AP, LAT & OBLIQUE - IMPRESSION: 1) Tibiofemoral prosthesis; 2) Small lucency in the medial tibial plateau suspicious for fracture, comparison to old films would be very useful; 3) Absence of the patella with dystrophic calcifications seen anteriorly; 4) Large joint effusion. Joint aspiration would be required if there is concern for septic joint. [**2119-7-4**] CHEST (PORTABLE AP) - IMPRESSION: 1. Left lower lobe pneumonia; 2. Mild pulmonary edema. . EEG: === [**2119-7-4**] - BACKGROUND: Somewhat unevenly modulated [**8-9**] Hz posterior background with occasional slower alpha was seen throughout the later portions of the record with the patient fully awake. The anterior-posterior voltage gradient was preserved. No focal, lateralized, or discharging abnormalities were noted in waking. HYPERVENTILATION: Not performed. INTERMITTENT PHOTIC STIMULATION: Not performed. SLEEP: The patient began the tracing in stage II sleep and only gradually, over time, was able to be aroused to full wakefulness, after which the patient maintained full wakefulness for the second half of the record. No abnormalities were noted in stage II sleep. CARDIAC MONITOR: No arrhythmias noted. IMPRESSION: Borderline EEG due to some uneven voltage modulation but without any marked or undue slowing or discharging features. The clinical significance of the uneven voltage modulation is uncertain and is of a lesser clinical significance. . EEG: === [**2119-7-4**] - IMPRESSION: Borderline EEG due to some uneven voltage modulation but without any marked or undue slowing or discharging features. The clinical significance of the uneven voltage modulation is uncertain and is of a lesser clinical significance. . MICROBIOLOGY: ============ [**2119-7-8**] STOOL - CLOSTRIDIUM DIFFICILE TOXIN A & B TEST (Pending): [**2119-7-8**] STOOL - OVA + PARASITES (Pending) [**2119-7-5**] BLOOD CULTURE (Source: Line-PICC) - Pending [**2119-7-4**] URINE C&S (Catheter) - NO GROWTH [**2119-7-4**] Blood Cultures x's 3 - pending [**2119-7-4**] JOINT FLUID (Knee) - GRAM STAIN (Final [**2119-7-4**]): 2+ (1-5 per 1000X FIELD): POLYMORPHONUCLEAR LEUKOCYTES; NO MICROORGANISMS SEEN. FLUID CULTURE (Final [**2119-7-7**]): NO GROWTH. . DISCHARGE LABS: =============== [**2119-7-7**] STOOL - FECAL CULTURE (Pending); CAMPYLOBACTER CULTURE (Pending); OVA + PARASITES (Pending); CLOSTRIDIUM DIFFICILE TOXIN A & B TEST (Final [**2119-7-8**]): Feces negative for C.difficile toxin A & B by EIA. [**2119-7-7**] 04:59AM BLOOD Vanco-27.9* [**2119-7-8**] 05:03AM BLOOD WBC-8.1 RBC-3.07* Hgb-9.4* Hct-27.5* MCV-89 MCH-30.4 MCHC-34.0 RDW-16.6* Plt Ct-297 [**2119-7-8**] 05:03AM BLOOD Neuts-58.7 Lymphs-30.1 Monos-7.1 Eos-3.3 Baso-0.8 [**2119-7-8**] 05:03AM BLOOD Glucose-89 UreaN-14 Creat-1.4* Na-139 K-3.6 Cl-108 HCO3-24 AnGap-11 [**2119-7-8**] 05:03AM BLOOD Calcium-8.7 Phos-3.1 Mg-1.7 Brief Hospital Course: 82 year old male with h/o RA on chronic prednisone, multiple joint replacements with h/o recent L knee septic joint [**5-7**] on Vanc/rifampin admitted [**7-4**] with hypotension/hypoxia/MS changes/fevers/possible seizures. Found to have severe sepsis [**12-31**] PNA (HAP), placed on zosyn with improvement in above and admitted to ICU. Transfered to Gen Med [**7-5**] for further management. . Hospital/healthcare Aquired Pneumonia - admitted with fevers, leukocytosis, MS changes, cough/hypoxia--> severe sepsis/septic shock (pressors), which has resolved. Patient with LLL and RML PNA on imaging, ?HAP vs aspiration pneumonitis. Improved clinical status on Zosyn (10 day course, Day 1 = [**2119-7-4**], last day = [**2119-7-13**], d/c on [**2119-7-14**]) and Vanc 750mg q24h (until [**7-11**] for septic joint), currently on RA. Of note, Vancomycin dose decreased from 1 g -> 750 mg for a Vancomycin level of 27.9 on [**2119-7-7**] at 0500H. . Diarrhea: per wife, this was a [**Last Name 16423**] problem when previously on nafcilin in [**5-7**], then switched to vanc and placed on imodium with some improvement but still persistant diarrhea 2-3X/day. Now, over past day back to having frequent loose stools (not able to provide more info). No feves, white count is stable. of note, has also been off imodium while here. not associated with meals, thus secretory (not osmotic). Stool for C diff negative x's one & second pending. Given past h/o diarrhea, ID reccomended NOT starting c. diff rx empirically. Some perirectal skin rash [**12-31**] stool incot, & need to monitor I/O's & lytes. . Acute on chronic renal failure, resolved. Per chart review, baseline creatinine appears to be around 1.2-1.4. Has improved with IVF, creatinine 1.4 on [**2119-7-8**]. Would monitor closely given multiple antibiotics & potential for electrolyte imbalance with diarrhea. . Chronic Septic Arthritis, seen by ID here. Left knee tap this admission negative cx (inflamm effusion). Continue Vancomycin and Rifampin (plan to Rx until 8/12 per notes, then bactrim suppression). Follow up by [**Hospital1 2025**] Ortho and ID clinics: has Ortho appointment but NEEDS APPOINTMENT WITH [**Hospital1 2025**] ID. . Anemia NOS: normocytic, no evidence of bleeding, Fe studies not suggesting Fe def, T.bili normal so no hemolysis. Most likely ACD given chronic septic joint. Received 2U PRBC on [**2119-7-6**]. Hct 27.5 on D/C. . Altered Mental Status/delirium - multifactorial, but mostly likely brewing PNA. CT head negative. MS now back to baseline. ? staring episode concerning for seizure, EEG unremarkable, but does not rule out (nonepileptiform). [**Month (only) 116**] have been related to hypotension/[**Month (only) **] cerebral perfusion. Neuro exam nonfocal. If concern or repeat ? sz like activity, MRI as outpt, but none indicated currently. . Rheumatoid arthritis ?????? chronic prednisone, was placed on stress dose steroids in ICU X2days, then prednisone X50mg X2doses, then switched to Prednisone 5mg [**Hospital1 **] and now on Prednisone 5 mg qd. . Hyperlipidemia ?????? continue Atorvastatin 20 mg PO QD . Hypertension - normotensive currently, re-started on Metoprolol Tartrate 25 mg PO BID. . Decreased appetite & ? Depression - started on Mirtazapine 15 mg PO QHS on [**2119-7-7**]. . PPx: Heparin 5000 units SQ TID; Protonix 40 mg po QD . Dispo/Code: DNR but not DNI, confirmed with patient. Medications on Admission: Rifampin 300 mg [**Hospital1 **] Bactrim 1 tab daily Vancomycin 1 gm IV Q 24 hrs Prednisone 5 mg daily Omeprazole 20 mg daily Loperamide 2 mg [**Hospital1 **] PRN Tylenol 650 mg Q 6 hrs PRN Oxycodone 5 mg Q 6 hrs PRN Calcium carbonate 1 tab daily Lactobacillis 1 packet [**Hospital1 **] Ferrous sulfate 324 mg daily. Lovenox 40 mg sub Q daily Simvastatin 10 mg daily Multivitamins with minerals 1 tab daily Lopressor 25 mg [**Hospital1 **] Nexium 40 mg PO daily Discharge Medications: 1. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed. 2. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection [**Hospital1 **] (2 times a day). 3. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 4. Atorvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 6. Rifampin 300 mg Capsule Sig: One (1) Capsule PO Q12H (every 12 hours). 7. Mirtazapine 15 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 8. Prednisone 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. 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. 10. Piperacillin-Tazobactam Na 2.25 g IV Q6H x's 10days, Day 1=[**2119-7-4**], last day = [**2119-7-13**], d/c on [**2119-7-14**] 11. Vancomycin 750 mg IV Q 24H, last day = [**2119-7-11**] Discharge Disposition: Extended Care Facility: [**Hospital1 700**] TCU - [**Location (un) 701**] Discharge Diagnosis: Primary Diagnosis: ================= Hospital Aquired Pneumonia, Sepsis Altered Mental Status Acute Renal Failure . Secondary Diagnosis: =================== #. s/p Bilateral hip and knee replacements, L knee replacement ([**2099**]) c/b hardware dislocation and infection in ?[**2113**], cultures grew coag negative staph and p. acnes. #. Septic L knee [**5-7**], arthrocentesis showed >35k WBC with 98% polys, s/p I+D and linear replacement but retained hardware, culture grew Staph lugdunesis (Tet R, Ox/Vanc/Clinda/Bactrim S), associated diarrhea on [**6-4**] (workup negative) #. Rheumatoid arthritis and OA #. Hypertension #. Hypercholesterolemia #. Anemia #. Prostate cancer s/p prostatectomy #. Spinal stenosis s/p laminectomy #. s/p wrist surgery, plate #. Polyneuropathy #. s/p TURP Discharge Condition: Stable: o2 sat 97% RA, no longer hypotensive, taking & retaining PO's, continues incot loose/liquid brown stools. Discharge Instructions: You were admitted to the hospital after experiencing a change in mental status, low blood pressure, and vomitting. You also developed a high fever and trouble breathing. Initially you were sent from Rehab ([**Hospital1 **]) to a local hospital (Caritas Good Saamaritan)and then transfered to [**Hospital1 **]. You were found to have Pneumonia in several places in your lungs, probably from aspiration. An aspiration of the fluid in your left knee did not reveal any bacteria or fungus. Your breathing and blood pressure has gotten better, so we are transferring you back to your rehabilitation site. . It is important that you take all of your medications as prescribed and also to follow the instructions of the therapists at rehabilitation. . A new antibiotic called Zosyn was started. You will need to complete a ten day course of this medication. Your Rifamoin was continued as was your Vancomycin (but at a lower dose). Your Bactrim was discontinued. . Please let your care givers know if you have any of the following: changes in mental status, fever or shaking chills, uncontrolled vomiting, any blood or "coffee grounds" in any vomit, chest pain/pressure, trouble breathing, pain in your throat or abdomen, increased difficulty walking, feel dizzy or light-headed, blood in your stools, black stools, pain not adequately controled by medications or other health-related concerns. . Please make and keep all of your follow-up apointments. You should follow-up with your Primary Care Provider when you are discharged from the rehabilitation setting. Followup Instructions: Please make & keep your follow-up appointments. . [**Hospital1 2025**] Orthopaedic Surgery: Dr. [**First Name11 (Name Pattern1) 3613**] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 23001**], MD, [**Telephone/Fax (1) 94428**], for [**2119-8-14**]: 7:30 AM x-rays & 8:00 AM with Otho Fellow and Dr. [**Last Name (STitle) 23001**]. . Please call Dr. [**Last Name (STitle) **] [**Last Name (NamePattern4) 94429**], MD, Infectious Disease at [**Hospital1 2025**], ([**Telephone/Fax (1) 94430**] to schedule a follow-up appointment. Completed by:[**2119-7-8**] ICD9 Codes: 0389, 5070, 5849, 5859, 2720
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Medical Text: Admission Date: [**2146-11-21**] Discharge Date: [**2146-11-28**] Date of Birth: [**2066-7-29**] Sex: F Service: MEDICINE Allergies: Sulfasalazine / Morphine / Nsaids / Fosamax Attending:[**First Name3 (LF) 10682**] Chief Complaint: Fever and Vomiting Major Surgical or Invasive Procedure: A line [**2146-11-21**] Central venous line, RIJ, [**2146-11-21**] History of Present Illness: 80F with RA on prednisone and chronic diastolic CHF admitted with hypotension and tachycardia. Presented to PCP's office on the day of admission with headache and rhinitis beginning 3 days prior. Symptoms followed with anorexia and nonbloody, nonbilious vomiting. Reports fever as high as 103.4, dysuria, and epigastric pain which she attributes to dry heaving. Reports [**7-9**] constant nonradiating nonpositional substernal chest pressure beginning earlier this evening, without associated lightheadedness, diaphoresis, palpitations, nausea, dyspnea, or edema. Reports that her weight is stable. Never experienced chest pressure before. Had a flu vaccine earlier this season. On exam in clinic T 99 O2sat 96%RA BP 86/60 HR 120 while standing and 90/60 HR 120 while supine. EKG showed newly discovered AFib with RVR. Referred to ED. Triage V/S 98.0 120 119/81 14 95% 3L NC. Rectal temp 102 BP 86/51 normal mentation guaiac negative. Labs notable for lactate 0.7 (after 3L NS) WBC# 16.3 (86.5% PMN), BNP 7980, trop 0.09, U/A+. CXR showed cardiomegaly but no acute process. Persistently hypotensive (MAP 50s) despite 3L NS - right IJ was placed. Started levophed gtt. Given vancomycin 1 g IV, zosyn 4.5 g IV, ASA 325, acetaminophen 1 g, 3L NS. V/S prior to transfer 118 93/52 (levophed 0.04 mcg/kg/min) 29 96%2L. Past Medical History: RA Chronic diastolic CHF Hyperparathyroidism Hyperlipidemia Shingles Osteoporosis DJD Adenomatous/hyperplastic polyps Internal & external hemorrhoids s/p R THR ([**2135**]), bilat TKR Social History: [**Hospital 8735**] home health aide. Lives with her husband in [**Name (NI) 2312**]. Former smoker, quit ~20 years ago. Family History: Two sisters have had "heart attacks" but are alive and well in their 80s. Physical Exam: Physical Exam on Arrival to [**Hospital Unit Name 153**]: V/S: T 98.3 BP 126/65 HR 133 RR 17 O2sat 98%2LNC. GEN: Appears well, respirations nonlabored HEENT: OP clear dry MM NECK: R IJ site c/d/i flat neck veins RESP: bibasilar rhonchi clear with coughing no wheeze CV: irreg irreg tachy nl S1S2 no m/r/g ABD: soft NTND normoactive BS EXT: warm, dry tr pitting edema to mid-calves bilat no leg swelling SKIN: no rash NEURO: AAOx3 Pertinent Results: Admission labs: [**2146-11-21**] 02:15PM BLOOD WBC-16.3* RBC-4.21 Hgb-13.4 Hct-38.7 MCV-92 MCH-31.8 MCHC-34.5 RDW-13.8 Plt Ct-280 [**2146-11-21**] 02:15PM BLOOD Neuts-86.5* Lymphs-9.7* Monos-3.4 Eos-0.1 Baso-0.4 [**2146-11-21**] 02:15PM BLOOD PT-14.8* PTT-28.0 INR(PT)-1.3* [**2146-11-21**] 02:15PM BLOOD Glucose-87 UreaN-21* Creat-1.1 Na-134 K-4.0 Cl-94* HCO3-27 AnGap-17 [**2146-11-21**] 02:15PM BLOOD ALT-16 AST-31 LD(LDH)-245 AlkPhos-91 TotBili-0.7 [**2146-11-21**] 02:15PM BLOOD proBNP-7980* [**2146-11-21**] 02:15PM BLOOD cTropnT-0.09* [**2146-11-22**] 02:40AM BLOOD cTropnT-0.09* [**2146-11-22**] 12:54PM BLOOD CK-MB-7 cTropnT-0.05* [**2146-11-21**] 02:15PM BLOOD Albumin-3.4* Calcium-8.7 Mg-1.8 [**2146-11-22**] 02:40AM BLOOD Iron-12* [**2146-11-22**] 02:40AM BLOOD calTIBC-215* Hapto-295* Ferritn-284* TRF-165* [**2146-11-21**] 06:00PM URINE Color-Yellow Appear-Hazy Sp [**Last Name (un) **]-1.010 [**2146-11-21**] 06:00PM URINE Blood-TR Nitrite-NEG Protein-75 Glucose-NEG Ketone-TR Bilirub-SM Urobiln-NEG pH-5.0 Leuks-MOD [**2146-11-21**] 06:00PM URINE RBC-0-2 WBC->50 Bacteri-MANY Yeast-NONE Epi-0 [**2146-11-21**] 6:00 pm URINE Site: CATHETER Discharge labs: [**2146-11-28**] 06:00AM BLOOD WBC-11.3* RBC-3.93* Hgb-11.8* Hct-37.3 MCV-95 MCH-30.1 MCHC-31.7 RDW-14.9 Plt Ct-361 [**2146-11-28**] 06:00AM BLOOD Glucose-80 UreaN-22* Creat-0.9 Na-143 K-3.9 Cl-107 HCO3-31 AnGap-9 [**2146-11-28**] 06:00AM BLOOD Calcium-8.1* Phos-3.5 Mg-1.8 [**2146-11-24**] 06:55AM BLOOD CK(CPK)-66 [**2146-11-24**] 06:55AM BLOOD CK-MB-6 cTropnT-0.03* [**2146-11-28**] 06:00AM BLOOD PT-27.2* PTT-34.3 INR(PT)-2.7* [**2146-11-24**] 10:28AM BLOOD %HbA1c-6.4* eAG-137* [**2146-11-24**] 06:55AM BLOOD Triglyc-88 HDL-36 CHOL/HD-3.1 LDLcalc-59 [**2146-11-24**] 06:55AM BLOOD calTIBC-234* Ferritn-229* TRF-180* **FINAL REPORT [**2146-11-23**]** URINE CULTURE (Final [**2146-11-23**]): ESCHERICHIA COLI. >100,000 ORGANISMS/ML.. PRESUMPTIVE IDENTIFICATION. Piperacillin/tazobactam sensitivity testing available on request. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ ESCHERICHIA COLI | AMPICILLIN------------ <=2 S AMPICILLIN/SULBACTAM-- <=2 S CEFAZOLIN------------- <=4 S CEFEPIME-------------- <=1 S CEFTAZIDIME----------- <=1 S CEFTRIAXONE----------- <=1 S CIPROFLOXACIN---------<=0.25 S GENTAMICIN------------ <=1 S MEROPENEM-------------<=0.25 S NITROFURANTOIN-------- <=16 S TOBRAMYCIN------------ <=1 S TRIMETHOPRIM/SULFA---- <=1 S [**2146-11-21**] ECG Atrial fibrillation, average ventricular rate 123. Early transition. Diffuse non-specific T wave changes. No previous tracing available for comparison. [**2146-11-21**] CXR: PA and lateral views of the chest are obtained. The heart is moderately enlarged. Mild interstitial prominence within the lungs could indicate chronic lung disease and clinical correlation is advised. No gross CHF. No pleural effusion or pneumothorax. Aorta is unfolded. Bony structures appear grossly intact. IMPRESSION: Cardiomegaly. Prominence of the interstitial markings could reflect interstitial lung disease for which clinical correlation is advised. ECHO [**11-25**]-The left atrium is mildly dilated. The right atrium is moderately dilated. No atrial septal defect is seen by 2D or color Doppler. The estimated right atrial pressure is 10-20mmHg. There is mild symmetric left ventricular hypertrophy with normal cavity size. Regional left ventricular wall motion is normal. Overall left ventricular systolic function is low normal (LVEF 50-55%). There is no ventricular septal defect. Right ventricular chamber size is normal. with borderline normal free wall function. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. Mild to moderate ([**1-1**]+) mitral regurgitation is seen. The tricuspid valve leaflets are mildly thickened. There is mild pulmonary artery systolic hypertension. There is a trivial/physiologic pericardial effusion. Brief Hospital Course: A/P: 80F with RA on prednisone and chronic diastolic CHF admitted with shock and afib with RVR. #Sepsis from urinary tract infection. Patient presented with fever, dysuria, and positive UA on the background of hypovolemia [**2-1**] poor oral intake and vomiting, complicated by rate-related hypotension from poor distolic filling time in the setting of rapid AF. She required phenylepherine the night of ICU admission. Her initial antibiotics were vancomycin and zosyn, but vancomycin was discontinued as E coli was growing out on [**2146-11-22**]. She was switched from Zosyn to ceftriaxone as the E. coli turned out to be pan-sensitive on [**2146-11-23**]. This was changed to PO cipro on the medical floor. She will need 2 weeks of antibiotics for acute complicated urinary tract infection. She also received stress dose steroids given that she is on chronic steroids as an outpatient. This was weaned down to prednisone 20 mg with instructions to further wean to home dose. #Atrial fibrillation with RVR: Upon further review, pt states that this not new and she was told she had afib during an OR procedure in the past. Current afib with RVR likely promoted by increased sympathetic drive in the setting of septic shock and baseline chronic diastolic CHF. Pt had an echo showing mild-mod dilation of the L and R atria, mild symmetric LVH, EF 50-55%, mild to moderate [**1-1**]+MR and mild pulmonary artery hypertension. Her rate improved with antibiotics treatment for the underlying urosepsis. Pressor was weaned and she was able to restart metoprolol. This dose was uptitrated to toprol xl 75 mg daily She continued with aspirin and was transitioned to coumadin with a heparin/lovenox bridge for CHADS2 score of 2. She will need to have her INR monitored in the outpatient setting with adjustment of coumadin as pt is taking cipro. #Elevated troponin (0.09 on admit, decreased to 0.03): This was thought to be related to demand from AF with RVR and sepsis. Cardiac enzymes trended down. Aspirin was continued, BB was uptitrated. Simvastatin continued. #Chest pain: Pt reported chest pressure at home with some DOE on occasion, relieved by rest. Patient had 1 episode this admission. EKG was unchanged. Cardiac enzymes x2 were flat; these troponins had trended down from admission troponins. CP occurred in the setting of HR ~150 afib. DDX includes angina from CAD vs. poor rate control. BB was uptitrated. Pt remained on asa. Lipid panel ordered showing LDL of 59, AIC of 6.4%. Informed pt's PCP of the above. Pt will be scheduled for an outpatient stress test for further evaluation. Pt did not have any additonal episodes as an inpatient. #chronic diastolic CHF: Patient had elevated BNP upon admission to the hospital. ECHO as above showing EF 50-55%. Pt's lasix dose was held while in the ICU and initially on the medical floor. However, given development of crackles on exam, this was resumed on [**11-26**] at a dose of 20mg daily, then titrated to 40 mg daily. (reported home dose 60mg daily). This can be uptitrated as needed and followed as an outpatient. #Chest xray showing mild interstitial prominence within the lungs: This was read as "could indicate chronic lung disease and clinical correlation is advised". Pt denies smoking. This may or may not be related to her underlying rheumatoid arthritis. Pt did not have any respiratory difficulty and had good room air sats. This can be further worked up as an outpatient if indicated. #Rheumatoid arthritis: Pt continued on plaquenil. She got home dose prednisone which was later switched to stress dose steroid given hypotension from septic shock while in the ICU. Her steroid dose was changed to PO on the floor and tapered down to prednsione 20mg upon discharge, which she was instructed to taper to her home dose of 5mg [**Hospital1 **] after 1 week. #Comm: [**Name (NI) **] [**Name (NI) 43429**], husband, [**Telephone/Fax (1) 43430**]. Medications on Admission: Medications at home (per Atrius records) Prednisone 5 mg [**Hospital1 **] Plaquenil 200 mg [**Hospital1 **] Simvastatin 20 mg daily Alendronate 70 mg weekly Furosemide 60 mg daily Metoprolol 25 mg QAM, 37.5 mg QPM Omeprazole 20 mg daily Caltrate+D 600 mg-400 IU 1 tab [**Hospital1 **] Discharge Medications: 1. hydroxychloroquine 200 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 2. simvastatin 20 mg Tablet Sig: One (1) Tablet PO once a day. 3. alendronate 70 mg Tablet Sig: One (1) Tablet PO once a week. 4. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 5. Caltrate-600 Plus Vitamin D3 600-400 mg-unit Tablet Sig: One (1) Tablet PO twice a day. 6. Toprol XL 50 mg Tablet Sustained Release 24 hr Sig: Three (3) Tablet Sustained Release 24 hr PO once a day. Disp:*90 Tablet Sustained Release 24 hr(s)* Refills:*0* 7. ciprofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours) for 8 days: last dose [**2146-12-5**]. 2 week course. Disp:*16 Tablet(s)* Refills:*0* 8. Outpatient [**Name (NI) **] Work PT/INR. Please have this checked in 2 days after discharge Name: [**Last Name (LF) **],[**First Name8 (NamePattern2) 26**] [**Last Name (NamePattern1) **] Location: [**Location (un) 2274**]-[**Location **] Address: 291 INDEPENDENCE DR, [**Location **],[**Numeric Identifier 1700**] Phone: [**Telephone/Fax (1) 43431**] Fax: [**Telephone/Fax (1) 6808**] 9. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). Disp:*30 Tablet, Chewable(s)* Refills:*2* 10. furosemide 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 11. warfarin 2 mg Tablet Sig: One (1) Tablet PO Once Daily at 4 PM. Disp:*30 Tablet(s)* Refills:*2* 12. prednisone 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily) for 6 days: Then change to 5 mg twice a day. Disp:*6 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: Americare VNA Discharge Diagnosis: Major: Sepsis due to urinary tract infection Atrial fibrillation with rapid ventricular rate Minor: relative adrenal insufficiency chronic diastolic heart failure rheumatoid arthritis Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: Dear Ms. [**Known lastname 43429**], It was pleasure taking care of you. You were initially admitted to the ICU with sepsis related to a urinary tract infection. You also were found to have atrial fibrillation with a rapid heart rate. For your infection you were given antibiotics with good effect. Your symptoms have improved. For your atrial fibrillation, you were given increased doses of metoprolol to better control your heart rate. You were started on blood thinning medication called coumadin to decrease your risk of stroke. You will need your INR closely followed as an outpatient. You also reported chest pressure when your heart rate was fast. You will need to undergo a stress test soon to evaluate for possible disease in your heart's blood vessels. Please discuss scheduling this test with your PCP [**Last Name (NamePattern4) **]. [**Last Name (STitle) 36055**]. You were also given increased steriods due to your current illness and this will need to be slowly decreased. Medication changes: 1.coumadin 2mg daily 2.Toprol XL 150mg daily 3.Aspirin 81mg daily 4.Prednisone 20 mg daily for 1 week, then 5 mg twice a day. 5.Ciprofloxacin 250 mg twice a day until [**12-5**]. Please take all of your medications as prescribed and follow up with the appointments below. Followup Instructions: Name: [**Last Name (LF) **],[**First Name8 (NamePattern2) 26**] [**Last Name (NamePattern1) **] Location: [**Location (un) 2274**]-[**Location **] Address: 291 INDEPENDENCE DR, [**Location **],[**Numeric Identifier 1700**] Phone: [**Telephone/Fax (1) 43431**] *Someone from Dr. [**Last Name (STitle) 43432**] office will contact you to book an appointment. You should follow up with the doctor within a week. If you dont hear from the office in 2 business days, please call the number above. Please also follow up with your cardiologist Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] at [**Hospital1 **] within 2 weeks. Her clinic number is [**Telephone/Fax (1) 38275**]. ICD9 Codes: 5990, 2762, 4280, 2859
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Medical Text: Admission Date: [**2147-7-25**] Discharge Date: [**2147-7-28**] Date of Birth: [**2102-4-23**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 25876**] Chief Complaint: increased SOB and abdominal girth over the past 3 days with subjective fevers Major Surgical or Invasive Procedure: none History of Present Illness: Patient presented to ED with increased SOB and abdominal girth over the past 3 days with subjective fevers. She reports increased nausea with poor po intake but no diarrhea, melena or hematochezia. She also reports cough productive of bloody sputum for the last two days. She dnies any dysuria, hematuria, frequency or urgency. In the ED she was febrile and hypotensive and was given 4L NS with improved hypotension but developed respiratory distress. CXR was c/w PNA with superimposed CHF so she was given 20mg IV lasix X 2 with good effect. She was transferred to the [**Hospital Unit Name 153**] for further management. Pt initially hypotensive in [**Hospital Unit Name 153**], receiving stress dose steroids until home doses were available. No documented fevers. Pt states her breathing is now improved. Past Medical History: Onc hx: Initially presented with mole at her left flank which grew and turned black. She underwent a resection of a 12.5-mm thick ulcerated melanoma from her left abdominal wall in [**Month (only) 958**] of [**2145**]. She underwent wide local excision and sentinel node biopsy, with melanoma present in one of four inguinal sentinel lymph nodes. On [**2146-5-11**], she underwent complete left inguinal node dissection, with no melanoma in three remaining lymph nodes. She was enrolled in intergroup protocol S0008 and was randomized to the biochemotherapy arm. She received three cycles of biochemotherapy initiated on [**2146-7-11**]. Following that therapy, she developed a psychotic depression, which fully resolved on antidepressant therapy. CT scans in [**Month (only) 116**] showed possible bilateral pulmonary nodules. PET scans in [**Month (only) **] confirmed metastatic disease in the lungs, liver, and bone and a head MRI showed multiple small CNS metastases. Upon documentation of this CNS metastases, she was referred to Neuro-Oncology for evaluation. She underwent an LP, which disclosed no evidence of leptomeningeal disease. Because of multiple CNS lesions and skull metastasis, she was started on whole brain radiation in early [**Month (only) 205**]. She completed her treatment last Wednesday. Social History: originally from [**Country 38213**], moved to US with family 2 1/2 years ago. Worked as cashier. 2 daughters in college and husband. [**Name (NI) **] [**Name2 (NI) **]/EtOH or drugs. Family History: no melanoma Physical Exam: T 97.8 HR 120 BP 120/80 RR 18 O2sat 94% on 2L NC HEENT: PERRL, EOMI O/P clear CVS: tachycardic, regular, S1, S2 lungs: crackles on L base, fair air entry Abd: tense, mild diffuse tenderness, no rebound or guarding, significant ascites present Extrem: 2+ radial and DP pulses Neuro: grossly intact Pertinent Results: [**2147-7-24**] 11:45PM URINE RBC-<1 WBC-<1 BACTERIA-OCC YEAST-NONE EPI-0-2 [**2147-7-24**] 11:45PM URINE BLOOD-LG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-1 PH-5.0 LEUK-NEG [**2147-7-24**] 11:45PM PLT SMR-VERY LOW PLT COUNT-57*# [**2147-7-24**] 11:45PM WBC-5.8 RBC-2.85*# HGB-8.6*# HCT-24.4*# MCV-86 MCH-30.4 MCHC-35.5* RDW-14.0 [**2147-7-24**] 11:45PM NEUTS-69 BANDS-4 LYMPHS-10* MONOS-10 EOS-1 BASOS-0 ATYPS-0 METAS-3* MYELOS-3* [**2147-7-24**] 11:45PM GLUCOSE-110* UREA N-21* CREAT-0.6 SODIUM-136 POTASSIUM-3.9 CHLORIDE-97 TOTAL CO2-28 ANION GAP-15 [**2147-7-24**] 11:45PM ALT(SGPT)-87* AST(SGOT)-54* ALK PHOS-198* AMYLASE-72 TOT BILI-0.4 [**2147-7-24**] 11:56PM LACTATE-3.2* [**2147-7-25**] 07:42PM WBC-6.4 RBC-3.20* HGB-9.3* HCT-27.0* MCV-85 MCH-29.1 MCHC-34.4 RDW-14.9 CT: Marked interval progression of metastatic disease - innumerable new liver mets with hepatomegaly, new adrenal mets, splenic mets, intraperitoneal seeding with ascites, breast nodules, lungs mets, diffuse alveloar opacities likely represents lymphatic spread of tumor with interstitial edema, no obstruction, focal consolidation in right lower lobe. Brief Hospital Course: Hypotension - resolved following initial hydration with 4L IVF in ED. No further episodes of hypotension. Pt initially on stress dose steroids, later switched to home dose of decadron 2mg [**Hospital1 **]. Respiratory distress - initial shortness of breath worsened after IVF but improved after some lasix. CXR consistent with pneumonia given hx of fevers and cough, but metastatic spread also possible. Pt remained afebrile in hospital. Started on levo/flagyl. Pt was chronically oxygen dependent, stable on 4L per nasal cannula Ascites - pt tolerating discomfort, does not want therapeutic tap at this time, likely would reccur quickly. Anemia: some vague hx of vaginal bleeding. No other known bleeding. Received 2 units pRBC during hospitalization. No bleeding noted in hospital. Depression: Continued on home Zoloft and Risperidone. Metastatic Melanoma - prognosis dire, after discussion between hematology/oncology and pt and her family, it was decided that pt would go home with hospice care. Contact: daughters [**Name (NI) **] [**Name (NI) **] [**Telephone/Fax (1) 56508**] [**Doctor First Name 56509**] [**Telephone/Fax (1) 56510**] Discharge Medications: 1. Risperidone 1 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* 2. Sertraline 50 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 3. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. Disp:*30 Tablet(s)* Refills:*0* 4. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours) for 11 days. Disp:*11 Tablet(s)* Refills:*0* 5. Metronidazole 500 mg Tablet Sig: One (1) Tablet PO TID (3 times a day) for 11 days. Disp:*33 Tablet(s)* Refills:*0* 6. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 7. Dexamethasone 2 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours). Disp:*60 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Location (un) **] Discharge Diagnosis: Metastatic Melanoma Pneumonia Discharge Condition: guarded Discharge Instructions: Please follow-up with your oncology physician as desired. Followup Instructions: Please call Dr. [**Last Name (STitle) 24699**] office as needed with questions. Completed by:[**2147-7-28**] ICD9 Codes: 486, 4280, 2851, 2875, 311
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Medical Text: Admission Date: [**2193-2-4**] Discharge Date: [**2193-2-19**] Service: HISTORY OF PRESENT ILLNESS: This is a 79-year-old female with a past medical history significant for increased cholesterol who presented to our hospital who presented for several days of malaise, nausea, vomiting, weakness, and dizziness. The patient was OB+. She had a Hartmann in her 40's and was found to be hypotensive. She denies any chest pain or shortness of breath. Electrocardiogram showed [**Street Address(2) 11741**] depression in V2 and V4 and ST elevations in 2, 3, and AvF as well as complete heart block. The patient was started on IV heparin and then became apneic and hypotensive in the emergency room. This required intubation and administration of dopamine. She was transferred to the [**Hospital1 18**] for cardiac catheterization, but has now become hypotensive on admission and still in complete heart block. She had a left heart catheterization which revealed 95% of left anterior descending stenosis and 100% occluded left circumflex which was stented. She was also found to have a small RC not supplying a large part of myocardium. After this cardiac catheterization, the patient has hypotension with an episode of supraventricular tachycardia. All of these stopped with the initiation of intra-aortic balloon pump. In addition on doing cardiac catheterization, the saturations in the left and right side of the heart suggested presence of atrioventricular septal defect. PAST MEDICAL HISTORY: Unremarkable. MEDICATIONS: None. ALLERGIES: None. SOCIAL HISTORY: She is widowed and lives alone. No smoking or alcohol. FAMILY HISTORY: Noncontributory. PHYSICAL EXAMINATION: Temperature is 98.7, heart rate of 105, blood pressure was 126/50. Respiratory rate is 20, oxygen saturation is 98. The patient is intubated and was generally nonreactive to stimuli. Head, ears, eyes, nose and throat: Pupils are small, but equal and reactive to light. Mucus membranes are dry. Neck: Difficult to appreciate jugular venous distention. No lymphadenopathy is palpable. Cardiovascular: Tachycardic, obscured heart sounds. Chest: Good breath sounds bilaterally. Abdomen: Soft and nontender and normal active bowel sounds. Extremities: No edema. Good bilateral pulses. LABORATORY DATA: Significant for CK of 159, MB of 15, index of 10 and troponin of 1.9. HOSPITAL COURSE: 1. Cardiovascular: The patient was admitted to the Coronary Care Unit for close observation monitoring. Immediately upon admission, she had a TU which revealed anteroseptal defect. The initial impression was to try to close this with a clam shell procedure which is going to offer her best chances of stabilizing a hemodynamics given that she became to be very hypotensive. However, discussion with the family, they decided that they did not want any procedures done. The patient's blood pressure remained extremely labile requiring a few pressors in the beginning with fair satisfactory result. Initial subsequent echocardiogram revealed that she had global left ventricular hypokinesis. She was started on aspirin, Plavix and maintained on IV heparin. She was also started on Lipitor. Initially, we could not start a beta-blocker given her complete heart block and hypotension. However, this subsequently improved. This was added to her regimen. To further improve her hemodynamics upon arrival to the CCU she received large amounts of fluid and became about 15 liters positive. However, this increased preload and had significant improvement in her hemodynamics and initially was tolerated. After while she became volume overloaded without evidence of compromising her oxygenation. This volume overload was gradually improved with gentle diuresis and sometimes with autodiuresis. Once the condition improved, she was started on Captopril which she tolerated a small dose. The balloon pump was stopped and had no significant effect on her hemodynamics. On hospital day #4 and #5, it became apparent that the patient was aseptic which is the cause of her continued hypotension. She required pressors for about 10 consecutive days, but eventually was able to be weaned off completely and maintained good blood pressure. In terms of rhythm, the patient remained most of the time in first degree AV block and notable in complete heart block with tachycardia in the unit. However, she did have one episode of atrial fibrillation in the context of ventilatory weaning. Because of this, she was started on amiodarone 400 mg p.o. q. day. She had no further episodes of atrial fibrillation. She is also being anticoagulated for atrial fibrillation and for low ejection fraction with akinetic ventricle. 2. Infectious disease: There were multiple consults involving infectious disease. The patient was probably aspirated during episodes of nausea and vomiting in the outside hospital and particularly given the findings on x-ray. Sputum showed multiple organisms including gram positive cocci and gram negative rods, but none of these were grown. She received a 14 day course of levofloxacin and Flagyl with marked improvement in her symptoms. Additionally, the patient had 2 out of 4 blood cultures positive for staph. Both local lines were stopped and she received a 14 day course of IV vancomycin. Upon discharge, all of her infectious disease issues has been resolved and she has no evidence of being infected at this point. 3. Renal: Upon admission, the patient may be in very mild acidosis which could have an myocardial infarction. This improved. She was being diuresed while in the hospital course. She had a mild increase of creatinine and this is probably normal and to be expected. 4. Endocrine: The patient initially had very labile blood sugars in the 300 to 500 range. She required initiation of IV insulin drip and this was continued for at least 4 days. This patient was getting better and was changed to a standing NPH insulin. It is quite likely that she has unrecognized underlying diabetes mellitus that has not been treated. She will probably require further follow up for this condition. 5. Pulmonary: The patient was initially intubated for protection. She had a very prolonged and complicated course including inability to wean over a week, pneumonia and fluid overload. On hospital day #10, the final attempts to extubate the patient was successful and she remained very stable from respiratory standpoint and positioned to room air shortly thereafter. She has no acquired pneumonia and was able to breathe comfortably on room air at this point. 6. Gastrointestinal: The patient had some episodes of bleeding from the oropharyngeal tract, but this is believed more to be due to injury from the TE and intubation rather than any gastrointestinal bleed. Consultation of ENT was obtained. There is no continued gastrointestinal bleeding from the gastrointestinal tract. DISCHARGE CONDITION: Stable. DISCHARGE STATUS: To rehabilitation. DISCHARGE MEDICATIONS: 1. Plavix 75 p.o. q. day indefinitely. 2. Aspirin 325 p.o. indefinitely. 3. Amiodarone 400 mg p.o. q. day to be switched to 200 mg p.o. q. day in about 3 to 4 weeks. 4. Lisinopril 5 mg p.o. q. day. 5. Lipitor 10 mg p.o. q. day, this may need to be readjusted for proper INR. 6. NPH 60 units in the morning, 10 units at night. 7. Lopressor 12.5 b.i.d. DISCHARGE DIAGNOSIS: 1. Acute myocardial infarction. 2. Status post catheterization. 3. Diabetes mellitus. 4. Atrial fibrillation. 5. Sepsis. 6. Aspiration pneumonia. DR.[**Last Name (STitle) **],[**First Name3 (LF) 251**] 12-191 Dictated By:[**Name8 (MD) 5094**] MEDQUIST36 D: [**2193-2-18**] 10:59 T: [**2193-2-19**] 05:54 JOB#: [**Job Number 45730**] ICD9 Codes: 5070, 4280
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Medical Text: Admission Date: [**2114-7-2**] Discharge Date: [**2114-7-5**] Date of Birth: [**2062-8-21**] Sex: M Service: NEUROLOGY Allergies: Morphine / Erythromycin Base / Valium / Robaxin / Penicillins / Felbatol / Phenobarbital / Thorazine / Sulfa (Sulfonamides) Attending:[**First Name3 (LF) 7575**] Chief Complaint: confusion, spell in ER Major Surgical or Invasive Procedure: Intubation [**7-2**] Extubated [**7-3**] History of Present Illness: 51 year old man with history of temporal lobe epilepsy as well as a history of nonepileptic spells that resemble seizures, as well as a psychotic disorder who presented on [**7-2**] for feelings of confusion while sitting at a cafe, which he described as "feeling seizurey," and a spell he had in the ER for which he was intubated. He is followed by Dr. [**Last Name (STitle) **], and had earlier in the day told Dr. [**Last Name (STitle) **] that he had been hearing voices. The patient also reports feelings of "uncontrollable crying in the absense of emotion," which he also refers to as "brain tears" while sitting in a cafe [**Location (un) 1131**] a book. This sensation lasted two hours, and then his right eye closed; he at that point felt "seizurey," and he called an ambulance because he felt as if he were about to have a seizure. He was brought to [**Hospital1 18**] where in the ER he had a witnessed spell which was observed by Dr. [**First Name (STitle) **] and Dr. [**First Name (STitle) **] of the neurology service. Dr.[**Name (NI) 104030**] description is as follows: "When I went to evaluate patient, I noted the his head was extended back, eyes fixed upwards, eye lids fluttering repetitively. The rate and frequency of the fluttering was not regular. It would cease if you held the patient's eye lids open. It would stop if you held up eyes to blink to threat or to test corneal reflex. At that same time, both of his arms were flexed in and rigid. Patient would actively resist movement of the arms. Legs were extended and rigid. When noxious stimuli was used, rate of patient's eye lid fluttering would change. There was a brief withdrawal of the bilateral lower extremities. ED completed Dilantin 1 gram. Patient then began to have convulsive activity. Head was extended and jerking. Arms were flexed in and stiff. Resisted opening. Legs were shaking symmetrically but shaking was dysrhytmic. If you held one of the legs, shaking could be stopped and would start up again at a faster frequency when you let leg go. Babinski testing made shaking stop. ED gave him another 2 mg of Ativan. Several minutes after that, shaking stopped. About one hour after patients arrival, called emergently to room as "actively seizing". Dr. [**First Name (STitle) **] (Chief Resident) and I went to evaluate patient. ED staff had given another 4 mg of Ativan. Arms again in and stiff, actively resisting opening. Legs shaking, both frequency and amplitude of movement varying. Would blink to threat and stop eye lid fluttering with confrontation. Patient moved to Red Zone for possible intubation. However, maintaining O2 sats in high 90s with nonrebreather. Dr. [**First Name (STitle) **] and I arranged for emergent EEG to assess if activity had electrographic correlate. While being manipulated by ED staff for IVs, patient would cry out, spit, puff cheeks. While tech putting on leads, patient had generalized shaking. No electrical correlate [**Doctor Last Name **] seen by myself nor by EEG Fellow. During remainder of EEG, patient was calm but not yet oriented or alert. Shortly before 8pm, ED docs called to patient's room again for recurrent convulsions. I was at bedside. Patient was tachycardic, but with respiratory rate in 20s, Oxygen saturation in high 90s on the non-rebreather. ED staff planning to intubate patient. I argued that seizures were not clinically consistent with epileptic seizures, that EEG did not show ongoing epileptiform activity, and that patient was protecting airway at that time." The ER attending Dr. [**Last Name (STitle) 6633**] was worried about the patient's risk of aspirating and despite neurology input that this was not in fact a seizure, the patient was intubated and transferred to the neuro ICU after receiving more ativan. The following day, he was extubated and transferred to the floor. Per Dr. [**First Name (STitle) **], the spell had lasted over twenty minutes. Interview at that time reveals recent psychosocial stressors including being evicted from his apartment. Past Medical History: -Pt has extensive psych history-please see d/c summary from [**10/2111**] for excellent summary, including complex social history. -Temporal lobe epilepsy from OMR diagnosed in [**2087**] by Dr. [**Last Name (STitle) 104031**]. See d/c summary from [**2101**]. -multiple admissions for seizures from [**2103**]-[**2107**] with no electrographic correlate. -syphilis in late [**2078**]'s Social History: Patient lives in [**Hospital1 8**], desribes himself as writer. He does not report any recent Etoh, tobacco, or drug use. Family History: No known history of seizures Physical Exam: ADMISSION PHYSICAL EXAM BY DR. [**First Name (STitle) **]: PHYSICAL EXAM: Most recent vitals post intubation: Tc: Still awaiting rectal temp by ED nurse BP: 81/30 after intubation meds and propofol HR: 89 RR: 14 O2Sat: 100% on vent Rest of exam is pre intubation: Gen: WD/WN,uncomfortable, diaphoretic. HEENT: NC/AT. Anicteric. MMM. Neck: Supple. No masses or LAD. No JVD. No thyromegaly. No carotid bruits. Lungs: CTA bilaterally. No R/R/W. Cardiac: RRR. S1/S2. No M/R/G. Abd: Soft, NT, ND, +NABS. No rebound or guarding. No HSM. Extrem: Warm and well-perfused. No C/C/E. Neuro: Mental status: Eyes open at times, but eyelids fluttering. Will not alert to examiner. Not following commands. No verbal output. Cranial Nerves: I: Not tested II: Pupils equally round and reactive to light, 4 to 3 mm bilaterally. Blinks to threat bilaterally. III, IV, VI: +Oculocephalic reflex bilaterally. V, VII: Facies symmetric. VIII: Unable to assess. IX, X: +Gag. [**Doctor First Name 81**]: Unable to assess. XII: Tongue midline without fasciculations. Motor: Normal bulk. Tone in arms and legs mostly rigid, with patient actively resisting limb movements. Grimaced and had increased respiratory rate in upper extremities after noxious stimuli. Withdrew to noxious in the lower extremities bilaterally. Sensation: Grimaced and had increased respiratory rate in upper extremities after noxious stimuli. Withdrew in lower extremities to noxious. Reflexes: Patient's arms and legs both rigid; unable to elicit reflexes. Toes downgoing bilaterally. Coordination: Unable to assess. Gait: Unable to assess. WHEN EVALUATED ON THE FLOOR: General: Awake, alert, and cooperative with exam in no acute distress. HEENT: Normocephalic, no scleral icterus noted, clear oropharynx with moist mucus membranes Neck: supple, with no JVD or carotid bruits appreciated Pulmonary: Lungs clear to auscultation bilaterally without wheezes, rhonchi or rales Cardiac: regular rate and rhythm, with no murmurs Abdomen: soft, nontender, with normoactive bowel sounds, no masses or organomegaly noted. Extremities: Warm with no edema and good pulses throughout Skin: no rashes or lesions noted. Neurologic: Mental status: The patient is awake, alert, and oriented x 3. Able to relate history without difficulty. Language is fluent with intact repetition and comprehension, and speech is normal rate, tone and volume. Patient was able to register 3 objects and recall [**2-15**] at 30 seconds and at 5 minutes. The patient had good knowledge of current events. There was no apraxia. Cranial Nerves: Olfaction not tested. Pupils equal, round and reactive to light bilaterally, and visual fields intact to confrontation bilaterally with no hemineglect. No ptosis is noted, and fundoscopic exam revealed sharp discs and venous pulsations. Extra-ocular muscles were intact without nystagmus. Sensation was intact to light touch over face. No facial asymmetry was noted, and hearing was intact to finger-rub bilaterally. Palate and uvula elevate at midline. There is [**4-19**] strength in trapezii and sternocleidomastoids bilaterally. Tongue protrudes in midline, with no fasciculations. Motor: normal bulk, tone throughout. No tremor, asterixis or drift. Delt Bic Tri WrF WrE FFl FE IO IP Ham TA [**First Name9 (NamePattern2) 2339**] [**Last Name (un) 938**] L 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 Sensory: No deficits to light touch, pinprick, vibratory sense, proprioception throughout. No extinction to DSS. Coordination: Normal finger to nose and heel to shin, with no dysmetria. No dysdiadochokinesia noted on rapid alternating hand movements or finger tapping. Reflexes: 2+ biceps, triceps, brachioradialis, patellar and 1+ ankle jerks bilaterally. The patient had downgoing toes on plantar response bilaterally. Gait: Normally based, with normal arm swing. Able to walk in tandem without difficulty. Romberg absent. Pertinent Results: [**2114-7-2**] 04:45PM URINE bnzodzpn-NEG barbitrt-NEG opiates-NEG cocaine-NEG amphetmn-NEG mthdone-NEG [**2114-7-2**] 04:45PM URINE BLOOD-NEG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-50 BILIRUBIN-NEG UROBILNGN-NEG PH-6.0 LEUK-NEG [**2114-7-2**] 03:58PM ALT(SGPT)-36 AST(SGOT)-25 LD(LDH)-164 ALK PHOS-84 TOT BILI-0.4 [**2114-7-2**] 03:58PM ASA-NEG ETHANOL-NEG ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**2114-7-2**] 03:58PM WBC-8.6 RBC-4.71 HGB-14.9 HCT-39.7* MCV-84 MCH-31.6 MCHC-37.5* RDW-13.1 [**2114-7-2**] 03:58PM PLT COUNT-206 EEG DURING SPELL: FINDINGS: NOTE: At the beginning of the record, the patient presented in the video for less than five seconds clonic flexion of both arms synchronously with fast breathing. During this episode there were no EEG correlations except movement artifact noted. BACKGROUND: Is a low voltage [**9-25**] Hz alpha frequency rhythm with normal anterior-posterior voltage gradient. There is a superimposed beta frequency activity seen throughout the record. HYPERVENTILATION: Could not be performed due to the patient's clinical condition. INTERMITTENT PHOTIC STIMULATION: Could not be performed because this was a portable study. SLEEP: Normal transitions of the sleep architecture were not seen. CARDIAC MONITOR: A sinus tachycardia with a rate between 100 and 120 were seen. IMPRESSION: This is a normal portable EEG. There were no clear epileptiform activities recorded, especially no epileptiform features during the clinical presentation of clonic flexion of both arms. Beta frequency activity was seen and this is likely a medication effect. A sinus tachycardia was noted. Brief Hospital Course: The patient was admitted initially to the ICU and soon afterwards extubated and transferred to the floor the following evening. His spell was proven by EEG to have been nonepileptic, and despite the fact that this patient has known epilepsy, his recent spell was considered to be psychiatric in nature, possibly in response to recent stressors in his life. Physical therapy was consulted to help him out of bed, as he reported feeling "unsteady" on his feet after his brief ICU stay. His medications were not adjusted, and he was monitored clinically for further spells. Physical therapy felt that his difficulty with walking was not physiologic, and the primary team felt that as his anxiety improves, his walking will likely improve. Of note, he takes a total of 8 mg ativan each day at home; Dr. [**Last Name (STitle) **] prescribes him for 6 mg per day (split dosing). He has follow up with Dr. [**Last Name (STitle) **] in the near future and should keep his appointment. He was seizure-free on the day of discharge and his physical exam was completely unchanged from the previous day. Medications on Admission: Medications prior to admission: 1. Trileptal [**Telephone/Fax (3) 104032**]. Ativan 2 mg po tid 3. Seroquel 100 mg po qid 4. Effexor XR 150 mg po bid 5. Zantac 300 mg po qHS Discharge Medications: 1. Oxcarbazepine 300 mg Tablet Sig: One (1) Tablet PO QAM (once a day (in the morning)). 2. Oxcarbazepine 300 mg Tablet Sig: One (1) Tablet PO QAFTERNOON (). 3. Oxcarbazepine 300 mg Tablet Sig: One (1) Tablet PO QPM (once a day (in the evening)). 4. Docusate Sodium 150 mg/15 mL Liquid Sig: One (1) PO BID (2 times a day) as needed. 5. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed. 6. Venlafaxine 75 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 7. Quetiapine Fumarate 300 mg Tablet Sig: One (1) Tablet PO QHS (once a day (at bedtime)). 8. Lorazepam 1 mg Tablet Sig: Two (2) Tablet PO TID (3 times a day): or as directed. Discharge Disposition: Home Discharge Diagnosis: Nonepileptic spell Temporal Lobe Epilepsy Nonepileptic Spell Complex Partial Seizure disorder Discharge Condition: no signs of seizure good Followup Instructions: F/u with PMD as previously scheduled; follow up with Dr. [**Last Name (STitle) **] in [**1-19**] weeks Provider: [**Name10 (NameIs) 251**] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 6929**], MD Where: KS [**Hospital Ward Name **] BUILDING ([**Hospital Ward Name **]/[**Hospital Ward Name **] COMPLEX) BEHAVIORAL NEUROLOGY UNIT Phone:[**Telephone/Fax (1) 1690**] Date/Time:[**2114-7-19**] 2:30 Provider: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], MD Where: BA [**Hospital Unit Name **] ([**Hospital Ward Name **] COMPLEX) NEUROLOGY/[**Hospital Ward Name **] 503 Phone:[**Telephone/Fax (1) 5285**] Date/Time:[**2114-7-27**] 3:00 Provider: [**First Name11 (Name Pattern1) 1216**] [**Last Name (NamePattern4) 1217**], MD Where: [**Hospital6 29**] NEUROLOGY Phone:[**Telephone/Fax (1) 32084**] Date/Time:[**2114-8-31**] 11:00 Completed by:[**2114-7-5**] ICD9 Codes: 2765
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6638 }
Medical Text: Admission Date: [**2117-9-29**] Discharge Date: [**2117-10-5**] Service: CARDIOTHORACIC Allergies: aspirin Attending:[**First Name3 (LF) 922**] Chief Complaint: Shortness of breath Major Surgical or Invasive Procedure: [**2117-9-29**] Aortic valve replacement with a 29-mm [**Company 1543**] Mosaic Ultra bioprosthesis. Replacement of ascending aorta with a 30-mm Dacron tube graft using deep hypothermic circulatory arrest which included hemi-arch replacement. History of Present Illness: [**Age over 90 **] year old male known to our service (see previous notes) who has a history of severe AS ([**Location (un) 109**] 0.8cm2), HTN, chronic GI bleeding ([**1-6**] AVMs, UC) requiring frequent transfusion, myelodysplastic syndrome s/p recent chemotherapy. He has been undergoing work-up for potential aortic valve replacement and asc. aorta repl. He first needed neuro clearance after new left foot drop. Neuro decided foot drop is related to peroneal nerve lesion. Given his complex GI history, he was also waiting GI clearance and to make sure that his colitis was in control and hopefully off steroids. Following cardiac surgery, it was recommended that he have a colectomy because of the ulcerative colitis and a large polyp that is almost to the anal verge. There are multiple other polyps that are also adenomas. He now presents again in clinic for further discussion of surgery. Past Medical History: - Severe aortic stenosis - Hypertension - Hyperlipidemia - Systolic congestive heart failure - Benign Prostatic Hypertrophy - Ulcerative colitis with recurrent GI bleeding on sulfasalazine - Gastric AVMs s/p GI bleed, admitted on [**2117-7-26**] to [**2117-7-28**] - Myelodysplastic syndrome, tx with Vidaza [**Date range (1) 32684**] - Prostate Cancer in [**2095**]'s - Left foot drop - common peroneal nerve lesion, likely at the fibular head. Wears foot orthosis and foot drop splint. - s/p b/l cataract extraction and lens implants Social History: Race: Caucasain Last Dental Exam: edentulous Lives with: Wife Occupation: Retired carpenter Cigarettes: Smoked no [] yes [X] Hx:quit smoking 50 years ago and smoked for 20 years Other Tobacco use: Denies ETOH: < 1 drink/week [X] [**1-11**] drinks/week [] >8 drinks/week [] Illicit drug use: Denies Family History: Daughter - breast ca Father - died at age 72 prostate Ca Physical Exam: Pulse: 85 Resp: 16 O2 sat: 99/RA B/P 99/56 Height: 5'5" Weight: 75 kgs General: Well-developed elderly male 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 [Xx] Irregular [] 3/6 systolic murmur Abdomen: Soft [X] non-distended [X] non-tender [X] bowel sounds + [X] Extremities: Warm [X], well-perfused [X] Edema Trace Varicosities: None [X] Neuro: Grossly intact [X] Pulses: Femoral Right: 1+ Left: 1+ DP Right: 1+ Left: 1+ PT [**Name (NI) 167**]: 1+ Left: 1+ Radial Right: 1+ Left: 1+ Carotid Bruit Right/Left: systolic murmur radiating Pertinent Results: Echo [**2117-9-29**]: PRE-BYPASS: No spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. No atrial septal defect or patent foramen ovale is seen by 2D, color Doppler or saline contrast with maneuvers. 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%). Doppler parameters are most consistent with Grade II (moderate) left ventricular diastolic dysfunction. Right ventricular chamber size and free wall motion are normal. The aortic root is mildly dilated at the sinus level. The ascending aorta is mildly dilated. There are simple atheroma in the aortic arch. The descending thoracic aorta is mildly dilated. There are complex (>4mm) atheroma in the descending thoracic aorta. The aortic valve leaflets are severely thickened/deformed. There is 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. There is a trivial/physiologic pericardial effusion. Dr. [**Last Name (STitle) 914**] was notified in person of the results at time of surgery. POST-BYPASS: The patient is AV paced. The patient is on no inotropes. Biventricular function is unchanged. There is a well-seated, well-functioning bioprosthetic valve in the aortic position. No aortic regurgitation is seen. No paravalvular leak is seen. There is a mean gradient of 7 mmHg across the aortic valve at a cardiac index of 2.1. Mitral regurgitation is trace. Tricuspid regurgitation is unchanged. The aorta is intact. [**2117-10-4**] 05:45AM BLOOD WBC-4.3 RBC-2.85* Hgb-8.6* Hct-27.9* MCV-98 MCH-30.2 MCHC-30.9* RDW-18.0* Plt Ct-219 [**2117-9-30**] 03:18AM BLOOD PT-14.4* PTT-33.3 INR(PT)-1.2* [**2117-10-4**] 05:45AM BLOOD Glucose-100 UreaN-34* Creat-1.4* Na-140 K-4.3 Cl-104 HCO3-30 AnGap-10 [**2117-10-4**] 05:45AM BLOOD Mg-2.1 [**2117-10-5**] 06:05AM BLOOD UreaN-37* Creat-1.3* Na-142 K-4.4 Cl-105 [**2117-10-5**] 06:05AM BLOOD Mg-2.0 Brief Hospital Course: Mr. [**Known lastname 14218**] was a same day admit after undergoing pre-operative work-up prior to admission. On [**2117-9-29**] he was brought to the operating room where he underwent an aortic valve replacement and ascending aorta replacement. Please see operative report for surgical details. Overall the patient tolerated the procedure well and post-operatively was transferred to the CVICU in stable condition for recovery and invasive monitoring. POD 2 the patient extubated, alert and oriented and breathing comfortably. The patient was neurologically intact and hemodynamically stable, weaned from inotropic and vasopressor support. He was seen by speech and swallow for a bedside evaluation and was cleared for a regular diet. His rhythym was initially asystole and then became nodal and eventually he was in a sinus rhythm in the 60's. EP service was consulted. Low dose beta blocker was initiated and titrated up and the patient tolerated this well. He was gently diuresed toward his preoperative weight. The patient was transferred to the telemetry floor for further recovery. Chest tubes and pacing wires were discontinued (patient was in sinus rhythm in the 80's) after third dose of beta blocker without complication. The patient was evaluated by the physical therapy service for assistance with strength and mobility. By the time of discharge on POD 6 the patient was ambulating with assistance, the wound was healing and pain was controlled with oral analgesics. The patient was discharged to [**Hospital 88006**] [**Hospital **] Rehab in [**Location (un) 38**] in good condition with appropriate follow up instructions. Medications on Admission: AZACITIDINE [VIDAZA] - (Prescribed by Other Provider) - Dosage uncertain EPOETIN ALFA [PROCRIT] - (Prescribed by Other Provider) - 20,000 unit/mL Solution - 60,000 units twice a week FOLIC ACID - 1 mg Tablet - 1 Tablet(s) by mouth DAILY (Daily) FUROSEMIDE [LASIX] - (Prescribed by Other Provider) - 40 mg Tablet - 0.5 (One half) Tablet(s) by mouth once a day MESALAMINE [CANASA] - 1,000 mg Suppository - 1 Suppository(s) rectally at bedtime PREDNISONE - 7.5 mg Tablet - 1 Tablet(s) by mouth once a day as directed SULFASALAZINE [SULFAZINE] - 500 mg Tablet - 2 Tablet(s) by mouth twice a day TERAZOSIN - (Prescribed by Other Provider) - 2 mg Capsule - 1 Capsule(s) by mouth once a day Medications - OTC CYANOCOBALAMIN (VITAMIN B-12) [VITAMIN B-12] - (Prescribed by Other Provider) - 1,000 mcg Tablet - 1 Tablet(s) by mouth once a day Discharge Medications: 1. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day) for 1 months. 2. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4 hours) as needed for pain or fever. 3. oxycodone-acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*30 Tablet(s)* Refills:*0* 4. magnesium hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO HS (at bedtime) as needed for constipation. 5. bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal DAILY (Daily) as needed for constipation. 6. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: Two (2) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 7. mesalamine 1,000 mg Suppository Sig: One (1) Suppository Rectal HS (at bedtime). 8. folic acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. prednisone 5 mg Tablet Sig: 1.5 Tablets PO DAILY (Daily). 10. metoprolol tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day): hold for SBP <100 or HR <60. 11. sulfasalazine 500 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 12. atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 13. furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day for 10 days. 14. potassium chloride 10 mEq Tablet Extended Release Sig: One (1) Tablet Extended Release PO once a day for 10 days. Discharge Disposition: Extended Care Facility: tbd Discharge Diagnosis: Severe aortic stenosis s/p Aortic valve replacement Dilated ascending aorta s/p Ascending aorta replacement Past medical history: - Hypertension - Hyperlipidemia - Systolic congestive heart failure - Benign Prostatic Hypertrophy - Ulcerative colitis with recurrent GI bleeding on sulfasalazine - Gastric AVMs s/p GI bleed, admitted on [**2117-7-26**] to [**2117-7-28**] - Myelodysplastic syndrome, tx with Vidaza [**Date range (1) 32684**] - Prostate Cancer in [**2095**]'s - Left foot drop - common peroneal nerve lesion, likely at the fibular head. Wears foot orthosis and foot drop splint. - s/p b/l cataract extraction and lens implants Discharge Condition: Alert and oriented x3 nonfocal Ambulating with steady gait Incisional pain managed with oral analgesics Incisions: Sternal - healing well, no erythema or drainage Edema - 2+ bilaterally Discharge Instructions: Please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. Look at your incisions daily for redness or drainage Please NO lotions, cream, powder, or ointments to incisions Each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart No driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive No lifting more than 10 pounds for 10 weeks Please call with any questions or concerns [**Telephone/Fax (1) 170**] Females: Please wear bra to reduce pulling on incision, avoid rubbing on lower edge **Please call cardiac surgery office with any questions or concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call person during off hours** Followup Instructions: You are scheduled for the following appointments Surgeon: Dr. [**Last Name (STitle) 914**] on on [**11-8**] at 1:00pm Cardiologist: Dr. [**Last Name (STitle) **] on [**10-15**] at 9:45a Please call to schedule appointments with your Primary Care Dr. [**First Name7 (NamePattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 25693**] in [**3-9**] weeks [**Telephone/Fax (1) 25694**] **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:[**2117-10-5**] ICD9 Codes: 4241, 4280, 2724, 4019
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Medical Text: Unit No: [**Numeric Identifier 73151**] Admission Date: [**2105-5-29**] Discharge Date: [**2105-6-2**] Date of Birth: [**2105-5-29**] Sex: M Service: NB HISTORY: Baby [**Name (NI) **] [**Known lastname 73152**] was the 3.1 kg product born to a 33-year-old, G2, P1 mother. Prenatal screens: A positive, antibody negative, hepatitis surface antigen negative, RPR nonreactive, rubella immune, GBS positive. EDC of [**2105-6-12**]. Benign prenatal course. Normal first trimester nuchal translucency. Maternal history noncontributory. Family history: A 2-1/2-year-old, well. Infant born by precipitous vaginal delivery with cord cut on perineum, brought to warmer and noted to have respiratory distress. Infant brought to the newborn intensive care unit with CPAP for further evaluation. Mother was GBS positive. Temp was 99.1. Rupture of membranes a half hour prior to delivery. Antepartum antibiotics a half hour prior to delivery. Due to infant's severe respiratory distress and need for 100% positive pressure ventilation, infant intubated. Transillumination and chest x-ray consistent with right pneumothorax. Additionally, infant with decreased perfusion and received 20 cc/kg of normal saline bolus. PHYSICAL EXAM ON DISCHARGE: Anterior fontanel open and flat. Palate intact. Breath sounds clear and equal bilaterally. Regular rate and rhythm. Normal S1, S2. No audible murmur. Pulses 2+ x4. Abdomen: Nontender, nondistended abdomen, active bowel sounds, no hepatosplenomegaly. Normal external male genitalia with testes descended bilaterally. Hips: Stable. Patent anus. Spine: Intact. Infant active and alert with exam. HISTORY OF HOSPITAL COURSE BY SYSTEMS: RESPIRATORY: [**Known lastname 916**] was admitted to the newborn intensive care unit and intubated, received 1 dose of surfactant and was weaned to nasal cannula O2. He also received a thoracentesis on the right side for a right pneumothoraces which resolved with needle aspiration. He is currently in room air without cardiorespiratory compromise. CARDIOVASCULAR: On admission received a total of 30 cc/kg of normal saline. He is currently cardiovascular stable with heart rates 90s-120s, blood pressure 77/47 with a mean of 57. FLUIDS, ELECTROLYTES AND NUTRITION: He was initially started on 60 cc/kg/D of D10W. Enteral feedings were initiated on day of life #1. Infant is currently ad lib feeding breast milk or Similac 20 calorie, taking in adequate amounts. His weight at the time of transfer was 3055 grams. GI: Peak bilirubin was on day of life #3 of 9.8/0.6. Most recent bilirubin is on [**2105-6-2**] of 8.8/0.7. Infant has not required intervention. INFECTIOUS DISEASE: CBC and blood culture obtained on admission. CBC on admission had an ANC of 198, white count was 2.2, platelets 253, 1 poly, 6 bands, 1 meta, 1 myelo. Follow-up CBC at 24 hours had an ANC of 8618. Because of his abnormal chest xray and shifted cbc, he was diagnosed with pneumonia. Infant is going to receive a total of 10 days of ampicillin and gentamicin. Gentamicin levels on day of life #2: Pre was 0.5, post was 8.3. Infant also had a lumbar puncture performed, and lumbar puncture was within normal limits. HEMATOLOGY: Hematocrit on admission was 42.3 He has not required any blood transfusions. His most recent cbc was wbc 13.9 hct 42.7 and plt 283 on [**2105-5-30**]. NEURO: Infant has been appropriate for gestational age. SENSORY: Hearing screen has not been performed but should be done prior to discharge. DISCHARGE DISPOSITION: To newborn nursery. NAME OF PRIMARY PEDIATRICIAN: Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 66546**], telephone number [**Telephone/Fax (1) 43701**]. CARE RECOMMENDATIONS: 1. Continue ad lib feedings, Similac or breast milk 20 calorie. 2. Medications: Continue ampicillin and gentamicin for a total of 10 days, [**6-2**] being day 5 of 10. 3. State newborn screen was sent on day of life #3 and is pending. 4. Infant has not received any immunizations to date. DISCHARGE DIAGNOSES: Term infant, pneumonia treated with antibiotics for a total of 10 days, right pneumothoraces, respiratory distress syndrome, hypovolemia, presumed sepsis. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 48738**], MD [**MD Number(2) 55708**] Dictated By:[**Last Name (NamePattern1) **] MEDQUIST36 D: [**2105-6-2**] 07:06:21 T: [**2105-6-2**] 07:28:19 Job#: [**Job Number 73153**] ICD9 Codes: 486, 769
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Medical Text: Admission Date: [**2119-4-18**] Discharge Date: [**2119-4-24**] Date of Birth: [**2056-4-16**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1674**] Chief Complaint: "My VNA found me at 65%" Major Surgical or Invasive Procedure: none History of Present Illness: Mr. [**Known lastname **] is a 63 yo male with severe COPD on home oxygen, s/p recent PEA arrest, referred to the ED by his VNA. Per his report, his visiting nurse found him satting 65% on his supplemental O2. He states that his sat rose to 81% with "some exercises." He states that he felt extremely short of breath at the time but is unable to identify any precipitating event. He states that he felt sluggish that morning and had returned to bed, but was up out of bed by the time his VNA arrived. He denies any fever or chills or rigors. He has had a productive cough for several months, which he distinguishes from his baseline "smokers cough." He reports that it is occasionally productive of deep green sputum. He states that his coughing has been limited by chest wall pain since he underwent CPR 2 weeks ago. He was recently seen by the NP[**Company 2316**] on [**4-13**] and was prescribed a steroid taper for a COPD flare at that visit; he states that he did not take this taper as prescribed. He continues to smoke [**4-18**] cigarettes per day. In the ED, he received combivent nebs x3, azithromycin 500 mg PO, ceftriaxone 1 g IV, ASA 325 mg, and prednisone 60 mg PO. Past Medical History: 1. COPD- on home O2 (3L), FEV1 22% predicted, FEV1/FVC ratio 43% predicted, last intubated 3 years ago. followed by Pulm 2. Tobacco Abuse 3. DM II 4. Diverticulosis 5. h/o SBO 6. C6-C7 HERNITATION 7. B12 Deficiency- on monthly injections 8. Obesity Social History: Pt is married and lives with wife and 2 of his children. He is currently umemployed- former restaurant manager Tob: smokes [**6-20**] cigs/day, used to smoke 5PPD for 50 years, cut down 3 years ago EtOH: last drink over [**Holiday 944**], used to drink heavily Drugs: no IV drug use, no other illicits Family History: Mother and Father died of lung cancer in their 60s, sister just recently died at age 50s from lung CA, daughter with cystic fibrosis Pertinent Results: [**2119-4-18**] 11:00AM WBC-9.3 RBC-4.59* HGB-13.4* HCT-42.3 MCV-92 MCH-29.2 MCHC-31.7 RDW-14.1 [**2119-4-18**] 11:00AM NEUTS-75.4* LYMPHS-15.1* MONOS-6.7 EOS-2.5 BASOS-0.3 [**2119-4-18**] 11:00AM CK-MB-NotDone [**2119-4-18**] 11:00AM cTropnT-0.02* [**2119-4-18**] 11:00AM CK(CPK)-53 [**2119-4-18**] 11:00AM GLUCOSE-128* UREA N-22* CREAT-0.8 SODIUM-148* POTASSIUM-3.9 CHLORIDE-105 TOTAL CO2-37* ANION GAP-10 [**2119-4-18**] 11:00AM PLT COUNT-199 [**2119-4-18**] 11:00AM PT-11.9 PTT-22.1 INR(PT)-1.0 Brief Hospital Course: A/P: Mr. [**Known lastname **] is a 63 yo male with severe COPD who presents with hypoxia . 1) COPD flare: No clear infectious trigger identified with a clear CXR, normal WBC, negative ROS. Treated with steroids, IV then to prednisone with slow taper. Plan to see NP[**Company 2316**] in week and determine whether can taper to off. 2) Diastolic heart failure: Continue lasix 40 mg daily 3) Hypertension: Continue Norvasc, Lisinopril 4) Chest wall pain, s/p chest compressions: Ibuprofen PRN 5) DM2: Glyburide, Glucophage at home. Required insulin while on higher doses of steroids, but fsbg better controlled as glucophsge restarted and prednisone tapered down. Pt told to check fsbg at home and report to his primary nurse practitioner. 6)Pneumonia: CXR c/w pneumonia, sputum with MRSA. Double coverage with Bactrim and Levofloxacin. Medications on Admission: Prednisone 10 mg QOD Albuterol MDI 2 puffs 4x/day Aledronate 70 mg PO qMonday Norvasc 5 mg daily ASA 325 mg daily Calcium + Vit D [**Hospital1 **] Colace 100 mg [**Hospital1 **] Senna 2 tabs qHS Combivent QID Flonase 50 mcg 2 sprays daily Metformin 100 mg [**Hospital1 **] Glyburide 2.5 mg QOD Lasix 40 mg daily Prilosec 20 mg [**Hospital1 **] Ranitidine 300 mg qHS Ferrous sulfate 325 mg daily Advair 250/50 [**Hospital1 **] Ibuprofen 600 mg TID:PRN Lisinopril 20 mg daily Lumigan OU daily Vitamin B12 1000 mcg qmonth Discharge Medications: 1. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 2. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Simvastatin 10 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 4. Lisinopril 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Ferrous Sulfate 325 mg (65 mg Iron) Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Fluticasone-Salmeterol 250-50 mcg/Dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). 7. Alendronate 70 mg Tablet Sig: One (1) Tablet PO QMON (every Monday). 8. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO BID W/ MEALS (). 9. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: One (1) Tablet PO DAILY (Daily). 10. Hexavitamin Tablet Sig: One (1) Cap PO DAILY (Daily). 11. Furosemide 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 12. Amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 13. Ibuprofen 600 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours) as needed for pain. 14. Latanoprost 0.005 % Drops Sig: One (1) Drop Ophthalmic HS (at bedtime). 15. Trimethoprim-Sulfamethoxazole 160-800 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) for 3 days. Disp:*6 Tablet(s)* Refills:*0* 16. Magnesium Oxide 400 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 17. Metformin 500 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 18. Glyburide 2.5 mg Tablet Sig: One (1) Tablet PO twice a day. 19. Prednisone 10 mg Tablet Sig: 1-3 Tablets PO once a day: Take 30 mg [**4-25**], then Prednisone 20 mg per day until you see your nurse [**5-2**]. Disp:*30 Tablet(s)* Refills:*0* 20. Levofloxacin 750 mg Tablet Sig: One (1) Tablet PO once a day for 3 days. Disp:*3 Tablet(s)* Refills:*0* 21. Albuterol 90 mcg/Actuation Aerosol Sig: One (1) inhalation Inhalation every 4-6 hours as needed for shortness of breath or wheezing. Disp:*1 inhaler* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: COPD flare pneumonia Discharge Condition: stable Discharge Instructions: Please continue your steroids (prednisone) until you see your nurse at [**Hospital6 733**]. She will let you know how much longer you need to take the prednisone. Please continue the antibiotics until completed. Call your PCP with increased shortness of breath. Followup Instructions: Provider: [**First Name8 (NamePattern2) 1238**] [**Last Name (NamePattern1) 1239**] [**Name8 (MD) **], [**MD Number(3) 1240**]:[**Telephone/Fax (1) 250**] Date/Time:[**2119-5-2**] 10:00 Provider: [**First Name8 (NamePattern2) 11136**] [**Last Name (NamePattern1) **], [**Name Initial (NameIs) **].D. Date/Time:[**2119-5-29**] 2:00 [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] MD [**MD Number(2) 1677**] Completed by:[**2119-4-28**] ICD9 Codes: 4280, 3051
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Medical Text: Admission Date: [**2110-7-9**] Discharge Date: [**2110-7-14**] Date of Birth: [**2057-7-18**] Sex: M Service: CARDIOTHOR REASON FOR ADMISSION: Mitral valve repair. HISTORY OF PRESENT ILLNESS: The patient is a 52 year old Mandarin speaking gentleman with a history of severe mitral regurgitation. For the past several years, the patient has continued to have significant exercise intolerance which has limited his ability to work. He reports severe dyspnea on exertion. The patient had a recent admission earlier in the month and he was discharged on [**2110-7-3**], after undergoing cardiac catheterization. This was significant for demonstrating no flow-limited disease in the coronaries but several fistulae from the left anterior descending to the PA. Several of these were coil embolized during this admission. He tolerated this well, was sent home, and now returns for his mitral valve repair. PAST MEDICAL HISTORY: 1. Mitral valve regurgitation. PAST SURGICAL HISTORY: None. MEDICATIONS ON ADMISSION: 1. Atenolol 25 mg p.o. q. day. 2. Enteric-coated aspirin 325 mg p.o. q. day. 3. Nitroglycerin sublingual p.r.n. ALLERGIES: No known drug allergies. SOCIAL HISTORY: The patient is currently on Disability and lives at home with his wife. [**Name (NI) **] was born in [**Country 651**]. He denies any ETOH or tobacco use. FAMILY HISTORY: Negative. PHYSICAL EXAMINATION: The patient is in no acute distress. Temperature is 98.3 F.; pulse is 76; blood pressure 113/52; breathing 18; 98% on room air. HEENT: The patient is missing many teeth. Oropharynx is clear. There is no cervical lymphadenopathy. Supple neck. Heart is regular rate and rhythm with a III/VI systolic ejection murmur. His lungs are clear to auscultation bilaterally. Abdomen is soft and nontender. The patient has no cyanosis, clubbing or edema in extremities. LABORATORY: On admission include a white blood cell count of 5.6, hematocrit of 32.5, platelets of 202. Sodium of 140, potassium of 3.5, BUN of 4, creatinine of 0.6, glucose of 137. Chest x-ray shows no infiltrate or pneumothorax. Cardiac catheterization demonstrates no significant disease in the coronary arteries. Two branches of an left anterior descending to PA fistula which was successfully coiled. There is a persistent flow through an inferior branch of the left anterior descending to PA fistula and a persistent branch of the circumflex to PA branch fistula which anatomically were not suitable for coil embolization. Ejection fraction was 60%. HOSPITAL COURSE: On the day of admission, the patient went to the Operating Room and underwent a minimally invasive mitral valve repair. He tolerated this procedure well. The patient was brought to the cardiothoracic Intensive Care Unit in stable condition on minimal pressor support. He was successfully weaned off this support. The patient was fully weaned from ventilatory support secondary to a persistent acidemia. This was treated with sodium bicarbonate and a Swan-Ganz was placed to provide close hemodynamic monitoring. The patient was found to have stable hemodynamics with appropriate mixed venous saturations in the 70% range. The patient was corrected to a normal pH of 7.41 by the first postoperative night and remained stable. He was then weaned off of ventilatory support and was successfully extubated. The patient did have a slight bit of confusion early in post-extubation course which cleared. This was also compounded by a language barrier since the patient cannot speak English. In addition, the patient's early postoperative course had a tremendous urine output. It was equally up to 700 cc. an hour and a renal consultation was obtained. He underwent a head CT scan to rule out intracranial pathology leading to diabetes insipidus. This was negative. The patient's serum and urine electrolytes indicated that this diuresis was appropriate. The patient's urine output has decreased and his BUN and creatinine remained normal. The patient's Foley was discontinued. He had developed some hematuria which has resolved. The patient has remained stable and is now ready for discharge to home with follow-up in approximately four weeks. DISCHARGE DIAGNOSES: 1. Mitral regurgitation status post minimally invasive mitral valve repair. DISCHARGE MEDICATIONS: 1. Lopressor 75 mg p.o. twice a day. 2. Colace 100 mg p.o. twice a day. 3. Percocet one to two p.o. q. four hours p.r.n. 4. Aspirin 325 mg p.o. q. day. CONDITION ON DISCHARGE: Stable. DI[**Last Name (STitle) 408**]E INSTRUCTIONS: 1. The patient will follow-up with Dr. [**Last Name (Prefixes) **] in four weeks. 2. He will follow-up with his primary care physician, [**Last Name (NamePattern4) **]. [**Last Name (STitle) 25213**], in two weeks. 3. The patient will call for any fevers or difficulties with the wound care, and will be instructed with an interpreter present. [**Doctor Last Name 412**] [**Last Name (Prefixes) 413**], M.D. [**MD Number(1) 414**] Dictated By:[**Last Name (NamePattern1) 3835**] MEDQUIST36 D: [**2110-7-14**] 08:34 T: [**2110-7-19**] 15:44 JOB#: [**Job Number 25214**] ICD9 Codes: 4240, 4280, 2762
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Medical Text: Admission Date: [**2107-1-28**] Discharge Date: [**2107-2-14**] Date of Birth: [**2032-5-22**] Sex: M Service: CARDIOTHORACIC Allergies: Penicillins / Azithromycin Attending:[**First Name3 (LF) 1406**] Chief Complaint: Shortness of breath Major Surgical or Invasive Procedure: [**2107-2-4**] Off-pump coronary bypass grafting x1 with the left internal mammary artery to left anterior descending artery History of Present Illness: 74M p/t OSH w chest pain, exertional dyspnea. Ruled in for NSTEMI. Echo revealed decline in EF to 10% (from 30% in [**2099**]) and AS with [**Location (un) 109**] 0.8cm2. He has a h/o 2vessel CAD on cath in [**2099**]. Cardiac cath will be performed on Monday, [**2107-1-31**]. Cardiac surgery is asked to evaluate for AVR, CABG. Past Medical History: Past Medical History: CAD chronic systolic heart failure DM CRI (baseline Cr 1.9) ^lipids htn right foot w diabetic ulcer PVD Depression Past Surgical History Left CEA Right fem-[**Doctor Last Name **] bypass [**2-/2106**] Prostatectomy Partial colectomy for adenoma [**2104**] Social History: Race: Caucasian Last Dental Exam: 50 yrs. ago Lives with: wife Occupation: retired, sales Tobacco: 60 pack yrs, quit 2 weeks ago ETOH: denies Family History: Family History: Father, CHF, d. age 54 pneumonia Mother DM, d. age [**Age over 90 **] myocardial infarction Brother CA unknown Brother Bladder ca No family history of early MI, arrhythmia, cardiomyopathies, or sudden cardiac death Physical Exam: Pulse: 63 Resp: 18 O2 sat: 98%RA B/P Right: Left: 90/50 Height: Weight: 79kg General: NAD, appears stated age 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: 1+pedal edema bilaterally Varicosities: None [x] well healed incision of RLE fem-[**Doctor Last Name **] bypass right lateral foot w 3mm round ulcer- no erythema, minimal drainage on dressing, does not appear infected Neuro: Grossly intact x Pulses: Femoral Right: Left: DP Right: NP Left: NP PT [**Name (NI) 167**]: NP Left: NP Radial Right: 1+ Left: 1+ Carotid Bruit Right: Left: no bruits Pertinent Results: [**2107-2-4**] Introp TEE Pre-Procedure: No spontaneous echo contrast is seen in the left atrial appendage. Overall left ventricular systolic function is severely depressed (LVEF= 10 - 15 %). with moderate global free wall hypokinesis. There is significant calcification of the ascending aorta. There are complex (>4mm) atheroma in the descending thoracic aorta. The aortic valve leaflets are severely thickened/deformed. There is critical aortic valve stenosis (valve area <0.8cm2). Trace aortic regurgitation is seen. The mitral valve leaflets are moderately thickened. Moderate (2+) mitral regurgitation is seen. There is no pericardial effusion. The patient was started on NTG and his PA pressures came down from 70/35 to 55/30 with modest improvement of RV fxn. LV remained severely depressed. Based on the epi-aortic scan and the surgeon's assessment of the ascending aorta, the procedure was changed to an off-pump LIMA - LAD CABG only. The plan was to refer the patient for a trans-vascular aortic valve replacement. Post-procedure:: The patient is on low-dose phenylephrine. RV systolic fxn remains mildly depressed. LV systolic fxn is severly depressed. AI remains trace. MR is trace. [**2107-2-10**] 04:27AM BLOOD WBC-13.6* RBC-3.18* Hgb-10.0* Hct-29.3* MCV-92 MCH-31.5 MCHC-34.2 RDW-14.1 Plt Ct-496* [**2107-2-10**] 08:15AM BLOOD PT-45.0* PTT-37.4* INR(PT)-4.8* [**2107-2-10**] 04:27AM BLOOD Glucose-82 UreaN-25* Creat-1.5* Na-135 K-4.5 Cl-100 HCO3-27 AnGap-13 [**2107-2-13**] 05:08AM BLOOD WBC-11.5* RBC-3.05* Hgb-9.5* Hct-28.3* MCV-93 MCH-31.3 MCHC-33.7 RDW-13.9 Plt Ct-615* [**2107-2-14**] 05:24AM BLOOD PT-22.2* INR(PT)-2.1* [**2107-2-14**] 05:24AM BLOOD UreaN-24* Creat-1.3* Na-134 K-4.8 Cl-99 Brief Hospital Course: This is a 74-year-old male who presented to an outside hospital with chest pain, exertional dyspnea, and ruled in for non-ST-elevated myocardial infarction. He had an echocardiogram that revealed a decline in his ejection fraction to 10% from 30% in [**2099**]. He also had aortic stenosis with an aortic valve area of 0.8 cm2. Cardiac catheterization demonstrated 3-vessel coronary artery disease with 60% left anterior descending artery stenosis, 70-95% left circumflex artery stenosis, an occluded right coronary artery with poor left-to-right collaterals. He was taken to the operating room on [**2107-2-4**] and underwent an off-pump coronary bypass grafting x1 with the left internal mammary artery to left anterior descending artery. The aorta was palpated and found to be heavily calcified throughout the entire ascending aorta all the way down to the annulus. Intraoperatively Dr. [**Last Name (STitle) **] was asked to evaluate the level of calcific anatomy, and confirmed Dr[**Doctor Last Name **] findings. A discussion was carried out as to what options the patient had. It was felt that it would be a prohibitively high risk to replace the aortic valve, since there was no safe place to clamp on the aorta. At this point, it was elected to do the left internal mammary artery to left anterior superior descending artery bypass off pump. See operative note for full details. Post operatively he was extubated and epinephrine was slowly weaned. He went into rapid atrial fibrillation on POD#1 and dropped his systolic blood pressure into the 70's. He was cardioverted x 3 with 200/360/360 Joules and converted to sinus rhythm. He was weaned from all vasoactive medications over the next 3 days and was hemodynamically stable in sinus rhythm. He did have post operative acute renal failure with a peak creatinine of 2.0 and this was decreasing at the time of discharge. He was started on Coumadin for paroxysmal atrial fibrillation and received 2 doses of 5 mg and INR went to 4.8. He was resumed with Coumadin at a lower dose and INR was therapurtic at the time of discharge. He was evaluated by physical therapy for strength and mobility and cleared for home. He was transferred to the step down floor on post operative day 5. Chest tubes and pacing wires were removed per cardiac surgery protocol. He was tolerating a full oral diet, ambulating with assistance and his wounds were healing well. It was felt that he was safe for discharge home with services on POD # 8. The patient will be advised to follow up with Dr [**Last Name (STitle) **] in 3 weeks and at that time discuss Corevalve options for aortic stenosis. All follow up appointments were advised. Medications on Admission: Aspirin 325mg daily Atenolol 50mg Daily Glyburide 5mg daily Lovastatin 40mg daily Metformin Lisinopril Discharge Medications: 1. amiodarone 200 mg [**Last Name (STitle) 8426**] Sig: Two (2) [**Last Name (STitle) 8426**] PO BID (2 times a day): x 3 days, then decrease to 1 tab twice daily x 7 days, then dcrease to 1 tab daily . Disp:*120 [**Last Name (STitle) 8426**](s)* Refills:*2* 2. atorvastatin 80 mg [**Last Name (STitle) 8426**] Sig: One (1) [**Last Name (STitle) 8426**] PO DAILY (Daily). Disp:*60 [**Last Name (STitle) 8426**](s)* Refills:*2* 3. glyburide 2.5 mg [**Last Name (STitle) 8426**] Sig: One (1) [**Last Name (STitle) 8426**] PO BID (2 times a day). Disp:*60 [**Last Name (STitle) 8426**](s)* Refills:*2* 4. aspirin 81 mg [**Last Name (STitle) 8426**], Delayed Release (E.C.) Sig: One (1) [**Last Name (STitle) 8426**], Delayed Release (E.C.) PO DAILY (Daily). Disp:*60 [**Last Name (STitle) 8426**], Delayed Release (E.C.)(s)* Refills:*2* 5. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 6. furosemide 20 mg [**Last Name (STitle) 8426**] Sig: One (1) [**Last Name (STitle) 8426**] PO BID (2 times a day) for 14 days. Disp:*28 [**Last Name (STitle) 8426**](s)* Refills:*0* 7. potassium chloride 10 mEq [**Last Name (STitle) 8426**] Extended Release Sig: Two (2) [**Last Name (STitle) 8426**] Extended Release PO Q12H (every 12 hours) for 14 days. Disp:*56 [**Last Name (STitle) 8426**] Extended Release(s)* Refills:*0* 8. warfarin 1 mg [**Last Name (STitle) 8426**] Sig: [**Name8 (MD) **] MD [**First Name (Titles) 8426**] [**Last Name (Titles) **] Once Daily at 4 PM: INR goal=[**12-30**] for Atrial Fibrillation. Disp:*150 [**Month/Day (3) 8426**](s)* Refills:*2* 9. carvedilol 3.125 mg [**Month/Day (3) 8426**] Sig: One (1) [**Month/Day (3) 8426**] PO BID (2 times a day). Disp:*60 [**Month/Day (3) 8426**](s)* Refills:*2* Discharge Disposition: Home With Service Facility: [**Hospital **] Home Health Care Discharge Diagnosis: 1. Coronary artery disease. 2. Aortic valve stenosis. 3. Calcified ascending aorta. 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 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:[**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 8583**], MD Phone:[**Telephone/Fax (1) 170**] Date/Time:[**2107-3-9**] 1:30 Cardiologist: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2385**], MD Phone:[**Telephone/Fax (1) 62**] Date/Time:[**2107-3-21**] 8:00 Please Draw INR for Coumadin dosing to be called into Dr. [**Last Name (STitle) **] #[**Telephone/Fax (1) 55136**], Fax # [**Telephone/Fax (1) 55139**] Coumadin indication:postoperative Atrial Fibrillation INR goal=[**12-30**] 1st INR draw on [**2107-2-15**] Please call to schedule appointments with your Primary Care Dr. [**Last Name (STitle) **] in [**3-1**] weeks [**Telephone/Fax (1) 55136**] **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:[**2107-2-14**] ICD9 Codes: 5849, 5990, 2761, 4280, 4241, 5859, 4439
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Medical Text: Admission Date: [**2152-12-5**] Discharge Date: [**2152-12-11**] Date of Birth: [**2152-12-5**] Sex: M Service: NB HISTORY OF PRESENT ILLNESS: Baby [**Name (NI) **] [**Known lastname **] was the 1895 gram product of a 37 and [**11-26**] week gestation, born to a 29 year-old, Gravida 2, Para 1 now 2 mother. Prenatal screen: A positive, antibody negative, hepatitis surface antigen negative, RPR nonreactive, GBS positive. This pregnancy was notable for intrauterine growth restriction. Mother received several doses of intrapartum antibiotics. Infant was delivered by Cesarean section due to non reassuring fetal tracing. Apgars were 8 and 9. Infant was admitted to the newborn intensive care unit for hypoglycemia and hypothermia and was then readmitted 24 hours later for hypothermia. PHYSICAL EXAMINATION: On admission, weight was 1885 grams. Length 17.5 cm. Head circumference 31.5 cm. Anterior fontanel open and flat. Regular rate and rhythm. Clear breath sounds with good aeration. No retractions. No murmur. Good femoral pulses. Abdomen soft, nondistended. Positive bowel sounds. No hepatosplenomegaly. Pink and well perfused. Moves all extremities with good tone. Normal male. Active and alert. HOSPITAL COURSE BY SYSTEMS: Respiratory: [**Known lastname **] has been stable in room air since admission to the Neonatal Intensive Care Unit. Cardiovascular: No issues. Fluids, electrolytes and nutrition: Birth weight was 1895 grams. Infant has been ad lib breast feeding with supplementation of NeoSure 22 calories, taking in good amounts. Discharge weight is [**2080**] grams . Gastrointestinal: Bilirubin on [**12-8**] was 7.4 over 0.3. Hematology: Hematocrit on admission was 40.7. Infant has not required any blood transfusions. Infectious disease: CBC and blood culture on admission were within normal limits with a white count of 19.2. Platelet count of 415. 62 polys, 0 bands. Blood cultures remained negative at 48 hours. Infant did not require antibiotics. A urine CMV culture was sent to evaluate the patient's growth retsriction. It is no growth to date. Neurologic: The infant has had some temperature instability which has resolved over time. He has been stable in an open crib, swaddled for the past 48 hours. Audiology: Hearing screen was performed with automated auditory brain stem responses and the infant passed both ears. A care est test was passed. CONDITION ON DISCHARGE: Stable. DISCHARGE DISPOSITION: To home. NAME OF PRIMARY PEDIATRICIAN: Dr. [**First Name8 (NamePattern2) 17563**] [**Last Name (NamePattern1) **], telephone number [**Telephone/Fax (1) 71413**]. CARE RECOMMENDATIONS: Feeds at discharge: Continue ad lib breast feeding or supplementing with NeoSure 22 calories. MEDICATIONS: Not applicable. Car seat position screening was performed and the infant . Infant received hepatitis B vaccine on [**2152-12-10**]. IMMUNIZATIONS RECOMMENDED: Synagis RSV prophylaxis should be considered from [**Month (only) **] through [**Month (only) 958**] for infants who meet any of the following three criteria: (1) Born at less than 32 weeks; (2) Born between 32 weeks and 35 weeks with two of the following: Day care during RSV season, a smoker in the household, neuromuscular disease, airway abnormalities or school age siblings; (3) chronic lung disease. Influenza immunization is recommended annually in the Fall for all infants once they reach 6 months of age. Before this age, and for the first 24 months of the child's life, immunization against influenza is recommended for household contacts and out-of-home caregivers. DISCHARGE DIAGNOSES: 1. Term infant, small for gestational age. 2. Rule out sepsis. 3. Hypothermia. [**First Name11 (Name Pattern1) 449**] [**Last Name (NamePattern1) **], [**MD Number(1) 54604**] Dictated By:[**Last Name (NamePattern1) 56160**] MEDQUIST36 D: [**2152-12-10**] 23:34:19 T: [**2152-12-11**] 04:55:46 Job#: [**Job Number 71414**] ICD9 Codes: V290
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Medical Text: Admission Date: [**2113-5-19**] Discharge Date: [**2113-5-31**] Date of Birth: [**2036-2-4**] Sex: M Service: MEDICINE Allergies: olanzapine Attending:[**First Name3 (LF) 4891**] Chief Complaint: Chest pain --> bradycardia Major Surgical or Invasive Procedure: Intubation and extubation Central line placement and removal History of Present Illness: 76 yo man with DM, HTN, HL, (possibly CHF, CAD) who presented to OSH today after several days of worsening CP and apparently self titrating up of his home medical regimen (see below: digoxin, BB, amlodipine) who was found to be bradycardic to 20s (? BP) and was electively intubated (difficult intubation) and was externally paced. While at OSH, he received 1mg of atropine, digibind (1 vial), calcium gluconate (10g), glucagon (4mg). He was also started on Dopamine and propofol. Transferred to [**Hospital1 18**] for further evaluation. . On arrival to OSH his BP was 100/40 and in ventricular escape. with rate in 20s. His BP trended upward to 229/112 prior to transfer to [**Hospital1 18**]. In the [**Last Name (LF) **], [**First Name3 (LF) **] attempt to place an internal pacer (now at R atrium vs. vent. wall) was made, however there was no capture. He required continued external pacing throughout as apparently w/o this he had no intrinsic rhythm. He received 4 vials of dibibond, 4mg glucagon, 2mg of calcium gluconate. The patient spontaneously converted to slow afib with LBBB. . Unable to obtain ROS given intubation. 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: - Atrial Fibrillation, likely permanent - managed with Metoprolol and Digoxin, previously anticoagulated. - CKD, likely Cr 1.4 baseline. Social History: - Tobacco history: Quit smoking 15 years ago - ETOH: Noted in [**Hospital1 6136**] notes that he drinks 2-3 beers/daily - Illicit drugs: None noted in OSH records Family History: Noncontributory. Physical Exam: On admission: GENERAL: Sedated, intubated HEENT: NCAT. Sclera anicteric. PERRL, although small. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. No xanthalesma. NECK: Supple with JVP of 7cm. CARDIAC: PMI located in 5th intercostal space, midclavicular line. [**Last Name (un) **], normal S1, S2. II/VI HSM at apex. No thrills, lifts. No S3 or S4. LUNGS: CTAB, no crackles, wheezes or rhonchi. ABDOMEN: Soft, distended. Hypoactive BS. No rebound or guarding. EXTREMITIES: No c/c/e. SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. PULSES: Right: DP 1+ PT 1+ Left: DP 1+ PT dopplerable On discharge: ____________ Pertinent Results: On admission: [**2113-5-19**] 06:00AM BLOOD WBC-9.7 RBC-3.76* Hgb-12.1* Hct-36.7* MCV-97 MCH-32.1* MCHC-33.0 RDW-14.3 Plt Ct-203 [**2113-5-19**] 06:00AM BLOOD Neuts-78.0* Lymphs-18.4 Monos-2.8 Eos-0.3 Baso-0.4 [**2113-5-19**] 06:00AM BLOOD PT-16.4* PTT-31.5 INR(PT)-1.4* [**2113-5-19**] 06:00AM BLOOD Fibrino-416* [**2113-5-19**] 06:00AM BLOOD UreaN-53* Creat-2.9* Na-139 K-6.3* Cl-109* HCO3-22 AnGap-14 [**2113-5-19**] 06:00AM BLOOD ALT-27 AST-38 AlkPhos-42 TotBili-0.6 [**2113-5-19**] 10:30AM BLOOD LD(LDH)-314* [**2113-5-19**] 06:00AM BLOOD Lipase-72* [**2113-5-19**] 06:00AM BLOOD Albumin-3.8 Calcium-8.9 Phos-4.2 Mg-2.3 [**2113-5-19**] 10:30AM BLOOD %HbA1c-6.1* eAG-128* [**2113-5-19**] 10:30AM BLOOD TSH-1.1 [**2113-5-19**] 10:30AM BLOOD Digoxin-6.8* [**2113-5-19**] 06:00AM BLOOD ASA-NEG Ethanol-NEG Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG [**2113-5-19**] 07:49AM BLOOD Type-ART FiO2-100 pO2-107* pCO2-60* pH-7.16* calTCO2-23 Base XS--8 AADO2-553 REQ O2-91 Intubat-INTUBATED Creatinine [**2113-5-19**] 06:00AM BLOOD Creat-2.9* [**2113-5-19**] 06:07PM BLOOD Creat-2.7* [**2113-5-20**] 04:09AM BLOOD Creat-3.0* [**2113-5-21**] 02:49PM BLOOD Creat-2.4* [**2113-5-23**] 04:57AM BLOOD Creat-1.7* [**2113-5-25**] 02:23PM BLOOD Creat-1.9* [**2113-5-27**] 07:16AM BLOOD Creat-1.8* MICROBIOLOGY: Joint fluid: WBC-135 RBC-195* Polys-15 Lymphs-5 Monos-9 Mesothe-11* Macro-60 GRAM STAIN (Final [**2113-5-22**]): NO POLYMORPHONUCLEAR LEUKOCYTES SEEN. NO MICROORGANISMS SEEN. Sputum cx: GRAM STAIN (Final [**2113-5-20**]): >25 PMNs and <10 epithelial cells/100X field. 3+ (5-10 per 1000X FIELD): GRAM NEGATIVE ROD(S). 2+ (1-5 per 1000X FIELD): GRAM POSITIVE COCCI. IN PAIRS AND CHAINS. RESPIRATORY CULTURE (Final [**2113-5-26**]): MODERATE GROWTH Commensal Respiratory Flora. HAEMOPHILUS SPECIES NOT INFLUENZAE. HEAVY GROWTH. Beta-lactamse negative: presumptively sensitive to ampicillin. HAEMOPHILUS SPECIES NOT INFLUENZAE. MODERATE GROWTH. 2ND MORPHOLOGY. Beta-lactamse negative: presumptively sensitive to ampicillin. Stool: CLOSTRIDIUM DIFFICILE. FECES POSITIVE FOR C. DIFFICILE TOXIN BY EIA. IMAGING: TTE (on admission): The left atrium is mildly dilated. No atrial septal defect is seen by 2D or color Doppler. There is mild symmetric left ventricular hypertrophy. The left ventricular cavity size is normal. Regional left ventricular wall motion is normal. Overall left ventricular systolic function is normal (LVEF>55%). There is no ventricular septal defect. The ascending aorta is mildly dilated. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. Mild (1+) mitral regurgitation is seen. There is borderline pulmonary artery systolic hypertension. There is no pericardial effusion. TEE: 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 intracardiac shunt seen at rest (with agitated saline). No atrial septal defect is seen by 2D or color Doppler. Overall left ventricular systolic function is normal (LVEF>55%). Right ventricular chamber size and free wall motion are normal. There are simple atheroma in the aortic arch. There are simple atheroma in the descending thoracic aorta. No thoracic aortic dissection is seen. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Mild to moderate ([**2-5**]+) mitral regurgitation is seen. There is a trivial/physiologic pericardial effusion. IMPRESSION: No spontaneous echo contrast or thrombus in the atria/ atrial appendages. No intracardiac shunt. No thoracic aortic dissection. Normal global [**Hospital1 **]-ventricular systolic function. Mild to moderate mitral regurgitation. EKG: Atrial fibrillation. Left bundle-branch block. Since the previous tracing of [**2113-3-27**] no significant change. CT head: IMPRESSION: 1. No evidence of hemorrhage or recent infarction. 2. Moderate-to-severe small vessel ischemic changes. CT chest/abd/pelvis: IMPRESSION: 1. Bibasilar consolidative opacities, likely atelectasis. Superimposed pneumonia however is not excluded and may account for the enlarged subcarinal lymph nodes. Small focus of hyperdense material at the right base could suggest aspiration. 2. CBD dilation without intrahepatic duct dilation. No definite mass or stone. A non-emergent MRCP could be used to further evaluate. Probable gallbladder sludge. Changes from initial wet read were discussed via phone with Dr. [**Last Name (STitle) 10755**] at 9:20pm on [**2113-5-19**]. 3. Left adrenal nodule, indeterminate for an adenoma. If clinically warranted, recommend dedicated adrenal cross sectional imaging. Abdominal U/S: IMPRESSION: Dilated common bile duct measuring 1.9 cm proximally, tapering down to 0.8 cm but not completely visualized along its entire length. No cause for dilation identified. Further evaluation with an MRCP is recommended. Brief Hospital Course: 76 yo man with DM, HTN, HL, ?CHF who presented to OSH with complete heart block needing transcutaneous pacing possibly secondary to B-blocker or Digoxin toxicity, intubated with hypoxemic respiratory failure with PNA/parapneumonic effusion and extubated on [**5-24**]. Hospital course complicated by poor rate control with atrial fibrillation, acute on chronic renal failure, non-typeable Haemophilus pneumonia, C. difficile diarrhea, and resolving toxic-metabolic encephalopathy with labile blood pressures. # Complete Heart Block ?????? He arrived in complete heart block, potentially secondary to digitalis and beta-blocker toxicity, s/p glucagon and repeated administrations of digibind. There was increased concern for B-blocker toxicity given his initial hypoglycemia and hyperkalemia, both of which seem to have resolved. His digoxin and metoprolol were held and his baseline heart rate of atrial fibrillation with left bundle branch block with heart rates 80s-110s returned. We started a low-dose B-blocker (lower than home dose) with good control of HR, without deficits in blood pressure. # Acute Hypoxemic Respiratory Failure with Severe Hypoxemia [**3-8**] Pneumonia with ?parapneumonic effusions: PaO2/FiO2 ratio was initially 185, so it was presumed that he developed ARDS. On review of his echocardiogram, his LVEF was preserved and his RV was normal, without evidence of strain. TEE with Bubble Study was negative for shunt. Given his ETOH history, it is possible the patient could have aspirated. The patient did have a retrocardiac opacity and bibasilar atelectasis as well as bilateral pleural effusions. He continued to have copious secretions and a worsening leukocytosis, for which he was started on broad-spectrum antibiotics. ?VAP vs. aspiration PNA. His sputum showed GPCs and GNRs on Gram stain, but only non-typeable haemophilus grew out in culture. He was quite difficult to extubate, secondary to agitation and hypertension, but was eventually extubated on [**5-24**]. He was kept NPO due to inability for the Speech and Swallow service to clear him secondary to delirium. Once he was cleared, he resumed a normal diet. His vancomycin ([**5-20**]- [**5-24**]) and pip/tazo ([**5-20**] ?????? [**5-25**]) was narrowed to ceftriaxone to cover these GPCs and Haemophilus for a total 8-day antibiotic course, ending on [**2113-5-27**]. # Hypertension: He developed hypertensive urgency with systolic BPs reaching >200s, felt to be secondary to volume overload and known essential hypertension. Multiple anti-hypertensive agents were tried, but only a nitroglycerin gtt with PRN IV hydralazine, and uptitrated doses of captopril TID were able to keep his blood pressure under control. Given persistent HTN despite multiple agents, we also considered secondary causes of hypertension such as renovascular or endocrine disease, but these were not evident. He was weaned off a nitro gtt and he was started back on the majority of his home anti-hypertensives: amlodipine, captopril TID (instead of lisinopril), and labetalol [**Hospital1 **] (instead of metoprolol). If his blood pressure continues to be difficult to control, we would recommend an outpatient work-up for secondary causes of hypertension. On the floor his catpropril was changed to lisinopril and his labetalol was uptitrated. His home imdur was added back and his hydralazine was changed to [**Hospital1 **] dosing. # Atrial Fibrillation: Patient in Afib with LBBB, at baseline, anticoagulated with Coumadin. While he was being treated with antibiotics, we adjusted his Coumadin dosing as needed. He was rate controlled with increasing doses of metoprolol, which was eventually changed over to labetalol for both blood pressures and rate control. Digoxin was discontinued and should not be restarted as an outpatient. # C. Diff: Patient noted to be C. Diff positive, likely in the setting of recent hospitalization and antibiotic use. Abdominal exam without peritoneal signs, but patient did eventually develop an ileus. Tube feeding had been started given the patient's relatively long period of intubation, but was held. An aggressive bowel regimen caused copious stool output, prompting placement of a flexiseal. He was initially started on PO vancomycin and IV metronidazole for severe C. diff (elevated creatinine, leukocytosis, and fevers). IV metronidazole was discontinued when his leukocytosis and creatinine began to resolve. He should be continued on PO vancomycin for 14 days after completing his PNA antibiotics ([**5-28**] ?????? [**6-11**] for 14-day course - see below). # Toxic-metabolic encephalopathy: Patient with underlying infection, s/p extubation, unfamiliar environment with confusion and agitation likely consistent with delirium. He was given seroquel 25 mg prn and standing QHS for agitation. He is also quite hard of hearing, so reorientation was difficult, but his delirium mostly resolved prior to transfer from the ICU and seemed to resolve on the floor. # Acute on chronic renal failure with hyperkalemia ?????? The initial hyperkalemia was likely caused by beta-blocker toxicity although it can also be seen with digitalis toxicity. He has underlying CKD (stage III per note) likely worsened in setting of reduced perfusion and diuresis. Cr 2.9 on admission. His baseline nephropathy is likely secondary to HTN and DM, but this acute kidney injury may have been secondary to hypovolemia vs. ATN for hypotension secondary to bradycardia. # Normocytic Anemia - His admission Hct 36.7 trended down to 28, without active signs/symptoms of acute blood loss. While it stabilized now in high 20s, iron studies were unrevealing. We did not uncover a cause of this anemia, though his initial hematocrits may have been due to hemoconcentration. # Right knee effusion: His right knee was noted to be quite enlarged with a large effusion. There was no evidence of crystals or septic arthritis on joint aspiration. Per family, he has had swelling in the past, possibly related to underlying OA. Joint aspirate had no growth on culture. There was not any further erythema or warmth throughout the hospitalization # DM II: He is on Glipizide at home and his HbA1c was 6.1 on admission, indicating good control. He was maintained on SSI while in house. # Hyperlipidemia: He was continued on simvastatin. # CODE: Full code # CONTACT: Daughter [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 1004**] [**Telephone/Fax (1) 90116**] (HCP) Medications on Admission: - Lisinopril 10mg daily - ASA 81mg daily - Digoxin 125mcg daily - Glipizide 5mg daily - Simvastatin 40mg daily - Warfarin 5mg daily - Furosemide 40mg daily - Metoprolol Tartrate 200mg [**Hospital1 **] - Spironolactone 25mg daily - Imdur 60mg daily - Ativan 1mg daily - ? Amlodipine 5mg daily (per OSH records, but no medication bottle) Discharge Medications: 1. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 2. furosemide 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. isosorbide mononitrate 60 mg Tablet Extended Release 24 hr Sig: One (1) Tablet Extended Release 24 hr PO DAILY (Daily). 5. glipizide 5 mg Tablet Sig: One (1) Tablet PO once a day. 6. vancomycin 125 mg Capsule Sig: One (1) Capsule PO Q6H (every 6 hours) for 10 days. Disp:*40 Capsule(s)* Refills:*0* 7. warfarin 3 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* 8. Outpatient Lab Work Please check the INR on [**2113-5-30**] and fax to Dr. [**Last Name (STitle) 90117**]. Fax: [**Telephone/Fax (1) 78086**] 9. lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily): Please start this medication AFTER your BP has been checked at your appointment this Friday, [**2113-6-2**]. 10. amlodipine 5 mg Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Home With Service Facility: [**Hospital 2255**] [**Name (NI) 2256**] Discharge Diagnosis: Primary: Digoxin toxicity Heamophilus pneumonia Clostridium difficle diarrhea Hypertension Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: You were admitted to the hospital due to a slow heart rate due to one of your medications (dignoxin). Due to your instability with the slow heart rate, you were intubated (a breathing tube was placed) This medication was stopped and your heart rate was treated and improved. You were also found to have a pnuemonia and were treated with an antibiotic with improvement. Additionally you developed diarrhea caused by a bacteria called Clostridium difficile. You will need to complete an antibiotic course for this infection. You blood pressure was also very elevated and multiple medication changes were made. Medication changes: RESTART lisinopril 10 mg daily after your follow-up appointment Friday STOP spironolactone STOP digoxin STOP ativan DECREASE metoprolol to 100 mg twice daily START vancomycin 125 mg every 6 hours until the last dose on [**6-10**] CHANGE warfarin to 3mg daily Otherwise continue your outpatient medications as prescribed. Followup Instructions: Primary care doctor [**First Name (Titles) **] [**Last Name (Titles) **] Practitioner Name: [**Last Name (LF) **],[**Name8 (MD) **] MD Address: 237A [**Street Address(1) **] ROUTE 6, [**Location **],[**Numeric Identifier **] Phone: [**Telephone/Fax (1) 9674**] Fax: [**Telephone/Fax (1) 78086**] FRIDAY [**2113-6-2**] 1:15 PM You will need to have your INR checked within the next 72hours because the level was slightly lower today after you received a slightly higher dose of your coumadin yesterday. Completed by:[**2113-6-2**] ICD9 Codes: 0389, 5070, 5849, 2930, 4280, 2724, 2767, 2859
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Medical Text: Admission Date: [**2195-4-21**] Discharge Date: [**2195-4-27**] Date of Birth: [**2126-6-27**] Sex: F Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 922**] Chief Complaint: Chest Burning Major Surgical or Invasive Procedure: [**2195-4-21**] Coronary Artery Bypass Graft Surgery with Left internal mammory artery -> Left anterior descending artery, Reverse saphenous vein graft --> obtuse marginal and Reverse saphenous vein graft to right coronary artery History of Present Illness: 68 year old female with symptoms of exertional chest burning and shortness of breath. She had + stress test and was referred for cardiac catheterization to further evaluate which showed coronary artery disease. Past Medical History: Hypertension Dyslipidemia Diabetes Mellitus thyroid nodule- last u/s- size stable polpyectomy during colonoscopy- benign Past Surgical History: s/p tonisillectomy Social History: Lives with:husband Occupation:retired Tobacco: quit 3 years ago, [**7-23**] cigs/day x 45 years ETOH: denies Recreational drugs: denies Family History: Father died of MI age 71, Mother with heart problems, 2 sisters s/p MI, brother s/p stent Physical Exam: Pulse:51 Resp:16 O2 sat:96%RA B/P Right:167/63 Left: 165/ Height:4'[**96**]" Weight:64.9kg (143 lbs) General: Skin: Dry [x] intact [x] 5mm raised erythematous papule with crust on bilateral cheeks HEENT: PERRLA [] EOMI [x] Neck: Supple [x] Full ROM [x] Chest: Lungs clear bilaterally [x] Heart: RRR [x] Irregular [] Murmur II/VI SEM LUSB, III/VI HSM RUSB Abdomen: Soft [x] non-distended [x] non-tender [x] Extremities: Warm [x], well-perfused [x] Edema Varicosities: None [x] Neuro: Grossly intact Pulses: Femoral Right: nd Left: nd DP Right: 2+ Left: 2+ PT [**Name (NI) 167**]: 2+ Left: 2+ Radial Right: 2+ Left: 2+ Carotid Bruit Right: - Left: - Pertinent Results: [**2195-4-27**] 05:10AM BLOOD Hct-32.1* [**2195-4-26**] 05:45AM BLOOD WBC-9.6 RBC-3.98* Hgb-11.3* Hct-33.9* MCV-85 MCH-28.5 MCHC-33.4 RDW-14.0 Plt Ct-402 [**2195-4-21**] 01:20PM BLOOD WBC-20.0*# RBC-3.87*# Hgb-11.2*# Hct-32.0*# MCV-83 MCH-29.0 MCHC-35.1* RDW-13.7 Plt Ct-310 [**2195-4-21**] 12:24PM BLOOD WBC-12.2*# RBC-2.77*# Hgb-7.9*# Hct-23.1*# MCV-83 MCH-28.5 MCHC-34.2 RDW-13.7 Plt Ct-222 [**2195-4-26**] 05:45AM BLOOD Plt Ct-402 [**2195-4-21**] 01:20PM BLOOD PT-13.1 PTT-26.9 INR(PT)-1.1 [**2195-4-27**] 05:10AM BLOOD Glucose-119* UreaN-18 Creat-0.6 Na-136 K-4.8 Cl-101 HCO3-27 AnGap-13 [**2195-4-21**] 01:20PM BLOOD UreaN-12 Creat-0.5 Cl-117* HCO3-25 [**2195-4-27**] 05:10AM BLOOD Mg-2.2 Echocardiographic Measurements Results Measurements Normal Range Left Ventricle - Ejection Fraction: 55% to 60% >= 55% Findings LEFT ATRIUM: No spontaneous echo contrast is seen in the LAA. RIGHT ATRIUM/INTERATRIAL SEPTUM: Normal interatrial septum. LEFT VENTRICLE: Overall normal LVEF (>55%). RIGHT VENTRICLE: Normal RV chamber size and free wall motion. AORTA: Normal ascending aorta diameter. Simple atheroma in descending aorta. AORTIC VALVE: Normal aortic valve leaflets (3). No AS. No AR. MITRAL VALVE: Mildly thickened mitral valve leaflets. Mild (1+) MR. TRICUSPID VALVE: Mild [1+] TR. PULMONIC VALVE/PULMONARY ARTERY: Physiologic (normal) PR. PERICARDIUM: No pericardial effusion. GENERAL COMMENTS: A TEE was performed in the location listed above. I certify I was present in compliance with HCFA regulations. The patient was under general anesthesia throughout the procedure. The TEE probe was passed with assistance from the anesthesioology staff using a laryngoscope. No TEE related complications. Conclusions Pre-CPB: No spontaneous echo contrast is seen in the left atrial appendage. Overall left ventricular systolic function is normal (LVEF>55%). Right ventricular chamber size and free wall motion are normal. There are simple atheroma in the descending thoracic aorta. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. The mitral valve leaflets are mildly thickened. Mild (1+) mitral regurgitation is seen. There is no pericardial effusion. Post-CPB: A-Paced, low dose Neo. Normal biventricular systolic fxn. Trace MR, no AI. Aorta intact. I certify that I was present for this procedure in compliance with HCFA regulations. Electronically signed by [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 3318**], MD, Interpreting physician [**Last Name (NamePattern4) **] [**2195-4-21**] 12:22 Sinus rhythm. Consider inferior myocardial infarction of indeterminate age but baseline artifact in the inferior leads makes assessment difficult. Low precordial lead QRS voltage is non-specific. Lateral precordial lead ST-T wave changes are non-specific. Clinical correlation is suggested. Since the previous tracing of [**2195-4-15**] sinus bradycardia is absent and lateral precordial lead ST-T wave changes are seen but baseline artifact in the inferior leads makes comparison of these leads difficult. Read by: [**Last Name (LF) **],[**First Name3 (LF) 177**] W. Intervals Axes Rate PR QRS QT/QTc P QRS T 88 172 92 380/429 48 -1 -41 Brief Hospital Course: Admitted same day surgery and underwent coronary artery bypass graft surgery. See operative report for full details. She received cefazolin for perioperative antibiotics. Post operatively she was transferred to the intensive care unit for management. In the first twenty four hours she was weaned from sedation, awoke neurologically intact and was extubated without complications. She remained in the intensive care unit post operative day one due hypotension and was started on vasoactive medications. She was transfused 2 units of packed red blood cells for a hematocrit of 24 and low blood pressure on postoperative day 2 and improved. She was transferred to the floor later on post operative day 2. Physicial therapy worked with her on strength and mobility. She continued to progress and was ready for discharge home with services on post operative day six. Medications on Admission: Atenolol 25mg po daily Lisinopril 5mg po daily Metformin 500mg po daily Simvastatin 20mg po daily ASA 81 mg po daily Calcium Carbonate-Vit D 1 tab po daily Ergocalciferol-400 unit capsule po daily Glucosamine chondroitin 1 capsule po daily MVI 1 tab po daily Omega-3 fatty acids 1 cap po 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. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 3. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 4. Simvastatin 20 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*0* 5. Multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 6. Tramadol 50 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for pain. Disp:*50 Tablet(s)* Refills:*0* 7. Cipro 500 mg Tablet Sig: One (1) Tablet PO twice a day for 5 days. Disp:*10 Tablet(s)* Refills:*0* 8. Metformin 500 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 9. Lisinopril 5 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 10. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: Centrus Home Care Discharge Diagnosis: Coronary Artery Disease s/p CABG Hypertension Dyslipidemia Diabetes Mellitus type 2 thyroid nodule Discharge Condition: Alert and oriented x3 nonfocal Ambulating, gait steady Sternal pain managed with Ultram prn Discharge Instructions: Please shower daily including washing incisions, no baths or swimming Monitor wounds for infection - redness, drainage, or increased pain Report any fever greater than 101 Report any weight gain of greater than 2 pounds in 24 hours or 5 pounds in a week No creams, lotions, powders, or ointments to incisions No driving for approximately one month, and while taking narcotics No lifting more than 10 pounds for 10 weeks Please call with any questions or concerns [**Telephone/Fax (1) 170**] Followup Instructions: Please call to schedule appointments Surgeon Dr [**Last Name (STitle) 914**] in 4 weeks [**Telephone/Fax (1) 170**] [**5-26**] at 1:30 PM Primary Care Dr [**Last Name (STitle) 54049**] [**Name (STitle) **] in [**1-17**] weeks Cardiologist Dr [**First Name8 (NamePattern2) 19118**] [**Last Name (NamePattern1) 23705**] in [**1-17**] weeks Completed by:[**2195-4-27**] ICD9 Codes: 5180, 5990, 2859, 4019, 2724
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Medical Text: Admission Date: [**2134-4-6**] Discharge Date: [**2134-4-22**] Date of Birth: [**2066-3-29**] Sex: F Service: MEDICINE Allergies: Latex / Keflex / Codeine / Statins-Hmg-Coa Reductase Inhibitors / Ace Inhibitors / Ciprofloxacin / adhesive tape / Angiotensin Receptor Antagonist / Tomato / morphine Attending:[**First Name3 (LF) 2387**] Chief Complaint: dyspnea Major Surgical or Invasive Procedure: Left Carotid Endarterectomy Diagnostic Cardiac Catheterization History of Present Illness: 68 y/o F with hx of DMII, HTN, PVD, admitted for CEA of left now POD #2 with SOB and EKG changes. Pt was dx with critical carotid stensois >80 L and R, [**1-1**] at [**Hospital1 2177**] and was admitted for CEA of left. Post op she was hypotensive and given IVF. She has been having increased O2 needs since, now on face tent + NC 5 liters and nitro gtt. Her wt increased from 90.7 on admission to 98kg. CXR with pulm edema and BNP elevated to [**Numeric Identifier **]. Post op, she also developed EKG changes with STD in lateral leads and CE are elevated with MB peaked at 24 and Trop 0.67. She has worsened renal function since admission, with Cr now 2.7. She was given lasix 60mg IV last night and 20mg IV and 60mg IV today. Heparin is being started at time of transfer without a bolus. [**Name (NI) 94597**] pt is SOB with +orthopnea, with some CP with coughing in center of chest. Cough is nonproductive. No fever, no n/v. No BM since surgery, but passing flatus. No HA or vision changes. Pt has chronic neuropathy in feet and leg claudication. Past Medical History: 1. CARDIAC RISK FACTORS: -Diabetes, on insulin and actos, with peripherial neuropathy -Dyslipidemia, intolearant of statins due to severe cramps, failed lipitor and pravastatin -Hypertension, higher BP in left arm 2. CARDIAC HISTORY: -Inferior MI seen on stress test, with EF 40% on stress echo [**4-1**] with apical inferior and inferior lateral hypokinesis -Heart murmur per pt 3. OTHER PAST MEDICAL HISTORY: -CRF, stage II -right and left internal carotid stenosis, >80%, dx [**2134-1-5**], now s/p CEE on left -GERD -Osteo arthritis -Asthma -PVD with hx of thrombophlebitis -Hypotension with anesthesia -Epistaxis on left -Endometeriosis -Nephrolithiasis x 2 -UTIs -Anemia -Hyperplastic cells in right breast bx, ductal cyst removed [**7-1**] rt; star angioma rmoved from right breast -bilateral cataracts s/p surgery -s/p chole [**2101**] -s/p appy [**2121**] -s/p removal of abscess in right groin [**2075**] -hx of assault from pts including facial assault and back/rib cage injury -s/p right retinal laser surgery in [**2131**] Social History: No children, lives alone with cat. Semi-retired psych RN. Uses a cane when there is ice. - Tobacco history: former heavy smoker ([**3-26**] ppd), from age 20-35 - ETOH: social - Illicit drugs: none Family History: - No family history of early MI, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. - Mother: mesothelioma - Father: unknown - GF: asthma - [**1-24**] Sister: breast CA in situ, HTN - GM: [**Month/Day (2) 1106**] disease Physical Exam: Admission Exam: VS: 99.8 144/64 100 26 93-97% 5L NC +face tent, I/O- yest 1800/[**2038**]; today 130/805 GENERAL: anxious. Oriented x3. Mood, affect appropriate. HEENT: Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. No xanthalesma. NECK: Supple with JVP elevated at mid neck with sitting at 45 degrees, wound on left neck healing well CARDIAC: RRR, No M, +2 radial pulses, 1+ DP pulses LUNGS: Crackles bilaterally, [**2-25**] of the way up ABDOMEN: Soft, NTND. No HSM or tenderness. +BS EXTREMITIES: No c/c, trace edema . Discharge Exam: GENERAL: anxious. Oriented x3. Mood, affect appropriate. HEENT: Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. No xanthalesma. NECK: Supple with JVP elevated at mid neck with sitting at 45 degrees, wound on left neck healing well CARDIAC: RRR, No M, +2 radial pulses, 1+ DP pulses LUNGS: Crackles bilaterally, [**2-25**] of the way up ABDOMEN: Soft, NTND. No HSM or tenderness. +BS EXTREMITIES: No c/c, trace edema Pertinent Results: Admission Labs ([**4-6**]): WBC-8.4 RBC-3.48* Hgb-10.2* Hct-30.7* MCV-88 MCH-29.2 MCHC-33.2 RDW-14.6 Plt Ct-200 Glucose-154* UreaN-40* Creat-1.7* Na-145 K-3.9 Cl-111* HCO3-25 AnGap-13 CK-MB-3 cTropnT-<0.01 CK(CPK)-88 Calcium-8.4 Phos-3.7 Mg-1.7 Type-ART pO2-186* pCO2-39 pH-7.43 calTCO2-27 Base XS-2 Intubat-INTUBATED freeCa-1.16 . Cardiac Enzyme Trend: [**2134-4-6**] 02:21PM BLOOD CK-MB-3 cTropnT-<0.01 [**2134-4-6**] 09:57PM BLOOD CK-MB-3 cTropnT-<0.01 [**2134-4-7**] 04:04AM BLOOD CK-MB-8 cTropnT-0.09* [**2134-4-7**] 04:20PM BLOOD CK-MB-24* MB Indx-7.6* cTropnT-0.44* proBNP-[**Numeric Identifier **]* [**2134-4-7**] 10:17PM BLOOD CK-MB-24* MB Indx-6.8* cTropnT-0.55* [**2134-4-8**] 03:57AM BLOOD CK-MB-21* cTropnT-0.67* [**2134-4-8**] 01:55PM BLOOD CK-MB-15* MB Indx-4.9 cTropnT-0.83* . Imaging: ECHO ([**2134-4-7**]): The left atrium is moderately dilated. The estimated right atrial pressure is 10-15mmHg. Left ventricular wall thicknesses are normal. The left ventricular cavity size is normal. There is mild regional left ventricular systolic dysfunction with infero-lateral akinesis (EF 45%). No masses or thrombi are seen in the left ventricle. There is no ventricular septal defect. Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. An eccentric, posteriorly directed jet of moderate to severe (3+) mitral regurgitation is seen. The tricuspid valve leaflets are mildly thickened. Tricuspid regurgitation is present but cannot be quantified. There is moderate pulmonary artery systolic hypertension. There is no pericardial effusion. . ECHO ([**2134-4-21**]): The left atrium is mildly dilated. Left ventricular wall thicknesses and cavity size are normal. There is mild to moderate regional left ventricular systolic dysfunction with severe hypokisis of the basal and mid inferior and inferolateral walls. The remaining segments contract normally (LVEF = 45 %). Right ventricular chamber size and free wall motion are normal. The aortic root is mildly dilated at the sinus level. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. Mild to moderate ([**1-24**]+) mitral regurgitation is seen. The pulmonary artery systolic pressure could not be determined. There is no pericardial effusion. IMPRESSION: Normal left ventricular cavity size with regional systolic dysfunction c/w CAD. Mild-moderate mitral regurgitation. Dilated aortic root. Compared with the prior study (images reviewed) of [**2134-4-15**], the findings are similar. . CXR ([**2134-4-16**]): IMPRESSION: 1. Significant interval improvement in severity of pulmonary edema. 2. New mild lingular atelectasis. Brief Hospital Course: CCU Course: 68 yo female with hx of inferior MI, PVD, DMII, now s/p CEA on left on [**2134-4-6**] transferred to the CCU on [**2134-4-8**] with s/s of CHF secondary to iv fluid administration and new mitral regurgitation. # PUMP: Patient was admitted to the CCU with signs and symptoms of CHF. Her echo on [**4-7**] showed EF 45% along with severe mitral regurgitation. She also had an elevated BNP and CXR that showed pulm edema. On admission to the CCU, her weight was up 8 kg from admission. This weight gain was likely caused by IVF given for hypotension post op. She was started on diuresis with iv lasix, lasix drip and diuril with limited effect. Her diuresis was improved when she was wearing her BIPAP mask but she had difficulty tolerating this mask. Her severe mitral regurgitation likely contributed to the difficulty with diuresis as she had limited forward flow. She was intubated on [**2134-4-11**] for persistent hypoxia, difficulty tolerating BIPAP mask. She was also started on CVVH on [**2134-4-12**]. She became 6-7 liters negative over 48 hours. Her oxygenation was improved and her CXR was much improved. She was extubated and transitioned to 50% shovel mask with good O2 saturations. Her weight also returned to baseline. She was started on torsemide iv boluses with the goal to make her fluid even. She had a repeat echo which showed improved [**1-24**]+ mitral regurgitation and resolution of pulmonary hypertension. She was seen by CT surgery for evaluation of her mitral regurgitation and they recommended she follow-up with them as an outpatient. She has been intolerant of an ACE-I/[**Last Name (un) **] in the past. She was started on imdur and hydralazine for afterload reduction, but was founf to have orthostatic hypotension and so it the hydralazine was discontinued and the Imdur was initially lowered to 30mg PO Daily and then eventually discontinued. She continued to be orthostatic with physical therapy, but her symptoms of dizziness and nausea resolved. She will be discharged to Rehab with a prescription for torsemide 5mg to be given if Ms [**Known lastname **] is noted to be gaining weight on a daily basis. However at this time, we held off on starting afterload reducing agents given her orthostasis. # CAD: Pt has a hx of a inferior MI seen on stress test last fall and she was admitted to the CCU with new CE elevations and lateral STD in post op setting, concerning to ACS vs demand ischmia. Stress echo prior to surgery did not show ischemic changes, but was at subopitimal exercise <4.5 METs. Pt was also not on a BB perioperatively. She has not tolearted statins, ACE-I or ARBs in the past. Also pt had hypotension post operatively, which may have worsened any ischemia. Echo [**4-7**] with new presumed MR, which may be from ischemia. She was initially treated with heparin drip, plavix (loaded with 600 mg po x1 then maintained on 75 mg po daily), metoprolol, nitro drip, aspirin 325 mg po daily. She had a cardiac catheterization on [**2134-4-12**] which showed diffuse coronary disease but did not show any intervenable lesions. Her plavix was stoppped on [**4-12**] given that she may need mitral valve surgery. # Acute on Chronic Renal Failure: Patient has underlying CKD, with creatinine of 1.8 on admission. She developed acute renal failure in the setting of aggressive diuresis, cath and her creatinine became elevated to a max of 4.0. This may also be related to the poor forward flow from her severe mitral regurgitation. She required CVVH for fluid removal. She was treated with mucomyst prior to cath. Her creatinine eventually began trending down and on discharge was 2.1. She will need follow up labs to monitor whether she returns to baseline or whether she will be at a new baseline of her kidney function given this recent injury. # RHYTHM: patient was in sinus rhythm. She developed bradycardia along with hypotension after a femoral groin line was placed, though to be a vagal response. Her metoprolol was stopped and her bradycardia improved when the groin line was pulled on [**2134-4-15**]. Her metoprolol was eventually restarted and she tolerated it well. She will be discharged on metoprolol XL 50mg PO Daily. She will continued to be monitored by her cardiologist. # HTN: Patient has hypertension and all blood pressures were monitored on the left arm. Her right arm shows falsely low blood pressure related to right sided subclavian stenosis. She was initially managed on amlodipine, metoprolol, nitro gtt for goal SBP 100-140. She was then transitioned to imdur and hydralazine for afterload reduction. On hospital day 13, pt was orthostatic lying BP 138/61 HR 88 to standing BP 80/48 HR 92. She was a little dizzy and nuaseaus. Her Imdur and Hydralazine were held and no diuretics started. She continued to be orthostatic, but less symptomatic. Her orthostasis likely has some autonomic component given her prolonged hospital stay and bedrest. She will be discharged to rehab where she will likely improve. She will be given a prescription for torsemide in the event that she gains some weight and needs a diuretic, but her afterload reducers are being held at this time. # HLD: Patient has failed atrovastatin and pravastatin as an outpatient due to severe cramps and she was resistant to retry a statin. Her lipid panel was not at goal, but not severely elevated- LDL 109, HDL 45, total cholesterol 175. Her fish oil was held during her hospital stay but was restarted the day prior to discharge. She was also started on Crestor 5mg PO Daily. She will continue to be monitored in the outpatient setting. # Anemia: Iron studies are consistent with anemia of chronic disease and may also be related to anemia [**2-24**] CKD. She required 1 unit of PRBC for HCT of 22.4 with an appropriate response. Her HCT then remained stable in high 20s, low 30s. . # Carotid stenosis: stable, healing well s/p left CEA. She will likely need a future procedure for right sided stenosis. . # DMII: Patient was treated with lantus 28 hs and humalog sliding scale. Her A1c was 7.2. Her actos was held and was not restarted as it may contribute to worsened CHF. # Hypothyroidism: TSH within normal limits. She was continued on her home dose of levothyroxine. # Asthma: ? asthma vs COPD vs cardiac asthma due to heavy prior tobacco use. She was continued on Albuteral nebs and Advair. . # Anxiety: patient has significant underlying anxiety and becomes more anxious when she does not know her plan of care. She was treated with lorazepam 1 mg iv prn. #Code: FULL CODE (confirmed with patient) Medications on Admission: -Actos (pioglitazone) 45mg qday -Levoxyl 150mcg qday -Amlodipine 10mg qday -Xalantan 1 drop each eye HS -Alprazolam 0.25mg 1-2 tabs prn, none for last 4 months -Humalog, 2 units for BS >250 -Lantus 28 units HS -Protonix 40mg -Lasix 10mg PO qday -MV qday -ASA 81mg qday -Calcitrol 0.25mcg qday -fluticasone-salmeterol 250 mcg-50 mcg/Dose 1 puff IH [**Hospital1 **] -Montelukast 10 mg qday -Calcium carbonate 600 mg -Coenzyme Q10 100 mg -Omega-3 fatty acids 1,200 mg-144 mg qd -Salmon oil 1000mg qday -Pen VK 500mg prn tooth infection Discharge Medications: 1. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. montelukast 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. levothyroxine 75 mcg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 4. fluticasone-salmeterol 250-50 mcg/dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). 5. alprazolam 1 mg Tablet Sig: One (1) Tablet PO at bedtime as needed for sleep. 6. insulin glargine 100 unit/mL Solution Sig: Twenty Eight (28) units Subcutaneous at bedtime. 7. insulin lispro 100 unit/mL Solution Sig: 0-12 units Subcutaneous four times a day: per sliding scale. 8. pramoxine-mineral oil-zinc 1-12.5 % Ointment Sig: One (1) Appl Rectal TID (3 times a day). 9. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 10. hydrocortisone acetate 25 mg Suppository Sig: One (1) Suppository Rectal DAILY (Daily). 11. senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed for constipation. 12. metoprolol succinate 25 mg Tablet Extended Release 24 hr Sig: One (1) Tablet Extended Release 24 hr PO once a day. 13. Protonix 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. 14. latanoprost 0.005 % Drops Sig: One (1) Drop Ophthalmic HS (at bedtime). 15. trazodone 50 mg Tablet Sig: 0.5 Tablet PO HS (at bedtime) as needed for insomnia. 16. rosuvastatin 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 17. omega-3 fatty acids Capsule Sig: One (1) Capsule PO TID (3 times a day). 18. ezetimibe 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 19. calcitriol 0.25 mcg Capsule Sig: One (1) Capsule PO once a day. 20. Calcitrate 200 mg (950 mg) Tablet Sig: One (1) Tablet PO twice a day. 21. torsemide 5 mg Tablet Sig: One (1) Tablet PO once a day. 22. clopidogrel 75 mg Tablet Sig: One (1) Tablet PO once a day. 23. Xalatan 0.005 % Drops Sig: One (1) gtt Ophthalmic at bedtime: each eye. Discharge Disposition: Extended Care Facility: [**Hospital 6594**] Rehabilitation & Nursing Center Discharge Diagnosis: Status-post Left Carotid Endarterectomy Myocardial Infaction Acute Systolic Congestive Heart Failure: allergy to ACEi and [**Last Name (un) **] Mitral Regurgitation Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Ms. [**Known lastname **], You were admitted to the hospital for surgery of your left carotid artery. Following your surgery, you developed a low blood pressure with difficulty breathing and your lab tests and EKG changes were concerning for a heart attack. You were transfered to the cardiac intensive care unit where you were evaluated and treated by the cardiology service. You were found to have a significant excess of fluid throughout your body and improtantly in your lungs that made it difficult for you to breathe. You received medication to help your kidneys remove the excess fluid, but your breathing continued to be difficult and you required intubation and assistance from a breathing machine. You also required temporary dialysis because your kidneys were not able to remove enough fluid. Careful use of dialysis allowed enough fluid to be removed and you were extubated with improved breathing. You also received a cardiac catheterization that revealed your known coronary disease but did not require intervention. While your fluid volume was very high, you were noted to have worsened heart valve disease (mitral regurgitation) that improved after removing a large amount of fluid. You will need to follow up with your outpatient doctors. Please take your medications as prescribed and keep your outpatient appointments. The following changes have been made to your home medications: 1. Stop taking Actos, amlodipine, furosemide and co-enzyme Q10 2. Start Torsemide to prevent fluid buildup 3. Increase aspirin to 325 mg daily for one month 4. STart Tucks and hydrocortisone suppositories for your hemmorrhoids 5. STart colace and senna to prevent constipation 6. STart metoprolol succincate to slow your heart rate and improve your heart function 7. STart trazadone to help you sleep 8. STart crestor and zetia to lower your cholesterol. Please talk to Dr. [**Last Name (STitle) 1836**] is you get leg cramps again 9. Start Plavix to prevent blood clots in your carotid artery . Please check your weight daily before breakfast. Call Dr. [**Last Name (STitle) **] if your weight increases more than 3 pounds in 1 day or 5 pounds in 3 days. Followup Instructions: Department: [**Last Name (STitle) **] SURGERY When: THURSDAY [**2134-5-6**] at 2:00 PM [**Telephone/Fax (1) 1237**] Building: LM [**Hospital Unit Name **] [**Location (un) **] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage Provider: [**Name10 (NameIs) **] [**Apartment Address(1) 871**] ([**Doctor First Name **]) [**Doctor First Name **] LMOB (NHB) Phone:[**Telephone/Fax (1) 1237**] Date/Time:[**2134-5-6**] 2:00 Department: [**Month/Day/Year **] SURGERY When: THURSDAY [**2134-5-6**] at 2:30 PM With: [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern4) 2604**], MD [**Telephone/Fax (1) 1237**] Building: LM [**Hospital Unit Name **] [**Location (un) **] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage Name: [**Last Name (LF) **], [**First Name7 (NamePattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] Specialty: Cardiology Location: [**Doctor Last Name **] BLDG, [**Apartment Address(1) 17383**] Address: [**Last Name (NamePattern1) 8541**], [**Location (un) **],[**Numeric Identifier 8542**] Phone: [**Telephone/Fax (1) 7960**] **Please contact Dr. [**Last Name (STitle) **] office on [**Last Name (LF) 766**], [**4-26**] to book a follow up appointment. You will need to be seen by Dr. [**Last Name (STitle) **] within 2-4 weeks of your discharge from the hospital.** Name: [**Last Name (LF) 94598**],[**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] MD Location: [**Hospital3 **] CTR Address: [**Location (un) **], 7TH FL, STE#7A Phone: [**Telephone/Fax (1) 94599**] Appointment: Tuesday [**5-18**] at 11:30AM ICD9 Codes: 9971, 5849, 4280, 3572, 4240, 2859, 2449
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Medical Text: Admission Date: [**2185-7-24**] Discharge Date: [**2185-7-27**] Date of Birth: [**2142-6-2**] Sex: F Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 6701**] Chief Complaint: Altered Mental Status Major Surgical or Invasive Procedure: Esophagogastroduodenoscopy History of Present Illness: 43 y/oF with polysubstance abuse and hepatitis who presented to ED with altered mental status. According to patient, she used heroine along with 2 beers and 1 "shot" of rum earlier yesterday and was then found unresponsive by family members who then called EMS. Upon initial assessment, patient was given narcan with improvement of mental status. Patient was then brought to ED for further evaluation. . In ED, patient's initial VS were 97.8 86 130/99 14 100% RA. On initial evaluation patient appeared tired however did not require any further narcan and eventually was more interactive. She apparently vomitted approximately 350cc of coffee ground emesis. NG tube was placed and revealed more coffee grounds with active bleeding. Hct was 39 which was thought to be hemoconcentrated however repeat Hct was not drawn. GI was consulted who recommended admission to MICU for EGD. She remained hemodynamically stable. . Also while in ED, patient was noted to have a lactic acidosis to 4.4 with anion gap of 18. She was also hypernatremic to 149 and had a Cr of 2.5. Patietn was given a total of 2000cc of NS and 1000cc of D5 1/2 NS. Repeat lactate was 2.4. Patients serum ETOH level was 98 on admission and utox/serum tox were positive for opioids and cocaine. . Prior to transfer, patients VS were HR 86 BP 138/91 RR 18 SpO2 100%RA . In the MICU, patient was resting comfortably however complaining of thirst. Review of systems: (+) Per HPI (-) Denies fever, chills, night sweats, recent weight loss or gain. Denies headache, sinus tenderness, rhinorrhea or congestion. Denies cough, shortness of breath, or wheezing. Denies chest pain, chest pressure, palpitations, or weakness. Denies nausea, vomiting, diarrhea, constipation, abdominal pain, or changes in bowel habits. Denies dysuria, frequency, or urgency. Denies arthralgias or myalgias. Denies rashes or skin changes. . Past Medical History: - hepatitis C - depression - polysubstance abuse - hypertension. - tubal ligation at the age of 27 - right hand surgery to remove an abscess at the age of 30. Social History: - Lives with [**Location (un) 686**] - Has 4 children ages 20, 19, 17 and 14. - currently on [**Social Security Number 93147**]Social Security disability - tobacco: never - illicits: current heroine/cocaine, occ marijuana - ETOH: 6pack of beer + liquor 3-4times per week. Family History: - mother passed away at age 50 from gastric cancer also with hypertension, and had polysubstance abuser - father is an alcoholic. Physical Exam: Vitals: 98 143/90 77 95%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: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly GU: no foley Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Neuro: CNII-XII intact, 5/5 strength, tremulous Discharge Exam: VItals, afebrile, VSS Gen: AxO x3, comfortable CV: RRR, no murmurs RESP: CTAB ABD: soft, NT/ND Ext: warm, no LE edema Pertinent Results: ADMISSION LABS [**2185-7-24**] 01:30AM BLOOD WBC-5.1 RBC-3.59* Hgb-12.7 Hct-37.3 MCV-104*# MCH-35.3* MCHC-34.0 RDW-12.9 Plt Ct-248 [**2185-7-24**] 01:30AM BLOOD Neuts-88.1* Lymphs-7.8* Monos-3.6 Eos-0.1 Baso-0.3 [**2185-7-24**] 01:30AM BLOOD PT-11.3 PTT-26.5 INR(PT)-0.9 [**2185-7-24**] 01:30AM BLOOD Glucose-93 UreaN-15 Creat-2.5*# Na-149* K-4.1 Cl-103 HCO3-28 AnGap-22* [**2185-7-24**] 01:30AM BLOOD ALT-33 AST-110* AlkPhos-77 TotBili-0.3 [**2185-7-24**] 01:30AM BLOOD Albumin-4.8 [**2185-7-24**] 06:13AM BLOOD Calcium-7.6* Phos-5.0* Mg-2.3 [**2185-7-24**] 09:50AM BLOOD D-Dimer-360 [**2185-7-24**] 01:30AM BLOOD ASA-NEG Ethanol-98* Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG [**2185-7-25**] 04:21AM BLOOD Type-[**Last Name (un) **] pH-7.37 Comment-GREEN TOP [**2185-7-24**] 02:41AM BLOOD Lactate-4.4* [**2185-7-24**] 05:20AM BLOOD Lactate-2.4* [**2185-7-24**] 01:15AM URINE bnzodzp-NEG barbitr-NEG opiates-POS cocaine-POS amphetm-NEG mthdone-NEG [**2185-7-24**] 01:15AM URINE Blood-MOD Nitrite-NEG Protein-30 Glucose-NEG Ketone-TR Bilirub-NEG Urobiln-NEG pH-6.5 Leuks-NEG [**2185-7-26**] 06:20AM BLOOD VitB12-1326* Folate-13.0 EKG ADMISSION: Sinus rhythm. Prolonged Q-T interval. Poor R wave progression in the anterior precordial leads. Inferior and anterior T wave changes suggest myocardial ischemia. No previous tracing available for comparison. TTE: IMPRESSION: Normal biventricular cavity sizes with preserved global and regional biventricular systolic function. Mild mitral regurgitation with normal valve morphology. EGD: normal esophagus, stomach, duodenum DISCHARGE LABS [**2185-7-27**] 06:10AM BLOOD WBC-4.6 RBC-3.85* Hgb-13.3 Hct-38.0 MCV-99* MCH-34.7* MCHC-35.1* RDW-12.5 Plt Ct-229 [**2185-7-27**] 06:10AM BLOOD Glucose-86 UreaN-9 Creat-1.2* Na-139 K-4.2 Cl-95* HCO3-34* AnGap-14 [**2185-7-26**] 06:20AM BLOOD ALT-45* AST-86* AlkPhos-69 [**2185-7-27**] 06:10AM BLOOD Calcium-9.5 Phos-4.3 Mg-2.1 Brief Hospital Course: 43 y/o F with history of hepatitis C and polysubstance abuse who presents with altered mental status in setting of opioid intoxication found to have coffee ground emesis concerning for upper GI bleed. . ACTIVE ISSUES: 1. GI Bleed: Patient presented with coffee ground emesis c/w upper GI source, however NG lavage did not show active bleed. Pt was admitted to MICU and serial Hct's were stable. She had no further melena or hematemesis. Pt was given IV PPI [**Hospital1 **]. GI was consulted and deferred EGD while in the unit given that pt appeared tremulous and was possibly withdrawing from EtOH. When the patient was transferred to the floor, GI performed an EGD which showed a normal esophagus, stomach and duodenum. There was no evidence of varices. Her bleeding was thought to be secondary to gastritis or from trauma due to retching. No further interventions needed. 2. Overdose/Polysubstance abuse/Altered Mental Status: Patient apparently used cocaine and heroin prior to arrival to ED which caused somnolence. She responded to narcan and was mentating well on arrival to MICU. Last drink was day before admission and pt with unclear h/o withdrawal but appeared tremulous on MICU admission. She was kept on CIWA scale, SW was consulted, and she was given a banana bag. Patient was stable but somnolent on transfer to the floor. While on the floor she required no Valium for CIWA scale. Social work offered patient substance abuse treatment resources and information but patient declined. She plans to return to AA and to see her psychiatrist. 3. Acute renal failure: Likely pre-renal. She was given 3L IVF's in the ED and Cr quickly trended down to normal. . # transaminitis - likely secondary to ETOH and chronic Hep C - trended down during admission . # macrocytic anemia - likely vitamin B12, folate deficiency from ETOH - HCTs stable during admission . # Hypernatremia: Initially 149 with free water deficit of 0.9L. Received a total 2L of NS and 1L D5 1/2NS. Responded to fluids and now resolved. . # Depression - continue Celexa, trazodone, risperdone, depakote TRANSITIONAL ISSUES Antihypertensive regimen was adjusted while in the hospital. This will likely need further titration after discharge. Medications on Admission: medications confirmed, doses however not - Citalopram 20 mg tablet, 1 tablet by mouth daily. - Divalproex 250 mg tablet delayed release, 1 tablet by mouth 3 times daily. - Risperidone 2 mg tablet, 1 tablet by mouth daily. - Trazodone 150 mg tablet, 1 tablet by mouth at bedtime. Discharge Medications: 1. amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 2. citalopram Oral 3. Depakote Oral 4. risperidone Oral 5. multivitamin Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* 6. folic acid 1 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* 7. trazodone Oral Discharge Disposition: Home Discharge Diagnosis: Primary diagnosis: Upper gastrointestinal bleed Secondary diagnosis: polysubstance abuse, hepatitis C, depression, hypertension Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Dear Ms [**Known lastname 9513**], It was a pleasure caring for you while you were in the hospital. You were admitted for altered mental status due to drug and alcohol use and concern for blood in your vomit. You were treated for alcohol withdrawal. The gastroenterology team also followed you while you were in the hospital. They performed an esophagogastroduodenoscopy which showed normal GI tract. After discharge you should continue to avoid drugs and alcohol. You should follow up with your primary providers at [**Hospital1 778**] health. The following medication changes have been made. You should START taking: amlodipine You should STOP taking: hydrochlorathiazide Followup Instructions: [**Hospital1 778**] Health ([**Telephone/Fax (1) 2776**] [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 3321**] NP Thursday [**2185-8-4**] at 11:00 am [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] MD [**MD Number(2) 6708**] Completed by:[**2185-8-1**] ICD9 Codes: 5789, 311, 4019
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Medical Text: Admission Date: [**2158-4-28**] Discharge Date: [**2158-5-2**] Date of Birth: [**2091-3-11**] Sex: M Service: MEDICINE Allergies: Penicillins / Fenofibrate / STEROIDS / Wellbutrin / lobsters / crabs Attending:[**First Name3 (LF) 4611**] Chief Complaint: confusion, altered mental status Major Surgical or Invasive Procedure: none this hospitalization History of Present Illness: 67 yo M with widely metastatic lung cancer since [**6-/2157**] including brain mets found [**2158-4-8**] presents today with increased confusion x 1 day. Patient was scheduled to receive final fraction of course of Whole Brain Radiation Therapy today. On Monday [**2158-4-24**] was started on a steroid taper-dose was decreased from Dexamethasone 4 MG PO twice a day down to once a day. Yesterday received first cycle of Pemetrexed. Wife states as part of chemo regimen on day before chemo (Wed); day of (Thurs) and plan is for today (Fri) was to take 4 MG PO Dexamethasone PO twice each day. States was instructed to resume Dexamethasone 4MG PO once a day tomorrow. Was noted in pre-treatment labs to have a lower Na level of 121 with Cl of 86 and decreased the amount of iv fluids that he received with chemo and advised fluid restriction to [**Telephone/Fax (1) 20571**] ml per day. He and his wife report that the headaches are improving, and that his gait originally improved, but is now worse again since yesterday. Wife reports that he was repeating routines and forgetful of habitual activities last night such as [**Location (un) 1131**] the psalm and seen trying to take his medications twice. She performed a minimental at home yesterday and he scored very poorly but now he is improved. They phoned his outpt provider who recommended [**Name9 (PRE) **] evaluation. Of note, pt has hx of hyponatremia attributed to SIADH from [**7-/2157**] resulting in discontinuation of diuretics. . ED course: initial vitals 98.8 71 164/85 14 100%. No fluids given in ED. Initial labs showed WBC 7.7, Hct 37.4, plt 149, coag wnl, Na 119, lactate 0.7. Blood cultures sent. Neuro exam felt to be non-focal. Pt admitted to [**Hospital Unit Name 153**] for management of hyponatremia. Outpt oncologist/[**Doctor Last Name 3274**] was emailed. . On arrival to the ICU pt is [**Name (NI) **]3 and feels well. He denies nausea/vomiting, anorexia, fever/chills or urinary complaints. Had headache and visual changes for the last few weeks with intermittent confusion per wife. Confusion was worse over last couple days. Pt reduced fluid consumption after chemo appt yesterday. Currently wife and pt feel he is at baseline. . Review of systems: (+) Per HPI (-) Denies fever, chills, night sweats, recent weight loss or gain. Denies headache, sinus tenderness, rhinorrhea or congestion. Denies cough, shortness of breath, or wheezing. Denies chest pain, chest pressure, palpitations, or weakness. Denies nausea, vomiting, diarrhea, constipation, abdominal pain, or changes in bowel habits. Denies dysuria, frequency, or urgency. Denies arthralgias or myalgias. Denies rashes or skin changes. Past Medical History: Stage IV Adenocarcinoma lung (KRAS wild-type;EGFR negative; ALK rearrangement unknown) Oncologic history: - [**6-/2157**] - Imaging of the back for severe back pain revealed metastatic vertebral lesions - [**7-/2157**] - Biopsy of L2 lesion consistent with metastatic carcinoma positive for CK7 and TTF-1. - Staging scans revealed primary lesion in the right lower lobe and right hilum with mediastinal lymphadenopathy, lung lesion in the left lower lobe, liver lesion, left adrenal lesion, and multiple bone lesions. No brain lesions. - [**2157-8-11**] - Carboplatin (6 AUC)/Paclitaxel (200 mg/m2)/Bevacizumab (15 mg/kg) initiated (C1D1) - [**2157-9-1**] - C2D1 [**Doctor Last Name **]/Taxol/Bevacizumab - [**2157-9-16**] - Palliative radiotherapy to lumbosacral vertebrae. - [**2157-9-22**] - C3D1 [**Doctor Last Name **]/Taxol (Bevacizumab held as patient receiving radiation treatment) - [**2157-10-13**] - C4D1 [**Doctor Last Name **]/Taxol/Bevacizumab - [**2157-11-3**] - C5D1 [**Doctor Last Name **]/Taxol/Bevacizumab - [**2157-11-24**] - [**2158-3-9**] C1-6 Maintenance Bevacizumab (15 mg/kg) - [**4-/2158**] - MRI brain revealed metastatic lesions to the brain. Presented with gait changes and headaches. - [**2158-4-13**] - whole brain radiation, completed 10 cycles. Also with dexamethasone PO . Other medical history: 1) Hypertension 2) Hyperlipidemia 3) Vitamin D deficiency 4) Bronchial asthma 5) Allergic rhinitis/sinusitis 6) Monoclonal gammopathy Social History: Social History: He has a 15 pack year smoking history and currently smokes 6 cig/day. He usually drinks [**2-13**] glasses of wine with dinner. He has 2 grown sons who live in [**Name (NI) 583**]. He is widowed and remarried 3 years ago. He works as a plasma physicist. Family History: Family History: His mother died at the age of eight nine of unknown causes. His father died at the age of 81 of emphysema. He has a sister who is 57 years old and is well. Physical Exam: Admission Physical Exam: . Vitals 97.1 138/86 73 13 98/RA General: Alert, oriented, elderly male in no acute distress HEENT: PERRL, EOMI, Sclera anicteric, MMM, oropharynx clear Neck: supple, JVP not elevated, no LAD Lungs: Clear to auscultation bilaterally, no wheezes, rales, rhonchi CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly GU: no foley Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Neuro: AOx3, strength intact b/l, reflexes 2+ b/l upper/lower ext, downgoing plantar reflexes, gait deferred, CN II-XII grossly intact, finger to nose intact . Discharge Exam: Vitals: T 96.7 BP 110s-130s/60s-80s HR 60s-80s RR 18 O2 sat 97% RA General: Alert, oriented, elderly male in no acute distress HEENT: Sclera anicteric, EOMI, MMM, oropharynx clear Neck: supple, JVP not elevated, no LAD Lungs: Clear to auscultation bilaterally, no wheezes, rales, rhonchi CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Neuro: AOx3 CN II-XII intact, 5/5 strength, intact finger to nose, gait deferred Pertinent Results: ADMISSION LABS: . [**2158-4-27**] 08:50AM BLOOD WBC-10.3 RBC-4.13* Hgb-13.3* Hct-39.7* MCV-96 MCH-32.2* MCHC-33.5 RDW-13.5 Plt Ct-183 [**2158-4-27**] 08:50AM BLOOD Neuts-84.3* Lymphs-8.5* Monos-6.2 Eos-0.7 Baso-0.2 [**2158-4-28**] 11:00AM BLOOD PT-9.7 PTT-27.7 INR(PT)-0.9 [**2158-4-27**] 08:50AM BLOOD UreaN-13 Creat-0.6 Na-121* K-4.3 Cl-86* HCO3-29 AnGap-10 [**2158-4-27**] 08:50AM BLOOD ALT-36 AST-26 AlkPhos-49 TotBili-0.5 [**2158-4-27**] 08:50AM BLOOD TotProt-6.4 Albumin-4.3 Globuln-2.1 Calcium-9.1 Phos-2.8 Mg-2.1 [**2158-4-28**] 11:00AM BLOOD Osmolal-249* [**2158-4-28**] 03:21PM BLOOD TSH-0.67 [**2158-4-27**] 08:50AM BLOOD CEA-3.2 [**2158-4-28**] 11:00AM BLOOD ASA-NEG Ethanol-NEG Acetmnp-7* Bnzodzp-NEG Barbitr-NEG Tricycl-NEG [**2158-4-28**] 11:12AM BLOOD Lactate-0.7 . DISCHARGE LABS: [**2158-5-2**] 06:25AM BLOOD Glucose-102* UreaN-16 Creat-0.6 Na-130* K-4.8 Cl-97 HCO3-27 AnGap-11 [**2158-5-2**] 06:25AM BLOOD WBC-7.3 RBC-4.00* Hgb-12.4* Hct-38.3* MCV-96 MCH-30.9 MCHC-32.4 RDW-13.5 Plt Ct-140* . MICROBIOLOGIC DATA: . [**2158-4-27**] Monospot testing - negative [**2158-4-28**] MRSA screen - pending [**2158-4-28**] Blood culture - pending [**2158-4-28**] Urine legionella - negative [**2158-4-28**] Influenza culture - pending [**2158-4-28**] Respiratory viral culture - pending [**2158-4-28**] Sputum culture - contaminated; PCP immunostain [**Name Initial (PRE) **] pending [**2158-4-28**] Urine culture - negative [**2158-4-29**] HIV viral load PCR - pending . [**2158-4-28**] 2D-ECHO - The left atrium is normal in size. No atrial septal defect is seen by 2D or color Doppler. The estimated right atrial pressure is 0-5 mmHg. Left ventricular wall thickness, cavity size and regional/global systolic function are normal (LVEF >55%). There is no ventricular septal defect. Right ventricular chamber size and free wall motion are normal. The 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. The main pulmonary artery is dilated. There is no pericardial effusion. . [**2158-4-28**] CHEST (PORTABLE AP) - As compared to the previous radiograph, there is no relevant change. No evidence of pneumonia. No pulmonary edema. No pleural effusions. Normal size of the cardiac silhouette. CT HEAD W/O CONTRAST Study Date of [**2158-4-28**] 11:41 AM IMPRESSION: Extensive metastatic disease without evidence of acute hemorrhage, edema, or mass effect. Brief Hospital Course: 67y M w h/o metastatic lung ca s/p 9/10 sessions total brain irradiation presenting with acute confusion/MS changes and hyponatremia. . # Hyponatremia: Given acute MS changes would presume acute Na decrease from baseline however on arrival to ICU pt and wife confirmed return to baseline wo intervention. He had started fluid restricting the day prior after his clinic appt. Serum Osm 249. Likely SIADH related to brain mets given hyponatremia and hypochloremia but differential would include hypervolemic and hypovolemic states but exam is not clinically consistent with either. Low suspicion for adrenal insufficiency given normal adrenal findings 1 year ago on CT and normotensive. FeNA 1.7%. TSH was wnl. He was monitored overnight in the ICU and remained clinically stable. Serial Na levels showed improvement with fluid restriction to 1000cc daily and the addition of salt tabs twice per day. At time of discharge his sodium level was 130. . # Mental status changes: He presented with 2 days of waxing/[**Doctor Last Name 688**] quality of mental status. CT head negative for findings to explain MS changes. Chest xray and cultures were NGTD as part of infectious etiology for confusion. Neurology exams remained nonfocal. His mental status improved as his sodium levels improved as well. . # Brain metastases: Has been on outpt course of TBI for recently diagnosed mets 02/[**2158**]. CT head on presentation negative for edema or midline shifts. He was continued on dexamethasone 4mg daily per outpt plan. He completed his last dose of whole brain radiation during this hospitalization. . # Lung ca: Dx'd [**6-/2157**] s/p most recent chemo treatment with Pemetrexed on [**2158-4-27**]. He follows up with Dr. [**Last Name (STitle) 3274**] as an out patient. . # HTN: continued home dose amlodipine and ASA. # HL: continued home dose rosuvastatin . TRANSITION OF CARE ISSUES: 1. Pt has a follow up appointment with Dr. [**Last Name (STitle) 3274**] two days post discharge. His sodium level should be repeated at that time. The pt should also be given further guidance about whether to continue the salt tabs at that time as well. Medications on Admission: AMLODIPINE 5 mg daily CLONAZEPAM 1-2 mg qhs DEXAMETHASONE 4 mg [**Hospital1 **] (will change to daily [**2158-4-24**]) FLUTICASONE nasal spray [**Hospital1 **] HYDROMORPHONE 2 mg po q4h prn IPRATROPIUM-ALBUTEROL nebs prn OMEPRAZOLE 20 mg daily PROCHLORPERAZINE 190 mg q6h ROSUVASTATIN 40 mg qhs SILDENAFIL prn ACETAMINOPHEN prn ASCORBIC ACID 500 mg [**Hospital1 **] ASPIRIN 81 mg daily CHOLECALCIFEROL 8000 u daily loratidine NICOTINE patch OMEGA-3 miralax prn SENNOSIDES 1-2 tabs qhs Discharge Medications: 1. amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. clonazepam 1 mg Tablet Sig: 1-2 Tablets PO QHS (once a day (at bedtime)) as needed for anxiety. 3. dexamethasone 4 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. fluticasone 50 mcg/actuation Spray, Suspension Sig: Two (2) Spray Nasal DAILY (Daily). 5. hydromorphone 2 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for pain. 6. ipratropium-albuterol 0.5 mg-3 mg(2.5 mg base)/3 mL Solution for Nebulization Sig: One (1) nebulizer Inhalation every [**5-19**] hours as needed for shortness of breath or wheezing. 7. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 8. prochlorperazine maleate 10 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for nausea. 9. rosuvastatin 20 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime). 10. sildenafil 50 mg Tablet Sig: One (1) Tablet PO as needed : take 1 hr before sexual activity. 11. acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for pain. 12. ascorbic acid 500 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 13. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 14. cholecalciferol (vitamin D3) 1,000 unit Tablet Sig: Two (2) Tablet PO four times a day. 15. loratadine 10 mg Tablet Sig: One (1) Tablet PO once a day as needed for allergy symptoms. 16. nicotine 14 mg/24 hr Patch 24 hr Sig: One (1) Patch 24 hr Transdermal DAILY (Daily). 17. Omega 3 350-400 mg Capsule Sig: One (1) Capsule PO once a day. 18. polyethylene glycol 3350 17 gram Powder in Packet Sig: One (1) Powder in Packet PO DAILY (Daily) as needed for constipation. 19. senna 8.6 mg Tablet Sig: 1-2 Tablets PO at bedtime as needed for Constipation. 20. sodium chloride 1 gram Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Hyponatremia Stage IV Adenocarcinoma lung Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Mr. [**Known lastname 103023**], It was a pleasure taking care of you at [**Hospital1 827**]. You were admitted to the hospital with low blood sodium levels. We restricted your fluid intake and supplemented your diet with salt. These treatments have caused your sodium level to rise. It is important that you continue to restrict your fluid intake to no more than 1.5L per day until instructed by your doctor not to do so. The following changes have been made to your medications: START: Sodium Chloride Tabs twice per day until instructed by a physician to stop Please see below for follow up appointments that have been made for you. Followup Instructions: Department: HEMATOLOGY/ONCOLOGY When: THURSDAY [**2158-5-4**] at 10:00 AM With: [**First Name8 (NamePattern2) 251**] [**Name8 (MD) **], MD [**0-0-**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 24**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: HEMATOLOGY/ONCOLOGY When: THURSDAY [**2158-5-4**] at 10:00 AM With: DR. [**Last Name (STitle) **] [**Name (STitle) **] [**Telephone/Fax (1) 22**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 24**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: HEMATOLOGY/ONCOLOGY When: THURSDAY [**2158-5-18**] at 9:30 AM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 21833**], MD [**0-0-**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 24**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage ICD9 Codes: 2930, 4019, 2724, 3051
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Medical Text: Admission Date: [**2189-8-31**] Discharge Date: [**2189-10-23**] Date of Birth: [**2150-9-4**] Sex: M Service: NEUROSURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2724**] Chief Complaint: s/p fall ~ 30 feet Major Surgical or Invasive Procedure: T5-T11 posterior fusion with CSF leak repair Lumbar drain History of Present Illness: 38 year old male portugese speaking s/p fall ~30 feet landed on stomach. No LOC at scene- Unable to move feet, loss of LE sensation/+step-offs. Past Medical History: None Social History: Nonsmoker, family lives in [**Location 4194**] Family History: None Physical Exam: PHYSICAL EXAM upon admission: Gen: AOx3, NAD HEENT: multiple facial lacerations, right periorbital ecchymosis Pupils: 3>2 bilateral EOMs full and intact Neck: in cervical collar Lungs: not examined Cardiac: not examined Abd: not examined 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 0 0 0 0 0 0 L 5 5 5 5 5 0 0 0 0 0 0 Sensation: Intact to light touch in upper extremities and on trunk superior to xiphoid process bilaterally, no sensation to light touch on trunk distal to xiphoid process and in lower extremities bilaterally. Rectal Tone: reported intact by General Surgery Trauma service on their exam Reflexes: B T Br Pa Ac Right 1+ 1+ 1+ absent Left 1+ 1+ 1+ absent Toes neutral on Babinski, no clonus Exam upon discharge: [**6-2**] UE 0/5 LE no sensation T8 distal wound well healed Pertinent Results: [**2189-8-31**] 08:59AM WBC-9.2 RBC-5.26 HGB-15.4 HCT-43.8 MCV-83 MCH-29.3 MCHC-35.1* RDW-14.5 [**2189-8-31**] 08:59AM PLT COUNT-236 [**2189-8-31**] 08:59AM PT-13.2 PTT-21.2* INR(PT)-1.1 [**2189-8-31**] 08:59AM FIBRINOGE-378 [**2189-8-31**] 08:59AM ASA-NEG ETHANOL-NEG ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**2189-8-31**] 09:14AM GLUCOSE-147* LACTATE-3.0* NA+-142 K+-3.6 CL--100 TCO2-25 [**2189-8-31**] 09:25AM URINE BLOOD-NEG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-NEG [**2189-8-31**] 09:25AM URINE COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.006 CT C-spine [**8-31**]: IMPRESSION: 1. No acute fracture or malalignment involving the cervical spine. 2. Old T1 spinous process. 3. Biapical lung scarring, likely sequelae of prior TB/granulomatous exposure. CT CAP [**8-31**]: IMPRESSION: 1. Comminuted vertebral fracture at T8 with retropulsion of multiple bony fragments into the central spinal canal concerning for transection. There is associated paravertebral hematoma. 2. Posterior mediastinal hematoma adjacent to the distal esophagus and descending aorta which may reflect tracking of hematoma from paraspinal hematoma. Howevre, esophageal injury cannot be entirely excluded. Recommend correlation with esophagram if needed. No definite evidence for aortic injury, though follow-up recommended if there is clinical concern given the hematoma adjacent to the descending thoracic aorta at the level of the spinal fractures. 3. Retrosternal hematoma along the anterior aspect of the heart without identifiable sternal fracture. Findings may be secondary to blunt trauma and cardiac contusion cannot be excluded. Clinical correlation is advised. 4. Biapical lung scarring suggestive of prior TB with areas of ground-glass opacity in the peripheral aspect of the right middle lobe, unclear etiology, may reflect chronic interstitial lung disease, less likely contusion. 5. Multiple rib fractures, multiple transverse process fractures. CT sinus/mandible [**8-31**]: IMPRESSION: 1. Right lamina papyracea fracture with small extraconal hematoma and air locules in the medial right orbit. 2. Right nasal bone fracture. 3. Pansinus mucosal thickening. 4. No other fractures identified. 5. Mucosal thickening involving the paranasal sinuses. Recommend clinical correlation for sinusitis. MRI T-spine [**2189-8-31**]: IMPRESSION: 1. Acute compression fracture of the T8 vertebral body with Grade II anterolisthesis of T7 on T8 and retropulsion of fracture fragments posteriorly and superiorly causing severe spinal cord compression and possible spinal cord transection. Additional punctate T2 hyperintense focus within the spinal cord at T10 may represent a small post traumatic syrinx. 2. Large prevertebral soft tissue hematoma. 3. Large bilateral pleural effusions with a probable right hemothorax. Cardiology Report ECG [**2189-9-1**] 10:59:58 AM Sinus rhythm. No diagnostic abnormalities. No previous tracing available for comparison. Intervals Axes Rate PR QRS QT/QTc P QRS T 97 116 80 [**Telephone/Fax (2) 82810**] 44 [**9-6**] CXR: FINDINGS: Interval surgery for thoracic spine fracture with [**Location (un) 931**] rods in place. Cardiomediastinal contours are within normal limits. Moderate layering right pleural effusion with adjacent retrocardiac opacity, probably atelectasis, although infection is not excluded. Nonspecific fibronodular opacities at the lung apices, potentially due to scarring, although active disease is not excluded without older studies for comparison. Several rib fractures are demonstrated and seen to better detail on recent CT of [**2189-8-31**]. LENI [**9-7**] IMPRESSION: No evidence of deep vein thrombosis of the right or left lower extremity. thoracic spine xrays [**9-8**]: FINDINGS: There is again seen a burst fracture involving the T8 vertebral body with loss of approximately 40% of the anterior height. There is again seen anterolisthesis of T7 over T8, but the alignment is improved since the initial study. There is a posterior stabilizing hardware spanning T5 to T12 with pedicle screws within the T5, T7, T10, T11, and T12. There are no signs of hardware-related complications. Abdominal US [**9-8**] IMPRESSION: Sludge in gallbladder without other signs of cholecystitis. [**Doctor Last Name 515**] sign is negative. No specific US signs of acute cholecystitis. CXR [**9-8**] IMPRESSION: AP chest compared to [**9-6**]: Lateral aspect of the right lower chest is excluded from the examination. The imaged pleural surfaces are normal. The region of chronic right lower costal pleural thickening is not examined. Lungs are grossly clear. Heart size normal. Spinal stabilization device and skin staples project over the thoracic and upper lumbar spine. Stomach is at least moderately distended with air. Abdomen [**9-9**] No evidence of ileus, obstruction or fecal impaction seen. R wrist [**9-9**] IMPRESSION: No evidence of fracture. Normal right wrist. Brief Hospital Course: Patient is a 38 year old Protugese speaking male s/p fall ~30 feet landed on stomach. No LOC noted at sceen. Patient was found to have comminuted vertebral fracture at T8 with retropulsion of multiple bony fragments into the central spinal canal with cord transection demonstrated. Neurosurgery was consulted in the trauma unit. The patient was admitted to the TICU and stabilized. Upon clearance of the C-spine the patients c-collar was removed. The patient was then transfered to the floor and on [**9-2**] the patient was taken to the operating room with Neurosurgery for repair of his injuries and was transfered to the Neurosurgery service for continued care.He underwent posterior instrumented fusion T5-11 with repair of dura, right iliac crest bone harvest and placement of lumbar drain all done under general anesthesia. There was estimated 1 liter of blood loss during the procedure and the patient recieved 2 units of packed red blood cells in the OR. He tolerated this proceure well, was extubated in TICU. Lumbar drain was functioning and drained 5-10cc/hr. Diet was advanced, medication changed to PO. He was transferred to the floor on [**9-3**]. His activity was advanced with help of PT and [**Doctor Last Name 2598**] lift, he tolerated being upright. The patient had fevers beginning on [**9-3**] and again on [**9-6**] with workup all being negative(CXR, cultures,abdominal US,LENIs) though this was during time he was being covered with ancef while lumbar drain was in place. The lumbar drain was clamped on [**9-7**]. Lumbar drain was removed [**9-8**] with wound being dry. Good placement of operative hardware noted on thoracic Xray. ID consult was obtained but pt remained afebrile after lumbar drain removed and ancef stopped. He was also begun on bowel regimen and remained with foley. Urine cultures showed no growth. Blood and CSF cultures were all negative.Wound was clean and dry. He required enemas and suppositories for bowels, had foley for bladder. On [**9-9**], the patient developed right wrist pain. The wrist xray was negative for fracture. He experienced reported chest pain and his EKG was negative. His abdomen was distended and a KUB xray was performed which showed no ileus or obstruction or fecal impaction. [**9-10**] stool was sent for C-Diff which was negative. The patient continues to be seen by Rehab medicine during his hospital stay. On [**9-17**] he had some mild dehiscence of the upper 1/3rd of his incision. There was scant drainage. Wound care consult was requested. The wound adequately healed in time. On [**9-18**] he was instructed how to straight cath himself. On [**9-19**] he was found to have mild diabetes, diet controlled and also started on emycin for conjuctivitis. On [**9-24**] he received wrist brace for transfer. On [**2189-10-19**] he was found to have foul smelling urine with negative urinalysis but culture showing MSSA and he was started on 7d course of cipro on [**2189-10-22**]. Weekly case management meetings have been taking place with the patient, his pastor, friends, the neurosurgery team, case management, Dr [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] and nursing throughout his prolonged hospital stay. The meetings have explored all options of rehab (he is unable to go to due to no insurance), medical shelters (denied due to no longer follow term care), going back to [**Country 4194**] and apartments in the local area. Dr [**Last Name (STitle) **] has set up free care at [**Hospital6 **] with a spinal cord specialist. Free medications have been set up through our free care pharmacy. A reconditioned wheelchair was obtain, a commode and a slider board, and cath equipment were all given to the patient. The patient is now proficient in self cath and bowel care. His PPD was read as negative for tuberculosis. He was discharged to apartment with community support on [**2189-10-23**]. Medications on Admission: None Discharge Medications: 1. Enoxaparin 30 mg/0.3 mL Syringe Sig: One (1) Subcutaneous Q12H (every 12 hours) for 2 weeks. Disp:*28 * Refills:*3* 2. Imipramine HCl 10 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). Disp:*30 Tablet(s)* Refills:*0* 3. Oxybutynin Chloride 5 mg Tablet Sig: One (1) Tablet PO TID (3 times a day) for 1 months. Disp:*90 Tablet(s)* Refills:*0* 4. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal QAM (once a day (in the morning)). Disp:*60 Suppository(s)* Refills:*2* 5. Senna 8.6 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime). Disp:*120 Tablet(s)* Refills:*2* 6. Acetaminophen 500 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for fever,pain. 7. Docusate Sodium 100 mg Capsule Sig: Two (2) Capsule PO BID (2 times a day) as needed for constipation. Disp:*120 Capsule(s)* Refills:*2* 8. Cipro 500 mg Tablet Sig: One (1) Tablet PO twice a day for 7 days. Disp:*14 Tablet(s)* Refills:*0* 9. Outpatient Physical Therapy s/p thoracic instrumented fusion please treat and evaluate Discharge Disposition: Home Discharge Diagnosis: spinal cord injury abdominal distention fever of unknown origin conjuctivitis Discharge Condition: stable,paraplegic Discharge Instructions: DISCHARGE INSTRUCTIONS FOR SPINE CASES * Do not smoke * Take pain medication as instructed; you may find it best if taken in the a.m. when you wake for morning stiffness and before bed for sleeping discomfort * Do not take any anti-inflammatory medications such as Motrin, Advil, aspirin, Ibuprofen etc. until after [**12-1**]. * Increase your intake of fluids and fiber as pain medicine (narcotics) can cause constipation * The following places are where you can get urinary catheters: [**Hospital 43292**] Medical Supply [**Telephone/Fax (1) 51271**] and [**Hospital3 **] Medical Supply [**Telephone/Fax (1) 82811**] CALL IMMEDIATELY IF YOU EXPERIENCE ANY OF THE FOLLOWING: ?????? Pain that is continually increasing or not relieved by pain medicine ?????? Fever greater than or equal to 101?????? F Followup Instructions: *The following clinic services free care patients. Please call and arrange for appointment to establish a primary care physician for general care: [**Location (un) 3786**] Family Medicine Center (part of the [**Hospital6 12736**]) [**Street Address(2) 82812**], [**Location (un) 3786**] MA [**Telephone/Fax (1) 25050**]. *Please follow up with Spinal Cord Injury Specialist [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 805**], MD, [**Telephone/Fax (1) 82813**], [**Last Name (NamePattern1) **] [**Location (un) 442**] [**Location (un) 20473**] Family Building at [**Hospital6 **] on [**10-30**] at 1:30 PM. *Follow up with Dr. [**Last Name (STitle) 548**] in 6 weeks, you will need xrays at this appt. Please call [**Telephone/Fax (1) 2992**] to schedule. Completed by:[**2189-10-23**] ICD9 Codes: 5990
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6650 }
Medical Text: Admission Date: [**2158-10-22**] Discharge Date: [**2158-10-28**] Date of Birth: [**2089-11-8**] Sex: F Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 1253**] Chief Complaint: Shortness of breath Major Surgical or Invasive Procedure: Central line placement and removal History of Present Illness: The patient is a 68 year-old female with history of bilateral breast cancer and metastatic kidney cancer, with extensive osseous and pulmonary metastases, who was discharged to NH from [**Hospital1 18**] on [**2158-10-19**] after an admission during which she was diagnosed with extensive bony metastasis, and was treated with T9-L1 posterior fusion for unstable T11 metastasis. Reportedly, she developed fever and was found to have decreased oxygen saturation to 80s at room air at the NH and some confusion and was transferred to the ED at [**Hospital1 18**]. She had denied chest pain, and reported mild sob. Denied abdominal pain, diarrhea, or dysuria. Denied calf pain. She had been minimally mobile at NH and was taking heparin SQ TID for DVT prophylaxis. Her VS in the ED were: 99.6 (Tm:101),124/91, 20, 96% 4L Nasal Cannula. A UA was abnormal. And she had an elevated WBC to 15. She had a head CT that did not show evidence of acute CVA. Unfortunately due to IV access issues (it could not be determined whether she had a power port), she could not obtain a CT chest with contrast to evaluate for PE. But was empirically treated with therapeutic dose of lovenox after a D-dimer was found to be mildly elevated. A chest CXR showed worsening pul edema, but given extensive lung mets, a consolidative process could not be ruled out. She was empirically started on vancomycin and cefepime for UTI as well as possible pneumonia, and admitted to the floor. Review of Systems: (+) Per HPI (-) Denies chills, night sweats, recent weight loss or gain. Denies blurry vision, diplopia, loss of vision, photophobia. Denies sinus tenderness, rhinorrhea or congestion. Denies chest pain or tightness, palpitations, lower extremity edema. Denies cough, or wheezes. Denies nausea, vomiting, diarrhea, constipation, abdominal pain, melena, hematemesis, hematochezia. Denies rashes or skin breakdown. No numbness/tingling in extremities. All other systems negative. Past Medical History: ONCOLOGIC HISTORY: [**2142-6-26**]: left nephrectomy for 11 cm clear cell renal cell carcinoma [**2155-3-15**]: diagnosted with bilateral breast cancer (node-positive on left, ER/PR positive, HER-2 negative). Treated with neoadjuvant dose-dense AC and weekly taxol ending [**2155-10-3**], bilateral mastectomy [**2155-12-25**] (after lumpectomy with positive margins), radiation ending [**3-22**]. On arimidex since completion of chemotherapy. [**2156-7-14**]: CT torso (done because of elevated alk phos) showed 1.5 and 0.6 cm left upper lobe nodules. [**2156-8-26**]: Left upper lobectomy showed two foci of clear cell renal cell carcinoma. [**2157-5-4**]: MRI of T/L spine with disease at T10, T11 vertebral bodies, soft tissues T10-T12, and L3 body. CT-guided biopsy consistent with renal cell carcinoma. Bone scan [**2157-4-18**] also showed involvement of several left ribs. Subsequently received XRT to thoracic spine. [**5-/2157**]: Began sunitinib; dose reduced over time to 25 mg because of toxicities. Sutent ended in [**2158-1-14**] because of disease progression. [**2158-2-7**]: MRI L-spine with T11 disease with persistent mass effect on thecal sac but no significant cord compression, and T9 and T10 disease, all likely unchanged. New T12 compression fracture. Significant progression of L3 vertebral body lesion with pathologic fracture and retropulsion of posterior cortex. [**2158-2-13**]: CT torso with interval marked progression of innumerable pulmonary mets since [**2157-8-2**]. Destructive lytic lesion within left femoral head. [**2158-2-14**]: XRT to lumbar spine [**2158-4-12**]: signed consent for 08-184 trial of avastin and temsirolimus. CT torso showed osseous mets in spine and left ibs, with interva lincrease in size in soft tissue component at T11 encasing thecal sac, invading cord, and invading more than 50% of the spinal canal. At L3, compression fracture with soft tissue component extending into spinal canal. Increase in number and size of numerous pulmonary mets bilaterally. Destructive lytic lesion within left femoral head. [**2158-4-19**]: C1D1 08-184 (avastin/temsirolimus) [**2158-6-7**]: CT torso with significant decrease in size of bilateral pulmonary lesions and stable osseous disease with decrease in soft tissue mass at T11 - [**Date range (3) 10263**]: admitted for PNA, mental status changes, found to have frontal CVA, taken off study - [**2158-8-9**] CT TORSO: stable disease Other Past Med Hx: - Hypertension - Breast Cancer s/p resection - gout Social History: She lives with her 3 sons who assist with her medical care. She used to work at [**Hospital3 2568**] in the GI division. She is a non-smoker, no alcohol or other drugs. Family History: Father had esophageal cancer. Her maternal grandmother had breast cancer in her 70s. Physical Exam: ADMISSION PHYSICAL EXAM: Vitals: T: 100.4 BP: 132/81 P: 111 R: 28 O2: 100% on 4L NC General: Drowsy, confused but orientable, mild respiratory distress HEENT: Sclera anicteric, MMM, oropharynx clear Neck: supple, JVP not elevated, no LAD, exam limited by body habitus Lungs: Clear to auscultation bilaterally, no wheezes, rales, ronchi, mildly decreased air entry. CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops Abdomen: soft, non-tender, non-distended, +Obesity, bowel sounds present, no rebound tenderness or guarding, no organomegaly GU: foley in place, draining yellow urine. Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema DISCHARGE PHYSICAL EXAM: Vitals: 96.0 100-140/70-90 90-100 18-22 93-96%RA, requiring some O2 at night General: Awake and oriented but anxious appearing HEENT: Sclera anicteric, MMM, oropharynx clear Neck: supple, JVP difficult to interpret, no LAD, exam limited by body habitus Lungs: Clear to auscultation bilaterally except for mild anterior wheezes (unable to get full posterior lung exam due to pain) and some bibasilar crackles CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops Abdomen: Soft, non-tender, obese, bowel sounds present, no rebound tenderness or guarding, no organomegaly GU: Foley in place, draining yellow urine Ext: Warm, well perfused with 2+ nonpitting edema on all four extremities, LUE>RUE Pertinent Results: ADMISSION LABS [**2158-10-22**] 05:05PM WBC-15.7*# RBC-3.09* HGB-9.2* HCT-28.1* MCV-91 MCH-29.8 MCHC-32.9 RDW-16.6* [**2158-10-22**] 05:05PM NEUTS-96.5* LYMPHS-1.6* MONOS-1.5* EOS-0.3 BASOS-0.1 [**2158-10-22**] 05:05PM PLT COUNT-263 [**2158-10-22**] 05:05PM PT-15.0* PTT-50.1* INR(PT)-1.3* [**2158-10-22**] 05:05PM GLUCOSE-100 UREA N-12 CREAT-0.9 SODIUM-136 POTASSIUM-3.8 CHLORIDE-101 TOTAL CO2-25 ANION GAP-14 [**2158-10-22**] 05:38PM LACTATE-2.0 [**2158-10-22**] 08:43PM D-DIMER-2523* [**2158-10-22**] 06:15PM URINE BLOOD-SM NITRITE-NEG PROTEIN-100 GLUCOSE-NEG KETONE-TR BILIRUBIN-SM UROBILNGN-8* PH-5.5 LEUK-LG [**2158-10-22**] 06:15PM URINE RBC-14* WBC-173* BACTERIA-MOD YEAST-NONE EPI-2 TRANS EPI-1 [**2158-10-22**] 06:15PM URINE COLOR-AMBER APPEAR-Hazy SP [**Last Name (un) 155**]-1.030 DISCHARGE AND OTHER PERTINENT LABS: [**2158-10-25**] 04:34AM BLOOD WBC-8.6 RBC-2.94* Hgb-8.7* Hct-27.1* MCV-92 MCH-29.6 MCHC-32.1 RDW-16.5* Plt Ct-281 [**2158-10-25**] 04:34AM BLOOD PT-14.7* PTT-38.7* INR(PT)-1.3* [**2158-10-24**] 12:29PM BLOOD ESR-81* [**2158-10-24**] 04:09AM BLOOD Ret Aut-2.3 [**2158-10-25**] 04:34AM BLOOD Glucose-94 UreaN-14 Creat-0.7 Na-136 K-4.0 Cl-105 HCO3-21* AnGap-14 [**2158-10-24**] 04:09AM BLOOD LD(LDH)-226 TotBili-0.5 [**2158-10-25**] 04:34AM BLOOD TotProt-PND Calcium-7.0* Phos-2.0* Mg-2.0 [**2158-10-24**] 04:09AM BLOOD Hapto-348* [**2158-10-25**] 04:34AM BLOOD TSH-PND [**2158-10-24**] 04:09AM BLOOD Cortsol-19.5 [**2158-10-24**] 04:09AM BLOOD CRP-GREATER TH [**2158-10-23**] 08:41AM BLOOD Lactate-1.4 [**2158-10-22**] CXR: UPRIGHT FRONTAL CHEST RADIOGRAPH: A right-sided catheter terminates within the right atrium. Spinal fusion hardware in the mid thoracic region is unchanged in position. Multiple left upper quadrant surgical clips are present. Again seen are innumerable pulmonary nodules, compatible with known history of metastatic disease. Since the [**2158-10-13**] examination, there has been interval increase in pulmonary vascular congestion and mild underlying pulmonary edema is present. Small bilateral pleural effusions are present. There is no pneumothorax. [**2158-10-22**] CT Head w/o contrast: No acute intracranial process or evidence. No evidence of metastatic disease, though please note MRI is more sensitive. [**2158-10-23**] CTA Chest: 1. No pulmonary embolism or acute aortic pathology. 2. Ground-glass opacification in the right middle lobe likely reflects infectious process with new right greater than left small-to-moderate pleural effusions. 3. Innumerable pulmonary metastases, many of which are increased in size. Unchanged left sixth rib, left pectoral and T11 vertebral body metastases with interval vertebral fusion, which is incompletely characterized. [**2158-10-23**] LLE US: 1. No left lower extremity DVT above the knee. 2. Diffuse subcutaneous edema. [**2158-10-23**] LUE US: 1. No left upper extremity DVT. 2. Diffuse subcutaneous edema. [**2158-10-24**] TTE: The left atrium is normal in size. Left ventricular wall thicknesses are normal. The left ventricular cavity size is normal. Overall left ventricular systolic function is normal (LVEF>55%). Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets (3) are mildly thickened. Trace aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. An eccentric, laterally directed jet of at least mild to moderate ([**1-15**]+) mitral regurgitation is seen (likely moderate 2+). The tricuspid valve leaflets are mildly thickened. There is mild pulmonary artery systolic hypertension. There is no pericardial effusion. [**2158-10-24**]: MRI T/L spine: Metastatic disease to L3 vertebral body is again identified and unchanged. Indentation on the thecal sac and moderate spinal stenosis is also seen at this level. Fluid collection is identified in the upper lumbar posterior soft tissues at L1 level measuring 3 x 2.5 cm which likely is postoperative in nature, but MRI appearances alone cannot help in excluding infection in this postoperative collection and clinical correlation is recommended. [**2158-10-26**]: CT T/L spine: 1. No evidence of retroperitoneal fluid collection, however, a large fluid collection in the subcutaneous fat posterior to the paraspinal region extending from L2-T10, larger than on MR from 2 days prior. In order to visualize if this is a CSF leak, a CT myelogram would be a more appropriate study. 2. L3 compression fracture secondary to metastatic disease. Lytic lesion within the posterior rib at the T8 vertebral level. 3. Multiple pulmonary metastatic nodules. Bilateral pleural fluid, right greater left. 4. Cholelithiasis. 5. Possible kink in the centralv enous catheter on the scout, unchanged from prior CTA Chest - d/w RN taking care of pt by Dr.[**Last Name (STitle) **] on [**2158-10-27**]. PENDING STUDIES: - Pleural fluid cytology - TSH - Pleural fluid beta2-transferrin and protein electropheresis - [**10-22**] Blood cultures pending, no growth to date - [**10-26**] Pleural fluid culture, no growth to date Brief Hospital Course: 68 year-old female with history of bilateral breast cancer and metastatic kidney cancer with extensive osseous and pulmonary metastases who was discharged to NH from [**Hospital1 18**] on [**2158-10-19**] after an admission during which she was diagnosed with extensive bony metastasis, and was treated with T9-L1 posterior fusion for unstable T11 metastasis. On this admission, she presented with fevers, confusion, hypoxia and felt to have sepsis due to UTI. #. Hypotension: She was admitted with hypotension that was fluid responsive. It was ultimately felt to be sepsis due to UTI. She did not require pressors. She was ruled out for PE. AM cortisol was 19.5. TTE was unremarkable. She was initially treated with vancomycin and cefepime which was narrowed to cipro and then changed to bactrim. #. Hypoxia: She has extensive pulmonary disease as evidenced by her CXR and CTA. No evidence of PE as above. She had the new development of pleural effusions felt to be either related to her spinal wound drainage or the fluid resuscitation in the ICU. She responded well to one dose of lasix but further doses were deferred as she was on room air most of the time and refused further labs draws. She also responded to nebulizers at times. # Urinary tract infection: Admission UA was consistent with infection. Urine culture grew E Coli and Klebsiella both sensitive to cipro and Bactrim. She was initially on broad spectrum antibiotics and then narrowed to cipro. There was some concern for delirium induced by cipro and her antibiotics were changed to bactrim. She is being discharged with a chronic foley. #. Wound drainage s/p Spinal Fusion: She recently had spinal fusion on [**2158-10-11**] and her wound drained a large amount of serous fluid during her admission. Her orthopedics team followed her wound and consulted neurosurgery. She had multiple imaging studies that showed a fluid collection around the wound. There was concern that her new pleural effusions may be related to leakage of CSF. Therefore, she underwent thoracentesis to sample the fluid. Beta2 transferrin and PEP are pending at the time of discharge, which will help determine if the pleural fluid is CSF. The neurosurgery team will follow-up these studies as an outpatient and decide if a lumbar drain is needed. She has follow-up scheduled with neurosurgery. #. Metastatic renal cancer with mets: Patient was recently found to have extensive bony mets and has reportedly had difficulties controlling pain. Palliative care follwed during this admission for titration of pain control meds. #. Anemia: Likely anemia of chronic disease secondary to underlying cancer. Received 1 unit pRBC on [**2158-10-24**] with good response. Hemolysis labs were unremarkable. # HTN: Valsartan was held given episode of hypotension that responded well to fluid boluses. It can be restarted after discharge. #. Port-a-cath blockage: She had difficulty with blood return from her port. She refused a chest film to confirm patency of indwelling chest port. There was also some concern that the line was kinked on her CT chest. Her line was given TPA in an attempt to clog it. Blood return was achieved and line was patent on DC. #. Delirium/Anxiety: She was mildly delirious during her admission with difficulty with attention. This is likely related to her ongoing medical issues, as well as pain. She responded well to olanzapine 2.5mg po at night, and also was written for Ativan as needed. She continued to be anxious, requiring frequent reminders of her medical plan. #. Goals of care: The patient was refusing multiple procedures and studies during this admission. She was following by primary care and her primary oncologist. She expressed a desire to focus on comfort, but a full discussion of hospice was deferred until her delirium improves. She refused all labs and xrays over the last 1-2 days of her admission. TRANSITIONAL ISSUES: - Pending studies: TSH, blood culture, pleural fluid culture, cytology, beta2 transferrin and PEP - Needs neurosurgical/ortho-spine followup for her wound in 2 weeks. It has continued to drain serous fluid requiring multiple changes per day. Medications on Admission: - anastrozole 1 mg Tablet 1 Tablet(s) by mouth once a day (Not Taking as Prescribed: no prescription now so not taking) - levothyroxine 50 mcg Tablet 1 Tablet(s) by mouth once a day - lorazepam [Ativan] 0.5 mg Tablet [**1-15**] Tablet(s) by mouth three times a day as needed for anxiety - ondansetron 4 mg Tablet, Rapid Dissolve 1 Tablet(s) by mouth every 8 hours as needed for nausea - oxycodone 5 mg Tablet 1 Tablet(s) by mouth every 4 hours as needed for pain - oxycodone [OxyContin] 10 mg Tablet Extended Release 12 hr 2 Tablet(s) by mouth twice a day - prochlorperazine maleate 10 mg Tablet 1 Tablet(s) by mouth every six (6) hours as needed for nausea/vomiting - simvastatin 10 mg Tablet 1 Tablet(s) by mouth once a day - valsartan [Diovan] 160 mg Tablet 1 Tablet(s) by mouth once a day hold for bp < 110 - acetaminophen 325 mg Tablet 1 Tablet(s) by mouth every 6 hours (OTC) prn - aspirin 81 mg Tablet, Chewable 1 Tablet(s) by mouth daily - docusate sodium 100 mg Capsule 1 Capsule(s) by mouth Discharge Medications: 1. anastrozole 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. levothyroxine 50 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. lorazepam 0.5 mg Tablet Sig: 1-2 Tablets PO every eight (8) hours as needed for anxiety. 4. ondansetron 4 mg Tablet, Rapid Dissolve Sig: One (1) Tablet, Rapid Dissolve PO Q8H (every 8 hours) as needed for nausea. 5. oxycodone 60 mg Tablet Extended Release 12 hr Sig: One (1) Tablet Extended Release 12 hr PO Q8H (every 8 hours). 6. hydromorphone 2 mg Tablet Sig: 3-5 Tablets PO Q3H (every 3 hours) as needed for pain. 7. prochlorperazine maleate 10 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for nausea. 8. simvastatin 10 mg Tablet Sig: One (1) Tablet PO once a day. 9. docusate sodium 100 mg Tablet Sig: One (1) Tablet PO twice a day. 10. senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed for Constipation. 11. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 12. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours). 13. lactulose 10 gram/15 mL Syrup Sig: Fifteen (15) ML PO BID (2 times a day): Hold for loose stool. 14. olanzapine 2.5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) as needed for insomnia: Patient may refuse. 15. enoxaparin 30 mg/0.3 mL Syringe Sig: Thirty (30) mg Subcutaneous Q12H (every 12 hours): For prophylaxis. 16. sulfamethoxazole-trimethoprim 800-160 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) for 5 days. 17. ipratropium bromide 0.02 % Solution Sig: One (1) nebulization Inhalation Q6H (every 6 hours) as needed for wheeze. Discharge Disposition: Extended Care Facility: [**First Name8 (NamePattern2) 3075**] [**Last Name (NamePattern1) 10264**] Rehab Discharge Diagnosis: Primary Diagnosis: Urinary tract infection Pleural effusions Wound fluid collections Metastatic renal cell carcinoma Secondary Diagnosis: Hypertension Gout Discharge Condition: Activity Status: Out of Bed with assistance to chair or wheelchair. Level of Consciousness: Alert and interactive. Mental Status: Confused - sometimes. Discharge Instructions: You were admitted to the hospital due to fevers, confusion and low blood pressures felt to be related to an urinary tract infection (UTI). You were admitted to the ICU and were given antibiotics for your UTI and your symptoms improved. Your oxygen level was also low on admission, but improved prior to discharge. It was felt to be due to some fluid around your lungs, as well as the cancer in your lungs. You had a procedure where fluid was removed around your lungs. You were also evaluated by the orthopedic surgeons and neurosurgeons due to concern about leakage from your wound. It is still leaking significantly and you have labs that are pending to determine the source of leakage. Your neurosurgery team will follow-up on these studies. CHANGES TO YOUR MEDICATIONS: ADD Bactrim 1 DS tab by mouth twice daily for 5 more days INCREASED oxyCONTIN to 60mg by mouth every 8 hours ADD olazapine 2.5mg by mouth at bedtime as needed ADD enoxaparin 30 mg SC every 12 hours for prophylaxis Followup Instructions: You have the following appointments scheduled: Department: SPINE CENTER When: FRIDAY [**2158-11-10**] at 9:30 AM With: [**Name6 (MD) **] [**Name8 (MD) **], MD [**Telephone/Fax (1) 3736**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 551**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage *You should discuss with him if you need a separate appointment with Dr. [**Last Name (STitle) **]* ICD9 Codes: 0389, 5119, 2930, 5990, 4019, 2749
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Medical Text: Admission Date: [**2133-5-26**] Discharge Date: [**2133-6-4**] Date of Birth: [**2068-9-24**] Sex: M Service: CSU HISTORY OF PRESENT ILLNESS: This is a 64 year old gentleman who has a recent significant history for excision of malignant melanoma in [**2133-3-19**], with bilateral groin lymph node dissection with positive groin lymph nodes, had been recovering well until one week prior to admission when he developed increasing shortness of breath and decreased exercise tolerance, positive orthopnea, paroxysmal nocturnal dyspnea, and left sided chest discomfort with exertion. The patient presented to outside radiation technologist to receive radiation therapy to his groin, where upon discovery of symptoms, the patient was referred to the Emergency Department for further evaluation. PAST MEDICAL HISTORY: Type 2 diabetes mellitus. Hypertension. Hypercholesterolemia. History of malignant melanoma as previously described. Status post ventral hernia repair. MEDICATIONS ON ADMISSION: 1. Glucophage 500 mg p.o. twice a day. 2. Glipizide 1.25 mg p.o. once daily. 3. Hydrochlorothiazide 25 mg p.o. once daily. 4. Lisinopril 40 mg p.o. once daily. 5. Verapamil XR 240 mg p.o. once daily. HOSPITAL COURSE: The patient was admitted to [**Hospital1 346**] where he was noted to have congestive heart failure by chest x-ray, was started on Heparin drip, Lasix for diuresis and he subsequently improved. The patient was taken for cardiac catheterization on [**2133-5-27**], which showed pulmonary artery pressure of 59/32 with a wedge of 32, 100 percent mid right coronary artery lesion, 100 percent mid left anterior descending coronary artery lesion, 90 percent first diagonal lesion, 100 percent obtuse marginal lesion. During the cardiac catheterization, the patient developed worsening pulmonary edema and subsequent respiratory failure and required emergent intubation for this. The patient had an intra-aortic balloon pump placed in the cardiac catheterization laboratory and the patient was taken to the operating room by Dr. [**Last Name (STitle) 70**] emergently for a coronary artery bypass graft and a mitral valve repair. The patient's ejection fraction had previously been determined on echocardiogram to be 25 percent with three plus mitral regurgitation. In the operating room upon performing sternotomy, it was noted the patient had a fair number of darkly colored nodules as well as a dark rubbery spot on the heart. These tissues were sent to the pathology department with the subsequent frozen section coming back positive for melanoma. In the operating room, the patient [**Last Name (STitle) 1834**] a coronary artery bypass graft times two, saphenous vein graft to left anterior descending coronary artery, saphenous vein graft to obtuse marginal, as well as a mitral valve repair. Postoperatively, the patient was transported to the Intensive Care Unit in stable condition with an intra-aortic balloon pump which had been placed in the cardiac catheterization laboratory on a Milrinone infusion, Levophed infusion, Epinephrine infusion. Please see operative note for full details. The patient remained intubated on his first postoperative night with good hemodynamics. The Milrinone was weaned down. Intra-aortic balloon pump was removed on postoperative day number one. The patient was weaned and extubated from mechanical ventilation on postoperative day number two. On postoperative day number two after the patient developed atrial fibrillation, the patient was started on Amiodarone and Lopressor after the pressors and inotropes had been weaned off. The pulmonary artery catheter was removed as the patient continued to have good hemodynamics in spite of the atrial fibrillation. Chest tubes were removed without incident. On postoperative day number three, the patient began working with physical therapy. On postoperative day number four, the patient was transferred from the Intensive Care Unit to the regular part of the hospital. By that time, he had converted into sinus rhythm. He had no further atrial fibrillation. The patient's pacing wires were removed on postoperative day number five. At that time, he was noted to have a moderate amount of serosanguinous drainage from his sternal incision. The patient was started on Keflex. The amount of drainage decreased over the next several days and had completely disappeared by postoperative day number seven. By postoperative day number six, the patient had completed a level V with physical therapy and was able to ambulate 500 feet and climb one flight of stairs without difficulty and at that time had been cleared for discharge to home by physical therapy; however, due to the patient's drainage from his sternal incision, the patient remained in the hospital until postoperative day number eight at which time he was cleared from a cardiac surgery standpoint. CONDITION ON DISCHARGE: Temperature maximum 98.8, pulse 93, sinus rhythm, blood pressure 123/79, respiratory rate 16, oxygen saturation in room air 94 percent. Laboratory date showed white blood cell count 12.9, hematocrit 31.4, platelet count 337,000. Sodium 137, potassium 4.6, chloride 100, bicarbonate 26, blood urea nitrogen 27, creatinine 1.0. The patient's weight on [**2133-6-4**], is 126 kilograms. The patient weighed 120 kilograms preoperatively. Neurologically, the patient is awake, alert and oriented times three. Examination is nonfocal. Heart is regular rate and rhythm without rub or murmur. Respiratory - breath sounds are decreased at bilateral bases. Gastrointestinal - The abdomen is obese, positive bowel sounds, nontender, nondistended. Sternal incision is clean and dry. There is a small amount, less than one half centimeter, of erythema at the distal portion of the incision. The sternum is stable. Bilateral lower extremities have two to three plus pitting edema. The left lower extremity vein harvest site has a small amount of serous drainage, no erythema and no pain on palpation. MEDICATIONS ON DISCHARGE: 1. Lasix 40 mg p.o. twice a day times ten days. 2. Potassium Chloride 20 mEq p.o. twice a day times ten days. 3. Colace 100 mg p.o. twice a day. 4. Zantac 150 mg p.o. twice a day. 5. Enteric Coated Aspirin 325 mg p.o. once daily. 6. Plavix 75 mg p.o. once daily. 7. Lopressor 25 mg p.o. twice a day. 8. Keflex 500 mg p.o. once daily times seven days. 9. Glucophage 500 mg p.o. twice a day. 10. Glipizide 1.25 mg p.o. once daily. DISCHARGE STATUS: The patient is to be discharged to home in stable condition. DISCHARGE DIAGNOSES: Coronary artery disease. Status post emergent coronary artery bypass graft and mitral valve repair. Malignant melanoma. Postoperative sternal drainage. FOLLOW UP: The patient has an appointment with Dr. [**Last Name (STitle) 70**] on [**2133-7-1**], at 1:15 p.m. and the patient has an appointment with Dr. [**Last Name (STitle) 6530**], his oncologist, on [**2133-7-8**], at 9:15 a.m. The patient is to follow-up with his primary care physician in one to two weeks. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 5662**], [**MD Number(1) 5663**] Dictated By:[**Last Name (NamePattern4) 8524**] MEDQUIST36 D: [**2133-6-5**] 18:57:06 T: [**2133-6-6**] 10:27:34 Job#: [**Job Number 11886**] ICD9 Codes: 4280, 4240
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Medical Text: Admission Date: [**2179-11-10**] Discharge Date: [**2179-11-17**] Date of Birth: [**2108-11-8**] Sex: F Service: NEUROSURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1835**] Chief Complaint: SDH Major Surgical or Invasive Procedure: RIGHT CRANIOTOMY FOR SDH EVACUATION History of Present Illness: HPI:71 y.o. F. who has complained of a headache for the past three weeks according to family. She had a negative MRI at [**Hospital **] hospital three weeks ago. Family reports frequent falls due to drinking. Found trying to unlock her neighbor's house, confused, with a bruise over L thigh. She was transported to an outside hospital, where a head CT showed a sdh with uncal herniation, which prompted [**Hospital1 18**] transfer. She was intubated for the transfer, and received Mannitol 40 gm, and dilantin 750 mg bolus. Past Medical History: PMHx: low platelet count; alcoholic HTN Hypothyroidism Hearing loss Depression Social History: Social Hx: alcoholic, binges daily, family thinks last drink 4 days ago, lives alone, smoke pack year history 106. She has six children, and her healthcare proxy is [**Name (NI) **] [**Name (NI) 11135**]. Family History: Family Hx:unknown Physical Exam: ON ARRIVAL PHYSICAL EXAM: O: BP: 116/78 HR:58 R 15 O2Sats 100% intubated, FiO2 100%, PeeP 5 HEENT: Pupils: unreactive EOMs unable to assess Extrem: Warm appears malnourished, multiple scratches on legs. Neuro: Mental status: Intubated Orientation: does not follow commands. Cranial Nerves: II: Pupils equally round non-reactive to light, 1.5 mm bilaterally. Motor: Localizes to noxious stimuli with bilateral upper extremities, withdraws bilateral lower extremities to noxious stimuli, tows up-going. Pertinent Results: RADIOLOGY Final Report CHEST (PORTABLE AP) [**2179-11-15**] 11:28 AM CHEST (PORTABLE AP) Reason: r/o pneumonia [**Hospital 93**] MEDICAL CONDITION: 71 year old woman with s/p SDH, large smoking history, desating REASON FOR THIS EXAMINATION: r/o pneumonia HISTORY: Status post subdural hematoma, desaturation, evaluate for pneumonia. COMPARISONS: [**2179-11-10**]. FINDINGS: Single semi-upright portable chest radiograph performed at 11:45 a.m. demonstrates interval removal of endotracheal tube. Lungs are clear. There is no pneumothorax or pleural effusions. Cardiomediastinal silhouette is normal and unchanged. Left clavicular fracture is unchanged. Healing right posterior lower rib fracture seen. IMPRESSION: No acute cardiopulmonary process. RADIOLOGY Final Report CT HEAD W/O CONTRAST [**2179-11-12**] 8:37 AM CT HEAD W/O CONTRAST Reason: assess for interval change [**Hospital 93**] MEDICAL CONDITION: 71 year old woman with SDH, uncal herniation s/p evacuation REASON FOR THIS EXAMINATION: assess for interval change CONTRAINDICATIONS for IV CONTRAST: None. COMPARISON: [**2179-11-10**]. NON-CONTRAST HEAD CT: There is a large right frontal, parietal, and temporal subdural hematoma with mixed acute and chronic components that has decreased in size and now measures approximately 1 cm from the skull base. Decreased associated pneumocephalus is noted. There is an approximately 3 mm midline shift, and there is no evidence of subfalcine or uncal herniation. The mastoid air cells are well aerated. There are air-fluid levels within the right and left maxillary sinus and opacification of the anterior ethmoid air cells, unchanged. IMPRESSION: 1. Improved appearance of large right acute on chronic subdural hematoma with markedly decreased midline shift and no evidence of subfalcine or uncal herniation. 2. Multiple air-fluid levels in the maxillary and sphenoid sinuses with near complete opacifications of air cells may represent sinusitis, although not significantly changed from prior exam. Recommend clinical correlation. The study and the report were reviewed by the staff radiologist. DR. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 94**] DR. [**First Name8 (NamePattern2) 11136**] [**Last Name (NamePattern1) 11137**] Approved: SUN [**11-14**], RADIOLOGY Final Report CT HEAD W/O CONTRAST [**2179-11-10**] 8:55 PM CT HEAD W/O CONTRAST Reason: FOUND DOWN [**Hospital 93**] MEDICAL CONDITION: 71 year old woman with SDH and ?herniation REASON FOR THIS EXAMINATION: eval ich CONTRAINDICATIONS for IV CONTRAST: None. HISTORY: Subdural hematoma. Evaluate for herniation. No priors are available. NON-CONTRAST HEAD CT: FINDINGS: There is a large right frontal, parietal and temporal subdural hematoma with mixed acute and chronic components causing extensive effacement of the adjacent sulci, severe subfalcine herniation of approximately 17 mm, and mild uncal herniation causing mass effect on the brainstem and effacement of the ambient cistern. There is prominence to the left occipital/temporal horns, likely related to mass effect on the third ventricle. The fourth ventricle also appears slightly prominent. There is no evidence of intraparenchymal hemorrhage with periventricular hypoattenuation likely related to chronic small vessel disease. Soft tissues appear unremarkable with mastoid air cells appearing well aerated. There are air-fluid levels noted within the right and left maxillary sinus and right sphenoid sinus with near-complete opacification of the majority of the anterior middle ethmoid air cells. Mild mucosal thickening is noted within the frontal sinuses. Large amount of secretions is noted within the oropharynx consistent with the patient's intubation. IMPRESSION: 1. Large right acute on chronic subdural hematoma causing significant subfalcine herniation and mild-to-moderate uncal herniation. Prominence to the left occipital and temporal horns along with effacement of the third ventricle is suggestive of hydrocephalus/outflow obstruction. 2. Multiple air-fluid levels within the maxillary sinus and sphenoid sinus with near-complete opacification of ethmoid air cells in this intubated patient. Findings are worrisome for developing sinusitis. Please correlate clinically. RADIOLOGY Final Report CT C-SPINE W/O CONTRAST [**2179-11-10**] 8:55 PM CT C-SPINE W/O CONTRAST Reason: FOUND DOWN [**Hospital 93**] MEDICAL CONDITION: 71 year old woman with SDH and ?herniation REASON FOR THIS EXAMINATION: eval fx CONTRAINDICATIONS for IV CONTRAST: None. HISTORY: Known subdural hematoma. Evaluate for acute fracture. No prior comparison exams are available. CT OF THE CERVICAL SPINE WITH CORONAL AND SAGITTAL REFORMATIONS: IMPRESSION: No evidence of acute fracture or malalignment. Vertebral body heights appear well preserved. Small ossific fragment anterior to C4-C5 is likely degenerative in nature, and there is mild multilevel degenerative joint and disc disease. Visualized contents of the intrathecal sac appear unremarkable; however, MRI is more sensitive for evaluation of spinal cord injury. There is no prevertebral soft tissue swelling. Pooled secretions are noted within the oropharynx consistent with patient's intubation. Please refer to dedicated CT head for better description of sinus findings. The soft tissues display atrophic or absent right thyroid gland with multiple calcifications noted within the left thyroid gland. There is biapical pleural scarring and areas of linear atelectasis along with mild centrilobular emphysema. Hematology COMPLETE BLOOD COUNT WBC RBC Hgb Hct MCV MCH MCHC RDW Plt Ct [**2179-11-14**] 08:00AM 7.3 2.88* 9.7* 30.3* 105* 33.8* 32.1 15.5 253 DIFFERENTIAL Neuts Bands Lymphs Monos Eos Baso Atyps Metas [**2179-11-10**] 08:45PM 70.3* 24.4 3.3 1.6 0.5 BASIC COAGULATION (PT, PTT, PLT, INR) PT PTT Plt Ct INR(PT) [**2179-11-14**] 08:00AM 253 Chemistry RENAL & GLUCOSE Glucose UreaN Creat Na K Cl HCO3 AnGap [**2179-11-14**] 08:00AM 85 2* 0.4 141 3.8 105 30 10 Brief Hospital Course: Pt was seen and admitted through the emergency department on [**2179-11-10**] for complaint of a headache for the past three weeks according to family. She had a negative MRI at [**Hospital **] hospital three weeks ago. Family reports frequent falls due to drinking. Found trying to unlock her neighbor's house, confused, with a bruise over L thigh. She was transported to an outside hospital, where a head CT showed a sdh with uncal herniation, which prompted [**Hospital1 18**] transfer. She was intubated for the transfer, and received Mannitol 40 gm, and dilantin 750 mg bolus. Pt was brought to OR emergently for evacuation of R SDH. Pt underwent the procedure and awoke from anesthesia without complication. She was extubated in SICU the following morning. Her exam improved and she was following commands. Her post-op CT scan was stable. Diet and acitivity were advanced. She was seen by PT/OT/ST for eval. She passed swallow eval and was recommended for rehab from PT/OT perspective. Foley was d/c'd and pt is voiding. She will require follow up in [**4-23**] weeks with CT scan of brain - dilanitin should continue unitl that time and be managed by PCP. Upon discharge, she is neurologically stable, she is oriented x3; following commands; no focal deficit found on her neuro exam. Medications on Admission: family usure, knows of antihypertensives and hypothyroid drugs Discharge Medications: 1. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed. 2. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) dose Injection TID (3 times a day). 3. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed. 4. Lorazepam 1 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for dose per CIWA scale: Please dose according to CIWA scale. . 5. Nicotine 21 mg/24 hr Patch 24 hr Sig: One (1) Patch 24 hr Transdermal DAILY (Daily). 6. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 7. Famotidine 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 8. Phenytoin Sodium Extended 100 mg Capsule Sig: One (1) Capsule PO TID (3 times a day): Patient should continue taking this medication at least until seen in [**Hospital 4695**] clinic. . 9. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 10. Hexavitamin Tablet Sig: One (1) Cap PO DAILY (Daily). 11. Thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 12. Albuterol Sulfate 0.083 % (0.83 mg/mL) Solution Sig: One (1) Inhalation Q6H (every 6 hours) as needed. 13. HYDROmorphone (Dilaudid) 0.5-1 mg IV Q3H:PRN 14. Zolpidem 5 mg Tablet Sig: 1-2 Tablets PO HS (at bedtime) as needed for insomnia. Discharge Disposition: Extended Care Facility: Highgate Manor Discharge Diagnosis: RIGHT SUBDURAL HEMATOMA Discharge Condition: NEUROLOGICALLY STABLE Discharge Instructions: DISCHARGE INSTRUCTIONS FOR CRANIOTOMY ?????? Check your incision daily for signs of infection ?????? Take your pain medicine as prescribed ?????? Exercise should be limited to walking; no lifting, straining, excessive bending ?????? You may wash your hair only after sutures and/or staples have been removed ?????? You may shower before this time with assistance and use of a shower cap ?????? Increase your intake of fluids and fiber as pain medicine (narcotics) can cause constipation ?????? Unless directed by your doctor, do not take any anti-inflammatory medicines such as Motrin, aspirin, Advil, Ibuprofen etc. ?????? If you have been prescribed an anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing as ordered ?????? Clearance to drive and return to work will be addressed at your post-operative office visit CALL YOUR SURGEON IMMEDIATELY IF YOU EXPERIENCE ANY OF THE FOLLOWING: ?????? New onset of tremors or seizures ?????? Any confusion or change in mental status ?????? Any numbness, tingling, weakness in your extremities ?????? Pain or headache that is continually increasing or not relieved by pain medication ?????? Any signs of infection at the wound site: redness, swelling, tenderness, drainage ?????? Fever greater than or equal to 101?????? F Followup Instructions: PLEASE HAVE THE REHAB FACILITY REMOVE THE STAPLES ON [**11-23**] PLEASE CALL [**Telephone/Fax (1) **] TO SCHEDULE AN APPOINTMENT WITH DR.[**Last Name (STitle) **] TO BE SEEN IN [**4-23**] WEEKS. YOU WILL NEED A CAT SCAN OF THE BRAIN WITHOUT CONTRAST YOU SHOULD FOLLOW UP WITH YOUR PCP REGARDING YOUR HOSPITALIZATION - IT IS BEST TO BE SEEN WITHIN 2 WEEKS / Your PCP will manage your dilantin levels. Completed by:[**2179-11-17**] ICD9 Codes: 3051, 2875, 311, 4019
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Medical Text: Admission Date: [**2143-6-28**] Discharge Date: [**2143-7-4**] Service: MEDICINE Allergies: Aspirin Attending:[**First Name3 (LF) 14961**] Chief Complaint: CC - MS changes Major Surgical or Invasive Procedure: Intubation [**2143-6-28**], extubation [**2143-6-29**] History of Present Illness: HPI - This is a 89 y/o male with h/o demetia, depression, SI in past requiring inpt psych hospitalization 2 months ago, CAD, HL, orthostatic hypotension, ITP, p/w MS changes on [**2143-6-28**]. Per pt's wife, pt found around 12:30 am at home on [**2143-6-28**] sitting, but unresponsive and unable to speak. Pt taken to ED, code stroke was called. Pt was admitted to the Neuro ICU, and MRI depicted two small foci likely representing small infarcts in right periventricular matter. During this time the pt was intubated for airway protection as he had been vomiting; extubated successfully this AM. However, it was felt by the Neuro team that these small changes were unlikely to cause his MS changes. A metabolic w/u showed elevated LFTs and a serum tylenol level of 165 on [**2143-6-28**] at 2pm, drawn approximately 12-16 hrs after presentation. Pt was not given any NAC until [**2143-6-29**] at 3pm (24 hrs after level was drawn). Upon further questioning with pt, he confessed to taking to tylenol for a suicide attempt and did not want his family to know. Upon detailed coversation with his family and HCP, we were told the patient has done this in the past requiring inpt psychiatric hospitalization 2-3 months ago. Per his son, he has not seemed more depressed or expressed any suicidal ideations. . Currently, pt has no complaints except for the bruising on his arms. Patient does have active SI and says "I didn't take enough tylenol" Past Medical History: 1. Dementia - sees Dr. [**Last Name (STitle) **] 2. Depression, ?prior SI/attempts - sees Dr. [**Last Name (STitle) **] 3. s/p MVA earlier this year 4. CAD s/p CABG x 3v 5. HL 6. Orthostatic hypotension 7. h/o ARF resulting in MS changes 8. thrombocytopenia, h/o ITP - sees Dr. [**First Name (STitle) **] Social History: SH - Lives at home with his wife. [**Name (NI) **], [**Name (NI) **] [**Name (NI) 17931**], is HCP ([**Telephone/Fax (1) 106034**]). Former tobacco h/o (>130 pk/yr), no EtOH or illicits. Family History: FH - Sister died of cancer. Father had GI cancer. Physical Exam: VS - T 96.5, BP 135/95, HR 78, RR 20, SaO2 100%/2LNC, I/O = 1475/950 General - Pleasant, AO x 3 though conversation rambling. In NAD. HEENT - NC/AT, PERRL/EOMI. MM dry, OP clear. Neck - supple, no JVD Chest - bibasilar crackles, otherwise clear CV - RRR s1 s2 nl, 2/6 SEM at LSB Abd - soft, NT/ND, NABS Ext - no c/c/e, pulses 2+ b/l Neuro - AO x 3, conversant though rambling. Moving all four extremities equally. CN II-XII intact grossly Psych - +SI Pertinent Results: [**2143-7-1**] 05:45AM BLOOD Plt Ct-48* [**2143-7-1**] 11:00AM BLOOD Plt Ct-37* [**2143-7-2**] 05:55AM BLOOD PT-15.6* PTT-26.0 INR(PT)-1.4* [**2143-7-2**] 05:55AM BLOOD Plt Ct-49* [**2143-7-3**] 06:55AM BLOOD PT-13.0 PTT-24.6 INR(PT)-1.1 [**2143-7-3**] 06:55AM BLOOD Plt Ct-36* [**2143-6-29**] 02:45AM BLOOD ALT-237* AST-292* AlkPhos-56 TotBili-0.6 [**2143-6-29**] 02:14PM BLOOD ALT-1156* AST-1416* AlkPhos-62 TotBili-1.0 [**2143-6-30**] 04:33AM BLOOD ALT-[**2105**]* AST-[**2153**]* LD(LDH)-1131* AlkPhos-61 TotBili-1.1 [**2143-7-1**] 05:45AM BLOOD ALT-2651* AST-2197* LD(LDH)-1093* AlkPhos-67 TotBili-1.0 [**2143-7-2**] 05:55AM BLOOD ALT-1621* AST-706* LD(LDH)-295* CK(CPK)-135 AlkPhos-68 TotBili-1.5 [**2143-7-3**] 06:55AM BLOOD ALT-1106* AST-278* LD(LDH)-256* AlkPhos-79 TotBili-0.9 [**2143-6-28**] 02:44PM BLOOD ASA-NEG Ethanol-NEG Acetmnp-165.5* Bnzodzp-NEG Barbitr-NEG Tricycl-NEG [**2143-6-29**] 02:14PM BLOOD Acetmnp-11.9 TTE [**6-28**] - The left atrium is normal in size. No atrial septal defect or patent foramen ovale is seen by 2D, color Doppler or saline contrast with maneuvers. There is mild symmetric left ventricular hypertrophy. The left ventricular cavity size is normal. Overall left ventricular systolic function is normal (LVEF 60-70%). Tissue velocity imaging demonstrates an e' of <0.08m/s c/w an elevated left ventricular filling pressure (>12mmHg). No masses or thrombi are seen in the left ventricle. There is no ventricular septal defect. Right ventricular chamber size and free wall motion are normal. The ascending aorta is mildly dilated. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. The left ventricular inflow pattern suggests impaired relaxation. There is mild pulmonary artery systolic hypertension. There is no pericardial effusion. EEG [**6-28**] - IMPRESSION: This is an abnormal portable EEG due to the presence of slow and disorganized background rhythms with superimposed fast activity. This finding suggests an encephalopathy. Medications, infection, or metabolic disturbances are among the most common causes. There were no clear focal abnormalities recorded. CT head [**6-28**] - IMPRESSION: Limited study due to motion. No evidence of hemorrhage. If there is a further concern for stroke, please perform further evaluation by MRI. The information was discussed with the referring physician, [**Last Name (NamePattern4) **]. [**First Name (STitle) **] in person at the completion of the study. MRI/MRA of head [**6-28**] - IMPRESSION: Small foci of restricted diffusion seen in the left frontal and right frontal lobes, likely representing small distal infarcts. MRA: Major branches of the Circle of [**Location (un) 431**] appear patent. There is no evidence of significant stenosis. The vertebral arteries and basilar artery appear unremarkable with normal appearing flow. Incidentally noted is a 3mm right carotid cavernous aneurysm. IMPRESSION: Vertebral arteries and basilar arteries appear unremarkable. Incidental note of a 2 mm right carotid cavernous aneurysm. Brief Hospital Course: This is an 89 y/o male with depression, h/o SI, CAD, dementia, ITP, who initially presented with mental status changes, initially thought to be [**2-28**] CVA and admitted to the Neuro ICU service. He was intubated on arrival for airway protection as he was vomiting and to be able to accurate scans. An MRI/MRA of the head demonstrated two small ischemic foci in the right and left frontal lobes, likely [**2-28**] old infarcts. Based on these findings, it was felt that the etiology of the MS changes was not secondary to an acute CVA. He had a stroke w/u, including a TTE and carotid u/s which was unremarkable. He was not started on any anti-platelet regimen due to his thrombocytopenia [**2-28**] ITP. An EEG showed diffuse slowing c/w toxic/metabolic process. During the w/u, the patient was noted to have elevated LFTs (transaminases in the 200-300's) on [**2143-6-28**]. A serum tylenol level was checked approximately 12-16 hrs after admission and was elevated in the hepatotoxic range of 165 on [**2143-6-28**]. Once the patient was extubated, it was elicited from the patient that he had taken too much tylenol to "call it quits." It was also further elicited from the patient's family that the patient has a history of suicidal attempts, requiring a recent inpt psychiatric hospitalization 2-3 months ago in [**Hospital 17065**] hospital. The patient was transferred to the Medicine service for further management on [**2143-6-29**]. Psychiatry and Hematology were involved during his course. . 1. Tylenol toxicity - Toxic/metabolic w/u revealed elevated LFTs and a serum tylenol level of 165 on [**6-28**] (12-16 hrs after pt presented, no level checked on admission). Pt not given any mucomyst (NAC) until [**6-29**] for unclear reasons and was started on NAC continuous gtt 18 mg/kg/hr per in-house toxicologist. The patient's LFTs continued to trend upward as well as his INR (indicative of synthetic function) and finally peaked on [**2143-7-1**]. His enzymes then began trending down, with return of his INR to 1.1 (normal) on [**2143-7-3**]. The NAC gtt was d/c'd on [**2143-7-2**] as it was clear the patient's liver was recovering - this was confirmed with in-house toxicology. During his course, he did not demonstrate any signs of encephalopathy or other end-organ damage. Medications metabolized through the liver, including aricept, risperdal, zocor, and effexor were held during the active hepatitis. They may be restarted once his LFTs are back to baseline. LFTs should be checked every day or every other day until they normalize. His synthetic function is preserved, indicated by his INR of 1.1 (normal). Given this was a suicide attempt, 1:1 sitter was always present and psych was consulted (see below). . 2. Dementia - per family, pt at baseline. Aricept was held given acute hepatic injury, could be restarted once LFTs completely back to baseline. . 3. Depression, NOS - follows with psych as outpt, h/o SI/attempts in past. Psych was consulted during this admission and recommended geriatric psych placement given patient is not safe at home. Family was agreeable to this plan. His risperdal and effexor was d/c'd during this course given acute hepatic injury - may be restarted once LFTs back to baseline and depending on psych's preferences. Patient is a section 12 and continues to be actively suicidal. He has not been agitated at all and not required any prn anti-psychotics. . 4. Thrombocytopenia - pt w/history of ITP, unresponsive to steroids but given Rhogam in past for plts<40 (last dose per OMR [**3-31**]). Likely his thrombocytopenia is [**2-28**] ITP, although risperdal is associated with thrombocytopenia and was recently started in [**6-1**]. Another concern is his thrombocytopenia could have been worsened acutely from hepatic injury. Hematology was consulted in-house and recommened one dose of Rhogam (250 units/kg) for plts<40 as patient was having an episode of nose bleed. This was given w/o complication on [**2143-7-1**]. Rhogam works to hemolyze the RBCs through the spleen, saving the platelets from being destroyed instead. His platelets are currently stable and there are no signs of bleeding. If patient becomes more thrombocytopenic or begins to bleed, hematology should be consulted as the patient may need additional doses of Rhogam. To monitor his platelets, his Hct, platelets, and coags need to be checked weekly to ensure stability. . 5. Orthostatic hypotension - continue fludrocort and midodrine . 6. HL - held zocor given hepatic injury, may be restarted once LFTs back to baseline . 7. F/E/N - regular diet, IVF . 8. PPx - PPI, pneumoboots . 9. Code - FULL (confirm each situation w/HCP son [**Name (NI) **] [**Name (NI) 17931**] [**Telephone/Fax (1) 106034**]; h [**Telephone/Fax (1) 106035**]) . 10. Dispo - medically stable to be transferred to [**Female First Name (un) **]-psych facility. Liver function has returned to [**Location 213**] and thrombocytopenia has stabilized. Medications on Admission: MEDS (home) - 1. Aricept 5 mg qd 2. Effexor SR 75 mg q24 3. Fludrocort 0.1 mg [**Hospital1 **] 4. Midodrine 10 mg tid 5. Zocor 40 mg qd 6. Risperdal 0.5 mg qd Discharge Medications: 1. Fludrocortisone 0.1 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 2. Midodrine 5 mg Tablet Sig: Two (2) Tablet PO TID (3 times a day). 3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 4. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 5. Trazodone 50 mg Tablet Sig: 0.5 Tablet PO HS (at bedtime) as needed. Discharge Disposition: Extended Care Facility: [**Hospital1 **] 4 Discharge Diagnosis: Primary - hepatotoxicity [**2-28**] tylenol overdose Secondary - depression, suicidal ideations, dementia, ITP, HL, orthostatic hypotension Discharge Condition: Medically stable, liver synthetic function at baseline Discharge Instructions: -continue medications as prescribed -anti-depressants and anti-psychotic medications were stopped given pt's hepatotoxicity; once liver enzymes return to baseline can likely restart medications -please follow-up with appts below Followup Instructions: Provider: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 8753**], MD Phone:[**Telephone/Fax (1) 1682**] Date/Time:[**2143-7-31**] 12:00 Provider: [**First Name8 (NamePattern2) **] [**Name11 (NameIs) **], MD Phone:[**Telephone/Fax (1) 719**] Date/Time:[**2143-8-8**] 10:30 Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 658**], M.D. Phone:[**Telephone/Fax (1) 1690**] Date/Time:[**2143-8-27**] 11:30 Completed by:[**2143-7-4**] ICD9 Codes: 2724
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Medical Text: Admission Date: [**2171-4-15**] Discharge Date: [**2171-4-23**] Service: CCU CHIEF COMPLAINT: The patient was transferred to the Coronary Care Unit from Catheterization Laboratory status post myocardial infarction, status post intra-aortic balloon pump placement. HISTORY OF PRESENT ILLNESS: The patient is an 82 year old female with no known prior history of coronary artery disease, with a history of lung, breast and colon carcinoma, who presented to [**Hospital 26200**] Hospital with a CK of 3,243. The patient was in her usual state of health prior to her presentation to that hospital until three days prior when she developed dyspnea on exertion. Her symptoms developed into dyspnea at rest, and she was noted to have an O2 saturation of 83%. The patient denied any chest pain at that time. At the outside hospital, her EKG showed ST elevations in V2 through V6, with Q waves present. She was transferred to [**Hospital1 69**] at which time she had a heart rate of 87, a blood pressure of 128/80 and an O2 saturation of 97 on five liters. She got aspirin, nitro paste, Lopressor intravenously, intravenous Lasix, and a heparin drip. She was then taken to the Catheterization Laboratory on arrival at [**Hospital1 69**] which showed a total occlusion of her proximal left anterior descending, total occlusion of her left circumflex, 60% proximal right coronary artery and a 30% obtuse marginal coronary artery. She had minimal right to left collaterals and left to left collaterals. Her right heart catheterization showed a wedge pressure of 27 and a PA-saturation of 49%. Her ejection fraction was 15% with anterior and inferior septal akinesis with an apical thrombus present. An intra-aortic balloon pump was placed secondary to cardiogenic shock. She was going to be evaluated by Cardiothoracic Surgery for whether she is an operable candidate. PAST MEDICAL HISTORY: 1. Hypertension. 2. Osteoporosis. 3. Colon carcinoma status post partial colectomy in 11/98. 4. Lung carcinoma. 5. Status post left upper lobe lobectomy in [**2167**]. 6. Breast carcinoma. 7. Peripheral vascular disease. 8. Irritable bowel syndrome. 9. Chronic obstructive pulmonary disease. 10. Spinal stenosis. 11. History of transient ischemic attack. 12. Depression. MEDICATIONS: 1. Imipramine 25 q. day. 2. Oxybutynin 5 q. day. 3. Aricept 10 q. day. 4. Zestril 20 q. day. 5. Tylenol 650 three times a day. 6. Lomotil 2 tablets q. day. 7. Aspirin 325 q. day. ALLERGIES: Aricept causes nausea and the patient is allergic to penicillin. SOCIAL HISTORY: The patient lives with her husband in a senior living complex. She has a remote smoking history. FAMILY HISTORY: Noncontributory. PHYSICAL EXAMINATION: On admission, vital signs are temperature 98.9 F.; heart rate 85; blood pressure 127/68; O2 saturation 97%; respiratory rate 24. In general, the patient is mildly agitated, answering questions appropriately, in no acute distress. HEENT: Pupils are equal, round, and reactive to light and accommodation. Extraocular movements intact. Tongue midline; moist mucous membranes. Neck: No bruits. Jugular venous distention above clavicle with minimal head elevation. Heart is regular rate and rhythm with normal S1 and S2, positive S3. No murmurs, rubs or gallops. Lungs are clear to auscultation anteriorly. Abdomen with positive bowel sounds, soft, nontender, nondistended. Guaiac negative on presentation at outside hospital. Extremities with palpable dorsalis pedis pulses bilaterally, trace lower extremity edema. Left groin sheath without hematoma. Neurological: Cranial nerves II through XII intact. Moving all extremities. LABORATORY: On arrival, white blood cell count 17.9; hematocrit 41.9, platelets 226; 85% neutrophils, 11 lymphs, 3 monocytes. PT 14.8, PTT 150 and INR 1.5. Sodium 149, potassium 4.5, chloride 113, bicarbonate 20, BUN 23, creatinine 1.1 and glucose 146. CK 3294, up from 3243 at the outside hospital. Arterial blood gas was 7.48, 29 and 94. EKG after catheterization showed ST elevation as well as Q waves in V2 through V6, with Q's in II and AVL. Chest x-ray showed congestive heart failure with a left sided effusion. HOSPITAL COURSE: 1. Cardiovascular: 1) Ischemia - the patient who presented with acute ST elevation myocardial infarction. She had cardiac catheterization with a total occluded proximal left anterior descending, totally occlusion in the left circumflex and 60% proximal right coronary artery. The patient had three-vessel disease. Also noted on catheterization was severe systolic dysfunction and elevated filling pressures with cardiogenic shock. She had an intra-aortic balloon pump placed. She was continued on heparin and aspirin. The patient was found not to be a surgical candidate. She was eventually started on an ACE inhibitor and beta blocker after her blood pressure had stabilized when she was out of the Intensive Care Unit and continued on aspirin. The patient was also sent home on Coumadin given her low ejection fraction. 2) Pump - the patient was found to be in cardiogenic shock and had an intra-aortic balloon pump placed during cardiac catheterization. She developed some hypotension on the following day and the patient was started on Dobutamine. The patient also was put on Nipride. She had an echocardiogram that was done on [**2171-4-17**], which showed [**Doctor First Name **] ejection fraction of 20 to 25% and severe left global hypokinesis and severe pulmonary artery hypertension. The patient was then weaned off the intra-aortic balloon pump on the 2nd and pressors were eventually weaned off. She was started on ACE inhibitor and beta blocker. Given her poor ejection fraction, she was continued on heparin and started on Coumadin. She was discharged home on Coumadin. The patient was also started on low-dose Lasix and eventually sent home on 20 q. day. DISCHARGE DIAGNOSES: 1. Acute myocardial infarction. 2. Cardiogenic shock. 3. Hypertension. 4. Osteoporosis. 5. Colon carcinoma. 6 Lung carcinoma. 7. Breast carcinoma. 8. Peripheral vascular disease. 9. Irritable bowel syndrome. 10. Chronic obstructive pulmonary disease. 11. Spinal stenosis. 12. History of transient ischemic attack. 13. Depression. 14. Severe systolic dysfunction with an ejection fraction of 20%. DISCHARGE MEDICATIONS: 1. Imipramine 25 q. day. 2. Oxybutynin 5 q. day. 3. Aricept 10 q. day. 4. Zestril 10 q. day. 5. Tylenol 650 three times a day. 6. Lomotil 2 tablets q. day. 7. Aspirin 325 q. day. 8. Lopressor 12.5 twice a day. 9. Lasix 20 q. day. DISCHARGE INSTRUCTIONS: 1. The patient is going to follow-up with Dr. [**First Name (STitle) **] [**Name (STitle) 121**] of Cardiology at [**Hospital3 4527**], whose phone number is [**Telephone/Fax (1) 4105**]. 2. The patient will follow-up with her primary care physician, [**Last Name (NamePattern4) **]. [**Last Name (STitle) 27226**]. DISPOSITION: The patient will be discharged home to [**Hospital3 **] with 24-hour care, Visiting Nurses Association and Physical Therapy. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1013**], M.D. [**MD Number(1) 1014**] Dictated By:[**Name8 (MD) 2069**] MEDQUIST36 D: [**2171-6-27**] 11:15 T: [**2171-6-29**] 16:14 JOB#: [**Job Number 27227**] ICD9 Codes: 4280, 496
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Medical Text: Admission Date: [**2163-10-5**] Discharge Date: [**2163-10-14**] Date of Birth: [**2108-8-14**] Sex: F Service: MEDICINE Allergies: Penicillins / Erythromycin / Compazine / Bactrim Ds / Sulfa (Sulfonamides) / Dapsone / Levaquin / Lisinopril Attending:[**Last Name (NamePattern4) 290**] Chief Complaint: fever Major Surgical or Invasive Procedure: None History of Present Illness: Ms. [**Known lastname **] is a 55 year old woman with h/o NHL (27 years ago), complicated by lung toxicity [**1-25**] to Bleomycin treatment, sarcoidosis, Factor V Leiden, systolic CHF (EF 30%, adriamycin toxicity), CKD, recently discharged to rehab after a complicated hospital course for respiratory distress, requiring trach and PEG placement, s/p treatment for PNA, currently being treated for Cdiff colitis, now presents with fever. Patient was recently admitted [**Date range (1) 107084**] for respiratory failure, requiring intubation. The patient was unable to be weaned from the [**Last Name (LF) **], [**First Name3 (LF) **] trach and PEG were placed. During this hospitalization, the patient was persistently febrile, despite treatment with Abx. She was treated for an 9d course of Vanc/Cefepime for presumed HAP. Given an Abx holiday for 48-72 hrs given concern for drug fevers, but fevers persisted. She was restarted on Vanc/Cefepime with addition of IV Flagyl and PO Vanc for positive Cdiff. Prior to d/c, sputum culture grew gram negative rods, so IV Vanc was d/c'd and Cefepime was changed to Meropenem. Meropenem was continued until [**2163-9-29**] at rehab. The patient is currently still on PO Vanc and PO Flagyl for Cdiff treatment. The patient was noted to have low grade fevers for the past week at rehab. She was restarted on Vanc and Meropenem. Temp was up to 102.6 today, so she was transferred to the ED for further care. The patient currently feels well. She notes some R wrist pain/tendinitis. There have been no changes in her [**Month/Day/Year **] settings. She is currently on Flagyl and PO Vanc for Cdiff colitis. She continues to have loose stools, although improved from when she intially went to rehab. No chills, sweats, increased cough, worsening shortness of breath, chest pain, abdominal pain, nausea, vomiting. In the ED, initial vs were: T 102.2 P 119 BP 143/83 RR 43 O2 sat 100% [**Month/Day/Year **]. The patient was tachycardic to 110, but BP remained stable. CXR unchanged from prior. UA unremarkable. Patient was given Tylenol, Vancomycin, and Meropenem. Vitals on transfer: P 97 BP 108/54 RR 30 O2sat 100% [**Month/Day/Year **]. On the floor, the patient remains comfortable. She notes R wrist pain, but otherwise has no complaints. Past Medical History: - s/p trach/PEG [**9-2**] -Sarcoidosis: treatment History: methotrexate [**12-31**], stopped [**1-31**] due to reaction, prednisone 10-20-10-7.5mg [**Date range (1) 107077**] stopped due to Cushingoid side effects in [**11-1**]. - Non-Hodgkin's lymphoma (27 years ago) s/p chemotherapy c/b bleo lung tox, autologous BMT, and high-dose myeloablative total body irradiation. - Pulmonary embolism with Factor-5 Leiden- long term coumadin goal INR [**1-26**] therapy - Status post CVA with memory deficit. - Stage III-IV chronic kidney disease. - Systolic CHF- [**1-25**] adriamycin from large cell lymphoma several years ago. Recent Echo 30%. - Hypertension. - Hyperlipidemia - Mild sleep apnea. - Anxiety - Gout. - Anemia - on Aranesp - Iron overload. - Multiple environmental allergies Social History: Currently living at [**Hospital 100**] Rehab x2 weeks. She has been on disability for the past 15 years, but used to work in a hotel as a reservations consultant. - Tobacco: None - Alcohol: None - Illicits: None Family History: - Maternal: clots, PE, TIA, Factor V Leiden, dementia at 92 - Paternal: CAD, pancreatic CA - Siblings: sister died [**2162-12-24**] from complications of DM, another sister with thyroid problems and high cholesterol - Children: one healthy daughter without [**Name2 (NI) **] V Leiden - Uncle: colon cancer Physical Exam: Vitals: T 100.1 P 96 BP 102/60 RR 22 O2sat 98% General: Alert, oriented, no acute distress, trach in place, mechanically ventilated HEENT: Sclera anicteric, dry MM, oral thrush Neck: supple, JVP not elevated, no LAD Lungs: coarse breath sounds bilaterally anteriorly CV: tachycardic, S1 + S2, no murmurs, rubs, gallops appreciated given coarse breath sounds Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly, PEG site c/d/i - no erythema/induration/pus GU: foley Skin: redness in groin area, lower back/buttocks, under breasts Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema, no calf tenderness, RUE PICC c/d/i - no erythema, induration, pus Pertinent Results: ADMISSION LABS: [**2163-10-5**] 12:40PM BLOOD WBC-16.7*# RBC-2.73* Hgb-8.4* Hct-24.9* MCV-91 MCH-30.7 MCHC-33.6 RDW-15.7* Plt Ct-430 [**2163-10-5**] 12:40PM BLOOD Neuts-81.5* Lymphs-11.9* Monos-5.5 Eos-0.7 Baso-0.3 [**2163-10-5**] 12:40PM BLOOD PT-27.8* PTT-30.5 INR(PT)-2.7* [**2163-10-5**] 12:40PM BLOOD Glucose-110* UreaN-55* Creat-1.5* Na-125* K-4.3 Cl-86* HCO3-29 AnGap-14 [**2163-10-5**] 12:40PM BLOOD ALT-19 AST-27 AlkPhos-143* TotBili-0.2 [**2163-10-5**] 12:40PM BLOOD Albumin-3.2* Phos-4.3 Mg-2.8* [**2163-10-5**] 12:54PM BLOOD Glucose-118* Lactate-0.8 [**2163-10-5**] 12:40PM BLOOD Lipase-66* OTHER PERTINENT LABS: [**2163-10-6**] 05:00PM BLOOD Ret Aut-1.1* [**2163-10-6**] 05:00PM BLOOD LD(LDH)-161 TotBili-0.2 [**2163-10-6**] 05:00PM BLOOD Hapto-521* URINE: [**2163-10-5**] 12:40PM URINE Color-Yellow Appear-Clear Sp [**Last Name (un) **]-1.006 [**2163-10-5**] 12:40PM URINE Blood-TR Nitrite-NEG Protein-25 Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-NEG pH-5.0 Leuks-TR [**2163-10-5**] 12:40PM URINE RBC-0-2 WBC-0-2 Bacteri-FEW Yeast-NONE Epi-0-2 [**2163-10-5**] 04:20PM URINE Hours-RANDOM UreaN-296 Creat-24 Na-10 K-12 Cl-<10 [**2163-10-5**] 04:20PM URINE Osmolal-177 MICRO: [**10-5**] BCx: negative [**10-5**] UCx: negative [**10-5**] SputumCx: sparse yeast, GNR [**10-5**] PICC catheter tip Cx: negative [**10-12**] Feces negative for C.difficile toxin A & B by EIA. IMAGING: [**10-5**] CXR: Low lung volumes and overall stable interstitial opacities. Given differences in technique and patient position, left pleural effusion is likely without significant change. [**10-12**] CXR: In comparison with the study of [**10-10**], there is still diffuse bilateral pulmonary opacifications bilaterally in a patient with known sarcoidosis. No definite evidence of acute focal pneumonia. Tracheostomy device remains in place. [**10-10**] Upper Extremity Doppler: Deep venous thrombosis involving the right subclavian and axillary veins, with extension into one of two brachial veins. The internal jugular, basilic and cephalic veins remain patent. [**10-6**] CT abd/pelvis: 1. No acute intra-abdominal or pelvic process. 2. Redemonstration of interstitial and peribronchial thickening consistent with the patient's history of sarcoidosis with new areas of ground-glass opacity within the medial lower lobes bilaterally. While this could be related to sarcoidosis, superimposed infection or aspiration cannot be excluded and clinical correlation is recommended 3. Small bilateral pleural effusions 4. Hyperenhancing 1.8 mm region within segment VIII of the liver peripherally, which likely represents a benign perfusion abnormality. 5. Hypodensities within the kidneys bilaterally, which are incompletely characterized, but likely represent renal cysts, some of which were present on the prior non-contrast study. DISCHARGE LABS: [**2163-10-14**] 03:25AM BLOOD WBC-7.3 RBC-2.78* Hgb-8.5* Hct-25.6* MCV-92 MCH-30.4 MCHC-33.0 RDW-15.9* Plt Ct-487* [**2163-10-14**] 03:25AM BLOOD Glucose-106* UreaN-24* Creat-0.8 Na-136 K-4.2 Cl-102 HCO3-27 AnGap-11 [**2163-10-14**] 03:25AM BLOOD Calcium-9.0 Phos-3.4 Mg-1.9 Brief Hospital Course: Ms. [**Known lastname **] is a 55 year old woman with h/o restrictive lung disease (bleomycin toxicity), sarcoidosis, systolic CHF (EF 30%, adriamycin toxicity), Factor V Leiden, s/p trach and PEG placement, here with recurrent fevers. #. Fever: Patient was admitted with fever and leukocytosis. Infectious considerations initially included VAP vs line infection vs UTI vs Cdiff. On admission PICC line was removed and foley was replaced. Patient was transiently on Meropenem and IV Vanco however was discontinued on [**10-10**], as there was low suspicion for active infection. Sputum cultures grew gram negative rods (ACHROMOBACTER DENTRIFICANS) which was though to be a colonizer. Patient remained on PO vanco throughout stay and will continue on it until [**10-21**]. Rheumatology and ID were consulted however no source for the fever could be found. She had a DVT in her right upper extremity that may be causing her fevers. She was started on enoxaparin for DVT therapy, as she developed a clot despite Coumadin therapy. This should be continued at therapeutic dose lifelong, given the patient's h/o Factor V Leiden. # Upper Extremity DVT: Pt with new RUE DVT seen on U/S at the site of her PICC. She developed this despite being therapeutic on Coumadin. She was started on Lovenox, which should be continued lifelong as above. # Transient hypotension: SBP transiently dropped to 80s, typically while she was sleeping. Responded to IVF boluses. No other intervention was necessary. # Diarrhea: Had C. diff infection since late [**9-2**] and was being treated with PO Vanco. Patient will remain on PO Vanco until [**10-21**]. Last C. diff toxin in stool was negative. Patient was started on banana flakes to bulk stool which seemed to help stool output. # Hyponatremia: On admission hyponatremia was considered likely secondary to hypovolemia. It resolved in 12 hours of admission. # Skin rash: Pt presented with fungal rash under breasts, groin, and lower back/buttocks. She was treated w/miconazole powder and PO diflucan. # Thrush: Pt noted to have oral thrush on exam. She was treated with PO diflucan. # Respiratory failure: Secondary to bleomycin toxicity. Pt arrived trached and on [**Month (only) **]. Weaning process was started during this hospitalization. Pt tolerated several hours a day on trach mask. Does get anxious when on the trach mask - Ativan is effective for relief. # CHF: [**Last Name **] problem. [**Name (NI) **] interventions were necessary. # CKD: [**Last Name **] problem. [**Name (NI) **] interventions were necessary. # Factor V Leiden: H/o Factor V Leiden. Pt was on Coumadin for life-long anticoagulation. Coumadin was discontinued given that patient developed a DVT on coumadin. Pt should continue on therapeutic dose of Lovenox lifelong. # HTN: Prior h/o hypertension, although had hypotension during last admission. Coreg was held given normal blood pressures. Meds should be restarted upon outpatient assessment and uptitrated as necessary. #. Psych: continued Ativan prn for agitation/anxiety #. Anemia: HCT was as low as 21 and received 2 unit pRBC. No clear source of bleeding and patient's hct remained stable. Receives Aranesp as an outpatient. #. Sarcoidosis: Followed by Dr. [**Last Name (STitle) 575**]. Stable on this admission. Ventilation requirements should be weaned as tolerated. Medications on Admission: Meropenem 500mg IV q8h x7days - completed [**2163-9-29**], restarted [**10-5**] Vancomycin 1000mg IV q24h - restarted [**10-4**] Vancomycin 125mg PO q6h x21 days Flagyl 500mg PO q8h x21days Warfarin 5mg PO daily Coreg 12.5mg PO BID White Petrolatum-Mineral Oil Ophthalmic TID prn redness Bisacodyl 10mg PO daily prn Maalox PO QID prn Miconzaole powder [**Hospital1 **] prn Tylenol solution 650mg PO q6h prn Chlorhexidine 1mL [**Hospital1 **] Famotidine 20mg PO q24h Heparin 5000units SC TID Discharge Medications: 1. vancomycin 125 mg Capsule Sig: One (1) Capsule PO Q6H (every 6 hours) for 9 days. 2. chlorhexidine gluconate 0.12 % Mouthwash Sig: One (1) ML Mucous membrane [**Hospital1 **] (2 times a day). 3. sertraline 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. simvastatin 40 mg Tablet Sig: One (1) Tablet PO QHS (once a day (at bedtime)). 5. miconazole nitrate 2 % Powder Sig: One (1) Appl Topical [**Hospital1 **] (2 times a day). 6. acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for pain/fever. 7. oxycodone 5 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for pain. 8. enoxaparin 60 mg/0.6 mL Syringe Sig: One (1) Subcutaneous Q12H (every 12 hours). 9. famotidine 40 mg/5 mL Suspension Sig: One (1) PO once a day. 10. Maalox Advanced 200-200-20 mg/5 mL Suspension Sig: One (1) PO four times a day as needed for indigestion. 11. bisacodyl 5 mg Tablet Sig: Two (2) Tablet PO once a day as needed for constipation. 12. ipratropium bromide 17 mcg/Actuation HFA Aerosol Inhaler Sig: Two (2) Puff Inhalation Q4H (every 4 hours) as needed for shortness of breath or wheezing. 13. albuterol sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig: 6-8 Puffs Inhalation Q4H (every 4 hours) as needed for Wheezing. 14. Ativan 1 mg Tablet Sig: One (1) Tablet PO every six (6) hours as needed for anxiety. 15. darbepoetin alfa in polysorbat 25 mcg/mL Solution Sig: Twenty Five (25) mcg Injection once a week: last received [**2163-10-5**] at prior rehab. Discharge Disposition: Extended Care Facility: [**Hospital3 105**] - [**Location (un) 1121**] - [**Location (un) 1456**] Discharge Diagnosis: Upper Extremity Deep Venous Thrombosis Chronic respiratory failure Upper Extremity Deep Venous Thrombosis Chronic respiratory failure 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: Dear Ms. [**Known lastname **], You were admitted because you were having fevers. After extensive work-up, we do not believe you were having an active infection causing the fever. You will remain on the Vancomycin for your prior C. difficile infection. You had a clot in your right arm vein. You were started on a new blood thinner called Lovenox. Many changes were made to your medications; please see attached list. Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight goes up more than 3 lbs. Followup Instructions: Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 2722**], MD Phone:[**Telephone/Fax (1) 1971**] Date/Time:[**2163-10-28**] 1:30 Provider: [**Name10 (NameIs) 1571**] FUNCTION LAB Phone:[**Telephone/Fax (1) 609**] Date/Time:[**2163-11-22**] 11:30 Provider: [**Name10 (NameIs) 1570**],INTERPRET W/LAB NO CHECK-IN [**Name10 (NameIs) 1570**] INTEPRETATION BILLING Date/Time:[**2163-11-22**] 11:30 [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**Name8 (MD) **] MD [**MD Number(1) 292**] Completed by:[**2163-10-14**] ICD9 Codes: 4280, 2761
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Medical Text: Admission Date: [**2188-8-21**] Discharge Date: [**2188-9-8**] Date of Birth: [**2111-12-1**] Sex: M Service: MEDICINE Allergies: Phenytoin / Decadron Attending:[**First Name3 (LF) 7223**] Chief Complaint: Meningioma Major Surgical or Invasive Procedure: [**2188-8-20**]: Left Craniotomy for Meningioma with reconstruction [**2188-8-31**]: G-tube placement History of Present Illness: 76-year-old male with history of recurrent meningioma s/p bifrontal craniotomy with cranioplasty and bone flap [**2188-8-21**], transferred from TICU for further management of post-operative atrial fibrillation. Patient has baseline sinus bradycardia and underwent ablation after presentation with tachyarrythmia on [**2188-7-16**]. Patient unable to give history. Past Medical History: 1. Atypical Reccurent Right Frontal Meningioma: Symptoms began in [**2180-6-22**] per [**First Name8 (NamePattern2) 38984**] [**Last Name (NamePattern1) **] "when he became forgetful and sluggish. Initially he was treated for depression. A head MRI showed a large dura-based mass in the right frontal brain. A resection was done by [**Name6 (MD) 1528**] Cares, MD [**First Name (Titles) **] [**Last Name (Titles) **] [**Hospital1 38994**]. Pathology was atypical meningioma. He did well until [**10-22**] when the mass recurred. He had a second resection on [**2182-1-9**] by Dr. [**Last Name (STitle) 38985**]. This was followed with involved-field cranial irradiation by [**First Name8 (NamePattern2) 636**] [**Last Name (NamePattern1) 38986**], MD [**First Name (Titles) **] [**Last Name (Titles) **] [**Hospital1 **] from [**Month (only) **] to [**2182-3-22**] to 5760 cGy. A follow up MRI on [**2183-6-26**] showed a 0.5-mm dural based nodular enhancement and he was referred here for SRS. Surveillance MRI on [**2184-12-8**] revealed growth of the meningioma in the superior margin of the surgical cavity invading the skull. He underwent craniectomy on [**2185-1-26**] by [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], MD [**First Name (Titles) **] [**Last Name (Titles) 38987**]. There had been invasion into the inner and outer tables of the skull. A piece of Duagen dural substitute was placed over the dural defect and then Methyl Methacrylate cranioplasty was placed over the skull defect. Pathology revealed atypical meningioma." Underwent cyberknife therapy in [**2-27**]. He has been maintained on temodar (chemo) 25mg/m2. 2. Atrial fibrillation: Known to Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] and followed by Dr. [**Last Name (STitle) 16958**]. 3. GERD 4. OA of knee 5. Hypothyroid Social History: Married with two children. Used to smoke a pack a day but quit in [**2151**]. Used to drink beer but stopped when he was put on Coumadin. Mother died at 80 from stroke. Father died at 60's, unclear cause. Bother died 60 from lung cancer. Family History: Non-contributory Physical Exam: Gen: elderly male in NAD. Oriented x 1. Mood, affect appropriate. HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. CV: Regular rate, normal S1, S2. No m/r/g. No thrills, lifts. No S3 or S4. Chest: Resp were unlabored, no accessory muscle use. Poor air flow bases bilateral. No wheezes or crackles. Abd: Soft, NTND. PEG tube inplace. No HSM or tenderness. Ext: No c/c/e. Skin: No stasis dermatitis, ulcers, scars. Pertinent Results: [**2188-8-22**] Echocardiogram: The left atrium is mildly dilated. There is mild symmetric left ventricular hypertrophy. The left ventricular cavity is unusually small. Overall left ventricular systolic function is normal (LVEF 60%). The right ventricular cavity is dilated with depressed free wall contractility. There are focal calcifications in the aortic arch. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. The estimated pulmonary artery systolic pressure is normal. There is a small pericardial effusion. There is an anterior space which most likely represents a fat pad. There are no echocardiographic signs of tamponade. . Compared with the findings of the prior study (images reviewed) of [**2188-7-15**], the findings are similar. . Head CT [**2188-8-31**]: Multifocal intraparenchymal hemorrhage centered within the right frontal lobe with surrounding edema is relatively unchanged when compared to prior exam. A small amount of extra-axial hemorrhage along the right frontal craniotomy is stable in appearance as well. Areas of pneumocephalus near the right frontal craniotomy mesh is persistent. There is no shift of normally midline structures. The ventricle configuration is unchanged. Hypodensity in the periventricular and subcortical white matter reflects chronic microvascular and vascular ischemic changes. Secretions in the right frontal sinus is unchanged. . MRI [**2188-8-22**]: Status post interval resection of right frontal scalp mass and the contiguous extra-axial enhancing lesions. There is stable enhancing heterogeneous tissue in the inferior right frontal lobe. There are findings suggestive of ischemia in the right frontal lobe which is new compared to the prior study of [**2188-8-21**]. There is a new mesh cranioplasty in the right frontal region. . Labs on Admission: [**2188-8-21**] 11:30AM BLOOD WBC-2.5* RBC-3.39* Hgb-11.0* Hct-29.7* MCV-87 MCH-32.5* MCHC-37.1* RDW-14.1 Plt Ct-202 [**2188-8-21**] 08:20AM BLOOD PT-23.0* PTT-33.7 INR(PT)-2.2* [**2188-8-21**] 05:45PM BLOOD Glucose-196* UreaN-15 Creat-1.2 Na-142 K-3.9 Cl-105 HCO3-26 AnGap-15 [**2188-8-21**] 05:45PM BLOOD Calcium-10.0 Phos-3.3 Mg-2.5 . Labs on Discharge: Brief Hospital Course: Patient was electively admitted on [**8-21**] for a planned surgical resection and esthetic reconstruction of his left cranium for recurrent meningioma. On admission, his coagulation studies were elevated, requiring the use of FFP infusion and vitamin K infusion to correct prior to surgery. This was done uneventfully, and surgery proceded. Intraoperatively, he had several episodes of atrial fibrillation with rapid ventricular response, which was refractory to cardioversion. He also underwent an intraoperative TEE for further interrogation of this process. Post-operatively, he was admitted to the ICU for this reason, and cardiology consulted for control of his atrial fibrillation he was started on an Amiodarone drip and Diltiazem drips which eventually converted him. He remained abulic, followed commands inconsistently and answered in one word answers. . # Atrial Fibrillation: On [**8-27**] he was transferred to the step down unit. On [**8-27**]: Back into afib on Esmolol. On [**8-29**]: amio 200 [**Hospital1 **], LFTs wnl; back in afib. Lopressor 37.5mg PO BID. On [**2188-8-29**], patient was transferred from trauma SICU to medicine cardiology service. On arrival, he was in atrial fibrillation with RVR. Per cardiology recs, he was given acebutolol 200mg via the NG tube. Overnight, patient pulled out his NG tube. Given that he had failed swallow studies twice in the previous week, he was not able to take any medications by mouth. Plan was to give patient IV beta-blockers as needed until a PEG tube was placed. On the morning of [**2188-8-30**], patient was given metoprolol IV 5mg x1 for atrial flutter with heart rate in 130s. Patient converted back to sinus rhythm. On [**2188-9-1**] patient re-entered A Fib with RVR. Patient was started on Acebutolol, Amiodarone 100mg qd and digoxin 0.125mg. Metoprolol was not started as patient become bradycardiac last time he converted. However, patient did not convert with Acebutolol titrated up to 400mg [**Hospital1 **] consequently we started Metoprolol. Patient converted on [**2188-9-6**] when titrated to Metoprolol 100mg [**Hospital1 **]. No significant pauses or brady on conversion. Patient recently had ablation in [**6-29**]. Pacemaker placement not an ideal option as patient will require multiple MRI for meningioma resection follow-up. - Discharge on the following medications for rate control: Metroprolol 75mg po BID, Amiodarone 100mg po qd, Digoxin 0.125mcg po every other day. - Started Aspirin 81 mg, Neurosurgery stated this was ok. **** Per neurosurgery, need to wait 1 month before anticoagulation can be started due to recent craniotomy. Patient is a candidate for anti-coagulation, was in A Fib with AVR during hospitliazation. In 1 month need to discuss with Neurosurgery and Cardiology re-starting anti-coagulation **** . # s/p frontal craniotomy: Of note, on [**2188-8-30**] plastic surgery noted fluid build up at the incision site on frontal region. Fluid was cultured and final report was no growth. Patient received vancomycin for a 5 day course given that infection to that area could be devastating. Kept head of bed elevated. Continued Keppra for seizure prophylaxis. Patient has follow-up appointments with Neurosurgery and Plastic surgery (will be removing sutures). . # FEN: Patient has failed swallow study twice. Patient pulled out NG tube night of [**2188-8-29**]. G tube placed [**2188-8-31**]. On tube feeds with banana flakes secondary to bowel incontinence. - Diet order per nutrition in page 1 - discontinue banana flakes if patient becomes constipated - peg site needs to changed daily with dry dressing . # Hypothyroidism: Repeat TSH 1.3, however free T4 remained elevated at 1.9. Decreased Levothyroxine from 50mcg to 37.5 mcg. - Recheck TSH and free T4 in 1 month . # Hematuria: Urine culture negative. Repeat Ua no RBC. Hematuria most likely secondary to trauma from patient pulling at foley. Condom cath did not work, patient currently incontinent. Discharge on foley. When patient becomes more oriented can d/c foley - recheck Ua for hematuria in [**1-23**] months . # DM: Morning NPH units increased to 14 from 12 as blood sugars slightly elevated.Can adjust sliding scale at rehab as appropriate. . #. Hypertension: Well-controlled throughout admission. Continued lisinopril 10mg PO daily, for rate control patient on Metoprolol 75 mg [**Hospital1 **] with hold parameters. . # Code Status: Full, confirmed with wife Medications on Admission: 1. Amiodorone (200 mg daily) 2. Coumadin [Warfarin] (stopped [**2188-8-17**]) 3. Levoxyl (50mcg daily) 4. Lisinopril [Prinivil, Zestril] (10 mg daily) 5. Metoprolol succinate [Toprol XL] (25 mg daily) 6. Neurontin (Gabapentin)(400 mg [**Hospital1 **]) 7. Sanctura 20 mg [**Hospital1 **]) 8. Pepcid (Famotidine)(20 mg daily) Discharge Disposition: Extended Care Facility: [**Hospital3 7**] & Rehab Center - [**Hospital1 8**] Discharge Diagnosis: Primary Diagnosis: Meningioma Atrial fibrillation with RVR . Secondary Diagnosis: Hypothyroidism Diabetes GERD Discharge Condition: Vitals stable, sinus rythm. Discharge Instructions: You were admitted on [**2188-8-21**] for removal of a meningioma. During the hospital course you were transferred to the cardiology service for further management of a fast heart rhythm. You eventually converted to sinus rythym. . We have made changes to your medications please take them as directed. . Please attend your follow-up appointments as listed: 1) You have an appointment with Plastic Surgery Clinic on [**2188-9-12**] 01:30p [**Hospital6 29**], [**Location (un) **]. They will be removing your sutures. 2) You have an appointment with Radiology on [**2188-10-7**] 08:30a XCT [**Apartment Address(1) 9394**] [**Hospital Ward Name **] CC CLINICAL CENTER, [**Location (un) **] RADIOLOGY to have a CT head. Immediately following you have an appointment with Neurosurgery on [**2188-10-7**] 9:30 am with Dr. [**Last Name (STitle) **],[**First Name3 (LF) **] M. LM [**Hospital Unit Name **], [**Location (un) **] NEUROSURGERY WEST. You will not need an MRI of the brain, as this was done during your hospital stay. If you have any questions there number is [**Telephone/Fax (1) 1669**]. 3) Follow-up with your Cardiologist, Dr. [**Last Name (STitle) **] [**Telephone/Fax (1) 62**] on [**10-16**] at 10:20am. His office is at [**Hospital6 29**], [**Location (un) **] CC7 CARDIOLOGY 4) Follow with primary care doctor Mr. [**Name13 (STitle) **] in [**2-25**] weeks. Have [**Hospital **] rehab call [**Telephone/Fax (1) 38995**] to make an appointment. . Call your primary care doctor or go to the ER if you experience rapid heart rate, feeling dizzy, pass out, chest pain, shortness of breath or any other symptoms. . The following discharge Instructions have been provided by Neurosurgery regarding your surgery: ?????? Unless directed by your doctor, do not take any anti-inflammatory medicines such as Motrin, Advil, and Ibuprofen etc. - If you have been prescribed an anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing as ordered. - Clearance to drive and return to work will be addressed at your post-operative office visit. CALL YOUR SURGEON IMMEDIATELY IF YOU EXPERIENCE ANY OF THE FOLLOWING - New onset of tremors or seizures. - Any confusion or change in mental status. - Any numbness, tingling, weakness in your extremities. - Pain or headache that is continually increasing, or not relieved by pain medication. - Any signs of infection at the wound site: redness, swelling, tenderness, or drainage. - Fever greater than or equal to 101?????? F. Followup Instructions: 1) You have an appointment with Plastic Surgery Clinic on [**8-23**] 1:30pm at [**Hospital Ward Name 23**] Building [**Location (un) 470**]. They will be removing your sutures. . 2) You have an appointment with Radiology on [**2188-10-7**] 08:30a XCT [**Apartment Address(1) 9394**] [**Hospital Ward Name **] CC CLINICAL CENTER, [**Location (un) **] RADIOLOGY to have a CT head. Immediately following you have an appointment with Neurosurgery on [**2188-10-7**] 9:30 am with Dr. [**Last Name (STitle) **],[**First Name3 (LF) **] M. LM [**Hospital Unit Name **], [**Location (un) **] NEUROSURGERY WEST. You will not need an MRI of the brain, as this was done during your hospital stay. If you have any questions there number is [**Telephone/Fax (1) 1669**]. . 3) Follow-up with your Cardiologist, Dr. [**Last Name (STitle) **] [**Telephone/Fax (1) 62**] on [**10-16**] at 10:20am. His office is at [**Hospital6 29**], [**Location (un) **] CC7 CARDIOLOGY . 4) Follow with primary care doctor Mr. [**Name13 (STitle) **] in [**2-25**] weeks. Have rehab call [**Telephone/Fax (1) 38995**] to make an appointment. Completed by:[**2188-9-8**] ICD9 Codes: 2760, 4280, 4019, 2449, 2859
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Medical Text: Admission Date: [**2174-9-5**] Discharge Date: [**2174-10-4**] Date of Birth: [**2121-3-15**] Sex: F Service: HISTORY OF PRESENT ILLNESS: The patient is a 53-year-old Hispanic female was last admitted on [**2174-3-31**] with chest pain and shortness of breath. She ruled out for a myocardial infarction and had a normal exercise MIBI. She had medical management and has had intermittent substernal chest pain with exertion since that time. Her pain radiates to the right arm and can last for one hour. She is now admitted for chest pain lasting more than one hour on [**9-5**]. She also has a history of nephrotic syndrome with an increased creatinine, and cardiac catheterization was trying to be avoided. An echocardiogram on [**9-8**] revealed an ejection fraction of 60%, mild left ventricular hypertrophy, 1 to 2+ mitral regurgitation, and 1+ tricuspid regurgitation. A catheterization on [**9-8**] revealed the left anterior descending artery had a 70% mid stenosis and a 70% first diagonal stenosis. The left circumflex had a 90% small obtuse marginal stenosis. The right coronary artery had an 80% stenosis at the origin, 80% proximal stenosis, and 90% distal stenosis. PAST MEDICAL HISTORY: (Past medical history is significant for) 1. History of angina. 2. History of hypertension. 3. History of nephrotic syndrome with a baseline creatinine of 1.9. 4. History of hypercholesterolemia. 5. Status post total abdominal hysterectomy and bilateral salpingo-oophorectomy. 6. Status post appendectomy. MEDICATIONS ON ADMISSION: 1. Lopressor 75 mg by mouth twice per day. 2. Hydrochlorothiazide 50 mg by mouth once per day. 3. Lipitor 20 mg by mouth once per day. 4. Norvasc 5 mg by mouth once per day. 5. Lisinopril 40 mg by mouth once per day. 6. Glipizide 10 mg by mouth once per day. 7. Nitroglycerin as needed. 8. Ciprofloxacin 250 mg by mouth twice per day (started on [**9-8**]). ALLERGIES: She has no known drug allergies. SOCIAL HISTORY: She does not smoke cigarettes. She does not drink alcohol. FAMILY HISTORY: Family history is significant for diabetes. REVIEW OF SYSTEMS: Review of systems was unremarkable. PHYSICAL EXAMINATION ON PRESENTATION: On physical examination, the patient was a well-developed Hispanic female in no apparent distress. Vital signs were stable. The patient was afebrile. Head, eyes, ears, nose, and throat examination revealed normocephalic and atraumatic. Extraocular movements were intact. Pupils were equal, round, and reactive to light and accommodation. The oropharynx was benign. The neck was supple. Full range of motion. No lymphadenopathy or thyromegaly. Carotids were 1+ in the ankles bilaterally and without bruits. The lungs were clear to auscultation and percussion. Cardiovascular examination revealed a regular rate and rhythm. No murmurs, rubs, or gallops. The abdomen was soft and nontender. Positive bowel sounds. No masses or hepatosplenomegaly. Extremity examination revealed no clubbing, cyanosis, or edema. Pulses were 2+ and equal bilaterally except for the bilateral posterior tibialis pulses which were 1+. Neurologic examination was nonfocal. PERTINENT LABORATORY VALUES ON PRESENTATION: CONCISE SUMMARY OF HOSPITAL COURSE BY ISSUE/SYSTEM: The patient was seen by Dr. [**Last Name (STitle) 1537**], and she had an elevated creatinine following catheterization, so her coronary artery bypass graft was delayed. She continued to have chest pain while in the hospital. Her creatinine went up to 2.8 following the catheterization and then eventually came back down to 2.4. On [**9-15**], she underwent a coronary artery bypass graft times two with left internal mammary artery to the left anterior descending artery and saphenous vein graft to posterior descending artery. The patient tolerated the procedure well and was transferred to the Cardiothoracic Surgery Recovery Unit in stable condition. She was extubated. Her creatinine did continue to rise postoperatively; up to 3.3. She still continued to be diuresed with Lasix. Her chest tubes were discontinued on postoperative day one. Her creatinine continued to rise and 3.9 and then went to as high as 5.4 on [**9-19**], and then she eventually started to trend down to her baseline. She did have hemodialysis on [**9-19**] and tolerated this well. On [**9-19**], she had a left effusion, and she had a pleurocentesis from which 400 cc of serosanguineous fluid was obtained. She was then started on continuous venovenous hemofiltration and tolerated this well and then went back to hemodialysis. On [**9-23**], the patient was transferred to [**Hospital Ward Name 121**] Two. She did not require dialysis at that point anymore. She continued to improve. She had her epicardial pacing wires discontinued. On [**9-26**], she was noted to have a large left pleural effusion which had reaccumulated. She underwent a pleurocentesis again, and 800 cc of serosanguineous fluid was obtained, and the patient had been oxygen dependent and after that was not oxygen dependent and had symptomatic relief. She continued to have a sizeable left effusion at that point. On [**9-28**], she had a chest tube placed, and 700 cc of serosanguineous fluid was obtained. On [**9-29**], the chest tube was discontinued, and she had a small pneumothorax following that. She had another chest tube placed that had a slight air leak and still had a pneumothorax following this placement. She also underwent a bronchoscopy which did not reveal anything. She had the chest tube discontinued on [**10-3**]. There was a small bilateral pleural effusion on the final x-ray, slightly elevated hemidiaphragm, and a small left apical pneumothorax. She also had an issue urinary retention. She had a Foley catheter in for several days. Eventually, this was discontinued. Then she had to have it put back in again three days prior to discharge. She had it discontinued on the night prior to discharge and voided well following that. DISCHARGE DISPOSITION: On postoperative day 19, she was discharged to home. CONDITION AT DISCHARGE: Condition on discharge was stable. PERTINENT LABORATORY VALUES ON DISCHARGE: Her laboratories on discharge revealed her white blood cell count was 6800, her hematocrit was 31.3, and her platelets were 502,000. Her sodium was 130, potassium was 4.7, chloride was 97, bicarbonate was 16, blood urea nitrogen was 27, creatinine was 2.1, and her blood glucose was 203. MEDICATIONS ON DISCHARGE: (Her medications on discharge were) 1. Colace 100 mg by mouth twice per day. 2. Glipizide 10 mg by mouth twice per day. 3. Atenolol 50 mg by mouth twice per day. 4. Ecotrin 325 mg by mouth once per day. 5. Protonix 40 mg by mouth once per day. 6. Norvasc 10 mg by mouth once per day. 7. Lasix 20 mg by mouth once per day. 8. Vioxx 25 mg by mouth once per day. 9. Tylenol No. 3 one to two tablets by mouth q.4-6h. as needed (for pain). DISCHARGE INSTRUCTIONS/FOLLOWUP: The patient was to follow up with Dr. [**Last Name (STitle) 33950**] in one to two weeks and by Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 70**] in six weeks. [**First Name11 (Name Pattern1) **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **], M.D. [**MD Number(1) 75**] Dictated By:[**Last Name (NamePattern1) 11726**] MEDQUIST36 D: [**2174-10-4**] 17:00 T: [**2174-10-4**] 17:02 JOB#: [**Job Number 33951**] ICD9 Codes: 4111, 5849, 5990, 5119, 2767
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Medical Text: Admission Date: [**2178-6-21**] Discharge Date: [**2178-6-26**] Date of Birth: [**2111-11-10**] Sex: M Service: MEDICINE Allergies: Lisinopril / Effexor Attending:[**First Name3 (LF) 2387**] Chief Complaint: Chest pain Major Surgical or Invasive Procedure: cardiac catheterization, no intervention History of Present Illness: 66-year-old man with CAD s/p LAD PCI, right SFA/peroneal bypass and angioplasty, asymptomatic right subclavian and carotid disease, brittle diabetes on insulin pump, hyperlipidemia, and hypertension, who was POD#3 s/p Right total knee replacement at the [**Hospital1 **] who developed chest pain with BP in the 180s, and EKG changes infero-laterally with ST depressions similar to EKG changes during stress test before surgery and concern for V1-3 STe, which was unchanged from EKG at [**Hospital1 18**] 1mo ago. Given the EKG changes (not aware of baseline EKG at [**Hospital1 18**]) and CP, he was started on heparin gtt, and he was transferred to [**Hospital1 18**] for emergent catheterization, which revealed no changes from c.cath 1mo ago. . On arrival to cath lab, he was hypertensive and required a nitro gtt to maintain SBPs < 160, he was given full dose ASA and 600mg of Plavix. Upon completion of cath, was transferred to the floor, hypoxemic on 10 L facemask and tachypneic. Nitro gtt was discontinued. At ~ 1600, had an acute episode of SOB, desaturations to 92 on max NC, thus requiring NRB to maintain sats > 96%, BP at the time was 144/65. He was given IV lasix for suspected pulmonary edema and haldol for agitation. UOP from lasix was 1L in one hour and his RR improved to low 20s, though he remained confused. CTA chest was peformed which preliminarily showed no PE and a ? RUL consolidation with mild pulmonary edema. He was briefly transferred to the MICU for continued SOB, hypoxemia and nursing care. During his MICU course he was given 80 mg IV lasix and put out nearly 1.8 L of urine. He was also quite agitated and delerious (which has been ongoing) and received 20 mg olanzapine which calmed him down. He is transferred to the CCU for further management. . Notably, most recent cath findings as follows: SBPs 160s - 180s. 60% LAD, MR, right dominant system with 70% 1st diag, 60% 2nd diagnoal, moderate LCX disease and 60% small PDA. Per discussion with cards fellow, it was felt that EKG changes constituted demand ischemia in setting of acute drop in hematocrit from 35 to 26 and was consistent with prior stress test. Of note, [**5-22**] cath showed diffuse CAD, EF > 60%, there was no intervention and findings were similar to above. Also of note, upon transfer to [**Hospital1 18**], he was given 1 unit pRBC for anemia. . At OSH, Labs were notable for HCT 35->26 post op, WBC 4.7->9.5 admission to [**6-21**] with left shift, CO2 31, Cr. 0.7 and CK/CKMB/Trop 503/6.1/0.26 (high/high/nl(< 0.4)). BNP was 311. . Per review of OSH nursing notes, pt has been confused since at least [**6-19**], has been receving dilaudid for pain. On [**6-20**] AM was noted to be somnolent and resonded to narcan. . On review of systems, he denies any prior history of stroke, TIA, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. he denies recent fevers, chills or rigors. he denies exertional buttock or calf pain. All of the other review of systems were negative. . Cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope Past Medical History: DM1 (dx'ed in late 20s) c/b triopathy CAD s/p PTCA/stent to LAD in [**2-5**] PVD s/p fem/tib bypass Enviromental allergies Non-healing R foot ulcer s/p R first toe amputaton ([**2173-2-11**]) Orthostatic hypotension Hyperlipidemia HTN Depression [**12-6**]+MR (by echo [**4-8**]) moderate pulm HTN Social History: Works as administrator at [**Hospital1 498**] [**Location (un) 5169**] Smoked pipe for several years in 20s h/o EtOH abuse ([**7-14**] drinks/day x 10 years) now sober Family History: [**Name (NI) 61930**] pt is adopted. Physical Exam: Admission PE: VS: T=98.7 BP=144/46 HR=96 RR= 24 O2 sat= 93% 6 Liters GENERAL: WDWN 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 at clavicle. 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. EXTREMITIES: No c/c/e. SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. PULSES: Right: DP 2+ PT 2+ Left: DP 2+ PT 2+ Pertinent Results: [**2178-6-21**] 01:44PM BLOOD WBC-15.5*# RBC-3.09*# Hgb-9.6*# Hct-28.0*# MCV-91 MCH-31.0 MCHC-34.2 RDW-13.7 Plt Ct-209 [**2178-6-22**] 05:11AM BLOOD WBC-9.8 RBC-3.09* Hgb-9.5* Hct-27.6* MCV-89 MCH-30.7 MCHC-34.4 RDW-13.9 Plt Ct-182 [**2178-6-25**] 07:15AM BLOOD WBC-6.4 RBC-3.53* Hgb-10.5* Hct-31.7* MCV-90 MCH-29.8 MCHC-33.2 RDW-15.1 Plt Ct-300 [**2178-6-21**] 01:44PM BLOOD PT-13.5* PTT-39.0* INR(PT)-1.2* [**2178-6-24**] 04:43AM BLOOD PT-12.3 PTT-29.2 INR(PT)-1.0 [**2178-6-21**] 01:44PM BLOOD Glucose-220* UreaN-12 Creat-0.6 Na-133 K-3.9 Cl-97 HCO3-29 AnGap-11 [**2178-6-25**] 07:15AM BLOOD Glucose-120* UreaN-10 Creat-0.6 Na-140 K-3.8 Cl-102 HCO3-33* AnGap-9 [**2178-6-21**] 01:44PM BLOOD LD(LDH)-273* TotBili-1.7* [**2178-6-22**] 05:11AM BLOOD ALT-24 AST-55* CK(CPK)-754* AlkPhos-67 Amylase-12 TotBili-1.1 [**2178-6-22**] 05:11AM BLOOD Lipase-9 [**2178-6-21**] 08:37PM BLOOD cTropnT-0.24* [**2178-6-22**] 05:11AM BLOOD CK-MB-9 cTropnT-0.21* [**2178-6-21**] 01:44PM BLOOD Calcium-8.0* Phos-2.5* Mg-1.9 [**2178-6-25**] 07:15AM BLOOD Calcium-8.3* Phos-3.5 Mg-2.2 [**2178-6-21**] 01:44PM BLOOD Hapto-96 [**2178-6-23**] 09:19AM BLOOD Ammonia-19 . Discharge Labs Microbiology: [**2178-6-21**] 6:46 pm URINE Source: Catheter. **FINAL REPORT [**2178-6-22**]** URINE CULTURE (Final [**2178-6-22**]): NO GROWTH. [**2178-6-21**]: BCx2 pending Radiology: Radiology Report CTA CHEST W&W/O C&RECONS, NON-CORONARY Study Date of [**2178-6-21**] 3:50 PM [**Last Name (LF) **],[**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 53630**] [**2178-6-21**] 3:50 PM CTA CHEST W&W/O C&RECONS, NON- Clip # [**Clip Number (Radiology) 61931**] Reason: POD # 2 s/p kmee surgery, chest pain, clean cath Note: recei Contrast: OPTIRAY Amt: 100 HISTORY: 66-year-old male, with two-vessel coronary artery disease and LVEF on LV gram 60%. Now two days status post knee surgery. Presents with shortness of breath. Chest pain. Evaluate for pulmonary embolism or acute aortic pathology. COMPARISON: Limited comparison from prior chest radiograph on [**2173-4-30**]. TECHNIQUE: MDCT images were acquired from the thoracic inlet to the lung bases before and after administration of IV contrast. Multiplanar reformatted images were obtained for evaluation. CTA CHEST: The pulmonary arterial vasculature is normally opacified to the subsegmental level without filling defect to suggest acute pulmonary embolism. There is an aorta arch with bovine variant, but the aorta is otherwise normal in course and caliber without acute pathology. Scattered vascular calcifications are noted along the aortic arch. The remaining great mediastinal vessels are normal. Moderate coronary calcifications are noted. The heart is normal in size without pericardial effusions. There are bilateral pleural effusions, small on the right and tiny on the left. There are mild adjacent bilateral atelectasis. Increased septal lines are compatible with mild pulmonary edema. In the upper lobes, there are hazy patchy opacities, right greater than left. While this could represent the underlying pulmonary edema, early infectious process cannot be excluded. There is no pneumothorax. No mediastinal, hilar or axillary lymphadenopathy is noted. The study is not designed for subdiaphragmatic diagnosis but no gross abnormalities are noted. BONE WINDOW: Multilevel degenerative changes are mild-to-moderate, with subchondral cysts and Schmorl's node formation. No suspicious lytic or sclerotic lesions are noted. IMPRESSION: 1. No pulmonary embolism or acute aortic pathology. 2. Mild pulmonary edema. Patchy opacities in the upper lobes, right greater than left, cannot rule out early infectious process. 3. Bilateral pleural effusions with dependent atelectasis. 4. Coronary artery disease. Dr. [**First Name8 (NamePattern2) 5586**] [**Last Name (NamePattern1) **] has discussed the findings with the primary team, Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] at 4:33 p.m. shortly after the preliminary interpretation of the exam. 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: SUN [**2178-6-21**] 7:05 PM CXR: Radiology Report CHEST (PORTABLE AP) Study Date of [**2178-6-22**] 8:20 AM FINDINGS: The pulmonary vasculature is prominent and there are bilateral pleural effusions, consistent with congestive heart failure. There are also foci of hazy opacities at the right upper and right lower lobe, consistent with infection. No pneumothorax. The cardiomediastinal silhouette remains unchanged. IMPRESSION: Multifocal infection and increased pulmonary venous pressure. The study and the report were reviewed by the staff radiologist. DR. [**First Name (STitle) 251**] [**Name (STitle) 8580**] DR. [**First Name4 (NamePattern1) 2618**] [**Last Name (NamePattern1) 2619**] CXR: Radiology Report CHEST (PORTABLE AP) Study Date of [**2178-6-23**] 7:48 AM FINDINGS: As compared to the previous radiograph, the pre-existing parenchymal opacities show improvement. No other changes, constant size of the cardiac silhouette, no evidence of pleural effusions. DR. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 4130**] Arterial duplex scan: Radiology Report ART DUP EXT LO UNI;F/U RIGHT Study Date of [**2178-6-23**] 2:01 PM STUDY: Lower extremity arterial duplex. REASON: Decreased pulse post-total knee replacement. FINDINGS: Duplex evaluation was performed of the right lower extremity bypass. Peak velocities in centimeters per second from proximal-to-distal are as follows: Common femoral 115, profunda 142, SFA 150, 91, 94; proximal anastomosis 138, vein graft 110,89, 59; distal anastomosis 157, outflow 105. IMPRESSION: Patent right lower extremity bypass with no evidence of stenosis. DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] Carotis U/S: Radiology Report CAROTID SERIES COMPLETE Study Date of [**2178-6-24**] 10:11 AM [**Last Name (LF) **],[**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 61932**] [**2178-6-24**] 10:11 AM CAROTID SERIES COMPLETE Clip # [**Clip Number (Radiology) 61933**] Reason: pre-op for CABG, assess stenosis [**Hospital 93**] MEDICAL CONDITION: 66 year old man with CAD, multivessel disease requiring CABG. REASON FOR THIS EXAMINATION: pre-op for CABG, assess stenosis Final Report STUDY: Carotid series complete. REASON: Preop CABG. FINDINGS: Duplex evaluation was performed of bilateral carotid arteries. There is heterogeneous plaque seen bilaterally. On the right, peak velocities are 94, 107, and 183 in the ICA, CCA, and ECA respectively. This is consistent with less than 40% stenosis. On the left, ICA velocity is 184/50, CCA is 93, the ECA is 210. The ICA/CCA ratio is 2.0. This is consistent with 60-69% stenosis. There is antegrade vertebral flow bilaterally. The right vertebral waveform is notched suggesting possible subclavian stenosis. There is a normal right CCA waveform. IMPRESSION: Right ICA less than 40% stenosis. Left ICA 60-69% stenosis. DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] Venous duplex scan: Radiology Report UNILAT LOWER EXT VEINS RIGHT Study Date of [**2178-6-25**] 4:01 PM [**Last Name (LF) **],[**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 53630**] [**2178-6-25**] 4:01 PM UNILAT LOWER EXT VEINS RIGHT Clip # [**Clip Number (Radiology) 61934**] Reason: SWELLING PAIN RULE OUT DVT ON RIGHT [**Hospital 93**] MEDICAL CONDITION: 66 year old man with recent knee surgery and more swelling on right. REASON FOR THIS EXAMINATION: rule out dvt on right Wet Read: [**First Name9 (NamePattern2) 20005**] [**Doctor First Name **] [**2178-6-25**] 4:23 PM No DVT right lower extremity. Preliminary Report No DVT right lower extremity. DR. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] Cardiology results: Cardiology Report ECG Study Date of [**2178-6-21**] 11:39:18 AM Sinus rhythm. A-V conduction delay. Left atrial abnormality. Cannot exclude prior anterior wall myocardial infarction. Left ventricular hypertrophy. Secondary repolarization abnormalities most prominent in the lateral leads. Compared to the previous tracing of [**2178-5-22**] the lateral ST segment depressions, which are new, raise concern for concomitant myocardial ischemia. Clinical correlation is suggested. Cardiac catheterisation: Cardiology Report Cardiac Cath Study Date of [**2178-6-21**] 1. Selective coronary angiography in this right dominant system demonstrated two vessel coronary artery disease. The LMCA had mild disease. The LAD had diffuse calcific disease, and the previously placed stent(s) was patent. There was 60% stenosis in the proximal vessel. There was 70% stenosis of the first diagonal and 60% stenosis of the second diagonal. The LCx had moderate, diffuse disease in a small vessel. The RCA had a 60% stenosis in a small PDA. The anatomy appeared stable when compared to the recent cath of [**2178-5-23**]. 2. Limited resting hemodynamics revealed moderate systemic arterial systolic hypertension SBP 167mmHg. 3. Left ventriculography was deferred. 4. Hemostasis of the left femoral arteriotomy site was successfully achieved with a 6 French Angioseal device. FINAL DIAGNOSIS: 1. Unchanged two vessel coronary artery disease. 2. Moderate systemic arterial systolic hypertension. 3. Successful angioseal deployment. Brief Hospital Course: 66-year-old man with CAD s/p LAD PCI, right SFA/peroneal bypass and angioplasty, asymptomatic right subclavian and carotid disease, brittle diabetes on insulin pump, hyperlipidemia, and hypertension, who was POD#3 s/p Right total knee replacement at the [**Hospital1 **] who developed chest pain with BP in the 180s, and EKG changes infero-laterally with ST depressions similar to EKG changes during stress test before surgery and concern for V1-3 STe, which was unchanged from EKG at [**Hospital1 18**] 1mo ago. He was started on heparin gtt and transferred to [**Hospital1 18**] for emergent catheterization, which revealed no changes from cardiac cath 1 month ago. . On arrival to cath lab, he was hypertensive and required a nitro gtt to maintain SBPs < 160, he was given full dose ASA and 600mg of Plavix. Upon completion of cath, was transferred to the floor, hypoxemic on 10 L facemask and tachypneic. Nitro gtt was discontinued. He was transitioned to nasal cannula but then had an acute episode of SOB, desaturations to 92 on max NC, requiring NRB to maintain sats > 96%. BP at the time was 144/65. He was given IV lasix for suspected pulmonary edema and haldol for agitation. CTA chest was peformed which showed no PE and a ? RUL consolidation with mild pulmonary edema. He was briefly transferred to the MICU for continued SOB, hypoxemia and nursing care. During his MICU course he was given 80 mg IV lasix and put out nearly 1.8 L of urine. He was also quite agitated and delerious, and received 20 mg olanzapine which calmed him down. He is transferred to the CCU for further management. . Cath findings as follows: SBPs 160s - 180s. 60% LAD, MR, right dominant system with 70% 1st diag, 60% 2nd diagnoal, moderate LCX disease and 60% small PDA. Per discussion with cards fellow, it was felt that EKG changes constituted demand ischemia in setting of acute drop in hematocrit from 35 to 26 and was consistent with prior stress test. Of note, [**5-22**] cath showed diffuse CAD, EF > 60%, there was no intervention and findings were similar to above. Also of note, upon transfer to [**Hospital1 18**], he was given 1 unit pRBC for anemia. . CCU Course: # NSTEMI: Felt to be secondary to demand in setting of decrease in Hct from 35 -> 26 causing enzyme elevations and ST depressions in lateral leads. Initial concern for STEMI as STE seen in V1-V3, however this was unchanged from old EKG. No intervention performed during cardiac cath, and patient was chest pain free on transfer to CCU. Troponin peaked at 0.24 and was trending down. He was continued on aspirin, Plavix, atorvastatin, atenolol and an ACE inhibitor. His lisinopril was stopped on [**2178-6-23**] in setting of fluctuating blood pressures. He was monitored on telemetry. His HCT was trended given concern for ischemia. He was transfused an additional unit of PRBCs on [**2178-6-23**]. Carotid U/S revealed a right ICA less than 40% stenosis and a left ICA 60-69% stenosis. He will follow up with CT surgery as an outpatient, plan for CABG. . # Diastolic Heart Failure: The patient was breathing comfortably with sats in the mid-90s on supplemental oxygen at time of CCU tranfer. His fluid balance was monitored with a goal of net even to negative 500cc per day. He was continued on a beta blocker. His lisinopril was stopped on [**2178-6-23**] in setting of varying blood pressures. . # Hypoxemic resp. failure: Respiratory status improved with diuresis. Respiratory decline most likely due to flash pulmonary edema, in setting of hypertension, and volume overload (likely received fluid in OR), 1U PRBCs, as well as adrenergic drive in setting of CP. CTA revealed mild pulmonary edema and patchy opacities in the upper lobes, right greater than left, which could represent an early infectious process. Echo [**2178-6-22**] showed 1+ MR [**First Name (Titles) 151**] [**Last Name (Titles) 61935**] EF (65-70%) and elevated filling pressures consistent with diastolic dysfunction which could support flash pulmonary edema etiology. CTA did not reveal any evidence of PE. PNA seemed less likely based on the location (RUL), however the patient was febrile and aspiration PNA/HAP remained on differential. He was continued on empiric antibiotic coverage with vanc/cefepime/flagyl. CXR on [**2178-6-23**] showed improvment in previously seen opacities. Patient's antibiotics were stopped, as it was felt he did not have PNA. His O2 was titrated to keep his sats above 92%. . # Delirium. Slowly improved with holding additional pain medications. Per OSH records, he had been confused and agitated since TKR. Confusion thought to be multifactorial, and related to post-op course, opioids, fever, and hypoxemia. He was given Zyprexa prn agitation, and also ordered for haldol prn agitation. His home anxiolytics were held, but sertraline and buproprion were continued. He was started on vicodin prn pain after his delerium had resolved, and was tolerating the medication well at time of discharge. . # Fever: Tmax 100.8F over 24 hours prior to CCU transfer. Source of fever was unknown, but DDx included PNA, possible wound infection, or post-op fever. His WBC was trended, and he was initially continued on empiric antibiotics until it was felt he did not have any clincial signs of PNA. His antibiotics were then discontinued. His WBC normalized and he was afebrile at time of discharge with no sign of active infection. . # PVD: He was continued on plavix, aspirin, and a statin. His extremities were warm, and well-perfused during the admission. An arterial duplex study of his right lower extremity on [**2178-6-23**] revealed a patent right lower extremity bypass with no evidence of stenosis. He will be followed up in teh community by vascular surgery. . # s/p R TKR: Patient in soft cast at time of admission, and knee was not tender to palpation. Dr. [**Last Name (STitle) 61936**] (ortho) was aware of patient's admission. Ortho team followed patient during his hospital course. He was continued on partial weight bearing and continuous power machine. PT was also consulted for recommendations. He developed increased pain in the knee, for which he received vicodin prn pain. Dr. [**Last Name (STitle) **] from Orthopedics called to consult about right knee erythema around suture site which was felt likely to be inflammation as opposed to any soft tissue infection, and recommended 10 days of Cephalexin which was given to pt at discharge. A right lower extremity ultrasound did not reveal any evidence of DVT. . # DM: Patient has h/o brittle diabetes, with A1C 7.9% 1.5 months ago. He was placed on Lantus 18 plus an insulin sliding scale. His blood glucose levels were difficult to control during the admission, and [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] Diabetes Center consult was called. He was restarted on his home insulin pump regimen, with minor adjustments made after the [**Last Name (un) **] consult. . # Autonomic and Peripheral Neuropathy: Patient had orthostatic hypotension and a very labile BP during admission, which has been chronic issue. His postural BP as monitored, and his atenolol and lisinopril were held in setting of fluctuating BPs. The patient was continued on fludrocortisone. . #) Anxiety: On transfer to CCU, patient was agitated and encephalopathic. He was continued on sertraline and bupropion, but other anxiolytics were initially held. . #) Neuropathy: His gabapentin was initially held. . #) OSA: He was continued on Bipap, 15/8 as per home regimen. . #) Prophylaxis: He was initially on SC heparin, then switched to Lovenox for DVT prophylaxis. Medications on Admission: Afrin prn ambien 10 mg prn aspirin 81 daily Atenolol 25 daily Fludrocortisone 0.05 mg q pm Gabapentin 200 [**Hospital1 **] Lipitor 40 daily Lisinopril 10 mg AM and 5 mg PM Novolog pump Percocet prn plavix 75 daily wellbutrin 200 daily zoloft 25 daily viagra 100 prn vicodin prn xanax 0.5-1.0 mg q pm prn vitamins plus b complex q AM Discharge Medications: 1. Aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 2. Atorvastatin 40 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 3. Bupropion HCl 200 mg Tablet Sustained Release Sig: One (1) Tablet Sustained Release PO once a day. 4. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Sertraline 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Atenolol 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. Multivitamin Tablet Sig: One (1) Tablet PO once a day. 8. Hydrocodone-Acetaminophen 5-500 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for pain. Tablet(s) 9. Oxymetazoline 0.05 % Aerosol, Spray Sig: One (1) Spray Nasal HS (at bedtime) as needed for Nasal congestion. 10. Ambien 10 mg Tablet Sig: One (1) Tablet PO once a day. 11. Insulin Lispro 100 unit/mL Solution Sig: per sliding scale units Subcutaneous ASDIR (AS DIRECTED). 12. Xanax 0.5 mg Tablet Sig: 1-2 Tablets PO at bedtime. 13. Gabapentin 100 mg Capsule Sig: Two (2) Capsule PO twice a day. 14. Viagra Oral 15. Lisinopril 5 mg Tablet Sig: One (1) Tablet PO twice a day. 16. Fludrocortisone 0.1 mg Tablet Sig: 0.5 Tablet PO once a day. Discharge Disposition: Home With Service Facility: [**Hospital1 **] VNA, [**Location (un) 260**] Discharge Diagnosis: Non ST Elevation Myocardial Infarction Diabetes Type 1 on insulin pump Coronary Artery Disease Peripheral Vascular Disease Autonomic Dysfunction Hypertension Hyperlipidemia Acute on Chronic Diastolic Congestive Heart Failure Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: You had some chest pain and changes on your alectrocardiogram at the [**Hospital **] hospital after your knee operation. You were transferred to [**Hospital1 18**] for a cardiac catheterization that showed no change in the blockages in your coronary arteries from previously. You had a small heart attack but your echocardiogram was unchanged. The pressures inside of your heart has been high and you received some diuretics to lower the pressures. You had some delirium, confusion that is common in the hospital, this has now improved greatly. You will return in [**Month (only) 216**] to talk to Dr. [**Last Name (STitle) **] about bypass surgery. WE made the following changes to your medicine. 1. Increase Aspirin to 325 mg daily 2. Decrease Lisinopril to 5mg twice daily 3. Continue on home insulin pump . Weigh yourself every morning, call Dr. [**Last Name (STitle) **] if weight goes up more than 3 lbs in 1 day or 6 pounds in 3 days. Followup Instructions: Department: CARDIAC SURGERY When: THURSDAY [**2178-7-30**] at 1 PM With: [**Name6 (MD) **] [**Name8 (MD) 6144**], MD [**Telephone/Fax (1) 170**] Building: LM [**Hospital Unit Name **] [**Location (un) 551**] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage Department: VASCULAR SURGERY When: THURSDAY [**2178-10-8**] at 1:45 PM With: VASCULAR LAB [**Telephone/Fax (1) 1237**] Building: LM [**Hospital Unit Name **] [**Location (un) **] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage Department: PODIATRY When: THURSDAY [**2178-7-30**] at 10:45 AM With: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 722**], DPM [**Telephone/Fax (1) 543**] Building: Ba [**Hospital Unit Name 723**] ([**Hospital Ward Name 121**] Complex) [**Location (un) **] Campus: WEST Best Parking: [**Street Address(1) 592**] Garage Department: Cardiology Who: Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] When: The office of Dr. [**Last Name (STitle) **] will be calling you regarding the date of your upcoming appointment within 1 month of your discharge. Please call the office in 2 business days if you have not heard from the office. Where: [**Last Name (NamePattern1) 14648**], [**Location (un) 86**], MA [**Doctor Last Name 3649**] Building [**Apartment Address(1) 40601**] Phone: ([**Telephone/Fax (1) 32215**] Department: Orthopaedics Who: Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 61936**] When: The office of Dr. [**Last Name (STitle) 61936**] will be calling you regarding the date of your upcoming appointment within 1 month of your discharge. Please call the office in 2 business days if you have not heard from the office. Where: [**Last Name (NamePattern1) 14648**], [**Location (un) 86**], MA [**Hospital1 756**] 5, [**Apartment Address(1) 61937**] Phone: ([**Telephone/Fax (1) 61938**] ICD9 Codes: 4280, 3572, 4168, 311
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Medical Text: Admission Date: [**2169-9-23**] Discharge Date: Date of Birth: [**2117-12-21**] Sex: M Service: NSU HISTORY OF PRESENT ILLNESS: This 51-year-old man with a newly diagnosed GBM status post resection on [**2169-9-8**] with residual right hemiparesis was discharged to rehabilitation but was noted to have increased word finding difficulties on [**2169-9-23**]. He had been at [**Hospital6 310**] from [**2169-9-12**] until [**2169-9-23**]. Per his wife, she first noticed increased word finding difficulties on the Saturday prior to admission. On Sunday, the day of admission, he was unable to articulate three word sentences which was his baseline at [**Hospital1 **]. PAST MEDICAL HISTORY: Significant for GBM diagnosed in [**9-/2169**], resected on [**2169-9-8**], with a plan to have radiation therapy done. History of inflammatory bowel disease status post resection with ileostomy in [**2143**]. Hyperlipidemia, gastroesophageal reflux disease and steroid-induced diabetes mellitus. MEDICATIONS ON ADMISSION: 1. Decadron 2 mg p.o. b.i.d. 2. Hydrochlorothiazide 25 mg q day. 3. Lopressor 12.5 mg b.i.d. 4. Lipitor 10 mg q day. 5. Insulin. 6. Tylenol. SOCIAL HISTORY: He transferred from [**Hospital3 7**]. No tobacco. No ETOH. Married. Works as a consultant. Has two children. FAMILY HISTORY: Significant for breast cancer for mother and father with coronary artery disease. PHYSICAL EXAMINATION: On admission, vital signs: Temperature 100.0, blood pressure 157/77, heart rate 82, respirations 18, O2 is 95 percent. General: He was agitated. HEENT: Ruddy complexion baseline per wife, pupils equal, round and reactive to light and accommodation, extraocular movements were full. Cardiac: Regular rate and rhythm. Lungs are clear bilaterally. Abdomen: Soft, nontender, nondistended. Extremities: No edema. He was awake, alert and completely aphasic but able to follow commands such as "close your eyes" and able to repeat "no ifs, ands or buts about it". Cranial nerves II-XII are grossly intact except for a right facial droop with decreased labial fold and tongue deviation to the right. Strength was five out of five on the left. Unable to assist on the right due to neglect. Reflexes were three plus on the right and two plus on the left. LABORATORY DATA: White blood cell count 18.7, hematocrit 37.7, platelets 226, sodium 133, potassium 4.6, 93/25 and 29 for BUN, 0.8 for creatinine, 234 for glucose, calcium 8.9, alkaline phosphatase 4.6, magnesium 2.1. Urinalysis was within normal limits. ALT was noted to be at 131. AST was 26. LDH 243, lipase 224, CK were within normal limits. Head CT showed air and blood products in the subdural space along the left convexity and surgical resection site and in the left cortex/basal ganglia with surrounding hypo-attenuation into the left caudate nucleus and internal capsule and thalamus. Normal ventricles. No midline shift. Chest x-ray showed a retrocardiac opacity in the left lower lobe likely atelectasis. Electrocardiogram showed atrial bigeminy at a rate of 78. Blood cultures on [**2169-9-23**] on both anaerobic and aerobic were positive for GPC pairs and clusters. HOSPITAL COURSE: The patient was admitted to the Oncology service where he underwent a fever workup. He had reported fevers at [**Hospital1 **]. Also is part of the fever workup they obtained lower extremity Dopplers, which showed a clot in his left peroneal vein. He also was started on Dilantin to rule out seizures given his change in mental status and he was given a dose of 10 mg intravenous and changed to 6 mg q six hours. It was noted that his incision site on his head from his previous surgery was fluctuant with what was felt to be a fluid collection underneath. Blood cultures from [**2169-9-23**] and [**2169-9-24**] showed coag positive staphylococcus aureus methicillin sensitive. The blood culture results were indicative of high- grade MSSA bacteremia. An Infectious Disease consultation was obtained and the patient was started on oxacillin 2 gm intravenously q four hours with a recommendation for six weeks. For empiric coverage prior to starting the oxacillin, he was started on vancomycin and cefepime. Those were discontinued on [**2169-9-26**] and as mentioned he was started on the oxacillin. Infectious Disease also recommended an echocardiogram be done to rule out endocarditis. No vegetation was seen via echocardiogram that was completed on [**2169-9-26**]. On [**2169-9-25**], [**Name6 (MD) **] [**Name8 (MD) 739**], M.D. aspirated 80 cc of purulent fluid from his wound site which showed Gram positive cocci in pairs and clusters and grew out staphylococcus aureus coagulopathy positive. Regarding the patient's deep venous thrombosis, Dr. [**Last Name (STitle) 739**] did not want to anticoagulate but follow with serial ultrasounds to see if the clot propagated. On [**2169-9-25**], the patient underwent a left-sided craniotomy for wound debridement and evacuation of subdural intracranial empyema. On [**2169-9-25**], the patient had an upper extremity ultrasound to rule out a deep venous thrombosis in his right arm and that was negative for any deep venous thrombosis. Postoperatively, he was sent to the Intensive Care Unit where he was monitored with close neurological checks. He was awake and alert and aphasic with right-sided hemiplegia. While in the Intensive Care Unit, it was noted that his platelets dropped to as low as 85. His subcutaneous heparin was discontinued and a heparin panel was sent off. Also, his sodium at that time started to fall to the 133 range. He was started on sodium p.o. The HIT panel was positive for heparin-induced thrombocytopenia. His liver function tests were monitored closely while continuing to receive oxacillin. He was transferred to the surgical floor on [**2169-9-27**] where he remained awake, alert and aphasic. The patient expressed extreme need to be discharged home along with his wife. They did not want to go back to any rehabilitation facility and were adamant that he be discharged home as soon as possible. The discharge planning process was begun. Home physical therapy, occupational therapy, necessary medical equipment were ordered. Also, home visiting nurse service was set up due to the fact that he would need continuous infusion of oxacillin. On [**2169-9-28**], a repeat ultrasound was performed of the patient's right lower extremity which showed propagation of deep venous thrombosis to the popliteal vein and distal superficial femoral vein. Given that new finding, Interventional Radiology was contact[**Name (NI) **] and an inferior vena cava filter was placed. The patient had no complications from his inferior vena cava filter placement. On [**2169-9-29**], a PICC line was inserted into the patient's left median vein without complication. Also, a psychiatry consultation was obtained also on [**2169-9-29**] given the patient's depression, periods of confusion, agitation and then occasional treatment opposition. Their recommendation was to avoid benzodiazapine, use Haldol for acute agitation and have psychiatric follow-up as needed at home. Social Work also saw the family and offered services as needed. On [**2169-9-30**], it was noted that the patient's HIT panel was positive. At that time, Hematology/Oncology was consulted who recommended starting argatroban. They recommended avoiding all heparin and continuing argatroban only until it is clear that the platelets had normalized. Further recommendations on [**2169-10-2**] from Hematology/Oncology was to discontinue the argatroban and to start a fondaparinux 7.5 mg subcutaneously q day and introduce Coumadin in the next 4-5 days continuing on the fondaparinux until his INR level was at 2.0, and he should continue on Coumadin therapy for four weeks. On [**2169-10-3**], the day of discharge, it was noted that his hematocrit was 26.8. Dr. [**Last Name (STitle) 739**] recommended transfusing one unit of packed red blood cells and starting on iron. Also, on [**2169-10-3**], his platelet count had recovered to 245. His sodium had recovered to 137. At this time, the patient and his family again expressed a profound interest to be discharged home. They are acutely aware of the amount of services that will be needed at home and the 24 hour supervision that the patient's care will entail. They once again were offered the option of DICTATION ENDED [**Name6 (MD) **] [**Name8 (MD) 739**], MD [**MD Number(2) 2930**] Dictated By:[**Last Name (NamePattern1) 8633**] MEDQUIST36 D: [**2169-10-3**] 14:39:58 T: [**2169-10-3**] 15:20:54 Job#: [**Job Number 58060**] ICD9 Codes: 7907, 2761, 2875
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Medical Text: Admission Date: [**2108-6-15**] Discharge Date: [**2108-6-19**] Date of Birth: [**2048-1-15**] Sex: M Service: MEDICINE Allergies: Sulfonamides / Ciprofloxacin Attending:[**First Name3 (LF) 4232**] Chief Complaint: RLE cellulitis and concern for endocarditis Major Surgical or Invasive Procedure: none History of Present Illness: HPI: 60 year old male with PMH of HIV/AIDS (CD4 nadir < 100, recent CD4 562), s/p mechanical AVR (Cardiomedics mechanical valve) following episode of strep pneumo endocarditis ([**2100**]), and hypertension, now presenting with redness and swelling of the right ankle shortly after dental work without prophylaxis. . Patient states that he noted swelling inferior to the right ankle on Monday, [**6-11**]. This area became more painful and swollen over the course of the week. He also noted subjective fevers with chills. He took ibuprofen for the pain with some relief. He became more concerned on Thursday so presented to the ED. . He states that he had a dental cleaning last Thursday but did not take antibiotics at the same time per his usual routine. He denies any falls at home but is using a cane due to the increased pain in the right foot with walking. . In the ED, intitial vitals were: T 98.7 HR 80 BP 148/72 RR 16 98% on RA. The patient had an ultrasound which showed small fluid collections in the right leg but no DVT. He was treated with vancomycin 1 g IV X 1 and gentamycin 80 mg IV X 1 and received a total 2 L NS. . ROS: No nausea, vomiting, constipation, diarrhea, melena, BRBPR, chest pain (pleuritic or otherwise), palpitations, dizziness or lightheadedness change in vision, hearing, hematuria, dysuria, numbness, tingling, weakness, joint pain, myalgias. Had a slight headache this morning which resolved with ibuprofen. Has lost about 10 pounds in the past few months, ascribes this to eating less junk food. Had a high INR lately so stopped his coumadin last weekend; resumed on Monday at 5 mg daily. Reports no recent travel and no sick contacts. . Past Medical History: Past medical history: * HIV/AIDS: diagnosed [**2091**], CD4 nadir < 100; h/o PCP & HSV; Last CD4 562 in [**3-29**] * Strep pneumoniae bactermia/endocarditis/empyema ([**2100**]) resulting in mechanical aortic valve replacement * h/o seizure disorder in setting of heavy alcohol use in past * s/p partial splenectomy [**2081**] * hypertension * hyperlipidemia * h/o polyneuropathy * h/o asthma (not using inhalers currently) * s/p incisional hernia repair with mesh Social History: Social history: Lives with partner, [**Name (NI) **]. Does not work but previously worked in general labor. Prior smoking history but quit 25 years ago. Drinks [**12-23**] alcoholic beverages in moderation most days per week but not all. Smokes marijuana daily. No injection drug use. Family History: Family history: Mother with DM and colon cancer. Father with prostate cancer. Physical Exam: VS: T=99.4 BP=150/91 HR=66-71 RR=16 O2 sat= 96% on RA GENERAL: NAD, AOx3, somewhat flat affect HEENT: Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. NECK: No LAD, supple CARDIAC: RRR, + mechanical S2, III/VI WEM, loudest at LUSB but heard throughout, no audible S3 LUNGS:CTAB ABDOMEN: Soft, NT/ND, NABS Extremities: Erythema, swelling and warmth of lateral aspect of right ankle surrounding medial malleolus and anterior surface of foot, slightly TTP, no open wound. Ankle dorsiflexion & plantarflexion both active & passive do not elicit more pain bilaterally. DP & PT pulses 2+ BL. No other edema. Pertinent Results: [**2108-6-15**] 09:38PM PT-20.0* PTT-68.0* INR(PT)-1.8* [**2108-6-15**] 06:05AM WBC-11.9* RBC-4.71 HGB-15.7 HCT-45.8 MCV-97 MCH-33.4* MCHC-34.3 RDW-15.2 [**2108-6-15**] 06:05AM GLUCOSE-79 UREA N-18 CREAT-1.0 SODIUM-140 POTASSIUM-3.8 CHLORIDE-104 TOTAL CO2-28 ANION GAP-12 [**2108-6-14**] 10:23PM WBC-12.5* RBC-5.01 HGB-16.8 HCT-48.9 MCV-98 MCH-33.5* MCHC-34.3 RDW-14.7 Brief Hospital Course: 60 y/o man with HIV/AIDS, hypertension, and prior mechanical AVR, originally admitted with right leg pain and swelling and new murmur shortly after having dental work without antiobitc prophylaxis. . 1. Right Leg Cellulitis: Patient presented with a 10cm by 15cm erythematous region which was tender to touch and palpation on his right lower leg, surrounding his ankle, which was felt to be consistent with a cellulitis. He remained afebrile and his WBC was not elevated from his baseline. Fluid collections were seen on ultrasound and confirmed with MR. [**Name13 (STitle) **] was examined by ortho and it was agreed there was no evidence of a septic joint. He was started on Doxycycline and Cephalexin. The appearance of his leg improved significantly each day of his admission, and by the third day he had only a trace of edema and erythema. His WBC rose on day 3, however, to > 13 (from 11) and this raised concern about an underlying infection. Given patient??????s history of HIV and prosthetic aortic valve, it was felt that any underlying fluid collection could serve as a reservoir for infection and may pose a risk to this patient. Accordingly, the fluid collection was drained under ultrasound on the third day of hospitalization. The procedure was tolerated well. The patient??????s WBC count returned to baseline the day after the drainage. He was discharged with a home course of the same antibiotics (Cefalexin and Doxy) and scheduled for follow up at the [**Hospital 778**] clinic shortly after discharge. 2. New SEM Murmur: On admission the patient was found to have a III/VI SEM which was not documented in his most recent physical exam. Accordingly, this was felt to be a new murmur, and in the setting of a patient with a mechanical aortic valve with a recent history of dental work without prophylactic antibiotics the concern for endocarditis was very high. An initial TTE was inconclusive, but showed elevated gradient across the valve. Given the concern, arrangements were made for a TEE, which due to the weekend schedule involved the patient being transferred overnight to the CCU (note that the patient was stable throughout his hospitalization, and was not transferred to the CCU due to clinical instability). The TEE was negative. Given the high risk of the patient, however, it was felt that after the current course and antibiotics are resolved, a surveillance set of blood cultures should be performed on an outpatient basis. 3. Anticoagulation for Prosthetic Aortic Valve: The patient was admitted with a subtherapeutic INR after recent changes to his daily Coumadin dose. A heparin drip was started and titrated to ensure adequate anticoagulation. Coumadin was held pending the patient??????s TEE, and then restarted at 3mg the night after the procedure, and raised to his regular home dose of 5mg the day after that. The patient??????s Coumadin was continued at 5mg but his ritonavir, which had inadvertently been held on admission, was restarted with the expectation that it likely boosts warfarin effects. The patient??????s INR was 2.0 on the day of discharge, which was considered therapeutic for his valve (therapeutic range of 2.0 to 3.0 for newer valves, per cardiology recommendations). 4. HIV/AIDS: CD4 Nadir < 100, most recent > 400. The patient was continued on his ARV regimen across his hospitalization, with the exception of his ritonavir, which was inadvertently held on admission and then restarted on day #3. He was likely approximately 2 days without ritonavir to boost his primary protease inhibitor. He will continued to be followed closely as an outpatient for his HIV care. 5. Hyperlipidemia: His outpatient statin was continued. 6. Hypertension: We continued beta blockade and the patient remained stable and in good blood pressure control across hospitalization. Medications on Admission: Medications (Reconciled with Patient) * Metoprolol 50 mg [**Hospital1 **] * Coumadin 5 mg daily, INR checked at [**Hospital 778**] clinic q few weeks * Emtricitabine/Tenofovir (Truvada) 200/300 mg 1 daily * Lipitor 10 mg daily (recently decreased from 20mg daily) * Fosamprenavir 700 mg q12h * Ritonavir 100 mg q12h * Amoxicillin prn dental work - ordered but not filled this past time * Abacavir (Ziagen) 300 mg po q12h * depo-testosterone IM q2weeks Discharge Medications: 1. Acetaminophen 500 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for pain/fever. 2. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 3. Emtricitabine-Tenofovir 200-300 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours) as needed for insomnia/agitation. Disp:*15 Tablet(s)* Refills:*0* 6. Warfarin 5 mg Tablet Sig: One (1) Tablet PO Once Daily at 4 PM. 7. Cephalexin 500 mg Capsule Sig: One (1) Capsule PO Q6H (every 6 hours) for 6 days. Disp:*24 Capsule(s)* Refills:*0* 8. Fosamprenavir 700 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours). 9. Abacavir 300 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 10. Doxycycline Hyclate 100 mg Capsule Sig: One (1) Capsule PO Q12H (every 12 hours). Disp:*12 Capsule(s)* Refills:*0* 11. Ritonavir 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: PRIMARY: 1. Cellulitis, RLE SECONDARY: 1. HIV/AIDS 2. Mechanical Aortic Valve 3. Hypertension 4. Hyperlipidemia Discharge Condition: Improved. Vital signs stable and patient ambulating well Discharge Instructions: You were admitted for cellulitis of your right lower leg as well as concern for endocarditis. A transesophageal echocardiograph, which is an ultrasound that can look closely at your heart, determined that you did not have endocarditis. Your cellulitis was treated with two antibiotics: Cephalexin and Doxycyclin. You should continue both of these medications after you are discharged. Please take 1 tab of the Cephalexin every 6 hours for 6 more days (until [**2108-6-25**]). Please take the 1 tablet of the Doxycycline (100mg) twice every day for 6 more days (until [**2108-6-25**]). During your stay we stopped your Coumadin temporarily and used other medications to thin your blood. We started you back on Coumadin before you were discharged, and you should continue to take your regular dose of 5mg every day until you see your primary care physician. [**Name10 (NameIs) **] should resume all of the other medications you were on before coming to the hospital. We have arranged for you to see Dr. [**First Name4 (NamePattern1) 449**] [**Last Name (NamePattern1) 103217**] at the [**Hospital 778**] Clinic on the day after discharge, Wednesday, [**6-20**] at 11:20am. He should examine your foot and check your white blood cell count as well as your INR. He may want to adjust your Coumadin dose. Please call your physician or return to the emergency department if you experience any of the following: increased pain, swelling or warmth in your right lower leg; fevers above 100.4; shortness of breath, chest pain; nausea, vomiting or diarrhea, or any bloody stool; bleeding from the site on your right leg where fluid was withdrawn; increased weakness, light-headedness, or any loss of consciousness; or any other concerning symptoms. Followup Instructions: We have made a follow up appointment for you to see your physician, [**Last Name (NamePattern4) **]. [**First Name4 (NamePattern1) 449**] [**Last Name (NamePattern1) 103217**], at the [**Hospital 778**] Clinic, on Wednesday [**2108-6-20**] at 11:20 AM. His office is located at the [**Hospital1 9060**] Center, [**Street Address(2) 6421**], [**Location (un) 86**], MA, and his office can be reached at [**Telephone/Fax (1) 798**]. In addition, we have made a follow up appointment for you with your cardiologist, Dr. [**Last Name (STitle) **], for Tuesday, [**7-3**], at 1:45PM. [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(1) 4236**] ICD9 Codes: 4019, 2724
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Medical Text: Admission Date: [**2189-12-29**] Discharge Date: [**2190-1-26**] Date of Birth: [**2142-10-18**] Sex: F Service: CHIEF COMPLAINT: Respiratory distress HISTORY OF PRESENT ILLNESS: The patient is a 47-year-old female with human immunodeficiency virus with a CD4 nadir of 150 and a CD4 count of 443 and a viral load of less than 50 in [**2189-9-17**], as well as history of intravenous drug use, chronic obstructive pulmonary disease and bipolar disorder who presented on [**10-13**] to an outside hospital with several weeks of cough, was treated for primary care physician without response and transferred to [**Hospital6 1760**] for further evaluation and treatment. The patient had presented with several weeks of increased cough, green sputum, low grade fever, low back pain, weakness, bilateral hand swelling and non bloody diarrhea. The patient had bilateral crackles on exam at the outside hospital with a white blood cell count of 10.5. The patient was treated for Pneumocystis carinii pneumonia, despite having a CD4 count greater than 200 and being on Bactrim prophylaxis. The patient's course was complicated by acute renal failure, thought to be secondary to a combination of ACE inhibitor and NSAIDS. The patient was treated with Bactrim, prednisone, intravenous fluids and Levaquin. A CT scan was done at the outside hospital which revealed severe diffuse bilateral fibrosis with honeycombing, no lymphadenopathy and no effusion. Echocardiogram was performed which revealed ejection fraction of 45% to 50%, concentric left ventricular hypertrophy by atrial enlargement and pulmonary artery pressures in the 50s. Cocaine was positive on the admission toxicology screen. The patient was bronchoscoped in early [**Month (only) 956**] at the outside hospital revealing rare white blood cells and rare gram positive cocci with negative stains for fungi acid fast bacteria and PCP. [**Name10 (NameIs) 3754**] was concern for cocaine associated BOOP. The patient also ruled in for a non Q-wave myocardial infarction. Her course was complicated by atrial fibrillation with rapid ventricular response. Over the course of the few days prior to transfer, the patient developed increasing O2 requirement and was intubated. She was finally transferred to [**Hospital6 2018**]. PAST MEDICAL HISTORY: 1. Human immunodeficiency virus complicated by cryptococcal meningitis, spinal abscess, thrush, [**Female First Name (un) 564**] esophagitis. The patient had most recent labs in [**2189-9-17**] with a viral load of less than 50 and a CD4 count of 443. 2. Myocarditis 3. Cervical cancer, status post total abdominal hysterectomy/bilateral salpingo-oophorectomy 4. Recurrent pneumonia 5. Gastroesophageal reflux disease 6. Hypertension 7. Bipolar disorder 8. Chronic obstructive pulmonary disease 9. History of duodenal tumor 10. History of ruptured ectopic MEDICATIONS FROM OUTSIDE HOSPITAL: 1. Levofloxacin 500 mg po q day 2. Bactrim Double Strength 3. Dyazide 1 po q day 4. Diflucan 200 mg po q day 5. Celexa 30 mg po q day 6. Prevacid 30 mg po q day 7. Zocor 20 mg po q day 8. Sustiva 600 mg q hs 9. Guaifenesin 1 mg po q hs 10. Premarin 0.25 mg po q day 11. Neurontin 300 mg po tid 12. Remeron 20 mg po q hs 13. Prednisone 40 mg po bid 14. Atenolol 100 mg po q day 15. Norvasc 10 mg po q day 16. Klonopin 0.5 mg po tid 17. Combivir ALLERGIES: PENICILLIN SOCIAL HISTORY: The patient works as a community health educator. She lives alone. She has one daughter. Mother lives in the area. The patient smoked one pack per day for 17 years. The patient has a history of alcohol and polysubstance abuse. The patient uses heroin and cocaine. FAMILY HISTORY: Breast cancer, congestive heart failure, father with history of pulmonary fibrosis. PHYSICAL EXAMINATION: VITAL SIGNS: The patient had a blood pressure of 90/44, pulse of 51 and oxygen saturation of 95%. The patient was on ventilatory support with pressure support of 20, PEEP of 5 and FIO2 of 100%. The patient had a respiratory rate of 20. GENERAL: The patient was intubated, sedated and in no apparent distress. HEAD, EARS, EYES, NOSE AND THROAT: Pupils equal, round and reactive to light. Extraocular movements intact. Oropharynx clear. NECK: Supple with no lymphadenopathy. CARDIOVASCULAR: Regular bradycardia, normal S1, S2 and a 1/6 systolic murmur at the left lower sternal border and patient had jugular venous distention to 8 cm. PULMONARY: Bilateral inspiratory rales. ABDOMEN: Belly that was soft, nontender and nondistended with normal bowel sounds and no hepatosplenomegaly. EXTREMITIES: No edema. NEUROLOGIC: Withdrawal to pain, moving all four extremities and 3+ deep tendon reflexes with downgoing plantar reflexes. SKIN: No rash. There was presence of needle tracks on the forearms. IMAGING: Chest x-ray revealed diffuse bilateral nodular interstitial infiltrates. Chest CT from the outside hospital revealed diffuse bilateral interstitial infiltrates with slightly geographic distribution, mild honeycombing. These were most prominent at the bases. PERTINENT LABORATORY FINDINGS: The patient had arterial blood gases with a pH of 7.35, PCO2 of 35 and P02 of 110 on 100% FIO2. The patient's white blood cell count was 7.9 with a hematocrit of 3.4 and platelets of 132. The patient's sodium was 138 with a potassium of 5.2, chloride of 110, bicarbonate of 20, BUN of 71, creatinine of 1.6 and glucose of 94. Albumin was 2.5. Calcium 8.1, magnesium 2.1, CK 55 and troponin 4.6. The patient had an LDH of 665. SUMMARY OF HOSPITAL COURSE: On [**12-31**], the patient underwent open lung biopsy which revealed pathology consistent with BOOP. The patient was continued on ventilatory support, given steroid therapy and nebulizer treatments, as well as antibiotics. The patient continued to have atrial fibrillation with rapid ventricular response. The patient's course was complicated by thrombocytopenia and anemia. The patient was taken off heparin prophylaxis and Zantac. Low extremity ultrasounds were negative and a hit antibody was negative. On [**1-6**], electrophysiology was consulted and they recommended starting the patient on a heparin infusion as well as sotalol 80 mg po tid and Lopressor. On the 21st, the patient was found to have low grade DIC based on labs. On [**1-9**], the patient had a febrile episode with hypotension. The patient had atrial fibrillation with rapid ventricular response and was cardioverted. There was question of ventilator associated pneumonia and the patient was started on clindamycin. On [**1-14**], the patient was gradually weaned to pressure support ventilation. Steroids and sedation were gradually weaned. On the [**12-22**], the patient underwent PEG placement and tracheostomy. She experienced marked agitation which was thought to be secondary to withdrawal from tapering of the patient's sedation. The patient's sedation was tapered more slowly and a head CT was done which revealed no signs of intracranial hemorrhage or mass effect. The patient's mental status gradually improved. The patient was eventually weaned off of mechanical ventilation and converted to trach mask. Neurology was contact[**Name (NI) **] regarding the patient's mental status and they felt that the picture was most consistent with benzodiazepine withdrawal. Infectious disease was also contact[**Name (NI) **] in order to facilitate on the patient's human immunodeficiency virus care, as she moved to the outpatient setting. The patient was continued on Bactrim with fluconazole. The patient had daily QTCs monitored secondary to occasional administration of Haldol with the patient being on sotalol. Case management and social work followed the patient in hospital. The patient had culture results with no growth at the time of this dictation. Vitamin B12, TSH and cortisol were normal during the hospitalization. DISCHARGE CONDITION: Stable The remainder of this dictation will be dictated as the [**Hospital 228**] hospital course continues. [**Last Name (LF) **],[**First Name3 (LF) **] N. M.D. [**MD Number(1) 39096**] Dictated By:[**Last Name (NamePattern1) 5246**] MEDQUIST36 D: [**2190-1-26**] 08:15 T: [**2190-1-26**] 08:49 JOB#: [**Job Number 39097**] ICD9 Codes: 496
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Medical Text: Admission Date: [**2180-5-3**] Discharge Date: [**2180-5-24**] Date of Birth: [**2110-6-29**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 3326**] Chief Complaint: alcohol intoxication Major Surgical or Invasive Procedure: none History of Present Illness: This is a 69yo M with hitory of extensive alcohol abuse(refused detox), extensive smoking(2-3ppd) who was found down and brought to the ED by EMS. HE was unable to relate the incidenve prior to the event. IN thet ED, he was initially placed in observation with hydration but developed guiac positive dark stool. He was hemodynamically stable with stable hematocrit. He was admiited for withdrawal and GIB. Patient refused NGT, colonoscope, endoscopy and blood produst(patient was oriented and cognitively appropriate) In the ED, he was given banana bag, valium, head CT was negative and protonix Past Medical History: hypertension GERD alcohol abuse with multiple admissin for withdrawal Social History: Lives in a senior communityHeavy Drinker for >40 yearsTob 2ppdformer mailman.No familyFriend [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 96052**] takes care of his cats[**Telephone/Fax (1) 99557**] Family History: NC Physical Exam: GEn-A+O x3, lethargic, smells of ETOH, tremulous HEENT-poor dentition CV-tachycardic, no r/m/g resp-course breath sounds, decreased BS bilaterally [**Last Name (un) 103**]-thin,soft, NT/ND, small liver, no splenomelagy ext-palmar erhythema, neuro-tremulous, A+O x3, moves all feet Brief Hospital Course: 69 yo M with extensive alcohol abuse admitted yet [**Last Name (un) 7162**] for alcohol intoxication and now has guiac positive stool and hemodynamically stable. He had a witnessed aspiration on the floor and then was transferred to the MICU for resp failure. . # Resp failrue: the aptient has a large aspiration PNA while on the floor during a period of decreased MS. [**Name13 (STitle) **] was initially on 3 days of decadron for airway edema. He was covered with clinda and Ceftazidime (since his sputum grew pseudomonas). He has completed a 14 day course. He was very difficult to wean from the vent intially mainly because of agitation and copious secretions. He was extubated on [**5-15**] following which he had a strong cough to clear secretions and only required 2 L NC. On [**5-18**] pt was called out to the floor from the MICU in stable condition after extubation, but was returned to the MICU 18 hours later and reintubated for emergent bronchoscopy due to a collapsed right lung from a right mainstem bronchus mucus plug. The plug was removed and the pt was extubated the following day. He had aggressive chest PT and was stable from a respiratory standpoint from that time until discharge. . # alcohol intoxication - He is no longer withdrawing. He was placed on Valuim for agitation initially while intubated which should be decreased and/or stopped before discharge. . #GIB: one episode of melena; likely from upper(varices, [**Doctor First Name 329**] [**Doctor Last Name **], gastritis etc due to alcohol). patient refused scopes/blood product/lavage. HCT stable since admission and increased today. Continue aggressive nutrition, consider checking Fe studies. . # hypertension: on ACE-inhibitors, Lopressor as an outpt. Continuing outpt meds. . # No active family or healch care proxy Medications on Admission: accupril ranitidine Discharge Medications: 1. Thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 3. Insulin Regular Human 100 unit/mL Solution Sig: per sliding scale units Injection ASDIR (AS DIRECTED). 4. Albuterol 90 mcg/Actuation Aerosol Sig: Eight (8) Puff Inhalation Q4H (every 4 hours) as needed. 5. Ipratropium Bromide 18 mcg/Actuation Aerosol Sig: Eight (8) Puff Inhalation Q4-6H (every 4 to 6 hours) as needed. 6. Nicotine 14 mg/24 hr Patch 24HR Sig: One (1) Patch 24HR Transdermal DAILY (Daily). 7. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). 8. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 10. Ceftazidime-Dextrose (Iso-osm) 2 g/50 mL Piggyback Sig: Two (2) grams Intravenous Q8H (every 8 hours) for 6 days: Until [**5-24**]. 11. Quinapril HCl 40 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Discharge Disposition: Extended Care Facility: [**Hospital6 85**] - [**Location (un) 86**] Discharge Diagnosis: alcohol withdrawal aspiration pneumonia hypertension Discharge Condition: stable, afebrile Discharge Instructions: Please seek medical attention for fevers>101.4, or for anything else medically concerning. Please stop drinking alcohol. Please take your medications as directed. Followup Instructions: please see your pcp [**Last Name (NamePattern4) **] [**1-9**] weeks for follow-up ICD9 Codes: 5070, 5789, 5180, 2765, 496, 2859, 4019, 3051
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Medical Text: Admission Date: [**2116-8-10**] Discharge Date: [**2116-8-19**] Date of Birth: [**2048-2-1**] Sex: M Service: CHIEF COMPLAINT: Sigmoid perforation. HISTORY OF THE PRESENT ILLNESS: The patient is a 68-year-old male brought to [**Hospital1 69**] by [**Location (un) **] for sigmoid perforation. The patient has no pneumoperitoneum. The patient has had pain in the morning in his lower abdomen. The patient has also had fever and chills. The patient went to [**Hospital3 22439**], where a CT was performed, which showed 6 cm x 6 cm mass with air next to the sigmoid colon. The patient was medflighted to the [**Hospital3 22439**] to [**Hospital1 69**]. On the way, NG tube was placed due to vomiting. PAST MEDICAL HISTORY: The patient has a history of diverticular disease and hypertension. MEDICATIONS ON ADMISSION: The patient is on the following medications at home: 1. Cardura. 2. Toprol XL. 3. Protonix. 4. Paxil. ALLERGIES: The patient has no known drug allergies. PHYSICAL EXAMINATION: Examination revealed the following: Temperature 101. Heart rate 112. Blood pressure 171/80. Respirations: 28, 99% on nonrebreather mask. GENERAL: The patient appears to be in mild distress. HEENT: Normocephalic, atraumatic, pupils equal, round, and reactive to light. Extraocular muscles are intact. Oropharynx clear. Neck was supple. There was no lymphadenopathy. Chest was clear to auscultation bilaterally, no wheezes, rhonchi, or crackles. CARDIOVASCULAR: The patient is tachycardiac; no murmurs; normal S1 and S2, no S3 or S4. ABDOMEN: The patient is diffusely tender in the lower quadrants, more so than in the upper quadrants. The patient displays rebound tenderness and guarding. EXTREMITIES: Symmetrical. No clubbing, cyanosis or edema. SKIN: Warm and moist. NEUROLOGICAL: The patient is alert and oriented times three. Otherwise, the neurological system is intact. EKG was performed. The patient was in sinus rhythm with no ischemic changes. Chest x-ray showed no free air in the abdomen. A new CT was performed because the CT from [**Hospital3 22439**] did not have the correct name. The name on the film was [**First Name8 (NamePattern2) **] [**Known lastname 986**], as opposed to [**Known firstname 3065**] [**Known lastname 986**]. New CT indicated a sigmoid perforation. The patient was admitted and immediately sent to the operating room, where a partial colectomy and colostomy with Hartmann pouch was performed. The patient was placed on IV antibiotics including Ampicillin, Gentamicin, and Flagyl. After the surgery was complete, the patient was transferred to the Surgical Intensive Care Unit having had no apparent complications from the operating room. The patient was immediately extubated and placed on nasal cannula. While in the ICU, the patient experienced a decrease in the urine output for which he received multiple IV fluid boluses, which resolved the urine outpatient problems. The patient's hypertension was controlled with Lopressor. As the patient had quite a bit of pain, he was controlled with a morphine PCA, which had the side effect of causing him to be somewhat confused and caused visual hallucinations. The patient was also treated with subcutaneous heparin, having had a history of DVT. The patient was transferred to the floor on postoperative day #4, where he was left on telemetry to monitor the cardiac function. While on the floor, he developed periodic visual hallucinations associated with his pain medications. This resolved with d/c of narcotis. While on the floor, he slowly began to improve. He started to put out gas and stool through his ostomy and the patient was placed on clears and then a regular diet, which he tolerated well. Urine output continued to be maintained adequately. The patient was also placed on some Lasix to try to decrease edema caused by the earlier fluid boluses that he had received. The patient was also visited on a number of occasions by an ostomy nurse who was pleased with the patient's ability to care for his ostomy. The ostomy remained pink and healthy-appearing with only a minimal amount of necrotic tissue, which was actively sloughing. The patient was also seen by the Department of Physical Therapy on a number of occasions, who were pleased with his physical ability and ability to ambulate comfortably. The patient has also been seen by the Department of Nutrition who has indicated to him that it would be alright for him to enjoy a regular diet. The patient was changed from antibiotic therapy of Ampicillin, Gentamicin, and Flagyl to PO Levaquin and Flagyl. The patient will be discharged on [**2116-8-19**]. The patient is in stable condition. He and his wife strongly preferred the patient's recuperation in [**State 531**] where they live. He will be driven home by his wife. The patient and his wife have made follow-up appointments with the VNA for ostomy care, his PCP and [**Name Initial (PRE) **] surgeon where he will have his colostomy taken down sometime in the future. The patient will be discharged on the following medications: DISCHARGE MEDICATIONS: 1. PO Levaquin. 2. PO Flagyl. The patient will also be sent with copies of his records and CT scan to aid in his follow up care in [**State 531**]. FINAL DIAGNOSIS: Sigmoid perforation of diverticulum status post partial colectomy with colostomy and Hartmann pouch. [**First Name11 (Name Pattern1) 4952**] [**Last Name (NamePattern1) 4953**], M.D. [**MD Number(1) 4954**] Dictated By:[**Last Name (NamePattern1) 44041**] MEDQUIST36 D: [**2116-8-18**] 11:20 T: [**2116-8-18**] 11:27 JOB#: [**Job Number 44042**] ICD9 Codes: 2765, 4019
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Medical Text: Admission Date: [**2156-8-23**] Discharge Date: [**2156-8-26**] Date of Birth: [**2087-10-23**] Sex: M Service: [**Hospital 11212**] [**Hospital6 733**] Firm HISTORY OF PRESENT ILLNESS: The patient was a 68-year-old gentleman with a history of stage IV colon cancer metastatic [**Known firstname **] lung and liver who was transferred from a nursing home status post developing tachypnea, hypoxia [**Known firstname **] 80% on room air, and a change in mental status. The patient was seen in the Emergency Department and was hypotensive with blood pressures of 80/47 and a respiratory rate in the 30s. The patient was in moderate respiratory distress, and chest x-ray showed a retrocardiac density. The patient was persistently hypotensive despite multiple fluid boluses. Antibiotics were started. The patient was started on pressors and intubated with an arterial blood gas on room air of a pH of 7.21, a PCO2 of 60, and a PO2 of 86. The patient's oncologist (Dr. [**First Name (STitle) **] from [**Hospital 10908**] was contact[**Name (NI) **] in order [**Known firstname **] gain more information on the patient's stage IV colon cancer. Apparently, the patient refused any further treatment about six months ago and desired [**Known firstname **] be do not resuscitate/do not intubate. The patient's course was also discussed with the family, and it was decided [**Known firstname **] make the patient comfort measures only. The patient was subsequently extubated on [**2156-8-25**]. Pressors were weaned off, and morphine drip was started. The patient remained comfortable and in no apparent distress and was transferred out of the Intensive Care Unit [**Known firstname **] the general medical floor. PAST MEDICAL HISTORY: 1. Stage IV colon cancer widely metastatic [**Known firstname **] lung and liver. A computerized axial tomography on [**2156-8-5**] showed a left pleural effusion, bilateral lung nodules, and liver enlargement with increasing new liver masses, left adrenal nodule, left moderate-[**Known firstname **]-severe hydronephrosis secondary [**Known firstname **] retroperitoneal lymph nodes. The patient is status post gastrojejunostomy tube placement secondary [**Known firstname **] dysphagia and failure [**Known firstname **] thrive. 2. Hypertension. 3. Hypercholesterolemia. 4. Right cerebrovascular accident. PHYSICAL EXAMINATION ON PRESENTATION: On physical examination, the patient's temperature was 96.9 degrees Fahrenheit, his blood pressure was 70s [**Known firstname **] 80s/30s [**Known firstname **] 40s, his heart rate was 60s [**Known firstname **] 70s, and his oxygen saturation was 96% on room air. In general, the patient was not arousable. Not responsive [**Known firstname **] pain, but he appeared comfortable. Head, eyes, ears, nose, and throat examination revealed nonreactive pupils but equal. The mucous membranes were dry. Neck examination revealed no jugular venous distention. Pulmonary examination revealed coarse rhonchi throughout the lung fields. Cardiovascular examination revealed a regular rate and rhythm. Normal first heart sounds and second heart sounds. No murmurs, rubs, or gallops. The abdomen was distended, notable bowel sounds, and jejunostomy tube in place. Extremity examination revealed 3+ pitting edema [**Known firstname **] the lower extremities. Neurologic examination revealed pupils were nonreactive. Positive corneal reflexes. Negative doll's eyes. The patient did not withdraw [**Known firstname **] pain. Negative Babinski. BRIEF SUMMARY OF HOSPITAL COURSE: The patient was a 68-year-old gentleman with metastatic stage IV colon cancer admitted with respiratory distress, hypotension, hypoxia, acute renal failure, and unresponsiveness. The patient was made comfort measures only; per family's wishes. The patient was extubated. Pressors were withdrawn. A morphine drip was started. The patient was comfortable and in no apparent distress. The patient expired on [**2156-8-26**] with the time of death being approximately 11:15 in the evening. The patient was examined by night float resident. The patient's family friend [**First Name8 (NamePattern2) **] [**Name (NI) 724**]) was notified of the patient's death. She helped [**Known firstname **] interpret this information [**Known firstname **] the patient's son who was [**Name (NI) 46396**] only. The patient's attending was contact[**Name (NI) **]. The patient's family declined autopsy. The immediate cause of death was cardiopulmonary arrest secondary [**Known firstname **] stage IV metastatic colon cancer. [**Doctor Last Name **] [**Name6 (MD) **] [**Name8 (MD) **], M.D. [**MD Number(1) 5712**] Dictated By:[**Name8 (MD) 4937**] MEDQUIST36 D: [**2156-9-3**] 15:12 T: [**2156-9-6**] 09:30 JOB#: [**Job Number 50099**] ICD9 Codes: 5070, 5849, 4019, 2720
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Medical Text: Admission Date: [**2163-3-24**] Discharge Date: [**2163-3-26**] Service: MEDICINE Allergies: Pneumovax 23 Attending:[**First Name3 (LF) 4327**] Chief Complaint: Dyspnea on exertion Major Surgical or Invasive Procedure: Pacemaker placement History of Present Illness: 88yo F Russian speaking woman with dCHF, s/p AVR 3 years ago, SSS with baseline HR in the 40s, feeling week and tired today with heart rates in the 30s. Patient has had "good days" and "bad days" with some days feeling very tired and fatigued and other days feeling more energetic. Today, patient felt especially tired. Noted dyspnea on exertion and some accompanied chest pressure with exertion and nausea. No dizziness, diaphoresis, syncope, blurred vision. Patient called Dr [**Last Name (STitle) 171**] and he requested direct admission from home. Denies any fevers or chills but does endorse ~5lbs weight loss over the past several months and decreased appetite. . On arrival to the floor, patient felt tired. Denied any current nausea, SOB, or CP. However systolic BP was 90-100. Her HR was 20-30 bpm. On going to the bathroom she described chest pain, [**5-26**], mild substernal with no radiation, that is not positonal and is new for her. She complained of some mild headache and continued to have some baseline orthopnea. Labs were drawn and she was admitted to the CCU to be started on a low dose dopamine infusion and is due for PPM implantation in the AM. . REVIEW OF SYSTEMS As above, also denies abdominal pain, diarrhea, urinary frequency, dysuria, lower extremity edema, cough. . Past Medical History: 1. CARDIAC RISK FACTORS: DM, hyperlipidemia, HTN 2. CARDIAC HISTORY: -Aortic stenosis s/p bioAVR [**2-24**] -Diastolic Heart Failure (EF >75%) -CABG: CAD s/p single-vessel CABG [**2-24**] (SVG-PDA) 3. OTHER PAST MEDICAL HISTORY: NASH GERD Reducible umbilical hernia Social History: Widowed, lives in [**Location 86**] with family nearby. Has VNA 3x/wk. -Tobacco history: none -ETOH: none -Illicit drugs: none Family History: Family hx of heart disease in many members, unable to specify what kind, otherwise non-contributory. Physical Exam: ADMISSION exam: VS: T=94.5 BP=117/44 HR=34 RR=16 O2 sat=98%RA GENERAL: WDWN woman in NAD. HEENT: MMM. PERRL, EOMI. NECK: No JVD CARDIAC: Bradycardic with 3/6 harsh systolic murmur heard throughout precordium, nl S1 S2, no S3 or S4 LUNGS: CTAB, no crackles, wheezes or rhonchi. ABDOMEN: Soft, NTND. No HSM EXTREMITIES: No c/c/e. 2+DP b/l DISCHARGE EXAM: P62 98% 120/87 GENERAL: WDWN woman in NAD. HEENT: MMM. PERRL, EOMI. NECK: No JVD CARDIAC: Bradycardic with 3/6 harsh systolic murmur heard throughout precordium, nl S1 S2, no S3 or S4 LUNGS: CTAB, no crackles, wheezes or rhonchi. CDI PM dressing over left anterior chest wall. ABDOMEN: Soft, NTND. No HSM EXTREMITIES: No c/c/e. 2+DP b/l Pertinent Results: ADMISSION LABS: [**2163-3-24**] 10:13PM BLOOD WBC-6.5 RBC-2.60* Hgb-8.4* Hct-23.5*# MCV-91 MCH-32.2* MCHC-35.6*# RDW-13.4 Plt Ct-185 [**2163-3-24**] 10:13PM BLOOD PT-10.9 PTT-32.1 INR(PT)-1.0 [**2163-3-24**] 10:13PM BLOOD Glucose-124* UreaN-83* Creat-2.7*# Na-129* K-6.6* Cl-99 HCO3-20* AnGap-17 [**2163-3-24**] 10:13PM BLOOD CK-MB-3 cTropnT-0.02* [**2163-3-24**] 10:13PM BLOOD Calcium-7.9* Phos-5.9*# Mg-2.6 DISCHARGE LABS: [**2163-3-26**] 07:36AM BLOOD WBC-5.5 RBC-2.71* Hgb-8.9* Hct-24.2* MCV-90 MCH-32.9* MCHC-36.7* RDW-13.0 Plt Ct-213 [**2163-3-26**] 07:36AM BLOOD Glucose-125* UreaN-44* Creat-1.6* Na-141 K-4.6 Cl-106 HCO3-27 AnGap-13 [**2163-3-26**] 07:36AM BLOOD Calcium-8.3* Phos-4.5 Mg-2.3 ECG On admission the ECG showed extreme sinus bradycardia, with a junctional or fascicular escape rhythm (rate 30-40 bpm)having a RBBB, left axis deviation. This represented a marked change from previous ECGs that showed NSR or sinus bradycardia with short-normal PR interval, and minor, nonspecific intraventricular conduction delay, with QRS duration 110-120 msec. TTE [**2163-3-24**]: The left atrium is elongated. The right atrium is moderately dilated. The estimated right atrial pressure is at least 15 mmHg. The left ventricular cavity is unusually small. Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. Left ventricular systolic function is hyperdynamic (EF>75%). There is a mild resting left ventricular outflow tract obstruction. A mid-cavitary gradient is identified. The right ventricular cavity is mildly dilated with normal free wall contractility. The aortic valve is not well seen. A bioprosthetic aortic valve prosthesis is present. The transaortic gradient is higher than expected for this type of prosthesis. No aortic regurgitation is seen. Mild to moderate ([**1-17**]+) mitral regurgitation is seen. Moderate [2+] tricuspid regurgitation is seen. There is moderate pulmonary artery systolic hypertension. Significant pulmonic regurgitation is seen. There is no pericardial effusion. Compared with the prior study (images reviewed) of [**2162-12-8**], the aortic valve gradient and max TR gradeint are higher however they were probably underestimated on the prior study. CXR [**2163-3-26**]: There has been placement of new left-sided pacemaker with the distal lead tips in the right atrium, right ventricle and appropriately sited. Median sternotomy wires are again seen. There are low lung volumes with crowding of the pulmonary vascular markings. There is mild pulmonary vascular congestion. Heart size is enlarged but stable. No large areas of consolidation are seen. There are no pneumothoraces. Brief Hospital Course: HOSPITAL COURSE: 88yoF, Russian speaking, dCHF (preserved EF), s/p AVR 3 years ago, presenting with symptomatic bradycardia and some CP on ambulation. Transferred to CCU for dopamine infusion and PPM placement, tolerated the procedure well and was discharged home. . # Syptomatic bradycardia: Pt with hx of SSS w/o pacemaker as she had previously been asymptomatic, now with fatigue, DOE and HR in the 30s. SBPs were in 90s and the pt had CP but she was alert and interactive. However, EKG and troponins did not suggest any ischemia and the patient went for ppm placement. Patient tolerated procedure well with improvement in her HR and systolic pressures, she had resolution of symptoms with pacer placement. Post procedural CXR demonstrated no effusions or pneumothroax and correct placment of leads. . # Hypotension: Patient had episode of hypotension to the 90s and concurrent chest pain. There were no other symptoms or laboratory abnormalities. Amlodipine, enalapril were transiently held and started her on dopamine infusion at 5/hr and gave 250+500cc of IV NS. This was felt to be related to her bradycardia and improved after placer placement. # Chronic Diastolic Heart Failure: Patient had no symptoms or exam findings suggestive of an acute exacerbation though did have pulmonary edema noted on CXR and hyperkalemia. She was given IV lasix dose x1. . # [**Last Name (un) **]: patient presented with a Cr of 2.7, with a K of 6.6 and Na of 129. Felt to be prerenal in the setting of poor forward flow and kidney hypoperfusion. Hyperkalemia was treated with calcium gluconate, kayexcelate, insulin and fluids. Cr improved to 2.4 in after pacer placement. # CAD: pt had CP but cardiac enzymes and EKG were negative for signs of ischemia. We continued ASA 81 and atorvastatin # DM: stable. Last Hba1c 6.5, Oral antihyperglycemics were held on admission and patient was discharged on home metformin and glipizide. # Dementia: stable. We continued donepezil 10mg # GERD: stable. We continued omeprazole . TRANSITIONAL ISSUES: -patient is a full code, this should be readressed. Medications on Admission: Amlodipine 5mg daily Aspirin 81 mg/day glipizide 2.5 mg/day metformin atorvastatin 20 mg/day donepezil 10 mg/day enalapril 15 mg/day furosemide 30 mg/day esomeprazole Discharge Medications: 1. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 2. atorvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for pain. Disp:*64 Tablet(s)* Refills:*0* 4. Keflex 500 mg Capsule Sig: One (1) Capsule PO three times a day for 2 days. Disp:*6 Capsule(s)* Refills:*0* 5. glipizide 2.5 mg Tablet Extended Rel 24 hr Sig: One (1) Tablet Extended Rel 24 hr PO once a day. 6. metformin 500 mg Tablet Sig: One (1) Tablet PO once a day. 7. donepezil 10 mg Tablet Sig: One (1) Tablet PO once a day. 8. esomeprazole magnesium Oral Discharge Disposition: Home With Service Facility: [**Hospital6 1952**], [**Location (un) 86**] Discharge Diagnosis: Symptomatic bradycardia due to sinus node dysfunction (normal AV conduction). Treated with implantation of permanent pacemaker. Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: Dear Ms [**Known lastname **], You were admitted to [**Hospital1 18**] for a slow heart beat. A pacemaker was placed that will help keep your heart beating at an acceptable rate. You will need to take antibiotics until Sunday [**2163-3-28**]. A prescription is below. . Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight goes up more than 3 lbs. . While you were here we made the following changes to your medications: We STARTED you on Keflex (antibiotic) We STARTED Acetaminophen (as needed for pain) . We STOPPED Your amlodipine We STOPPED Your enalapril We STOPPED Your furosemide . . We made no other changes to your medications. Followup Instructions: Department: CARDIAC SERVICES When: THURSDAY [**2163-3-31**] at 9:00 AM With: DEVICE CLINIC [**Telephone/Fax (1) 62**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: CARDIAC SERVICES When: THURSDAY [**2163-4-14**] at 2:00 PM With: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 2003**], NP [**Telephone/Fax (1) 62**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: CARDIAC SERVICES When: TUESDAY [**2163-6-7**] at 3:00 PM With: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 2003**], NP [**Telephone/Fax (1) 62**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage ICD9 Codes: 4280, 2767, 2724, 4019, 4589
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Medical Text: Admission Date: [**2147-12-8**] Discharge Date: [**2148-1-2**] Date of Birth: [**2114-10-13**] Sex: M Service: ORTHOPAEDICS Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 8587**] Chief Complaint: s/p MVC with injuries Major Surgical or Invasive Procedure: [**2147-12-9**]: Traction pin to LLE [**2147-12-9**]: 1.IM nail right femur, 2.Closed reduction right pilon fracture, 3.Application multiplanar external fixator, 4.Operative treatment of left subtrochanteric femur fracture with intramedullary nail, 5.Washout and debridement, left open femur fracture wound, 6.Treatment of left femoral shaft fracture with IM implant. [**2147-12-12**]: IVC filter placement, I&D Left open femur fx [**2147-12-22**]: ORIF Right pilon fx History of Present Illness: Mr. [**Name13 (STitle) 27294**] is a 33 year old man who was invoved in a high speed rollover motor vehicle crash on [**2147-12-8**]. He was trapped under his car for 30 minutes with a GCS of 3 He was taken by [**Location (un) **] to [**Hospital1 18**] for further care and treatment. Past Medical History: denies Social History: Works as a forklift operator Lives with wife Family History: n/a Physical Exam: Upon admission Intubated Cardiac: Regular rate rhythm Chest: No crepitus, equal but decreased breath sounds Abdomen: Soft nontender nondistended Extremities: In cervical collar Left arm, large laeration over dorsum of left hand Bilateral LE: Thighs grossly swollen, L lateral thigh with open laceration around 2 cm in lenght, Right lower extremity externall rotated to 90 degrees, Right ankle grossly unstable, RLE pappable DP, Doppler PT weak, LLE no DP doppler PT Pertinent Results: [**2147-12-25**] 10:35AM [**Month/Day/Year 3143**] WBC-8.3 RBC-3.25* Hgb-9.6* Hct-28.3* MCV-87 MCH-29.6 MCHC-33.9 RDW-14.2 Plt Ct-666* [**2147-12-23**] 10:31AM [**Month/Day/Year 3143**] WBC-12.1* RBC-3.37* Hgb-10.1* Hct-29.4* MCV-87 MCH-30.0 MCHC-34.4 RDW-14.5 Plt Ct-677* [**2147-12-19**] 06:07AM [**Month/Day/Year 3143**] WBC-12.4*# RBC-3.14* Hgb-9.8* Hct-27.4* MCV-87 MCH-31.2 MCHC-35.7* RDW-15.0 Plt Ct-610*# [**2147-12-13**] 06:37AM [**Month/Day/Year 3143**] WBC-7.6 RBC-3.03*# Hgb-9.0*# Hct-26.7*# MCV-88 MCH-29.8 MCHC-33.8 RDW-14.4 Plt Ct-206 [**2147-12-12**] 06:50AM [**Month/Day/Year 3143**] WBC-7.9 RBC-2.26* Hgb-7.1* Hct-19.5* MCV-86 MCH-31.4 MCHC-36.4* RDW-14.2 Plt Ct-149* [**2147-12-11**] 05:45PM [**Month/Day/Year 3143**] Hct-21.2* [**2147-12-11**] 01:30PM [**Month/Day/Year 3143**] Hct-20.8* [**2147-12-11**] 07:57AM [**Month/Day/Year 3143**] WBC-8.9 RBC-2.63* Hgb-8.0* Hct-22.6* MCV-86 MCH-30.5 MCHC-35.6* RDW-13.9 Plt Ct-134* [**2147-12-11**] 05:00AM [**Month/Day/Year 3143**] WBC-9.3 RBC-2.32* Hgb-7.2* Hct-20.0* MCV-86 MCH-30.9 MCHC-36.0* RDW-14.2 Plt Ct-135* [**2147-12-10**] 01:15PM [**Month/Day/Year 3143**] WBC-9.0 RBC-2.35* Hgb-7.5* Hct-20.5* MCV-87 MCH-31.9 MCHC-36.7* RDW-13.4 Plt Ct-143* [**2147-12-10**] 03:13AM [**Month/Day/Year 3143**] WBC-8.4 RBC-2.61* Hgb-8.1* Hct-22.9* MCV-88 MCH-31.2 MCHC-35.5* RDW-13.5 Plt Ct-154 [**2147-12-9**] 02:28PM [**Month/Day/Year 3143**] WBC-9.1 RBC-3.38* Hgb-10.5* Hct-29.4* MCV-87 MCH-31.0 MCHC-35.6* RDW-13.5 Plt Ct-213 [**2147-12-9**] 04:54AM [**Month/Day/Year 3143**] WBC-8.0 RBC-3.96* Hgb-12.0* Hct-34.8* MCV-88 MCH-30.4 MCHC-34.6 RDW-13.5 Plt Ct-214 [**2147-12-9**] 01:11AM [**Month/Day/Year 3143**] WBC-11.6* RBC-3.93* Hgb-12.1* Hct-34.3* MCV-87 MCH-30.9 MCHC-35.4* RDW-13.5 Plt Ct-216 [**2147-12-11**] 07:57AM [**Month/Day/Year 3143**] Neuts-75.7* Lymphs-13.4* Monos-5.9 Eos-4.9* Baso-0.2 [**2147-12-23**] 10:31AM [**Month/Day/Year 3143**] Glucose-133* UreaN-7 Creat-0.7 Na-130* K-4.2 Cl-94* HCO3-25 AnGap-15 [**2147-12-19**] 06:07AM [**Month/Day/Year 3143**] Glucose-102 UreaN-12 Creat-0.7 Na-133 K-4.4 Cl-97 HCO3-26 AnGap-14 [**2147-12-12**] 06:50AM [**Month/Day/Year 3143**] Glucose-104 UreaN-8 Creat-0.7 Na-138 K-3.5 Cl-103 HCO3-28 AnGap-11 [**2147-12-11**] 05:00AM [**Month/Day/Year 3143**] Glucose-109* UreaN-8 Creat-0.8 Na-136 K-3.7 Cl-102 HCO3-29 AnGap-9 [**2147-12-10**] 01:15PM [**Month/Day/Year 3143**] Glucose-138* UreaN-12 Creat-0.9 Na-129* K-4.2 Cl-99 HCO3-26 AnGap-8 [**2147-12-10**] 03:13AM [**Month/Day/Year 3143**] Glucose-148* UreaN-13 Creat-0.8 Na-134 K-4.2 Cl-103 HCO3-26 AnGap-9 [**2147-12-9**] 02:28PM [**Month/Day/Year 3143**] Glucose-150* UreaN-9 Creat-0.7 Na-139 K-4.3 Cl-108 HCO3-23 AnGap-12 [**2147-12-9**] 04:54AM [**Month/Day/Year 3143**] Glucose-113* UreaN-10 Creat-0.8 Na-143 K-3.5 Cl-108 HCO3-21* AnGap-18 Brief Hospital Course: Mr. [**Name13 (STitle) 27294**] presented to [**Hospital1 18**] via [**Location (un) **] on [**2147-12-8**] after a motor vehicle crash in which he was ejected and pinned under the car. He was intubated at the scene. He was seen by the trauma surgery service and was consulted on by orthopaedics and plastic surgery. Injuries:1. Left open femur fx, 2. Right femur fx, 3. Avulsion of left hand with extension tendon exposure. 4. Right pilon fx. He was admitted to the trauma intensive care unit for further monitoring. On [**2147-12-9**] a traction pin was placed on his LLE which resulted in return of DP/PT doppler pulses. Later that day he was consented and prepped for surgery, he was taken to the operating room for a IM nail right femur, Closed reduction right pilon fracture, Application multiplanar external fixator, Operative treatment of left subtrochanteric femur, fracture with intramedullary nail, Washout and debridement, left open femur fracture wound, Treatment of left femoral shaft fracture with IM implant. He tolerated the procedure well and was taken back to the trauma intensive care unit for recovery. He was later extubated without difficulty. He remained hemodynamically stable and was able to be transferred out of the trauma intensive care unit to the floor on [**2147-12-10**]. He returned to the operating room on [**2147-12-12**] for a washout and debridement of the Left open femur fracture. During that procedure an IVC filter was placed by Dr. [**Last Name (STitle) **] of trauma surgery. He tolerated the procedure well without difficulty. He was also transfused with 2 units of packed red [**Last Name (STitle) **] cells for post-operative anemia. On [**2147-12-15**] Mr. [**First Name (Titles) 27294**] [**Last Name (Titles) **] pressure was noted consistently high, with his pain controlled and was started on 12.5mg daily of lopressor, with noted effect. On [**2147-12-22**] he was taken to the operating room for removal of the right leg ex-fix with ORIF of ther fibula and tibia. He remained hemodynamically stable and tolerated the procedure well. He continued to work with physical therapy to improve his strenght and mobility. Throughout his stay his pain was controled and his vital signs remained within normal limits. He was discharged in stable condition with instructions for follow up care. Medications on Admission: denies Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 2. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed. 3. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed. 4. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 5. Zolpidem 5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) as needed for sleep. 6. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily): Hold for SBP less than 120. 7. Oxycodone 5 mg Tablet Sig: 1-4 Tablets PO Q4-6H (every 4 to 6 hours) as needed for pain. 8. Enoxaparin 30 mg/0.3 mL Syringe Sig: One (1) 30mg syringe Subcutaneous Q12H (every 12 hours) for 4 weeks. 9. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). Discharge Disposition: Extended Care Facility: [**Hospital6 2222**] - [**Location (un) 538**] Discharge Diagnosis: Multi-trauma Post operative anemia Discharge Condition: Stable Discharge Instructions: If you develop any swelling, redness, or drainage from your incision, or if you have a temperature greater than 101.5 or if you become short of breath please call the office or come to the emergency department. Continue to be nonweight bearing on your right leg and weight bearings as tolerated on your left leg. Continue your lovenox injestions as directed Physical Therapy: Activity: Activity as tolerated Right lower extremity: Non weight bearing Treatment Frequency: You may apply a dry sterile dressing to draining right ex-fix areas. Your staples on your right pilon fx can be removed in 4 days (14 days after surgery) Followup Instructions: Please follow up with Dr. [**Last Name (STitle) **] in clinic in 2 weeks, please call [**Telephone/Fax (1) 1228**] to schedule that appointment. Completed by:[**2148-1-2**] ICD9 Codes: 2859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6667 }
Medical Text: Admission Date: [**2103-7-29**] Discharge Date: [**2103-8-2**] Date of Birth: [**2046-3-31**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 949**] Chief Complaint: Hemetemesis Major Surgical or Invasive Procedure: endoscopy s/p banding History of Present Illness: 57F H/O ETOH cirrhosis with known varices admitted [**2103-7-29**] with hematemesis x3 on the prior night. +nausea during the day, then ~9pm she vomited several mouthfuls of bright red blood. She then had an episodes of coffee ground emesis around midnight, thus came to ED. . Per the patient and her husband, she tends to be chronically hyponatremic with a Na ~130 at baseline. She also tends to have a low BP, with SBP 80-90 when in the hospital and 95-110 out of the hospital. . In the ED, her vitals were T 100.6 103 84/56 20 100%2L. she was given 2 L NS, octreotide 50mg IV once, protonix IV once, zofran 4mg iv and ativan 1mg iv. The patient had one more episode of hematemesis in the ED. The patient refused NG lavage. . Per ICU note, on arrival to the floor she was hypotensive with sbps in the 80s. Hepatology saw her and scoped her emergently in the CCU. Upon arrival to the MICU VS= 99.6 92/42 88 16 100%RA. EGD revealed 4 cords of varices without active bleeding. Banding was performed. . She received a total of 2U PRBCs since admission (last [**2103-7-29**] 5am), her HCT improved from 20->27->26->26->24 over 24hrs. She is being called out to the medical floor for further management of presumed GIB, hyponatremia and etoh cirhosis. Past Medical History: - ETOH cirrhosis with known varices - The patient lives in [**State 108**] and was diagnosed with ETOH cirrhosis around 1 year ago. She had an EGD several weeks ago that showed evidence of esophageal varices, was tried on trial of beta blocker, but failed secondary to hypotension. She has had 2 paracenteses in the past and denies history of SBP, though has been on cipro in past per her husband. She is not currently on the transplant list. The patient reports that her last drink was when she found out that she had liver disease. . denies CAD/HTN/DM/PE/DVT/cancer, beleives she had a stroke, though not diagnosed by MD. Social History: Social History: Pt. lives in [**State 108**] and is here visiting her ill mother. [**Name (NI) **] reports drinknig [**1-24**] glasses of wine a night for years, and then for the last 4 years drinking about 3 cocktails a night. She reports not drinking since learning of her diagnosis [**5-30**], per son prior to that was drinking 0.5 bottles wine/day x 5 yrs. Family History: Family history: denies family history of liver disease, DM. Family history of CA. Physical Exam: Vitals: 99.3 84 94/50 24 100%RA Gen: no acute distress HEENT: Clear OP, dry mucous membranes NECK: Supple, No LAD, No JVD CV: RR. NL S1, S2. 3/6 SEM loudest @ apex (first heard here) LUNGS: crackles @ bilateral bases ABD: Soft, distended, mild diffuse TTP, no rebound or gaurding. negative fluid wave. EXT: No edema. 2+ DP pulses BL SKIN: spider hemangeomas, diffuse NEURO: A&Ox3. Appropriate. CN 2-12 grossly intact. Preserved sensation throughout. 5/5 strength throughout. [**1-24**]+ reflexes, equal BL. Normal coordination. Gait assessment deferred. faint axterixis PSYCH: Listens and responds to questions appropriately, pleasant Pertinent Results: Admission Labs: WBC-17.1* Hgb-8.6* Hct-25.7* MCV-92 Plt Ct-267 Neuts-66 Bands-5 Lymphs-23 Monos-3 Eos-1 Baso-0 Atyps-2* Metas-0 Myelos-0 Hypochr-NORMAL Anisocy-NORMAL Poiklo-NORMAL Macrocy-2+ Microcy-NORMAL Polychr-1+ Stipple-1+ PT-16.3* PTT-36.2* INR(PT)-1.5* Glucose-94 UreaN-31* Creat-1.2* Na-123* K-5.5* Cl-88* HCO3-27 ALT-33 AST-53* LD(LDH)-255* AlkPhos-99 TotBili-2.0* . Discharge Labs: WBC-6.3 Hgb-8.2* Hct-24.6* MCV-91 MCH-30.6 Plt Ct-148* Glucose-84 UreaN-7 Creat-0.9 Na-133 K-3.3 Cl-100 HCO3-25 Calcium-8.0* Phos-3.2 Mg-1.3* . Studies: [**2103-7-29**] EGD: Findings: Esophagus: Lumen: A medium size hiatal hernia was seen. Protruding Lesions 4 cords of grade II varices were seen in the lower third of the esophagus. The varices were not bleeding. Stomach: Mucosa: Diffuse continuous congestion, erythema, friability and mosaic appearance of the mucosa with contact bleeding were noted in the antrum, stomach body and fundus. These findings are compatible with portal hypertensive gastroapthy. Other procedures: 4 bands were successfully placed in the lower third of the esophagus. Impression: Varices at the lower third of the esophagus Medium hiatal hernia Congestion, erythema, friability and mosaic appearance in the antrum, stomach body and fundus compatible with portal hypertensive gastroapthy (ligation) Otherwise normal EGD to second part of the duodenum [**2103-7-30**] CXR: The cardiomediastinal silhouette is stable. There is increase in distention of the azygos vein which might represent volume overload. There is no evidence of pulmonary edema. The new opacity in the right lower lung most likely consistent with the right middle lobe atelectasis. There is no evidence of pleural effusion. Rib fractures partially healed on the left are again noted. . [**2103-7-30**] RUQ U/S: No portal vein thrombosis. 1. Minimal free fluid noted in the perihepatic space not sufficient for diagnostic or therapeutic paracentesis. . 2. Please note the gallbladder was not visualized. In the absence of history of cholecystectomy, this could reflect a collapsed gallbladder obscured by overlying bowel gas. Otherwise unremarkable abdominal ultrasound. . [**2103-7-31**] Liver U/S with doppler IMPRESSION: 1. 3.9 cm solid right hepatic mass. A multiphasic CT or MRI is recommended for further characterization. 2. Patent hepatic vasculature. 3. Trace of ascites. 4. Splenomegaly. . Brief Hospital Course: 57 year old female with a history of alcoholic cirrhosis with known varices presenting with likely variceal bleed. . 1. Upper GI Bleed: The patient has known esophageal varices. She was initially admitted to the MICU and GI was consulted for bleeding and an EGD was performed. Banding was done by hepatology with no evidence of active bleeding. Her hematocrit dropped from 25.7 to 20.8 between 11am [**7-28**] and 3am [**7-29**]. The patient was transfused 2 units PRBC on the morning of [**7-29**] with an increase in Hct to 27.8 A repeat Hct later in the day on [**7-29**] was 26.2. Hct the morning of [**7-30**] was stable at 26.1. The patient was maintained on protonix IV BID, octreotide gtt, and sucralfate PO. She received ceftriaxone 1g QD X5 days ([**7-29**] - [**8-2**]) for prophylaxis in the setting of a GI bleed. On the evening of [**7-30**] the patient was transferred to the hepatology service. Her hematocrit remained stable and she was switched to PO protonix. On discharge she was adivsed to follow-up with a repeat EGD in 2 weeks time, either with Dr. [**Last Name (STitle) 10285**] in [**Location (un) 86**], or with her gastroenterologist in [**State 108**] with whom she already has an appointment. . 2. EtOH Cirrhosis: The patient's home rifaximin and lactulose were held at presentation as the patient was NPO. There was no evidence of ascites on clinical exam. Ultrasound of the liver showed trace ascites, though not enough to be tapped. Lactulose and rifaximin were restarted on [**7-30**]; lasix and aldactone were initially held and restarted on [**7-31**] as the patient had developed worsening ascities. The ascities decreased somewhat for the remainder of her hospital stay after the diuretics were restarted. LFTs, INR, and Tbili were monitored and decreased from presentation to [**7-30**]. Doppler of the portal vein showed patent hepatic vasculature. . 3. Hyponatremia: The patient had hyponatremia at presentation which was thought to be related to diuretic use as the patient was on lasix QD and aldactone TID at home. This could have also been related to dehydration as patient got several liters of NS in the ED. There was also likely a component of hypotonic/hypervolemic hyponatremia secondary to the patient's known cirrhosis. The sodium increased to 129 on the morning of [**7-30**] and further increased to 133 on the day of discharge. . 4. Leukocytosis: The patient had a WBC of 17 on the day of admission ([**7-29**]). There was no clear source as there were no localizing symptoms, the patient was afebrile and CXR was negative for any acute processes. Blood cultures were negative. Admission urine culture grew out 3000 probable Enterococcus. The WBC decreased to 8 on the morning of [**7-30**]. Ceftriaxone was continued in the setting of the GI bleed. A second urine culture collected on [**8-1**] grew out only skin flora. . 5. Pain: The patient has a high opiate use at home (Percocet) and repeatedly complained of pain during her MICU stay, most often in the area of the esophagus after her EGD. She was put on morphine 2mg IV Q3h PRN and ativan 1-2mg Q4h PRN. She also received trazodone 50mg on the night of [**7-28**] for help with anxiety and sleeping, and was noted by nursing to also take some of her home pills "from her purse" which helped her to sleep. When she was tranferred to the floor, her home medications were held by nursing and she received oxycodone 5mg Q6H PRN and ativan. . 6. Chest pain: The patient reported pain in the area of the esophagus after the EGD procedure. Her EKG was negative and it was felt that the pain was unlikely to be related to an MI given its longevity and initiation around time of EGD. She likely had pain associated with the EGD and anxiety. The patient also likely has a low pain tolerance, but high opiate requirement, given her pain medication usage at home. There was no crepitus on exam. Her pain regimen was continued as per above. CXR on the morning of [**7-30**] showed no evidence of free air. . 7. Depression: Stable during the hospital course, though likely above her baseline given that she was in the city visiting her ill mother before her episodes of hematemesis. Home wellbutrin was held while she was NPO. Wellbutrin was restarted on the afternoon of [**7-30**] when she was taking PO. . 8. FEN: She was kept NPO for her GI bleed 24 hours after EGD and restarted on a liquid diet on [**7-30**]. She was advanced to a regular diet as tolerated. . 9. Prophylaxis: DVT prophylaxis with pneumoboots . 10. CODE: DNR/DNI Medications on Admission: Centrum silver Lasix 40 mg QD Aldactone 100mg TID Wellbutrin 150 mg [**Hospital1 **] Lactulose 45 mL QID Xifaxan 400 mg TID Milk thistle 175 mg QD Restoril 30 mg QHS Dulcolax Oxycodone and ativan prn Q6H Discharge Medications: 1. Thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 2. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 3. Sucralfate 1 gram Tablet Sig: One (1) Tablet PO QID (4 times a day) for 1 weeks. Disp:*28 Tablet(s)* Refills:*0* 4. Rifaximin 200 mg Tablet Sig: Two (2) Tablet PO TID (3 times a day). Disp:*180 Tablet(s)* Refills:*2* 5. Lactulose 10 gram/15 mL Syrup Sig: Forty Five (45) ML PO QID (4 times a day). Disp:*5400 ML(s)* Refills:*2* 6. Spironolactone 100 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). Disp:*90 Tablet(s)* Refills:*2* 7. Furosemide 40 mg Tablet Sig: One (1) Tablet PO QAM (once a day (in the morning)). Disp:*30 Tablet(s)* Refills:*2* 8. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day. Disp:*30 Capsule, Delayed Release(E.C.)(s)* Refills:*2* 9. Bupropion 150 mg Tablet Sustained Release Sig: One (1) Tablet Sustained Release PO BID (2 times a day). Disp:*60 Tablet Sustained Release(s)* Refills:*2* 10. Oxycodone 5 mg Tablet Sig: One (1) Tablet PO every eight (8) hours as needed for pain for 1 weeks. Disp:*21 Tablet(s)* Refills:*0* 11. Ativan 0.5 mg Tablet Sig: One (1) Tablet PO every eight (8) hours as needed for 5 days. Disp:*15 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: Primary: end stage liver disease cirrhosis esophageal varices and upper GI bleed Secondary: Depression Discharge Condition: stable, pain free, hematocrit Discharge Instructions: You had an upper GI bleed to to a bleeding esophageal varices from your liver cirrhosis. These were banded and you should have a repeat endoscopy in a few weeks to evaluate the varices. Please take all medications as directed. Please stop taking your restoril and ativan as it may cause excessive somnolence. Please attend your follow-up appointments. You have an appointment with Dr. [**Last Name (STitle) **] on [**2103-8-15**]. PLease call your doctor if you have any nausea, vomiting, abdominal pain, fevers, bloody vomit, black or tarry stools, bloody stools, or any other concerning symptoms. Followup Instructions: Please call [**Telephone/Fax (1) 463**] if you need to reschedule. Provider: [**Name10 (NameIs) **] [**Apartment Address(1) **] (ST-3) GI ROOMS Date/Time:[**2103-8-15**] 10:30 Provider: [**Name10 (NameIs) **] [**Last Name (NamePattern4) 2424**], MD Phone:[**Telephone/Fax (1) 463**] Date/Time:[**2103-8-15**] 10:30 ICD9 Codes: 2851, 2761, 311
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6668 }
Medical Text: Admission Date: [**2189-8-3**] Discharge Date: [**2189-8-5**] Date of Birth: [**2149-8-30**] Sex: M Service: MEDICINE Allergies: Penicillins Attending:[**First Name3 (LF) 398**] Chief Complaint: Diabetic Ketoacidosis Major Surgical or Invasive Procedure: None History of Present Illness: 39 year old male with DM1, h/o depression and polysubstance abuse, Hep C who presents with lethargy and polydipsia after not taking his insulin for 2 days. He reports that his lost his glucometer and insulin. Over the past 2 days he developed nausea and lethargy and polydipsia. He felt warm to the touch per his girlfriend, but [**Name2 (NI) 15598**]'t take his temperature. He also was more confused the evening prior to admission. He additionally complined of [**5-21**] chest pressure, non-radiating which lasted [**2-11**] hours. No associated SOB, cough, or urinary symptoms. . In the ED, T 97.6 HR 110 , BP 137/64 R 16 O2 sats 96 % on RA. K 7.0 with AG of 25, and pH 7.22 pCO2 27 pO2 103 and glucose above the dectable range on fingerstick with a serum glucose of 753 and peaked T waves, on ECG he receieved calcium gluconate 1 amp x1, 3 L NS, insulin 10 unit IVx1 and insulin drip at 10 units per hour, ASA 325 mg po x1. On arrival to the ICU he reported feeling better. Denies CP or SOB. Past Medical History: Past Psych History: -Patient's Psychiatrist: Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 78730**] at [**Hospital1 **], whom the patient has been seeing for the past 2 years for psychopharmacology. -Therapist: No present therapist. Pt had been seeing [**First Name4 (NamePattern1) 1060**] [**Last Name (NamePattern1) **] for 2 years but stopped seeing her. -inpatient hospitalizations including [**Hospital1 **], [**Hospital1 18**], FH. Last hospitalization [**9-15**] at [**Hospital1 18**]. Second to last hospitalization was at Bayridge last year- around [**9-13**]. He reports that his presentation has been similar with each presentation with depression, SI and PSA. -Although patient denies history of [**Last Name (LF) **], [**First Name3 (LF) **] [**First Name3 (LF) **], he has history of multiple suicide attempts. During a past admission, he reported cutting his wrists at 18yo, and h/o multiple o/d attempts with most recent [**3-15**] requiring ICU stay at FH. He reports h/o attempted asphyxiation. -Per [**Name (NI) **], pt reports a prior diagnosis of BPAD- he denies manic sxs, stating that he predominantly presents with "depression and anger". -Per [**Name (NI) **], h/o assaultive behaviors with h/o jail time for assault and battery. He reports that his last jail sentence was 3 years ago. He denied present legal issues, stating that his parole ended [**12-14**]. Past Medical History: DM type 1 (poorly controlled) Hepatitis C Polysubstance abuse Social History: Currently lives with his daughter and is a plumber. Has been sober from EtOH and substances for the last 3 years until relapsing a few days ago with EtOH and cocaine. Former heroine user. Quit smoking 3 yrs ago. Family History: Mother, Father, one brother with ETOH dependence Physical Exam: General Appearance: Well nourished Eyes / Conjunctiva: PERRL Head, Ears, Nose, Throat: Normocephalic Cardiovascular: (S1: Normal), (S2: Normal) Peripheral Vascular: (Right radial pulse: Not assessed), (Left radial pulse: Not assessed), (Right DP pulse: Present), (Left DP pulse: Present) Respiratory / Chest: (Expansion: Symmetric), (Breath Sounds: Clear : ) Abdominal: Soft, Non-tender, Bowel sounds present, No(t) Distended, No(t) Tender: Extremities: Right: Absent, Left: Absent Skin: Not assessed Neurologic: Responds to: Not assessed, Movement: Not assessed, Tone: Not assessed Pertinent Results: [**2189-8-5**] 04:28AM BLOOD WBC-4.9# RBC-4.11* Hgb-12.0* Hct-35.8* MCV-87 MCH-29.3 MCHC-33.7 RDW-13.6 Plt Ct-163 [**2189-8-5**] 04:28AM BLOOD Glucose-187* UreaN-12 Creat-1.0 Na-137 K-4.3 Cl-112* HCO3-17* AnGap-12 [**2189-8-5**] 04:28AM BLOOD Calcium-7.3* Phos-1.8* Mg-1.5* [**2189-8-3**] 08:33PM BLOOD ASA-NEG Ethanol-NEG Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG Brief Hospital Course: DKA - Upon admission to the [**Hospital Unit Name 153**], the patient's diabetic ketoacidosis was treated with IV fluids and an insulin drip. During the course of his first 12 hours of admission, his hyperglycemia decreased from 436 to a goal of between 100-200 with 25 units/hours insulin drip. The patient had an anion gap of 21 in the ICU, which closed by the morning of admission. He also received 8 liters NS IVF. After his serum glucose was stabilized and his anion gap closed, he was converted back to his home lantus, but at a reduced dose of 20 units SQ QHS, which was increased to 30 units SQ QHS the morning of discharge. He was also placed on a insulin glargine sliding scale, as recommended by endocrinology. Hyperkalemia - The patient had an elevated potassium up to 6.8 with ECG changes, specifically peaked T waves. He was given 1 gram of calcium gluconate and his potassium stabilized and on the morning of discharge was 4.3. Chest discomfort - The patient reported chest discomfort described as pressure for 1 hour the day of admission. The pain resolved prior to admission, and during the length of his hospital stay he reported no similar symptoms or chest pain. His ECG did not demonstrate any changes and his cardiac enzymes were negative x2. CAD - Received 81 mg ASA PO daily. Polysubstance abuse - Urine tox screen was negative. Depression - Received home dose of wellbutrin SR. Hepatitis C - Stable during admission. Medications on Admission: Bupropion SR 150 mg 1 tab po daily Insulin lantus 30 units SQ QHS Insulin lispro at sliding scale dose OTC ASA 81 mg po daily Multivitamin 1 tab daily Discharge Medications: 1. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 2. Bupropion 150 mg Tablet Sustained Release Sig: One (1) Tablet Sustained Release PO DAILY (Daily). 3. Insulin Glargine 100 unit/mL Solution Sig: Thirty (30) units Subcutaneous at bedtime. Disp:*900 units* Refills:*2* 4. Insulin Lispro 100 unit/mL Solution Sig: per sliding scale units Subcutaneous four times a day. Disp:*1000 units* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Primary 1. Diabetic ketoacidosis Secondary 1. Hepatitis C Discharge Condition: good Discharge Instructions: You were admitted for diabetic ketoacidosis. This was due to not taking your insulin. It is very important that you follow your diabetic regimen including measuring your blood glucose at least 4 times a day and taking appropriate insulin. Please return to the ED if you develop symptoms including nausea, vomiting, or abnormally high blood glucose levels. Please take all of your medications as directed. Please keep all of your follow up appointments. Followup Instructions: You have an appointment today, [**2189-8-5**], at 2pm at the [**Hospital **] Clinic with [**First Name9 (NamePattern2) 32887**] [**Doctor Last Name 1726**]. At that time, you will get a new glucometer. Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 8507**], MD Phone:[**Telephone/Fax (1) 2422**] Date/Time:[**2189-11-13**] 11:20 Provider: [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 5004**] [**Last Name (NamePattern1) **], M.D. Phone:[**Telephone/Fax (1) 250**] Date/Time:[**2189-11-2**] 4:20 Completed by:[**2189-8-5**] ICD9 Codes: 5849, 2767, 311
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Medical Text: Admission Date: [**2132-1-30**] Discharge Date: [**2132-2-6**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 12658**] Chief Complaint: Hypoxia Major Surgical or Invasive Procedure: None History of Present Illness: Ms. [**Known lastname 21214**] is a [**Age over 90 **]F with recent confusion and URI found to have PE on CT in ED. Pt was seen by her PCP today for followup of her recent hyponatremia. Pt's chronic venous stasis and leg ulcerations were thought to look worse and possibly be infected, so she was sent to the ED for further evaluation. There, her O2 sat dropped into 60s during her stay. A CXR was performed, which showed RLL collapse, and a CTA showed 2 large PEs in the R main pulmonary artery. . Pt denies SOB or chest pain. She states she is feeling comfortable. She does not remember being in the ED earlier today. She does not believe she is in [**Location (un) 86**]. . On further questioning of pt's son, he states that she had a recent URI, as did her husband. [**Name (NI) **] states that pt has been talking to herself more frequently at night over the last [**3-16**] days and has been more confused. She is usually oriented and sharp, and she has been confused and rambling. Her PCP notes this from their visit today, as well. [**Name (NI) 1094**] son does not recall pt complaining of SOB or chest pain. . In the [**Name (NI) **], pt rec'd D50 and insulin, 2 amps bicarb, Kayexalate, and Unasyn 3g x1. Heparin gtt started after CT angio results returned. Past Medical History: Hypertension s/p CVA [**2130**] Atrial fibrillation Macular degeneration h/o Breast cancer Social History: Lives with husband. They have nursing care 12 hours/day. Family History: Non-contributory Physical Exam: VS: 97.7 100 126/88 20 98% NRB Gen: cachectic, not oriented to place or person, kyphotic, no respiratory distress CV: tachycardic, irregularly irregular, nl S1, loud P2 Pulm: decreased breath sounds bilaterally, scattered wheezes at LUL, no crackles Abd: soft, distended, + BS, no masses Ext: cold to touch; [**2-16**]+ pitting edema in lower extremities to knees with skin changes c/w venous stasis; also with multiple areas of ulcerated lesions, weeping sanguinous and in certain places more purulent material; sensation intact to light touch Pertinent Results: 131 91 41 ------------< 227 5.9 30 1.2 12.2 > 15.2 < 397 45.3 N:90.4 Band:0 L:6.7 M:2.7 E:0.1 Bas:0 PT: 18.0 PTT: 31.9 INR: 1.7 EKG: 83bpm, v paced; TWI in aVL, no TWI in precordials, no S1Q3T3 . STUDIES: CTA Chest: Two large acute PEs in R main pulm A; filling defect in RLL bronchus - mucous plug vs mass; near total collapse of RLL [**2-15**] bronchial filling defect; bilateral large pleural effusions . CT head: no intracranial hemorrhage; high density air-fluid level in L maxillary sinus, lucency in posterior wall and focal indentation of anterior wall suspicious for fx . CXR: worsening bibasilar atelectasis/consolidation, with likely complete collapse of RLL, poss PNA . RUE US: No DVT identified . UE ARTERIAL STUDY: Essentially normal arterial inflow to the hands bilaterally. . RENAL U/S: Unremarkable renal ultrasound. Brief Hospital Course: A/P: Ms. [**Known lastname 21214**] is a [**Age over 90 **] year old female with a h/o afib admitted for PE and RLL PNA. # PE: She had been on coumadin chronically but became supertherapeutic so her coumadin was held. On admission her INR was 1.7 and CTA showed large acute pulmonary emboli in her right main pulmonary artery. She was initially transferred to the MICU and put on a heparin gtt. Her respiratory status remained stable and then trasferred to Medicine for futher care. She was transitioned to coumadin with a 2 day overlap with heparin when the INR was therapeutic between 2 and 3. She is discharged with coumadin 2mg daily, and she should have her INR monitored frequently and coumadin adjusted accordingly. She did not develop any bleeding complications. . # PNA: CXR showed RLL collapse, suggestive of a post-obstructive PNA. In the MICU,s he was covered emperically with ceftriaxone, azithromycin, and unasyn. Then her antibiotic regimen was later changed to azithromycin (for CAP) and Zosyn (for coverage of aspiration pneumonia). Her respiratory status was stable on nasal cannula. She completed a 5 day course of azithromycin. She will complete a 14 day course of zosyn upon discharge, last date [**2132-2-15**]. Vancomycin was added to cover for potential MRSA, and she will complete a 10 day course also on [**2132-2-15**]. She has a PICC line in for access. For her Vanc, she is dosed 1000mg q48 hours based on her renal function at this time. She should have her dose adjusted while in rehab. She was given xopenex for bronchodilation; albuterol should be avoided as she is tachycardic. Atrovent was avoided because of anticholinergic effects, which may cause some mental status change. . # DELIRIUM: Likely secondary to infectious process (PNA) and hospitalization in the elderly. She is not on any medication that would incite mental status decline. She is not hypoxic, and had an unremarkable ABG here. She had head CT that was negative for bleed. Her mental status improved over her hospital course. She should avoid narcotics and sedative including sleeping aids at night. . # ABD XRAY: She had a KUB that showed possible ileus. However, she was eating without symptoms and she had loose stools. She should have a follow up KUB to assess if this has resolved. Her loose stools were negative for cdiff x 2. She was on flagyl emperically briefly but this was discontinued since she has 2 sets negative. . # AFIB: She is rate controlled with metoprolol 50mg tid. She is on coumadin for anticoagulation. . # VENOUS STASIS ULCERS: She initially presented from PCP's office because her venous ulcers look infected. These improved on both legs with wound care consult. She should have dry guage changes [**Hospital1 **], wrapped with kerlex. Of note, she looses significant fluids from these ulcers so she might need fluid replacement. . # ELBOW ULCER: She has a pressure ulcer on her right elbow that does not look infected. This should be treated with guage and kerlex. . # ARF: She does not have baseline renal disease. Urine lytes and FENA suggested a prerenal picture. Her lisinopril was held in this setting. She was given gentle IVF's but she still has some renal insufficiency. She will continue to need IVF at rehab. Renal ultrasound was unremarkable. . # CYANOTIC RIGHT HAND: Arterial study was normal arterial blood flow and and ultrasound did not show DVT in her right arm. . # NUTRITION: She tolerates a regular cardiac diet with supplemental Ensure TID. Her albumin is 2.2 so she is has severe malnutrition. Would continue to enourage PO intake. . # CODE: DNR/DNI as discussed with pt's PCP Medications on Admission: lisinopril 5mg [**Hospital1 **] atenolol 75mg daily calcium citrate 2 tabs [**Hospital1 **] MVI spironolactone 25mg daily lipitor 10mg daily timoptic drops OU Discharge Medications: 1. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 3. Warfarin 2 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Levalbuterol HCl 0.63 mg/3 mL Solution Sig: Three (3) ML Inhalation q6H PRN (). 5. Piperacillin-Tazobactam 2.25 g Recon Soln Sig: One (1) Recon Soln Intravenous Q6H (every 6 hours) for 8 days: last day [**2132-2-15**]. 6. Vancomycin in Dextrose 1 g/200 mL Piggyback Sig: One (1) gram Intravenous Q48H (every 48 hours) for 8 days: last day [**2132-2-15**]. 7. Timoptic 0.25 % Drops Sig: One (1) drop Ophthalmic once a day: each eye. 8. Multivitamin Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - MACU Discharge Diagnosis: PRIMARY PE PNA Mental status change SECONDARY 1. Atrial fib- Patient is normally anticoagulated on coumadin. It had been held prior to admission secondary to an elevated INR. 2. S/P CVA one year ago in the right perisylvian region 3. Chronic venous stasis with leg ulcerations 4. Hyperlipidemia 5. S/P pacemaker placement 6. H/O breast cancer s/p mastectomy in [**2089**] 7. Macular degeneration 8. Syncopal episodes 9. S/P hip fracture with pinning [**6-/2131**] Discharge Condition: hemodynamically stable, afebrile Discharge Instructions: Please take all medication as prescribed. Keep all appointments listed below. If you have chest pain or shortness of breath, seek medical attention immediately. If you have any medical questions or concerns, please call your doctor or go to the emergency room. Followup Instructions: Please follow up with your PCP [**Last Name (NamePattern4) **] 1 week: [**Last Name (LF) **],[**First Name3 (LF) **] E. [**Telephone/Fax (1) 719**] ------------------ OTHER APPOINTMENTS: Provider: [**First Name11 (Name Pattern1) **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **], M.D. Phone:[**Telephone/Fax (1) 6197**] Date/Time:[**2132-6-17**] 2:20 Completed by:[**2132-2-6**] ICD9 Codes: 2767, 5849, 2724
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Medical Text: Admission Date: [**2104-12-8**] Discharge Date: [**2104-12-18**] Date of Birth: [**2026-12-30**] Sex: F Service: Vascular surgery #58 This is a stat ADDENDUM to the discharge summary dictated on [**2104-12-15**]. The patient complained of hoarseness postoperatively. She was seen by Ear, Nose and Throat specialist on [**2104-12-16**], who felt that there was no vocal cord paralysis. If the hoarseness persisted more than one week, then a fiberoptic examination was recommended. The patient had small amounts of drainage from her groin incision sites. She was started on Kefzol. She was screened and accepted by [**Hospital **] Rehabilitation on [**2104-12-18**]. She was discharged on Keflex until she followed up with Dr. [**Last Name (STitle) **] in the office in two weeks. [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern4) 2604**], M.D. [**MD Number(1) 6223**] Dictated By:[**Last Name (NamePattern1) 3954**] MEDQUIST36 D: [**2105-1-5**] 11:55 T: [**2105-1-6**] 04:51 JOB#: [**Job Number 27198**] ICD9 Codes: 4275, 4241, 2851, 4019
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Medical Text: Admission Date: [**2199-11-22**] Discharge Date: [**2199-12-6**] Service: MEDICINE Allergies: Captopril / Erythromycin Base / Ampicillin Attending:[**First Name3 (LF) 800**] Chief Complaint: hypoxia Major Surgical or Invasive Procedure: PEG tube placement NG tube placement History of Present Illness: Patient is a 84 yo female with h/o diastolic CHF who presents with dyspnea and lower extremity edema. The patient states that she has been having increasing lower extremity edema for the past 3 weeks. Last night, she woke up in the middle of the night to go to the bathroom and experienced abdominal cramping. She called the nurse [**First Name (Titles) **] [**Last Name (Titles) 100**] Rehab, who evaluated the patient and found her to be dyspneic and satting 94% on room air. Ms. [**Known lastname 94752**] denies orthopnea, as she states she now always sleeps on an incline because of her C2-C4 fusion in [**Month (only) 359**]. The patient also denies PND and states that she never felt subjectively dyspneic. Of note, the patient states that she takes Lasix 40 mg daily and has been compliant with her medications. She also denies eating many salty foods, but admits to frequent consumption of soups. . In the ED, the patient's VS were BP 189/86, P 76, R 20, O2 74% on 4L. She was placed on Bipap and received Lasix 80 mg IV, ASA 325 mg, was placed on a nitro gtt. An ECG demonstrated that the patient is in AFib, which is altered from her previous baseline. The patient diuresed 1.1L and her O2 requirement decreased to 2L. She was then admitted to [**Hospital Ward Name 121**] 3 for further workup and evaluation. . 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. He denies exertional buttock or calf pain. All of the other review of systems were negative. Cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. Past Medical History: HTN Diastolic CHF Gout Barrets Polymyositis Bell's Palsy (Rt) Massive PE s/p Trendy procedure, IVC filter placement TAH Appendectomy T4, T8 vertebroplasty [**2196-10-11**] C4-C5 disectomy and hardware placement 3.9 cm infrarenal AAA Recent BM biopsy from iliac crest Social History: 40 pack year hx of tobacco, quit over 20 years ago, no etoh/illict drug use; was living independently until recently; now in [**Hospital 100**] Rehab after recent surgery; does not have much family - is close with friends; good friend [**Name (NI) 2184**] [**Name (NI) 951**] is her HCP Family History: mom with osteoporosis and heart disease, died at age 79; no other history of heart disease Physical Exam: PHYSICAL EXAMINATION: VS: T 97.8, BP 160/80, P 57, R 22, O2 94% on 2L Gen: Elderly woman, pleasant, in NAD. Oriented x3. Mood, affect appropriate. HEENT: R sided facial droop and ptosis. PERRL, Sclera anicteric. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. No xanthalesma. Neck: Supple with JVD to base of ear. CV: PMI located in 5th intercostal space, midclavicular line. RR, normal S1, S2. 2/6 systolic murmur best heard at L lower sternal border. No thrills, lifts. No S3 or S4. Chest: Kyphosis. Resp were unlabored, no accessory muscle use. Diffuse crackles to mid-lung bilaterally Abd: Soft, NTND. No HSM or tenderness. No abdominial bruits. Ext: 3+ pedal edema bilaterally. Skin darkening in lower extremities bilaterally. No femoral bruits. Skin: + stasis dermatitis, no ulcers, scars, or xanthomas. . Pulses: Right: DP 2+ PT 2+ Left: DP 2+ PT 2+ Pertinent Results: [**2199-11-22**] 05:20AM BLOOD WBC-12.7* RBC-3.61* Hgb-10.1* Hct-31.8* MCV-88 MCH-28.1 MCHC-31.9 RDW-15.7* Plt Ct-456* [**2199-11-22**] 05:20AM BLOOD Neuts-82.8* Lymphs-12.3* Monos-2.9 Eos-1.9 Baso-0.2 [**2199-11-22**] 05:20AM BLOOD PT-31.2* PTT-26.3 INR(PT)-3.2* [**2199-11-22**] 05:20AM BLOOD Glucose-85 UreaN-28* Creat-1.5* Na-143 K-4.6 Cl-105 HCO3-30 AnGap-13 [**2199-11-22**] 05:20AM BLOOD CK(CPK)-32 [**2199-11-22**] 05:20AM BLOOD CK-MB-NotDone cTropnT-0.03* proBNP-9136* [**2199-11-22**] 02:43PM BLOOD cTropnT-0.03* [**2199-11-23**] 07:38AM BLOOD Calcium-8.7 Phos-3.8 Mg-1.8 [**2199-11-26**] 09:44PM BLOOD Lactate-1.9 . [**2199-12-2**] EKG - Sinus bradycardia. Left axis deviation likely due to left anterior fascicular block. Lateral ST-T wave changes are non-specific. Compared to the previous tracing of [**2199-11-29**] the findings are similar. . [**2199-12-2**] echo - The left atrium is mildly dilated. No atrial septal defect or patent foramen ovale is seen by 2D, color Doppler or saline contrast with maneuvers. Left ventricular wall thickness, cavity size and regional/global systolic function are normal (LVEF >55%). Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets are moderately thickened. There is mild aortic valve stenosis (area 1.2-1.9cm2). Trace aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Mild (1+) mitral regurgitation is seen. There is mild pulmonary artery systolic hypertension. There is no pericardial effusion. . IMPRESSION: No intracardiac shunt identified. Mild aortic valve stenosis. Mild mitral regurgitation. Mild pulmonary artery systolic hypertension. . [**12-1**] - echo - IMPRESSION: No hydronephrosis. Bilateral simple renal cysts. . [**12-1**] PA/Lateral chest x-ray - FINDINGS: Comparison is made to prior study of [**2199-11-27**]. There is again seen bibasilar atelectasis and small pleural effusions. There are no signs of overt pulmonary edema. No focal consolidation is seen. The filter and spinal fixation hardware is again seen. . [**2199-11-24**] - CT chest - IMPRESSION: 1. New centrilobular "tree-in-[**Male First Name (un) 239**]" and nodular opacities in the lower lobes and right middle lobe consistent with infection or aspiration. 2. Moderate centrilobular upper lobe predominant emphysema. 3. Extensive moderate aortic valve calcifications of uncertain physiologic significance. . [**12-2**] - echo with bubble study - IMPRESSION: No intracardiac shunt identified. Mild aortic valve stenosis. Mild mitral regurgitation. Mild pulmonary artery systolic hypertension. Brief Hospital Course: #. Hypoxia: With pulmoary engorment on CXR and elevated BNP of 9000 and new AF, the etiology of the patient's hypoxia was felt to be acute exacerbation of diastolic dysfunction. Over the course of her 4 day admission, the patient had been diureesed with IV lasix with removal of 6 liters. The patient had continued to be hypoxic during the hospitalization, and a chest CT was obtained, showing a question of right middle and lower lobe infitrate vs. aspiration. The patinet was started on levofloxacin/vanc/flagyl to treat a potential pneumonia. The patiet triggered after being noted to be hypoxic at 76% on 4L NC, 82% on 6L NRB despite the aggressive diuresis. The patient was transfered to the CCU for futher care. Differential for patient's hypoxia included blossoming PNA vs. aspiration pneumonitis vs. flash pulmonary edema with dCHF and AF vs. PE. The patient had been significantly diureesed during the course of the hospitalization, and on exam appeared euvolemic to dry. Patient was not acutly hypertensive during inciting event. Chest XR was without evidence of acute pulmonary edema. The patient was being treated for pneumonia and had been afebrile. Chest CT showed dependent area of nodular opacities which could be consistent with likely aspiration pneumonia. Patient has a history of severe aspiration on swallow study, and felt that this would be most likely explanation of patinet's hypoxia. PE seems less likely given supratherapeutic INR throughout hospitalization and IVC filter in place. The patient's O2 requirement improved over three days. She was given supportive nebs and a course of solumendral given wheezes on physical exam. With high O2 requirement, pulmonary was consulted, who agreed that aspiration pneumonitis likely etiology to patient's hypoxia with element of chronic bronchitis from aspiration. At the time of transfer from the unit, the patient's antibiotics were reduced to levofloxacin/flagyl with negative cultures, to complete a 5 day course. Her prednisone was increased to 60 mg daily every other day. On the floor patient was made NPO given her severe aspiration. She completed a total of 10 day course of antibiotics for aspiration pneumonia/pneumonitis. She underwent a PEG tube placement to reduce the risk of aspiration which was uncomplicated. In addition, her steroids are being decreased back to her home dose. Patient underwent an echo with bubble that showed no evidence of intracardiac shunt. Of discharge patietn saturatin 94% on 4L. Goal O2 sats are 90-92% and oxygen should continued to be adjusted to meet this goal. . # Coronaries: The patient has no history of coronary artery disease, and last PMIBI without any defects. No complaints if chest pain and no iscemic changes on EKG. . # Diastolic Congestive Heart: The patient presented with elevated BNP, hypoxia, and lower extremity edema. Patient initially was diagnosed over 6L, with continued hypoxia thought to be secondary to aspiration as described above. Patient came in with new atrial fibrillation possibly secondary to worsening heart failure, with possible insufficient lasix dose or poor dietary compliance. [**Last Name (un) **] being held in the setting of elevated Cr. Patient was started on a CCB to help supress ionotropic activity. Her beta blocker was continued and titrated up as tolerated. Patient underwent a TTE with a bubble study to evaluate for left to right shunt which was negative. . #. Atrial Fibrillation: The patient's ECG on admission demonstrates atrial fibrillation, which is a new diagnosis. She has been in and out of AF since admission, and is currently in sinus. Likely contributing to element of acute diastolic heart failure. She was continued on metoprolol and diltiazem was started, both were titrated up to improve blood pressure control. She is already anticoagulated for PEs. Coumadin was continued with goal INR [**1-20**]. Coumadin was held in the setting of needing to get PEG placed, however patient was transitioned with IV heparin drip and will go back to [**Hospital1 100**] with IV heparin bridge until INR is therapeutic again for 48 hours. . #. Hypertension: The patient has a history hypertension and had BP 189/86 on admission. She was continued on metoprolol. Her home amlodpine was held, and diltiazem was started as described above. Her [**Last Name (un) **] was being held in the setting of ARF. . # Acute Renal Failure: Patient with Cr of 1.2 on admission, and had risen to 2.1 after aggressive diuresis. Cr on day of discharge was 1.4. Renal ultrasound demonstrated no evidence of hydronephrosis. [**Last Name (un) **] was held secondary to rising Cr. Would continue to hold Losartan until she follows up with her primary care provider. . #. Polymyositis: The patient has a history polymyositis, for which she takes 20 mg prednisone every other day. Her prednisone had been increased to treat concern for COPD exacerbation in the setting of chronic fibrotic changes secondary to chronic aspiration after treatment with IV solumedrol. She is being weaned back to home dose on discharge. Currently patient recieving 40 mg PO QOD. In addition, she is on bactrim for PCP [**Name Initial (PRE) 1102**]. . # Hypercholesterolemia: Continued simvastatin 10mg daily . . #. Aspiration. The patient is a known sevear aspirater, and has failed passed swallow studies. The patient had been non-compliant with restricted diet in [**Hospital **] rehab. The patient had declined PEG in the past, but agreed on this admission given the severity of her aspiration. Patient had PEG placed [**2199-12-5**] with interventional radiology. Patient will continue to be NPO on discharge with tube feeding and free water flushes through her PEG to maintain her free water needs. . #. PPx: DVT: IV heparin drip until INR therapeutic for 48 hours. Goal INR [**1-20**]. If INR > 3 please hold coumadin and lower dose by 0.5 mg. If INR between [**1-20**] do not change dosing. If INR is < 2 for 2 days would increase dose by 0.5 mg. Continue PPi. Colace and senna. . #. Code: Full Code Medications on Admission: Acetaminophen 325-650 mg Simvastatin 10 mg daily Folic Acid 1 mg daily Calcium Carbonate 500 mg [**Hospital1 **] Losartan 25 mg TID Metoprolol Tartrate 50 mg TID Furosemide 40 mg daily Multivitamin daily Fluoxetine 10 mg daily Pyridoxine 50 mg daily Prednisone 20 mg qod Oxycodone 5-10 mg q3h prn for pain Vitamin D 400 unit daily Cortisone 1 % Cream TID prn Warfarin 2 mg daily Ipratropium Bromide INH q6h prn Docusate Sodium 50 mg [**Hospital1 **] (liquid) Fluticasone 110 mcg 2 puffs [**Hospital1 **] Lidocaine 5 %(700 mg/patch) Adhesive Patch, daily Polyvinyl Alcohol-Povidone 1.4-0.6 % Dropperette Sig: [**12-19**] Drops Ophthalmic Q8H (every 8 hours) as needed. Albuterol nebulization q6h prn Senna 8.6 mg [**Hospital1 **] Benzonatate 100 mg TID Discharge Medications: 1. Ipratropium Bromide 0.02 % Solution Sig: One (1) Inhalation Q6H (every 6 hours). 2. Isosorbide Mononitrate 30 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO DAILY (Daily): please hold for BP < 100 HR < 55. 3. Simvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Fluoxetine 10 mg Capsule Sig: One (1) Capsule PO DAILY (Daily). 5. Fluticasone 110 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation [**Hospital1 **] (2 times a day). 6. Trimethoprim-Sulfamethoxazole 80-400 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) Inhalation Q4H (every 4 hours) as needed for dyspnea. 8. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal HS (at bedtime) as needed for constipation. 9. Acetaminophen 650 mg Suppository Sig: One (1) Suppository Rectal Q6H (every 6 hours) as needed for pain, headache, fever. 10. Docusate Sodium 50 mg/5 mL Liquid Sig: One (1) PO BID (2 times a day). 11. Diltiazem HCl 240 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO once a day: please hold for BP < 100, HR < 55. 12. Prednisone 20 mg Tablet Sig: Two (2) Tablet PO once a day for 1 days: please give 40 mg dose, only [**12-8**]. 13. Prednisone 10 mg Tablet Sig: Two (2) Tablet PO EVERY OTHER DAY (Every Other Day): please start patient on this dose at [**12-10**]. 14. Metoprolol Succinate 50 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO once a day: please hold for BP < 100 HR < 55. 15. Chlorhexidine Gluconate 0.12 % Mouthwash Sig: One (1) ML Mucous membrane TID (3 times a day). 16. Warfarin 2 mg Tablet Sig: One (1) Tablet PO once a day: for goal INR [**1-20**]. 17. Oxymetazoline 0.05 % Aerosol, Spray Sig: One (1) Spray Nasal [**Hospital1 **] (2 times a day) as needed for 3 days. 18. 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. 19. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO once a day. 20. Ativan 0.5 mg Tablet Sig: 0.5 Tablet PO three times a day as needed for anxiety, insomnia: please hold for sedation or RR < 12. 21. Lasix 80 mg Tablet Sig: One (1) Tablet PO once a day. 22. Heparin (Porcine) Injection 23. Oxycodone 5 mg Capsule Sig: One (1) Capsule PO every [**3-24**] hours as needed for pain: please hold for sedation or RR < 12. 24. Calcium Carbonate 500 mg (1,250 mg) Tablet Sig: One (1) Tablet PO three times a day. 25. Multivitamin Capsule Sig: One (1) Capsule PO once a day. 26. Pyridoxine 50 mg Tablet Sig: One (1) Tablet PO once a day. 27. Vitamin D 400 unit Capsule Sig: One (1) Capsule PO once a day. Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - MACU Discharge Diagnosis: Primary: Hypoxia secondary to aspiration pneumonia, diastolic heart failure Secondary: gout Bell's palsy polymyositis massive PE and IVC filter placement 3.9 infrarenal AAA in [**2197**] Discharge Condition: afebrile, vital signs stable, saturing 94% on 4L Discharge Instructions: You were admitted to the hospital with worsening hypoxia and lower extremity swelling. You were diagnosed with aspiration pneumonia and treated with IV antibiotics. You were evaluated by speech and swallow who felt that you were extremely high aspiration risk. Given this you had a PEG tube inserted in order to feed you more safely. While you were eating nothing by mouth you were kept on IV fluids for maintence. You will be able to start using your new PEG tube tonight and we have consulted nutrition for tube feeding reccomendations for you in the meantim. We are going to reccomend that you keep your ins and out roughly even and adjust your lasix dose as needed to do this. We are currently holding one of your medications which can worsen renal function. We would reccomend that you continue to hold this medication until you see your primary care doctor. For your safety, we reccomend that you take NOTHING BY MOUTH as you are at high risk to put this into your lungs. You can use oral swabs if your mouth feels dry however you will get all of your fluids/water through your feeding tube. . You should continue on the IV heparin drip until your INR > 2 for at least 48 hours. We have increased your lasix dose in order to help maintain your urine output. This lasix dose can be adjusted while you are at [**Hospital 100**] Rehab in order to meet goals ins and outs even. You need to continue oxygen, and will likely need oxygen on discharge home from rehab. Currently you are on 4L of NC. Our goal oxygen saturation for you in between 90-92% so your oxygen can be adjusted down accordingly. . IV heparin drip until INR therapeutic for 48 hours. Goal INR [**1-20**]. If INR > 3 please hold coumadin and lower dose by 0.5 mg. If INR between [**1-20**] do not change dosing. If INR is < 2 for 2 days would increase dose by 0.5 mg. Followup Instructions: You should follow up with your primary care provider as previously scheduled on discharge from [**Hospital 100**] Rehab. You should regardless have an appointment within one month. Your PCP number Dr. [**Last Name (STitle) 2204**], [**First Name3 (LF) **] ([**Telephone/Fax (1) 2941**]. . Provider: [**Name10 (NameIs) **] DENSITY TESTING Phone:[**Telephone/Fax (1) 4586**] Date/Time:[**2200-6-30**] 10:30 . Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 10545**], M.D. Phone:[**Telephone/Fax (1) 4586**] Date/Time:[**2200-6-30**] 11:30 [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 810**] MD, [**MD Number(3) 811**] Completed by:[**2199-12-6**] ICD9 Codes: 5070, 5849, 5990, 4280, 5859, 2720, 2749
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Medical Text: Admission Date: [**2166-3-3**] Discharge Date: [**2166-3-4**] Date of Birth: [**2166-3-3**] Sex: M Service: [**Hospital 59074**] transfer to Newborn Nursery The patient is being transferred to the Newborn Nursery on [**2166-3-4**]. HISTORY OF PRESENT ILLNESS: The infant is a full term, 4250 gram male infant born on [**2166-3-3**], to a 36 year old gravida III, para II, mother. Prenatal screens were remarkable for blood type O positive, antibody unknown, rubella immune, RPR nonreactive, hepatitis B surface antigen negative, and GBS negative. There was a maternal history of depression for which mother was on Zoloft. Mother has had one previous child who is healthy and had no issues of thrombocytopenia. This pregnancy was reportedly uncomplicated. Neonatal Intensive Care Unit was called to assess the patient when the infant was noted to have bruising on the thorax and was subsequently found to be thrombocytopenic. Mother's platelet count was normal at 274,000. There were no prenatal risk factors. Mother was GBS negative. There was no maternal fever and rupture of membranes was less than 24 hours. Maternal anesthesia was via epidural/spinal. The infant was delivered by repeat cesarean section with Apgar of eight and nine. Neonatal nurse practitioner was asked to see the infant in the Newborn Nursery for petechiae and bruising. A complete blood count was drawn at that time, and platelet count was reported at 5000. A repeat level was sent and returned at 8000. At that point, the infant was transferred to the Neonatal Intensive Care Unit for further management. PHYSICAL EXAMINATION: On admission, weight is 4250 grams (LGA). In general, a comfortable appearing newborn in no acute distress, nondysmorphic. Anterior fontanelle open and flat. Red reflex times two. Positive suck. Normally placed ears. Intact clavicles with supple neck. Lungs were clear to auscultation bilaterally and equal. Examination of the heart revealed regular rate and rhythm with no murmurs. There were normal femoral pulses. The abdomen was soft with bowel sounds. Examination of genitourinary revealed normal male phallus with testes descended bilaterally. Patent anus. There were no sacral abnormalities noted. The hips were stable. The infant was pink and well perfused with some acrocyanosis. Examination of the skin revealed diffuse petechiae over the trunk, abdomen and groin areas of the extremities. The face and back were relatively spared. There was also some larger bruising over the chest and groin. No joint swelling or effusions. Neurologic examination revealed a normal alert infant and effective tone and strength. HOSPITAL COURSE: Respiratory - The patient was stable in room air throughout his admission. Cardiovascular - The patient was hemodynamically stable throughout his admission in the Neonatal Intensive Care Unit. Fluids, electrolytes and nutrition - The patient was allowed to breast feed and bottle feed Similac 20 with good p.o. intake during his admission. Hematology - Initial platelet count of 5,000 with follow-up of 8,000. The remainder of the complete blood count was unremarkable with a white blood cell count of 11.4 and hematocrit of 48.1. The patient was transfused with 15 cc/kg of platelets. Platelet count one hour after transfusion was 145,000. Platelet count four hours after transfusion was 139,000 and approximately ten hours after transfusion, the platelet count remained stable at 138,000. Maternal platelet count as reported earlier was normal. Maternal laboratories have been sent including a PLA-1 antibody. Infectious disease - Given the thrombocytopenia, complete blood count and blood culture were obtained as well as the baby being started on Ampicillin and Gentamicin. Blood cultures are no growth to date. The baby remains on Ampicillin and Gentamicin for a full 48 hour rule out. Neurology - Given the initial platelet count of 5,000, a head ultrasound was performed on [**2166-3-4**], which was reported as within normal limits. CONDITION ON DISCHARGE: Good. DISPOSITION: To normal Newborn Nursery. PRIMARY CARE PEDIATRICIAN: Dr. [**First Name8 (NamePattern2) **] [**Doctor Last Name 59075**], [**Location (un) 2274**] in [**Location (un) 8985**]. CARE/RECOMMENDATIONS: 1. Continue p.o. ad lib feedings. 2. Continue Ampicillin and Gentamicin for full 48 hour rule out. 3. Repeat platelet count in a.m. to assure that platelet count has stabilized and follow-up on maternal laboratories sent. DISCHARGE DIAGNOSES: 1. Thrombocytopenia, likely alloimmune. 2. Rule out sepsis. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], [**MD Number(1) 54936**] Dictated By:[**Last Name (NamePattern1) 58671**] MEDQUIST36 D: [**2166-3-4**] 15:45:44 T: [**2166-3-4**] 18:12:40 Job#: [**Job Number 59076**] ICD9 Codes: V290
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Medical Text: Admission Date: [**2102-12-31**] Discharge Date: [**2103-1-11**] Date of Birth: [**2102-12-31**] Sex: F Service: NEONATOLOG HISTORY OF PRESENT ILLNESS: Initially, this is a 29 [**12-19**] week gestation, mono-mono twin #1, delivered preterm by C section due to premature rupture of membrane. Mother was a 28 year old gravida 2, para 0 to 2, female with an unremarkable prenatal screen. The GBS was unknown. There was a mono-mono diabetes treated with Insulin. The mother did note epigastric pain prior to delivery which prompted her to come to the hospital for evaluation. Ultrasound was reassuring with biophysical profile of 8 and 8. She was treated with betamethasone and that was completed on [**2102-12-21**]. She was, also at the time noted to be hypertensive and started on Labetalol. She remained in house; then on the morning of delivery, spontaneous rupture of membranes occurred and there was therefore delivery by C section because of concern regarding a cord accident in the setting of a monoamnion. This twin emerged with spontaneous cry requiring facial CPAP and routine care in the Delivery Room. Apgars were 8 and 8 and the baby was transferred to the NICU on CPAP for further evaluation and management of prematurity. PHYSICAL EXAMINATION: On admission, the weight was 1,540 grams (90th percentile); length was 40 cm (60th percentile) and head circumference was 27.25 cm (55th percentile). Overall appearance was appropriate for age. The baby's physical examination was remarkable for mild intercostal and substernal retraction with excellent air entry. There was a three vessel cord. Abdominal examination was benign. There was no murmurs and normal female external genitalia for gestational age was noted. There was some bruising in the right groin, otherwise, well perfused and vigorous. The baby was admitted for continued management for prematurity and rule out sepsis and respiratory distress. HOSPITAL COURSE: 1. Respiratory - The baby was continued on CPAP but had increased respiratory rate and work. This prompted intubation followed by administration of Surfactant with good clinical response. The baby was extubated shortly thereafter and placed on a nasopharyngeal CPAP at FIO2 of 30 to 36 percent. She had only received one dose of Surfactant. The baby was loaded with caffeine prior to extubation as prophylaxis of apnea with prematurity. The baby did have some occasional desats as well at the time. On CPAP the baby did well from a respiratory standpoint and was weaned off to nasal cannula in the ensuing days. There was no evidence of PDA from her echocardiogram. She remained cardiovascularly stable. 2. Cardiovascular - From a cardiovascular standpoint, the baby was hemodynamically stable with no signs of a PDA throughout her entire NICU stay. 3. Fluids, Ellectrolytes and Nutrition: From a FEN standpoint, the baby was started on a [**Name (NI) **] with total fluids of 80 cc per kilo per day. This was quickly advanced and by the time of the baby's extubation, the baby was increasing slowly with enteral feeds. The baby's goal is total fluid to 150 cc per kilo per day with full enteral feeds at adequate calories. The baby's electrolytes were within normal limits. The baby had tolerated parenteral nutrition earlier on in her life without any incidents. 4. Gastrointestinal - From a gastrointestinal standpoint, the baby did have increased aspirates in the early part of the enteral feedings. Therefore the enteral feedings were at one point held and restarted following a normal KUB. After a few days of slow feeding with occasional intolerance, most likely secondary to low motility of prematurity, the baby's feeds were advanced without any further complications and by the time of this discharge was at full volume feeds, increasing in caloric content. 5. From a hematological standpoint, the baby continued to do well with satisfactory hematocrits. The baby did have hyperbilirubinemia which was treated satisfactorily with phototherapy. This was felt to be most likely secondary to physiologic jaundice. 6. From an Infectious Disease standpoint, the baby received 48 hours of antibiotics (Ampicillin and Gentamicin). She did not have any further infectious disease issues. At the time of this discharge, she continued to do well without any incidents. Due to her relatively well clinical course, as well as for familial convenience, there was discussion of transferring her and her sibling to a closer hospital at a level II. At the time of this dictation, the discussion issue is ongoing with a strong possibility of the transfer. TRANSFER MEDICATIONS: 1. Caffeine. The baby did receive Vitamin K and has not received the Recombivax vaccine as of this dictation. The baby is currently on a 26 calorie formula with a goal of going to a 28 calorie formula tomorrow. DR.[**Last Name (STitle) **],[**Doctor Last Name **] 50-470 Dictated By:[**First Name3 (LF) 40504**] MEDQUIST36 D: [**2103-1-11**] 14:38 T: [**2103-1-11**] 15:55 JOB#: [**Job Number 45701**] ICD9 Codes: 769, 7742, V053, V290
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Medical Text: Admission Date: [**2175-1-30**] Discharge Date: [**2175-2-9**] Service: MEDICINE Allergies: Nsaids Attending:[**First Name3 (LF) 6994**] Chief Complaint: Altered mental status. Major Surgical or Invasive Procedure: -Triple lumen placed on [**2175-1-31**]. -Intubation. History of Present Illness: Patient is an 82 year old female with ESRD on hemodialysis MWF, mild dementia, hypertension, CAD statsu post CABG in [**2162**], who presented with two days of confusion and mental status changes at her nursing home. [**Name (NI) **] son reports that he saw her [**2-4**] days prior to admission and she was her usual self--conversational, alert, oriented, and with mild memory difficulties. [**Name (NI) **] son went to see her on the morning of [**1-30**] and noted that she was writhing, lying in the fetal position and noticed shallow breathing. He could not elicit more detailed complaints out of her as she was not verbal on the day of admission. . Per the nursing home reports, she was hypoxic to the 70s on the morning of admission. It increased to the 90s% on 2-4L NC. Vomited x1 on morning of admission. Emesis was nonbilious and nonbloody. She was incontinent of stool x4, when she is typically continent. Last hemodialysis was on Friday (is on MWF schedule). Has had increasing confusion over the last few days. . In the ED, she was febrile to 101.4 and was cultured. She was hypertensive to 160s-190s systolic. CXR demonstrated fluid overload, with a question of pneumonia. A blood gas revealed an ABG 7.46/27/183. Initial lactate was 2.6. She was placed on BiPAP and as she could not be weaned from BiPAP, was admitted to MICU. She initially received one gram of vanco, 1g of ceftaz, 80mg of gentamicin. He received one dose of ASA 600mg PR. . In the MICU, patient was getting dialyzed and was found to be more unresponsive, cyanotic, not at all moaning or responding to sternal rub. She was intubated for airway protection, tachypneic, appeared moribund. L subclavian triple lumen placed, as well. HD was discontinued and 1L NS was run in through the HD catheter wide open. At that point, patient appeared somewhat more responsive. Past Medical History: -ESRD on HD (m/w/f) -Status post right hip repair in [**2174-8-2**] which has prompted prolonged nursing home stay -Hypertension -CABG x3 in [**2172**] at [**Hospital1 2025**] (found to have 3VD on cath) -Arthritis -Neuropathy -Laparscopic cholecystectomy in summer [**2174**] -Left temporal CVA [**11-7**] -Pneumothorax after line placement in [**2174-12-2**] status post chest tube -Herpes zoster right t3/t4 in [**2174-11-2**] Social History: Widowed, resides at [**Location (un) **] [**Hospital1 **] NH, four children, no tobacco, no ETOH. Generally pleasant but tends to isolate. Her four children visit her but she does not speak with them very often. Family History: Mother had coronary artery disease. Physical Exam: Physical Exam (on admission to MICU): VS: 101.8 165/82 99 28 88% (bad pleth) on BiPAP 10/5 Gen: moaning, does not respond verbally to questions, not responding to commands HEENT: mask interfering with exam Neck: JVD to 10cm CV: RRR, nl S1/S2, no m/r/g Chest: R tunneled s/c dialysis catheter - no surrounding erythema Pulm: CTAB anteriorly Abd: soft, NT/ND, +BS, no masses Ext: no c/c/e; onychomycosis Neuro: delirium, cannot answer questions . Physical Exam on admission to floor: T:97.9 BP:140/80 HR:80 RR:20 O2saturation: 100% on room air, blood sugar 41. Gen: Laying in bed. Minimally responding. Knew year and city, but assumed in nursing home. Elderly woman, in no apparent distress. HEENT: Slight conjunctival pallor. No icterus. Slightly dry mucous membranes. NGT in place. NECK: No cervical or supraclavicular lymphadenopathy. No JVD. No thyromegaly. Hemodialysis catheter in left upper chest. CV: RRR. Normal S1 and S2. No murmurs, rubs or [**Last Name (un) 549**] appreciated. LUNGS: Clear to auscultation bilaterally. Decreased breath sounds in lower lung fields, bilaterally. Slight crackles appreciated, bilaterally. ABD: Normal active bowel sounds in all four quadrants. Soft. Nontender and nondistended. No guarding or rebound. Liver edge not palpated. No splenomegaly appreciated. No abdominal aortic bruit. EXT: Distal extremities cool and cyanotic. No lower extremity edema, bilaterally. 2+ radial pulses, bilaterally. SKIN: Several ecchymoses. Pertinent Results: Images: AV fistulogram ([**2175-2-8**]): Left AV fistulogram demonstrates good flow in the anterior side of the fistula to the cephalic vein. Also there is patent subclavian, and SVC veins. . EKG ([**2175-1-30**]): 97bpm, NSR, LAFB, TWI in V2 (old) . Chest Xray Portable ([**2175-2-3**]): Perhaps slight improvement in pulmonary edema. Persistent left lower lobe atelectasis or consolidation. . Chest xray ([**2175-2-2**]): Left subclavian vein catheter tip is in the lower SVC. Right subclavian catheter tip is in the right atrium. Left lower lobe collapse is persistent. Small right pleural effusion is stable. NG tube tip is in the stomach. There is no pneumothorax. Mild cardiomegaly is stable. . CXR ([**2175-1-30**]): 1. Pulmonary edema with bilateral pleural effusions, new since the [**2174-12-15**] plain radiograph. 2. Confluent opacity in the right mid-lung zone and base likely represents alveolar edema, though pneumonic consolidation is a consideration. 3. No supine evidence of pneumothorax. . Cardiac ([**2175-1-31**]): The left atrium is mildly dilated. There is mild symmetric left ventricular hypertrophy. The left ventricular cavity size is normal. There is mild regional left ventricular systolic dysfunction with mid to apical anteroseptal/anterior hypokinesis. Overall left ventricular systolic function is mildly depressed. Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets are mildly thickened. There is a minimally increased gradient consistent with minimal aortic valve stenosis. Mild (1+) 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 mild pulmonary artery systolic hypertension. There is a small pericardial effusion. No vegetation seen. . Abdominal U/S ([**2175-1-31**]): 1. Unremarkable liver and no biliary dilatation. 2. Status post cholecystectomy. 3. Bilateral pleural effusions, loculated on the right. 4. Atrophic kidneys. . TTE ([**2174-11-25**]): [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) 3841**] dilated, RV mildly dilated, EF 60-70%, 1+ MR, mild pulmonary HTN. . Micro: Blood ([**1-30**]): Staph aureus coag +. . Endotracheal ([**2-1**]): Yeast. Staph aureus coag +. . Stool ([**1-31**], [**2-2**]): C. dificile negative. . Labs: [**2175-2-8**]: WBC 8.1, Hgb 9.4, Hct 29.6, Plt 248, PT 15.6, PTT 33.5, INR 1.4 [**2175-2-6**]: WBC 10.0, Hgb 9.6, Hct 29.8, Plt 235, PT 14.9, PTT 61.5, INR 1.3 [**2175-2-8**]: Na 139, K 4.3, Cl 106, HCO3 23, BUN 16, Cr 3.5, Glu 83 [**2175-2-6**]: Na 138, K 4.2, Cl 104, HCO3 23, BUN 25, Cr 4.1, Glu 100 [**2175-2-8**]: Ca 7.7, Mg 2.4, PO4 3.4 [**2175-2-6**]: Ca 8.0, Mg 2.6, PO4 3.4 [**2175-2-4**] 06:59AM BLOOD WBC-12.7* RBC-3.20* Hgb-9.7* Hct-30.7* MCV-96 MCH-30.3 MCHC-31.6 RDW-18.8* Plt Ct-189 [**2175-2-2**] 05:30AM BLOOD WBC-11.5* RBC-3.13* Hgb-9.3* Hct-29.8* MCV-95 MCH-29.9 MCHC-31.4 RDW-18.9* Plt Ct-126* [**2175-1-30**] 06:39PM BLOOD WBC-15.3*# RBC-3.82*# Hgb-12.2# Hct-36.9# MCV-97 MCH-31.9 MCHC-33.0 RDW-18.7* Plt Ct-229 [**2175-2-4**] 06:59AM BLOOD Plt Ct-189 [**2175-2-4**] 06:59AM BLOOD PT-13.9* PTT-31.4 INR(PT)-1.2* [**2175-1-30**] 06:39PM BLOOD PT-13.6* PTT-26.8 INR(PT)-1.2* [**2175-1-30**] 06:39PM BLOOD Plt Smr-NORMAL Plt Ct-229 [**2175-2-4**] 06:59AM BLOOD Glucose-225* UreaN-16 Creat-2.6* Na-141 K-3.9 Cl-104 HCO3-25 AnGap-16 [**2175-2-1**] 05:15AM BLOOD Glucose-89 UreaN-59* Creat-4.7*# Na-144 K-2.5* Cl-104 HCO3-22 AnGap-21* [**2175-1-31**] 03:33AM BLOOD Glucose-294* UreaN-44* Creat-3.5*# Na-137 K-3.9 Cl-98 HCO3-19* AnGap-24* [**2175-1-30**] 04:45PM BLOOD Glucose-206* UreaN-76* Creat-5.4*# Na-143 K-5.5* Cl-97 HCO3-19* AnGap-33* [**2175-2-3**] 04:30AM BLOOD ALT-175* AST-37 AlkPhos-97 Amylase-66 TotBili-0.4 [**2175-1-30**] 05:10PM BLOOD ALT-355* AST-269* LD(LDH)-598* CK(CPK)-143* AlkPhos-142* Amylase-356* TotBili-0.4 [**2175-2-3**] 04:30AM BLOOD Lipase-33 [**2175-1-30**] 05:10PM BLOOD Lipase-17 [**2175-2-2**] 09:02AM BLOOD CK-MB-NotDone cTropnT-0.67* [**2175-1-31**] 06:34PM BLOOD CK-MB-9 cTropnT-0.83* [**2175-1-31**] 02:08PM BLOOD CK-MB-8 cTropnT-0.81* [**2175-1-31**] 03:33AM BLOOD CK-MB-11* MB Indx-8.7* cTropnT-0.60* [**2175-1-30**] 05:10PM BLOOD CK-MB-8 cTropnT-0.59* [**2175-2-4**] 06:59AM BLOOD Calcium-8.3* Phos-2.5* Mg-3.1* [**2175-1-31**] 03:33AM BLOOD Albumin-3.2* Calcium-8.6 Phos-5.4*# Mg-2.2 [**2175-2-3**] 04:30AM BLOOD Genta-3.6* Vanco-28.2* [**2175-1-31**] 03:33AM BLOOD Genta-0.8* Vanco-16.1 [**2175-2-3**] 05:08PM BLOOD pO2-73* pCO2-37 pH-7.48* calTCO2-28 Base XS-3 [**2175-1-30**] 07:50PM BLOOD pO2-183* pCO2-27* pH-7.46* calTCO2-20* Base XS--2 [**2175-2-3**] 05:08PM BLOOD Lactate-1.4 Brief Hospital Course: Hospital Course/Assessment/Plan: Patient is an 82 year old female with a history of CAD status post CABG, ESRD on hemodialysis, CVA with dementia who presents with worsening mental status who was admitted to the ICU for hypoxic respiratory failure. . . 1) Hypoxic respiratory failure: On admission, most likely related to excess fluid, despite stable hemodialysis schedule. Pleural effusions and pulmonary edema on chest xray. No history of COPD. Appears to have underlying PNA, as well. - Continue hemodialysis for fluid removal. Blood culture on [**1-30**] revealed staph aureus, coag positive blood. Initial antibiotic was ceftazidime, but discontinued [**1-31**], as infection thought to be related to HD line. Decision made to treat through with vancomycin and gentamycin for potential line sepsis. Flagyl continued for two weeks, despite stool that was negative for C. difficile. Will be discharged on vancomycin and flagyl. By [**2-4**], patient maintaining 100% oxygen saturation on 2 liters nasal canula. On [**2-8**], patient oxygen saturation 95% on room air. . 2) Fever and leukocytosis: Multiple sources of infection. Sputum on [**2-1**] revealed some yeast. Stool on [**2-2**] was C. dificile negative and negative for salmonella, shigella, and campylobacter. Treated presumed HD line infection with gentamicin and vancomycin. AV fistulogram revealed AV fistula in left arm functioning. Removed tunneled left catheter line on [**2175-2-9**], so will continue only vancomycin for two weeks (until [**2175-2-24**]). Dosing of antibiotics after hemodialysis sessions for vancomycin trough less than 15. Will continue metronidazole for two weeks. -On [**2-6**], left triple lumen (placed on [**2175-1-31**]) appeared infected. Line removed. . 3) Abnormal LFTs: Most likely due to shock liver. Right upper quadrant ultrasound did not reveal any obstructive picture. . 4) Urinary Tract infection: Patient had positive urine analysis on admission. As above, treated with broad spectrum antibiotics. . 5) Mental status changes: Presented to hospital and unresponsive. Most likely due to multiple conditions. Initially, had fluid overload and hypoxia. In days prior to discharge, patient's mental status improved. Much more lucid and requesting to eat on own. Consulted speech and swallow to assist. Continued with thickened pureed liquids, with aspiration precautions. . 6) Diarrhea: Patient presented with recent vomiting and diarrhea. Most likely due to viral gastroenteritis. Rectal tube in place. - C. dificile culture from [**2175-2-2**] negative. Despite this, will continue on PO flagyl, as previous C. dificile infection and patient has been hospitalized for extended period. . 7) CAD status post CABG: Elevated troponin compared with previous troponins with similar degree of renal failure, but EKG shows no changes. Most likely due to demand ischemia, in setting of hypoxia and respiratory distress. factors. - Continued aspirin. Initially held beta blocker and ACE I as hypotensive. Trended cardiac enzymes. Did not start heparin. . 8) Tight glycemic control: Initiated for tight glycemic control in ICU setting. No history of diabetes. Blood sugars remained in good control. . 9) ESRD on HD: Patient with right HD line, with L fistula not being used. Initially, held nephrocaps and fosrenal as couldn't take PO medications. - Continued with HD on M,W,F schedule. Restarted nephro caps. . 10) Dementia: - Mild at baseline per son. Avoided ativan. . 11) Depression: Initially held effexor. . 12) FEN/GI: Initially NPO, with NGT placed secondary to altered mental status. -Consulted speech and swallow. With altered mental status, concern for aspiration. Tolerated thickened liquids. NGT removed, per patient on [**2-5**]. . 13) Prophylaxis: Placed on SC heparin and PPI. . 14) Access: R tunneled line for HD pulled on [**2175-2-9**]. L subclavian triple lumen catheter pulled on [**2-7**]. Right AV fistula with good flow. . 15) Code: DNR/DNI. Ok to be intubated for a short period of time. Family said that no heroic measures or long-term intubation or feeding tubes. Would not want a trach, but ok to intubate if we project that it would be a temporizing measure (for example, while we remove fluid) . 16) [**Name (NI) **] - son [**Name (NI) **] [**Name (NI) 7860**] is HCP - [**Telephone/Fax (1) 70582**] Medications on Admission: lisinopril 30mg daily marinol 2.5mg daily prednisone 7.5mg daily prilosec 20mg daily pravachol 20mg qHS calcium carbonate 500mg [**Hospital1 **] senna 1 tab qHS lopressor 50mg tid nephrocaps 1 tab qAM asa 81mg daily effexor 75mg daily ativan 0.25mg daily, 0.5mg qPM prn norvasc 10mg daily fosrenal 500mg tid Discharge Medications: 1. Metronidazole 500 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours): Continue for 2 weeks. Stop on [**2175-2-24**]. 2. Aspirin 81 mg Tablet Sig: One (1) Tablet PO once a day. 3. B Complex-Vitamin C-Folic Acid 1 mg Capsule Sig: One (1) Cap PO DAILY (Daily). 4. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed. 5. Vancomycin in Dextrose 1 g/200 mL Piggyback Sig: One (1) Intravenous QHD (each hemodialysis): Give after dialysis treatments, if trough<15. Give until [**2175-2-24**]. 6. Camphor-Menthol 0.5-0.5 % Lotion Sig: One (1) Appl Topical [**Hospital1 **] (2 times a day) as needed. 7. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection TID (3 times a day). 8. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 9. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day) as needed. 10. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 11. Acetaminophen 650 mg Suppository Sig: One (1) Suppository Rectal Q6H (every 6 hours) as needed: for fever>100.5. 12. Pravachol 20 mg Tablet Sig: One (1) Tablet PO at bedtime. Discharge Disposition: Extended Care Facility: [**Hospital **] [**Hospital **] Nursing Home - [**Location (un) **] Discharge Diagnosis: Primary: -Hypoxic episode requiring intubation -ESRD (dialysis treatments M,W,F) . Secondary: -Status post right hip repair in [**2174-8-2**] which has prompted prolonged nursing home stay -Hypertension -CABG x3 in [**2172**] at [**Hospital1 2025**] (found to have 3VD on cath) -Arthritis -Neuropathy -Laparscopic cholecystectomy in summer [**2174**] -Left temporal CVA [**11-7**] -Pneumothorax after line placement in [**2174-12-2**] status post chest tube -Herpes zoster right t3/t4 in [**2174-11-2**] Discharge Condition: Stable. Discharge Instructions: -You were admitted for depressed oxygenation levels. Initially, you needed to be intubated. -You were found to have an infection in your blood. Several antibiotics, vancomycin, gentamicin, and metronidazole, were started. One of these medications, vancomycin, can be administered after dialysis sessions and should be administered for two more weeks, until [**2175-2-24**]. -An AV fistulogram demonstrated patent flow. Your right tunneled catheter line was pulled on [**2175-2-9**]. -If you experience any more increased shortness of breath, chest pain, fever, or any other concerning symptoms, call your PCP or come to the ED immediately. Followup Instructions: -You are scheduled to continue to receive vancomycin until [**2175-2-24**]. This medication should be administered following dialysis sessions. Dose for vancomycin troughs less than 15. -Your PCP, [**Last Name (NamePattern4) **]. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] ([**Telephone/Fax (1) **]), will continue to follow your progress. ICD9 Codes: 486, 5990, 5856, 4280
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Medical Text: Admission Date: [**2124-1-14**] Discharge Date: [**2124-1-19**] Date of Birth: [**2059-7-17**] Sex: M Service: CARDIOTHORACIC Allergies: Penicillins Attending:[**First Name3 (LF) 1505**] Chief Complaint: chest pain Major Surgical or Invasive Procedure: emergency cabg x4 on [**2124-1-14**] (LIMA to LAD, SVG to ramus, SVG to OM, SVG to PDA History of Present Illness: 64 year old male with history of chest pain intermittently since last summer. It increases with exertion and is resolved with rest. Had a + ETT on [**1-5**] and referred for cath today. He had a dye reaction? in the cath lab and received solumedrol at that time. He continued to have some chest pain in the cath lab and was referred emergently to Dr. [**Last Name (STitle) **] for CABG. Cath showed LM 30%, LAD 80%, Ramus 90%, CX 70%, RCA 50%, EF 60%. Patient admits to having taken 40 mg oral prednisone the evening prior to cath for asthma flare. Past Medical History: asthma GERD hepatitis C at age 18 HTN elev. chol Social History: married and lives with wife businessman one drink per day quit smoking 15 years ago, 35 pk/yr history Family History: father died of MI at 52, mother with CABG Physical Exam: HR 94 165/77 RR 17 5'7" 179# RRR S1 S2 no murmur CTAB soft, NT, ND grossly nonfocal neuro exam right fem art. line in place with 2+ bilat. fem pulses + DP/PT pulses Pertinent Results: [**2124-1-17**] 06:00AM BLOOD WBC-6.8 RBC-3.51* Hgb-10.5* Hct-27.9* MCV-80* MCH-29.9 MCHC-37.5* RDW-14.6 Plt Ct-103* [**2124-1-17**] 06:00AM BLOOD Plt Ct-103* [**2124-1-17**] 06:00AM BLOOD Fibrino-638*# [**2124-1-17**] 06:00AM BLOOD Glucose-111* UreaN-18 Creat-0.8 Na-133 K-4.0 Cl-98 HCO3-26 AnGap-13 [**2124-1-14**] 09:10AM BLOOD ALT-16 AST-15 AlkPhos-74 Amylase-76 TotBili-0.3 [**2124-1-14**] 09:10AM BLOOD WBC-10.6 RBC-3.31* Hgb-10.3* Hct-28.0* MCV-85 MCH-31.2 MCHC-36.8* RDW-12.8 Plt Ct-233 [**2124-1-17**] 06:00AM BLOOD Calcium-8.2* Phos-2.1* [**2124-1-14**] 09:10AM BLOOD VitB12-417 [**2124-1-14**] 09:10AM BLOOD Triglyc-27 HDL-46 CHOL/HD-2.7 LDLcalc-73 Brief Hospital Course: Admitted for cath as above on [**1-14**] and taken to OR urgently for CABG by Dr. [**Last Name (STitle) **]. Transferred to CSRU in stable condition on titrated neo and propofol drips. Extubated in the early AM POD #1. Chest tubes were removed and lasix diuresis started along with beta blockade. Swan removed and transferred out to the floor on POD #2. Began to ambulate on the floor and made rapid progress. He went into afib briefly on [**1-17**], but converted to SR on lopressor and amiodarone. Pacing wires were removed on POD #4. Prelim. CXR on [**1-19**] shows left pleural effusion. Patient is asymptomatic , no rales or wheezing, but has decreased BS at left lung base. He remained in SR and was discharged to home with VNA services on POD #5. Medications on Admission: adviar discus 500 mg/50 mg one puff [**Hospital1 **] lisinopril 20 mg daily [**Doctor First Name 130**] 180 mg daily ASA 325 mg daily plavix 75 mg daily ( had dose AM of admission) lovastatin 20 mg daily singulair 10 mg daily toprol XL 25 mg daily prevacid 30 mg daily prednisone 20 mg po prn asthma flare ( had 40 mg last PM) Discharge Medications: 1. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*40 Tablet(s)* Refills:*0* 2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 4. Montelukast 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 5. Atorvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 6. Fluticasone-Salmeterol 250-50 mcg/Dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). Disp:*1 Disk with Device(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. Potassium Chloride 10 mEq Capsule, Sustained Release Sig: Two (2) Capsule, Sustained Release PO once a day for 5 days. Disp:*10 Capsule, Sustained Release(s)* Refills:*0* 9. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 10. Amiodarone 200 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day) for 5 days; then 400 mg daily for one week, then 200 mg daily ongoing. Disp:*80 Tablet(s)* Refills:*1* 11. Furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day for 5 days. Disp:*5 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital3 **] HOME CARE Discharge Diagnosis: CAD s/p cabg x4 asthma HTN GERD Hepatitis C a fib elev. chol. Discharge Condition: stable Discharge Instructions: may shower over wounds and pat dry no lotions, creams or powders on any incision no driving for one month no lifting greater than 10 pounds for 10 weeks call for fever greater than 100, or wound drainage Followup Instructions: follow up with Dr. [**Last Name (STitle) 2912**] in [**1-21**] weeks follow up with Dr. [**Last Name (STitle) **] in 4 weeks follow up with Dr. [**Last Name (STitle) **] in [**12-20**] weeks Completed by:[**2124-1-19**] ICD9 Codes: 9971, 4111, 2859, 4019, 2720
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6676 }
Medical Text: Admission Date: [**2145-12-15**] Discharge Date: [**2145-12-27**] Date of Birth: [**2067-7-11**] Sex: F Service: MEDICINE Allergies: Penicillins / Percodan / Percocet / Codeine / Talwin / Demerol / Valium / Aspirin Attending:[**First Name3 (LF) 783**] Chief Complaint: back pain Major Surgical or Invasive Procedure: Central Venous Catheter L subclavian Also attempted RIJ. History of Present Illness: patient is a 78 yo female with MMP including RA, afib, osteoporosis with compression fractures, AS and CHF presenting with 3 days of LBP. Patient said that she woke up 3 days ago with LBP that has worsening over the past couple of days. Denies trauma, but admits that she sometimes "bounces on the bed" when she comes back to bed from commode. Pain is [**10-20**] localized to low back withour radiation to the legs. Denies numbness, tingling, LE weaknes, bowel or bladder incontinence. She has not had pain in this area before but has had pain in the areas of her compression fractures in the past. Took some tylenol with little effect, so came in ED. . In the ED T 97 Bp 92/60 HR 68 O2 sats91-95% on RA She trasient dropped her SBPs of low 80s but went back up to low 100s after 1 liter NS. Received a total of 2 liters NS in ED. Of, note she was started on lisinopril 10 mg Po QD on [**12-13**]. She also receievd cipro 500 mg x1 for UTI, tylenol 1 g x1 and morphine 2 mg x1. . Past Medical History: # Aortic stenosis - valve area 1.1 on [**2144-4-3**] # CHF (EF of 60%) # atrial fibrillation - on warfarin # s/p femur fx [**8-16**] # s/p R BKD [**2144-10-28**] # COPD # Rheumatoid arthritis - on prednisone # RA/SLE/positive [**Doctor First Name **] antibody - in remission # osteoporosis # venous stasis # peripheral neuropathy # h/o Clostridium difficile in the past # spinal stenosis Social History: lives alone in home, able to do ADL's, has [**Name (NI) 269**], PT, home aid at home. +tob hx, quit 40 years ago, no ETOH, no drugs Family History: arthritis, mother - liver cancer, father - CVA Physical Exam: Admission T 96.7 BP 100/62 HR 72 RR 22 O2 sat 93% on RA 400 cc out foley Gen - Elderly female sleeping in bed in NAD becoming very uncomfortable with movement in bed HEENT - MM dry, Op clear, EOMI Neck: could not appreciate JVD, no thyroid nodules, no LAD CV - irregularly irregular, nl S1, S2, 3/6 SEM at RUSB radiating to carotids Lungs - CTA with crackles at lung bases, L>R Abd - obese, soft, NT/ND, NABS Back - tenderness to palpation in lumbar spine and paraspinal region, no CVAT Rectal - normal rectal tone per ED and guaiac negative Ext - s/p BKA on right, venous stasis changes on LLE with trace edema, well healed scar over knee, negative SLR Neuro - AAOx3, CN II-XII intact, strength in upper and LE extremtities [**5-15**], sensation to light touch grossly intact Skin - venous stasis changes on LLE, erythema under breast bilaterally . Discharge T 98.8 BP 130/90 HR 90 RR 2O O2 sat 91% on RA Gen - NAD HEENT - MMM Neck: difficult to evaluate JVD, no LAD CV - irregularly irregular, nl S1, S2, 3/6 SEM at RUSB radiating to carotids Lungs - CTA with crackles at lung bases increased from yesterday, L>R Abd - obese, soft, NT/ND, NABS Back - point tenderness to palpation in lumbar spine and right paraspinal region, no CVAT Neuro - AAOx3, CN II-XII intact, strength in upper and LE extremtities [**5-15**], sensation to light touch grossly intact Skin - venous stasis changes on LLE, improving erythema under breast bilaterally Pertinent Results: CT abd/ Pelvis: CT ABDOMEN WITHOUT INTRAVENOUS CONTRAST: Bilateral small pleural effusions have resolved in the interval. Chronic atelectasis and bronchiectasis is noted at the left lung base. Non-contrast evaluation of the liver is suboptimal, however unremarkable. The patient is status post cholecystectomy. The common bile duct is dilated, however, unchanged in appearance compared to the prior study. Hypodense lesions within the head of the pancreas noted on the prior study are not appreciated on this limited non-contrast evaluation. Spleen and adrenal glands are within normal limits. There is a large type 1 hiatal hernia, with almost the entire stomach located in the thorax. This appearance is stable from prior study of [**2144-10-11**] and appears uncomplicated by obstruction. Several hypodensities are noted in the renal parenchyma bilaterally, likely representing simple cysts. There is no free air, no free fluid, and no pathologically enlarged mesenteric or retroperitoneal lymph nodes. There is scattered diverticulosis of the descending and ascending colon without evidence of acute diverticulitis. CT PELVIS WITH INTRAVENOUS CONTRAST: The rectum, urinary bladder, uterus are unremarkable. The sigmoid is redundant. There is no evidence of acute diverticulitis. There is no retroperitoneal hematoma. There is right-sided femoral hernia, containing small bowel loops without evidence of obstruction or incarceration. The evaluation of the pelvis is somewhat limited by large streak artifact produced by right-sided total hip arthroplasty. No free pelvic fluid and no pathologically enlarged pelvic or inguinal lymph nodes. BONE WINDOWS: Demonstrate no suspicious lytic or sclerotic lesions. There are multiple compression fracture deformities in the lumbar and thoracic spine, the degree of compression on T10 as well as inferior endplate of L1 has increased in the interval. IMPRESSION: 1. No evidence of retroperitoneal hematoma. 2. Interval increase in degree of compression of T10 and L1 vertebral bodies. 3. Type 1 hiatal hernia. 4. Stable right femoral hernia containing nonobstructed small bowel loops. 5. Interval resolution of pleural effusions. 6. Coronary artery and aortic arch calcifications. . MRI T/L spine: IMPRESSION: 1. Acute/subacute compression of inferior endplate of L1. 2. Chronic compressions of L2, L4 and L5 vertebrae. 3. Degenerative changes at multiple levels as described above with moderate left subarticular recess narrowing and mild spinal stenosis at L4-5 level. 6. Multiple chronic compressions in the thoracic region with increased kyphosis. No spinal stenosis or extrinsic spinal cord compression. No evidence of acute compression fracture in the thoracic spine. CT dated [**2145-12-15**]. FINDINGS: The right kidney measures 10.1 cm and the left 10.8 cm. The renal parenchymal thickness is normal without evidence of calculi or hydronephrosis. Multiple renal cysts, the largest one measuring 2.2 x 1.8 cm in the upper pole of the right kidney. IMPRESSION: No evidence of hydronephrosis. . CHEST (PORTABLE AP) [**2145-12-20**] 3:48 AM Moderate left pleural effusion and mild pulmonary edema have increased. Cardiomegaly is moderate and unchanged partially obscured by the large intrathoracic stomach. No pneumothorax. Pleural effusion is probably moderate on the left and small on the right. No pneumothorax. . CHEST (PORTABLE AP) [**2145-12-22**] 4:04 AM There is motion artifact and rotation of the patient. Allowing for the technical limitations the left subclavian catheter tip is in the SVC. moderate pulmonary edema, cardiomegaly and small bilateral pleural effusions are stable. Left retrocardiac opacity is due to a large intrathoracic stomach. There is no pneumothorax. . ECHO: Conclusions The left atrium is elongated. The right atrium is markedly dilated. No atrial septal defect is seen by 2D or color Doppler. The estimated right atrial pressure is 10-20mmHg. Left ventricular wall thickness, cavity size and regional/global systolic function are normal (LVEF >55%) There is no ventricular septal defect. Right ventricular chamber size and free wall motion are normal. The ascending aorta is mildly dilated. The aortic valve leaflets are moderately thickened. There is moderate to severe aortic valve stenosis (area 0.9 cm2). No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Mild (1+) mitral regurgitation is seen. The tricuspid valve leaflets are mildly thickened. Moderate [2+] tricuspid regurgitation is seen. There is moderate pulmonary artery systolic hypertension. There is no pericardial effusion. Compared with the prior study (images reviewed) of [**2144-12-28**], the aortic valve area has further decreased (now moderate to severe aortic stenosis, [**Location (un) 109**] 0.9 cm2). Brief Hospital Course: #)LBP: The patient was admitted with lower back pain located at L5/S1 and somewhat latterally near the SI joint as well. There was no clinical evidence for cauda equina syndrome or sciatica. The patient received A CT abd/pelvis was performed in the ED, which ruled out RP bleed and also found old T10/L1 compression fracture. An MRI was performed which showed no cord compression, chronic compressions of L2, L4 and L5 vertebrae and Acute/subacute compression of inferior endplate of L1. This may be the source of her pain although on physical exam her point tenderness appears to be much lower. She should have a pelvic MRI as an outpatient to evaluate the SI joint. The patient's pain was not controlled on tylenol, lidocaine patch and small doses of PRN Morphine. Calcitonin 200 units daily was added. Oxycontin SR was added with continued [**2148-8-20**] pain. A pain consult was obtained, and the patient was placed on Oxycotonin SR TID 20mg-10mg-20mg and IV morphine breakthrough. Home dose of neurontin was also increased. This combination prooved too sedating. The patient became somnolent, and the oxycontin was discontinued. She was subsequently controlled with neurontin, tylenol and lidocaine patch. She was evaluated by PT who recommended acute rehab which the patient refused. She will receive home PT. . #Hypoxia: On admission, the patient's lasix was held due to acute renal failure and low blood pressures. In the ED, she initially received IVF. On the evening of [**12-19**], she began having difficulty breathing. She was found to have SOB, wheezing as well as crackels. O2 sats were low 80s on 2L NC and she was placed on a 35% shovel mask. She received nebulizers. ABG was 7.32/54/87. EKG showed known atrial fibrillation. a CXR showed now change. She received lasix 120mg IV with transient improvement in O2 sats. Later on that evening, she was once again hypoxic. Second ABG with 7.31/53/69 on 6L NC and 35% shovel mask. Pt still only satting 94% on NRB. Patient was transferred to MICU for BiPap. In the MICU, she received Bipap. She also developed a fever, rigors and a leukocytosis to 22. Hospital acquired pneumonia vs aspiration pneumonia was deemed likely and she was started on Vanc/levo/flagyl. Although there was no infiltrate seen on CXR, patient subsequently improved and her leukocytosis trended down. She was also restarted her home doses of lasix when her blood pressure improved. On [**12-23**], Vanc was discontinued due to no evidence of MRSA on culture. . #)UTI: Pt was found to have UTI in the ED. Started on Bactrim. ABx were switched to vanc/levo/flagyl while in the MICU for pneumonia. However, Ucx grew 2,000 E.Coli resistant to Cipro. Given the low organism count and negative UA, the patient was not restarted on Bactrim. UA and Ucx were followed and showed no subsequent infection. . #) Hypotension: On admission, the patient was hypovolemic on exam with SBP 90-100. Lasix and Lisinopril were held in the setting of hypotension and ARF. IVF hydration was given. Her blood pressure improved while on the floor. However, after transfer the the MICU, she became hypotensive and required pressors likely secondary to PNA sepsis versus morphine. She was briefly on dopamine then switched to levophed and quickly weaned off. IV hydration was given. Her blood pressure remained stable after that, and she was restarted on 80 mg Lasix ([**1-12**] home dose) given pulmonary edema and hx CHF. . #) ARF: Pt was found to have a Cr of 1.8 on admission with a baseline of 1.3. The is was thought to be due to recent addition of Lisinopril and increase of Lasix causing pre-renal acute renal failure. Creatinine peaked at 2.0 after transfer to MICU and improved with IVF and BP control with pressors. The creatinine returned to below baseline with good UOP. On [**12-23**], she was restarted on [**1-12**] dose home lasix (80mg QD) with good UOP and BPs tolerated. As her creatinine and blood pressure remained stable, lasix was increased to her home dose 120 [**Hospital1 **] and her lisinopril was also restarted. She will need outpatient labs with Chem 7 to monitor her creatinine. . #)CHF: On admission, the patient appeared hypovolemic, so lisinopril and lasix were held in the setting of ARF and hypotension. The patient's acute hypoxia on the floor was thought to be due to a pneumonia with some associated pulmonary edema. She was treated in the ICU with Bipap and lasix as above. Cardiac enzymes were negative. An echo was performed which showed EF>55% without change in wall motion or systolic function but continued worsening AS. She was restarted on lasix at 1/2 home dose and then titrated up as her blood pressure improved. She had increased crackles at the bases on the morning of discharge without worsening hypoxia. She received an additional Lasix 20 IV with improvement prior to discharge. She was also restarted on Lisinopril. . #)Afib: INR was closely monitored given that pt received cipro in ED and was then given bactrim for UTI. INR was found to 3.1 on HD1 and 3.7 on HD2. Her warfarin was held. Patient subsequently became subtherapeutic on INR. Coumadin was restarted on [**12-22**]. On the day of discharge, her INR was low at 1.8 and she was given an elevated dose of coumadin 5mg. She should have her INR drawn in two days prior to seeing her PCP [**Last Name (NamePattern4) **] [**12-29**]. Medications on Admission: Lisinopril 10 mg PO Qday just started on [**2145-12-13**] Ascorbic Acid 500 mg PO once a day Calcium-Cholecalciferol (D3) [Calcium 600 + D] 1 Tablet PO BID COLACE 50MG PO BID Dorzolamide 2 % Drops 1 gtt od twice a day glaucoma Ergocalciferol (Vitamin D2) [Vitamin D] 400 unit PO QDAY Furosemide 40 mg Tablet 3 Tablet(s) by mouth in am, 3 in pm Gabapentin [Neurontin] 300 mg PO TID Ibandronate 150 mg by mouth q mo for osteoporosis Latanoprost 0.005 % Drops 1 ggt od ut dict Metoprolol Succinate 50 mg PO QDAY Multivitamin 1 Tablet(s) by mouth once a day Protonis 40 mg by mouth once a day Potassium Chloride 10 mEq by mouth once a day Prednisone 10 mg by mouth once a day Warfarin 3 mg Tablet [**1-12**] Tablet(s) by mouth once a day ut dict afib Discharge Medications: 1. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO TID (3 times a day). 3. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: Two (2) Tablet PO DAILY (Daily). 4. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 5. Latanoprost 0.005 % Drops Sig: One (1) Drop Ophthalmic HS (at bedtime). 6. Dorzolamide-Timolol 2-0.5 % Drops Sig: One (1) Drop Ophthalmic QDAY (). 7. Acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours). 8. Lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: One (1) Adhesive Patch, Medicated Topical DAILY (Daily) for 30 days: Apply in the morning and take off at night. Disp:*30 Adhesive Patch, Medicated(s)* Refills:*1* 9. Senna 8.6 mg Tablet Sig: 1-2 Tablets PO BID (2 times a day). Disp:*30 Tablet(s)* Refills:*2* 10. Hexavitamin Tablet Sig: One (1) Cap PO DAILY (Daily). 11. Calcitonin (Salmon) 200 unit/Actuation Aerosol, Spray Sig: One (1) Nasal DAILY (Daily) for 3 days. Disp:*qs * Refills:*0* 12. Potassium Chloride 10 mEq Capsule, Sustained Release Sig: One (1) Capsule, Sustained Release PO once a day. 13. Prednisone 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 14. Warfarin 1 mg Tablet Sig: Three (3) Tablet PO DAILY16 (Once Daily at 16). 15. Gabapentin 400 mg Capsule Sig: One (1) Capsule PO TID (3 times a day). Disp:*90 Capsule(s)* Refills:*2* 16. Lisinopril 10 mg Tablet Sig: One (1) Tablet PO once a day. 17. Lasix 40 mg Tablet Sig: Three (3) Tablet PO twice a day. 18. Metoprolol Succinate 50 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO once a day. 19. Ibandronate 150 mg Tablet Sig: One (1) Tablet PO once a month. 20. Morphine 15 mg Tablet Sig: One (1) Tablet PO every six (6) hours as needed for pain for 10 doses. Disp:*10 Tablet(s)* Refills:*0* 21. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours) for 6 days: Day 1 is [**12-20**]. Disp:*6 Tablet(s)* Refills:*0* 22. Metronidazole 500 mg Tablet Sig: One (1) Tablet PO TID (3 times a day) for 6 days: Day 1 is [**12-20**]. Disp:*18 Tablet(s)* Refills:*0* 23. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day. 24. Outpatient Lab Work INR checked x 30 - Please draw on the morning of [**12-29**] - Fax results to Dr. [**Last Name (STitle) 7790**] [**Telephone/Fax (1) 11038**] 25. Outpatient Lab Work Check creatinine x10 - please check on [**2145-12-29**] - Fax results to Dr. [**Last Name (STitle) 7790**] [**Telephone/Fax (1) 11038**] Discharge Disposition: Home With Service Facility: All Care [**Telephone/Fax (1) 269**] of Greater [**Location (un) **] Discharge Diagnosis: Lumbar Compression Fracture Pneumonia Discharge Condition: Improved Discharge Instructions: You were admitted for back pain which is most likely due to a compression fracture. You will need to have another MRI of the pelvis as an outpatient. You should use the lidocaine patch, neurontin and tylenol for pain. You also developed Pneumonia. You will need to finish a course of antibiotics for the Pneumonia. . If you have any difficulty breathing or high fevers, please call your doctor or go to the emergency room. If you have weakness in your legs, trouble urinating or worsening back pain, call your doctor or go to the emergency room. . For your heart failure: Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight > 3 lbs. Adhere to 2 gm sodium diet . Your coumadin on discharge was slightly low: INR 1.8. You were given an increased dose of 5mg once prior to discharge. You should have your INR check in the next 2-3 days. Followup Instructions: Please follow up with your PCP [**Last Name (NamePattern4) **]. [**Last Name (STitle) **]: [**12-29**] 1:50pm . Please obtain an outpatient MRI of your pelvis: [**Telephone/Fax (1) 327**] Date/Time:[**2146-1-7**] 1:00 [**Hospital Ward Name 517**], basement level. . Provider: [**Name10 (NameIs) 1576**],[**First Name8 (NamePattern2) 2352**] [**Doctor Last Name 4694**] APG (SB) Phone:[**Telephone/Fax (1) 1579**] Date/Time:[**2146-2-1**] 12:10 Provider: [**Name10 (NameIs) 2352**] ECHO Phone:[**Telephone/Fax (1) 15347**] Date/Time:[**2146-2-4**] 1:30 Provider: [**First Name8 (NamePattern2) 1903**] [**Last Name (NamePattern1) 1904**], [**MD Number(3) 1240**]:[**Telephone/Fax (1) 3512**] Date/Time:[**2146-3-15**] 1:00 [**First Name11 (Name Pattern1) 734**] [**Last Name (NamePattern1) 735**] MD, [**MD Number(3) 799**] ICD9 Codes: 5849, 5990, 486, 4280, 4241, 2859
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Medical Text: Admission Date: [**2131-4-5**] Discharge Date: Date of Birth: [**2083-11-16**] Sex: F Service: TRAUMA SURGERY Of note, this discharge summary will encompass the time of admission from [**2131-4-5**] to hospital day number 17, [**2131-4-21**]. The remainder of the discharge summary will be dictated at a later time. HISTORY OF PRESENT ILLNESS: This is a 47-year-old morbidly obese woman who was transferred from an outside hospital for multiple injuries after falling from her horse three days prior. She was transferred to [**Hospital1 18**] on [**2131-4-5**]. Her injury was sustained on [**2131-3-31**]. Apparently, this patient landed on her right side. She was taken to a hospital in [**Location (un) 8641**], [**Location (un) 3844**]. The extent of her injuries there were as follows: 1. Hepatic contusion, grade III. 2. Right renal contusion. 3. Right hemothorax. 4. Right rib fractures, [**12-25**], posteriorly displaced. 5. Right scapular fracture. 6. Left transverse process fracture, L1-3. 7. Right thigh hematoma. On day number three of her hospital stay at the outside hospital, she developed abdominal pain and became hemodynamically unstable. She was taken to the OR where she was found to have a biliary leak with bile peritonitis. They were unable to close her abdomen at the outside hospital and she was transferred to [**Hospital1 18**] still intubated and sedated with an open abdomen and a right chest tube for further management. PAST MEDICAL HISTORY: 1. Morbid obesity with a BMI of 40. 2. Adult onset diabetes. 3. Asthma. 4. Hypertension. PAST SURGICAL HISTORY: 1. Cholecystectomy. 2. Total abdominal hysterectomy. 3. Umbilical hernia. ADMISSION MEDICATIONS: 1. Glucophage. 2. Monopril. 3. Albuterol. ALLERGIES: The patient has no known drug allergies. PHYSICAL EXAMINATION: Upon presentation, the patient arrived intubated and sedated with a temperature of 98.8. She had a pulse of 98 and blood pressure of 100/42. She was saturating 100%. She was on SIMV 40% 02 and PEEP of 5. General: She is an obese, pale woman who was intubated and sedated. She had a normocephalic and atraumatic HEENT examination with equal and reactive pupils, full extraocular movements. She had distant heart sounds secondary to body habitus but appeared to be in a regular rate and rhythm with no murmur heard. Lungs: Her lung sounds were likewise distant with decreased sounds at the right base. Abdomen: Her abdomen was soft. There were no bowel sounds. It was obese. There was an open wound with mesh dressing and serosanguinous drainage from two JPs. She had 2+ pitting edema of her hands bilaterally, trace edema of the arms and legs, with a wrist brace on the right wrist. Neurologic: Unable to be assessed secondary to sedation. LABORATORY AND RADIOLOGIC DATA: The initial laboratories at [**Hospital1 18**] showed a white blood cell count of 15.9, hematocrit 29.7, platelets 207,000. She had a Chem-7 with a sodium of 146, potassium 3.6, chloride 118, bicarbonate 21, BUN 22, creatinine 0.9. She had glucose of 199. She had a PT of 13.8, PTT 24.5, and an INR of 1.3. Her fibrinogen was 872. She had an ALT of 230, AST 117, and LDH of 590. Her alkaline phosphatase was 88. Her amylase was 66, total bilirubin 3.0, lipase 63, albumin 2.2, calcium 7.4, phosphate 1.4. An ABG was performed and showed adequate oxygenation and ventilation. HOSPITAL COURSE: The patient remained in the ICU and was transferred to the floor on hospital day number 15. The remainder of the hospital course will be summarized by system. 1. GASTROINTESTINAL: On the first day of admission, the patient was taken to the OR for abdominal evaluation and washout. She returned to the OR for washout on hospital day number four and hospital day number 11. At each operative intervention, she was given perioperative antibiotics. JP drains were placed. Despite aggressive diuresis and repeated OR visits, the abdomen was unable to be closed. The most recent OR evaluation showed no signs of infection of the open abdominal wound with slow healing by granulation tissue. There is currently a mesh covering the abdominal wound. Please see the operative notes for more detail. At the time of this dictation, the plan is for the patient to heal by secondary intention with granulation tissue. Plastics has been consulted for future repair of the abdominal wound with flap when deemed appropriate. She had VAC dressing placement on hospital day number 17. It is anticipated that she will be discharged to rehabilitation with this VAC dressing in place and will follow-up with plastics for further reevaluation of the healing process and the appropriate timing for flap. 2. NEUROLOGIC: The patient arrived from the outside hospital intubated and sedated. Sedation was weaned daily and the patient was always responsive and moving all extremities well. She was also able to follow commands. After extubation on hospital day number 12, she was somewhat confused and required frequent reorientation. By the time she transferred to the floor, she was alert and oriented times three. 3. RESPIRATORY: The patient was maintained on mechanical assistance. She arrived intubated and sedated. She was extubated successfully on hospital day number 12. 4. CARDIOVASCULAR: The patient was maintained on a Levophed drip with a goal of mean arterial pressure under 65. This was eventually discontinued on hospital day number 11 and she was switched over to metoprolol 12.5 mg p.o. b.i.d. She was diuresed aggressively with Lasix. Diamox was added as gases indicated an alkalotic state. All diuretics were discontinued by the time that the patient was transferred to the floor. There were no events on the ICU telemetry. Telemetry was continued 24 hours while she was on the floor with no events and then discontinued. 5. HEMATOLOGY: The patient was admitted with a hematocrit of 29. This decreased and remained stable at a hematocrit of 26. She received 2 units of packed red blood cells that were transfused on [**2131-4-5**], hospital day number one, and again 1 unit of packed red blood cells was transfused on hospital day number eight. Her hematocrit has been stable at approximately 26-28 since hospital day number eight. 6. GENITOURINARY: The patient has a Foley in place with multiple urine cultures which have been negative. 7. ENDOCRINE: The patient was on insulin drip for glycemic control while she was in the ICU. This was changed to a regular insulin sliding scale when she was on the floor and having a p.o. diet. 8. INFECTIOUS DISEASE: The patient was admitted and promptly became febrile with elevated white count. She intermittently spiked fevers since the time of her admission to hospital day number three. She was initially started on Zosyn and vancomycin but this was discontinued after approximately four days of treatment. She was cultured multiple times including surveillance cultures for MRSA which were negative. All of the multiple cultures have been negative except for blood cultures from hospital day number seven. This revealed three out of four bottles positive for Staphylococcus aereus. Sensitivities were not performed. The patient was started on vancomycin on this day and is to continue for a ten day course which will be complete on [**2131-4-23**]. During this time when she was febrile, central lines were rewired and eventually resided even though catheter tips have shown no growth. She currently has a right IJ which was placed after documentation of positive blood cultures. At the time of this dictation, hospital day number 17, the patient has been afebrile for greater than 48 hours, the longest period of time since her admission. 9. FLUIDS, ELECTROLYTES, AND NUTRITION: The patient was started on TPN when she initially arrived. Tube feeds were initiated on hospital day number seven after bowel sounds were noted and flatus was observed. An insulin drip was used while the patient was in the ICU for glycemic control. Once the patient was extubated, she was started on a clear diet on hospital day number 14 and this has been slowly advanced to a full diabetic diet. The patient has had some episodes of loose stool on hospital 16 which has been sent for Clostridium difficile. She remains on a regular insulin sliding scale now that she is on the floor. 10. VASCULAR: A surveillance ultrasound of the lower extremities was performed on hospital day number 12 and revealed a thrombosis in the left greater saphenous vein. The right leg was unremarkable. The presence of this clot was close to the junction to enter the deep venous system, although it is currently not in the deep venous system. The ultrasound was repeated of the left leg two days later on hospital day number 14 and was without change. Per Vascular recommendations, the patient will continue on Lovenox at this time and she will have a repeat ultrasound in one week which will be hospital day number 21 which is [**2131-4-25**]. 11. SPINE: A CT of the L spine was obtained and a consult was also called for. The CT of the L spine showed left transverse process fractures of L1 and L2 and a thoracic disk protrusion at T11 and T12. There is also a right disk osteophyte at L2 and L3. Final recommendations are pending from the spine team at this time. She is to be fitted for a TLSO brace when her abdominal issues are stable. 12. PROPHYLAXIS: The patient was placed on Lovenox on hospital day number three. Prior to that, she had been on subcutaneous heparin. Lovenox has been maintained throughout her stay. She has received Prevacid during the times that she was n.p.o. She has been on pneumatic boots bilaterally which was changed to a pneumatic boot on the right side only given the nature of her left thrombus. 13. FINAL SUMMARY: This is a 47-year-old woman who was transferred from an outside hospital for management of her biliary peritonitis. She also has multiple other injuries. These other injuries are a hepatic contusion, grade III, a right renal contusion, right hemothorax, right rib fractures, I-12 posteriorly and displaced, a right scapular fracture, and left transverse processes fractures of L1-3 and a right thigh hematoma. She is currently status post four trips to the OR and has an open abdominal wound that is unable to be closed primarily. The plan for closure of this wound is to allow granulation tissue to form and then to have a flap placed by Plastics. During the hospital stay here, the patient became bacteremic and febrile. She is currently afebrile and will remain on a ten day course of vancomycin, the last day of which is [**2131-4-23**]. She incidentally was found to have a thrombus of her left greater saphenous vein close to the junction of the deep venous vein system; however, it is not considered to be a DVT. A repeat ultrasound for evaluation of this is to occur on [**2131-4-25**]. She is currently on Lovenox. She is being followed by Spine Surgery for management of her lumbar transverse processes fractures. Specific recommendations are pending. At the time of this dictation, she is extubated successfully, being cared for on the floor, alert and oriented times three, taking solid foods, and has been afebrile for greater than 48 hours. Her activity is currently bed rest due to the open abdominal wound and the risk of disrupting the site as well as the unknown status of her transverse processes fractures. It is anticipated that she will be able to go to rehabilitation later this week to continue VAC dressing changes and Physical Therapy evaluation. She will return per Plastic Surgery recommendations for future grafting of her abdominal wound site. The remainder of this discharge summary will be dictated upon the patient's discharge from the hospital. This discharge summary encompasses the time from the patient's admission from [**2131-4-5**] to hospital day number 17, [**2131-4-21**]. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 9325**], M.D. [**MD Number(1) 10637**] Dictated By:[**Last Name (NamePattern1) 37631**] MEDQUIST36 D: [**2131-4-21**] 03:26 T: [**2131-4-21**] 16:17 JOB#: [**Job Number 56539**] ICD9 Codes: 5185, 5849, 7907
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Medical Text: Unit No: [**Numeric Identifier 67887**] Admission Date: [**2173-6-18**] Discharge Date: [**2173-7-28**] Date of Birth: [**2173-6-18**] Sex: M Service: Neonatology INTERIM HISTORY: Baby [**Name (NI) **] [**Known lastname 7568**] [**Known lastname **] is a 1370 gram male boy who was born on [**2173-6-18**] at 31-4/7 weeks of gestation. He has trisomy-21 and was admitted to the Neonatal Intensive Care Unit for prematurity and respiratory distress. Mother is a 29 year-old female, gravida I, para 0, I. Prenatal screens were O positive, antibody negative, hepatitis B negative, Rubella immune, RPR nonreactive and HSV negative. Prenatal son[**Name (NI) 867**] did not show any structural heart disease. Fetal ultrasounds did have indication for echogenicities in the bowel that resolved on subsequent ultrasounds. Mother received a full course of betamethasone in mid-[**Month (only) 116**]. [**Known lastname 7568**] was delivered by cesarean section for worsening uteroplacental insufficiency with absence of end diastolic flow on the ultrasound. Rupture of membranes was at delivery with clear fluid. Apgars were 7 and 9 at one and five minutes respectively. He was vigorous, active with spontaneous respirations at delivery. Upon admission to the Neonatal Intensive Care Unit his weight was 1370 grams (75%), length 41.5 cm (50%) and head circumference 28 cm (50%). Vital signs: Heart rate 122, temperature 97.9, respiratory rate 50s, blood pressure 77/43 and mean of 55. In general: Infant was a dysmorphic, premature baby in mild respiratory distress. Anterior fontanelle open and flat, wide set eyes, low -set ears and upslanting palpebral fessures, flat occiput. CV: No murmurs. S1 and S2, full femoral pulses. Pulmonary: he had retractions. No flaring, grunting or tachypnea on room air. Coarse breath sound decreased but equal bilaterally. Abdomen soft, nondistended. Anus patent. Extremities warm, pink, well perfused. Positive simian crease on upper extremities, spacing between first and toes on lower extremities. Genitourinary: Normal male genitalia, testes descended bilaterally. Neurologic: Slightly decreased tone. HOSPITAL COURSE BY SYSTEM: Respiratory: He was placed initially on nasal CPAP with 21% of FIO2 for 1 day and then was gradually weaned and changed to room air. Initially he had some apnea, then bradycardia especially with feeding but gradually resolved and currently he is breathing room air and his respirations are between 40 to 60 breaths per minute. His last documented apnea or bradycardia of prematurity was [**2173-7-17**]. Cardiology: Initially there was no murmur but during the hospital stay he has had an intermittent soft systolic murmur heard at the left sternal border. The femoral pulses are full and positive bilaterally. His blood pressure is in the range of 77/44 with a mean of 50 and his heart rate is between 140 to 150s. An electrocardiogram was done which showed slight left axis deviation and an echocardiogram was revelaed a small atrial septal defect versus patent foramen of ovale, qualitatively normal left ventricular systolic function and no pericardial effusion. Fluids, Electrolytes and Nutrition: He was kept NPO for the first day and given IV fluids. Feedings were gradually started on the second day of life and IV fluids were weaned. Currently, he is feeding Breast Milk at the breast or expressed breast milk with 24 calories per ounce supplemented with Similac Powder. He is also being sent home on Goldline baby multivitamins. Discharge weight is 2555 grams. During the hospital course he had hyperbilirubinemia and was placed on phototherapy. The maximum bilirubin was 8.7 with a direct of .3 on day of life 5. His last bilirubin was 7.0/0.3 on day of life 11 ([**2173-6-29**]). Hematology: His last hematocrit was on [**2173-7-9**] which revelaed a count of 42 with a reticulocyte count of 3.7. He is being sent home on supplemental iron. Infectious disease: He received oxacillin and gentamicin for 2 days. Blood culture were negative. GI: He has a small umbilical hernia on exam. Neurology: He had two head ultrasounds. The first on [**6-25**] did not reveal any abnormlities. The second on [**7-19**] revealed a small resolving subependymal bleed on the left. Audiology: Hearing screen was performed on [**2173-7-27**] and he passed in both ears. Ophthalmology: The initial ophthalmology screen which was done on [**2173-6-25**] revelaed immature retina to zone 3. The repeat screen on [**2173-7-26**] showed mature retina. Follow-up is recommended at 9 months of age. Genetics: A chromosome study on [**6-22**] confirmed the diagnosis of trisomy 21. Social: The family was consulted by the [**Hospital1 190**] social worker. The social worker can be reached at [**Telephone/Fax (1) **]. CONDITION ON DISCHARGE: Good. PRIMARY PEDIATRICIAN: Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 67888**] and [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], NNP at the [**Location (un) 686**] House. (p) [**Telephone/Fax (1) 1260**] (f) [**Telephone/Fax (1) 67889**]. CARE/RECOMMENDATIONS: 1. Feeding: Breast Nilk and/or Similac 24 po ad lib. 2. Medications: (a) Goldline baby multivitamins 1 ml po qday. (b) Ferrous Sulfate (concentration 25 mg/ml) 0.4 ml po qday. 3. Car seat position screen: Passed. 4. State newborn screening status: Samples sent [**7-2**] and [**7-28**]. No abnormal results have been reported. 5. Immunizations received: Hepatitis B vaccine on [**2173-7-18**]. Immunizations recommended: 1. Synagis RSV prophylaxis should be considered from [**Month (only) **] through [**Month (only) 958**] for infants who meet any of the following 3 criteria: 1) born at less than 32 weeks. 2) born between 32 and 35 weeks with 2 of the following: Day care during RSV season, a smoker in the household, neuromuscular disease, airway abnormalities, or school age siblings, or 3) with chronic lung disease. 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. FOLLOW UP: 1. Pediatrician within 2 days of discharge. 2. Gentics/Down Syndrome Clinic at [**Hospital3 1810**] ([**Telephone/Fax (1) 47723**]). 3. Ophthamology at 9 months of age. 4. Bay Cove Early Intervention Program, [**Telephone/Fax (1) 43091**]. 5. [**Location (un) 86**] VNA (f) [**Telephone/Fax (1) 37119**]. DISCHARGE DIAGNOSES: 1. Prematurity at 31 weeks of gestation. 2. Trisomy-21. 3. Transitional respiratory distress. 4. Hyperbilirubinemia. 5. Sepsis rule out. 6. Atrial Septal Defect versus Patent Foramen Ovale. 7. Small umbilical hernia. [**Name6 (MD) **] [**Last Name (NamePattern4) **], [**MD Number(1) 55472**] Dictated By:[**Name8 (MD) 67890**] MEDQUIST36 D: [**2173-7-26**] 14:18:42 T: [**2173-7-26**] 15:06:12 Job#: [**Job Number 67891**] ICD9 Codes: 7742, V290, V053
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Medical Text: Admission Date: [**2106-8-19**] Discharge Date: [**2106-8-25**] Date of Birth: [**2066-11-7**] Sex: M Service: MEDICINE Allergies: lisinopril Attending:[**First Name3 (LF) 16851**] Chief Complaint: hypotension Major Surgical or Invasive Procedure: none History of Present Illness: Mr. [**Known lastname **] is a 39M with ESRD on HD and renal cell CA with brain, pulmonary, and hepatic mets. He underwent MRI this morning on [**Hospital Ward Name 516**]. Shortly after receiving gadolinium contrast he developed worsening RLQ abdominal pain, then developed shaking of all 4 extremities. He reports that he was awake and alert throughout the episode. He was noted to be alert and oriented x3 directly afterward. BP noted to be 70s/40s on machine and manual recheck. He has had worsening RLQ pain for the last five days. Today he noticed his abdomen to be more distended than usual. Approximately one week ago his oxycodone was increased. Last HD session yesterday. Last round of chemotherapy was [**8-11**]. In ED, he received 2L NS but SBP still in 80s. Started peripheral levophed at 0.09 with response to 100s-110s. Initial VS in ED: T 98.1 HR 105 BP: 104/68 RR 22 O2Sat 97 on 4L NC In the ED, he started empiric vancomycin and cefepime for broad-spectrum coverage. CT revealed significant progression of his metastases (pulmonary, hepatic) but could not rule out pneumonia. New ascites but no evidence of appendicitis or acute abscess. Initial VS in MICU: T 98.5 HR 101 BP 105/72 RR 19 O2Sat 96% on 4L NC Past Medical History: Metastatic renal cell carcinoma: -- [**2106-3-10**]: cough x 2 weeks -- [**2106-4-15**]: Chest/Abd/Pelvis CT with pulm nodules, RUL mass, mediastinal/hilar lymphadenopathy, retroperitoneal adenopathy -- [**2106-5-3**]: Brain MRI with lesions in R choroid plexus, L parieto-occipital junction, L frontal lobe -- [**2106-5-5**]: VATS wedge resection of RUL mass; path confirmed renal cell carcinoma with clear cell features as well as the presence of a TFE3 gene fusion -- [**2106-6-10**]: CyberKnife radiosurgery to brain met -- [**2106-7-23**]: CyberKnife radiosurgery to brain met ESRD - secondary to focal glomerulonephritis, on HD since [**2089**] HTN Anxiety Past Surgical History: -multiple AV fistula placements/repairs -2 breast reduction procedures -2 operations for undescented testes -right orchiectomy -kidney biopsy -repair of a ruptured quadriceps tendon Social History: Mr. [**Known lastname **] is single. He is currently on disability. Smoked 1PPD x 20yrs and quit approximately one month ago. Prior history of alcohol dependence, but quit approximately four years ago. He has been living with friends in [**Name (NI) 1110**]. Family History: His mother is healthy at age 60. His father died at age 48 from throat cancer (he consumed cigarettes and alcohol) and colon cancer. His sister and brother are healthy but another brother has the "gene" for colon cancer and gets yearly check ups Physical Exam: At [**Hospital Unit Name 153**] admission: General: Alert, oriented, appears uncomfortable HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, PERRL. CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops. JVP flat. Lungs: Shallow breathing with accessory muscle use. Distant breath sounds, crackles at bilateral bases, no wheezes, rales, ronchi. Posterior lung fields not examined due to patient's pain attempting to sit up. Abdomen: Distended, tense, diminished bowel sounds. Nontender to palpation. Ext: Warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema. AV fistula in RUE; scars of prior AV fistula in LUE. R hand exquisitely tender to palpation. Neuro: CNII-XII intact, 2+ reflexes bilaterally, gait deferred. At discharge: VS: 97.4 92/60 97% on 2L pain 3 GEN: nad, laying in bed NECK: supple HEENT: op clear, poor dentition CHEST: faint wheezing anteriorly CV: rrr no m/r/g ABD: distended EXT: feet tender (chronic) no edema NEURO: AAOx3 PSYCH: appropriate, pleasant Pertinent Results: CT C/A/P on admission: 1. New enhancing hepatic mass and increased number and size of pulmonary nodules at the lung bases compatible with worsening metastatic disease. Several osseous metastatic lesions with soft tissue components are not significantly changed in the interval. 2. Worsening diffuse septal thickening, likely reflective of worsening pulmonary edema, though lymphangitic carcinomatosis is not excluded. Small bilateral pleural effusions, right larger than left. 3. New moderate volume ascites. 4. Atrophic kidneys with multiple cysts, likely related to dialysis. Dominant, peripherally calcified complex cystic lesion in the right upper pole of the kidney could reflect the patient's primary renal carcinoma. [**2106-8-24**] 09:36AM BLOOD WBC-4.3# RBC-3.18* Hgb-9.2* Hct-29.6* MCV-93 MCH-29.0 MCHC-31.1 RDW-18.6* Plt Ct-204 [**2106-8-24**] 09:36AM BLOOD Glucose-95 UreaN-22* Creat-6.5*# Na-140 K-4.2 Cl-102 HCO3-26 AnGap-16 [**2106-8-24**] 09:36AM BLOOD Calcium-9.2 Phos-4.0 Mg-1.8 [**2106-8-20**] 10:53AM ASCITES WBC-2050* RBC-1475* Polys-80* Lymphs-3* Monos-14* Atyps-0 Mesothe-3* Brief Hospital Course: Mr. [**Known lastname **] is a 39M with ESRD on HD and renal cell CA with brain, pulmonary, and hepatic mets admitted to the MICU with hypotension after receiving gadolinium during MRI on day of admission. Active Issues: --------------- # Septic shock: [**3-11**] SBP: He met SIRS criteria (HR, RR, WBC)on admission and required levophed after 2L NS with most likely etiology SBP. He was treated with ceftriaxone (see SBP for further details). Hypersensitivity reaction to gadolinium has been described but is rare, and he has previously received gadolinium. He received HD to remove gadolinum once he was hemodynamically stabilized. Adrenal insufficiency was ruled out. His shock resolved and he was transferred to the general medical floor without any further infectious issues. # SBP: He completed a course of ceftriaxone and given albumin on day 1 and day 3. He will continue on norfloxacin for prophylaxis. #New Onset Ascites: likely due to new hepatic mets and or carcinomatosis. No portal or splenic vein thrombosis seen. # ESRD: The patient received HD to remove gadolinum for MRI . He then continued on a MWF HD schedule. He had difficulty removing fluid during HD due to hypotension, which had been a problem at his out patient facility as well and so he was started on midorine. # Pain: pt with groin, leg, feet, back and abdominal pain. Pain regimen adjusted to increased home oxycontin dose, continued home oxycodone, tramadol, started naproxen and tylenol around the clock. # HTN: pt remained normo-tensive with his baseline SBP in the 100s. He was not discharged on his previous anti-hypertensive, nifedipine. # Anemia: likely [**3-11**] chronic disease and chemo. No evidence of bleeding. - cont epo # Metastatic renal cell CA: Pt had been followed by Dr. [**Last Name (STitle) 22658**] in [**Location (un) 1110**]. Will establish care in [**Location (un) 86**] with Dr. [**Last Name (STitle) **]. His records from Dr. [**Last Name (STitle) 22658**] were faxed to the new office on the day of discharge. He was found to have progression of known brain and pulmonary mets and new hepatic mets during admission. Patient and mother are aware of this. Pt expressed wishes to be resuscitated but not intubated. Explained that this was not possible. Discussed his poor prognosis of weeks to months and the likelyhood of suscessful resuscitation would be at most 5%. Patient stated that he would remain full code for now and would discuss it with his friends and mother. Medications on Admission: NIFEDIPINE 60 mg QSunday/Tues/Thurs OXYCODONE-ACETAMINOPHEN PRN TRAMADOL 50 mg TID Discharge Medications: 1. Acetaminophen 1000 mg PO Q6H 2. Docusate Sodium 100 mg PO BID 3. Midodrine 5 mg PO TID 4. Naproxen 500 mg PO Q12H 5. Nephrocaps 1 CAP PO DAILY 6. OxycoDONE (Immediate Release) 5-10 mg PO Q4H:PRN pain hold for sedation 7. Oxycodone SR (OxyconTIN) 30 mg PO Q12H hold for sedation or RR<10, 8. Polyethylene Glycol 17 g PO DAILY Hold if patient having daily BMs. 9. Senna 1 TAB PO BID constipation 10. TraMADOL (Ultram) 50 mg PO TID 11. Lorazepam 0.5-1 mg PO Q4H:PRN anxiety 12. norfloxacin *NF* 400 mg Oral daily SBP prophylaxis Discharge Disposition: Expired Facility: [**First Name4 (NamePattern1) 5279**] [**Last Name (NamePattern1) **] Center Discharge Diagnosis: spontaneous bacertial peritonitis new hepatic metastasis of renal cell carcinoma Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Out of Bed with assistance to chair or wheelchair. Discharge Instructions: You were admitted due to an infection in your abdomen which has been treated.You will require prophylactic antibiotics from now on to prevent this infection from returning. Followup Instructions: Department: HEMATOLOGY/ONCOLOGY When: TUESDAY [**2106-8-31**] at 4:00 PM With: DRS. [**Name5 (PTitle) **]/[**Doctor Last Name **] [**Telephone/Fax (1) 13016**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 24**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage ICD9 Codes: 0389, 5856, 3051
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6680 }
Medical Text: Admission Date: [**2132-11-13**] Discharge Date: [**2132-11-18**] Date of Birth: [**2070-10-14**] Sex: M Service: CARDIOTHORACIC Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 165**] Chief Complaint: anxiety attacks" associated with chest tightness Major Surgical or Invasive Procedure: [**2132-11-14**] Urgent coronary artery bypass graft x4: Left internal mammary artery to left anterior descending artery and saphenous vein grafts to diagonal obtuse marginal and distal right coronary arteries [**2132-11-13**] Cardiac cath History of Present Illness: 62 year old male has a history of hypertension, dyslipidemia, type 2 diabetes and CAD s/p OM1 stenting in [**2122**]. Over the past six months the patient has been having episodes of what he describes as "anxiety attacks", associated with chest tightness. Many of these episodes have correlated with exertion although several months ago he did have some episodes that woke him from sleep. Last evening while taking the dogs out into his back yard he had additional chest tightness, unassociated with any other symptoms. Stress testing in [**2132-9-15**] revealed new septal hypokinesis with exercise. He was referred for left heart catheterization. He was found to have three vessel diseae and is now being referred to cardiac surgery for revascularization. Past Medical History: Coronary Artery Disease s/p Coronary Artery Bypass Graft Diabetes Mellitus type 2 Hyperlipidemia Secondary diagnosis Hypertension Anemia Fatty liver Erectile dysfunction Social History: Race:Caucasian Last Dental Exam:3 years ago Lives with:Wife Contact:[**Name (NI) 22678**] (wife) Phone #[**Telephone/Fax (1) 22679**] Occupation:Chef Cigarettes: Smoked no [x] yes [] Other Tobacco use:denies ETOH: denies Illicit drug use: denies Family History: Father with MI at age 62 Physical Exam: Pulse:53 Resp:18 O2 sat:99/RA B/P Right:127/62 Left:133/76 Height:5'7" Weight:185 lbs 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 [] grade ______ Abdomen: Soft [x] non-distended [x] non-tender [x] bowel sounds + [x] Extremities: Warm [x], well-perfused [x] Edema [] _no____ Varicosities: None [x] Neuro: Grossly intact [x] Pulses: Femoral Right: 2+ Left: 2+ DP Right: 1+ Left: 1+ PT [**Name (NI) 167**]: 2+ Left: 2+ Radial Right: cath site Left: 2+ Carotid Bruit Right: no Left: no Pertinent Results: [**2132-11-13**] Cath: 1) Selective coronary angiography of this right-dominant system demonstrated severe 3 vessel CAD. The distal LMCA had 70-80% stenosis. The origin and proximal segment of the LAD had diffuse 80% disease with good distal targets. The mid LCX stents were subtotally occluded with probable good targets distal to the stents. The RCA was totally occluded at the origin with left-to-right collaterals. 2) Limited resting hemodynamics revealed normal systemic arterial pressures with a central aortic pressure of 111/61 with a mean of 73mmHg. 3) Refer for CABG [**2132-11-14**] Carotid U/S: Right ICA 80-99% stenosis. Left ICA 70-79% stenosis. [**2132-11-14**] Echo: PRE-BYPASS: 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 atrial septal defect is seen by 2D or color Doppler. There is mild symmetric left ventricular hypertrophy with normal cavity size. There is mild symmetric left ventricular hypertrophy. The left ventricular cavity size is normal. Overall left ventricular systolic function is moderately depressed (LVEF=35 %). with normal free wall contractility. There are simple atheroma in the aortic arch. There are simple atheroma in the descending thoracic aorta. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. There is no aortic valve stenosis. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. Mild (1+) mitral regurgitation is seen. There is no pericardial effusion. Dr. [**First Name (STitle) **] was notified in person of the results before surgical incision. POST_BYPASS: Normal RV systolic function. Overall LVEF 40% to 45% Mild MR> Intact thoracic aorta. Prebypass hypokinetic lateral wall seem to be moving well. [**2132-11-17**] 04:48AM BLOOD WBC-7.3 RBC-3.60* Hgb-10.8* Hct-30.7* MCV-85 MCH-30.1 MCHC-35.2* RDW-13.8 Plt Ct-136* [**2132-11-16**] 04:13AM BLOOD WBC-9.1 RBC-3.84* Hgb-11.5* Hct-31.3* MCV-82 MCH-29.9 MCHC-36.7* RDW-14.3 Plt Ct-140* [**2132-11-18**] 08:54AM BLOOD Glucose-352* UreaN-27* Creat-1.0 Na-139 K-4.6 Cl-97 HCO3-31 AnGap-16 [**2132-11-17**] 04:48AM BLOOD Glucose-115* UreaN-19 Creat-0.9 Na-138 K-3.5 Cl-97 HCO3-34* AnGap-11 Brief Hospital Course: Mr. [**Known lastname 17684**] was admitted following his cardiac cath which revealed severe three vessel coronary artery disease. He underwent pre-operative work-up and on [**11-14**] was brought to the operating room where he underwent a coronary artery bypass graft x 4. Please see operative report for surgical details. Following surgery he was transferred to the CVICU for invasive monitoring in stable condition. POD 1 found the patient extubated, alert and oriented and breathing comfortably. He did show Right Upper Lobe collapse on CXR, which resolved. The patient was neurologically intact and hemodynamically stable, weaned from inotropic and vasopressor support. Beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. The patient was transferred to the telemetry floor for further recovery. Chest tubes and pacing wires were discontinued without complication. Glyburide and Metformin were titrated for blood glucose management. The patient will keep a blood glucose log on discharge to present to his PCP. [**Name10 (NameIs) **] patient was evaluated by the physical therapy service for assistance with strength and mobility. By the time of discharge on POD 4 the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. The patient was discharged home with VNA in good condition with appropriate follow up instructions. Medications on Admission: ATENOLOL 50 mg Daily ATORVASTATIN80 mg Daily COLCHICINE 0.6 mg Daily FLUOXETINE 40 mg Daily GLYBURIDE 5 mg [**Hospital1 **] LISINOPRIL 40 mg Daily METFORMIN 1000 mg [**Hospital1 **] NAPROXEN 500 mg twice a day as needed for pain, take with food NIFEDIPINE 90 mg Daily NITROGLYCERIN 0.4 mg Tablet, Sublingual - 1 Tablet(s) sublingually daily as needed for chest pain, may repeat in 5 minutes, call 911, proceed to Emergency TADALAFIL [CIALIS] 20 mg [**2-17**] to one Tablet(s) by mouth daily as needed; do not take ntg while taking cialis ASPIRIN 325 mg Daily MULTIVITAMIN Dosage uncertain Discharge Medications: 1. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*1* 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:*1* 3. oxycodone-acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*60 Tablet(s)* Refills:*0* 4. fluoxetine 40 mg Capsule Sig: One (1) Capsule PO once a day. Disp:*30 Capsule(s)* Refills:*1* 5. colchicine 0.6 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*1* 6. atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*1* 7. multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. lisinopril 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*1* 9. metformin 1,000 mg Tablet Sig: One (1) Tablet PO twice a day. Disp:*60 Tablet(s)* Refills:*1* 10. glyburide 5 mg Tablet Sig: Two (2) Tablet PO twice a day. Disp:*120 Tablet(s)* Refills:*1* 11. metoprolol succinate 50 mg Tablet Extended Release 24 hr Sig: Three (3) Tablet Extended Release 24 hr PO DAILY (Daily). Disp:*90 Tablet Extended Release 24 hr(s)* Refills:*1* 12. Lasix 20 mg Tablet Sig: One (1) Tablet PO once a day for 1 weeks: to be reevaluated at wound check [**11-27**]. Disp:*7 Tablet(s)* Refills:*0* 13. Diabetes Glucometer Lancets Test Strips Discharge Disposition: Home With Service Facility: [**Company 1519**] Discharge Diagnosis: Coronary Artery Disease s/p Coronary Artery Bypass Graft Past medical history: Hyperlipidemia Hypertension Diabetes Mellitus Type 2 Anemia Fatty liver Erectile dysfunction Discharge Condition: Alert and oriented x3 nonfocal Ambulating with steady gait Incisional pain managed with percocet Incisions: Sternal - healing well, no erythema or drainage Leg Left - healing well, no erythema or drainage. Edema no lower extremity edema Discharge Instructions: Please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. Look at your incisions daily for redness or drainage Please NO lotions, cream, powder, or ointments to incisions Each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart No driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive No lifting more than 10 pounds for 10 weeks Please call with any questions or concerns [**Telephone/Fax (1) 170**] **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) **] [**Telephone/Fax (1) 170**] [**2132-12-22**] 1:00 pm Cardiologist: Dr. [**Last Name (STitle) **] [**Telephone/Fax (1) 62**] Date/Time:[**2132-11-28**] 2:40 Wound check with cardiac surgery [**Telephone/Fax (1) 170**] Date/Time:[**2132-11-27**] 10:30 at [**Hospital **] medical building Please call to schedule appointments with your Primary Care Dr. [**Last Name (STitle) **] in [**5-20**] 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:[**2132-11-18**] ICD9 Codes: 4280, 4019, 2720
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6681 }
Medical Text: Admission Date: [**2115-4-30**] Discharge Date: [**2115-5-8**] Date of Birth: [**2067-12-7**] Sex: F Service: SURGERY Allergies: Penicillins / Ceclor Attending:[**First Name3 (LF) 16769**] Chief Complaint: ESRD on hemodialysis s/s SFSGS Major Surgical or Invasive Procedure: Living related kidney transplant [**2115-4-30**] History of Present Illness: Ms. [**Known lastname 2816**] is a 47year old female with ESRD secondary to FSGS. She had 0nset of kidney disease at age 3 and started dialysis two year later. She had initial dialysis by PD tolerated by hemodialysis via neck catheter and right upper arm fistula. Past Medical History: ESRD secondary to FSGS aortic endocarditis ITP PSH: s/p AVR [**1-2**] R knee '[**10**] L elbow '[**11**] splenectomy '[**83**] Social History: +tobacco Physical Exam: NAD RRR CTAB s/nt/nd no c/c/e Pertinent Results: [**5-1**] Renal u/s "1) Renal artery outside of the parenchyma is very tortuous and pulsatile which is probably the cause of turbulent color flow in the renal hilum. There is no evidence of AV fistula. The peak systolic velocities may be slightly increased. Although, these findings could be artifactual due to tortuosity of this vessel, if renal function deteriorates, recommend imaging wiht MRA, CTA, or angiogram. 2) Normal intra-renal artery waveforms with RIs in expected range. This is improved when compared to the study performed yesterday." [**2115-4-30**] 06:03PM PT-15.4* PTT-26.1 INR(PT)-1.6 [**2115-4-30**] 02:37PM GLUCOSE-115* UREA N-37* CREAT-6.6* SODIUM-138 POTASSIUM-4.9 CHLORIDE-100 TOTAL CO2-26 ANION GAP-17 [**2115-4-30**] 02:37PM PHOSPHATE-4.1# MAGNESIUM-1.6 [**2115-4-30**] 02:37PM WBC-5.2 RBC-3.15* HGB-10.7* HCT-32.7* MCV-104* MCH-34.1* MCHC-32.9 RDW-17.2* [**2115-4-30**] 02:37PM PLT COUNT-278 [**2115-4-30**] 08:15AM PT-15.6* PTT-28.8 INR(PT)-1.6 TOXICOLOGY, SERUM AND OTHER DRUGS FK506 [**2115-5-7**] 06:15AM 12.71 Hematology COMPLETE BLOOD COUNT WBC RBC Hgb Hct MCV MCH MCHC RDW Plt Ct [**2115-5-8**] 05:42AM 3.4* 2.61* 8.9* 26.9* 103* 34.3* 33.2 17.2* 156 BASIC COAGULATION (PT, PTT, PLT, INR) PT PTT Plt Ct INR(PT) [**2115-5-8**] 05:42AM 156 [**2115-5-8**] 05:42AM 20.7*1 37.8* 2.8 1 NOTE NEW NORMAL RANGE AS OF 12 AM [**2115-4-27**] Chemistry RENAL & GLUCOSE Glucose UreaN Creat Na K Cl HCO3 AnGap [**2115-5-8**] 05:42AM 68* 87* 3.8* 140 5.6* 113* 19* 14 CHEMISTRY TotProt Albumin Globuln Calcium Phos Mg UricAcd Iron [**2115-5-8**] 05:42AM 3.1* 8.1* 4.7* TOXICOLOGY, SERUM AND OTHER DRUGS FK506 [**2115-5-8**] 05:42AM PND Brief Hospital Course: Ms. [**Known lastname 2816**] was taken to the OR on [**2115-4-30**]. Please see Dr. [**Name (NI) 16770**] Operative Note for detail. Intra-operatively, she was noted to have minimal urine output. In the PACU, she continued to have minimal urine output of only 8cc and 9cc for the first two hours. She was given Lasix 80mg IV but with poor response, again only putting out 9cc of urine. Ms. [**Known lastname 2816**] also had low systolic blood pressures and was unable to maintain a systolic blood pressure greater than 110mmHg with fluid boluses. She was started on a Dopamine drip but she failed to respond appropriately. She was then switched to a Neosynephrine drip and her systolics increased to 120s-130s. Once these pressures were achieved, Ms. [**Known lastname 2816**] began to have brisk urine output 300-500cc per hour. On POD#1, because she still required a Neo drip, Ms. [**Known lastname 2816**] was transferred to the SICU. She did well in the PACU, with continued brisk urine output and weaned off the Neo drip. She was transferred to the floor on POD #2. Her daily urine creatine to protein ratios were followed by the renal team. She was continued on a heparin drip given her AVR -- she was transitioned to Coumadin, starting on POD #5, and by POD #6 had a therpautic INR and her heparin drip was stopped. On POD #7 her JP drain was pulled. Throughout her hospital course she was on MMF and Tacrolimus, with her FK levels appropriately adjusted by daily levels. At the time of discharge, Ms. [**Known lastname 2816**] was voiding without difficulty, had good pain control, a therapeutic INR, and adquate FK levels. She was discharged home with explicit follow-up instructions. Medications on Admission: Nephrocaps, Phoslo, Renagel, Xanax, Epogen, Zestril, Lipitor, Lasix. Discharge Medications: 1. Trimethoprim-Sulfamethoxazole 80-400 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 3. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed. 4. Diphenhydramine HCl 25 mg Capsule Sig: [**12-30**] Capsules PO Q12H OR QHS PRN () as needed for sleep. 5. Nystatin 100,000 unit/mL Suspension Sig: Five (5) ML PO QID (4 times a day). 6. Valganciclovir HCl 450 mg Tablet Sig: One (1) Tablet PO QOD (). 7. Mycophenolate Mofetil 500 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 8. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). 9. Hydrocodone-Acetaminophen 5-500 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. Disp:*30 Tablet(s)* Refills:*0* 10. Tacrolimus 5 mg Capsule Sig: One (1) Capsule PO BID (2 times a day) 11. Epogen 10,000 unit/mL Solution Sig: One (1) Injection once a week. Disp:*5 * Refills:*2* 12. Warfarin Sodium (Coumadin)2mg tablet: take one tablet every day Discharge Disposition: Home Discharge Diagnosis: ESRD secondary to focal segmental glomerular sclerosis Living related kidney transplant [**2115-4-30**] s/p Aortic valve replacement [**2115-1-2**] Discharge Condition: stable. good Discharge Instructions: Call if fevers, chills, nausea, vomiting, inability to take medications, increased drainage from JP drain, decreased urine output or increased abdominal pain. [**Telephone/Fax (1) 697**] Labs every Monday & Thursday for cbc, chem 7, calcium, phosphorus, ast, t.bili, urinalysis, PT, PTT, INR, and trough prograf level. Fax results immediately to transplant office [**Telephone/Fax (1) 697**] Collect 24 hour urine output starting 6am [**5-9**] after first voiding. End collection Friday at 6 am. Bring 24 hour urine collection to transplant office on Friday [**5-10**] No driving while taking pain medication no heavy lifting may shower with soap & water. Followup Instructions: Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 15475**], MD Where: LM [**Hospital Unit Name 3126**] CENTER Phone:[**Telephone/Fax (1) 673**] Date/Time:[**2115-5-10**] 1:00 Provider: [**Name10 (NameIs) 2105**] [**Name11 (NameIs) 2106**], MD Where: LM [**Hospital Unit Name 3126**] CENTER Phone:[**Telephone/Fax (1) 673**] Date/Time:[**2115-5-17**] 9:20 Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 15475**], MD Where: LM [**Hospital Unit Name 3126**] CENTER Phone:[**Telephone/Fax (1) 673**] Date/Time:[**2115-5-24**] 2:00 Completed by:[**2115-5-8**] ICD9 Codes: 2859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6682 }
Medical Text: Admission Date: [**2180-4-22**] Discharge Date: [**2180-4-24**] Date of Birth: [**2105-6-27**] Sex: F Service: SURGERY Allergies: Aspirin / Ampicillin / Penicillins / Latex Attending:[**First Name3 (LF) 1**] Chief Complaint: Increase in drainage at thyroidectomy and parathyroidectomy site and shortness of breath. Major Surgical or Invasive Procedure: Drainage of seroma Direct laryngoscopy History of Present Illness: 74 yo female presented to the emergency department four days s/p thyroidectomy and parathyroidectomy complaining of increased drainage from the surgical site and shortness of breath. She reported shortness of breath since her procedure and presented with some new tightness in the throat. Past Medical History: PMH: Hepatitis C, DM, HTN, Erythema nodosum, Thyroid goiter, urinary incontience, diabetic neuropathy, obesity PSH: open CCY with IOC Social History: No alcohol or drug use. Lives alone, has involved family and assistance from a home health aide. Physical Exam: On presentation: 99.7, HR 100, 123/104, 20, 97% Constitutional: Mild difficulty breathing HEENT: Anicteric Thyroid incision intact with mild surrounding induration and serosanguineous drainage from lateral aspect of wound. Chest: Prominent upper airway sounds and mild stridor. Cardiovascular: Regular Rate and Rhythm Abdominal: Soft, Nontender Pelvic: Normal GU/Flank: No costovertebral angle tenderness Extr/Back: No cyanosis, clubbing or edema Skin: No rash Neuro: Speech fluent Psych: Normal mood Pertinent Results: [**2180-4-24**] 06:50AM BLOOD WBC-12.7*# RBC-4.45 Hgb-13.1 Hct-39.1 MCV-88 MCH-29.4 MCHC-33.4 RDW-12.8 Plt Ct-358 [**2180-4-23**] 04:57AM BLOOD WBC-6.3# RBC-4.20 Hgb-12.5 Hct-38.0 MCV-91 MCH-29.9 MCHC-33.0 RDW-13.1 Plt Ct-284 [**2180-4-22**] 12:20PM BLOOD Neuts-78.9* Lymphs-13.8* Monos-5.6 Eos-1.2 Baso-0.6 [**2180-4-23**] 04:57AM BLOOD Glucose-182* UreaN-25* Creat-0.7 Na-142 K-3.5 Cl-106 HCO3-23 AnGap-17 [**2180-4-22**] 12:20PM BLOOD Glucose-109* UreaN-22* Creat-0.9 Na-142 K-3.9 Cl-102 HCO3-25 AnGap-19 [**2180-4-24**] 06:50AM BLOOD Calcium-7.6* Phos-2.7 Mg-2.0 [**2180-4-23**] 04:57AM BLOOD Calcium-7.8* Phos-4.2# Mg-1.9 [**2180-4-22**] 12:29PM BLOOD pH-7.44 Comment-GREEN TOP [**2180-4-22**] 12:29PM BLOOD Lactate-1.5 K-5.1 [**2180-4-22**] 12:29PM BLOOD freeCa-0.92* Brief Hospital Course: The patient was seen in the emergency department by ENT. Neck films showed fluid or hematoma projecting into the airway. ENT visualized airway by laryngoscope which revealed significant soft tissue edema which was attributed to recent intubation. The appearance of the patience neck without erythema or purulent drainage indicated seroma as most likely diagnosis. The seroma was drained in the emergency room and the patient received IV Decadron and IV antibiotics, she was stabilized in the emergency department and then transferred to the [**Hospital Unit Name 153**] for further monitoring of the airway. Gram stain of the fluid of the seroma showed leukocytes and no microorganisms. Preliminary culture of the wound showed sparse growth of beta streptococcus group B. The patients stay in the [**Hospital Unit Name 153**] was uneventful, wicks were placed in the anterior neck wound and she was transferred to the inpatient floor for further monitoring. The patients stay on the inpatient floor was uneventful. The wound was changed as ordered, and appeared stable. The patients laboratory values were stable and she was discharged home [**2180-4-24**] with appropriate discharge instruction. Medications on Admission: Lasix 20 mg Tablet Sig: One (1) Tablet PO twice a day. Lisinopril 40 mg Tablet Sig: One (1) Tablet PO once a day. Glyburide 2.5 mg Tablet Sig: One (1) Tablet PO once a day. Amlodipine 2.5 mg Tablet Sig: One (1) Tablet PO once a day. Colchicine 0.6 mg Tablet Sig: One (1) Tablet PO twice a day. Metformin 850 mg Tablet Sig: One (1) Tablet PO once a day. Ursodiol 250 mg Tablet Sig: One (1) Tablet PO three times a day. Discharge Medications: 1. Lasix 20 mg Tablet Sig: One (1) Tablet PO twice a day. 2. Lisinopril 40 mg Tablet Sig: One (1) Tablet PO once a day. 3. Glyburide 2.5 mg Tablet Sig: One (1) Tablet PO once a day. 4. Amlodipine 2.5 mg Tablet Sig: One (1) Tablet PO once a day. 5. Colchicine 0.6 mg Tablet Sig: One (1) Tablet PO twice a day. 6. Metformin 850 mg Tablet Sig: One (1) Tablet PO once a day. 7. Ursodiol 250 mg Tablet Sig: One (1) Tablet PO three times a day. 8. Calcium Carbonate 1,000 mg Tablet, Chewable Sig: Three (3) Tablet, Chewable PO twice a day. Disp:*180 Tablet, Chewable(s)* Refills:*2* Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: Seroma Supraglottic edema Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Out of Bed with assistance to chair or wheelchair. Discharge Instructions: You were admitted for a fluid collection in the incision of your thyroidectomy. This fluid collection as well as irritation to your throat caused you to have some difficulty breathing. You were admitted to the ICU for airway mointoring, and with some medications and draining of the fluid collection you were able to breath easily. You were found to have a fluid collection known as a seroma. A seroma is a collection of fluid under the skin that can develop after surgery. There is not an infection in this fluid and you do not need antibiotics. This fluid collection was drained, wicks were placed in the wound and you are now stable to be discharged home. It is important that you monitor the wound for signs of infeciton incliding: increasing redness, increased pain not relieved with medication, or white, green or light pink drainage. The wick will need to be chagned twice daily and please apply sterile dry gauze to the wicked area three times daily. You will be referred to visiting nurses who will monitor the wound and assist you with the dressing. Followup Instructions: Please see Dr. [**Last Name (STitle) **] in one week. Call ([**Telephone/Fax (1) 9011**] to make an appointment. Completed by:[**2180-4-24**] ICD9 Codes: 3572, 2449
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Medical Text: Admission Date: [**2189-2-23**] Discharge Date: [**2189-3-2**] Date of Birth: [**2136-8-26**] Sex: M Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1556**] Chief Complaint: Patient admitted for weight reduction surgery. Major Surgical or Invasive Procedure: Status Post Laparoscopic Gastric Bypass with umbilical hernia repair with mesh. On [**2189-2-25**] patient taken back to operating room for bleeding. History of Present Illness: [**Known firstname **] has class III morbid obesity with weight of 317.9 lbs as of [**2188-11-24**] (his initial screen weight on [**2188-8-5**] was 309.9 lbs), height of 71 inches and BMI of 44.3. His previous weight loss efforts have included self-diets and monitoring. He has not done any formal programs, taken prescription weight loss medications or used over-the-counter ephedra-containing appetite suppressants/herbal supplements. His weight at age 21 was 200 lbs his lowest adult weight with his highest weight being his current weight of 317.9 lbs. Past Medical History: PMH: HTN, IDDM, severe OSA on CPAP (on 11), dyslipidemia, GERD, ED [**2-2**] testosterone deficiency, OA/joint pain (esp R knee), umbilical hernia, acute pancreatitis (hospitalized [**2-/2187**]), trigger finger release [**2185**], osteotomy [**2166**], ?ligament repair Social History: He used to smoke one pack per day cigarettes for 17 years quit in [**2172**], no recreational drugs, has 4 bottles of beer weekly, drinks 12- ounce cup of coffee 3-4 times a day and has 12-ounce diet soda daily. He is currently unemployed but occasionally does minimal home repairs. He is married living with his wife age 50 a software engineer and their 2 sons ages 24 and 27. Family History: Family history is noted for father deceased age 72 of heart disease (CHF); mother deceased age 38 of pneumonia and EtOH abuse; has 4 siblings with one sister age 53 living with obesity and another with EtOH abuse. Physical Exam: His blood pressure was 146/76, pulse 78 and O2 saturation 97% room air. On physical examination [**Known firstname **] was casually dressed in no distress. His skin was warm, dry, few skin tags and acneiform lesions, no rashes. Sclerae were anicteric, conjunctiva clear, pupils were equal round and reactive to light, fundi normal with sharp optic disks no retinal hemorrhages, mucous membranes were moist, tongue pink and the oropharynx was without exudates or hyperemia. Trachea was in the midline and the neck was supple without adenopathy, thyromegaly or carotid bruits. Chest was symmetric and the lungs clear to auscultation bilaterally with good air movement. Cardiac exam was regular rate and rhythm with normal S1 and S2, no murmurs, rubs or gallops. The abdomen was obese but soft and non-tender, non-distended with normal bowel sounds, no masses, there is 4 cm large reducible umbilical hernia, no incision scars. There was no spinal tenderness or flank pain. Lower extremities were noted for bilateral mild venous insufficiency, trace edema and no clubbing. There was no evidence of joint swelling or inflammation of the joints. There were no focal neurological deficits and his gait noted light limp. Pertinent Results: [**2189-2-24**] 07:05AM BLOOD WBC-12.3*# RBC-3.30*# Hgb-9.9*# Hct-29.2*# MCV-88 MCH-29.9 MCHC-33.9 RDW-14.4 Plt Ct-386 [**2189-2-24**] 03:50PM BLOOD WBC-10.9 RBC-3.08* Hgb-9.3* Hct-27.0* MCV-88 MCH-30.2 MCHC-34.5 RDW-14.5 Plt Ct-321 [**2189-2-25**] 06:00AM BLOOD WBC-11.4* RBC-2.50* Hgb-7.5* Hct-21.6* MCV-87 MCH-30.0 MCHC-34.6 RDW-14.7 Plt Ct-277 [**2189-2-25**] 09:20AM BLOOD Hct-22.0* [**2189-2-26**] 02:04AM BLOOD WBC-10.7 RBC-2.84* Hgb-8.6* Hct-24.9* MCV-88 MCH-30.2 MCHC-34.5 RDW-15.1 Plt Ct-256 [**2189-2-27**] 05:45AM BLOOD WBC-10.5 RBC-2.83* Hgb-8.5* Hct-25.0* MCV-88 MCH-30.1 MCHC-34.1 RDW-15.5 Plt Ct-249 [**2189-3-1**] 08:35AM BLOOD WBC-10.2 RBC-2.97* Hgb-8.8* Hct-25.8* MCV-87 MCH-29.8 MCHC-34.2 RDW-15.1 Plt Ct-340 [**2189-2-28**] 06:05AM BLOOD Glucose-111* UreaN-19 Creat-0.5 Na-141 K-3.7 Cl-104 HCO3-28 AnGap-13 [**2189-2-24**] UGI [**2-24**] IMPRESSION: Free passage of oral contrast from the gastric pouch into the non-dilated loops of jejunum, without evidence of anastomotic leak at the gastrojejunostomy. UGI [**2189-2-26**] Free passage of contrast into the gastric pouch without evidence of leak. However, severe stenosis of the gastrojejunal anastomosis with minimal passage of contrast into the jejunum. Free reflux of the gastric pouch contents into the upper esophagus. The patient was kept in a semi- upright position for concern of aspiration. KUB [**2189-2-27**] No remaining contrast seen within the area of the gastric pouch. Residual contrast seen within the colon to the level of the rectum. R Duplex [**2189-2-27**] Duplex and color Doppler demonstrate no right upper extremity DVT either acute or chronic. Brief Hospital Course: Patient admitted and underwent a laparoscopic gastric bypass on [**2189-2-23**]. He tolerated the procedure well, however his postoperative course was complicated by a low urine output and a falling hematocrit. His hct. dropped from 29.2 to 21.6 so it was decided to take him back to the operating room for open abdominal exploration with clot evacuation and Gastrostomy tube procedure. He recovered in the intensive care unit for approximately 24 hours and then was transferred back to floor. His blood level remained stable and he was progressed from a stage one to stage 3 diet without problems. We will discharge him to home with follow up with Dr. [**Last Name (STitle) **] and the bariatric clinic. He will go home with a g-tube and instruction has been given to him regarding this. He will also go home with metformin and 25 units of glargine qHS [**First Name8 (NamePattern2) **] [**Last Name (un) **]. He will monitor his blood sugars and speak/visit with his endocrinologist in one week. Medications on Admission: Lisinopril 40', Felodipine 10', Metoprolol 50'', HCTZ 25', NPH 15U qAM/15U qnoon/20U qPM, Lispro ISS, Metformin 1000''; Crestor 10', Omeprazole 20', ASA 81', Viagra 100''prn, MVI Discharge Medications: 1. Roxicet 5-325 mg/5 mL Solution Sig: [**5-10**] ml PO every four (4) hours as needed for pain. Disp:*500 ml* Refills:*0* 2. Colace 50 mg/5 mL Liquid Sig: Ten (10) ml PO twice a day as needed for constipation. Disp:*500 ml* Refills:*0* 3. Actigall 300 mg Capsule Sig: One (1) Capsule PO twice a day: Please take for 6 months. You must open capsule and place in drink. Disp:*60 Capsule(s)* Refills:*5* 4. Zantac 15 mg/mL Syrup Sig: Ten (10) ml PO twice a day: Please take for one month. Disp:*600 ml* Refills:*0* 5. Diabetes Regimen Please check your fingerstick blood sugars 4 times a day andn log. Please hold your NPH insulin and follow up with your primary care or endocrinologist in one week. You may continue your metformin. 6. Lisinopril 40 mg Tablet Sig: One (1) Tablet PO once a day: Please crush. 7. Felodipine 10 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO once a day. 8. Lopressor 50 mg Tablet Sig: One (1) Tablet PO twice a day: Please crush. 9. Metformin 1,000 mg Tablet Sig: One (1) Tablet PO twice a day: Please crush. 10. Crestor 10 mg Tablet Sig: One (1) Tablet PO once a day: Please crush. 11. HCTZ Please hold and follow up with your primary care in one week to assess need. Discharge Disposition: Home Discharge Diagnosis: Primary Diagnosis: Obesity Discharge Condition: Stable. Discharge Instructions: Discharge Instructions: Please call your surgeon or return to the emergency department if you develop a fever greater than 101.5, chest pain, shortness of breath, severe abdominal pain, pain unrelieved by your pain medication, severe nausea or vomiting, severe abdominal bloating, inability to eat or drink, foul smelling or colorful drainage from your incisions, redness or swelling around your incisions, or any other symptoms which are concerning to you. Diet: Stay on Stage III diet until your follow up appointment. Do not self advance diet, do not drink out of a straw or chew gum. Medication Instructions: Resume your home medications, CRUSH ALL PILLS. You will be starting some new medications: 1. 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. 2. You should begin taking a chewable complete multivitamin with minerals. No gummy vitamins. 3. You will be taking Zantac liquid 150 mg twice daily for one month. This medicine prevents gastric reflux. 4. You will be taking Actigall 300 mg twice daily for 6 months. This medicine prevents you from having problems with your gallbladder. 5. You should take a stool softener, Colace, twice daily for constipation as needed, or until you resume a normal bowel pattern. 6. You must not use NSAIDS (non-steroidal anti-inflammatory drugs) Examples are Ibuprofen, Motrin, Aleve, Nuprin and Naproxen. These agents will cause bleeding and ulcers in your digestive system. Activity: No heavy lifting of items [**10-15**] pounds for 6 weeks. You may resume moderate exercise at your discretion, no abdominal exercises. Wound Care: You may shower, no tub baths or swimming. If there is clear drainage from your incisions, cover with clean, dry gauze. Your steri-strips will fall off on their own. Please remove any remaining strips 7-10 days after surgery. Please call the doctor if you have increased pain, swelling, redness, or drainage from the incision sites. Followup Instructions: Provider: [**First Name11 (Name Pattern1) **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 18800**], RD Phone:[**Telephone/Fax (1) 305**] Date/Time:[**2189-3-12**] 1:30 Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 9325**], MD Phone:[**Telephone/Fax (1) 305**] Date/Time:[**2189-3-12**] 2:00 Provider: [**First Name11 (Name Pattern1) **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 18800**], RD Phone:[**Telephone/Fax (1) 305**] Date/Time:[**2189-4-24**] 9:00 Please follow up with your primary care provider [**Name Initial (PRE) **]/or endocrinologist in one week. Completed by:[**2189-3-2**] ICD9 Codes: 2851, 2724, 4019
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Medical Text: Admission Date: [**2131-4-2**] Discharge Date: [**2131-4-11**] Date of Birth: [**2065-10-1**] Sex: F Service: CARDIOTHORACIC Allergies: Amoxicillin / Valium / Darvon / Latex Attending:[**First Name3 (LF) 1283**] Chief Complaint: Chest and left lateral back pain Major Surgical or Invasive Procedure: Asc Ao Aneurysm repair [**Last Name (NamePattern4) 15255**] of Present Illness: Mrs. [**Known lastname **] is a delightful 65 year old woman who back in [**2130-12-27**] with a 6 month history of epigastric and left lateral chest and back pain. A CT scan showed an enlarged aorta. A cardiac catheterization was performed which showed no significant coronary artery disease. She was subseqquently referred to Dr. [**Last Name (Prefixes) **] for suirgical management. She is admitted to day for preoperative testing and surgery. Past Medical History: Ascending aortic aneurysm Hypertension Hypercholesterolemia Depression Anxiety Social History: Smoked 1 pack per day for 47 years. SHe does not drink alcohol. Lives with partner and has two daughters. Family History: Noncontributory Physical Exam: VITALS: 57 SB, BP: (L) 130/60, (R) 118/59 96% RA sat NEURO: Alert, no focal deficits CARDIAC: Regular rate and rhythm, No murmur LUNGS: Clear ABDOMEN: Soft, nontender, nondistened. Normoactive bowel sounds EXTEMITIES: No edema, no varicosities PULSES: 2+ femoral, 1+ dorsalis pedis and posterior tibial. Pertinent Results: [**2131-4-2**] 05:02PM URINE BLOOD-NEG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-TR BILIRUBIN-NEG UROBILNGN-NEG PH-7.0 LEUK-SM [**2131-4-2**] 05:02PM URINE RBC-0 WBC-[**7-6**]* BACTERIA-FEW YEAST-NONE EPI-0 [**2131-4-2**] 05:50PM PT-12.6 PTT-26.4 INR(PT)-1.0 [**2131-4-2**] 05:50PM WBC-5.8 RBC-3.98* HGB-12.2 HCT-35.0* MCV-88 MCH-30.6 MCHC-34.8 RDW-14.0 [**2131-4-2**] 05:50PM ALT(SGPT)-26 AST(SGOT)-37 ALK PHOS-85 AMYLASE-33 TOT BILI-0.4 [**2131-4-2**] 05:50PM GLUCOSE-99 UREA N-21* CREAT-0.7 SODIUM-141 POTASSIUM-3.6 CHLORIDE-100 TOTAL CO2-31* ANION GAP-14 [**2131-4-2**] CXR 1. No acute cardiopulmonary disease. 2. Stable tortuosity of the thoracic aorta consistent with an ascending aortic aneurysm. [**2131-4-10**] CXR Disappearance of tiny left apical pneumothorax. Persistent enlargement of the heart shadow and left lower lobe densities consistent with postoperative remaining pericardial effusion, left lower lobe atelectasis and pleural densities. Further followup to document embolization is recommended. [**Last Name (NamePattern4) 4125**]ospital Course: Ms. [**Known lastname **] was admitted to the [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 1675**] [**Last Name (NamePattern1) **] Medical Center on [**2131-4-2**] for surgical management of her aortic aneurysm. She was worked-up in the usual preoperative manner. The psychiatry service was consulted for her anxiety. It was recommended that Ms. [**Known lastname **] continue her paxil and ativan as per her at home doses. Levofloxacin and flagyl were started for a urinary tract infection. The infectious disease service was consulted and it was felt that her initial urinalysis was a vaginal contaminant. Repeat urinalysis was performed and she was cleared for surgery by the infectious disease service. On [**2131-4-3**], Ms. [**Known lastname **] was taken to the operating room where she underwent an ascending aorta replacement utilizing a 26 mm gelweave graft. Postoperatively she was taken to the cardiac surgical intensive care unit for monitoring. On postoperative day one, Ms. [**Known lastname **] [**Last Name (Titles) 5058**] neurologically intact and was extubated. She was transfused with packed red blood cells for postoperative anemia. On postoperative day two, she was transferred to the cardiac surgical step down unit for further recovery. Ms. [**Known lastname **] was gently diuresed towards her preoperative weight. The physical therapy service was consulted for assistance with her postoperative strength and mobility. Her pacing wires and drains were removed per protocol. Beta blockade was titrated for optimal heart rate and blood pressure control. Her diuretic was switched to hydrochlorothiazide for fluid management. Ms. [**Known lastname **] developed wheezing with ambulation. A chest x-ray showed a moderate left pleural effusion. Thoracentesis was performed which drained 700 cc's of fluid with good effect. Ms. [**Known lastname **] continued to make steady progress and was discharged home on postoperative day eight. She will follow-up with Dr. [**Last Name (Prefixes) **], her cardiologist and her primary care physician as an outpatient. Medications on Admission: Lipitor 20mg daily Hydrochlorothiazide 50mg once daily Multivitamin daily Atenolol 50mg once daily Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 2. Paroxetine HCl 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 3. Atorvastatin Calcium 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 4. Hydrochlorothiazide 50 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 5. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for pain. Disp:*50 Tablet(s)* Refills:*0* 6. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed. Disp:*30 Tablet(s)* Refills:*0* 7. Lopressor 50 mg Tablet Sig: One (1) Tablet PO twice a day. Disp:*60 Tablet(s)* Refills:*2* Discharge Disposition: Home With Service Facility: [**Location (un) 932**] Area VNA Discharge Diagnosis: s/p Asc Aortic Aneurysm repair (#26 Gelweave graft) PMH: HTN, ^chol, Depression, Anxiety Discharge Condition: good Discharge Instructions: keep wound clean and dry. OK to shower, no bathing or swimming. take all medications as prescribed. call for any fever, redness or drainage from wounds Followup Instructions: Dr [**Last Name (STitle) **] in [**3-30**] weeks Dr [**Last Name (STitle) **] in 4 weeks Completed by:[**2131-4-11**] ICD9 Codes: 2851, 5119, 4019, 2720
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Medical Text: Admission Date: [**2185-9-11**] Discharge Date: [**2185-9-19**] Date of Birth: [**2120-7-30**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2160**] Chief Complaint: hypertension Major Surgical or Invasive Procedure: none History of Present Illness: 65 yo male recently admitted to neurosurgery service at [**Hospital1 18**] from [**Date range (1) 9154**] after sustaining an unexplained fall after prolonged standing at work, who returned to [**Location **] today with persistent nausea, vomiting, and vertigo. The patient had been admitted for observation after a head CT showed a small longitudinal mastoid fracture and a small traumatic SAH along the lateral lining of the R. lower temporal bone. No surgical intervention was deemed necessary. The pt was also evaluated by ENT during that admission, noted to have fluid seen within the left middle ear cavity, possibly representing blood, on CT of temporal bones. Pt given Floxicin drops for 10 days with ENT follow-up in two weeks. . In the ED the patient was found to be hypertensive to the 200's systolic, improved with 20 mg IV labetalol. A CXR was thought to be concerning for a new infiltrate, and he was given a dose of levofloxacin. The patient underwent a repeat head CT which showed interval resolution of small subarachnoid hemorrhage, unchanged left temporal bone fracture. Neurosurgery was consulted and felt no surgical intervention necessary at this time. The patient was planned for admission to medicine for syncope workup, however his blood pressure became difficult to control and remained elevated despite 40 mg IV labetalol, 1 inch of nitropaste, and SL nitro. The patient was then started on a nitro drip with improvement of his blood pressure to 140's systolic and was admitted to the [**Hospital Unit Name 153**] for close monitoring and BP control. . On arrival to the floor patient states that he feels improved. Denies headaches, changes in vision, chest pain or SOB. Denies numbness or tingling in his extremities. No dysarthria. Denies orthopnea, no LE edema, no recent change in exercise tolerance. Has not had a history of syncope or falls in the past. Wife notes that he has been unable to keep down his medications, also notes "unsteady" on his feet, rises very slowly from sitting position. Repeat head ct is negative. he was converted to po anti-hypertensive medication and bp has been stable. Past Medical History: hypertension SAH s/p fall/syncope after prolonged standing at work Chronic gout- no flare for over a year Leg weakness NOS Pancreatic obstruction NOS 25 years ago, endoscopically released Social History: Lives with his wife, son, and daughter. [**Name (NI) 1403**] as a mechanic. Quit smoking over 30 years ago, no ETOH for 20+ years. Denies illicits. Family History: mother deceased age [**Age over 90 **], father died at age 55 of unknown cause, heavy drinker Physical Exam: vitals: 96.7 bp 150/72 hr 62/min RR 17/min sats 97% on RA GEN: comfortable at rest HEENT: PERLAA, oropharynx clear NECK: no LAD, no JVD, no carotid bruits CV: RRR, no murmurs or rubs, PMI non-displaced, LUNGS: CTA B/L w/ good inspiratory effort, no crackles or wheeze ABDOMEN: soft, nt, nd, hypoactive BS EXT: no [**Location (un) **], DP pulses palpable B/L SKIN: dry, no rash NEURO:CN II-XII grossly intact, A/O X3, normal finger-to-nose and heel to shin testing, no nystagmus Pertinent Results: [**9-11**] Head CT: 1. Interval resolution of blood products in the sulci of the anterior left temporal lobe, and occipital horns of the lateral ventricles. 2. Left temporal bone fracture, with persistent fluid/blood in that middle ear cavity, more completely evaluated and described on temporal bone CT from [**2185-9-9**]. . [**9-11**] CXR: FINDINGS: Two views are compared with the limited bedside AP examination labeled "trauma" dated [**2185-9-7**]. There is linear atelectasis at the left lung base with slight elevation of that hemidiaphragm, new. However, no evidence of focal consolidation is seen. The cardiomediastinal silhouette and pulmonary vessels are within normal limits, with no evidence of CHF. There are atherosclerotic changes involving the thoracic aorta. SEMI-UPRIGHT PORTABLE VIEW OF THE CHEST: Cardiac and mediastinal contours are normal. Left lower lobe atelectasis has decreased. There is interval development of pulmonary vascular engorgement without interstitial or alveolar edema. IMPRESSION: 1. New pulmonary vascular congestion without overt edema. 2. Interval improvement in left basilar atelectasis. . EKG: (not done in ED) sinus, Left bundle branch bloack, LAD, borderline PR interval . TTE [**2185-9-12**]: Conclusions: The left atrium is mildly dilated. The right atrium is moderately dilated. No atrial septal defect is seen by 2D or color Doppler. The estimated right atrial pressure is 0-5mmHg. There is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (LVEF>55%). There is no ventricular septal defect. Right ventricular chamber size and free wall motion are normal. The aortic root is moderately dilated at the sinus level. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. Mild (1+) mitral regurgitation is seen. There is borderline pulmonary artery systolic hypertension. There is no pericardial effusion. . Head CT [**2185-9-13**]: FINDINGS: At this time, it is extremely difficult to identify any intracranial hemorrhage. There has been no change in ventricular size since the prior examination nor evidence for new brain abnormality, including an infarct. There is re-demonstration of what is likely a 2-mm Virchow [**Doctor First Name **] space or sublenticular cyst, left-sided in locale. As the present examination is a head CT scan, the left temporal bone fracture is not clearly delineated at this time, compared to the high-resolution temporal bone study from [**9-9**]. CONCLUSION: No new intracranial pathology is defined [**2185-9-16**] 07:30AM BLOOD WBC-8.4 RBC-4.03* Hgb-13.3* Hct-35.7* MCV-89 MCH-33.1* MCHC-37.3* RDW-13.3 Plt Ct-216 [**2185-9-11**] 03:15PM BLOOD WBC-8.2 RBC-3.81* Hgb-12.7* Hct-33.6* MCV-88 MCH-33.4* MCHC-37.8* RDW-13.1 Plt Ct-194 [**2185-9-11**] 03:15PM BLOOD Neuts-81.9* Lymphs-13.8* Monos-3.3 Eos-0.6 Baso-0.4 [**2185-9-13**] 04:11AM BLOOD Hypochr-NORMAL Anisocy-1+ Poiklo-1+ Macrocy-NORMAL Microcy-1+ Polychr-1+ Spheroc-2+ Ovalocy-1+ Schisto-OCCASIONAL [**2185-9-15**] 07:50AM BLOOD PT-12.1 PTT-30.0 INR(PT)-1.0 [**2185-9-19**] 07:40AM BLOOD UreaN-16 Creat-0.6 Na-130* K-3.9 Cl-96 HCO3-25 AnGap-13 [**2185-9-15**] 07:50AM BLOOD Glucose-113* UreaN-15 Creat-0.6 Na-125* K-3.9 Cl-92* HCO3-23 AnGap-14 [**2185-9-11**] 03:15PM BLOOD Glucose-139* UreaN-9 Creat-0.6 Na-131* K-3.5 Cl-96 HCO3-26 AnGap-13 [**2185-9-11**] 03:15PM BLOOD ALT-21 AST-21 LD(LDH)-177 CK(CPK)-34* AlkPhos-60 Amylase-35 TotBili-0.6 [**2185-9-11**] 03:15PM BLOOD Lipase-19 [**2185-9-18**] 07:35AM BLOOD Mg-2.0 UricAcd-3.9 [**2185-9-16**] 07:30AM BLOOD Calcium-8.7 Phos-3.4 Mg-1.9 Cholest-187 [**2185-9-12**] 04:36AM BLOOD %HbA1c-8.5* [**2185-9-16**] 07:30AM BLOOD Triglyc-126 HDL-35 CHOL/HD-5.3 LDLcalc-127 [**2185-9-19**] 07:40AM BLOOD Osmolal-268* [**2185-9-13**] 06:12PM BLOOD Osmolal-273* [**2185-9-18**] 07:35AM BLOOD TSH-0.51 [**2185-9-18**] 07:35AM BLOOD Free T4-1.9* [**2185-9-18**] 07:35AM BLOOD Cortsol-12.0 [**2185-9-11**] 08:00PM URINE Color-Yellow Appear-Clear Sp [**Last Name (un) **]-1.018 [**2185-9-11**] 08:00PM URINE Blood-NEG Nitrite-NEG Protein-NEG Glucose-TR Ketone-150 Bilirub-NEG Urobiln-1 pH-7.0 Leuks-NEG [**2185-9-19**] 09:57AM URINE Osmolal-687 [**2185-9-13**] 02:20PM URINE Osmolal-717 [**2185-9-16**] 08:07PM URINE Osmolal-396 [**2185-9-18**] 05:22PM URINE Osmolal-617 [**2185-9-19**] 09:57AM URINE Hours-RANDOM UreaN-1205 Creat-124 Na-58 K-20 [**2185-9-13**] 02:20PM URINE Hours-RANDOM UreaN-605 Creat-93 Na-175 K-46 Cl-122 HCO3-LESS THAN [**2185-9-11**] 08:00PM URINE Blood-NEG Nitrite-NEG Protein-NEG Glucose-TR Ketone-150 Bilirub-NEG Urobiln-1 pH-7.0 Leuks-NEG [**2185-9-11**] 08:00PM URINE Color-Yellow Appear-Clear Sp [**Last Name (un) **]-1.018 Brief Hospital Course: Hypertension- Initially controlled with IV labetolol and ntg in the ICU, transitioned to oral medications on floor. Eventually BP was fairly controlled on 40 mg lisinopril daily, 12.5 mg of metoprolol [**Hospital1 **] and amlodipine 5 mg daily. These may need to be further titrated with PCP. [**Name10 (NameIs) **] morning of discharge, he accidentally got a dose of 25 mg metoprolol po x1 instead of 12.5 mg by the RN. He was asymptomatic at discharge. He denied dizziness or any other symptoms. He was monitored for many hours after this dose and was stable in terms of the vital signs. Vitals at discharge were: T -98.8 BP - 136/76, P - 59, RR -18, O2 sats 98% RA. He was advised to not take the metoprolol at home for tonight i.e. day of discharge. However, he was advised to start taking it on Tuesday [**2185-9-20**]. Nursing visits were set up at home for BP monitoring. SAH - repeat CT head did not show worsening of bleed. Cleared by neurosurgery. Occasionally complained of headache, and was treated with prn dosing of tylenol and oxycodone with good control of symptoms. Nausea/Vomiting- Had significant n/v initially and was not tolerating PO's. Slowly improved to regular POs and significant. Symptoms completely resolved at discharge and he was tolerating po diet well. Continued with ear drops as directed by ENT. ENT follow up arranged at discharge with Dr [**Last Name (STitle) 3878**] (as recommended by the receptionist it Dr[**Name (NI) 18353**] office - [**Doctor First Name 2411**]) SIADH, Hyponatremia was likely related to the intracranial process. Renal was consulted as despite fluid restriction, sodium remained low. Patient however, was asymptomatic. However, without any other treatment other than fluid restriction to 1 lit / 24 hours, sodium improved to 130. An urgent care appt was scheduled for this week at [**Company 191**] for rechecking Na levels and well as BP check. Anemia- hct stable, no signs of active bleeding seen. Will need further evaluation by PCP as outpatient. Impaired glucose tolerance - HbA1c was high but blood sugars were not very high. Mainly < 150. Not started on treatment. patient to discuss this with new PCP. Syncope - in past. Etiology unclear. It is not known if the SAH preceeded the syncope or was the cause of syncope. No recurrence. No arrythmias noted. ECG at the prior admission showed left bundle branch block. Repeat ECG this admit showed same. Per Dr [**Last Name (STitle) **] who saw patient at admit to floor, no older ECG at [**Hospital 1263**] hospital(where pt got prior care). Patient advised to discuss this with new PCP for further [**Name9 (PRE) 8019**]. Chronic gout- stable on allopurinol . PT consult given fall - initially tried to work with him on medical floor, but BP increased with SBP greater than 200mm Hg with any activity. With better BP control with oral meds, he was able to walk with PT. An out-patient stres evaluation is recommended. PT cleared patient for discharge home. Should also get follow up F T4 (mildly high) in [**5-13**] weeks with new PCP. Medications on Admission: 1. Acetaminophen 325-650 mg PO Q6H:PRN HydrALAzine 10 mg IV Q6H PRN SBP > 175 Allopurinol 200 mg PO DAILY Insulin SC (per Insulin Flowsheet)Sliding Scale Captopril 37.5 mg PO TID Labetalol 0.5-2 mg/min IV DRIP TITRATE TO SBP < 160 Ciprofloxacin 0.3% Ophth Soln 3 DROP BOTH EARS TID Metoprolol 12.5 mg PO BID HYDROmorphone (Dilaudid) 0.5 mg SC Q4-6H:PRN Pantoprazole 40 mg IV Q24H Heparin 5000 UNIT SC TID Prochlorperazine 10 mg PO/IV Q6H:PRN nausea Discharge Medications: 1. Allopurinol 100 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Disp:*60 Tablet(s)* Refills:*0* 2. Ciprofloxacin 0.3 % Drops Sig: Three (3) Drop Ophthalmic TID (3 times a day) for 5 days: to both ears . Disp:*1 bottle* Refills:*0* 3. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day): Start taking this medicine [**2185-9-20**]. Disp:*60 Tablet(s)* Refills:*0* 4. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*90 Capsule(s)* Refills:*0* 5. Lisinopril 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Disp:*90 Tablet(s)* Refills:*0* 6. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. Disp:*45 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 7. Amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*60 Tablet(s)* Refills:*0* 8. Outpatient Lab Work Sodium level. To be checked on [**2185-9-21**] by Dr [**First Name4 (NamePattern1) 488**] [**Last Name (NamePattern1) 6401**] in urgent care - [**Company 191**]. [**Telephone/Fax (1) 250**] Discharge Disposition: Home With Service Facility: Caregroup home Care Discharge Diagnosis: Subarachnoid hemorrhage and skull fracture Hypertension SIADH Syncope Left bundle branch block Impaired glucose tolerance Gout Discharge Condition: Stable Discharge Instructions: Take all medications as prescribed. Your have requested a new primary care physician at our hospital. An appointment has been made for you as below. Please keep your appointments. Your new primary care doctor will be Dr [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **]. The appointment for this doctor is in [**Month (only) **] [**2185**], but we have also made another appointment for this week for a follow up on the blood test. Call your doctor or return to the ED if you experience any: Worsening headache Lightheadedness Dizziness, pass out Nausea and vomiting Visual changes (double vision, blurred vision) Numbness or weakness of the arms or legs Your sodium level has been low and it is recommended that you follow up with the doctor on [**2185-9-21**] for monitoring blood tests for sodium level. You should also take less than 1 liter of fluids a day to maintain the sodium levels in your blood. Your blood sugars were ocassionally reported to be mildly high. Please adhere to the diet the nurse has discussed with you. You shoudl discuss these high blood sugars with your primary doctor, Dr [**First Name (STitle) **]. Also, your ECG was abnormal and has a 'left bundle branch block'. It is recommended that you discuss this with your Dr [**First Name (STitle) **] as well. You may need a stress test for your heart. This can arranged by your primary doctor. Do not take the evening dose of metoprolol (a BP pill) today i.e. [**2185-9-19**]. You should resume the prescribed dosing starting [**2185-9-20**]. Followup Instructions: [**Hospital1 18**], [**Location (un) 86**] - [**Hospital6 **] [**2185-10-25**] at 1330hrs, [**Hospital Ward Name 23**] 6 with Dr [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], your new primary care doctor. The tel number to his clinic is [**Telephone/Fax (1) 250**]. It is also recommended that you go for a urgent care visit at the [**Hospital6 **] ([**Hospital Ward Name 23**] 1) with Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] on Tuesday [**2185-9-21**] at 1330hrs This is to check blood work for sodium levels. ENT - Dr. [**Last Name (STitle) 3878**] - [**2185-9-30**] at 3pm. ([**Location (un) **], [**Location (un) **], MA ([**Telephone/Fax (1) 7767**] ICD9 Codes: 2859, 2749
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6686 }
Medical Text: Admission Date: [**2146-12-1**] Discharge Date: [**2146-12-5**] Date of Birth: [**2097-7-3**] Sex: M Service: MEDICINE Allergies: Penicillins Attending:[**First Name3 (LF) 20128**] Chief Complaint: AMS, tachycardia Major Surgical or Invasive Procedure: none History of Present Illness: 49 year old male with history of HTN, Hep C, alcohol abuse, epilepsy [**12-21**] TBI after motorcycle accident presents with AMS, tachycardia, and auditory and visual hallucinations. Patient had gone to a cognitive neurology clinic visit today, was noted to be acting strange, complaining of progressive short term memory loss for the last 6-8 weeks. His case worker accompanied him, says that this is very different from his baseline mental status. He was sectioned at cognitive neuro and sent to the ED. Patient reports having auditory and visual hallucinations for the last several months. Visual hallucinations are of bugs flying around his head, also states that he has been hearing voices; a few nights ago, felt that someone was hiding behind his chair trying to hurt him. Denies active SI; when asked about HI states "I feel like throttling someone". Endorses history of depression and anxiety, but denies previous psych hospitalizations or suicide attempts. Does not take psych meds or follow with a therapist. Baseline ETOH abuse (several "gallons" per day, beer and vodka), but states last drink 3 days ago. . In the ED, his initial vitals were: 98.7, 134, 134/93, 20, 98% RA. He was triggered for mental status and tachycardia. He got 3L of IV fluids, including a banana bag. Was treated with ativan 2mg IV x2, valium 10 mg PO x1, and valium 5 mg IV x1. His heart rate persisted in the 130's despite fluids and benzos. His blood pressure and respiratory rate remained stable. EKG was notable for sinus tachycardia. His neuro exam in the ED was nonfocal. He was confused and appeared to be hallucinating. Following the benzos, he was able to be aroused and have conversations, but was sleepy. Labs notable for white count of 13 and creatinine of 2.5 (baseline 1.0). Vitals prior to transfer were: 112/70, 130, 19, 99%. . In the MICU, patient was sleepy and occasionally fell asleep during the interview but was easily arousable. He had somewhat slowed speech and flat affect but did not appear to be actively hallucinating. His mini mental status score was 20/30. Pt [**Month/Day (2) 15797**] fever, chills, nausea, vomiting, abd pain, headache, stiff neck, weight loss. Did endorse intermittent racing heart. Tachycardia improved from 130 to 100 without further intervention. . 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, or weakness. Denies nausea, vomiting, diarrhea, constipation, abdominal pain, or changes in bowel habits. Denies dysuria, frequency, or urgency. Denies arthralgias or myalgias. Denies rashes or skin changes. Past Medical History: 1. Obstructive sleep apnea. 2. History of gastric ulcer. 3. Status post appendectomy. 4. Hypertension. 5. Hepatitis C. 6. Alcohol dependence since the age of 15 7. Epilepsy [**12-21**] TBI Social History: Lives alone in apartment, unemployed and on disability. H/o multiple arrests including A&B since adolescence and a charge of attempted murder (beating his stepfather) which was eventually dismissed. Reports biological father raped him multiple times when patient was four years old to get back at patient's mother. Lost custody of his children (multiple mothers) who are now in [**Doctor Last Name **] care. IVDU, cocaine, MJ and crack; last drug use 3 months ago (cocaine). Continues to drink heavily (as above). Denies smoking. Family History: One sister with brain tumor. Substance abuse including alcohol in multiple family members including siblings and father. Physical Exam: Vitals: BP: 124/83 P: 95 R: 18 O2: 99% RA General: Alert, oriented x 2, drowsy but easily arousable, 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: tachycardic, regular rhythm, normal S1 + S2, no murmurs, rubs, gallops Abdomen: obese, soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly GU: no foley Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Neuro: strength 5/5, sensation intact, no dysmetria, no drift, CN 2-12 intact. Pertinent Results: Admission Labs: [**2146-12-1**] 05:30PM BLOOD WBC-13.4*# RBC-5.38 Hgb-15.8 Hct-46.0 MCV-86 MCH-29.3 MCHC-34.2 RDW-15.6* Plt Ct-180 [**2146-12-2**] 12:16AM BLOOD WBC-8.9 RBC-4.45* Hgb-13.4* Hct-38.0* MCV-85 MCH-30.0 MCHC-35.1* RDW-15.4 Plt Ct-123* [**2146-12-1**] 05:30PM BLOOD PT-13.6* PTT-23.2 INR(PT)-1.2* [**2146-12-1**] 05:30PM BLOOD Glucose-76 UreaN-25* Creat-2.5*# Na-136 K-3.6 Cl-92* HCO3-26 AnGap-22* [**2146-12-2**] 12:16AM BLOOD Glucose-107* UreaN-23* Creat-1.6* Na-136 K-3.2* Cl-99 HCO3-26 AnGap-14 [**2146-12-1**] 05:30PM BLOOD ALT-44* AST-60* AlkPhos-64 TotBili-1.9* [**2146-12-2**] 12:16AM BLOOD ALT-35 AST-44* LD(LDH)-183 AlkPhos-50 TotBili-1.2 [**2146-12-1**] 05:30PM BLOOD Lipase-44 [**2146-12-2**] 12:16AM BLOOD Lipase-43 [**2146-12-2**] 12:16AM BLOOD cTropnT-<0.01 [**2146-12-1**] 05:30PM BLOOD Calcium-10.3 Phos-5.7*# Mg-2.0 [**2146-12-2**] 03:40PM BLOOD Albumin-4.0 Calcium-9.4 Phos-2.9 Mg-1.8 [**2146-12-2**] 12:16AM BLOOD VitB12-401 Folate-GREATER TH [**2146-12-2**] 12:16AM BLOOD TSH-2.8 [**2146-12-1**] 05:30PM BLOOD ASA-NEG Ethanol-NEG Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG URINE CULTURE (Final [**2146-12-2**]): NO GROWTH. RAPID PLASMA REAGIN TEST (Final [**2146-12-5**]): NONREACTIVE. Reference Range: Non-Reactive. EKG [**12-1**]: Probable sinus tachycardia. Diffuse ST-T wave changes which are non-specific. Compared to the previous tracing of [**2145-10-7**] profound sinus tachycardia is new. CXR: FINDINGS: The study is limited by body habitus and AP portable technique. Please note the left lung base is difficult to assess. Overall no focal consolidation is identified. However, lung volumes are markedly diminished with resultant bronchovascular crowding. No frank failure is identified. There is mild prominence of the central pulmonary vasculature again in part due to low lung volumes although mild element of vascular congestion cannot be excluded. The mediastinum is distorted due to low lung volumes. The cardiac silhouette size is exaggerated by the same. No definite effusion or pneumothorax is seen. IMPRESSION: Limited study due to factors above. No gross consolidation or failure noted. CT Head: IMPRESSION: 1. No acute intracranial process. 2. Marked cerebral and cerebellar atrophy. 3. Left anterior temporal encephalomalacia. Discharge Labs: [**2146-12-3**] 06:50AM BLOOD WBC-5.4 RBC-4.43* Hgb-13.1* Hct-38.5* MCV-87 MCH-29.6 MCHC-34.0 RDW-15.6* Plt Ct-124* [**2146-12-3**] 06:50AM BLOOD PT-12.1 INR(PT)-1.0 [**2146-12-5**] 06:20AM BLOOD Glucose-86 UreaN-15 Creat-0.9 Na-139 K-3.7 Cl-101 HCO3-30 AnGap-12 [**2146-12-3**] 06:50AM BLOOD ALT-27 AST-29 AlkPhos-45 [**2146-12-3**] 06:50AM BLOOD Calcium-9.1 Phos-2.9 Mg-1.8 Brief Hospital Course: 49 year old male with history of alcohol withdrawal complicated by seizures presents with sinus tachycardia, altered mental status and auditory/visual hallucinations. . # Alcoholic withdrawal - Patient was monitored in ICU overnight for withdrawal. Did not require any valium once on the floor. No signs/symptoms of withdrawal. Was continued on thiamine, folate, MVI. . # Mental status change - Unsure of the etiology. Seems chronic in nature with several week history of auditory/visual hallucinations. Psych and neurology saw patient and thought problems were secondary to either alcohol withdrawal, Korsokoff's, or traumatic brain injury. CT head negative for acute intracranial pathology. Patient discharged with instructions to follow up with cognitive neuro for testing. . # Acute renal failure - Pre-renal with creatinine of 2.5 on admission. Improved to 1.0 with intravenous fluids. . # HTN - Patient was not controlled on home regimen. Metoprolol and hydrochlorthiazide were uptitrated with better control. Inactive Issues - Cognitive neurology testing - Oral surgeon follow-up for right tongue lesion Medications on Admission: 1. multivitamin 1 tab daily 2. folic acid 1 mg daily 3. metoprolol succinate 25 mg daily 4. levetiracetam 1500 mg [**Hospital1 **] 5. hydrochlorothiazide 12.5 mg daily Discharge Medications: 1. multivitamin Capsule Sig: One (1) Capsule PO once a day. 2. folic acid 1 mg Tablet Sig: One (1) Tablet PO once a day. 3. metoprolol succinate 50 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO once a day. Disp:*30 Tablet Sustained Release 24 hr(s)* Refills:*0* 4. levetiracetam 500 mg Tablet Sig: Three (3) Tablet PO twice a day. 5. hydrochlorothiazide 25 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*0* 6. Vitamin B-12 250 mcg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*0* 7. thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: Primary: Altered Mental status, hypertension Discharge Condition: Mental Status: Confused - sometimes. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Dear Mr. [**Known lastname 732**], It was a pleasure taking care of you during your hospitalization. You were admitted because of altered mental status noted at your cognitive neurology appointment. This was thought to be secondary to withdrawal from alcohol as you had recently stopped drinking. You were monitored in the Intensive care unit for any signs of withdrawal and then were transferred to the general medicine floor. You had no signs of withdrawal while on the general medicine floor. You were seen by our psychiatrists and neurologsits who thought that your memory problems were either due to something called Korsakoff's syndrome, which can be caused from too much drinking, or from the trauma you suffered in your accident. You should not drink any more alcohol as this will lead to more problems with your thinking and memory. We noted your blood pressure to be elevated so we increased the dosage of your blood pressure medications. We made the following changes to your medications. INCREASED metoprolol succinate to 50mg by mouth daily hydrochlorthiazide (HCTZ) to 25mg by mouth daily ADDED Vitamin B12 250 mcg by mouth daily Thiamine 100mg by mouth daily Please follow-up with Dr. [**First Name (STitle) **] and your cognitive neurologist. Followup Instructions: Please follow-up with Dr. [**First Name (STitle) **] in the next 1-2 weeks for an appointment. His phone number is [**Telephone/Fax (1) 608**]. You will also need to talk to him about seeing an Oral surgeon to follow-up the swelling of your tongue. You need to reschedule your appointment with Cognitive Neurology to be reassessed. Department: RADIOLOGY When: WEDNESDAY [**2147-2-1**] at 9:30 AM With: ULTRASOUND [**Telephone/Fax (1) 327**] Building: CC CLINICAL CENTER [**Location (un) **] Campus: WEST Best Parking: [**Doctor First Name **]. GARAGE Department: LIVER CENTER When: WEDNESDAY [**2147-2-1**] at 10:40 AM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 7128**], MD [**Telephone/Fax (1) 2422**] Building: LM [**Hospital Unit Name **] [**Location (un) 858**] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] MD [**MD Number(2) 20129**] Completed by:[**2146-12-6**] ICD9 Codes: 5849
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6687 }
Medical Text: Admission Date: [**2152-2-2**] Discharge Date: [**2152-2-23**] Date of Birth: [**2152-2-2**] Sex: M Service: HISTORY OF PRESENT ILLNESS: This is an interim summary covering the dates between [**2152-2-2**] and [**2152-2-23**]. This is a 21 day old male infant, with a corrected gestational age of 34 weeks. He was born at 30 weeks gestation to a 36 year old, Gravida II, Para 0 to 2 woman. The pregnancy was complicated by preterm labor and the mother received a course of Betamethasone earlier in the pregnancy. She presented with a second episode of preterm labor and was noted to have a prolapsed cord. This infant was delivered via stat cesarean section. Birth weight was 1,290 grams. Rupture of membranes was unknown and clear fluid was noted at the time of delivery. The infant emerged vigorous with good spontaneous respiratory effort; however, he required bagged mask ventilation for poor air entry and respiratory distress. He was intubated in the delivery room. Apgars were 6 and 8. He was brought to the Neonatal Intensive Care Unit for prematurity and respiratory distress. PHYSICAL EXAMINATION: General: Pink, active infant in mild respiratory distress. HEAD, EYES, EARS, NOSE AND THROAT: Narrow palpebral fissures. Palate examination deferred. Orally intubated. Cardiovascular: Normal, regular rate and rhythm, normal S1 and S2, no murmurs. Normal pulses in the upper and lower extremities. Lungs: Good air entry; breath sounds coarse bilaterally. Mild retractions. Abdomen: Soft, nontender, nondistended, three vessel cord. Genitourinary: Normal male external genitalia with testes palpable in canals bilaterally. Neurologic: Tone appropriate for gestational age; moving all extremities bilaterally. Immature reflexes. HOSPITAL COURSE: 1.) Respiratory: The infant received one dose of Surfactant replacement therapy and was extubated shortly afterwards. He remained on C-Pap for one additional day and since then, has been on room air. He did have apnea of prematurity which was noted on day of life two. He has been on caffeine since day of life five with minimal ongoing apnea of prematurity. 2.) Cardiovascular: The infant has been hemodynamically stable. He has no murmur. 3.) Fluids, electrolytes and nutrition: The infant was advanced slowly on enteral feedings. During that time, he did receive parenteral nutrition given his low birth weight. He is currently on full enteral feedings, of which he is able to take by mouth. He is receiving premature Enfamil 26 calories per ounce with ProMod. He has been growing well. 4. Gastrointestinal: Peak bilirubin was 7.2 on day of life The infant was treated with single phototherapy until day of life 11. He has no clinical jaundice. 6. Hematologic: The infant has not received any transfusion. Most recent hematocrit was 44 on [**2-18**]. He has no signs or symptoms of anemia. 7. Infectious disease: The infant was initially started on Ampicillin and Gentamycin, given his prematurity and respiratory distress. His blood culture remained negative and antibiotics were discontinued at 48 hours. He has no current active infectious issues. 8. Neurologic: Head ultrasound on day of life 7 was negative. 9. Sensory: The patient will require both audiologic screening and ophthalmic examination prior to discharge. 10. Psychosocial: The [**Hospital1 69**] social worker has been involved with the family. CONDITION: Stable. NAME OF PRIMARY PEDIATRICIAN: Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **]. IMMUNIZATIONS RECEIVED: None. DISCHARGE DIAGNOSES: 1. Prematurity. 2. Respiratory distress syndrome. 3. Rule out sepsis. 4. Hyperbilirubinemia. 5. Breathing immaturity. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 36142**], M.D. [**MD Number(1) 36143**] Dictated By:[**Last Name (NamePattern1) 52805**] MEDQUIST36 D: [**2152-2-23**] 01:55 T: [**2152-2-23**] 15:18 JOB#: [**Job Number 52979**] ICD9 Codes: 769, 7742, V290
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Medical Text: Admission Date: [**2166-2-8**] Discharge Date: [**2166-2-13**] Date of Birth: [**2121-12-5**] Sex: M Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1556**] Chief Complaint: stab to R neck Major Surgical or Invasive Procedure: s/p exploration of wound, R neck (at bedside) History of Present Illness: This is a 44 y/o gentleman who takes coumadin for a recent DVT, who was Medflighted from [**Hospital3 **] with a self-inflicted stab wounds to his right neck. Estimated blood loss was 500 mL. He was intubated for airway protection at the OSH and transferred to [**Hospital1 18**] in stable condition. He had already received FFP and packed red cells upon arrival. Past Medical History: depression; severe schizophrenia; R leg DVT [**12-13**], on coumadin; MI '[**62**]; hx of coumadin/lovenox/glyburide overdose Social History: Unknown. Family History: Unknown. Physical Exam: Upon arrival in the [**Hospital1 18**]: Intubated, sedated. HR 97, BP 120/p, 100% on ventilator R neck: approximately 0.5 cm deep, 6 cm long laceration, active bleeding. L neck: superficical lac. Cor reg. Chest clear Abd soft. No obvious injury to any extremity. Spine: No stepoffs or malalignment noted. Pertinent Results: [**2166-2-8**] 09:00PM WBC-18.4* RBC-2.42* HGB-6.7* HCT-20.1* MCV-83 MCH-27.8 MCHC-33.6 RDW-14.7 [**2166-2-8**] 09:00PM PLT COUNT-195 [**2166-2-8**] 01:15PM TYPE-ART TEMP-38.3 RATES-/25 TIDAL VOL-500 PEEP-5 O2-50 PO2-184* PCO2-38 PH-7.42 TOTAL CO2-25 BASE XS-0 INTUBATED-INTUBATED VENT-SPONTANEOU [**2166-2-8**] 01:15PM GLUCOSE-120* LACTATE-1.4 [**2166-2-8**] 01:15PM freeCa-1.15 [**2166-2-8**] 01:03PM GLUCOSE-111* UREA N-19 CREAT-1.4* SODIUM-141 POTASSIUM-3.4 CHLORIDE-107 TOTAL CO2-24 ANION GAP-13 [**2166-2-8**] 01:03PM CALCIUM-8.1* PHOSPHATE-3.1 MAGNESIUM-2.0 [**2166-2-8**] 12:12PM URINE COLOR-LtAmb APPEAR-SlCldy SP [**Last Name (un) 155**]-1.015 [**2166-2-8**] 12:12PM URINE BLOOD-NEG NITRITE-NEG PROTEIN-30 GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-1 PH-6.5 LEUK-NEG [**2166-2-8**] 01:03PM PT-26.7* PTT-36.1* INR(PT)-2.7* Brief Hospital Course: Pt was admitted to the T-SICU after wound exploration in the emergency room. An active bleeding vessel was tied off and hemostasis was obtained. A CTA of the neck was performed which was negative for any large vessel injury. The pt was begun on levofloxacin because of a history of aspiration during a self-extubation attempt at the OSH, and a chest xray revealed a R upper lobe consolidation. On HD 2 the pt was extubated without event and transferred to the floor. Wound care was performed on his neck wound, which improved in appearance. He was evaluated by ENT and thought to have normal vocal cord function, and a barium swallow study showed no leakage of contrast from the esophagus. His diet was advanced and psychiatry was consulted for dispo planning and follow-up. On HD 4 the pts coumadin was restarted. On the advice of psychiatry the pt was maintained on IV Haldol. Serial EKG's were checked with normal QTc intervals. On HD 6 he was discharged to the Deaconass 4 psychiatric unit in stable condition, with instructions for wound care, INR checks and to continue levofloxacin for 6 days. Medications on Admission: Coumadin 5', Lamictal 25', Seroquel 200', Prevacid 30', Lipitor 40'; ToprolXL 50', glyburide 2.5", lisinopril 10' Discharge Medications: 1. Lansoprazole 30 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 2. Warfarin 5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 3. Atorvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Metoprolol Succinate 50 mg Tablet Sustained Release 24HR Sig: One (1) Tablet Sustained Release 24HR PO DAILY (Daily). 6. Glyburide 2.5 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 7. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours) for 6 days. 8. Haloperidol Lactate 5 mg/mL Solution Sig: One (1) mL Injection [**Hospital1 **] (2 times a day). Discharge Disposition: Home with Service Discharge Diagnosis: s/p stab wound to R neck Discharge Condition: Good. Discharge Instructions: 1) Resume all your home medications at their usual doses. 2) Have your INR checked twice a week and phone results to your primary care doctor-- [**Doctor First Name **] Caticha, Phone ([**Telephone/Fax (1) 66479**]. 3) Wet to dry dressings on your neck wound by nursing [**Hospital1 **]. Followup Instructions: Trauma clinic in 2 weeks: call [**Telephone/Fax (1) 6439**] to schedule an appointment. Completed by:[**2166-2-13**] ICD9 Codes: 5070, 311, 412
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Medical Text: Admission Date: [**2162-10-4**] Discharge Date: [**2162-10-11**] Date of Birth: [**2091-11-13**] Sex: F Service: MEDICINE Allergies: Penicillins / Sulfonamides / Latex / Lactose Attending:[**First Name3 (LF) 3283**] Chief Complaint: Fever, tachycardia Major Surgical or Invasive Procedure: None History of Present Illness: 70yo with PMH significant for chronic afib on coumadin, rate-controlled, and relatively recent soft tissue surgery with fever, cough productive of brown sputum x 4 d, starting 1d after receiving DTaP and pnuemovax. + cough, shaking chills, + lethargy, describes poor/minimal po intake. - dysuria, + loose stools x 2 months. No CP, SOB, n/v/diarrhea. . Went to [**Company 191**], where she was 101.5 in office, O2 sats 97%, crackles at right base, with HR in the 180s. She was then sent to ED for IV fluids, blood cultures, CXR, antibiotics. In ED, initially, SBPs >100, but SBPs dropped to 70s upon standing for CXR. Got IVFs, BP unresponsive, so sepsis line placed and started on neosynephrine. Asymptomatic throughout. CXR showed RLL PNA, so pt. was started on ceftriaxone/azithromycin. Lactate 2.3-->1.8. Pt. got cardiology consult in ED, who recommended not to start amio, and to treat infectious process. Past Medical History: atrial fibrillation, was on amio, but stopped [**1-1**] achilles tendonitis osteoarthritis rectal prolapse hyperlipidemia osteopenia Social History: Worked as psychiatric social worker at [**Hospital1 18**] in past, currently in private practice as a psychologisy Smoke until [**2126**], no smoking since. + occasional ETOH. Family History: nc Physical Exam: On admission: Vitals: 99.1, 123/87 on 1 mg/kg/min neo, 135 in Afib, 20/ 95% on 3L SvO2 75%, CVP 14-16 Gen: tired appearing, pleasant, cooperative, NAD HEENT: PERRL, EOMI, MM slightly dry. CV: tachy, irrefularly irregular, no MRGs noted Pulm: decreased BS R base, + mild crackles and egophany in same area. no wheezes Abd: soft, non distended, nontender, +BS Ext: lukewarm extremiteis, DP 2+ bilaterally Neuro/Psych: Alert and oriented, CN III-XII individually tested and intact Pertinent Results: [**2162-10-4**] 11:40AM BLOOD WBC-9.6 RBC-4.36 Hgb-14.1 Hct-42.3 MCV-97 MCH-32.3* MCHC-33.3 RDW-12.8 Plt Ct-237 [**2162-10-9**] 07:55AM BLOOD WBC-17.5* RBC-3.52* Hgb-11.6* Hct-34.0* MCV-96 MCH-32.9* MCHC-34.1 RDW-14.3 Plt Ct-341 [**2162-10-11**] 10:00AM BLOOD WBC-10.9 RBC-3.59* Hgb-11.8* Hct-35.1* MCV-98 MCH-32.9* MCHC-33.6 RDW-13.6 Plt Ct-473* [**2162-10-4**] 09:35PM BLOOD Neuts-76.0* Bands-0 Lymphs-19.3 Monos-3.5 Eos-0.5 Baso-0.7 [**2162-10-11**] 10:00AM BLOOD Glucose-143* UreaN-19 Creat-1.1 Na-140 K-4.1 Cl-106 HCO3-30 AnGap-8 [**2162-10-4**] 11:40AM BLOOD Glucose-127* UreaN-18 Creat-1.0 Na-137 K-3.9 Cl-102 HCO3-23 AnGap-16 [**2162-10-11**] 10:00AM BLOOD Calcium-9.4 Phos-3.2 Mg-2.2 [**2162-10-4**] 11:40AM BLOOD TSH-0.64 [**2162-10-7**] 05:15AM BLOOD VitB12-669 Folate-12.1 [**2162-10-4**] 11:40AM BLOOD T4-7.2 [**2162-10-5**] 05:06AM BLOOD Cortsol-34.6* [**2162-10-4**] 11:34PM BLOOD Cortsol-12.5 [**2162-10-4**] 03:44PM BLOOD Lactate-2.3* [**2162-10-5**] 02:08AM BLOOD Lactate-1.5 CXR [**10-4**]: 1. Right IJ CVL tip within the mid SVC. No evidence of pneumothorax. 2. Developing right lower lobe pneumonia CXR [**10-8**]:In comparison with the study of [**10-6**], there is again an area of increased opacification at the right base medially consistent with the clinical impression of pneumonia. This appears to be less prominent than on the previous examination. The right central catheter has been removed. Brief Hospital Course: 70yo with chronic Afib with hypotension and afib with RVR, likely pneumonial sepsis . # Afib with RVR: It was felt to be likely an exacerbation secondary to infection. Her TSH was normal. Given her hypotension, we initially avoided diltiazem and beta blockade. She was digoxin loaded for rate control with good effect, and as blood pressure increased, changed to beta blocade with uptitration of metoprolol. Cardiology recommended against amiodarone given thyroid toxicity. Upon transfer to the floor her metoprolol was further uptitrated to the maximum dose of 450mg per day. While her blood pressure remained stable in the 100s/60s, her HR continued to be in the 120's with increases to 140-150 upon ambulation. She was again digoxin loaded and begun on a standing dose of 0.125mg daily. This controlled her HR well and allowed her metoprolol to be decreased to 100mg PO TID. She restarted on her coumadin at 5mg but her INR became supratherapeutic, likely in conjuction with the levofloxacin. Her coumadin was held and her INR was allowed to drift to therapeutic levels, after which she was started on 2mg daily with stabilization of her INR betwen [**1-2**]. this will continue to be monitored by her PCP and [**Hospital3 **]. . # Sepsis. She was nitially treated with IV boluses to keep CVP>8, maintaining SvO2 >70%, (no dobutamine given tachycardia, and hct was above 30, and neo for MAPs>65. Given her infiltrate on CXR and focal exam, pt. was thought to have community-acquired pneumonial sepsis and changed from CTX/Azithromycin to levofloxacin day 1 [**2162-10-4**]. She became HD stable and was taken of the neosynephrine and the central line was removed. She was then transfered to the floor. Blood cultures and sputum cultures were NGTD at the time of discharge. She became afebrile with stable blood pressures and breathing comfortably on room air. She was discharged to complete a 14 day course of levofloxacin with follow up from her PCP/ . # GI: She developed diarrhea after starting levofloxacin. C.diff was negative x 2 with resolution of her diarrhea after several Percocet to control her chronic arthritis pain. # hypothyroidism: Continued on her home levothyroxine with good effect. # hyperlipidemia: continued on her home atorvastatin with good effect # Arthritis: continued on home regimen of celebrex, percocet, valium prn with minimal use and good effect. # osteopenia: continued on alendronate, calcium, and vitamin D Medications on Admission: Amitriptyline HCl 25 mg qhs CALCIUM 500 mg qdaily CELEBREX 200 mg qdaily Capsaicin 0.035%--apply to left wrist area, scar twice per day DUCODYL 5 mg--2 (two) tablet(s) by mouth once a day ESTRING 7.5 mcg/24 hour--one every 3 months FOSAMAX 70MG - One q week Fish Oil 1,000 mg--1 (one) cap qdaily Glucosamine Chondroitin SMConc 750 mg-600 mg-55 mg-5 mg; 1 qdaily LIPITOR 10MG qdaily Levothyroxine 50 mcg qdaily, 75mcg on sundays. MULTIVITAMIN qdaily PERCOCET 5 mg-325 mg--[**12-1**] tabq4h PRN TOPROL XL 75qdaily VALIUM 5MG tidPRN VITAMIN C 1,000 mg--[**Hospital1 **] WARFARIN 2.5 mg m,w,f,sa,[**Doctor First Name **] 5 mg tu,th Discharge Medications: 1. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 2. Celecoxib 200 mg Capsule Sig: One (1) Capsule PO qdaily (). 3. Flaxseed Oil Capsule Sig: One (1) Capsule PO DAILY (Daily). 4. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Levothyroxine 75 mcg Tablet Sig: One (1) Tablet PO QSUN (every Sunday). 6. Levothyroxine 50 mcg Tablet Sig: One (1) Tablet PO QDAILY MONDAY THROUGH SATURDAY (). 7. Hexavitamin Tablet Sig: One (1) Cap PO DAILY (Daily). 8. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. 9. Diazepam 5 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours) as needed for pain , stiffness. 10. Ascorbic Acid 500 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 11. Levofloxacin 250 mg Tablet Sig: Three (3) Tablet PO DAILY (Daily) for 10 days. Disp:*30 Tablet(s)* Refills:*0* 12. Warfarin 2 mg Tablet Sig: One (1) Tablet PO DAILY16 (Once Daily at 16). Disp:*30 Tablet(s)* Refills:*2* 13. Digoxin 125 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 14. Amitriptyline 25 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 15. Guaifenesin 100 mg/5 mL Syrup Sig: 5-10 MLs PO Q6H (every 6 hours) as needed. Disp:*100 ML(s)* Refills:*0* 16. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day) as needed for constipation. Disp:*30 Capsule(s)* Refills:*0* 17. Senna 8.6 mg Capsule Sig: One (1) Capsule PO twice a day as needed for constipation. Disp:*30 Capsule(s)* Refills:*0* 18. Toprol XL 100 mg Tablet Sustained Release 24 hr Sig: Three (3) Tablet Sustained Release 24 hr PO once a day. Disp:*60 Tablet Sustained Release 24 hr(s)* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Primary: Pneumonia of [**Last Name (un) 5487**] organism Atrial fibrillation with rapid ventricular response Secondary: Osteoarthritis Discharge Condition: Afebrile. All vitals stable. HR well controlled with normal BP. WBC in normal range. Ambulatory. Discharge Instructions: You were admitted for a pneumonia which also exacerbated your atrial fibrillation causing a rapid heart rate. You were treated with antibiotics and medications to slow your heart rate. You should finish your course of antibiotics at home. We have also adjusted your medications to control your heart rate. Please take all your medications as prescribed. Please call your doctor or return to the hospital if you experience a temperature greater than 100.5, chills, shortness of breath, chest pain, or any other symptoms that concern you. Followup Instructions: Please call Dr.[**Name (NI) 10427**] office at [**Telephone/Fax (1) 250**] to schedule a follow up appointment in the next 1-2 weeks. Provider: [**Name10 (NameIs) 13644**],NURSE [**First Name (Titles) 13644**] [**Last Name (Titles) **] Date/Time:[**2162-11-5**] 3:15 Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 8145**], M.D. Date/Time:[**2162-11-15**] 12:10 Provider: [**Name10 (NameIs) 1918**] [**Name11 (NameIs) **], MD Phone:[**Telephone/Fax (1) 902**] Date/Time:[**2162-11-18**] 1:00 ICD9 Codes: 0389, 486, 2449, 2724
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Medical Text: Admission Date: [**2183-1-22**] Discharge Date: [**2183-1-25**] Date of Birth: [**2148-4-23**] Sex: M Service: MICU MEDICINE MICU STAY/HISTORY OF PRESENT ILLNESS: The patient is a 34-year-old male, with poorly controlled hypertension of unclear etiology, who was discharged yesterday after a 2-week stay for the same presenting symptoms of nausea, vomiting, abdominal pain and hypertension. The patient did well after discharge and then after eating breakfast in the morning developed his same nausea and vomiting. The patient was unable to take any medications. The patient presented to the Emergency Department with abdominal pain no different than prior abdominal pain episodes. The patient had no bowel movement changes, no fevers or chills, no hemoptysis, no bright red blood per rectum, no headaches or vision changes. In the Emergency Department, the patient was treated with a Nitro drip and prn labetalol, as well as morphine and ativan. When nausea and pain were under better control, the patient still had increased blood pressure in the systolics of 200s. The patient tolerated doses of blood pressure medication on the floor. However, despite maximal Nitro drip and labetalol, the patient's blood pressures remained in the 200s. The patient was, therefore, transferred to the MICU for closer monitoring of his blood pressure. PAST MEDICAL HISTORY: 1. Type 1 diabetes. 2. Gastroparesis. 3. Malignant hypertension. 4. Autonomic neuropathy. 5. CAD. 6. Chronic renal insufficiency, baseline 1.7-1.9. 7. History of [**Doctor First Name **]-[**Doctor Last Name **] tears. ALLERGIES: No known drug allergies. MEDICATIONS: 1. Aspirin 81 qd. 2. Protonix 40 qd. 3. Clonidine patch. 4. Erythromycin. 5. Sertraline 50 qd. 6. Reglan 10 q 6 h. 7. Lopressor 150 [**Hospital1 **]. 8. Lisinopril 10 [**Hospital1 **]. 9. Glargine 5 q hs. 10.Ativan 2 prn. 11.Morphine prn. 12.Amlodipine. SOCIAL HISTORY: The patient lives in [**Location 686**]. No alcohol. No tobacco. Unemployed. PHYSICAL EXAM: Afebrile, heart rate 97, blood pressure 140s-220s/100-130s, 100% on room air. GENERAL: Fatigued, mildly ill-appearing, in no apparent distress. HEENT: Anicteric. OP clear. NECK: Supple with no lymphadenopathy. ABDOMEN: Positive bowel sounds, soft, nontender, nondistended, no hepatosplenomegaly, no rebound tenderness. CV: Regular rate, no murmurs. CHEST: Clear to auscultation bilaterally. EXTREMITIES: No clubbing, cyanosis or edema, 2+ pulses bilaterally. PERTINENT LABS ON ADMISSION: CBC - WBC count 8.5, crit 34.3. Otherwise, his Chem-7 and CBC were unremarkable. SUMMARY OF HOSPITAL COURSE - 1) UNCONTROLLED HYPERTENSION: By [**2183-1-24**], the patient was taken off all of his IV antihypertensives, including IV Nitro and labetalol. The patient was transitioned to his home dose PO medications of lisinopril, Lopressor, Norvasc and a clonidine patch. Etiology of his malignant hypertension still remains a mystery, and has been seen by multiple specialists in the past. The diagnosis of pseudopheochromocytoma was entertained, and urine studies were pending on discharge. On discharge, the patient's blood pressure was maintained on his home regimen of lisinopril, Lopressor, Norvasc, and a clonidine patch with the blood pressures in the 120s-130s. The patient additionally had no episodes of nausea or vomiting approximately 12 hours before discharge. 2) GI: Nausea, vomiting and abdominal pain were controlled with his home doses of Reglan, ativan, erythromycin, morphine and Protonix. 3) DIABETES TYPE 1: The patient is on glargine 8 U q hs and Humalog. 4) RENAL: The patient's creatinine was at baseline on discharge. 5) ACCESS: The patient has a port-A-Cath in place. 6) CODE STATUS: The patient remained full code throughout this admission. CONDITION ON DISCHARGE: The patient was discharged to home without any nausea or vomiting, and resolution of his hypertensive episode. The patient was discharged on his admission medication regimen for hypertension. DISCHARGE STATUS: The patient was discharged in stable condition to home. DISCHARGE DIAGNOSES: 1. Malignant hypertension. 2. Type 1 diabetes. 3. Anemia of unknown etiology. 4. Chronic renal insufficiency. DISCHARGE MEDICATIONS: 1. Aspirin 81 mg po qd. 2. Pantoprazole 40 mg po qd. 3. Clonidine 0.2 mg per 24 h patch q week. 4. Erythromycin 350 mg po q 6 h. 5. Sertraline 50 mg po qd. 6. Lisinopril 10 mg po bid. 7. Amlodipine 5 mg po qd. 8. Metoprolol 150 mg SR qd. 9. Reglan 5 mg/ml solution 1 injection q 6 h. FOLLOW-UP PLANS: The patient is to follow-up with his PCP [**Last Name (NamePattern4) **] [**2-14**] weeks on discharge. [**First Name11 (Name Pattern1) **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **], M.D. [**MD Number(1) **] Dictated By:[**Name8 (MD) 22260**] MEDQUIST36 D: [**2183-3-4**] 13:50 T: [**2183-3-4**] 14:04 JOB#: [**Job Number 93221**] ICD9 Codes: 2765, 311
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6691 }
Medical Text: Admission Date: [**2126-1-5**] Discharge Date: [**2126-1-14**] Date of Birth: [**2060-8-31**] Sex: M Service: CARDIAC ADMISSION DIAGNOSES: 1) Coronary artery disease. 2) Myocardial infarction. DISCHARGE DIAGNOSES: 1) Coronary artery disease. 2) Myocardial infarction. 3) Status post coronary artery bypass graft x 3. HISTORY OF PRESENT ILLNESS: The patient is a 65-year-old male who was being transferred from [**Hospital3 **]. He presented to that hospital while complaints of sudden onset nausea and vomiting. EKG there demonstrated inferolateral ST elevation MI with decreased ST anterior lead suggestive of posterior involvement. The patient is transferred for urgent cardiac catheterization. He received aspirin, heparin, Aggrestat, prior to departure. PAST MEDICAL HISTORY: 1) Hypercholesterolemia. 2) Hypertension. 3) Angina. MEDICATIONS: 1) lipitor, 2) Nitroglycerin prn. PHYSICAL EXAMINATION: Vital signs - temperature 96.9, heart rate 91, blood pressure 83-88/50-60, oxygen saturation 100%, weight 89.4 kg. General - the patient is intubated and sedated postcatheterization. Neck is supple, midline, with no masses or lymphadenopathy. No bruit. Cardiovascular - regular rate and rhythm. Patient currently has an intra-aortic balloon pump. Chest clear to auscultation bilaterally. Abdomen is soft, nontender, nondistended. Extremities are warm, noncyanotic, no redness x 4. Palpable distal pulses. LABS ON ADMISSION: CBC - 7.8/38.8/162. INR 1.3, PTT 77. Chemistries 140/3.5/104/26/20/0.9. First set of cardiac enzymes - CK 120, MB 5, troponins negative, less than 0.3. HOSPITAL COURSE: The patient was transferred via LifeFlight for emergent cardiac catheterization. Cardiac catheterization revealed a right dominant coronary circulation with severe three-vessel coronary artery disease. Left main had 20% distal tapering, LAD was totally occluded proximally after the takeoff of a diffusely diseased diagonal branch, moderate sized RI had 80% proximal lesion, left circumflex is totally occluded, RCA was a large vessel with 40% lesion in the proximal aspect and a thrombotic occlusion midvessel. An intra-aortic balloon was deployed after stenting of the RCA because of the patient's hypotension and requirement of a dopamine drip. Subsequent to catheterization, the patient was transferred to the CCU for support. He was continued on his dopamine drip. On hospital day #1, the patient was seen to have a brief run of NSVT. He was maintained on aspirin, heparin drip and statin. Cardiothoracic surgery consultation was obtained who agreed with urgent revascularization. The patient had several further runs of what looked to be V-tach in the unit. The patient was maintained on IABP. Dopamine was weaned off on hospital day #3. On [**2126-1-7**], the patient was taken to the operating room for urgent coronary artery bypass graft x 3. The patient tolerated the procedure well and was taken to the CSRU postoperatively. On postoperative day #1, the patient was extubated. He was A-paced at a rate of 70s. The patient was on multiple drips including amiodarone, insulin, neo, epi, at different times through his CSRU course. They were all weaned appropriately. On postoperative day #2, the balloon pump was discontinued. Neo was also weaned off. The patient had a brief run of atrial fibrillation. Once the patient began working with physical therapy, it was seen that he had some difficulties with abduction of both of his arms. He appeared neurologically intact and without any other sensorimotor deficits. The patient did have other episodes of rapid atrial fibrillation, but ultimately converted back to a sinus rhythm. He was begun on anticoagulation for this. The patient was transferred to the floor on postoperative day #3. OT consultation was also obtained who agreed with transfer to rehab facility. The patient had ultimately an unremarkable floor stay, and chest tubes and wires were removed appropriately. The patient was ultimately discharged to rehab facility for further work with movement of his arms, as well as simple gait conditioning and activities of daily living. He was discharged tolerating a regular diet, and adequate pain control on PO pain meds, and having a therapeutic INR. No more episodes of angina, or nausea or vomiting. PHYSICAL EXAMINATION ON DISCHARGE: An elderly man in no acute distress. Vital signs were stable, afebrile. Chest was clear to auscultation bilaterally. Cardiovascular was regular rate and rhythm without murmurs, rubs or gallops. There was no sternal click or sternal drainage. Abdomen was soft, nontender, nondistended, no masses or organomegaly. Extremities were warm, noncyanotic with 1+ pedal edema bilaterally. Musculoskeletal - the patient had difficulty with abduction of his arms and neural usage of his arms particularly when trying to abduct them beyond a horizontal level. Neuro grossly intact without specific sensory deficits. Of note, the upper extremity movement was bilateral in nature, but function was returning. MEDICATIONS ON DISCHARGE: 1) lopressor 25 mg [**Hospital1 **], 2) lasix 20 mg qd x 10 days, 3) potassium chloride 20 mEq qd x 10 days, 4) amiodarone 400 mg [**Hospital1 **], 5) Lipitor 10 mg qd, 6) percocet 5/325, [**12-6**] q 4 h prn, 7) aspirin 325 mg qd, 8) ibuprofen 400 mg q 6 h, 9) colace 100 mg [**Hospital1 **], 10) coumadin to be dosed appropriately to an INR between 1.5 and 2.0. On discharge, the patient was taking coumadin in the 1 to 2 mg qd range. DISCHARGE CONDITION: Stable. DISPOSITION: To rehab facility. DIET: Cardiac. INSTRUCTIONS: The patient should follow-up in one to two weeks with his cardiologist. He should address the needs of diuresis and/or adjustment of cardiac medications at that time. The patient should follow-up with Dr. [**Last Name (STitle) **] in four week's time. The patient is to continue aggressive physical and occupational therapy to return to his activities of daily living. INR checks should be done twice weekly and coumadin dosing adjusted by either the rehab facility or his primary care provider, [**Name10 (NameIs) **] alternatively the coumadin clinic. [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern1) **], M.D. [**MD Number(1) 3113**] Dictated By:[**MD Number(1) 46561**] MEDQUIST36 D: [**2126-1-14**] 12:42 T: [**2126-1-14**] 11:42 JOB#: [**Job Number 46562**] ICD9 Codes: 4271, 9971, 4019
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Medical Text: Admission Date: [**2155-12-9**] Discharge Date: [**2155-12-10**] Service: NEUROLOGY Allergies: Penicillins Attending:[**First Name3 (LF) 2569**] Chief Complaint: Transferred from OSH with intracranial hemorrhage. Major Surgical or Invasive Procedure: Intubated History of Present Illness: The pt is an 86 y/o F who presented to [**Hospital6 **] after 3 falls at home on [**2155-12-8**]. Details of the falls were related by her grandson, [**Name (NI) 401**] [**Name (NI) 31469**]. He reports that the patient was unable to walk because of weakness on the left side. She fell getting out of bed on [**2155-12-8**], 45 minutes later in the bathroom, and again at the breakfast table shortly thereafter. The grandson noted that the patient couldn't use her walker at all secondary to weakness after the third fall. Son arrived and picked patient up off floor. Noted L sided weakness and called EMS. Left facial droop was noted but this was this is somewhat confounded by an old bells palsy. At [**Hospital3 **], serial head CTs demonstrated worsening R intraparenchymal bleed. She was sent here for further care. She was admitted to the TSICU and was noted to be increasingly drowsy and a CT head was done this morning which showed worsening from previous CT. Past Medical History: HTN DM - diet controlled Bells palsy (30 yrs ago) Asthma Hypothyroidism S/p hysterectomy arthritis Social History: Lives with husband Denies Alcohol, Smoking, and drugs Family History: NC Physical Exam: Vitals: T:98.8 P:70 R:14 BP:124/84 SaO2:96%RA General: Awake, cooperative, NAD. HEENT: NC/AT, no scleral icterus noted, MMM, no lesions noted in oropharynx. pupils are surgical. Neck: Supple, no carotid bruits appreciated. No nuchal rigidity Pulmonary: With crackles at the right base. Cardiac: RRR, nl. S1S2, no M/R/G noted Abdomen: soft, NT/ND, normoactive bowel sounds, no masses or organomegaly noted. Extremities: No C/C/E bilaterally, 2+ radial, DP pulses bilaterally. Skin: Patient has lesions over abdomen, previously diagnosed with zoster. Neurologic: -Mental Status: keeps eyes closed. No spontaneous speech. Patient responded to [**Last Name (un) **] name with opening her eyes and saying "yes" after being aroused with sternal rub. When asked is she was in pain, she said "yes". She did not elaborate further. Her family and the ED team report that she asked for ice cream and that she asked her daughter if she watched the football game yesterday. This was not witnessed. Did not follow command. Patient is purposeful with right upper extremity, trying to move away the noxious stimuli applied to contralateral limb. -Cranial Nerves: Olfaction not tested. PERRL surgical bilaterally. There is no ptosis bilaterally. Unable to perform proper fundoscopic exam. Occulocephalic reflexes were intact. Corneal intact on the right but not on the left. Nasal tickel reflex intact. Flattened NLF on the left. Hearing intact to name as above. -Motor: Normal bulk, tone throughout. No adventitious movements noted. She spontaneously moves the RUE and RLE. She has a paucity of spontaneous movements on the left side. The LUE has minimal movement to noxious stimuli. The LLE has triple flexion. -Sensory: Intact to noxious throughout. -Coordination: Not tested. -DTRs: [**Name2 (NI) **] Tri [**Last Name (un) 1035**] Pat Ach L 1 1 1 0 0 R 1 1 1 0 0 Plantar response was extensor bilaterally. -Gait: Untested. Pertinent Results: [**2155-12-9**] 06:00AM BLOOD WBC-14.2* RBC-3.85* Hgb-13.1 Hct-37.1 MCV-97 MCH-34.0* MCHC-35.2* RDW-16.2* Plt Ct-158 [**2155-12-8**] 09:45PM BLOOD PT-15.7* PTT-39.4* INR(PT)-1.4* [**2155-12-9**] 11:06AM BLOOD PT-15.0* PTT-37.4* INR(PT)-1.3* [**2155-12-9**] 11:06AM BLOOD Glucose-146* UreaN-12 Creat-1.0 Na-140 K-2.9* Cl-101 HCO3-26 AnGap-16 [**2155-12-9**] 11:06AM BLOOD ALT-12 AST-18 CK(CPK)-53 AlkPhos-88 TotBili-0.5 [**2155-12-9**] 11:06AM BLOOD CK-MB-NotDone cTropnT-<0.01 [**2155-12-9**] 11:06AM BLOOD Albumin-3.9 Calcium-8.9 Phos-3.4 Mg-2.0 Cholest-154 [**2155-12-9**] 11:06AM BLOOD Triglyc-113 HDL-70 CHOL/HD-2.2 LDLcalc-61 [**2155-12-9**] 11:06AM BLOOD Osmolal-304 [**2155-12-9**] 11:06AM BLOOD TSH-0.19* [**2155-12-9**] 03:15PM BLOOD Type-ART Rates-16/ Tidal V-500 FiO2-50 pO2-126* pCO2-43 pH-7.40 calTCO2-28 Base XS-1 -ASSIST/CON Intubat-INTUBATED [**2155-12-9**] 03:15PM BLOOD Lactate-1.4 [**2155-12-9**] 03:15PM BLOOD freeCa-1.14 Head CT [**12-9**]: 1. Significantly limited study due to patient movement. Large parenchymal hemorrhage in the posterior right parietal lobe with local mass effect. Apparent effacement along the right suprasellar cistern likely represents volume averaging due to motion, however, evolving uncal herniation is not entirely excluded. Attention to this finding on follow-up imaging is recommended. 2. Diffuse white matter hypodensity throughout the bilateral basal ganglia, likely sequela of severe chronic microvascular ischemia, less likely infarction. Repeat Head CT [**12-9**]: 1. Interval increase in size of intraparenchymal hemorrhage within the right parietal lobe. Worsening of right lateral ventricle mass effect. 2. No subfalcine or uncal herniation. Brief Hospital Course: Ms. [**Known lastname 31469**] was admitted to the ICU for further monitoring. She was treated with mannitol and dilantin. Her systolic blood pressure was maintained between 120-160 with a Map < 130. She was also maintained normothermic and normoglycemic. In the morning she was noted to be increasingly drowsy, disproportionately to her initial lesion on CT. Her dilantin was stopped and she was sent for a repeat CT. This showed new bleeding extending into the ventricles and worsening edema. She was started on mannitol. Neurosurgery was also consulted to evaluate for possible interventions including a drain. They felt that she was not a surgical candidate. These finding were discussed at length with the family by both neurology and the ICU service. The family discussed their goals of care. The children wanted their mother to be [**Name (NI) 3225**], however her husband wanted her to be full code. Shortly after this discussion, she was noted to have agonal breathing. She was therefore intubated. After the intubation, the family and a further discussion regarding their goals of care. Mr. [**Known lastname 31469**] decided to make his wife [**Name (NI) 3225**]. She was extubated and started on morphine and scopolamine for comfort. The patient expired ~12hrs later. Medications on Admission: Calcium 400mg [**Hospital1 **]. Actonel 35 qfri Vit E dose uncertain. Levothyroxine 175 qd diazide 375/25 Singulair 10 qd Protonix 40 qd Combivent uncertain schedule. advair 500/50 [**Hospital1 **] Choline magnesium trisalycilate - 750 qd Potassium dose uncertain Discharge Medications: NA Discharge Disposition: Expired Discharge Diagnosis: Hemmorhagic Stroke Discharge Condition: Expired Discharge Instructions: NA Followup Instructions: NA [**First Name8 (NamePattern2) **] [**Name8 (MD) 162**] MD [**MD Number(2) 2575**] ICD9 Codes: 431, 4019, 2449
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Medical Text: Admission Date: [**2117-1-12**] Discharge Date: [**2117-2-1**] Date of Birth: [**2038-1-30**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 3531**] Chief Complaint: Acute Hypoxemic Respiratory Failure Major Surgical or Invasive Procedure: thoracentesis and placement of pig-tail catheter in right thorax History of Present Illness: 78M Myelofibrosis, Anemia requiring transfusions, Zenkers Diverticulum, hx of aspiration PNA requiring intubation ([**5-1**])presenting with acute hypoxia in setting of large right sided pleural effusions. . Of note the pt was recently admitted to [**Hospital 8**] Hospital on [**2117-1-2**] following a fall at home during which he had a work-up for head trauma and syncope. ECG at that time revealed RBBB and LAFB. Hct of 20.7, CT Head without acute intracranial pathology. CXR revealed right sided atelectasis vs PNA. The pt was treated for a right facial laceration and admitted. The pt states he received 2 blood transfusions ans was discharged home from the OSH after approximately 2 days. No discharge summary currently available. . The pt states that over the past few days he has noted worsening right sided pain that radiates to his chest. Worse with inspiration [**5-3**]. No palpitations. Denies fevers, but admits to chills. No diaphroses. The pt has had stable 1 pillow orthopnea and has DOE upon walking up one flight of stairs. The pt today presented to his PCP where he was noted to have a BP of 80/P and subsequently brought to the ED. . Upon arrival to the ED 97.9 93/37 70 19 94% (02 not listed). The pt was continued to complain of [**5-3**] back pain. ED exam was notabable for absent BS on right. CXR with low lung volumes on right. CT chest revealed effusion on right with mild ascites. No signs of acute bleed. . The pt received Vancomycin 1mg IV, Levofloxacin 750mg IV x1, Azreonam 1gm IVx1 for suspected right sided PNA in setting of question PCN allergy. A PIV 18g and 20g were placed. The pt received 2L of NS and 1L of D5W with 3 amp of Bicarb. UOP of 250cc. . The pt was seen by interventional pulmonary that who performed a bedside ultrasounded throacentesis during which 1200cc of serosanginous fluid was drained. Initial pH 7.08, pleural LDH of 468 indicative of an exudative process thus a pigtail catheter was placed. Follow-up CXRs without evidence of pneumothorax. . Vitals prior to transfer HR 70 122/58 16 100% on 12L NRB. . . REVIEW OF SYSTEMS: (+)ve: chills, chest pain, orthopnea, 1 episode of BRBPR 3 weeks ago. (-)ve: fever, night sweats, loss of appetite, fatigue, palpitations, rhinorrhea, nasal congestion, cough, sputum production, hemoptysis, dyspnea, paroxysmal nocturnal dyspnea, nausea, vomiting, diarrhea, constipation, hematochezia, melena, dysuria, urinary frequency, urinary urgency, focal numbness, focal weakness, myalgias, arthralgias Past Medical History: # Myelofibrosis - Bone Marrow Bx [**2-/2115**], 20q deletion, JAK-2 mutation # Chronic Anemia: Requiring Blood Transfusions [**1-26**] MF # Aspiration PNA ([**4-/2116**]) with hypoxemic respiratory failure requiring intubation (Unconfirmed Location - Per OSH Records) # Zenker's Diverticulum - hx of aspiration events # Significant macular degeneration and cataracts # Depression # Pruritis # Mild symmetric LVH # Moderate Pulmonary HTN ([**5-1**]) # ?BPH (Per OSH records) Social History: He does not smoke and denies any alcohol abuse. He lives alone, independent of ADLs, although declining. He is a retired english professor [**First Name (Titles) 767**] [**Last Name (Titles) 10358**] [**Location (un) 47997**]. Interest in [**Last Name (un) **]. Family History: Mother deceased - [**Name2 (NI) **] CA Physical Exam: T=97.3 BP=120/44 HR=75 RR=18 98 6L GENERAL: Pleasant, ill cachectic appearing M in NAD HEENT: Right facial laceration. Right purulence from conjunctiva. Mild conjunctival pallor. No icterus. Dry MM. NECK: Supple, No LAD, No thyromegaly. CARDIAC: Regular rhythm, normal rate. Normal S1, S2. No murmurs, rubs or [**Last Name (un) 549**]. JVP= flat LUNGS: Clear on left anteriorly. Clear superiorly on right anteriorly. Right pigtail catheter in place. ABDOMEN: NABS. Soft, NT, mild distension, +Hepatosplenomegaly. EXTREMITIES: No edema or calf pain, 2+ dorsalis pedis/ posterior tibial pulses. SKIN: No rashes/lesions, ecchymoses. NEURO: No asterxis. A&Ox3. Appropriate. CN 2-12 grossly intact. Preserved sensation throughout. 5/5 strength throughout. [**12-26**]+ reflexes, equal BL. Normal coordination. Gait assessment deferred PSYCH: Listens and responds to questions appropriately, pleasant . Exam as of [**2117-1-24**] Vitals: 96.5 101/49 85 18 95%2Lnc Pain: over sacrum and R chest wall Access: PIV and LUE double lumen PICC Gen: thin man, cachectic, weak HEENT: mm dry CV: RRR, no m Chest: R chest tube site dry with dressing Resp: +bibasilar crackles, no wheezing Abd; soft, thin, nontender, +SM Ext; R>L edema (new over past 2days) Neuro: A&OX3, grossly nonfocal Skin: sacral decub stage II with dressing, L 4th toe hyperemic but good distal pulse, area of erythema with darker and irregular border over R hip, pruritic for patient, not clear cellulitis, ?fungal psych: calm, pleasant Pertinent Results: Discharge Day Labs: Other Pertinent Labs: UA [**1-12**]: 6-10wbc, few bacteria, UCx neg UA [**1-21**]: 21wbc, +casts, mod LE, few bac, neg nitrites, 18rbc, UCx neg . [**1-21**]: Una 10, UCreat 98, Uurea 875 [**1-23**]: repeat urine lytes: FeNa 0.7 . BC [**1-12**] NGTD X2 . Pleural fluid Cx [**1-12**] NTD Pleural fluid: wbc 2550 with 89%PMNs, LDH 468, pH 7.08 pleural fluid cytology: neg for malignancy Sputum Cx upper flora . . Imaging/results: EKG: RBBB, LAFB . [**1-12**]: CXR Large right pleural effusion, with consequent lower and middle lobe collapse. . CXR [**1-16**]; Two views of the chest demonstrate a large right-sided pleural effusion with atelectasis/consolidation of the right lower lobe. Left lung is clear. A chest tube is present at the right lung base. There is little interval change with prior studies. Hila and mediastinum within normal limits . CXR [**1-22**] (post pigtail removal) There is a small right lower lobe pneumothorax. Small bilateral pleural effusions, left greater than right, are unchanged. Bibasilar consolidations and right middle lobe opacities are unchanged, as is faint right upper lobe opacity. Cardiomediastinal contours are normal. . CT chest w and w/o contrast [**1-22**] 1. Marked decrease in size of now small complex loculated right pleural effusion. The tip of the catheter remains within the pleural cavity, but the formed pigtail is extrathoracic in location with adjacent subcutaneous emphysema and soft tissue swelling. 2. Slight increase of small simple left pleural effusion. Persistent pneumonia with component of coexisting atelectasis of both lower lobes but improved aeration of the right upper and right middle lobes. Nonspecific ground-glass opacities are noted within the right middle and lower lung which may be related to infection or reexpansion pulmonary edema. 3. Unchanged hypoattenuating hepatic and splenic lesions as described. Many of the hepatic lesions are clearly simple cysts. There is stable hepatosplenomegaly with sequelae of portal hypertension. 4. Known Zenker's diverticulum. . CT chest noncontrast [**1-13**] 1. Decreased right pleural effusion, now moderate in size, status post right pleural pigtail catheter placement. Small left pleural effusion. 2. Multifocal pneumonia involving nearly the entire right lung, and large portions of the left lower lobe. 3. Unchanged hepatosplenomegaly. 4. Unchanged appearance of probable Zenker's diverticulum. . CT c/a/p [**1-12**] c contrast: 1. Large right pleural effusion with resultant compressive atelectasis or the right lung. 2. Hepatosplenomegaly. 3. Ascites. 4. Splenic hypodensity, not fully characterized, possible hamartoma or hemangioma. 5. Nodularity of the left adrenal gland, but no distinct nodule. This finding should be correlated clinically and if indicated, with serum biochemical markers. 6. Collection of fluid and gas at the thoracic inlet in the region of the esophagus, a finding which predisposes the patient to possible aspiration and should be clinically correlated. . Renal US [**1-23**]; 1. No hydronephrosis or nephrolithiasis. 2. Unchanged renal cysts and prostatic enlargement. . . LABS: Hematology COMPLETE BLOOD COUNT WBC RBC Hgb Hct MCV MCH MCHC RDW Plt Ct [**2117-1-31**] 12:27PM 6.5 2.73* 8.6* 24.7* 91 31.6 34.9 17.5* 93* Source: Line-PICC [**2117-1-30**] 05:04AM 5.7 2.51* 7.9* 23.0* 92 31.5 34.4 17.4* 70*1 Source: Line-PICC [**2117-1-29**] 08:00AM 4.9 2.51* 7.8* 22.8* 91 30.9 34.0 17.5* 68*2 Source: Line-left picc line [**2117-1-28**] 06:45AM 5.1 2.48* 7.6* 22.7* 92 30.6 33.5 17.4* 66*1 Source: Line-left picc line [**2117-1-27**] 04:06AM 5.1 2.25* 6.9* 21.5* 96 30.5 31.9 18.0* 59*3 Source: Line-PICC [**2117-1-26**] 05:00AM 5.4 2.50* 7.4* 23.0* 92 29.6 32.2 17.8* 72*3 Source: Line-PICC [**2117-1-25**] 08:47AM 5.4 2.59* 7.8* 24.1* 93 30.2 32.4 17.9* 107*1 Source: Line-picc line [**2117-1-24**] 08:00AM 6.0 2.68* 8.1* 25.0* 93 30.0 32.2 17.8* 113*1 [**2117-1-23**] 05:50AM 6.9 2.68* 8.0* 24.9* 93 30.0 32.2 17.9* 132*3 [**2117-1-22**] 06:45AM 7.1 2.77* 8.4* 25.6* 92 30.2 32.7 18.0* 1511 [**2117-1-21**] 06:45AM 9.3 3.09* 9.4* 28.9* 93 30.3 32.5 18.1* 1711 [**2117-1-20**] 10:55AM 12.2*# 3.17* 9.3* 29.6* 93 29.4 31.6 18.2* 187 [**2117-1-19**] 06:10AM 7.3 2.65* 8.0* 24.2* 91 30.2 33.1 18.5* 1703 [**2117-1-18**] 01:00PM 10.9# 3.11*# 9.0*# 28.5*# 92 28.8 31.5 18.4* 203 [**2117-1-17**] 06:00AM 6.9 2.20* 6.5* 20.8* 95 29.6 31.2 18.5* 1753 [**2117-1-16**] 05:40AM 6.1 2.30* 6.8* 21.8* 95 29.7 31.3 18.8* 185 [**2117-1-15**] 05:55AM 7.4 2.35* 6.9* 22.1* 94 29.3 31.2 18.5* 205 [**2117-1-14**] 05:20AM 13.8*# 2.72* 8.1* 25.7* 95 29.9 31.6 18.7* 2081 [**2117-1-13**] 08:35AM 28.2* [**2117-1-13**] 02:53AM 7.9 2.49* 7.4* 24.0* 97#4 29.8 30.9* 18.8* 1511 [**2117-1-12**] 11:16PM 8.5 2.92* 8.8* 30.2* 104*#4 30.3 29.2* 18.7* 1531 [**2117-1-12**] 02:00PM 12.8*#1 2.98*# 9.1*# 28.1*# 94 30.6 32.4 19.3* [**2007**] VERIFIED BY SMEAR LARGE FORMS PRESENT VERIFIED VERIFIED DIFFERENTIAL Neuts Bands Lymphs Monos Eos Baso Atyps Metas Myelos [**2117-1-28**] 06:45AM 80.7* 11.8* 4.8 2.6 0.1 Source: Line-left picc line [**2117-1-25**] 08:47AM 82.8* 0 11.2* 4.7 1.2 0 Source: Line-picc line [**2117-1-12**] 02:00PM 86* 3 4* 7 0 0 0 0 0 RED CELL MORPHOLOGY Hypochr Anisocy Poiklo Macrocy Microcy Polychr Ovalocy [**2117-1-12**] 02:00PM 3+ 2+ 2+ 1+ 1+ OCCASIONAL 2+ BASIC COAGULATION (PT, PTT, PLT, INR) PT PTT Plt Smr Plt Ct INR(PT) [**Name (NI) 11951**] [**2117-1-31**] 12:27PM LOW1 93* Source: Line-PICC [**2117-1-30**] 05:04AM VERY LOW2 70*3 3+ Source: Line-PICC [**2117-1-29**] 08:00AM VERY LOW4 68*5 3+ Source: Line-left picc line [**2117-1-28**] 06:45AM 66*3 Source: Line-left picc line [**2117-1-28**] 06:45AM 16.5* 37.3* 1.5* Source: Line-left picc line [**2117-1-27**] 04:06AM VERY LOW 59*6 Source: Line-PICC [**2117-1-26**] 05:00AM VERY LOW 72*6 Source: Line-PICC [**2117-1-25**] 08:47AM LOW7 107*3 2+ Source: Line-picc line [**2117-1-24**] 08:00AM LOW8 113*3 [**2117-1-23**] 05:50AM LOW 132*6 [**2117-1-23**] 05:50AM 15.7* 1.4* [**2117-1-22**] 06:45AM 1513 [**2117-1-21**] 06:45AM NORMAL 1713 2+ [**2117-1-20**] 10:55AM NORMAL9 187 [**2117-1-19**] 06:10AM NORMAL 1706 [**2117-1-18**] 01:00PM NORMAL10 203 1+ [**2117-1-18**] 01:00PM 15.9* 33.9 1.4* [**2117-1-17**] 06:00AM NORMAL 1756 1+ [**2117-1-16**] 05:40AM 185 [**2117-1-15**] 05:55AM NORMAL11 205 1+ [**2117-1-14**] 05:20AM NORMAL 2083 [**2117-1-14**] 05:20AM 17.0* 39.8* 1.5* [**2117-1-13**] 02:53AM 1513 [**2117-1-13**] 02:53AM 19.0* 39.2* 1.7* [**2117-1-12**] 11:16PM NORMAL 1533 2+ [**2117-1-12**] 02:00PM 17.4* 35.8* 1.6* [**2117-1-12**] 02:00PM NORMAL [**2009**] LOW FEW LARGE PLATELETS VERY LOW WITH LARGE FORMS VERIFIED BY SMEAR VERY LOW LARGE FORMS PRESENT LARGE FORMS PRESENT VERIFIED LOW OCC LARGE FORMS LOW LARGE PLTS SEEN NORMAL OCC LARGE FORMS NORMAL MANY LARGE PLATELETS NORMAL MOD. LARGE PLTS Chemistry RENAL & GLUCOSE Glucose UreaN Creat Na K Cl HCO3 AnGap [**2117-1-31**] 08:38AM 317*1 41* 0.8 137 4.7 105 26 11 Source: Line-PICC [**2117-1-30**] 05:04AM 103*1 38* 0.7 138 4.0 105 27 10 Source: Line-PICC [**2117-1-29**] 08:00AM 125*1 30* 0.8 138 3.7 106 28 8 Source: Line-left picc line [**2117-1-28**] 06:45AM 126*1 29* 0.8 140 3.7 109* 28 7* Source: Line-left picc line [**2117-1-27**] 04:06AM 134*1 30* 0.9 137 3.4 106 23 11 Source: Line-PICC [**2117-1-26**] 05:00AM 111*1 34* 0.9 137 4.3 110* 23 8 Source: Line-PICC [**2117-1-25**] 08:47AM 111*1 35* 1.1 140 4.2 111* 25 8 Source: Line-picc line [**2117-1-24**] 08:00AM 881 40* 1.3* 142 4.4 113* 24 9 [**2117-1-23**] 05:50AM 891 48* 1.4* 143 4.7 112* 25 11 [**2117-1-22**] 03:30PM 188*1 51* 1.7* 142 5.5* 112* 23 13 [**2117-1-22**] 06:45AM 971 56* 1.6* 142 5.8* 112* 23 13 [**2117-1-21**] 06:45AM 1001 44* 1.5* 143 5.7* 111* 28 10 [**2117-1-20**] 10:55AM 163*1 35* 1.2 140 5.0 109* 27 9 [**2117-1-19**] 06:10AM 891 28* 0.8 143 4.4 112* 28 7* [**2117-1-18**] 01:00PM 129*1 29* 0.9 141 4.6 109* 26 11 [**2117-1-17**] 06:00AM 117*1 30* 0.9 140 4.0 110* 27 7* [**2117-1-16**] 05:40AM 117*1 34* 0.8 138 3.6 107 28 7* [**2117-1-15**] 05:55AM 1001 44* 1.1 141 3.9 108 25 12 [**2117-1-14**] 05:20AM 107*1 39* 1.2 139 4.2 106 27 10 ADDED B12 @ 08:08AM ON [**2117-1-14**] [**2117-1-13**] 02:53AM 134*1 36* 1.2 142 4.3 108 27 11 [**2117-1-12**] 02:00PM 145*1 39* 1.5* 139 4.9 106 26 12 ADDED PON CPIS AT 1500 IF FASTING, 70-100 NORMAL, >125 PROVISIONAL DIABETES ESTIMATED GFR (MDRD CALCULATION) estGFR [**2117-1-28**] 06:45AM Using this1 Source: Line-left picc line [**2117-1-20**] 10:55AM Using this2 [**2117-1-12**] 02:00PM Using this3 ADDED PON CPIS AT 1500 Using this patient's age, gender, and serum creatinine value of 0.8, Estimated GFR = >75 if non African-American (mL/min/1.73 m2) Estimated GFR = >75 if African-American (mL/min/1.73 m2) For comparison, mean GFR for age group 70+ is 75 (mL/min/1.73 m2) GFR<60 = Chronic Kidney Disease, GFR<15 = Kidney Failure Using this patient's age, gender, and serum creatinine value of 1.2, Estimated GFR = 59 if non African-American (mL/min/1.73 m2) Estimated GFR = 71 if African-American (mL/min/1.73 m2) For comparison, mean GFR for age group 70+ is 75 (mL/min/1.73 m2) GFR<60 = Chronic Kidney Disease, GFR<15 = Kidney Failure Using this patient's age, gender, and serum creatinine value of 1.5, Estimated GFR = 45 if non African-American (mL/min/1.73 m2) Estimated GFR = 55 if African-American (mL/min/1.73 m2) For comparison, mean GFR for age group 70+ is 75 (mL/min/1.73 m2) GFR<60 = Chronic Kidney Disease, GFR<15 = Kidney Failure ENZYMES & BILIRUBIN ALT AST LD(LDH) CK(CPK) AlkPhos Amylase TotBili DirBili [**2117-1-31**] 08:38AM 9 9 51 0.5 Source: Line-PICC [**2117-1-17**] 03:00PM 9*1 [**2117-1-17**] 06:00AM 8*1 [**2117-1-12**] 02:00PM 7 6 54 0.7 ADDED PON CPIS AT 1500 VERIFIED BY REPLICATE ANALYSIS NEW REFERENCE INTERVAL AS OF [**2116-12-28**];UPPER LIMIT (97.5TH %ILE) VARIES WITH ANCESTRY AND GENDER (MALE/FEMALE);WHITES 322/201 BLACKS 801/414 ASIANS 641/313 OTHER ENZYMES & BILIRUBINS Lipase [**2117-1-12**] 02:00PM 12 ADDED PON CPIS AT 1500 CPK ISOENZYMES CK-MB cTropnT [**2117-1-17**] 03:00PM 2 <0.011 [**2117-1-17**] 06:00AM 2 <0.011 [**2117-1-12**] 02:00PM 0.012 ADDED ON TNT AT 1459 [**2117-1-12**] 02:00PM 2 ADDED PON CPIS AT 1500 <0.01 CTROPNT > 0.10 NG/ML SUGGESTS ACUTE MI CTROPNT > 0.10 NG/ML SUGGESTS ACUTE MI CHEMISTRY TotProt Albumin Globuln Calcium Phos Mg UricAcd Iron [**2117-1-31**] 08:38AM 7.7* 2.3 Source: Line-PICC [**2117-1-29**] 08:00AM 7.6* 3.7 2.1 Source: Line-left picc line [**2117-1-28**] 06:45AM 7.2* 3.5 2.1 Source: Line-left picc line [**2117-1-27**] 04:06AM 7.1* 3.0 2.1 Source: Line-PICC [**2117-1-26**] 05:00AM 7.3* 2.7 2.1 Source: Line-PICC [**2117-1-25**] 08:47AM 7.6* 3.2 2.3 Source: Line-picc line [**2117-1-24**] 08:00AM 7.6* 3.0 2.2 [**2117-1-23**] 05:50AM 2.3* 7.6* 3.9 2.3 [**2117-1-22**] 03:30PM 7.8* 4.7* 2.3 [**2117-1-22**] 06:45AM 7.8* 4.9* 2.3 [**2117-1-21**] 06:45AM 8.1* 4.6* 2.2 [**2117-1-20**] 10:55AM 7.8* 3.4 2.1 [**2117-1-19**] 06:10AM 8.0* 2.6* 2.1 [**2117-1-18**] 01:00PM 8.0* 2.6* 2.1 [**2117-1-16**] 05:40AM 2.5* 7.9* 2.4* 2.1 [**2117-1-15**] 05:55AM 8.1* 3.2 [**2117-1-14**] 05:20AM 8.0* 4.3 2.3 ADDED B12 @ 08:08AM ON [**2117-1-14**] [**2117-1-13**] 02:53AM 2.8* 7.3* 3.7 2.1 HEMATOLOGIC VitB12 [**2117-1-14**] 05:20AM 672 ADDED B12 @ 08:08AM ON [**2117-1-14**] LIPID/CHOLESTEROL Cholest Triglyc [**2117-1-26**] 05:00AM 501 Source: Line-PICC LDL(CALC) INVALID IF TRIG>400 OR NON-FASTING SAMPLE ANTIBIOTICS Vanco [**2117-1-16**] 05:30PM 26.2* Random . . Brief Hospital Course: 78 year old male (retired english professor) with h/o myelofibrosis/anemia (transfusion dependent, dx [**2114**]), longstanding zenker's diverticulum with chronic aspiration and recurrent aspiration pneumonias admitted on [**1-12**] with the same. . 1. Aspiration Pneumonia: Patient was initially admitted to the [**Hospital Unit Name 153**] with significant RLL PNA with pleural effusion and hypotension. Hypotension resolved with IVF and he was transferred to floor. He underwent thoracentesis with resultant exudative fluid, and a chest tube was placed with resultant drainage of 3L of fluid and removal of the catheter on [**2117-1-22**]. He received a ten day course of Levofloxacin/Clindaymycin. At the time of discharge he had normal oxygen saturations on room air. . 2. Chronic aspiration: Patient failed speech and swallow evaluation several times. Dobhoff tube placement was unsuccessful, a PICC was placed on [**2117-1-24**], and TPN was started. The plan is for endoscopic repair of his Zenker's diverticulum by Dr.[**Last Name (STitle) 1837**]. Dr[**Doctor Last Name **] office will call Rehab to schedule a pre-operative visit. . 3. Anemia [**1-26**] Myelofibrosis: Patient received intermittent transfusions to maintain a Hct>22 (is also transfusion dependent as an outpatient). Folate supplementation was continued. He is followed for this issue by his hematologist, Dr.[**Last Name (STitle) 3638**]. . 4. Thrombocytopenia: Platelet count began to trend down during the last week of hospitalization, thought to be [**1-26**] increased splenic congestion in the setting of volume overload while on TPN. There was also concern that his antibiotics were contributing. After completing antibiotics and undergoing diuresis with Lasix 20mg IV as needed, his platelet count began to trend up, and on the day of discharge was 103. . 5.Acute renal failure: Patient noted to have ARF on admission, which improved with IVFs to Cr=0.8. However, he once again developed ARF on [**1-21**] (peak creat 1.7) likely from volume depletion as well, which again improved with hydration. Renal US was within normal limits. . 6. Sacral decubitus ulcer: Patient has a stage II sacral ulcer and was getting wound care and turning frequently. . PCP: [**Last Name (NamePattern4) **].[**Last Name (STitle) 141**] Hematologist: Dr.[**Last Name (STitle) 3638**] ENT: Dr.[**Last Name (STitle) 97218**] Medications on Admission: Combivent Folic Acid Ferrous Sulfate Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - MACU Discharge Diagnosis: Aspiration pneumonia c/b Parapneumonic pleural effusion Zenker's diverticulum with chronic aspiration moderate to severe malnutrition sacral decub stage II Myelodysplastic syndrome and Anemia, transfusion dependent 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 with a recurrent aspiration pneumonia and pleural effusion which required drainage with a chest tube. You were briefly in the ICU. You were treated with antibiotics with improvement in your symptoms and completed these on [**2117-1-26**]. The chest tube had some trouble draining but we were able to fix this with TPA and it drained about 3L of fluid and your breathing improved. The cause of your pneumonia is due to recurrent aspiration, in part due to your large zenker's diverticulum. Dr. [**Name (NI) 97219**] office will contact you to arrange a pre-opertive visit to discuss repair of the diverticulum. A PICC line was placed for TPN, which is IV nutrition. Our hope is that this will make your nutrition status better so you can recover from the surgery. You also required occasional blood transfusions to keep your hematocrit above thirty. Your platelet count dropped to a low of 59, but was increasing at the time of discharge. This was thought to be due to splenic congestion due to volume overload. . Please take all medications as prescribed. It is very important to use your incentive spirometer and work with physical therapy going forward. Followup Instructions: Please follow up closely with your PCP as soon as possible: PCP: [**Name10 (NameIs) **],[**First Name3 (LF) **] R. [**Telephone/Fax (1) 142**] . You will be contact[**Name (NI) **] by Dr. [**Last Name (STitle) 97218**] to arranged for your endoscopic surgery for Zenker's ICD9 Codes: 5070, 5849, 5119, 4168, 2875
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6694 }
Medical Text: Admission Date: [**2177-5-11**] Discharge Date: [**2177-5-22**] Date of Birth: [**2177-5-11**] Sex: M Service: Neonatology HISTORY OF PRESENT ILLNESS: Baby boy [**Known lastname **], twin number two, is a 2,100 gram, 32 [**5-26**] week male born to a 32-year-old G2, para 0 now 2 mother with serologies B positive, antibody negative, RPR nonreactive, rubella immune, hepatitis B surface antigen negative, group B Streptococcus unknown. The mother presented three days prior to admission with premature rupture of membranes and in preterm labor treated with magnesium sulfate. She was not treated with betamethasone and unstoppable preterm labor proceeded to cesarean section. The pregnancy is also notable for IVF twins. The patient emerged and was vigorous. Apgar scores were eight and nine. PHYSICAL EXAMINATION: Weight: 2,100 grams (70th percentile). Length: 45.5 cm (70th percentile), head circumference 30 cm (30th percentile). Anterior fontanelle was soft and flat, nondysmorphic. Palate intact. He had some facial edema with bruising around his neck. Chest: Symmetric. He had fair aeration with coarse breath sounds, mild retractions, and grunting. Heart: Regular rate and rhythm without a murmur. He had 2+ femoral pulses. Abdomen: Soft, without hepatosplenomegaly. He had a three vessel cord. Genitalia: He had normal male genitalia with both testes descended into the scrotum. Hips: Stable without clicks or clunks. He had no sacral dimples. His anus appeared patent. Extremities: His extremities were all intact. He had normal tone, appropriate for gestational age. HOSPITAL COURSE: RESPIRATORY: Due to grunting, flaring, and retractions, the patient was initially placed on CPAP and a chest x-ray showed moderate HMD. However, given the increased FI02 and increased work of breathing, he was intubated and received Surfactant times two. Chest x-ray at that time was also notable for a moderate sized pneumomediastinum. On day of life 8 the infant was able to be extubated from the ventilator and transitioned to nasal cannula. On day of nine he was transitioned off nasal cannula to room air, where he remains. He has not demonstrated any apnea and bradycardia of prematurity. He has received any methylxanthines. CARDIOVASCULAR: The patient was initially cardiovascularly stable without a murmur and normal blood pressures for age. However, on day of life four, he was noted to have slightly widened pulse pressure and subsequently had blood via the ET tube. He subsequently developed a blowing murmur at the left sternal border. On day of life five, he was started on a course of Indomethacin for presumed patent ductus arteriosus. The murmur persisted and an echocardiogram was obtained on [**5-18**] (results included) which showed a small to moderate PDA. A second course of indocin was given with resolution of the murmur. A follow-up echocardiogram has not been done to date. This was planned to be done prior to discharge to home. GI/FLUIDS, ELECTROLYTES, AND NUTRITION: The patient had a peripheral IV placed, was n.p.o. on D10W at 80 cc per kilogram per day. Enteral feedings were started on day of life two and were advancing nicely; however, feeds were discontinued on day of life four for initiation of Indocin. After completion of the second course of Indocin, he has slowly re-advanced on his enteral feedings. He is currently on 140 cc/k/day of PE20 at 90 cc/k/day with the remainder of PN/IL. His most recent electrolytes were 135, 5.1, 103, and 22 on [**5-19**]. GASTROINTESTINAL: The patient had serial bilirubins followed. He was started on phototherapy on day of life number three for a bilirubin of 10.2/0.3. His peak bilirubin level was 12.5/0.3 on [**5-18**], day of life 7. Phototherapy was discontinued on day of life number nine. His rebound bilirubin level was 9.3/0.5 on [**2175-5-21**]. HEME: The patient's initial hematocrit was 50.5. He has received no blood transfusions. INFECTIOUS DISEASE: The initial white blood cell count was 10.9. There were 14 percent segs, 0 percent bands, with an ANC of 1,526. A blood culture was drawn. He was treated with ampicillin and gentamicin for 48 hours. Blood culture was negative and antibiotics were discontinued. INITIAL PKU: Sent on day of life number three. SOCIAL: Parents live in [**Location (un) **], [**Location (un) 3844**]. Their pediatrician will be Dr. [**Last Name (STitle) **] with [**Hospital 8117**] Pediatrics. They will consider transfer to [**State 20192**] Center at an appropriate interval. Discharge diagnoses: 1. Prematurity 2. Respiratory distress syndrome, s/p surfactant x 2 3. Pneumomediastinum 4. Sepsis evaluation 5. Hyperbilrubinemia 6. Patent ductus arteriosus [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], [**MD Number(1) 54936**] Dictated By:[**Last Name (NamePattern4) 55464**] MEDQUIST36 D: [**2177-5-16**] 17:23:34 T: [**2177-5-16**] 19:44:46 Job#: [**Job Number **] ICD9 Codes: 769, 7742, V290
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 6695 }
Medical Text: Admission Date: [**2197-11-3**] Discharge Date:[**2198-2-2**] Date of Birth: [**2197-11-3**] Sex: M Service: NEONATOLOGY HISTORY OF PRESENT ILLNESS: [**Known lastname **] [**Known lastname 75392**], boy twin #1, is the former 1.145 kg product of a twin 27-4/7 week gestation pregnancy born to a 30-year-old, G1, P0, now 2 woman. Prenatal screens: Blood type O positive, antibody negative, rubella unknown, RPR nonreactive, hepatitis B surface antigen negative, group beta strep status unknown. The pregnancy was known for in [**Last Name (un) 5153**] fertilization conception with resulting dichorionic-diamniotic twins. There was an echogenic cardiac focus noted on twin 1 on fetal ultrasounds; otherwise, the fetal surveys were unremarkable. The mother was admitted at 23-/57 weeks with preterm labor and vaginal bleeding. A chronic placental abruption was eventually diagnosed. She was treated with indomethacin and nifedipine. She also received a complete course of betamethasone which finished on [**2197-10-12**]. She had a spontaneous rupture of membranes three days prior to delivery and was treated with antibiotics. On the day of delivery, the mother experienced increasing contractions, so the decision was made to deliver. An elective C-section under spinal anesthesia was undertaken for known breech position of the second twin. This twin #1 emerged with cry. He received facial CPAP and then was intubated with a 3.0 endotracheal tube. The infant was admitted to the neonatal intensive care unit for treatment of prematurity. Apgars were 6 at one minute and 8 at five minutes. PHYSICAL EXAMINATION: Upon admission to the neonatal intensive care unit, weight 1.45 kg, length 37 cm, head circumference 27.5 cm all AGA. HOSPITAL COURSE BY SYSTEMS AND PERTINENT LABORATORY DATA: RESPIRATORY: This infant was treated with one dose of surfactant. His peak inspiratory pressure was 18 and positive end-expiratory pressure of 5, intermittent mandatory respiratory rate of 20. He was extubated to continuous positive airway pressure on day of life #1. He continued on the continuous positive airway pressure through day of life #8 when he transitioned to room air. He subsequently required nasal cannula O2 and on day of life #11 was placed back on continuous positive airway pressure for increased work of breathing. He continued on continuous positive airway pressure through day of life 17 when he again transitioned to a nasal cannula. On day of life #30, [**2197-12-3**], he transitioned to room air. He was treated for apnea of prematurity with caffeine citrate and this was d'cd on [**2197-12-20**]. At time of discharge, he has been free of any apnea/bradycardia for at least 5 days and is breathing comfortably in room air with a respiratory rate of 40-70 breaths per minute. CARDIOVASCULAR: This infant has maintained normal heart rate and blood pressures. A soft intermittent murmur has been heard but has not been present for the past few weeks. His baseline heart rate is 150-170 beats per minute with a recent blood pressure of 77/46 mm Hg, mean arterial pressure 56 mHg. FLUIDS, ELECTROLYTES AND NUTRITION: This infant was initially fed nothing by mouth and maintained on intravenous fluids. A double-lumen umbilical catheter was placed for nutritional support. Enteral feedings were started on day of life #2 and gradually advanced to full volume. He had immature suck/swallow and breathing coordination in the past, He is taking 160-200 mL/kg/D of breast milk or breastfeeding. Weight at the time of discharge is 3070 g. INFECTIOUS DISEASE: Due to his prematurity and severity of illness and unknown group beta strep status of his mother, this infant was evaluated for sepsis upon admission to the neonatal intensive care unit. A complete blood count and white blood cell differential were sent and were within normal limits. A blood culture was obtained prior to starting intravenous ampicillin and gentamicin. Blood culture was no growth at 48 hours and the antibiotics were discontinued. This infant has not had any other infectious disease issues. HEMATOLOGY: Hematocrit at birth was 45.7%. This infant has not received any transfusions of blood products. Most recent hematocrit was on [**1-23**], with hematocrit of 25.3 % and a reticulocyte count of 1.8%. He is on supplemental iron. GASTROINTESTINAL: This infant required treatment for unconjugated hyperbilirubinemia with phototherapy. Peak serum bilirubin occurred on day of life #2, a total of 4.9 mg/dL. He was treated with phototherapy for approximately one week. His most recent serum bilirubin and final rebound was on [**2197-11-23**], on day of life 20, with total 2.7 mg/dL. NEUROLOGY: Head ultrasounds were performed on [**11-9**] and [**2197-12-1**] with all results within normal limits. This infant has maintained a normal neurological exam thus far during admission. SENSORY: a. AUDIOLOGY: Hearing screening has been performed and passed on [**1-26**]. b. OPHTHALMOLOGY: Initial screening eye exam for retinopathy of prematurity was performed on [**2196-12-19**] showing immature retinas zone 3 both eyes. A follow- up on [**1-8**] was mature ou, no signs of retinopathy. PSYCHOSOCIAL: Parents have been very involved since birth. Mother is of Japanese and Brazilian descent. The father is of Brazilian descent. They live in [**Location (un) 1468**], [**State 350**]. ABDOMEN: [**Known lastname **] has a 1.5 cm umbilical hernia. IMMUNIZATIONS: On [**1-5**] he received his 2 month immunizations, which were Pediarix, Hemophilus B and Pneumoccocal vaccines. Synagis was given on [**1-19**]. DISCHARGE DISPOSITION: Pedi at [**Hospital1 **] Medical Ass is Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 47145**]. Mom to make appt VNA to come to house day post discharge. 2. Medications: Ferrous Sulfate 4 mg/kg/day , TriViSol 1cc daily. 3. Iron and vitamin D supplementation: a. Iron supplementation is recommended for preterm and low birthweight infants until 12 months corrected age. b. All infants fed predominantly breast milk should received vitamin D supplementation at 200 international units (may be provided as a multivitamin preparation) daily until 12 months corrected age. 4. Car seat position screening passed. 5. State newborn screen was sent on [**2197-11-7**] with an elevated phenylalanine level. Repeat specimen was sent with no notification of abnormal results to date. 6. Immunizations: Hepatitis B vaccine was administered on [**2197-12-4**]. 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 4 criteria: 1) born at less than 32 weeks; 2) born between 32 and 35-0/7 weeks with 2 of the following: Daycare during RSV season, a smoker in the household, neuromuscular disease, airway abnormalities or school-aged siblings; 3) chronic lungs disease; or 4) 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 and for the first 24 months of a 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 the initial vaccination of preterm infants at or following discharge from the hospital if they are clinically stable and at least 6 weeks but fewer than 12 weeks of age. DISCHARGE DIAGNOSES: 1. Prematurity at 27-4/7 weeks gestation. 2. Twin #1 of twin gestation. 3. Respiratory distress syndrome. 4. Apnea of prematurity. 5. Suspicion for sepsis ruled out. 6. Unconjugated hyperbilirubinemia. 7. Anemia of prematurity. 8. Umbilical hernia 9. S/PIntermittent cardiac murmur. 10.S/P Feeding immaturity. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 37691**], [**MD Number(1) 55783**] Dictated By:[**Last Name (Titles) **] MEDQUIST36 D: [**2197-12-11**] 18:28:22 T: [**2197-12-11**] 19:14:48 Job#: [**Job Number **] ICD9 Codes: 769, 7742, V053, V290
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Medical Text: Admission Date: [**2157-7-29**] Discharge Date: [**2157-8-4**] Date of Birth: [**2106-10-23**] Sex: M Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 371**] Chief Complaint: s/p Self hanging Major Surgical or Invasive Procedure: None History of Present Illness: 50 you male s/p self hanging attempt, ?5-10 minutes. GCS 8. He was taken to a referring hospital where he was later transfered to [**Hospital1 18**] with a C1 C2 subluxation. Past Medical History: HTN GERD Seasonal allergies EtOH abuse Depression Social History: +EtOH Family History: Noncontributory Physical Exam: GENERAL: The patient is sedated, in chemical coma. HEENT: Normocephalic, atraumatic. NECK: Has a hard cervical collar. CARDIOVASCULAR: Tachycardic. PULMONARY: Clear to auscultation. ABDOMEN: Soft and nontender. DERMATOLOGIC: Shows no rashes or lesions. NEUROLOGICAL: He is in coma, chemically induced. Pertinent Results: [**2157-7-29**] 03:10AM GLUCOSE-119* UREA N-6 CREAT-0.5 SODIUM-136 POTASSIUM-4.4 CHLORIDE-105 TOTAL CO2-22 ANION GAP-13 [**2157-7-29**] 03:10AM WBC-6.3 RBC-3.52* HGB-13.0* HCT-37.5* MCV-107* MCH-37.0* MCHC-34.7 RDW-15.3 [**2157-7-29**] 03:10AM PLT COUNT-112* [**2157-7-29**] 03:10AM PT-16.0* PTT-30.8 INR(PT)-1.5* [**2157-7-28**] 11:59PM ASA-NEG ETHANOL-121* ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG CT C-SPINE W/O CONTRAST Reason: please eval for fx or malalignment [**Hospital 93**] MEDICAL CONDITION: 50 year old man s/p hanging REASON FOR THIS EXAMINATION: please eval for fx or malalignment CONTRAINDICATIONS for IV CONTRAST: None. HISTORY: 50-year-old man status post hanging. Evaluate for fracture or malalignment. No prior comparison exams are available. CT THE CERVICAL SPINE TECHNIQUE: MDCT acquired axial images were obtained via cervical spine without intravenous contrast. Coronal and sagittal reformations were evaluated. FINDINGS: Vertebral body height and alignment appear preserved. Well corticated fragments noted anterior to the C4 through C6 vertebral bodies are likely small regions of anterior longitudinal ligament ossificiation as no prevertebral soft tissues identified, however in the setting of trauma, ligamentous injury cannot be completely excluded. The coronal view demonstrates mild asymmetry to the lateral masses of C1 on C2 on the left side due to slght head rotation. Visualized contents of the intrathecal sac appear unremarkable, however MRI examination will be more sensitive for evaluation of spinal cord injury. Retained oral secretions are noted within the nasal and oropharynx. IMPRESSION: 1. Maintained vertebral body height and alignment. Small well corticated osseous fragments adjacent to the C4 through C6 vertebral bodies appear degenerative in nature as no prevertebral soft tissue swelling is identified, however in setting of hanging injury, ligamentous injury cannot be entirely excluded. 2. Mild asymmetry to the lateral masses of C1 on C2 due to rotation. These findings may be better evaluated with dedicated MRI examination, if clinically indicated. CHEST (PORTABLE AP) Reason: please evaluate for ARDS/contusion s/p hanging [**Hospital 93**] MEDICAL CONDITION: 50 year old man with recent hanging REASON FOR THIS EXAMINATION: please evaluate for ARDS/contusion s/p hanging UPRIGHT PORTABLE CHEST X-RAY PERFORMED ON [**2157-7-29**] AT 8:10 A.M. COMPARISONS: None. TECHNIQUE: Single portable chest x-ray, upright. CLINICAL HISTORY: 50-year-old man with recent hanging, evaluate for ARDS, contusion. FINDINGS: An endotracheal tube is in place, with its tip approximately 7 cm above the carina. The NG tube is seen extending into the left upper quadrant. Lungs are clear bilaterally. Cardiomediastinal silhouette is unremarkable. There is no pneumothorax. No fractures are identified. IMPRESSION: ET tube and NG tube in good position. No acute intrathoracic abnormality. Brief Hospital Course: He was admitted to the Trauma Service. Neurosurgery was consulted given his cervical spine injury; no operative intervention, he was placed in a hard cervical collar which will need to remain in place for a total of 12 weeks. Cardiology was consulted because of persistent tachycardia; he was given beta blockers and placed on telemetry. His tachycardia has resolved. Behavioral Neurology was also consulted because of concerns over anoxic brain injury related to the hanging attempt. It was recommended to minimize sedation and to perform EEG to evaluate for seizures if slow to awaken. He did wake up and has been alert and oriented, cooperative with his care. He will require outpatient follow up in [**Hospital **] clinic after discharge. Psychiatry was also consulted given that this was a suicide attempt and have recommended inpatient psychiatric admission. He is being treated with a 7 day course Keflex for a right arm cellulitis from an infiltrated IV site. Medications on Admission: pt denies Discharge Medications: 1. Lactulose 10 g/15 mL Syrup Sig: Thirty (30) ML PO TID (3 times a day). 2. Metoprolol Tartrate 25 mg Tablet Sig: 1.5 Tablets PO BID (2 times a day): hold for HR <60; SBP <110. 3. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Haloperidol 1 mg Tablet Sig: 1-2 Tablets PO BID (2 times a day) as needed for agitation. 6. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed for pain. 7. Colace 100 mg Capsule Sig: One (1) Capsule PO twice a day as needed for constipation. 8. Albuterol Sulfate 0.083 % (0.83 mg/mL) Solution Sig: One (1) ML Inhalation Q6H (every 6 hours) as needed for shortness of breath or wheezing: via nebulizer. 9. Sodium Chloride-Aloe [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 37062**], Non-Aerosol Sig: [**1-25**] Sprays Nasal TID (3 times a day) as needed for nasal dryness. Discharge Disposition: Extended Care Facility: [**Hospital1 **] 4 Discharge Diagnosis: s/p Self hanging C1 C2 subluxation Discharge Condition: Stable Discharge Instructions: You must continue to wear your cervical (neck) collar for a total of 12 weeks. Return to the Emergency room if you develop any numbness, weakness, loss of function in any of your extremities, shortness of breath, chest pain and/or any other symptomsthat are concerning to you. Followup Instructions: Follow up with Dr. [**Last Name (STitle) 23813**], Neurosurgery, in 4 weeks. Call [**Telephone/Fax (1) 1669**] for an appointment. Inform the office that you will need a repeat CT scan of your cervical spine for this appointment. Completed by:[**2157-8-4**] ICD9 Codes: 4019, 311
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Medical Text: Admission Date: [**2105-11-13**] Discharge Date: [**2105-11-18**] Date of Birth: [**2034-12-5**] Sex: F Service: MEDICINE Allergies: Penicillins / Salicylates / Morphine / Sulfa (Sulfonamides) Attending:[**First Name3 (LF) 7934**] Chief Complaint: Aspiration Major Surgical or Invasive Procedure: Trach on vent. History of Present Illness: HPI: Pt is a 70 y/o F with a hx of COPD with a trach not currently being vented, who presented from a NF to [**Location (un) 745**]-Wellesly Hopsital with hypoxia and respiratory difficulty. She is well known to [**Location (un) 745**]-Wellesly with numerous previous admissions. Pt was not responsive to oxygen there and per report the patient is at high risk for aspiration, since peanuts and other food was found in her bedsheets. She is unable to provide an accurate history. The patient was transferred to [**Hospital6 **] CXR was suspicious for aspiration PNA ,R>L. In addition there was blood-tinged sputum from her trach. Patient was treated with Vancomycin and Imipenem, and transeferred to [**Hospital1 18**] as no ICU beds were available. Of note patient was noted to have a potassium of 6.0, and was given insulin, D50, and 1 amp of HCO3. . Of note, the patient was recently d/c'd from [**Location (un) 65053**] Hospital [**2105-9-18**] after fevers and RML, RLL, and LLL PNA. There was purelent material in the trach, and she was presumed to have a recurrent PNA. She was treated at that time with Linezolid, Aztreonam, and Tobramycin given her h/o PNA's with Proteus, Psuedomonas, Serratia, and MRSA. Past Medical History: PMHx: Morbid Obesity COPD CAD with old LBBB CHF Hypothroidism Paroxysmal Atrial Fibrillation Recurrent pancreatitis s/p failed cholecystectomy for gallstones h/o MRSA PNA, and MRSA bacteremia h/o complicated PNA's with Pseudomonas, Proteus, and Serratia h/o post-traumatic intubation w/ intubation requiring trach CRF (unknown baseline, was 1.4 in [**10-17**]) Chronic foley, with h/o recurrent UTI's h/o GIB h/o pseudoseizures secondary to anxiety h/o severe pustular psoriasis to certain antibiotics(amoxicillin and levofloxacin) h/o Anxeity and Depression Type II DM Catatracts Social History: Soc: Patient is resident of [**Hospital 745**] Healthcare Center; no current Etoh or tobacco hx. Primary family are nephews. Family History: FMHx: Noncontributory (per OSH records) Physical Exam: VS(on admission): T=99.5, BP=135/59, HR=74, O2 sat 100%; vent settings 500 x 18, PEEP 5, Rate 18 (breathing 20-26), FiO2 60% GEN: Pt morbidly obese, in no acute distress HEENT: nonicteric, mucosa moist; unable to assess JVP; erythema diffuse over neck bilaterally CHEST: transmitted vent sounds ant & lat CV: RRR; difficult exam ABD: obese, soft; prior surgical scars EXT: [**12-14**]+ pitting LE edema NEURO: pt alert, follows basic commands; tremor of left arm and mild tremor of right arm; complete neuro exam difficult due poor cooperation. Pertinent Results: [**2105-11-13**] 05:05PM GLUCOSE-98 UREA N-32* CREAT-1.3* SODIUM-141 POTASSIUM-5.5* CHLORIDE-110* TOTAL CO2-20* ANION GAP-17 [**2105-11-13**] 05:05PM ALT(SGPT)-14 AST(SGOT)-18 LD(LDH)-303* ALK PHOS-306* TOT BILI-0.2 [**2105-11-13**] 05:05PM LIPASE-102* [**2105-11-13**] 05:05PM ALBUMIN-3.4 CALCIUM-8.1* PHOSPHATE-3.3 MAGNESIUM-1.6 [**2105-11-13**] 05:05PM WBC-21.4* RBC-4.57 HGB-11.2* HCT-34.8* MCV-76* MCH-24.5* MCHC-32.2 RDW-18.4* [**2105-11-13**] 05:05PM TSH-1.0 [**2105-11-13**] 05:05PM NEUTS-93* BANDS-0 LYMPHS-1* MONOS-5 EOS-0 BASOS-1 ATYPS-0 METAS-0 MYELOS-0 [**2105-11-13**] 05:05PM HYPOCHROM-OCCASIONAL ANISOCYT-2+ POIKILOCY-1+ MACROCYT-OCCASIONAL MICROCYT-2+ POLYCHROM-NORMAL OVALOCYT-1+ TEARDROP-OCCASIONAL [**2105-11-13**] 05:05PM PLT COUNT-286 [**2105-11-13**] 05:05PM PT-15.0* PTT-21.7* INR(PT)-1.5 . Labs from outside hospital: ABG 7.28/41/162 on 50% FiO2 . UA with 11,000 WBC's, 323 RBC's, many bact, +nitrite, 12 epis . Na 136, K 6.0(hemolyzed), bicarb 20, Chl 112, BUN 27, Cr 1.2, Glu 192; Ca 7.8 (Alb 3.0), PO4 2.8, INR 1.4; negative cardiac enzymes, BNP 76.5 . WBC 24 (76N, no bands), Hct 44, Plt 326 . CXR(OSH) - read as bilateral infiltrates, R>L Brief Hospital Course: Hospital Course: 70 year old nursing home resident with multiple medical problems who presents with aspiration pneumonitis and UTI. . ## Aspiration pneumonitis: Patient was found to have a large right-sided consolidation that resolved quickly within a day. Patient was satting 98-100% trach on vent, then was taken off of the vent and continued to sat >95% on 35% FiO2. She required suctioning Q6H, and was only short of breath upon suctioning. She was maintained on Imipenem/Cilastatin for an 8 day course (to be completed after discharge) to cover for aspiration pneumonia. Sputum culture grew out minimal yeast and oropharyngeal flora, but no bacterial pathogen. She was placed on Vancomycin for 6 days to cover for MRSA, but no MRSA grew from the sputum culture, and Vanco was thus d/ced. Patient was not severely sick on admission, and gradually improved until discharge. Vitals were stable at all times. . Patient has a trach but is not vented, is not short of breath, and eats and drinks at baseline. She is known to aspirate, but "would rather die" than not be able to take food and drink by mouth. She was maintained NPO until the day before discharge. The patient is fully aware of the dangers of aspiration and possible death, but she wishes to eat and drink by mouth. The types of food that are least prone to aspiration were discussed with the patient as being safer foods for her. Upon admission, peanuts and potato chips were found in the patient's trach. Code status was discussed with the patient because of likely readmission to an ICU, and she would like to follow her nephew's wishes, and her nephew wishes her to be full code. . ## CHF: There was a component of pulmonary edema due to CHF. Patient was diuresed with a goal of -1 to -2 L per day, which was achieved with Lasix 20 mg x1/day. . ## Subglottic stenosis: Communication between Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 65054**] (pulm fellow, [**Hospital1 18**]) and Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] at [**Hospital3 1196**]. Patient does not wish to remove her trach at this time, and she would not like intervention or stent in her trachea. . ## Paroxysmal AFIB: Coumadin 4 QD (home regimen) had been held during admission, but was restarted upon discharge. Patient was in normal sinus rhythm during admission. . ## Hyperkalemia: Patient was hyperkalemic upon admission, and kayexylate was administered 1x with decrease of K to 5.0. Patient was asymptomatic. Patient was not hyperkalemic for the remainder of admission, and EKG showed NSR without hyperkalemic morphology. Cr was stable and wnl. Etiology of hyperkalemia was not established. . ## UTI: Patient has a chronic foley catheter that was changed on [**2105-11-16**]. UA showed 11,000 WBC, and urine culture was negative. Patient was covered with Imipenem/Cilastatin. . ## DM2: BG were well controlled on insulin sliding scale. . ## Pseudoseizures: Patient has a history of pseudoseizures and has been maintained on Dilantin. She was not able to take PO meds during admission, but was restarted on Dilantin on the day before discharge. No seizures were witnessed during admission. . ## Depression: Patient was discharged on Seroquel per home regimen. . ## History of gallstone pancreatitis: Right upper quadrant ultrasound was performed for RUQ pain, and was found to be negative for cholelithiasis, with no gallbladder wall thickness changes. LFTs and pancreatic enzymes were wnl. . ## Chronic pain: Patient has pain "all over" and in her right upper quadrant that is intermittent. She was on a fentanyl patch with good pain control. . ## Access: Patient has a mediport (placed on [**9-18**], clotted on [**9-24**]), which now appears to be functioning. Site of port was clean. . ## Code: FULL per nephew. . ## Primary Communication: [**First Name9 (NamePattern2) 65055**] [**Known lastname **] @ ([**Telephone/Fax (1) 65056**], ([**Telephone/Fax (1) 65057**]. Medications on Admission: Meds(at NH): Pulmicort neb [**Hospital1 **] Effexor XR 150mg QD Fentanyl patch 50mcg q72 hours Lasix 40mg QD Norvasc 5mg QD Prednisone 5mg QD Protonix 40mg QD Ursodiol 300mg QD Colace 100mg QD Oyster shell calcium w/ Vit D 500mg [**Hospital1 **] Seroquel 75mg QD Dilantin 100mg TID Neurontin 300mg HS Dilaudid 1mg QID prn pain Ativan 1mg Q6 hours prn Duoneb q4 hours prn Tylenol prn Coumadin 4mg QD Realfin 100mg QD? Metoprolol 75mg PO BID Ambien prn RISS . All: salicylates/ASA, amoxicllin, codeine, floroquinolones/levaquin, morphine, sulfa, PCN(h/o severe rxn w/ sloughing of skin; per records never had a cephalosporin), Metoclopromide Discharge Medications: 1. Ursodiol 300 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 2. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO BID (2 times a day). 3. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Albuterol 90 mcg/Actuation Aerosol Sig: 1-2 Puffs Inhalation Q6H (every 6 hours) as needed. 5. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 6. Miconazole Nitrate 2 % Powder Sig: One (1) Appl Topical TID (3 times a day) as needed. 7. Fluticasone 110 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation [**Hospital1 **] (2 times a day). 8. Ipratropium Bromide 18 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation QID (4 times a day). 9. Fentanyl 50 mcg/hr Patch 72HR Sig: One (1) Patch 72HR Transdermal Q72H (every 72 hours). 10. Venlafaxine 75 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 11. Docusate Sodium 150 mg/15 mL Liquid Sig: One (1) PO BID (2 times a day). 12. Lorazepam 0.5 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 13. Phenytoin Sodium Extended 100 mg Capsule Sig: One (1) Capsule PO TID (3 times a day). 14. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 15. Furosemide 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 16. Prednisone 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 17. Imipenem-Cilastatin 500 mg Recon Soln Sig: Five Hundred (500) mg Intravenous Q8H (every 8 hours): Last date to give: [**2105-11-20**]. 18. Dolasetron 12.5 mg/0.625 mL Solution Sig: 12.5 mg Intravenous Q8H (every 8 hours) as needed. 19. Warfarin 4 mg Tablet Sig: One (1) Tablet PO DAILY (Daily): Home regimen, restarted [**2105-11-18**]. Discharge Disposition: Extended Care Facility: [**Hospital3 1196**] - [**Location (un) 745**] Discharge Diagnosis: Primary diagnosis: Aspiration pneumonia Secondary diagnosis: UTI Discharge Condition: Good. Patient is eating and understands the associated dangers, vitals stable. Discharge Instructions: Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight > 3 lbs. Adhere to 2 gm sodium diet Fluid Restriction: 2 L Followup Instructions: 1. Primary Care: Please make an appointment to see Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 410**], [**Telephone/Fax (1) 65058**]. 2. Please follow up with a pulmonologist at [**Hospital1 16961**]. Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] has seen this patient in the past. Completed by:[**2105-11-18**] ICD9 Codes: 5070, 5990, 4280, 496, 5849, 5859, 2449, 311
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Medical Text: Admission Date: [**2197-6-13**] Discharge Date: [**2197-6-23**] Date of Birth: [**2142-8-18**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2297**] Chief Complaint: Weakness, Cough and SOB Major Surgical or Invasive Procedure: None History of Present Illness: 54 y/oM with HIV on HAART (viral load undetectable, last CD4 in [**3-11**] 374), stage IV squamous lung CA s/p RUL s/p lobectomy, chemo/XRT, local and distal recurrence, HCV who p/w worsening fatigue, weakness, increasing dyspnea and new pleuritic chest pain. . Pt. was in USOH (able to ambulate on flat ground ~ 1mi w/o DOE, independent in majority of ADLs) until ~ 1wk ago when he develped malaise and fatigue. Over the next few days he developed a dry cough, which by 3 days PTA became productive of yellow/green sputum. At the same time he developed left sided pleuritic chest pain. He never had subjective fevers or chills, no nightsweats, though had ~ 10-12lbs of wt loss over the past month. By 2 days PTA, his dyspnea had worsened to the point that he was unable to perform ADLs and required assisstance from his mother. [**Name (NI) **] has had weakness in RUE and has had difficulty using that arm, but this is unchanged from prior. Has not been exposed to anyone with RFs for TB, no recent travel. Has not skipped any of the [**Doctor Last Name **] meds. He had respiratory distress requiring intubation for hypoxemic failure in [**2194**] after his right thoracotomy and right upper lobectomy. In the ED initial VS were 97.9 82 116/79 16 he desaturated to 88% on RA, increased to 93% with 2L NC. CTA showed a small LLL PNA with no evidence of PE, and enlarging right apical tumor. Blood cultures were drawn and was treated with zosyn, bactrim, vancomycin. He was admitted to the floor and had a slowly increasing O2 requirement to the point that this AM was satting 86% on 6L NC, requiring an NRB. He became more confused and sleepy per nursing staff. MICU evaluation was initiated. On evaluation, VS were 99.8F 106/72 88 26 93% on NRB, using accessory muscles of respiration and nasal flaring and tachypneic. STAT ABG was pH 7.40 pCO2 50 pO2 67, which was essentially unchanged from the one prior. He c/o of SOB and appeared slightly sleepy, though arousable to voice. . Review of systems: (+) Per HPI, chronic weakness and tingling in right arm, otherwise negative in detail. Past Medical History: - stage IV squamous cell lung cancer (Superior sulcus, T3, N0 at presentation) - dx [**2193**] with biopsy right lung apex squamous cell carcinoma. - s/p right upper lobectomy in [**2195-8-14**] - localized recurrence: Right lung apex in [**2196-6-1**] rx with CTX and cyberknife [**2195**]-[**2196**] - metastatic dx: T1-T2 neural foramina and nerve roots - palliative CTX w/ gemcitabine d/ced [**3-11**] due to liver dysfunction other medical history - Hx of Pulmonary Aspergillus fumigatus infection dx w/ BAL [**2195-7-10**], tx w/ voriconazole, resolution in [**2195-11-19**]. - HIV on HAART, [**3-11**]: viral load undetectable; CD4 count 374 - HCV: genotype 1a, bx [**8-8**] - pulmonary aspergillus dx on BAL [**7-9**] s/p voriconazole rx - hx of + ppd s/p rx with INH - hypotestosterone - polysubstance abuse - depressive d/o - arthritis s/p R shoulder replacement . Social History: - unemployed, disabled. Living at home with his mother - recovering addict (heroin, ETOH, other drugs) - tobacco use: formerly smoked 1ppd, now [**4-10**] cigarettes daily - not currently sexually active, partners have been female Family History: FH: [**Name (NI) 28142**] aunts w/lung cancer in 40s and 50s. father alive w/o CA, mother w/ asthma and s/p removal of breast lesion. Physical Exam: General Appearance: Thin, cachectic, appeared fatigued Eyes / Conjunctiva: Conjunctiva pale, R horners Head, Ears, Nose, Throat: Normocephalic, Poor dentition Lymphatic: Cervical WNL, No(t) Supraclavicular WNL Cardiovascular: (PMI Normal), (S1: Normal), (S2: Normal), no m/r/g Peripheral Vascular: (Right radial pulse: Present), (Left radial pulse: Present), (Right DP pulse: Present), (Left DP pulse: Present) Respiratory / Chest: (Expansion: Symmetric), (Breath Sounds: Diminished: right apex and laterally, Rhonchorous: throughout), no crackles appreciated Abdominal: Soft, ND, no shifting dullness Extremities: Clubbing, UEs and [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) 28146**]; no edema, dry, warm Musculoskeletal: Muscle wasting Skin: Warm Neurologic: Responds to: Not assessed, Movement: Not assessed, Tone: Not assessed, awakened eailsy to command and answered questios appropriately, inquired about status. R horners, EOMi, face symmeteric, intact to LT b/l, symmetric smile, tongue midline, tremor. Shoulder shrig intact. Mild biceps and finger flexion weakness. Otherwise full. LUE full. [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) 28147**] weak, muscle wasting throughout. Toes down b/l. normal tone. sensory exam deferred. Pertinent Results: [**2197-6-15**] 04:42AM BLOOD WBC-12.6* RBC-3.55* Hgb-13.4* Hct-40.1 MCV-113* MCH-37.8* MCHC-33.5 RDW-14.1 Plt Ct-148* [**2197-6-16**] 01:45AM BLOOD WBC-12.0* RBC-3.29* Hgb-12.3* Hct-36.9* MCV-112* MCH-37.3* MCHC-33.2 RDW-14.1 Plt Ct-129* [**2197-6-16**] 04:23PM BLOOD WBC-11.6* RBC-3.38* Hgb-12.8* Hct-39.3* MCV-116* MCH-38.0* MCHC-32.7 RDW-14.4 Plt Ct-132* [**2197-6-13**] 03:54PM BLOOD Lactate-2.2* [**2197-6-13**] 11:14PM BLOOD Lactate-1.2 [**2197-6-14**] 08:59AM BLOOD Lactate-1.5 [**2197-6-14**] 10:28AM BLOOD Lactate-1.4 [**2197-6-15**] 06:51AM BLOOD Lactate-1.2 [**2197-6-13**] CXR: FINDINGS: Portable AP upright view of the chest is obtained. Post-surgical changes related to prior right upper thoracotomy and reconstruction as well as right upper lobectomy are again noted. There is subtle increased nodular opacity at the left lung base, which raises concern for pneumonia. No large pleural effusions are seen, though the right CP angle is excluded. Cardiomediastinal silhouette appears grossly stable. Left humeral head prosthesis is noted. IMPRESSION: Findings concerning for left basilar pneumonia. Brief Hospital Course: Mr. [**Known lastname 28145**] was a 54 yo man with HIV on HAART (viral load undetectable, last CD4 in [**3-11**] 374), stage IV squamous lung CA s/p RUL s/p lobectomy, chemo/XRT, local and distal recurrence, HCV who presented with worsening fatigue, weakness, increasing dyspnea, new pleuritic chest pain, sputum production and confusion. . # Stage IV lung CA: On presentation, Mr. [**Known lastname 28145**] had an apical mass expanding, adrenal mass on CTA suspicious for metastasis and radicular symptoms in right arm likely [**1-3**] nerve compression but per Pain Clinic. On hospital day six, Mr. [**Known lastname 28145**] reported significnt concern over a new foot drop on the right which progressed to include right leg paralysis and numbness. An MRI of the Spine revealed metastatic tumor cord compression at C7 to T3 with significant stenosis at T2. Neuro-Surgery determined that he was a poor surgical candidate because of the extensive surgical debridment required or and high-risk nature of the surgery. Radiation Oncology evaluated him and determined that re-radiation was unlikely to improve his symptoms because of poor tumor response in the past. Pain control was maintined and he with his mother decided that inpatient hospice with a change of code status to DNR/DNI would be best for Mr. [**Known lastname 28145**]. . # HYPOXIC RESPIRATORY FAILURE, CHRONIC - He was found to have a LLL consolodation consistent with a LLL pneumonia. The pneumonia was believed to be aspiration vs. CAP and sputum culture failed to identify a pathogen. He recieved 7 days of imperic antibotics with azithromycin, ceftriaxone and flagyl which seemed to have resolved the pneumonia, but he continued to [**Known lastname 28148**] difficulty oxygenating. A PE was ruled out w/ CTA. And a Bubble study and Echo did not further identifying cause of hypoxia. He was aided by albuterol nebs Q2 hours and ipratropium nebs Q6H PRN. In the setting of his lobectomy and recurrent lung cancer, his new hypoxia was believed to represent a new baseline oxygen need. . # ALTERED MENTAL STATUS ?????? Mr. [**Known lastname 28145**] [**Last Name (Titles) 28148**] several paroxysmal episodes of profound agitation and combativeness that responded best to zyprexa 5mg. These may have occured due to metabolic derangement in setting of tumor burden or possibly brain mets. . # HCV: unknown VL. Synthetic function at baseline. Bx in [**2193**] -chronic viral hepatitis C with grade 2 inflammation and stage 2 fibrosis. No stigmata of acute liver failure or cirrhosis. - HCV VL = 9,060,000 . # HIV/AIDS on HAART: CD4 374 in [**3-11**] with undetectable VL. Has had apthous ulcers recently. Had CD4 count resent. - cont current antiretroviral medications - f/u CD4 count. - nystatin swish and swallow . # Code status: DNR/DNI comfort measures only # Communication: Patient and mother [**Name (NI) 382**] [**Telephone/Fax (1) 28149**] [**Doctor First Name 1258**]) FYI: Pain medications over the last 24 hours, patient required a total of morphine 52mg IV, morphine SR 60mg po, morphine IR 105mg po and a one-time dose of morphine SR 90mg at noon. Of note, patient's home narcotic regimen prior to admission included: METHADONE [**Male First Name (un) **] 10MG/5ML 75 mg daily MS CONTIN 200 MG XR12H-TAB (MORPHINE SULFATE) 1 tab po bid HYDROMORPHONE HCL 8 MG TABS 1 tab po every 6 hours prn Medications on Admission: Methadone 75 mg PO/NG QAM Albuterol 0.083% Neb Soln 1 NEB IH Q4H Amitriptyline 25 mg PO/NG HS Multivitamins 1 TAB PO/NG DAILY CefePIME 2 g IV Q12H day 1 = [**6-13**] Nystatin 500,000 UNIT PO/NG Q8H Pregabalin 50 mg PO/NG [**Hospital1 **] Clonazepam 0.5 mg PO/NG QAM:PRN anxiety Sertraline 100 mg PO/NG DAILY Docusate Sodium 100 mg PO BID Senna 1 TAB PO/NG [**Hospital1 **] Emtricitabine-Tenofovir (Truvada) 1 TAB PO DAILY Fosamprenavir 1400 mg PO Q12H Sulfameth/Trimethoprim DS 2 TAB PO/NG Q8H HYDROmorphone (Dilaudid) 2-4 mg PO/NG Q6H:PRN pain Vancomycin 1000 mg IV Q 12H day 1 = [**2197-6-13**] Ipratropium Bromide Neb 1 NEB IH Q6H ValACYclovir 1 gm PO BID Lactulose 30 mL PO/NG Q8H:PRN constipation Discharge Disposition: Extended Care Facility: [**Hospital1 656**] House Discharge Diagnosis: Pneumonia Stage IV metastatic squamous cell lung cancer Cervial Spine Metastasis Discharge Condition: Mental Status: Confused - sometimes. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: You were admitted to the hospital with fatigue, weakness and difficulty breathing. You were treated for a pneumonia which improved your breathing. You were found to have a spinal metastatic cancer causing right leg weakness. You and your mother considered available options and decided to pursue hospice care. Please take all medications as prescribed. Followup Instructions: Please consult Dr. [**First Name (STitle) **] [**Name8 (MD) 831**], MD Phone:[**0-0-**] or Dr. [**First Name (STitle) **] [**Last Name (NamePattern4) 2424**], MD Phone:[**Telephone/Fax (1) 2422**] with questions about your condition. Completed by:[**2197-6-26**] ICD9 Codes: 5070, 486, 2930, 311
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Medical Text: Admission Date: [**2155-7-12**] Discharge Date: [**2155-7-15**] Date of Birth: [**2134-8-13**] Sex: F Service: UROLOGY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 5272**] Chief Complaint: Right Flank pain Major Surgical or Invasive Procedure: Right ureteral stent placement on [**2155-7-13**] with Dr. [**Last Name (STitle) 770**]. History of Present Illness: Unsigned notes are not to be used for clinical decision making. They are not final. Date: [**2155-7-13**] Signed by [**Name6 (MD) **] [**Name8 (MD) **], MD on [**2155-7-13**] at 7:40 am Affiliation: [**Hospital1 18**] NEEDS COSIGN ATTENDING UROLOGIST: Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 770**] covering for Dr. [**First Name8 (NamePattern2) 1158**] [**Last Name (NamePattern1) 770**] UROLOGY CONSULT: Nausea, vomiting, and flank pain s/p Extracorporeal Shockwave Lithotripsy (ESWL) 20F H/O bilateral nephrolithiasis presents to ER s/p ESWL 2 days prior at [**Hospital6 2910**] with persistant N/V and poor pain control. Denies Fever, chills, dysuria. Last UTI was [**2-2**] treated with Cipro, diagnosed by lab, asymptomatic. Notes increased frequencey since procedure but no passage of fragments. Denies gross hematuria. Last bowel movement 2 days prior. PMH: hypothyroidism, nephrolithiasis in contest of >60 pound weight loss, ADHD PSH: ESWL x2 MEDS: levoxyl ALL: NKDA Physical Exam: NAD Soft, NT, ND No CVAT Pertinent Results: [**2155-7-15**] WBC-7.0 Hgb-11.3* Hct-33.3* Plt Ct-248 [**2155-7-14**] Glucose-97 UreaN-6 Creat-1.1 Na-142 K-4.2 Cl-108 HCO3-26 Brief Hospital Course: The patient was admitted to Dr.[**Name (NI) 825**] Urology service from the [**Hospital1 18**] ED for overnight observation, pain control, and IV fluids. A urine culture was obtained and antibiotics (Cipro) were begun. She became febrile overnight and was taken urgently to the OR for stent placement. Op Note is dictated separately. She recieved Ancef pre-operatively in addition to the Cipro she had been receiving. She became septic post-operatively and was hypoxic requiring aggressive pulmonary toilet in the [**Hospital Unit Name 153**] overnight. Her antibiotics were broadened to Ceftriaxone and gentamycin. A CXR suggested volume overload and she received Lasix in the PACU. With aggressive pulmonary toilet and diuresis she improved and was transferred to the floor. Her cultures returned only Gardnerella, for which she received 2 doses of Flagyl. She was given fluconazole x1 given the broad coverage antibiotics she received and issues with vaginal yeast infections. She was D/C'd in stable condition with 14 days of Cipro and instructions to follow up with Dr. [**First Name8 (NamePattern2) 1158**] [**Last Name (NamePattern1) 770**]. Discharge Medications: 1. Acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed for pain. 2. Senna 8.6 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day) for 7 days: Can decrease frequency or stop if having loose stools. Disp:*28 Tablet(s)* Refills:*0* 3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day) for 20 days. Disp:*40 Capsule(s)* Refills:*0* 4. Hydromorphone 4 mg Tablet Sig: 1-2 Tablets PO every four (4) hours as needed for pain. Disp:*20 Tablet(s)* Refills:*0* 5. Levothyroxine 88 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Ciprofloxacin 500 mg Tablet Sig: One (1) Tablet PO twice a day for 7 days. Disp:*14 Tablet(s)* Refills:*0* Discharge Disposition: Home Discharge Diagnosis: Urosepsis with obstructing ureteral stone. Discharge Condition: Stable Discharge Instructions: -No vigorous physical activity for 2 weeks. -Expect to see occasional blood in your urine and to experience urgency and frequecy over the next month. This is normal with a stent in place. -Tylenol should be your first line pain medication, a narcotic pain medication has been prescribed for breakthough pain. Max daily Tylenol dose is 4gm. -Make sure you drink plenty of fluids to help keep yourself hydrated and facilitate passage of stone fragments. -You may shower as normal. No tub baths or submersion until stone is removed. -Do not drive or drink alcohol while taking narcotics -Colace and Senna have been prescribed to avoid post surgical constipation and constipation related to narcotic pain medication, discontinue if loose stool or diarrhea develops. -Resume all of your home medications, unless otherwise noted. -Call Dr.[**Name (NI) 825**] office for follow-up AND if you have any questions. -If you have fevers > 101.5 F, vomiting, severe abdominal pain, or inability to urinate, call your doctor or go to the nearest emergency room. Followup Instructions: -Call Dr.[**Name (NI) 825**] office for follow-up AND if you have any questions. Completed by:[**2155-7-20**] ICD9 Codes: 5849, 5990, 5180, 2449