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{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8300 }
Medical Text: Admission Date: [**2165-4-14**] Discharge Date: [**2165-4-16**] Date of Birth: [**2165-4-14**] Sex: M Service: Neonatology HISTORY: [**First Name8 (NamePattern2) 1790**] [**First Name8 (NamePattern2) **] [**Known lastname 47766**] was born at 36 weeks gestation by a repeat cesarean section for spontaneous rupture of membranes and a planned repeat cesarean section. The mother is a 37-year-old gravida 2, para 1 now 2 woman. Prenatal screens are blood type O-, antibody negative, rubella immune, RPR nonreactive, hepatitis surface antigen negative, and group B Strep negative. The pregnancy was previously uncomplicated. Rupture of membranes 7 hours prior to delivery. No antepartum fever or other sepsis risk factors are present. This infant emerged vigorous. Apgars were eight at one minute and eight at five minutes. NICU team was called at 10 minutes for grunting and retracting. The infant was found in the OR to be vigorous, but was grunting and retracting, and brought to the Newborn Intensive Care Unit on blowby oxygen. Birth weight was 2,585 grams, birth length 47 cm, and birth head circumference 34.5 cm. Admission physical exam reveals a vigorous nondysmorphic premature infant. Anterior fontanel is soft and flat which is approximated. Positive bilateral red reflexes. Palate intact. Neck is supple and without masses. Clavicles intact. Mild subcostal retractions. Respiratory rate in the 60s, intermittent and grunting. Breath sounds are equal with scattered rhonchi. Heart was regular, rate, and rhythm, no murmur. Pink on room air, well perfused. Femoral pulses present. Abdomen is soft, active bowel sounds, liver edge of the costal margin. Three vessel umbilical cord, hip laxed but stable. Sacrum without dimple. Normal digits and creases. Testes are descended bilaterally. Positive suck, weak, but equal grasp and an incomplete morrow. His NICU stay by systems: Respiratory: Infant developed increasing tachypnea 80-100 breaths per minute, but always remained in room air except for initially requiring some blowby oxygen. His symptoms resolved by approximately 12 hours of life, and on examination at the time of transfer, his respirations are comfortable. Lung sounds are clear and equal. He remains with O2 saturations greater than 95 on room air and has had no apnea or bradycardia. Cardiovascular: He has remained normotensive throughout his NICU stay. Blood pressure means have always been within normal limits. There are no cardiovascular issues. On examination, he has a regular, rate, and rhythm, and no murmur. Fluids, electrolytes, and nutrition: His weight at the time of transfer is 2,635 grams. Enteral feeds were begun at approximately 12 hours of life and they advanced without difficulty to full volume feedings of Enfamil 20 calories per ounce on an adlib schedule. Mother plans to bottle feed. He has maintained euglycemia with his last blood glucose being 96. Gastrointestinal: The infant past meconium stools, and there are no gastrointestinal issues. Hematology: The patient's blood type is O+, DAT negative. He has received no blood product transfusions. His hematocrit on admission was 44.6 with a platelet count of 350,000. Infectious disease: At the time of admission, he had a blood culture drawn and a complete blood count which had a white count of 19.7 with a differential of 50 polys and 0 bands. Blood culture remains negative at the time of transfer, and he was never started on any antibiotics. Audiology: Hearing screening has not yet been done. It was recommended prior to discharge. Psychosocial: Parents have been visiting in the NICU and has been involved in his care. He has a 14 month old sibling at home. The infant is discharged in good condition. The infant is discharged to the Newborn Nursery. Primary pediatric care will be provided by Dr. [**First Name8 (NamePattern2) 1743**] [**Last Name (NamePattern1) 37517**] of [**Location (un) 1887**]. CARE AND RECOMMENDATIONS AT DISCHARGE: 1. Feedings: Enfamil 20 calories/ounce on an adlib schedule. The infant is discharged on no medications. Car seat position screening test should be done prior to discharge as per the American Academy of Pediatrics Guidelines. State newborn screen should be sent on day of life three. The infant has not yet received any immunization, but meets the criteria for his first hepatitis B vaccine. DISCHARGE DIAGNOSES: 1. Prematurity 36 weeks gestation. 2. Transitional respiratory distress now resolved. 3. Sepsis ruled out. [**First Name8 (NamePattern2) 36400**] [**Name8 (MD) **], M.D. [**MD Number(1) 37201**] Dictated By:[**Last Name (NamePattern1) 37333**] MEDQUIST36 D: [**2165-4-16**] 02:41 T: [**2165-4-16**] 06:58 JOB#: [**Job Number 47767**] ICD9 Codes: V290, V053
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8301 }
Medical Text: Admission Date: [**2178-11-19**] Discharge Date: [**2178-11-26**] Date of Birth: [**2127-2-26**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 165**] Chief Complaint: Chest pain Major Surgical or Invasive Procedure: [**2178-11-19**] Coronary artery bypass grafting times three(left internal mammary to left anterior descending with vein grafts to diagonal and PDA) History of Present Illness: This is a 51 year old male with CAD s/p PCI at [**Hospital1 112**] in [**2170**]. Recently presented with a few months of chest pain, slowly getting worse. Catheterization on [**11-12**] revealed an occluded RCA, significant stenoses proximal and distal to a previously placed proximal LAD stent and moderate disease otherwise. He underwent preoperative evaluation and was cleared for surgery. Past Medical History: Coronary Artery Disease s/p stents [**2170**] Hyperlipidemia Hypertension Social History: He workes in the deli department at the Stop and Shop. -Tobacco history: denies any smoking. -ETOH: denies any alcohol use. -Illicit drugs: denies any drug use. Family History: He states his father died at the age of 54 of an MI. Denies any other family history. Physical Exam: General: NAD, WGWN, 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- none Varicosities: None [x] Neuro: Grossly intact x Pulses: Femoral Right: cath site Left: 2+ DP Right: 2+ Left: 1+ PT [**Name (NI) 167**]: 2+ Left: NP Radial Right: 2+ Left: 2+ Carotid Bruit: none Pertinent Results: [**2178-11-19**] Intraop TEE: PREBYPASS No atrial septal defect is seen by 2D or color Doppler. There is mild symmetric left ventricular hypertrophy. The left ventricular cavity is mildly dilated. Overall left ventricular systolic function is low normal (LVEF 50-55%). Right ventricular chamber size and free wall motion are normal. The ascending aorta is mildly dilated. The descending thoracic aorta is mildly dilated. 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 LV systolic function is normal EF-55%. RV systolic function remains normal. The study is otherwise unchanged from the prebypass period. Brief Hospital Course: Admitted and underwent coronary artery bypass grafting surgery by Dr. [**First Name (STitle) **]. For surgical details, please see operative note. Following the operation, he was brought to the CVICU for invasive monitoring. Within 24 hours, he awoke neurologically intact and was extubated. On postoperative day one, he showed signs of ETOH withdrawal. He became increasingly tachypneic, tachycardic and hypertensive. He concomitantly became more impulsive and confused/agitated requiring Ativan and Haldol prn. Due to delirium tremens and agitation, he was reintubated for safety on postoperative day three. On postoperative day four, patient self extubated. His mental status seemed improved on Valium three times daily. On postoperative day five, he transferred to the cardiac SDU. Valium was titrated down accordingly. Mental status and signs of ETOH withdrawal improved dramatically. He remained in a normal sinus rhythm. Beta blockade was advanced as tolerated and ACEI was added for hypertension. Over several days, he continued to make clinical improvements and was eventually cleared for discharge to [**Hospital1 38437**] for the Aged - MACU Medications on Admission: Aspirin Discharge Medications: 1. Zantac 150 mg Tablet Sig: One (1) Tablet PO once a day. 2. lisinopril 10 mg Tablet Sig: One (1) Tablet PO once a day. 3. Lasix 20 mg Tablet Sig: One (1) Tablet PO once a day for 5 days. 4. potassium chloride 10 mEq Capsule, Sustained Release Sig: One (1) Capsule, Sustained Release PO once a day for 5 days. 5. Colace 100 mg Capsule Sig: One (1) Capsule PO twice a day. 6. aspirin, buffered 81 mg Tablet Sig: One (1) Tablet PO once a day. 7. clonidine 0.3 mg/24 hr Patch Weekly Sig: One (1) Transdermal qsunday . 8. Lopressor 100 mg Tablet Sig: One (1) Tablet PO three times a day. 9. Plavix 75 mg Tablet Sig: One (1) Tablet PO once a day. 10. Wellbutrin SR 150 mg Tablet Sustained Release Sig: One (1) Tablet Sustained Release PO once a day. 11. thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO once a day. 12. folic acid 1 mg Tablet Sig: One (1) Tablet PO once a day. 13. Lipitor 20 mg Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - MACU Discharge Diagnosis: Coronary artery disease, s/p CABG Postop ETOH Withdrawal, Altered Mental Status Hyperlipidemia Hypertension Discharge Condition: Alert and oriented x3 nonfocal Ambulating with steady gait Incisional pain well controlled Incisions: Sternal - healing well, no erythema or drainage Leg Right - healing well, no erythema or drainage Edema trace 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 Name8 (NamePattern2) **] [**Name (STitle) **] [**2178-12-21**] @ 1 PM Cardiologist: Dr. [**First Name (STitle) **] [**Name (STitle) **] [**2178-12-15**] @ 140 PM Primary Care Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 1726**] on [**2178-12-1**] @ 145 PM **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:[**2178-11-26**] ICD9 Codes: 2851, 2724, 4019
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Medical Text: Admission Date: [**2137-6-9**] Discharge Date: [**2137-6-14**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2704**] Chief Complaint: Anterior ST segment myocardial infarction Major Surgical or Invasive Procedure: Coronary artery catheterization and angioplasty of left anterior descending artery to the right coronary artery Intraaortic Balloon Pump support Swan-Ganz catheterization Catherization results: . 1. Selective coronary angiography demonstrated two vessel coronary artery disease in this left dominant circulation. The LMCA was severely calcified. The proximal LAD was severely calcified and was completely occluded after the takeoff of a large D1 branch. The LCX had a distal tubular stenosis. The OM branches were without angiographically apparent flow limiting disease. The RCA had a proximal 80% stenosis and was a non-dominant vessel. . 2. Resting hemodynamics from right heart catheterization demonstrated severely elevated right and left sided filling pressures (RVEDP=17mmHg and mean PCWP=33mmHg). Cardiac output and index were severely depressed at 2.5 L/min and 1.3 L/min/m2 respectively. Severe pulmonary arterial hypertension was present (64/31). . 3. Left ventriculogram was not performed to reduce contrast load. . 4. PCI of the LAD and diagonal complicated by distal embolization into the diagonal. The LAD had a 20% residual stenosis with distal TIMI 2 flow and poor myocardial perfusion at the end of the procedure. . 5. Successful placement of an 8 French 40 cc IABP via the RFA. <br><br> FINAL DIAGNOSIS: 1. Two vessel coronary artery disease. . 2. Anterior ST segment elevation myocardial infarction. . 3. Severely elevated right and left sided filling pressures. . 4. Cardiogenic shock with placement of intra-aortic balloon assist device. . 5. PCI of the LAD/Diagonal. History of Present Illness: This is an 83 male with a history of hypertension, atrial fibrillation, subdural hematoma ('[**30**] on coumadin), who presented to an outside hospital 20 hours after the onset of substernal chest pain. An EKG performed at the time showed ST segment elevation in V4-V5, Q waves in leads II, III, avF, and atrial fibrillation. The patient received sublingual nitroglycerin X3 with no alleviation of chest pain. A nitroglycerin drip was then started and brought the patient some relief with 2/10 chest pain. Cardiac enzymes at the time showed an elevated CK of 2519. The patient was transferred to [**Hospital1 18**] for a cath. A PTCA was performed to the left anterior descemding artery to the right coronary (10% residual stenosis). A stent was not placed due to low residual flow. At the time the patient was found to have a low cardiac index of 1.3. An intra-aortic balloon pump was placed. The patient received Lasix 40mg IV and 300mg bolus of Plavix. Integrillin, ASA, and Lipitor were also started. Past Medical History: - CAD (unclear history) - Atrial fibrillation - Hypertension - Subdural Hematoma (s/p trauma on coumadin '[**30**]) Social History: Lives with wife, quit tobacco Family History: Non-contributory Physical Exam: Physical Exam on Admission VS: 93 144/71 (PA 58/26) 14 96% 2L Gen: NAD, lying in bed HEENT: neck supple, 7cm JVD Heart: nl rate, irreg rhythm (Atrial fibrillation), S1S2, no G/M/R Lungs: crackles at the bases Abdomen: soft, non-tender, non-distended, +BS; slight discomfort due to IABP R Groin: femoral pulse present, no bruits, no ecchymosis Extremities: feet cold, DP appreciated bilaterally with doppler; no c/c/e Neuro: II-XII grossly intact Pertinent Results: Cardiac Enzymes . [**2137-6-9**] 02:18PM BLOOD CK(CPK)-3071* [**2137-6-9**] 07:40PM BLOOD CK(CPK)-4538* [**2137-6-11**] 07:45AM BLOOD CK(CPK)-686* . [**2137-6-9**] 02:18PM BLOOD CK-MB->500 cTropnT-9.33* [**2137-6-10**] 01:58AM BLOOD CK-MB-486* MB Indx-14.5* cTropnT-22.87* [**2137-6-11**] 07:45AM BLOOD CK-MB-47* MB Indx-6.9* cTropnT-14.51* . Chemistry . [**2137-6-9**] 02:18PM BLOOD Glucose-168* UreaN-32* Creat-1.1 Na-132* K-4.5 Cl-98 HCO3-24 AnGap-15 [**2137-6-14**] 06:25AM BLOOD Glucose-87 UreaN-46* Creat-1.5* Na-135 K-4.3 Cl-100 HCO3-25 AnGap-14 . [**2137-6-9**] 02:18PM BLOOD Calcium-8.2* Phos-3.7 Mg-1.9 [**2137-6-14**] 06:25AM BLOOD Calcium-8.5 Phos-3.5 Mg-2.2 . CBC [**2137-6-14**] 06:25AM BLOOD WBC-9.5 RBC-4.20* Hgb-12.4* Hct-37.3* MCV-89 MCH-29.5 MCHC-33.2 RDW-13.6 Plt Ct-198 [**2137-6-9**] 02:18PM BLOOD WBC-15.3* RBC-4.87 Hgb-14.4 Hct-42.5 MCV-87 MCH-29.6 MCHC-33.9 RDW-13.5 Plt Ct-199 Brief Hospital Course: 83M s/p STEMI of LAD and RCA territory, loss of D1 [**1-2**] embolization, transferred to CCU for optimization of hemodynamics in the setting of cardiogenic shock. * Pump: Given cardiac index of 1.3 in cath lab, IABP was placed for optimization of systolic and diastolic pressures. On IABP, cardiac index improved to 1.7, and although patient diuresed successfully with 40mg IV Lasix, nesiritide gtt was started to further improve hemodynamics. On hospital day two, cardiac index improved to 2.3 on nesiritide and IABP, and both were discontinued on hospital day three as patient continued to do improve in function with excellent diuresis on lasix alone (PAP 43/21). Echocardiogram revealed EF<20%, 1+ MR, 1+ TR and global hypokinesis. Lisinopril was initiated for afterload reduction, and at the time of discharge, was uptitrated to 7.5mg QD. Patient was instructed to return for echocardiogram in one month following discharge. Digoxin was continued for additional rate control and to also further improve inotropy as outpatient. Despite poor ejection fraction, patient was considered extremely poor candidate for anticoagulation given history of subdural hematoma. * Rhythm: Atrial fibrillation. Stable throughout hospitalization. Given history of subdural hematoma, patient was not candidate for long-term anticoagulation. Patient did require one dose of IV metoprolol for stable Afib with RVR to improve rate control. * STEMI: Given patient's late presentation (infarct may have begun as early was 3 days before presentation), flow in LAD and RCA despite PTCA were extremely poor, making stent placement impossible. CK peaked at 4538, MB >500 on the evening of hospital day one consistent with transmural infarction. Patient was started on medical management regimen of ASA 325, Plavix 75, Atovastatin 80, with Integrilin for 18 hours post catheterization. Patient tolerated these medications without evidence of intracranial hemorrhage or other site of bleeding. To improve rate control post MI, metoprolol 25 [**Hospital1 **] was initiated. To improve afterload reduction, patient was started on lisinopril as above and titrated to 7.5mg QD. Patient remained chest pain free throughout hospitalization. * Urinary Tract Infection: Patient had a low grade fever (100.5) on hospital day four, and urinalysis revealed sm leuk esterase w/ few bacteria. However, given the fact that this was in the setting of indwelling foley, patient was initiated on bactrim for treatment with an intent to complete a 7 day course as an outpatient. * Dehydration: Patient was initially diuresed aggressively given cardiogenic shock, however, near the time of discharge, patient had mild bump in creatinine (chronic renal insufficiency Cr 1.1-1.2) to 1.5, and urine lytes revealed prerenal (UOsm [**Telephone/Fax (1) 63454**] mg/dL UCreat 86 mg/dL USodium 15 mEq/L). Patient was given 250cc NS for hydration and encouraged to take more PO fluids. At the time of discharge, patient continued to have mild ambulatory desaturations and exhaustion after minimal exertion, and was therefore referred to short term inpatient rehabilitation. Patient was instructed to followup with primary care physician and cardiologist one week and one month respectively following discharge from rehab. Medications on Admission: Digoxin Diltiazem Diovan Lasix Discharge Medications: 1. Aspirin 325 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. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 3. Atorvastatin Calcium 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 4. Digoxin 125 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 5. Trimethoprim-Sulfamethoxazole 160-800 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) for 5 days. Disp:*10 Tablet(s)* Refills:*0* 6. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 7. Lisinopril 5 mg Tablet Sig: 1.5 Tablets PO DAILY (Daily). Disp:*45 Tablet(s)* Refills:*2* 8. Metoprolol Succinate 50 mg Tablet Sustained Release 24HR Sig: One (1) Tablet Sustained Release 24HR PO once a day. Disp:*30 Tablet Sustained Release 24HR(s)* Refills:*2* Discharge Disposition: Extended Care Facility: [**Hospital3 7665**] Discharge Diagnosis: Anterior ST segment elevation myocardial infarction. Discharge Condition: Good Discharge Instructions: You must call 911 first if you experience any chest pain or chest pressure, if you become short of breath, or if you experience any numbness, tingling or pain radiating to your jaw or arms/hands. You can resume normal activities, but you are not to assume any strenous activity such as lifting or pulling until you are cleared by rehabilitation services. Followup Instructions: Draw blood for digoxin level in one week following discharge. Repeat echocardiogram in one month following discharge. ICD9 Codes: 5990, 2765, 4019
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Medical Text: Admission Date: [**2127-12-31**] Discharge Date: [**2128-1-8**] Date of Birth: [**2044-6-29**] Sex: M Service: NEUROSURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1835**] Chief Complaint: change in mental status Major Surgical or Invasive Procedure: Intubation PEG placement History of Present Illness: Pt is an 83 yo gentleman with PMHx sig for HTN, skin cancer NOS, and sleep apnea who fell down four stairs at home today. EMS was called and the patient was intubated due to combativeness. He was brought to an OSH where a head CT showed a large L temporal ICH, intraventricular hemorrhage, L SDH, and SAH. The patient was transferred to [**Hospital1 18**] for further management. Mechanism of fall unclear. Past Medical History: HTN, skin cancer, and sleep apnea Social History: non-contributory Family History: non-contributory Physical Exam: Exam upon admission: Vitals: T 98.2; BP 140/75; P 71; RR 13; O2 sat 99% General: intubated HEENT: NCAT, moist mucous membranes Pulmonary: CTA b/l Cardiac: regular rate and rhythm, with no m/r/g Abdomen: soft, nontender, non distended, normal bowel sounds Extremities: no c/c/e. Neurological Exam: Mental status: intubated. Does not open eyes and did not squeeze hands to command. Cranial Nerves: PERRL, 3-->2mm with light, + corneal, + VOR, face symmetric. Motor/[**Last Name (un) **]: Normal tone. withdraws legs to painful stimuli, also withdrawal of arm to painful stimuli. Reflexes: 1+ in UEs and patella, absent ankle jerks. Toes downgoing bilaterally. Pertinent Results: CT head [**2127-12-31**]: FINDINGS:There is a acute subdural hematoma which surrounds the left cerebral hemisphere which measures up to 9 mm in thickness. Subdural blood layers along the left tentorium. Blood is noted in the left quadrigeminal cistern and surrounding the left cerebral peduncle and within left portion of the suprasellar cistern. There is subarachnoid hemorrhage along the left cerebral hemisphere spanning the frontal and temporal lobes primarily. There is also subarachnoid blood on the right noted in the right sylvian fissure specifically. There is increase in parenchymal contusion in the left temporal lobe with surrounding edema and sulcal effacement noted. Areas of pneumocephalus are again noted in the left middle cranial fossa. Intraventricular hemorrhage is noted primarily in the left lateral ventricle and a small amount is noted to layer in the right lateral ventricle occipital [**Doctor Last Name 534**]. There is no increase in ventricular size when compared with prior study hough there is now approximately 4 mm of rightward subfalcine herniation which may be increased. There is no evidence of downward transtentorial herniation though there is some relative hypodensity in the left cerebral peduncle which may reflect edema. Overall, the most notable difference since the prior study is the increase in left temporal lobe hemorrhagic contusion and the surrounding edema. Impression: 1. Increased hemorrhagic contusion in left temporal lobe with resultant surrounding edema. No significant change in left cerebral subdural hematoma and extensive subarachnoid hemorrhage. 2. Partial opacification of left mastoid air cells and the left middle ear cavity raising concern for left temporal bone fx. The presence of pneumocephalus in the left middle cranial fossa also suggests an underlying fracture. HEAD AND NECK CTA [**1-1**]: The carotid and vertebral arteries and their major branches are patent. In particular, the left MCA is patent without evidence of stenosis, but this does not exclude ischemia. There is a mild narrowing ofthe basilar artery, most likely secondary to atherosclerotic plaque. The diamter of The distal cervical internal carotid arteries measures 7 mm on the right and 4 mm on the left. There is no evidence of aneurysm formation or other vascular abnormality. MPRESSION: 1. No interval change of the multiple intracranial hemorrhage and hematomas. Persistent mass effect with a rightward shift of midline structures. 2. No evidence of aneurysm. Mild narrowing of basilar artery. Left MCA patent, but this does not exclude ischemia. 3. Persistent hypodensity extending to the cortex, approximating the left MCA distribution. Question remains if parenchymal edema is secondary to infarction or contusion. Brief Hospital Course: 83 yo gentleman with PMHx sig for HTN, skin cancer NOS, and sleep apnea who fell down four stairs at home. EMS was called and the patient was intubated due to combativeness. He was brought to an OSH where a head CT showed a large L temporal ICH, intraventricular hemorrhage, L SDH, and SAH. The patient was in SICU during most of the hospital course. The patient's poor prognosis for a meaningful recovery was discussed with the family and no brain intervention was performed. Patient was made DNR. He was not improving and the family decided to make the patient comfort measures only on [**1-7**]. He was extubated and later transferred to the floor. He was placed on a morphine drip. Palliative care recommended a changed in the pain regimen and also recommended giving him medication for his secretions. The patient was kept comfortable. His family was with him on [**1-8**] when he expired at 5 pm. They did not want an autopsy. Medications on Admission: ASA 81 mg po q day Discharge Medications: NA Discharge Disposition: Expired Discharge Diagnosis: Left temporal intraparenchimal hemorrhage, left subdural hemorrhage and intraventricular hemorrhage Discharge Condition: expired Discharge Instructions: NA Followup Instructions: NA Completed by:[**2128-1-8**] ICD9 Codes: 486, 5990, 4019
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Medical Text: Admission Date: [**2172-9-16**] Discharge Date: [**2172-10-24**] Date of Birth: [**2124-2-26**] Sex: M Service: SURGERY Allergies: Ambien Attending:[**First Name3 (LF) 148**] Chief Complaint: Abdominal Pain Major Surgical or Invasive Procedure: Re-opening of Laparotomy Open Cholecystectomy Small Bowel Resection Roux-en-Y Duodeno-jejunosotmy Small Bowel Stricture-plasty x 10 J-tube Placement History of Present Illness: This is a 45 year old male who presented from [**Hospital1 14360**] with a 12 hour history of abdominal pain, nausea and vomitting and diarrhea. A CT revealed free fluid and free air with perforation of the duodenum. He was transfered via med-flight and intubated just prior to departure. Hisa O2 sats were in the low 80's. He was started on Dopamine for pressure support and received 7.5 liters of crystalloid. Past Medical History: s/p Bilroth II '[**58**], Crohn's, Anemia, Depression, PUD Physical Exam: VS: 99.3, 141 sinus tach, 112/57, 14, 92% intubated Gen: Intubated, PERRL, mucous membrane dry CV: tachy, regular Pulm: diffusely coarse BS Abd: distended, firm, reducable umbilical and right groin hernia, guaic negative Ext: no edema Pertinent Results: Cardiology Report ECHO Study Date of [**2172-10-7**] PATIENT/TEST INFORMATION: Indication: Endocarditis. ? Height: (in) 70 Weight (lb): 165 BSA (m2): 1.93 m2 BP (mm Hg): 128/69 HR (bpm): 88 Status: Inpatient Date/Time: [**2172-10-7**] at 16:21 Test: Portable TTE (Complete) Doppler: Full Doppler and color Doppler Contrast: None Tape Number: 2006W031-0:13 Test Location: West SICU/CTIC/VICU Technical Quality: Adequate REFERRING DOCTOR: DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] MEASUREMENTS: Left Atrium - Long Axis Dimension: 3.6 cm (nl <= 4.0 cm) Left Atrium - Four Chamber Length: 5.1 cm (nl <= 5.2 cm) Right Atrium - Four Chamber Length: 4.6 cm (nl <= 5.0 cm) Left Ventricle - Ejection Fraction: >= 75% (nl >=55%) Aorta - Valve Level: 3.5 cm (nl <= 3.6 cm) Aorta - Arch: *3.2 cm (nl <= 3.0 cm) Mitral Valve - E Wave: 0.8 m/sec Mitral Valve - A Wave: 0.4 m/sec Mitral Valve - E/A Ratio: 2.00 INTERPRETATION: Findings: LEFT ATRIUM: Normal LA size. RIGHT ATRIUM/INTERATRIAL SEPTUM: Normal RA size. LEFT VENTRICLE: Normal LV wall thicknesses and cavity size. Normal regional LV systolic function. Hyperdynamic LVEF. TVI E/e' < 8, suggesting normal PCWP (<12mmHg). No resting LVOT gradient. RIGHT VENTRICLE: Normal RV chamber size and free wall motion. AORTIC VALVE: Normal aortic valve leaflets (3). No AS. No AR. MITRAL VALVE: Normal mitral valve leaflets with trivial MR. No MVP. TRICUSPID VALVE: Normal tricuspid valve leaflets with trivial TR. Indeterminate PA systolic pressure. PULMONIC VALVE/PULMONARY ARTERY: Normal pulmonic valve leaflets with physiologic PR. PERICARDIUM: No pericardial effusion. GENERAL COMMENTS: Based on [**2163**] AHA endocarditis prophylaxis recommendations, the echo findings indicate a low risk (prophylaxis not recommended). Clinical decisions regarding the need for prophylaxis should be based on clinical and echocardiographic data. Conclusions: The left atrium is normal in size. Left ventricular wall thicknesses and cavity size are normal. Regional left ventricular wall motion is normal. Left ventricular systolic function is hyperdynamic (EF>75%). Tissue velocity imaging demonstrates an E/e' <8 suggesting a normal left ventricular filling pressure (<12mmHg). Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. The mitral valve appears structurally normal with trivial mitral regurgitation. There is no mitral valve prolapse. The pulmonary artery systolic pressure could not be determined. There is no pericardial effusion. IMPRESSION: No valvular pathology or pathologic flow identified. Hyperdynamic left ventricular systolic function. LIVER OR GALLBLADDER US (SINGLE ORGAN) [**2172-10-6**] 8:47 AM US HEPATOTOMY DRAIN ABSCESS/CY; GUIDANCE FOR ABSCESS ([**Numeric Identifier 10268**]) Reason: Please perform an ultrasound guided percutaneous drainage of [**Hospital 93**] MEDICAL CONDITION: 48 year old man with Crohn's s/p BII reconstruction (92) c/b jejunal perforation, enterectomy and now s/p Roux-en_y duodenojejunostomy and stricturoplasty x10 with post0operative fevers and leukocytosis REASON FOR THIS EXAMINATION: Please perform an ultrasound guided percutaneous drainage of the gallbladder fossae abscess and possible drainage of the left paracolic gutter collection on [**2172-10-6**] EXAMINATION: Ultrasound-guided abscess drainage, [**2172-10-6**] COMPARISON: CT of the abdomen and pelvis dated [**2172-10-5**]. INDICATION: History of Crohn's disease and multiple surgeries with postoperative fluid collections suspicious for abscess. PROCEDURE AND FINDINGS: Ultrasonography of the gallbladder fossa demonstrates a complex fluid collection with echogenic foci within it consistent with fluid collection containing foci of gas as seen on prior CT scan. Imaging of the left pericolic gutter demonstrates a complex heterogeneous fluid collection with multiple septations, which also corresponds to the fluid collection seen on CT along the left pericolic gutter. The procedure was explained along with risks and benefits to the patient's wife via telephone consent and informed consent was obtained. Throughout the procedure, the patient received 2.5 mg of Versed and 50 mcg of fentanyl. In addition, after the patient was prepped and draped in usual sterile fashion. Approximately 10 mL of lidocaine was used to provide local anesthesia. The left lower quadrant fluid collection was marked under ultrasound guidance and after the lidocaine was placed skin [**Doctor Last Name **] was made using a scalpel. Using ultrasound guidance, an 8-French pigtail drainage catheter was placed into the left lower quadrant fluid collection. A total of 300 mL of serosanguinous fluid was aspirated into a drainage bag and the cavity was flushed with approximately 150 mL of saline which was also aspirated into the drainage bag. The pigtail catheter was left to gravity drainage. The fluid and gas collection within the gallbladder fossa was then approached using ultrasound guidance. Using a transhepatic approach after the skin was numb, with lidocaine and a skin [**Doctor Last Name **] was performed, an 8-French pigtail catheter was inserted transhepatically into the complex fluid collection in the gallbladder fossa and the catheter was secured in place. Approximately 160 mL of reddish purulent material was aspirated and the cavity was flushed with 80 mL of saline. The pigtail catheter was left to gravity drainage. The patient tolerated the procedure well and there were no immediate post- procedural complications. Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 4401**] is present for placement of the pigtail catheter in in the gallbladder fossa collection and Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] and [**Doctor First Name **] [**Doctor Last Name 9835**] were present for placement of the catheter into the left lower quadrant fluid collection IMPRESSION:. Successful ultraound guided drain placement into the gallbladder fossa fluid collection and left pericolic gutter fluid. A portion of the aspirated fluid from each collection was sent for gram stain and culture and bilirubin levels which are pending. Pathology Examination Name Birthdate Age Sex Pathology # [**Hospital1 18**] [**Known lastname 94624**],[**Known firstname 251**] [**2124-2-26**] 48 Male [**-7/3321**] [**Numeric Identifier 94625**] Report to: DR. [**Last Name (STitle) **] [**Last Name (NamePattern4) **] Gross Description by: DR. [**Last Name (STitle) **] [**Last Name (NamePattern4) 63180**]/dif SPECIMEN SUBMITTED: GALLBLADDER, JEJUNUM AFFERENT PORTION. CT ABDOMEN W/CONTRAST [**2172-10-5**] 4:28 PM CT ABDOMEN W/CONTRAST; CT PELVIS W/CONTRAST Reason: ANASTOMOTIC LEAKS POST SURGERY Field of view: 37 Contrast: OPTIRAY [**Hospital 93**] MEDICAL CONDITION: 48 year old man with crohns s/p Bilroth II (remotely) c/b recent jejunal perforation (near L.O. Trietz), small bowel resection w/ duodenostomy, now s/p Roux-En-Y duodenojejunostomy and stricturoplasty of different small bowel stritures (due to his Crohns) and a feeding J-tube and drain placement near his pancreaticobiliary limb REASON FOR THIS EXAMINATION: Please give po and iv contrast Please use gastrograffin for po contrast and please put contrast via j-tube. We are looking for anastomotic leaks above and below the level of the j-tube CONTRAINDICATIONS for IV CONTRAST: None. CT ABDOMEN INDICATION: Status post Billroth II and extensive surgery for Crohn disease. TECHNIQUE: A CT of abdomen was performed with axial images taken from the lung bases to the symphysis pubis. Oral and IV contrast was administered. FINDINGS There are bilateral pleural effusions with associated compressive atelectasis and consolidation. The effusions have reduced in size when compared with the previous CT from [**9-26**]. In the gallbladder fossa, note is made of a fluid collection that measures 6 x 5.7 cm and contains air. The appearances are consistent with an abscess. Just inferior to this, note is made of an area of mixed attenuation in the right lower quadrant. No contrast-filled bowel loops are seen in this area, and it may represent some organizing hematoma. The surgical patient is post Roux en Y duodeno-jejunostomy and the draining duodenal catheter has been removed.The exact site of the anastomosis is difficult to appreciate, but there is a small amount of layering contrast within the third part of the duodenum suggesting communication between this loops and the opacified Jejunum. There are several loops of mildly dilated small bowel, but contrast flows freely to the rectum and there is no evidence of obstruction .There is also no evidence of intraabdominal spilage of oral contrast. A feeding tube has been placed in the jejunum. A JP-drain is also noted in the right lower quadrant. In relation to the liver, a collection which measures approximately 6 x 3 cm is seen in the left lobe just deep to the anterior abdominal wall at the site of recent abdominal wall closure. This collection contains air and likely represents an abscess.A tract extending from this collection to the superior extent of the suture line can be seen. In the liver, there is some minimal intrahepatic biliary dilatation which is . The spleen is identified and is normal. The adrenals, kidneys, and pancreas are unremarkable. There is significant free fluid throughout the abdomen, and this has increased since the previous CT. In the left paracolic gutter, fluid is identified which also contains some air. This fluid collection is relatively contained. The air may be postoperative or represent an abscess. In the pelvis, the bladder is normal and a flatus tube is seen in the rectum. CONCLUSION: Bilateral pleural effusions with atelectasis and consolidation. Probable abscess in the gallbladder fossa. Probable abscess in the left lobe of the liver just deep to the recent abdominal wall closure. Fluid collection in left paracolic gutter which contains air. Probable hematoma in right flank at the site of recent surgery. Minimal intrahepatic biliary dilatation. Jejunostomy tube. Right lower quadrant drain. Findings discussed with Surgical Service Procedure date Tissue received Report Date Diagnosed by [**2172-9-29**] [**2172-9-30**] [**2172-10-3**] DR. [**Last Name (STitle) **] [**Last Name (NamePattern4) **]/cma?????? Previous biopsies: [**-7/3151**] JEJUNUM AND GALLSTONE (1). [**Numeric Identifier 94626**] GI BIOPSIES. [**-2/3020**] GI BX'S/da/lp. DIAGNOSIS I. Gallbladder: Chronic cholecystitis; cholelithiasis. II. Jejunum, afferent portion: 1. Chronic active enteritis extending to margin resection (on side of stitch); consistent with Crohn's disease. 2. Organizing fibrinous serositis. CT ABDOMEN W/CONTRAST [**2172-9-26**] 1:37 PM CT ABDOMEN W/CONTRAST; CT PELVIS W/CONTRAST Reason: CT Pelvis and Abdomen w/ oral Contrast Through Nasogastric T [**Hospital 93**] MEDICAL CONDITION: 48 year old man with crohns s/p small bowel resection w/ duodostomy REASON FOR THIS EXAMINATION: CT Pelvis and Abdomen w/ oral Contrast Through Nasogastric Tube CONTRAINDICATIONS for IV CONTRAST: None. CT ABDOMEN REASON FOR EXAM: 48-year-old man with Crohn's disease s/p small bowel resection TECHNIQUE: Multidetector CT through the abdomen obtained after administration of oral contrast through the nasogastric tube and IV contrast. Axial contiguous images were obtained from the bases of the lungs through the symphysis pubis. Coronal and sagittal reformations are also provided. Comparison is made with prior study dated [**2172-9-16**]. FINDINGS: Small bilateral pleural effusions with adjacent relaxation atelectasis are mildlely larger. The liver, spleen, pancreas, adrenal glands and kidneys are unremarkable. The aorta is normal in caliber. The celiac, SMA, [**Female First Name (un) 899**] are patent as is the portal, splenic and superior mesenteric vein Innumerable enlarged lymph nodes present throughout the mesentery are enlarged. The patient has had oral contrast administered via his NG tube and is status post Billroth II procedure. There is extensive thickening of the jejunal bowel loops. Oral contrast proceeds through the Gastrojejunostomy, but there is then a long segment of bowel which has essentiazlly no oral contrast within its lumen.The bowel can be traced throughout its length, however, and this non-opacified segment apppears to then become contigous with opacified loops of bowel. The appearances are likely due to intermittent administration of oral contrast via the NG tube, but fistulization could also have a similar appearance. There does not appear, on this exam hwever to be evidence of fistula formation. There is no free contrast within the abdomen. Tiny pockets of air in the mesentery likely relate to recent surgery. Patient is s/p gastrojejunostomy(old) and small bowel resection. Two drain catheters are seen in the left flank and one catheter is in the subhepatic region. NG tube with tip is in the stomach. Jejunostomy tube in the right lower quadrant is folded within the jejunal loop.Also seen on the right side is an intraduodenal drainage catheter:Reference to the operative notes describes creation of a duodenal biliary reservoir with external drainage and a blind ending loop of duodenum with drainage catheter-corresponding to the described surgical procedure is seen. No overt evidence of complications are seen in this area. Several pockets of fluid are seen within the abdomen, the largest one in the right lower quadrant. There are no organized complicated fluid collections. PELVIC CT. The rectum and sigmoid colon are unremarkable. There is free fluid. Foley catheter is within the bladder lumen. There is no lymphadenopathy. There is and open wound in the anterior abdominal wall. There are bilateral fat-containing inguinal hernias. BONE WINDOWS: There are no concerning bone lesions. Coronal and sagittal reformations were essential in the interpretation of the bowel findings. IMPRESSION: 1. Status post extensive surgical repair, There is no evidence of significant intrabdominal fluid collection or free contrast within the abdomen 2. 3 surgical drains, One draining duodenal reservoir catheter and a feeding Jejunostomy tube appear in good position. The feeding tube is probably coiled within a loop of Jejunum 3. Moderate amount of fluid within the abdomen without complicated organized collections. 4. Reasonably long segment of nonopacified proximal Jejunum is though likely to reflect bolus administration of oral contrast. No evidence of Jejuno- Jejunal/ileal fistula is seen . 5. Thickening of bowel loops may reflect underlying Crohns versus Post- operative edema/change 6.Bilateral fat-containing inguinal hernias. CHEST (PORTABLE AP) [**2172-9-19**] 1:52 AM CHEST (PORTABLE AP) Reason: eval infil [**Hospital 93**] MEDICAL CONDITION: 48 year old man with acute abdomen, s/p intubation by med flight s/p left subclavian swan placement REASON FOR THIS EXAMINATION: eval infil AP CHEST. INDICATION: Status post line placement. A single AP view of the chest is obtained [**2172-9-19**] at 02:16 hours and is compared with the prior day's radiograph performed at 06:24 hours. Tubes and lines appear unchanged. Mild increase in density in the right base may represent a small layering pleural effusion as has been previously reported. No acute airspace disease is visualized. IMPRESSION: Stable radiograph. Pathology Examination Name Birthdate Age Sex Pathology # [**Hospital1 18**] [**Known lastname 94624**],[**Known firstname 251**] [**2124-2-26**] 48 Male [**-7/3151**] [**Numeric Identifier 94625**] Report to: DR. [**Last Name (STitle) **] [**Last Name (NamePattern4) **] Gross Description by: DR. [**Last Name (STitle) **] [**Last Name (NamePattern4) **]/dif SPECIMEN SUBMITTED: JEJUNUM AND GALLSTONE (1). Procedure date Tissue received Report Date Diagnosed by [**2172-9-17**] [**2172-9-17**] [**2172-9-21**] DR. [**Last Name (STitle) **]. [**Doctor Last Name **]/lo?????? Previous biopsies: [**Numeric Identifier 94626**] GI BIOPSIES. [**-2/3020**] GI BX'S/da/lp. DIAGNOSIS: Jejunum and Gallstone: 1. Gallstone, cholesterol type. 2. Acute perforation of jejunum, with marked mural inflammation and acute peritonitis. 3. No tumor. CHEST (PORTABLE AP) [**2172-9-16**] 11:21 PM CHEST (PORTABLE AP) Reason: eval ett position [**Hospital 93**] MEDICAL CONDITION: 48 year old man with acute abdomen, s/p intubation by med flight REASON FOR THIS EXAMINATION: eval ett position SINGLE AP PORTABLE VIEW CHEST. REASON FOR EXAM: Evaluate ETT position. COMPARISON: None. FINDINGS: ET tube tip is located 5 cm above the carina. NG tube with tip in the stomach, side hole projected over the GE junction. Mild pulmonary edema. Allowing supine position, the cardiac size is normal. Widened mediastinum warrants evaluation with CT. Bilateral small pleural effusions. Brief Hospital Course: He was med-flighted immediately to us and within an hour, he was taken to the operating room for findings of free air on his outside hospital CAT scan. Mr. [**Known lastname 7594**] [**Last Name (Titles) 94627**] the storm of postoperative sepsis quite well and returned to the operating room for abdominal wash-out and graduated midline closure using the mesh on [**2172-9-22**]. Then on [**2172-9-29**] he presented for a definitive closure of the abdomen, if not a definitive operation to reconstitute his bowel continuity. He had a reopening of a recent laparotomy, open cholecystectomy, small bowel resection, Roux-en-Y duodenojejunostomy, small-bowel stricturoplasty x10, and J tube placement. CV: Post-operatively he was on Neo and Levophed for pressure support and was getting aggressive volume repletion. On [**2172-9-20**] he came off of pressors/inotropes. Resp: He was intubated and on protective ventilatory support. Once extubated, he did well and was stable. GI: His abdomen was open with multiple JP drains. The plan was to reexplore in a couple days. He had a Duodenal [**Last Name (un) 10045**] drain tube and J-tube. His drains were working appropriately. The Right sided drain was D/C'd on [**2172-10-19**]. The left sided drain continued to put out thick tan fluid. Due to fevers and increased abdominal pain a CT was ordered on [**2172-10-20**]. A CT scan showed a 13 cm subhepatic fluid collection is contiguous with the previously identified gallbladder fossa collection. A new drain was placed under ultra sound guidance and drained 600 cc of fluid. He was discharged with drains in place on both sides and given instructions on drain care. Renal: Increased creatinine likely secondary to pre-renal. With hydration, he had improving creatinine ID: Ampicillin, Gentamycin, Flagyl, Fluconazole were started empirically. He was pancultured on [**2172-9-17**]. Blood and sputum cultures and urine cultures were negative from [**9-17**] and [**9-18**]. A Swab culture showed perfringes, aeromonas (pan-S), viridans strep. He was changed to Zosyn, Vanc, Flagyl, and Fluc. He had a temperature the morning of [**2172-10-20**]. A CT scan was done (see above). Heme: He received several units of PRBC for drifting HCT while in the SICU. On [**2172-10-14**] his HCT dipped to 19. He received 2 Units of RBC and his HCT responded appropriately to 25.6. FEN: He was on TPN after the OR for nutritional support. He was also started on tubefeedings. HD #30 ([**2172-10-15**]) his TPN was decreased and he was on a regular diet. He continued to increase his PO intake and had calorie counts of 1500+ kcal. His tube feedings were stopped and he did not require tube feedings nutrition at home. Pertinent Microbiology: [**10-20**] Peritoneal fluid - GRAM NEGATIVE ROD. [**10-11**] C.diff Neg; [**10-7**] BlCx P UCx NG; [**10-6**] Abscess-ecoli s:levo,; [**10-5**] Abd fluid-E. Coli levo S, BlCx- P, Line tip- Neg, MRSA- Neg, VRE- Neg; [**10-5**] UCx: Neg; [**10-4**]: UCx NG, BCx: P. [**9-29**] C.Diff neg; [**9-28**] tip- Neg, MRSA/VRE screens NEG, BCx P, UCx NEG; [**9-26**] BCx NEG, UCx: NEG, [**9-25**] BCx NEG, UCx NEG. 8 Pertinent Radiology: [**2172-10-20**] CT Abd: 13 cm subhepatic fluid collection. [**10-10**] CXR- PICC in RA, no acute dz [**10-7**] Echo- EF > 75, no abnormalities; [**10-6**] Pigtails placed in LLQ and gallbladder fossa; [**10-5**] CT A/P showed lg fluid collection in gallbladder fossa and L paracolic gutter [**9-30**] CXR: tubes and lines in good position, LLL atelectasis; [**9-26**] CT Abd/Pelv: free fluid w/o collections [**9-26**] CXR: LLL infiltrate.[**9-21**] CXR stable retrocardiac opacity/atelectasis; [**9-19**] CXR: unchanged; [**9-16**] CXR b/l pleural effusions; [**9-17**] CXR b/l pleural effusions stable; [**9-19**] CXR stable. Physical Therapy: He was seen by PT and made great progress and was able to walk the halls with assistance. He will receive PT at home. Medications on Admission: pentasa 750qam, Paxil 20', Folate 2' Discharge Disposition: Home With Service Facility: Interim Home Care Discharge Diagnosis: Crohn's Disease s/p Multiple operations for perforated duodenum, spesis, shock Discharge Condition: Fair Discharge Instructions: * Increasing pain * Fever (>101.5 F) * Inability to eat or persistent vomiting * Inability to pass gas or stool * Other symptoms concerning to you You may resume your normal home medications and take all new medications as ordered. You may shower and wash incision with soap and water. Pat area dry. Leave open to air. The staples ..... will be removed at your follow-up appointment. Monitor your incision for redness, swelling, or discharge. No lifting >10 lbs for 4 weeks. Walk several times every day and increase activity as tolerated. Followup Instructions: Please follow-up with Dr. [**Last Name (STitle) **] in 2 weeks. Call ([**Telephone/Fax (1) 15807**] to schedule an appointment. ICD9 Codes: 0389, 5185, 2859
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Medical Text: Admission Date: [**2198-2-13**] Discharge Date: [**2198-2-20**] Date of Birth: [**2140-10-10**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1505**] Chief Complaint: Asymptomatic, positive stress test Major Surgical or Invasive Procedure: [**2198-2-15**] Three Vessel Coronary Artery Bypass Grafting(left internal mammary to left anterior descending, vein grafts to diagonal and obtuse marginal) [**2198-2-13**] Cardiac Catheterization History of Present Illness: Mr. [**Known lastname 8430**] is a 57 yo Spanish speaking man with DM2, known CAD, ESRD on HD who presents to [**Hospital1 18**] for elective catheterization after a positive stress test. His stress test was notable for ST depressions in the inferolateral leads while imaging showed moderate reversible anterior and septal defects. He has never experienced any cardiac symptoms. Past Medical History: Coronary artery disease - s/p PCI in [**2197-1-31**], History of NSTEMI, ESRD - on hemodialysis and s/p AVF, Nephrotic Syndrome with hypoalbuminemia, Diabetes mellitus, Hypertension, Hypercholesterolemia, Retinopathy, Iron Deficiency Anemia, Bells Palsy, History of Rhabdomyolysis, History of left [**Doctor Last Name **] lobe pneumonia, s/p Hydrocele repair Social History: He is from El [**Country 19118**], and was a former sheet metal worker. He now works as an electrician. He smoked previously, about 1 [**12-4**]-packs-per-day for 10 years, but quit about 15 years ago. He stopped using alcohol on [**2195-12-3**]. Previously he drank approximately 2 beers/week. He lives with his wife. Family History: Notable for diabetes in both his mother and father. His father also had hypertension. There is no history of kidney disease in his family. Physical Exam: T 96.8, BP 161/73, P 60, R 16, SAT 98% RA Gen: NAD, pleasant, conversant HEENT: NCAT, PERRL Neck: could not assess JVD given lying flat post-cath Cor: s1s2, rrr, no r/g/m pulm: CTAB anteriorly (could not assess posterior given lying flat post cath ABD: soft, nt, nd, obese, +bs, R groin c/d/i, nt, no hematoma or bruit Ext: no c/c/e, 2+ PT pulses bilaterally GU: foley catheter in place with no urine in bag. Pertinent Results: [**2198-2-20**] 07:10AM BLOOD Hct-29.3* [**2198-2-18**] 09:10AM BLOOD WBC-7.3 RBC-3.19* Hgb-9.8* Hct-29.3* MCV-92 MCH-30.6 MCHC-33.3 RDW-16.1* Plt Ct-104* [**2198-2-20**] 07:10AM BLOOD UreaN-26* Creat-5.9* Na-141 K-4.4 [**2198-2-18**] 09:10AM BLOOD Calcium-8.7 Phos-3.7 Mg-2.0 [**2198-2-14**] 06:00AM BLOOD calTIBC-182* Ferritn-817* TRF-140* [**2198-2-13**] 10:00AM BLOOD %HbA1c-5.4 [Hgb]-DONE [A1c]-DONE Brief Hospital Course: Mr. [**Known lastname 8430**] was admitted and underwent cardiac catheterization. Angiography showed a right dominant system revealed and two vessel CAD. The LMCA had a 30% stenosis. The LAD had an 80% mid lesion and a long 70% lesion on both ends of previosuly placed stent. The first diagonal had an 80% ostial stenosis and second diagonal had an 80% ostial stenosis. The LCX had a 70% distal stenosis. The RCA was a dominant vessel with a 30% mid vessel stenosis. Left ventriculography revealed a normal EF of 60%. There was no transaortic gradient upon pullback of the catheter from the LV to the aorta. Based on the above results, cardiac surgery was consulted and further evaluation was performed. Plavix was discontinued in anticipation of surgery. Preoperative workup was essentially unremarkable and he was eventually cleared for surgery. He remained pain free on medical therapy. On [**2-15**], Dr. [**Last Name (STitle) **] performed three vessel coronary artery bypass grafting. The operation was uneventful and he was brought to the CSRU for invasive monitoring. Within 24 hours, he awoke neurologically intact and was extubated. He was transfused to maintain hematocrit near 30%. He successfully weaned from inotropic support and transferred to the SDU on postoperative day two. He remained on his regular dialysis schedule and continued to be followed closely by the renal service. He tolerated beta blockade and remained in a normal sinus rhythm throughout his hospital stay. He experienced no atrial or ventricular arrhythmias. Over several days, medical therapy was optimized and he continued to make clinical improvements. His hospital course was rather routine and he was cleared for discharge to home on postoperative day five. At discharge, his BP was 112/60 with a HR of 73. His oxygen sat was 96% on room air. All surgical wounds were clean dry and intact. His discharge chest x-ray was notable for bilateral pleural effusions, left greater than right associated with bibasilar atelectasis. Medications on Admission: ASA 325 renagel 800mg x 4 tabs TID avandia 4mg po bid atenolol 100mg po qday norvasc 5mg po qday plavix 75mg po qday pravachol 20mg po qday Discharge Medications: 1. Pravastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*100 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 4. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 5. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 6. Rosiglitazone 2 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). Disp:*120 Tablet(s)* Refills:*2* 7. Sevelamer 800 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). Disp:*90 Tablet(s)* Refills:*2* 8. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO every 6-8 hours as needed for pain. Disp:*50 Tablet(s)* Refills:*0* 9. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). Disp:*30 Tablet(s)* Refills:*2* Discharge Disposition: Home With Service Facility: Caregroup Discharge Diagnosis: Coronary artery disease - s/p CABG, Post op Pleural Effusion, ESRD - on hemodialysis, Nephrotic Syndrome, Diabetes mellitus, Hypertension, Hypercholesterolemia, Retinopathy, Anemia, Bells Palsy, s/p PCI, s/p AVF, s/p Hydrocele repair Discharge Condition: Good Discharge Instructions: Patient may shower, no baths. No creams, lotions or ointments to incisions. No driving for at least one month. No lifting more than 10 lbs for at least 10 weeks from the date of surgery. Monitor wounds for signs of infection. Please call with any concerns or questions. Followup Instructions: Cardiac surgeon, Dr. [**Last Name (STitle) **] in [**3-7**] weeks - call for appt. Local PCP, [**Last Name (NamePattern4) **]. [**Last Name (STitle) **] in [**1-5**] weeks - call for appt. Local cardiologist, Dr. [**Last Name (STitle) **] in [**1-5**] weeks - call for appt. Completed by:[**2198-2-20**] ICD9 Codes: 5856, 5119, 2859, 2720, 412
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Medical Text: Admission Date: [**2153-12-13**] Discharge Date: [**2153-12-19**] Date of Birth: [**2081-7-17**] Sex: F Service: HISTORY OF PRESENT ILLNESS: A 72 year-old female experiencing exertional angina for approximately one year. She experiences chest pain after walking for about 10 minutes. She denies shortness of breath and any chest pain at rest. A stress echo done in [**2152-10-20**] showed T wave inversion. It was decided a cardiac catheterization should be performed on [**2153-12-13**]. PAST MEDICAL HISTORY: 1. Hypercholesterolemia. PAST SURGICAL HISTORY: Noncontributory. ALLERGIES: Question cholesterol medication, question name. MEDICATIONS: 1. Cholesterol medications question name. PHYSICAL EXAMINATION: Afebrile. Vital signs are stable. HEENT - no adenopathy, no masses. COR - regular rate and rhythm. Lungs are clear to auscultation. Abdomen is soft, nontender, nondistended. Extremities - no edema, no varicosity. The patient was brought to the cardiac catheterization lab on [**2153-12-13**]. See report for full details. In brief LAD at 99%, ostial lesion with a left circumflex normal. The RCA noncritical with collaterals to the LAD. The left ventricular systolic function was normal. During the procedure an attempted catheterization of the LAD, the patient developed ST elevation anteriorly and chest pain. She then went into asystole and a code was called. Epinephrine and Atropine were given. The pulse and pressure were zero. After CPR and ventilation, the patient had an episode of V tach and rapid SVT with hypotension. Intra-aortic balloon pump was placed and IV Amiodarone was given and she converted to sinus rhythm. Cardiothoracic surgery was paged and the patient was brought to the operating room on an Intra-aortic balloon pump with Dopamine and Levo. In the operating room she had a CABG times two with SVG to the LAD and OM. Postoperatively she was AD paced on Epinephrine drip and brought to the Intensive Care Unit. On postoperative day one the patient stabilized and her Intra-aortic balloon pump was removed. On postoperative day two all pressers were appropriately weaned and she was extubated. Pain on postoperative day three minimal, operative chest tubes were removed. A portable chest x-ray revealed no pneumothorax. Also on postoperative day three the patient's wires were capped. On postoperative day four the patient had an episode of acute hypotension on the floor when she was transferred out. Her blood pressure was in the 80s. A stat echo obtained at this time revealed no effusions, no evidence of dissection, normal left ventricular function. She was ruled out by cardiac enzymes. A chest x-ray obtained at that time showed increased vascular markings for which she was given multiple doses of IV Lasix. On postoperative day five her pacing wires were removed. It was noted that her creatinine increased to 2.1. At that point the Lasix, Captopril and Toradol were all held. On postoperative day six her creatinine was stable and the patient was in stable condition. DISCHARGE CONDITION: Stable. DISCHARGE MEDICATIONS: 1. Lopressor 50 milligrams [**Hospital1 **]. 2. Aspirin 325 milligrams q day. 3. Protonix 50 milligrams q day. 4. Plavix 75 milligrams q day. 5. Percocet one to two tablets po four to six hours prn pain. 6. Colace 100 milligrams po bid. DISCHARGE STATUS: The patient will go to a rehabilitation facility, follow up with her primary care physician or cardiologist in three weeks. Follow up with Dr. [**Last Name (STitle) **] in four weeks. DISCHARGE LABORATORY DATA: White count 8.9, hematocrit 35.3, platelet count 100,000. Sodium 138, potassium 4.4, chloride 98, bicarbonate 30, BUN 21, creatinine 2.1, glucose 124. Calcium 1.09, magnesium 2.1, phosphorus 4.4. DISCHARGE PHYSICAL EXAMINATION: Heart was regular rate and rhythm. Abdomen is soft, nontender, nondistended. Lungs are clear to auscultation bilaterally. Sternum stable with no drainage. SVG site clean, dry and intact. DISCHARGE DIAGNOSIS: 1. Status post CABG times two. 2. Hypercholesterolemia. [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern1) **], M.D. [**MD Number(1) 3113**] Dictated By:[**Name8 (MD) 1308**] MEDQUIST36 D: [**2153-12-19**] 09:56 T: [**2153-12-19**] 10:05 JOB#: [**Job Number 20075**] ICD9 Codes: 4111, 9971, 4275, 2720
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Medical Text: Admission Date: [**2170-8-1**] Discharge Date: [**2170-8-14**] Date of Birth: [**2125-3-16**] Sex: M Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2534**] Chief Complaint: s/p 18 ft fall Major Surgical or Invasive Procedure: Splenectomy VATS procedure with empyema tube placement History of Present Illness: 45 year-old gentleman s/p fall approx 18 ft onto a large post which snapped in half who broke several left sided ribs and also ruptured his spleen. +EtOH He was transported to [**Hospital1 18**] where he was takne to the operating and underwent a splenectomy. Social History: +EtOH Family History: Noncontributory Pertinent Results: [**2170-8-1**] 11:58PM GLUCOSE-159* LACTATE-2.4* NA+-137 K+-4.6 CL--105 [**2170-8-1**] 03:22AM GLUCOSE-116* UREA N-19 CREAT-0.9 SODIUM-138 POTASSIUM-4.2 CHLORIDE-105 TOTAL CO2-20* ANION GAP-17 [**2170-8-1**] 03:22AM CALCIUM-7.9* PHOSPHATE-3.3 MAGNESIUM-2.1 [**2170-8-1**] 03:22AM WBC-10.8 RBC-4.19* HGB-14.0 HCT-40.4 MCV-97 MCH-33.5* MCHC-34.7 RDW-13.2 [**2170-8-1**] 03:22AM PLT COUNT-230 [**2170-8-1**] 12:30AM URINE bnzodzpn-NEG barbitrt-NEG opiates-NEG cocaine-NEG amphetmn-NEG mthdone-NEG CT CHEST W/CONTRAST IMPRESSION: 1. Resolving contusion in right apex and basal segment of right lower lobe. 2. Interval resolution of loculated effusion in left apex anteriorly. 3. Chest tube in situ with left pleural effusion noted. 4. The patient is status post splenectomy. 5. Multiple rib fractures on the left. 6. Small fluid collection in intercostal muscles on the left side at the site of a rib fracture. CT HEAD W/O CONTRAST IMPRESSION: No intracranial hemorrhage or fracture. CT C-SPINE W/O CONTRAST IMPRESSION: 1. No acute alignment abnormality or fracture. 2. Partial demonstration of patient's left pneumothorax. Brief Hospital Course: He was admitted to the Trauma service. Once stabilized in the trauma bay he was taken to the operating room for an exploratory laparotomy and splenectomy. There were no intraoperative complications. He remained in the Trauma ICU for several days for close monitoring given his injuries. He was noted to have dyspnea and increased oxygen requirements; chest imaging revealed a loculated left sided effusion. Thoracic surgery was consulted and he was taken to the operating room on [**8-6**] for left VATS decortication. Cultures of the pleural fluid and of his chest wound were sent which revealed a staphylococcal infection. It was recommended by Infectious Disease that he be treated with a 6 week course of Nafcillin. A PICC line was placed and plans were made or discharge home with IV antibiotics. He was given the appropriate vaccinations due to the splenectomy prior to his discharge. Follow up is needed in both Trauma and Thoracic clinic. Discharge Medications: 1. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for constipation. 2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day) as needed for constipation. 3. Oxycodone 5 mg Tablet Sig: 1-2 Tablets PO every 4-6 hours as needed for pain. Disp:*90 Tablet(s)* Refills:*0* 4. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed for pain. 5. Nafcillin in D2.4W 2 g/100 mL Piggyback Sig: Two (2) GM Intravenous Q6H (every 6 hours) for 6 weeks. Disp:*qs GM* Refills:*0* 6. Sodium Chloride 0.9 % 0.9 % Syringe Sig: Ten (10) ML Injection DAILY (Daily): Flush PICC line before and after use and PRN. Disp:*qs ML(s)* Refills:*2* 7. Central line dressing kit Change PICC line dressing as directed Discharge Disposition: Home With Service Facility: Critical Care Systems Discharge Diagnosis: s/p 18 ft fall Left pneumothorax Multiple left sided rib fractures Grade III splenic laceration Wound staphylococcal infection Discharge Condition: Stable Discharge Instructions: You will need to continue with the IV antibiotics for a total of 6 weeks. Return to the Emergency room if you develop any fevers, chills, shortness of breath, chest discomfort, redness or thick drainage from PICC lie site, abdominal pain, nausea, vomiting, diarrhea and/or any other symptoms that are concerning to you. Followup Instructions: Follow up with Dr. [**Last Name (STitle) **] in 1 week; call [**Telephone/Fax (1) 600**] for an appointment. Follow up in [**Hospital 16814**] clinic in [**2-6**] weeks, call [**Telephone/Fax (1) 170**] for an appointment. Completed by:[**2170-8-14**] ICD9 Codes: 5185, 7907, 2930
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Medical Text: Admission Date: [**2181-5-6**] Discharge Date: [**2181-5-11**] Date of Birth: [**2103-9-4**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 3266**] Chief Complaint: mental status change Major Surgical or Invasive Procedure: endoscopy History of Present Illness: 77 M with pmhx of pulmonary fibrosis, CHF, presents with one week history of altered mental status, increasing lethargy, and confused speech. He was brought to his PCP (Dr. [**Last Name (STitle) 3267**] for evaluation and was referred for a Head CT on 2 days PTA, negative. On the DOA, he was found by his son to be slumped in bed, minimally responsive, confused, with bowel incontinence, and brought to the ED. No report of LOC, trauma, fevers, chills, has had continued good PO intake, no diarrhea per report, or cp/sob In ED, VS 97.8 57 184/40 100% 2L, given levaquin, NS, lactulose, head CT was negative. NGL was negative. He was taken to MICU for closer monitoring. TBili was elevated and ammonia was 114. RUQ U/S revealed chronic liver disease changes and hepatology was consulted. Upon improvement of mental status with lactulose, he was transferred back to the floor. On the floor, he has no compliants of pain. He denies any F/C/N/V, abd pain. He does note feeling very thirsty. Past Medical History: Interstitial Fibrosis CHF Social History: Lives with wife (with alzheimers), son lives 3 blocks away, independant own ADLs, was driving up to 1 week ago, DC'd Etoh 5 yrs ago, was told to stop, o/w [**2-3**] drinks/day, quit smoking 25 yrs ago, but o/w 1-2ppd smoker. Family History: Brother died 40s, CAD Father died 40s, CAD 1 Sister healthy Physical Exam: VS 98.9 98.9 154-187/71-76 68 18 99%2L GEN: slightly agitated HEENT: PERRL, EOMI, icteric sclera, dry MM, OP with thrush CV: RRR, SEM III/VI, radiating R carotid ABD: +BS, NT, distended, splenomegaly, no hepatomegaly, no stigmata, trace guaiac positive Neuro: awake, oriented X 3, no asterixis Pertinent Results: Head CT Head: neg . CXray [**2181-5-6**] - New airspace opacities in left mid and both lower lungs, which may be due to asymmetrical edema or aspiration pneumonia. - Diffuse irregular interstitial opacities consistent with patient's history of fibrosis. - Multiple calcific densities projecting over the right upper quadrant likely gallstones. . Abd USG [**2181-5-6**] - findings consistent with chronic liver disease - no evidence of ascites - portal vein is patent with antegrade flow. - Cholelithiasis without cholecystitis. . ECHO [**2181-5-7**] - EF 55% - left atrium is dilated - mild symmetric LVH Right ventricular chamber - mild aortic valve stenosis (area 1.2-1.9cm2) - Mild (1+) aortic regurgitation - Mild (1+) mitral regurgitation is seen. - Mod pulmonary artery systolic hypertension - no pericardial effusion Endoscopy: Erythema and mosaic appearance in the stomach body and fundus compatible with portal gastropathy Varices at the lower third of the esophagus and middle third of the esophagus Varices at the lower third of the esophagus and middle third of the esophagus Erythema in the gastroesophageal junction compatible with esophagitis Otherwise normal EGD to second part of the duodenum Brief Hospital Course: 77 y/o M with pmhx of idiopathic pulmonary fibrosis, CHF p/w altered MS and found to have hepatic encephalopathy . # Chronic liver disease: The etiology for his liver disease is unclear. [**Name2 (NI) **] does drink alcohol but not excessively per patient and family report. Hepatitis serologies, hemachromatosis, A1AT, and [**Doctor First Name **] were sent and unremarkable. EGD revealed large varices, and he was started on nadolol and [**Hospital1 **] PPI. # Altered Mental Status: This was felt to be secondary to hepatic encephalopathy as well as a UTI. His mental status improved with lactulose and levaquin for UTI. It remained unclear what precipitated the hepatic encephalopathy, but may be infection. Patient remained afebrile, but with mild leukocytosis. Ultrasound revealed no ascites and thus no SBP. He continued lactulose, MVI, thiamine, folate. # Infectious: Patient noted to have urinary tract infection and possible radiographic evidence of PNA (although no cough, fever). He was started on levaquin on [**2181-5-6**]. He should continue for total of 14 day course. # Anemia: Patient noted to have macrocytic anemia felt likely from liver disease. B12 and folate were high. Although haptoglobin low and LDH high and fibrinogen 100, he was not felt to to be in DIC because no schistocytes on smear and he was hemodynamically stable with stable hematocrit. Low haptoglobin was attributed to cirrhosis. He did have guaiac positive stools and will need outpatient GI follow-up. EGD revealed ulcerations and Barrett's, and he was started on [**Hospital1 **] PPI. # Thrombocytopenia: Baseline in [**2171**] was 150's. Now lower possibly due to splenic sequestration. No evidence to suggest TTP/HUS. # Mild Coagulopathy: Felt likely from chronic liver failure. # HTN: Patient was found hypertensive on admission with elevated BP during MICU stay. He was initially on lopressor, but then switched to nadolol given varices. # Aspiration: NGT placed in MICU for possible aspiration and inability to swallow [**2-2**] delirium. Speech and swallow eval cleared him for ground solids. He will need further speech and swallow therapy at rehab. # CODE: Full . # Contacts: Son [**Telephone/Fax (3) 3268**] Medications on Admission: 1. Prednisone, 10 mg daily. 2. Spironolactone, 50 mg daily. 3. Atenolol, 50 mg daily. 4. Aspirin, 81 mg daily. 5. Ativan as needed for sleep. Discharge Medications: 1. Prednisone 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Lactulose 10 g/15 mL Syrup Sig: Thirty (30) ML PO Q2-3HRS () as needed for Titrate to 3 BMs/Day. Disp:*2700 ML(s)* Refills:*5* 3. Furosemide 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 4. Spironolactone 25 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 5. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 6. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours) for 7 days. 7. Nadolol 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 8. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Discharge Disposition: Extended Care Facility: [**Hospital 66**] Rehab & Nursing Center - [**Hospital1 392**] Discharge Diagnosis: Primary: cirrhosis esophageal varices urinary tract infection Secondary: idiopathic pulmonary fibrosis Discharge Condition: stable, mental status at baseline Discharge Instructions: You have several new diagnosis: 1) You have chronic liver disease of unclear cause. Your liver disease may have contributed to your confusion. 2) You also have esophageal varices, which are distended blood vessels inside your esophagus. 3) You had a urinary tract infection being treated with an antibiotic You will need to take several new medications due to your new diagnosis: 1) Lactulose: You can adjust your daily dose until your have three soft formed bowel movements every day. This medication is very important and will help prevent your from becoming confused. 2) Nadolol: This medication will help with your esophageal varices 3) Please STOP taking your metoprolol 4) Protonix: This is an acid suppressors for your stomach. Please take all medications as prescribed. Please attend all follow-up appointments. Please call your primary doctor or go to the emergency room if you have any increased confusion, yellowish tinge to your eyes or skin, increased itchyness, fever, chills, abdominal pain, bloody vomit or stools, black and tarry stools, or any other concerning symptoms. Followup Instructions: You have an appointment to follow-up with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], your new liver doctor [**First Name (Titles) **] [**2181-5-29**] at 3:00 PM in the [**Hospital Unit Name 3269**] [**Location (un) **], Deth [**Country **] [**Hospital Ward Name 517**]. Please attend the following appointments: Provider: [**Name10 (NameIs) 1571**] FUNCTION LAB Phone:[**Telephone/Fax (1) 609**] Date/Time:[**2181-5-24**] 2:00 Provider: [**Name10 (NameIs) 1570**],[**Name11 (NameIs) 2162**] [**Name12 (NameIs) 1570**] INTEPRETATION BILLING Date/Time:[**2181-5-24**] 2:00 Provider: [**Name Initial (NameIs) **]/[**Doctor Last Name **] Phone:[**Telephone/Fax (1) 612**] Date/Time:[**2181-5-24**] 3:00 ICD9 Codes: 5990, 486, 4019
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Medical Text: Admission Date: [**2129-11-2**] Discharge Date: [**2129-11-19**] Date of Birth: [**2055-12-1**] Sex: M Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 148**] Chief Complaint: Enterocutaneous fistula x2 and ventral incisional hernia Major Surgical or Invasive Procedure: [**2129-11-3**]: 1. Takedown of abdominal wall fistulae x2. 2. Enteroenterostomy with primary small bowel closure. 3. Repair of multiple enterotomies. 4. Ventral hernia repair with mesh inlay consisting of AlloDerm. 5. Extended adhesiolysis greater than half of the operation. History of Present Illness: This 73-year-old gentleman has had an unfortunate course with abdominal adhesions in the past and this led to an operation 8 months ago which led to an enterocutaneous fistula. Multiple operations were undertaken after that to try and repair this and ultimately the patient was transferred to my care with an enterocutaneous fistula. We temporized him and improved his nutrition and after that was stabilized after a couple of months here in our hospital, he was sent to a local rehab hospital for further conditioning. The plan would be to take down his fistula in greater than 6 months from the time of the original operation. Past Medical History: PMH: COPD, TIAs, Nephrolithiasis, BPH, Osteoporosis, Sarcoma L scapula s/p resect [**7-15**] PSH: Appendectomy, short of breath diversion and anastomosis to transverse colon Social History: Lives in [**Location **] Married with 4 kids Army Lt. General Quit tob 25 years ago No EtOH Family History: Non-contributory Physical Exam: On admission: 99.1, 74, 132/772, 16, 97% RA Gen: A+O x 3, NAD NCAT, PERRL Lungs clear CV: IRIR Abd: soft, NTND, +BS, large 25x15cm defect midline with ostomy appliance in place and 2 segments of prolapsed bowel, no CVA Ext: no C/C/E Pertinent Results: [**2129-11-10**] 01:46AM BLOOD WBC-8.6 RBC-2.97* Hgb-8.1* Hct-25.1* MCV-84 MCH-27.3 MCHC-32.3 RDW-14.5 Plt Ct-532* [**2129-11-9**] 03:35AM BLOOD WBC-9.1 RBC-2.90* Hgb-7.8* Hct-24.5* MCV-84 MCH-27.0 MCHC-32.1 RDW-14.5 Plt Ct-491* [**2129-11-8**] 01:00AM BLOOD WBC-11.6* RBC-3.11* Hgb-8.9* Hct-26.3* MCV-84 MCH-28.5 MCHC-33.8 RDW-14.1 Plt Ct-564* [**2129-11-7**] 11:33PM BLOOD WBC-11.9*# RBC-3.07* Hgb-8.3* Hct-25.9* MCV-84 MCH-27.1 MCHC-32.2 RDW-14.1 Plt Ct-558* [**2129-11-7**] 02:30AM BLOOD WBC-7.9 RBC-3.01* Hgb-8.3* Hct-25.4* MCV-84 MCH-27.6 MCHC-32.7 RDW-14.0 Plt Ct-511* [**2129-11-6**] 02:08AM BLOOD WBC-8.9 RBC-2.99* Hgb-8.2* Hct-25.2* MCV-84 MCH-27.4 MCHC-32.6 RDW-13.9 Plt Ct-430 [**2129-11-5**] 02:37AM BLOOD WBC-10.3 RBC-3.06* Hgb-8.5* Hct-25.5* MCV-83 MCH-27.6 MCHC-33.2 RDW-14.6 Plt Ct-456* [**2129-11-4**] 03:36AM BLOOD WBC-11.8* RBC-3.34* Hgb-9.0* Hct-27.8* MCV-83 MCH-27.0 MCHC-32.3 RDW-14.2 Plt Ct-451* [**2129-11-3**] 04:58PM BLOOD WBC-12.6*# RBC-3.37* Hgb-9.2* Hct-28.2* MCV-84 MCH-27.3 MCHC-32.5 RDW-14.0 Plt Ct-489* [**2129-11-3**] 12:16AM BLOOD WBC-6.8 RBC-3.24* Hgb-8.9* Hct-27.7* MCV-86 MCH-27.5 MCHC-32.2 RDW-13.7 Plt Ct-377 [**2129-11-10**] 01:46AM BLOOD PT-17.2* INR(PT)-1.6* [**2129-11-8**] 01:00AM BLOOD PT-15.4* PTT-33.8 INR(PT)-1.4* [**2129-11-7**] 02:30AM BLOOD PT-15.1* PTT-34.3 INR(PT)-1.3* [**2129-11-6**] 02:08AM BLOOD PT-15.2* PTT-32.9 INR(PT)-1.3* [**2129-11-3**] 12:16AM BLOOD PT-14.7* PTT-34.4 INR(PT)-1.3* [**2129-11-18**] 05:13AM BLOOD Glucose-121* UreaN-13 Creat-0.8 Na-139 K-3.7 Cl-103 HCO3-28 AnGap-12 [**2129-11-15**] 05:02AM BLOOD Glucose-120* UreaN-26* Creat-0.8 Na-136 K-4.3 Cl-107 HCO3-24 AnGap-9 [**2129-11-14**] 08:15AM BLOOD Glucose-145* UreaN-27* Creat-0.8 Na-135 K-4.9 Cl-106 HCO3-23 AnGap-11 [**2129-11-13**] 03:48AM BLOOD Glucose-121* UreaN-22* Creat-0.7 Na-136 K-4.1 Cl-106 HCO3-25 AnGap-9 [**2129-11-12**] 04:04AM BLOOD Glucose-125* UreaN-26* Creat-0.8 Na-136 K-4.5 Cl-107 HCO3-25 AnGap-9 [**2129-11-11**] 04:00AM BLOOD Glucose-127* UreaN-22* Creat-0.7 Na-138 K-4.1 Cl-106 HCO3-27 AnGap-9 [**2129-11-10**] 01:46AM BLOOD Glucose-123* UreaN-22* Creat-0.7 Na-140 K-3.8 Cl-106 HCO3-26 AnGap-12 [**2129-11-9**] 03:35AM BLOOD Glucose-153* UreaN-21* Creat-0.7 Na-137 K-4.1 Cl-103 HCO3-28 AnGap-10 [**2129-11-8**] 01:00AM BLOOD Glucose-122* UreaN-16 Creat-0.7 Na-136 K-4.2 Cl-103 HCO3-28 AnGap-9 [**2129-11-7**] 11:33PM BLOOD Glucose-138* UreaN-17 Creat-0.7 Na-136 K-4.3 Cl-103 HCO3-28 AnGap-9 [**2129-11-7**] 02:30AM BLOOD Glucose-122* UreaN-15 Creat-0.6 Na-135 K-4.4 Cl-102 HCO3-27 AnGap-10 [**2129-11-6**] 07:02AM BLOOD Glucose-129* UreaN-13 Creat-0.7 Na-135 K-4.3 Cl-102 HCO3-28 AnGap-9 [**2129-11-6**] 02:08AM BLOOD Glucose-124* UreaN-14 Creat-0.7 Na-133 K-4.3 Cl-101 HCO3-28 AnGap-8 [**2129-11-5**] 02:37AM BLOOD Glucose-152* UreaN-13 Creat-0.7 Na-133 K-4.6 Cl-102 HCO3-28 AnGap-8 [**2129-11-4**] 08:31PM BLOOD K-4.8 [**2129-11-4**] 03:36AM BLOOD Glucose-151* UreaN-14 Creat-0.8 Na-136 K-4.1 Cl-103 HCO3-25 AnGap-12 [**2129-11-3**] 04:58PM BLOOD Glucose-228* UreaN-15 Creat-0.9 Na-133 K-4.9 Cl-102 HCO3-24 AnGap-12 [**2129-11-3**] 12:16AM BLOOD Glucose-106* UreaN-19 Creat-0.9 Na-134 K-4.5 Cl-99 HCO3-29 AnGap-11 [**2129-11-5**] 02:37AM BLOOD ALT-21 AST-18 LD(LDH)-137 AlkPhos-209* TotBili-1.1 [**2129-11-18**] Transesophageal echocardiogram: The left atrium is normal in size. A patent foramen ovale is present. 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. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion. No masses or vegetations are seen on the aortic valve. Trace aortic regurgitation is seen. The mitral valve appears structurally normal with trivial mitral regurgitation. No mass or vegetation is seen on the mitral valve. No vegetation/mass is seen on the pulmonic valve. There is no pericardial effusion. Impression: No echocardiographic signs of endocarditis. Normal biventricular function, no significant valvular pathology. Brief Hospital Course: The patient was admitted to the West 2A surgery service on [**2129-11-2**] for enterocutaneous fistula x2, ventral incisional hernia, and dense adhesions of the small bowel and large bowel to the abdominal wall. On [**2129-11-3**], he had a takedown of abdominal wall fistulae x2, enteroenterostomy with primary small bowel closure, repair of multiple enterotomies, ventral hernia repair with mesh inlay consisting of AlloDerm, and extended adhesiolysis greater than half of the operation. Postoperatively, he was admitted to the SICU intubated and on phenylephrine. He was kept sedated on propofol and fentanyl while intubated. On POD#1, he was extubated and started on Dilaudid PCA. On POD#4, the patient was stable to be transferred to the floor, but had an episode of desaturations in the 80s and was transferred back to the SICU. He was put on NRB with aggressive pulmonary toilet and chest PT, after which his O2 sats improved. By POD#7, he was stable enough to be transferred to the floor. Neuro: While on the floor, the patient was on Dilaudid PCA with good effect and adequate pain control. When tolerating oral intake, the patient was transitioned to oral pain medications. CV: Postoperatively, the patient was kept on metoprolol for rate control given his atrial fibrillation. During his hospital stay, he had occasional runs of asymptomatic V-tach and was monitored on telemetry. He was otherwise stable from a cardiovascular standpoint; vital signs were routinely monitored. Pulmonary: While on the floor, he was stable from a pulmonary standpoint; vital signs were routinely monitored. GI: Postoperatively, the patient's abdomen (fascia closed, subcutaneous layer open) was covered with wet-to-dry dressings. On POD#4, an abdominal wound vac was placed with a binder. Wound vac changes were done every 3-4 days. FEN/GU: Post-operatively, the patient was started on TPN. He was also given IV fluids until tolerating oral intake. His diet was advanced when appropriate, which was tolerated well. He was also started on a bowel regimen to encourage bowel movement. Foley was removed on POD#9. Intake and output were closely monitored. ID: Post-operatively, the patient was started on IV Vanc/Cipro/Flagyl. POD#4 blood cultures revealed Enterococcus faecalis that was sensitive to vanc. On POD#7, Flagyl was d/c'd. On POD#11, Flagyl was d/c'd. On POD#13, ID was consulted for discharge antibiotic coverage recommendations given his BCx. They initially recommended a TEE, which was done on POD#15 and revealed no vegetations. The patient's temperature was closely watched for signs of infection. Prophylaxis: Postoperatively, coumadin was never restarted. Instead, the patient received subcutaneous heparin and pneumatic boots. However, heparin was discontinued on POD#3, and patient was only kept on pneumatic boots. On POD#13, he was started on Aspirin 81mg. He was also encouraged to get up and ambulate as early as possible. At the time of discharge on POD#16, the patient was doing well, afebrile with stable vital signs, tolerating a regular diet, ambulating, voiding without assistance, and pain was well controlled. Medications on Admission: Meds at Rehab: albuterol 90mcg (2puff q4h prn), fent 100mcg/72hr, fluticasone 110mcg(2puff q12h), furosemide 40', ativan 1' qhs, lopressor 75 [**Hospital1 **], montelukast 10', protonix 40', salmeterol 50mcg(1puff q12h), sertraline 75', flomax 4'', trazodone 25' qhs, coumadin, tylenol 325 (2tab q6h prn), ferrous sulfate 300', BenGay to neck prn TID, [**Last Name (un) **] protein supp (1 scoop daily), Eucerin cream (to legs daily), theophylline 600'', pulmicort inh 200mcg (2 puffs AM, 1 puff PM), actonel 35mg weekly, Calcium+VitD 250'', glucosamine chondrotine (2 tabs daily), slo-phyllin Discharge Medications: 1. Heparin, Porcine (PF) 10 unit/mL Syringe Sig: One (1) ML Intravenous PRN (as needed) as needed for line flush. 2. Fentanyl 100 mcg/hr Patch 72 hr Sig: One (1) Patch 72 hr Transdermal Q72H (every 72 hours). Disp:*10 Patch 72 hr(s)* Refills:*5* 3. White Petrolatum-Mineral Oil Cream Sig: One (1) Appl Topical [**Hospital1 **] (2 times a day). Disp:*5 5* Refills:*2* 4. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). Disp:*50 Tablet, Chewable(s)* Refills:*2* 5. Furosemide 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 6. Ipratropium-Albuterol 18-103 mcg/Actuation Aerosol Sig: [**2-9**] Puffs Inhalation Q4H (every 4 hours) as needed. Disp:*5 qs* Refills:*0* 7. Tamsulosin 0.4 mg Capsule, Sust. Release 24 hr Sig: One (1) Capsule, Sust. Release 24 hr PO BID (2 times a day). Disp:*60 Capsule, Sust. Release 24 hr(s)* Refills:*2* 8. Metoprolol Tartrate 25 mg Tablet Sig: Three (3) Tablet PO BID (2 times a day). Disp:*180 Tablet(s)* Refills:*2* 9. Albuterol 90 mcg/Actuation Aerosol Sig: One (1) puff Inhalation three times a day as needed for shortness of breath or wheezing. Disp:*1 inhaler* Refills:*2* 10. Methyl Salicylate-Menthol 15-15 % Ointment Sig: One (1) Appl Topical TID (3 times a day) as needed for neck pain. 11. Theophylline 200 mg Tablet Sustained Release 12 hr Sig: Three (3) Tablet Sustained Release 12 hr PO BID (2 times a day). Disp:*180 Tablet Sustained Release 12 hr(s)* Refills:*2* 12. Sertraline 50 mg Tablet Sig: 1.5 Tablets PO DAILY (Daily). Disp:*75 Tablet(s)* Refills:*2* 13. Hydromorphone 2 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for pain. Disp:*100 Tablet(s)* Refills:*0* 14. 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* 15. Montelukast 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 16. Trazodone 50 mg Tablet Sig: 0.5 Tablet PO HS (at bedtime) as needed. Disp:*30 Tablet(s)* Refills:*0* 17. Fluticasone 110 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation Q 12H (Every 12 Hours). Disp:*1 inhaler* Refills:*2* 18. Salmeterol 50 mcg/Dose Disk with Device Sig: One (1) Disk with Device Inhalation Q12H (every 12 hours). Disp:*60 Disk with Device(s)* Refills:*2* 19. Ferrous Sulfate 325 mg (65 mg Iron) Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*1 Tablet(s)* Refills:*2* 20. Acetaminophen 325 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed. 21. Insulin Regular Human 300 unit/3 mL Insulin Pen Sig: One (1) sliding scale Subcutaneous every six (6) hours: sliding scale. Disp:*10 insulin pens* Refills:*2* 22. One Touch Basic System Kit Sig: One (1) kit Miscellaneous every 4-6 hours: check finger sticks every [**5-15**] hours and record. Disp:*1 kit* Refills:*2* 23. Lancets Misc Sig: One (1) qs Miscellaneous every [**5-15**] hours: check fingersticks every 4-6 hours and record. Disp:*1 qs* Refills:*2* 24. Insulin Syringe 1 mL 28 x [**2-9**] Syringe Sig: One (1) qs Miscellaneous as directed: use 1 syringe as directed per sliding scale. Disp:*1 syringe* Refills:*2* 25. insulin sliding scale Insulin SC Sliding Scale Q6H Regular Glucose Insulin Dose 0-60 mg/dL [**2-9**] amp D50 61-120 mg/dL 0 Units 121-140 mg/dL 2 Units 141-160 mg/dL 4 Units 161-180 mg/dL 6 Units 181-200 mg/dL 8 Units 201-220 mg/dL 10 Units 221-240 mg/dL 12 Units 241-260 mg/dL 14 Units 261-280 mg/dL 16 Units 281-300 mg/dL 18 Units > 300 mg/dL Notify M.D. 26. Vancomycin 1,000 mg Recon Soln Sig: 1.25 grams Intravenous every twelve (12) hours for 10 days: Give 1.25 grams . Disp:*15 soln* Refills:*0* Discharge Disposition: Home With Service Facility: [**Doctor First Name **] hospital homecare Discharge Diagnosis: 1. Enterocutaneous fistula x2. 2. Ventral incisional hernia. 3. Dense adhesions of the small bowel, large bowel to the abdominal wall. Discharge Condition: good Discharge Instructions: Return to the ER if: * If you are vomiting and cannot keep in fluids or your medications. * If you have shaking chills, fever greater than 101.5 (F) degrees or 38 (C) degrees, increased redness, swelling or discharge from incision, chest pain, shortness of breath, or anything else that is troubling you. * Any serious change in your symptoms, or any new symptoms that concern you. * Please resume all regular home medications and take any new meds as ordered. * Do not drive or operate heavy machinery while taking any narcotic pain medication. You may have constipation when taking narcotic pain medications (oxycodone, percocet, vicodin, hydrocodone, dilaudid, etc.); you should continue drinking fluids, you may take stool softeners, and should eat foods that are high in fiber. Followup Instructions: Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 2832**], MD Phone:[**Telephone/Fax (1) 2833**] Date/Time:[**2129-12-9**] 11:30 Provider: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], MD Phone:[**Telephone/Fax (1) 457**] Date/Time:[**2129-12-9**] 12:00 Please follow-up with your primary care physician on the week of [**2129-11-21**]. Completed by:[**2129-11-22**] ICD9 Codes: 5185, 7907
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8310 }
Medical Text: Admission Date: [**2107-9-1**] Discharge Date: [**2107-9-1**] Date of Birth: [**2031-3-28**] Sex: M Service: NEUROLOGY Allergies: No Allergies/ADRs on File Attending:[**Last Name (NamePattern1) 11784**] Chief Complaint: patient found unresponsive at home Major Surgical or Invasive Procedure: Intubation History of Present Illness: The pt is a 76 year old , RHM , with a history of stroke in the past, presents after being found unresponsive. On the night of admission at approximately 5 pm the patiemt was in his usual stat of health. He went upstairs as he normally does. The patients wife became concerned when the patient did not come down for dinner. At approxilately 830 to 9 pm the wife went upstairs and found the patiemt unconscious and snoring. He was unarrousable and had vomited as per the wife. Th [**Name2 (NI) 105968**] has been in his usual satte of health. He was not complaining of headache. There was no nausea or vomiting noted. Past Medical History: polio stroke in the past (thought to be cerebellar) Social History: Lives at home with his wife and has three daughters Family History: N/C Physical Exam: ADMISSION PHYSICAL EXAM: Physical Exam: Vitals: Intubated T:afebrile BP:183/125 SaO2: General: Patient intubated. HEENT: NC/AT, no scleral icterus noted, Dry mucous membranes. Neck: Supple, no carotid bruits appreciated. No nuchal rigidity Pulmonary: Lungs CTA bilaterally without R/R/W Cardiac: RRR, nl. S1S2, no M/R/G noted Abdomen: soft, NT/ND, normoactive bowel sounds, no masses or organomegaly noted. Extremities: No C/C/E bilaterally, 2+ radial, DP pulses bilaterally. Skin: no rashes or lesions noted. Neurologic: -Mental Status: Intubated. Not responsive to sternal rub. Does not grimace to painful stimuli. Does not open eyes to command. Does not follow commands. -Cranial Nerves: I: Olfaction not tested. III, IV, VI: Pupils are midlne on primary gaze. The left pupil in 2 mm and minimally reactive. The left pupil is 2.5 mm and minimally reactive. No corneal reflex. -Motor: No spontaneous movement. Th epatient does withdraw from pain , more so on teh left than the right. -Sensory: Withdraws to pain. -DTRs: [**Name2 (NI) **] Tri [**Last Name (un) 1035**] Pat Ach L 1 1 1 1 1 R 1 1 1 1 1 Left upgoing toe. -Coordination: Unable to assess. -Gait: Unable to assess. EXAM ON PRONOUNCIATION OF DEATH GEN: patient lying in bed, unresponsive HEENT: no breath felt at mouth, pupils fixed and dilated bilaterally CV: no heart beat auscultated PULM: no breath sounds auscultated EXT: cool Pertinent Results: ADMISSION LABS: [**2107-8-31**] 09:25PM BLOOD WBC-11.6* RBC-4.69 Hgb-14.5 Hct-43.1 MCV-92 MCH-31.0 MCHC-33.8 RDW-14.3 Plt Ct-256 [**2107-8-31**] 09:25PM BLOOD PT-12.2 PTT-21.7* INR(PT)-1.0 [**2107-8-31**] 09:25PM BLOOD Fibrino-592* [**2107-9-1**] 02:18AM BLOOD Glucose-124* UreaN-14 Creat-0.5 Na-140 K-4.7 Cl-103 HCO3-26 AnGap-16 [**2107-9-1**] 02:18AM BLOOD ALT-18 AST-34 CK(CPK)-262 [**2107-9-1**] 02:18AM BLOOD CK-MB-10 MB Indx-3.8 [**2107-8-31**] 09:25PM BLOOD Calcium-8.4 Phos-2.9 Mg-1.8 [**2107-9-1**] 03:22AM BLOOD Osmolal-294 [**2107-9-1**] 02:18AM BLOOD TSH-0.62 [**2107-8-31**] 09:25PM BLOOD ASA-NEG Ethanol-NEG Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG [**2107-8-31**] 09:32PM BLOOD Glucose-146* Lactate-2.1* Na-140 K-3.6 Cl-100 calHCO3-26 Patient made CMO on the day he expired so he did not have labs drawn at that time. Imaging: CT HEAD [**2107-8-31**]: IMPRESSION: Large left-sided intraparenchymal hemorrhage with resultant subfalcine and uncal herniation. There is intraventricular hemorrhage, with associated hydrocephalus. CXR [**2107-8-31**]: IMPRESSION: Endotracheal tube tip terminates at the level of thoracic inlet, and could be slightly advanced, as it terminates 9 cm from the carina. Mild bibasilar atelectasis. Evaluation of the costophrenic angles is limited on this study. Brief Hospital Course: The pt is a 76 year old RHM with a history of stroke in the past who presented after being found unresponsive, with CT scan showing a large left sided intraparenchymal hemmorhage. Etiology was likely hypertensive in nature given the lobar distribution, but should also consider amyloid angiopathy given the patient's age. Per family discussion, patient was made CMO on [**9-1**]. . # NEURO: patient's bleed was considered devastating, and it was unlikely he would recover any meaningful neurological function. Prior to family decision, he was loaded with mannitol in order to allow family members enough time to gather at the bedside. He was pthen laced on a morphine gtt and ativan gtt once discussion was had with family to make him CMO. He was terminally extubated. Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] was called to the bedside to pronounce the patient's death at 3:03pm on [**9-1**]. Patient had no pupillary response, no heart beat and no breath sounds, and was determined to have expired. His family and friends were at the bedside. They declined autopsy as did the ME. Medications on Admission: Aspirin Simvastatin Discharge Medications: N/A pt expired Discharge Disposition: Expired Discharge Diagnosis: large intraparenchymal hemorrhage Discharge Condition: Pt expired. Discharge Instructions: Patient expired on [**9-1**] at 3:03pm surrounded by family and friends. Followup Instructions: N/A, pt expired ICD9 Codes: 431, 4019
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Medical Text: Admission Date: [**2166-10-16**] Discharge Date: [**2166-10-24**] Date of Birth: [**2100-6-16**] Sex: M Service: HISTORY OF PRESENT ILLNESS: The patient is a 60-year-old male with a significant history of coronary artery disease who presented to the [**Hospital1 69**] with a positive stress test on [**10-3**] for cardiac catheterization. His cardiac catheterization revealed 3-vessel disease and a right-dominant system. Left main coronary appeared angiographically normal. The left anterior descending artery had 90% stenosis, the left circumflex had a 90% proximal stenosis, the right coronary artery was completely occluded proximally with distal collateral filling from the conus branch and left-to-right collaterals. Hemodynamics showed elevated left ventricular end-diastolic pressure and systolic arterial hypertension. He was subsequently referred for a coronary artery bypass graft which was performed on [**2166-10-6**] with left internal mammary artery to left anterior descending artery, saphenous vein graft to first obtuse marginal, saphenous vein graft to first diagonal. His left circumflex was not grafted because of poor touchdown sites; therefore, he was taken to the catheterization laboratory where they performed a successful percutaneous transluminal coronary angioplasty/stenting of the proximal and middle circumflex. His postoperative course was complicated by atrial fibrillation which was originally treated with amiodarone but switched to procainamide due to transaminitis. Thereafter he converted to normal sinus rhythm. He was treated with aspirin and Plavix and discharged on [**10-16**]. After discharge, the patient was home for a few hours and developed shortness of breath and bradycardia and was brought back to the Emergency Room. Upon arrival to the Emergency Room he was intubated secondary to poor oxygenation from congestive heart failure. He was admitted to the Cardiothoracic Surgery Service, and his cardiac enzymes were cycled. A.m. enzymes revealed a creatine kinase of 310. He was then taken to the catheterization laboratory where he was found to have a thrombosed left circumflex stent distal to the obtuse marginal graft. The lesion received Angio-Jet and an intra-aortic balloon pump was placed, and the patient was transferred to the Coronary Care Unit. PAST MEDICAL HISTORY: 1. Hypertension. 2. Coronary artery disease. 3. Status post hip fracture. ALLERGIES: No known drug allergies. MEDICATIONS ON ADMISSION: Procainamide 750 mg and 500 mg alternating doses p.o. q.i.d., Plavix 75 mg p.o. q.d., Lasix 20 mg p.o. q.d. times five days, Lipitor 20 mg p.o. q.d., Lopressor 12.5 mg p.o. b.i.d., Percocet p.r.n., [**First Name5 (NamePattern1) 233**] [**Last Name (NamePattern1) 1002**] 20 mEq p.o. b.i.d. times five days. PHYSICAL EXAMINATION ON PRESENTATION: On admission temperature was 99.3, pulse of 109, blood pressure 102/42, oxygen saturation 100% on CPAP with pressure support of 10, PEEP of 5, FIO2 50%, tidal volume 450 cc with a respiratory rate of 19 on propofol and dopamine and Integrilin drips. In general, the patient was intubated and sedated. Head, ears, nose, eyes and throat revealed pupils were equal and reactive to light. No jugular venous distention. Sclerae were anicteric. Bilateral carotid bruits. Heart had sinus tachycardia, a [**2-11**] holosystolic murmur radiating to the axilla. Lungs were clear to auscultation anteriorly. The abdomen was soft, hyperactive bowel sounds. Extremities revealed pulses by Doppler, surgical incision on the lower extremities healing well. Lines: A right arterial and venous sheaths, left arch sheath. LABORATORY DATA ON PRESENTATION: White blood cell count 15.4, hematocrit 25.8, platelets 358. Sodium 137, potassium 4, chloride 101, bicarbonate 11, creatinine 0.9, BUN 11. INR 1.4, PTT 32.6, PT 14.3. Magnesium 1.5. Creatine phosphokinase 310, MB 20. Urinalysis had positive nitrites, moderate bacteria. RADIOLOGY/IMAGING: Electrocardiogram from [**2166-10-16**] revealed sinus bradycardia with normal axis and intervals, new T wave inversions in I, aVL, II, III, and aVF, V2 through V6 with ST depressions in V4. [**2166-10-16**], post intervention revealed normal sinus rhythm at 102 with no changes from prior electrocardiograms. HOSPITAL COURSE: While on the Coronary Care Unit the patient was successfully extubated and intra-aortic balloon pump was removed. The patient's course in the Coronary Care Unit was complicated by two episodes of paroxysmal atrial fibrillation which was converted with intravenous procainamide and DC cardioversion. He was eventually switched to oral procainamide and remained in normal sinus rhythm throughout the rest of his stay in the Coronary Care Unit. He will need to be reassessed for potential anticoagulation if he were to convert to atrial fibrillation. Additionally, he had episodes of chest pain which were not associated with any electrocardiogram changes and relieved by sublingual nitroglycerin. He was noted to have a pericardial friction rub and was treated with indomethacin. Once his vitals stabilized he was resumed on Lopressor and captopril. At the time of discharge he remained free of chest pain. His urinary tract infection was treated with 7-day course of ciprofloxacin; [**1-9**] blood culture bottles grew coagulase-negative Staphylococcus. He was treated with vancomycin for four days, but that was discontinued in light of no fever spikes and other culture bottles showing no growth. Surveillance cultures were drawn 48 hours after discontinuing vancomycin. They had not grown anything at the time of discharge. It was likely that the one positive blood culture was due to a skin contaminant. Per Interventional Cardiology recommendation, the patient was to be continued on Plavix 150 mg p.o. for two month. From and Endocrine standpoint the patient continued to have elevated serum glucose levels. He was put on an insulin sliding-scale while in the hospital. However, he will need to be evaluated for diabetes on an outpatient basis since he has clearly demonstrated fasting blood sugars greater than 126 on several occasions. The patient was seen by Physical Therapy, and they evaluated him as having good potential for returning to baseline functional status. He will need to be enrolled in a cardiac rehabilitation program upon return to his home in Bermuda. MEDICATIONS ON DISCHARGE: 1. Lopressor 100 mg p.o. b.i.d. 2. Procainamide 500 mg p.o. q.i.d. 3. Plavix 150 mg p.o. q.d. 4. Aspirin 325 mg p.o. q.d. 5. Captopril 37.5 mg p.o. t.i.d. DISCHARGE DIAGNOSES: 1. Myocardial infarction secondary to in-stent thrombosis of left circumflex stent, status post Angio-Jet and restenting. 2. Paroxysmal atrial fibrillation. CONDITION AT DISCHARGE: Condition on discharge was stable. DISCHARGE STATUS: Home. [**First Name8 (NamePattern2) 870**] [**Last Name (NamePattern1) **], M.D. [**MD Number(1) 5219**] Dictated By:[**Name8 (MD) 5753**] MEDQUIST36 D: [**2166-11-29**] 21:23 T: [**2166-12-3**] 07:28 JOB#: [**Job Number 35987**] (cclist) ICD9 Codes: 4280, 5990, 7907
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Medical Text: Admission Date: [**2114-4-11**] Discharge Date: [**2114-4-15**] Date of Birth: [**2037-1-13**] Sex: M Service: MEDICINE Allergies: Penicillins / Iodine Attending:[**First Name3 (LF) 2145**] Chief Complaint: Shortness of breath Major Surgical or Invasive Procedure: None History of Present Illness: Dr. [**Known lastname 102490**] is a 77yo physician w/hx of alcoholic cirrhosis, HCC s/p ablation, CHF (EF 55-60%), chronic afib not on coumadin, portal vein thrombus, who was transferred from [**Hospital 3278**] Medical Center for SOB. He initially presented to to his PCP [**Name Initial (PRE) 151**] 1 month of SOB and fatigue as well as syncope and was found to have a HR of 25. He reports syncope on [**2114-4-1**] and struck his head but did not seek medical attension. He was sent to the [**Hospital **] Hospital ED [**4-4**] and was found to have afib with HR in the 30s and SBPs in the 130s. An echo showed nl EF, 2+MR, mild AS, severe TR, septal HK, RV dysfunction. He was transferred to [**Hospital1 3278**] for a pacemaker insertion which was placed on [**4-6**] with single chamber pacemaker (VVI). He received no contrast with the PPM placement. His creatinine rose to 4.0 after the procedure and his urine output dropped. Renal was consulted and thought that this was HRS vs. ATN vs. pre-renal. Renal U/S was normal. His T bili rose to 7.0. RUQ U/S showed portal vein thrombus and ascites with no clear fluid pocket for paracentesis. Potassium was 5.8 prior to transfer, he got kayexalate yesterday. ABG 7.36/34/98 on 3L prior to transfer. INR 1.7. He was started on Vanc and Meropenem for possible sepsis as a cause for his decompensation. . He was to be transferred to the [**Hospital1 3278**] MICU today and family requested transfer to [**Hospital1 18**]. . On the floor, his primary complaint is SOB. He denies chest pain, palpitations, abdominal pain, nausea, vomiting, fevers, chills, night sweats. He has been having diarrhea after getting lactulose at [**Hospital1 3278**] Past Medical History: # alcoholic cirrhosis complicated by ascites (1x) # hepatocellular carcinoma s/p radiofrequency ablation in [**4-5**]. Recurrence in [**6-5**] with second radiofrequency ablation in [**8-5**]. # atrial fibrillation # partial portal vein thrombosis s/p short course of coumadin Social History: Patient is former heavy drinker consuming [**12-30**] pint of whiskey per day and approximately 2 bottles of wine per day. Has not drank in 15 years. Patient has never smoked cigarretes. Denies any illicit drug use. Patient is retired physician living alone in [**Location (un) 2624**]. Daugther lives nearby in [**Location (un) 538**]. Family History: Extensive family history of alcoholism on father's side. Brother died of bladder cancer. Sister died of unknown cause, but suffered from alcoholism. Father died of complications from a ruptured appendix in the Phillipines, also suffered from alcoholism. Mother died at age [**Age over 90 **] from old age. Physical Exam: Exam on admission: General: Alert, oriented, increased work of breathing HEENT: Sclera anicteric, MMM, oropharynx clear Neck: supple, JVP elevated to jaw, no LAD Lungs: Bilateral crackles throughout CV: Regular rate and rhythm, [**3-3**] holosystolic murmur at apex Abdomen: soft, non-tender, distended with appreciable ascites on exam, bowel sounds present, no rebound tenderness or guarding, no organomegaly GU: + foley with minimal yellow urine Ext: warm, well perfused, 2+ pulses, 2+ peripheral edema to thighs bilaterally . Pertinent Results: CXR ([**2114-4-11**]): Silhouette is markedly enlarged, and is accompanied by pulmonary vascular engorgement, perihilar haziness, and mild interstitial edema. Chronic blunting of right costophrenic sulcus could reflect small pleural effusion and/or pleural thickening. Permanent pacemaker lead terminates in right ventricle. . [**2114-4-11**] 09:46PM BLOOD WBC-12.7*# RBC-3.55* Hgb-9.9* Hct-30.2* MCV-85 MCH-27.9 MCHC-32.8 RDW-19.2* Plt Ct-75* [**2114-4-11**] 09:46PM BLOOD Glucose-114* UreaN-115* Creat-4.2*# Na-125* K-5.2* Cl-88* HCO3-20* AnGap-22* [**2114-4-11**] 09:46PM BLOOD ALT-115* AST-110* LD(LDH)-374* AlkPhos-104 TotBili-7.0* [**2114-4-11**] 09:46PM BLOOD Calcium-8.7 Phos-7.7*# Mg-2.8* Brief Hospital Course: Mr. [**Known lastname 102490**] is a 77M with a history of alcoholic cirrhosis, HCC s/p ablation, CHF, presents as a transfer from [**Hospital1 3278**] with worsening liver failure, oliguric acute on chronic renal failure, volume overload and respiratory distress. The acute renal failure may be due to hepatorenal syndrome or possibly ATN but given his minimal urine output and significant volume overload and electrolyte abnormalities the corrective option would be dialysis, which would likely be a longterm need. A discussion took place between the medicine ICU team, the daughter [**Name (NI) **] [**Name (NI) 102490**] (HCP) and the patient regariding dialysis, intubation, and resuscitation. The decision was made to focus on patient comfort and to not pursue dialysis, which was thought to be reasonable. He was placed on supplemental oxygen, given morphine or dilaudid as needed for dyspnea, and started on a scopolamine patch. The palliative care service was consulted and coordinated this care plan with the primary team. He was transitioned to the regular floor from the ICU where he received comfort care and eventually died on [**2114-4-14**] from acute renal failure, which was a consequence of his alcoholic cirrhosis and liver failure, also with underlying hepatocellular carcinoma. Medications on Admission: Home Medications: Lasix 40mg PO qday Lactulose 30ml PO BID - not taking Spironolactone 200mg PO qday Rifaximin 400mg PO TID - not taking due to cost Testosterone 1% gel apply to skin once a day . Medications on Transfer: Pantoprazole 40mg PO qday Lactulose 800mg PO TID Lasix 40mg IV x 1 [**2114-4-11**] Lasix 80mg IV x 1 [**2114-4-11**] Kayexalate 30gm PO x 1 [**2114-4-11**] Ipratropium/Albuterol q4H Vancomycin 1gm IV x 1 Meropenem 500mg IV q12H Discharge Medications: none Discharge Disposition: Expired Discharge Diagnosis: Primary Acute on chronic renal failure . Secondary alcoholic cirrhosis complicated by ascites - atrial fibrillation - COPD Discharge Condition: comfort measures only Discharge Instructions: (pt died in-house) Followup Instructions: none [**Name6 (MD) **] [**Name8 (MD) **] [**Known lastname **] [**MD Number(2) 2158**] ICD9 Codes: 5849, 5185, 5859, 2767, 496
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8313 }
Medical Text: Admission Date: [**2117-2-6**] Discharge Date: [**2117-2-10**] Date of Birth: [**2041-7-25**] Sex: F Service: SURGERY Allergies: Metrogel / Desipramine / Sanctura Attending:[**Last Name (NamePattern1) 4659**] Chief Complaint: sepsis Major Surgical or Invasive Procedure: R IJ central venous line placement History of Present Illness: The patient is a 75-year-old female who complains of progressively worsening rectal and buttock pain over the past 2 weeks. Upon presenting to the [**Hospital1 18**] ED today, she initially had a HR of 77 with a BP of 105/69, but quickly became hypotensive to 56/40 with a heart rate of 98. Sepsis protocol was initiated. A central line was placed with great difficulty due to near-complete IVC collapse. She was placed on a norepinephrine drip and underwent a CT scan when she was somewhat stable. The scan shows a large pre-sarcal abscess with rim enhancement, and air and fat stranding tracking to a R hip prosthesis. On [**2116-12-20**], she underwent a diverting loop colostomy by Dr. [**Last Name (STitle) **] for a large rectovaginal fistula. Intra-operatively, she was noted to have stool in the rectum, vaginal and presacral space, and the posterior/presacral space was cleaned out. She was discharged on POD#6. It is noteworthy that prior to her operation, she did manifest fever and hypotension to SBP of 75. An echocardiogram was reassuring, with an EF of 65% with trace valvular disease. She was evaluated in clinic about two weeks ago by Dr. [**Last Name (STitle) **], who was not reassured by her progress at that time. She appeared to be slowly declining with a pelvic choleca situation which was not amenable to repair due to the prior radiation damage and poor vascular supply. Past Medical History: CAD s/p MI in 94 PVD (s/p aorto-fem bypass and L femoral endarterectomy) L Breast CA s/p mastectomy in early 90's Colon adenocarcinoma '[**08**] s/p LAR with Chemo and XRT SBO s/p XLap with LOA in [**3-20**] Asthma Hypothyroidism Hyperlipidemia Osteoporosis ORIF R tibia Bilateral THR [**2110**] PAF Social History: She lives in [**Location 4288**] with her husband. She is a former smoker but quit 15 years ago. She reports drinking vodka and fruit juice "most days." She has worked various jobs throughout her life and cared for her four children Family History: he is unable to give much specific history but reports "everyone is dead" of different things. Physical Exam: Gen: elderly female, NAD, no icterus HEENT: NC/AT, EOMI, PERRLA bilat., dry MM, without cervical LAD on my exam Cor: RRR without m/g/r, no JVD, no bruits Lungs: CTA bilat. [**Last Name (un) **]: +BS, soft, ND, NT, no masses Rectal: large communicating fistula palpable between rectum and vagina anteriorly. Tender on vaginal and ++ tender on rectal exam. No perineal erythema Ext: warm feet, 2+ pitting edema to knees Pertinent Results: Labs: | 138 | 108 | 14 / 83 AGap=13 | 3.7 | 21 | 0.9 \ Ca: 7.1 Mg: 1.7 P: 3.5 ALT: 11 AP: 145 Tbili: 0.4 AST: 15 Lip: 6 Cortsol: 34.3 CRP: Pnd 7.4 25.8 >--< 622 23.5 N:88 Band:4 L:4 M:3 E:0 Bas:1 PT: 19.0 PTT: 54.0 INR: 1.8 lactate 2.8 -> 3.1 -> 3.4 Imaging: CT [**Last Name (un) 103**]/pelvis with IV contrast: * 65 x 34 mm collection posterior to the rectum highly suggestive of an abscess * Pockets of air in the fascial planes of the right thigh and around the right hip joint suggestive of either a fistula or a developing abscess * Stable severe compression of L1 * distal limbs of aortobifemoral graft not in continuity with iliac/femoral vessels Brief Hospital Course: Patient admitted to SICU. Started on antibiotics, resuscitated with fluids, intubated, and placed on pressors. She quickly deteriorated and had worsening acidosis with a ph as low as 6.9 and lactate greater than 20. She was requiring multiple pressors and her due to her age and prognosis, it was decided to speak with the family regarding comfort measures, as there was no effective long term treatment for the pelvic source of sepsis. The family agreed. It took about 24 hours to get all the family members to the hospital to say their goodbyes. Once they arrived the ETT was removed, pressors and IVFs were stopped. The patient continued to breath spontaneous and maintain a blood pressure in the low 80s. After many hours it appeared that the dying process may take a while longer. Therefore she was transferred to the floor and treated with an infusion of morphine for pain control. On [**2117-2-10**] at 0405 am the patient expired, immedicate cause of death being cardiopulmonary failure secondary to sepsis. The family was present at the time of death, and declined an autopsy. The attending physician of record, Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] was [**Name (NI) 653**], as well as the chief surgical resident of the service, Dr. [**First Name8 (NamePattern2) 429**] [**Last Name (NamePattern1) **]. Medications on Admission: Amiodarone 200 [**Last Name (LF) 6222**], [**First Name3 (LF) **] 81', Vit B 12, Advair, Folic acid 1', Imdur 30', Combivent, Levoxyl 112, MVI, Toprol 25', Singulair 10', Nitro 0.3', Omeprazole 40', Oxytol, Oxycodone 10", Plavix 75', Ranitidine 150", Simvastatin 20', Trazadone 50 Discharge Disposition: Expired Discharge Diagnosis: sepsis multiorgan failure Discharge Condition: expired [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] [**Name8 (MD) **] MD, [**MD Number(3) 4661**] Completed by:[**2117-2-10**] ICD9 Codes: 0389, 5849, 5990, 2762, 4241, 4280, 2449
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8314 }
Medical Text: Admission Date: [**2130-3-31**] Discharge Date: [**2130-4-11**] Date of Birth: [**2052-7-17**] Sex: F Service: MEDICINE Allergies: Penicillins / Sulfa (Sulfonamide Antibiotics) / Ace Inhibitors / Angiotensin Recp Antg&Calcium Chanl Blkr / Meloxicam Attending:[**First Name3 (LF) 1257**] Chief Complaint: anemia Major Surgical or Invasive Procedure: Transfusions with packed red blood cells and fresh frozen plasma History of Present Illness: 77 yo female with HTN, DM, CRI, on prednisone for RA, open laparotomy for perforated dudenal ulcer at [**Hospital3 **] on [**2130-3-10**], and recently hosp from [**Date range (1) 104274**] for high INR who was sent to the ED from [**Hospital3 **] for high INR and HCT of 16.9. She was seen in ED on [**2130-3-29**] and found to have UTI yeast > 100,000. She was started on ciprofloxacin 500mh [**Hospital1 **] on [**3-29**]. Per [**Hospital3 **] she has had no bloody/black stool or bleeding from her coccyx wound site. She has had no n/v. She has received 2.5mg po vit K on [**2130-3-29**]. WBC today at [**Hospital3 **] was 11. Given increasing creatinine they were holding lasix on [**2-24**], and [**3-31**] and giving 500ml po TID. VS prior to transfer to [**Hospital1 **] were 97/64 P103 100% RA. . In the ED, initial vs were T95.6 P98 (HR 77-92) BP108/77 (103-115/54-68) R22 (18-28) O2 sat 100%. In the ED HCT was noted to be 16.9 (HCT 25.7 2 days ago). INR was 5.3. Patient was given 10mg po vit K and 1.5 units of blood. She was guaiac negative and NG lavage was not done given high INR and no evidence of GI bleed. She reported back pain and CT abd was negative for RP bleed. Initially only had 25cc of pus looking UOP. She received 80mg IV lasix and had made 250cc of urine by the time she arrived to the floor. Her urine cx from [**2130-3-29**] grew >100,000 yeast. Her UA from today had >50 WBC, moderate bacteria, and [**12-24**] WBC. She was given IV ceftriaxone. Her lung exam was notable for crackles at the bases. She was difficult to obtain access on and a right IJ was placed. Max HR in the ED was 92 and lowest BP was 103. Vitals prior to transfer were T98 HR 78 BP 124/68 RR18 100% on 2L. CXR showed small bilateral pleural effusions. . On the floor, pt reports [**11-13**] back pain worse this AM than previously. However, she has been having the back pain since earlier this month after her abdominal surgery. . Review of systems: (-) 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: #. Left deep venous thrombosis involving the internal jugular and brachial veins [**2-14**] on coumadin #. Hypertension - TTE [**3-14**] - EF >55%. Mild AR #. DM2 - diagnosed [**2118**], has been on insulin in the past but no longer takes any diabetes medications #. CKD - baseline creatinine 3.0 #. Rheumatoid arthritis - diagnosed at age 50; [**Doctor First Name **] 1:1280 - followed by Dr. [**Last Name (STitle) 6426**]; on chronic steroids #. Hypothyroidism #. Osteoarthritis #. Possible SLE, discoid lupus since [**2121**] with a positive right sided lymph node biopsy #. Left renal mass detected in [**2121-8-4**] - pt doesn't want further w/u #. Anemia - Normocytic in past #. Asthma #. History of low back pain #. C. diff colitis with recurrence 8 and [**10-9**] #. ?Cecal Mass on CT - [**Last Name (un) **] [**6-10**] negative. CEA 5.7 #. L renal mass #. ?Coronary atherosclerosis #. h/o PNA #. Dysphagia #. UTIs- multiple recent UTIs + for yeast . Allergies: Ace Inhibitors Angiotensin Recp Antg&Calcium Chanl Blkr Meloxicam Penicillins Sulfa (Sulfonamide Antibiotics) Social History: . Social History: Drugs: None Tobacco: None Alcohol: None Other: The patient currently at [**Hospital3 2558**] Nursing Center, previously living in a home one floor above her daughters . Family History: Family History: Father had DM, CAD, HTN. No cancer or stroke in family. . Physical Exam: Physical Exam on ICU admission: Vitals: T: 97.1 BP:152/58 P: 87-97 R:12 18 O2: 100% 1L Gen: NAD, AAOx2-3 HEENT: moist mm, EOMI grossly, OP clear Neck: Supple CV: +s1+s2 RRR, II/VI SEM Resp: Mild crackles at bases bilaterally, no rales/wheezes Abd: +bs, well-healing midline incision, soft, NTND, no rebound or guarding, no palpable masses. Ext: 2+ pitting edema bilaterally to knees, chronic venous statis changes, LE warm and well perfused, faint DP pulses bilaterally. GU: foley in place and urine with gross pus Neuro: CN: II-XII, grossly intact. Moving all extremities. Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema . Pertinent Results: Labs from [**Hospital3 **]: HCT 25.4 INR 4.4 BUN 59 creatinine 3.4 K 5.4 (? given kayexelate). note that was holding lasix x 3 days and giving 500ml po fluid per shift. . [**Hospital1 **] labs: . [**2130-3-31**] 10:02PM WBC-11.7* RBC-2.88*# HGB-8.7*# HCT-26.5*# MCV-92 MCH-30.3 MCHC-32.9 RDW-15.6* [**2130-3-31**] 10:02PM NEUTS-86.2* LYMPHS-9.0* MONOS-4.3 EOS-0.3 BASOS-0.3 [**2130-3-31**] 10:02PM PLT COUNT-189 [**2130-3-31**] 04:10PM URINE COLOR-Amber APPEAR-Cloudy SP [**Last Name (un) 155**]-1.014 [**2130-3-31**] 04:10PM URINE BLOOD-SM NITRITE-NEG PROTEIN-75 GLUCOSE-NEG KETONE-TR BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-MOD [**2130-3-31**] 04:10PM URINE RBC-[**12-24**]* WBC->50 BACTERIA-MOD YEAST-NONE EPI-0 [**2130-3-31**] 12:56PM PH-7.48* COMMENTS-GREEN TOP [**2130-3-31**] 12:56PM GLUCOSE-92 LACTATE-1.2 NA+-137 K+-4.7 CL--113* TCO2-18* [**2130-3-31**] 12:56PM HGB-5.3* calcHCT-16 [**2130-3-31**] 12:56PM freeCa-1.02* [**2130-3-31**] 12:45PM GLUCOSE-94 UREA N-68* CREAT-3.6* SODIUM-139 POTASSIUM-4.8 CHLORIDE-112* TOTAL CO2-17* ANION GAP-15 [**2130-3-31**] 12:45PM ALT(SGPT)-19 AST(SGOT)-27 LD(LDH)-280* CK(CPK)-100 ALK PHOS-397* TOT BILI-0.4 [**2130-3-31**] 12:45PM CK-MB-5 [**2130-3-31**] 12:45PM cTropnT-0.10* [**2130-3-31**] 12:45PM ALBUMIN-1.8* CALCIUM-7.1* PHOSPHATE-6.0* MAGNESIUM-1.8 IRON-30 [**2130-3-31**] 12:45PM calTIBC-108* VIT B12-1095* FOLATE-4.0 HAPTOGLOB-248* FERRITIN-645* TRF-83* [**2130-3-31**] 12:45PM NEUTS-89.5* BANDS-0 LYMPHS-7.1* MONOS-3.0 EOS-0.2 BASOS-0.2 [**2130-3-31**] 12:45PM HYPOCHROM-3+ ANISOCYT-1+ POIKILOCY-OCCASIONAL MACROCYT-1+ MICROCYT-1+ POLYCHROM-OCCASIONAL OVALOCYT-OCCASIONAL SCHISTOCY-OCCASIONAL STIPPLED-OCCASIONAL TEARDROP-OCCASIONAL [**2130-3-31**] 12:45PM PLT COUNT-269 [**2130-3-31**] 12:45PM PT-48.6* PTT-46.2* INR(PT)-5.3* [**2130-3-31**] 12:45PM RET AUT-3.3* . Micro: Urine cx [**2130-3-29**]: URINE CULTURE (Final [**2130-3-31**]): YEAST. >100,000 ORGANISMS/ML. urine culture [**4-1**]: 10,000-100,000 yeast Images: [**2130-3-31**] CXR Pa/lat: UPRIGHT AP AND LATERAL VIEWS OF THE CHEST: There are low inspiratory lung volumes. Heart size remains enlarged but unchanged. Pulmonary vascularity is not engorged. Bibasilar opacities are noted, slightly worse on the right compared to the prior study, which may reflect atelectasis. There are small bilateral pleural effusions which are stable. Clips from prior thyroidectomy are present. S-shaped scoliosis of the thoracic spine is again noted. IMPRESSION: Bibasilar airspace opacities, slightly worse on the right, likely reflective of atelectasis. Infection is not fully excluded. Small bilateral pleural effusions, unchanged. . CT abd/pelvis without contrast [**2130-3-31**]: Evaluation of visceral organs is limited due to lack of intravenous contrast. Small bilateral pleural effusions with adjacent areas of compressive atelectasis are unchanged. Pleural based hyperdensity within the right lung base is unchanged. Extensive coronary calcifications are noted. There is no evidence of retroperitoneal hematoma. Moderate amount of ascitesis unchanged from [**2130-3-21**] exam. Focal calcifications of the liver and spleen, likely represent prior granulomatous disease. Tiny calcified gallstones are noted within the gallbladder. The pancreas and adrenal glands appear unremarkable. Bilateral renal hypodensities, most likely renal cysts, unchanged. There is no evidence of mesenteric or retroperitoneal lymphadenopathy. Intra-abdominal aorta is notable for calcified atherosclerotic disease without aneurysmal changes. There is no free air within the abdomen. . CT OF THE PELVIS [**2130-3-31**]: Moderate amount of fluid within the pelvis is unchanged. The rectum, bladder, and sigmoid colon appear unremarkable. Moderate sized fat-containing right inguinal hernia appears unchanged. There is no free air within the pelvis. Generalized anasarca is noted. OSSEOUS STRUCTURES: No suspicious lytic or sclerotic lesions are identified. Grade 1 anterolisthesis involving L4-L5 is unchanged. IMPRESSION: 1. No evidence of retroperitoneal hematoma. 2. In comparison to [**2130-3-21**] exam, there are no significant change in moderate amount of ascites within the abdomen and pelvis. 3. Small bilateral pleural effusions with adjacent areas of compressive atelectasis, unchanged. 4. Cholelithiasis. . Echo [**2130-2-14**]: The left atrium is elongated. There is moderate symmetric left ventricular hypertrophy. The left ventricular cavity size is normal. Regional left ventricular wall motion is normal. Overall left ventricular systolic function is normal (LVEF>55%). Doppler parameters are most consistent with Grade I (mild) left ventricular diastolic dysfunction. Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets are moderately thickened. There is mild aortic valve stenosis (valve area 1.2-1.9cm2). Mild (1+) aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Mild (1+) mitral regurgitation is seen. There is moderate pulmonary artery systolic hypertension. There is a very small pericardial effusion. IMPRESSION: Moderate symmetric LVH with normal global and regional biventricular systolic function. Calcific aortic valve disease with mild stenosis/mild regurgitation. Mild mitral regurgitation. Moderate pulmonary hypertension. Very small pericardial effusion. . Lower extremity dopplers - negative DVT . Venous ultrasound [**2130-2-15**]: FINDINGS: Waveforms of the subclavian veins are symmetric bilaterally. On the left, the internal jugular vein is notable for isoechoic endoluminal contents and that vessel is incompletely compressible and shows only partial flow on color Doppler analysis, consistent with non-occlusive thrombus. The left axillary, basilic and one of the left brachial veins are normal with appropriate compressibility and wall-to-wall flow on color analysis. The second left brachial vein shows absent compressibility and no flow on color Doppler analysis. The cephalic vein is not identified, though note is made of subcutaneous edema in the expected region of the cephalic vein. IMPRESSION: Left deep venous thrombosis involving the internal jugular and brachial veins. Cephalic vein not identified. . . EKG: Old t wave inversion in I and AVL Brief Hospital Course: 77 year old woman who presented from [**Hospital3 **] for high INR (5.3), HCT of 16.9, and no clear source of bleeding. The HCT drop was from 25.7 to 16.9 in 2 days. She had no clear GI bleeding. She had Guaiac negative stools in ED and in ICU. She had recent laparotomy for perforation of duodenal ulcer at OSH on [**2130-3-10**] so initially there was concern for possible intraabdominal bleed. CT torso showed no evidence of internal bleeding. Folate and B12 levels were normal. With normal bilirubin, elevated hapto and only marginally elevated LDH hemolysis seemed unlikely. Both ASA and coumadin were held. She was admitted to the ICU for close observation, although her hemodynamics were stable. She received 4 units of blood and 3 units of FFP. HCT increased appropriately and have remained stable in the mid 30s. The exact cause of her presenting anemia remained unclear. She did not undergo endoscopy. She received one dose of coumadin 2.5 mg on [**4-2**] while in the ICU for history of DVT. Subsequently her INR continued to rise significantly to 6.8. We sought the input of our hematology consult service. They felt that the increase was due to coumadin, given recent antibiotics use and poor nutritional status. In regards to her upper extremity DVT, it was line-associated and has been anticoagulated since then. Hematology advised that the risk/benefit ratio favors discontinuing anticoagulation. She had persistent pyuria in urine and several cultures showed yeast. Of note, several days prior to admission she was initiated on cipro for pyuria, although this proved not to be a bacterial infection. This admission our ICU initiated fluconazole, but we have since discontinued it due to above INR issues. She remained asymptomatic. The patient had stage IV renal failure and hyperkalemia from Losartan. Losartan was discontinued and received several doses of kayexalate. Her discharge was delayed because of hyperkalemia and her discharge potassium was 5.0. Her home lasix was held at nursing facility but we increased the dose as she had severe edema up to the chest wall and hypoalbuminemia (anasarca; bilateral pleural efusions and ascites). Because of her low GFR, lower doses of Lasix are usually ineffective. We found no portal hypertesnion or thrombosis on ultrasound and no liver cirrhosis. The patient has a recent history of pancreatitis/pancreatic head enlargement on ultrasound from prior admission 1/[**2130**]. Ultrasound mentions multiple pancreatic cystic structures which may be related to pseudocyst formation and/or previously characterized side branch IPMN. Given these findings we have recommended GI follow-up in clinic. Her PCP was also notified of these findings although she has been unable to see him lately because of her stays in rehab. We also diagnosed her with stage III decubitus ulcer upon admission. She had no clinical wound infection. We stopped the Losartan, Clonidine and Hydralazine and increased the Metoprolol and she remained normotensive. Her avarage in hospital BP in fact was low (124/76). If she becomes hypertensive hydralazine 50 mg Tablet every 8 hours can be restarted. She was DNR/DNI but family needs to consider comfort measures only. She was disharged back to [**Hospital3 **] but to a different floor per family request. PCP can reconsider starting aspirin only. Potassium should be monitored with her low potassium diet. Medications on Admission: -amlodipine 5 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). -metoprolol succinate 50 mg Tablet Extended Release 24 hr Sig: One (1) Tablet Extended Release 24 hr PO q 8 hrs ??????? daily -hydralazine 50 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours). -omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO daily -acetaminophen 650mg q6hrs prn - sodium bicarbonate 650 mg Tablet Sig: One (1) Tablet PO TID -humalog sliding scale -tylenol 650mg every q 6 hrs -aspirin 81mg daily -Wellbutrin 100mg daily -clonidine 0.2 mg/24 hr 1 patch QFRI -levothyroxine 50 mcg po daily -hydralazine 50mg q 8hrs -warfarin being held -lasix 40mg daily (holding since [**3-29**]) -losartan 50 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). -prednisone 5 mg daily . Discharge Medications: 1. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours). 2. sodium bicarbonate 650 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 3. bupropion HCl 100 mg Tablet Extended Release Sig: One (1) Tablet Extended Release PO DAILY (Daily). 4. prednisone 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. levothyroxine 50 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. ipratropium bromide 0.02 % Solution Sig: One (1) Inhalation Q6H (every 6 hours). 7. pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). 8. calcium carbonate 200 mg (500 mg) Tablet, Chewable Sig: One (1) Tablet, Chewable PO QID (4 times a day) as needed for GI upset. 9. metoprolol tartrate 25 mg Tablet Sig: One (1) Tablet PO three times a day. 10. amlodipine 5 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 11. polyvinyl alcohol-povidone 1.4-0.6 % Dropperette Sig: [**2-5**] Drops Ophthalmic PRN (as needed) as needed for dry eyes. 12. simethicone 80 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO QID (4 times a day) as needed for gas. 13. furosemide 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Discharge Disposition: Extended Care Facility: coolige house Discharge Diagnosis: coagulopathy from coumadin anemia, blood loss? deep venous thrombosis of upper extremity Type II DM without treatment pancreatic lesion stage III decubitus ulcer hyperkalemia Discharge Condition: Mental Status: Confused - sometimes. Level of Consciousness: Alert and interactive. Activity Status: Out of Bed with assistance to chair or wheelchair. Discharge Instructions: You were admitted with anemia (low red blood count) and abnormal labs that showed your blood was too thin. The exact cause is not clear, but we do believe that you are very sensitive to blood thinning medicines. You received several transfusions in the ICU, where you stayed for close monitoring. A CT scan showed no sign of bleeding in your abdomen, and your stool was also negative for blood. The blood thinner (that you were previously taking for the clot in your arm) has been stopped. A review of your prior imaging studies from your [**2130-2-4**] admission for pancreatitis also showed an ultrasound with some cystic changes and enlargement in an area of your pancreas. You should see a GI specialist to further evaluate and follow-up these findings. Your potassium was elevated and you were placed on a low potassium diet. Some of your BP medications were stopped including a medication that elevates the potassium level (losartan). Please follow up with your PCP in regards to your potassium, Losartan, need for Aspirin, and anemia Followup Instructions: The patient needs GI follow-up for pancreatic changes with possible IPMN (tumor) mentioned on ultrasound [**2-/2130**] if family and patient want to pursue it further. Department: RHEUMATOLOGY When: THURSDAY [**2130-5-11**] at 10:30 AM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 14465**], MD [**Telephone/Fax (1) 2226**] Building: LM [**Hospital Ward Name **] Bldg ([**Last Name (NamePattern1) **]) [**Location (un) 861**] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage ICD9 Codes: 2449, 2767
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8315 }
Medical Text: Admission Date: [**2114-5-7**] Discharge Date: [**2114-5-11**] Date of Birth: [**2062-4-28**] Sex: M Service: ENT ADMISSION DIAGNOSIS: Tongue cancer. DISCHARGE DIAGNOSIS: Tongue cancer. HISTORY OF PRESENT ILLNESS: Mr. [**Known lastname 32496**] is a 52 year old male with a history of squamous cell carcinoma of the right tongue who underwent a tracheostomy and placement of brachytherapy catheters on [**2114-5-7**]. He has plans to undergo chemotherapy in the future. He underwent brachytherapy during this hospital stay. PAST MEDICAL HISTORY: Hypertension, cardiomyopathy with diastolic dysfunction, home oxygen, pulmonary hypertension, mitral and tricuspid valve regurgitation, chronic renal insufficiency with a baseline creatinine of 2.5. MEDICATIONS AT HOME: Norvasc 10 mg po qd, Lasix 40 mg po bid, Coreg 12.5 mg po bid and lisinopril 5 mg po qd. HOSPITAL COURSE: Mr. [**Known lastname 32496**] [**Last Name (Titles) 8337**] his operative procedure well. For the full details of this procedure, please see the dictated operative report. He spent two nights in the ICU and then was transferred to the Step-down Unit. He had brachytherapy in house. By system, his hospital course is as follows: Neuro: His pain was well controlled on subcutaneous morphine. He is going to be transitioned to Roxicet elixir. His mental status has been within normal limits. Cardiovascular: His postoperative EKG was normal. He has similar right bundle branch block to his previous EKGs. He was on continuous monitoring. He had some infrequent PVCs. His electrolytes were repleted prn. He was hemodynamically stable throughout his hospital stay. Respiratory: He was maintained on continuous O2 sat monitoring. His trach was down-sized to a Portex No. 6 nonfenestrated, noncuffed trach on postoperative Day 4 before discharge. He [**Last Name (Titles) 8337**] this procedure well. He is to have trach care prn and to be taught to care for his trach. He will likely be decannulated in one week. He is breathing comfortably with his new trach. GI: He was tolerating Nepro tube feeds at 45 with 30 gm of protein qd. He was seen by Nutrition and this was determined to be his goal. He was also seen by Speech and Swallow. He had a video swallow on [**2114-5-11**] which showed a very small amount of aspiration which was easily expelled with cough. His PO diet was recommended to be thin liquids with advancement to puree diet. If he tolerates this, he can advance to soft solids only if he wears his dentures. With every bite, he must do swallow, cough, swallow. His abdomen is soft, nontender and nondistended. His G tube is in place. GU: Mr. [**Known lastname 32496**] is making good urine. His creatinine is his baseline 2.3-2.5. His electrolytes were repleted prn. ID: He was kept on Ancef and Flagyl while brachytherapy catheters were in place. These catheters were removed on postoperative Day 3. He is currently on no antibiotics. His white blood cell count is normal and he is afebrile. Oncology: He is to follow up with his radiation oncologist. He has an appointment. He did get brachytherapy treatment while in house. The brachytherapy catheters were removed, as mentioned, on postoperative Day 3. PT: [**Name (NI) **] was seen by PT and OT while in house and he will continue while in Rehab. DISPOSITION: Mr. [**Known lastname 32496**] was discharged to Rehab in stable condition on [**2114-5-11**]. DISCHARGE MEDICATIONS: Amlodipine 5 mg and 10 mg po qd, carvedilol 12.5 mg po bid, lisinopril 5 mg po qd, lansoprazole 30 mg po qd, furosemide 40 mg po bid, subcu heparin 5000 units [**Hospital1 **] and Roxicet prn for pain. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], M.D. [**MD Number(1) 25181**] Dictated By:[**Last Name (NamePattern1) 54593**] MEDQUIST36 D: [**2114-5-11**] 20:48:15 T: [**2114-5-11**] 22:54:57 Job#: [**Job Number **] ICD9 Codes: 4254, 4240, 4019
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Medical Text: Admission Date: [**2151-11-21**] Discharge Date: [**2151-12-2**] Date of Birth: [**2084-11-16**] Sex: M Service: CARDIOTHORACIC Allergies: Ambien Attending:[**First Name3 (LF) 1283**] Chief Complaint: shortness of breath Major Surgical or Invasive Procedure: s/p redo sternotomy OPCABGx1 (SVG to PDA) on [**11-22**], MVR (#29 Medtroinc Mosaic), TV repair (#32 CE ring) via right thoracotomy [**11-23**] History of Present Illness: Mr. [**Known firstname **] [**Known lastname **] is a 67 year old gentleman who has had multiple recent hospital admissions for congestive heart failure. A subsequent work-up revealed severe mitral regurgitation, severe tricuspid regurgitation, and 90% occlusion of left main. He was therefore recommended for surgical correction of his cardiac pathologies. Past Medical History: - CHF, EF 20% - Hyperlipidemia - Hypertension - Severe Mitral valve disease. - Severe Tricuspid valve disease. - Chronic renal failure. - Idiopathic thrombocytopenic purpura (ITP). - Cholestatic jaundice. - Pancreatic cysts s/p biopsy. - Renal artery stenosis. - Bilateral EEA approximately [**2147**]. - Coronary artery bypass graft (CABG) x 5. - Pulmonary hypertension. - Left inguinal hernia repair in [**2149**]. - Knee surgery. - Cardiomyopathy. - Atrial fibrillation. - Congestive heart failure. - Hypothyroidism. Social History: He used to drink alcohol excessively, but had his last drink several months ago. He smoked a half pack to one pack per day for 15 years until he quit in [**2113**]. He lives with his wife. . Family History: His mother died of a heart attack. His brother died of a heart attack at age 33. His father died with [**Name (NI) 2481**] disease. Pt's maternal side of the family has marked hyperlipidemia. He has no known family history of cancer. Physical Exam: On physical exam Mr. [**Name13 (STitle) **] was found to be awake, alert, and oriented. On auscultation of his lungs, he was found to have scattered rales. His heart was of regular rate and rhythm. His sternum was stable and his incision was clean, dry, and intact with no erythema or drainage. His abdomen was soft, non-tender, and non-distended. His extremities were warm with no edema. His lower extremity harvest site was clean and dry. Pertinent Results: [**2151-12-2**] 07:40AM BLOOD WBC-8.3# RBC-3.82* Hgb-11.4* Hct-36.5*# MCV-96 MCH-29.9 MCHC-31.3 RDW-17.9* Plt Ct-195# [**2151-12-2**] 07:40AM BLOOD Plt Ct-195# [**2151-12-2**] 07:40AM BLOOD Glucose-76 UreaN-48* Creat-1.8* Na-147* K-4.1 Cl-109* HCO3-28 AnGap-14 Brief Hospital Course: [**Known firstname **] [**Known lastname **] is a 67 year old gentleman who has had multiple recent hospital admissions for congestive heart failure. A subsequent work-up revealed severe mitral regurgitation, severe tricuspid regurgitation, and 90% occlusion of left main. He was therefore recommended for surgical correction of his cardiac pathologies. He was taken to the operating room on [**2151-11-22**] with [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] for a redo sternotomy and off pump CABGx1. He tolerated the procedure well and transferred to the surgical intensive care unit in critical but stable condition. On the following day on [**2151-11-23**] he underwent the second stage of his intervention, a mirtal valvereplacement with a #29 [**Company 1543**] mosaic valve and a tricuspid valve repair with a 32 CE ring via a right thoracotomy. He tolerated this procedure well and was transferred in critcal but stable condition to the surgical intensive care unit. He was extubated on post-operative day 7 after multiple failed attempts. He was weaned from his pressors, his chest tubes were removed. His LFTs were found to be elevated early in his post-operative course, but these lab values were trending toward normal by the end of his stay. By post-operative day 9 he was transferred to the step down floor. His epicardial wires were removed. Mr. [**Known lastname **] was ready for discharge to a rehab by post-operative day 10. Medications on Admission: protonix 40 toprol XL 25 lisinopril 2.5 lasix 80 TID digoxin 0.125 Discharge Medications: 1. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). Disp:*30 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:*0* 3. Digoxin 125 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 4. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*0* 5. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 6. Ipratropium-Albuterol 18-103 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation Q4H (every 4 hours). Disp:*qs qs* Refills:*0* 7. Fluticasone 110 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation [**Hospital1 **] (2 times a day). Disp:*qs qs* Refills:*0* 8. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4 hours) as needed. Disp:*30 Tablet(s)* Refills:*0* 9. Lactulose 10 gram/15 mL Syrup Sig: Thirty (30) ML PO Q6H (every 6 hours) as needed. Disp:*qs ML(s)* Refills:*0* Discharge Disposition: Extended Care Facility: [**Hospital 12414**] Healthcare Center - [**Location (un) 12415**] Discharge Diagnosis: CAD, severe mitral regurgitation, severe tricuspid regurgitation s/p redo sternotomy OPCABGx1, MVR, TV repair congestive heart failure hypercholesterol hypertension chronic renal failure ITP pancreatic cysts renal artery stenosis s/p CEA s/p CABG1984 pulmonary hypertension Discharge Condition: good Discharge Instructions: Follow medications on discharge instructions. Do not drive for 4 weeks. Do not lift more than 10 lbs. for 2 months. Shower daily, let water flow over wounds, pat dry with a towel. Do not use creams, lotions, or powders on wounds. Followup Instructions: Please see your primary care physician and your cardiologist in [**1-26**] weeks. Please see Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] in [**3-28**] weeks. ([**Telephone/Fax (1) 11763**]. Call to make appointments. Provider: [**First Name11 (Name Pattern1) 2295**] [**Last Name (NamePattern4) 11222**], MD Phone:[**Telephone/Fax (1) 22**] Date/Time:[**2151-12-22**] 3:00 Provider: [**Name10 (NameIs) 706**] MRI Phone:[**Telephone/Fax (1) 327**] Date/Time:[**2152-3-7**] 10:20 Completed by:[**2151-12-2**] ICD9 Codes: 4240, 5849, 4254, 5185, 9971, 4280, 5859, 2720, 2449, 5715
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Medical Text: Admission Date: [**2180-10-20**] Discharge Date: [**2180-12-19**] Date of Birth: [**2162-10-22**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2186**] Chief Complaint: Headache Major Surgical or Invasive Procedure: Lumbar puncture Stereotactic brain biopsy Intubation and mechanical ventilation LIJ central line placement History of Present Illness: [**Known firstname **] is a 17 yo right handed girl with childhood onset relapsing MS referred here for urgent LP per IR from Dr. [**Name (NI) 58349**] clinic for positional but persistent HA without visual disturbance concerning for increased ICP from infectious process or pseudotumor cerebri. . Per records, given that patient refused to give hx, patient reported persistent, positional HA to Dr. [**Last Name (STitle) 8760**] on [**10-10**] that interfered with sleep. She denied any nausea/vomiting or visual disturbance and was still on prednisone taper 10mg daily. The steroids were stopped per Dr. [**Last Name (STitle) 8760**] on [**10-10**] then patient appears to have presented to [**Hospital1 **] on [**10-12**] with 2 seizures (R arm extension then head thrown back with followed by generalized convulsion for ~ 1 minute) with EEG showing mainly L sided discharges. Because she refused to be admitted, patient was started on Dilantin then discharged with prescription which was promptly thrown away per Mom. Open MRI at outside facility was arranged per Dr. [**Last Name (STitle) 10208**] but patient aborted the study in 5 minutes due to anxiety. With some police and legal assistance, patient was admitted to [**Hospital1 **] and had MRI under sedation on [**10-17**] which showed a new T2/FLAIR lesion in the R superior-lateral pons near trigeminal root entry and also question of enhancement of left meninges. Although ID was consulted, patient was clinically stable, hence further work-up was deferred and patient was discharged with Keppra to be increased from 500 to 1000mg at bedtime in 1 week. . Given the hx of questions meningeal enhancement and persistent positional headache in a patient with recent high dose steroids, infectious process was suspected hence Dr. [**Last Name (STitle) 8760**] recommended urgent LP under IR to rule out increased ICP and CNS infection. . As for her prior demyelinating disorder, patient developed bilateral leg weakness followed by R eye vision loss after 2 weeks of URI symptoms and high fever back in [**5-13**]. Upon admission to [**Hospital1 **], she was diagnosed with ADEM and treated with IVMP for 5 days. She improved significantly but was readmitted on [**6-12**] after recurrence of vision loss in R eye and repeat imaging showed new lesions hence had another 5 day course of IVMP. Then in [**7-13**], she presented with vague visual complaints and found to have LUQ field cut and MRI showing lesions in bilateral occipital lobes with brainstem lesions hence received another 5 days of IVMP. In [**9-12**], she was readmitted for vision loss and APD that recovered with another course of IVMP. Then in [**7-18**], patient again had decreased vision with pain in R eye hence received 3 days of IVMP with oral steroid taper. She was also treated with Avonex from [**9-12**] through [**2-16**] as weekly injections but discontinued due to depression. . She had earlier been evaluated at [**Hospital3 14659**] as well where Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 58350**] believed that she has an NMO spectrum disorder although Ab negative with absent myelopathy and good visual recovery. He also advised considering prolonged steroid treatment of 9 months co-administered with either CellCept or Imuran. . Patient on admission was very upset that she had been told to lay flat for 1 hr after LP hence would like to be discharged. However, upon reassuring that she will be moved to a more comfortable bed soon and that she needs treatment until infections has been rule out, she was willing to stay, although she was only semi-cooperative with the exam. Past Medical History: 1. Childhood onset relapsing remitting MS [**First Name (Titles) **] [**Last Name (Titles) 41770**]-negative neuromyelitis optica (NMO) 2. HTN 3. hx of myringostomy 4. s/p tonsillectomy Social History: Family from [**Country 15800**] but patient born and raised in the United States. Lives at home with family. She was newly a freshman at [**University/College 5130**] before becoming ill. Family History: No FH of MS or other neurological disease. Physical Exam: Exam: Gen: Lying in bed supine, NAD HEENT: NC/AT, moist oral mucosa Neck: Normal lateral ROM CV: RRR, no murmurs/gallops/rubs Lung: Clear anteriorly Abd: +BS, soft, nontender Ext: No edema Neurologic examination: Mental status: Awake and alert, mostly cooperative with exam, normal affect. Oriented to person, place, and date. Speech is fluent with normal comprehension. No dysarthria. No right left confusion. Cranial Nerves: II: Pupils equally round and reactive but afferent pupillary defect on R. Blinks to visual threat bilaterally. III, IV & VI: Extraocular movements intact bilaterally, no nystagmus. V: Sensation intact to LT. VII: Facial movement symmetric. VIII: Hearing intact to finger rub bilaterally. X: Palate elevation symmetrical. [**Doctor First Name 81**]: Sternocleidomastoid and trapezius normal bilaterally. XII: Tongue midline, movements intact Motor: Normal bulk and tone bilaterally. No observed myoclonus or tremor. No asterixis or pronator drift [**Doctor First Name **] Tri [**Hospital1 **] WE FE FF IP H Q DF PF TE TF R 5 5 5 5 5 5 5 5 5 5 5 5 5 L 5 5 5 5 5 5 5 5 5 5 5 5 5 Sensation: Intact to light touch and cold throughout. Reflexes: +2 and symmetric throughout. Toes downgoing bilaterally Coordination: FTN, FTF and RAMs normal. Gait: Deferred since post LP and was told to be supine for > 1 hr. Pertinent Results: >>Labs on Admission<< [**2180-10-20**] WBC-9.9 RBC-4.38 Hgb-12.7 Hct-39.9 MCV-91 MCH-29.0 MCHC-31.8 RDW-14.7 Plt Ct-339 [**2180-10-20**] Neuts-69.5 Lymphs-22.9 Monos-5.8 Eos-0.8 Baso-1.0 [**2180-10-20**] Glucose-142* UreaN-7 Creat-0.9 Na-139 K-3.9 Cl-103 HCO3-24 [**2180-10-23**] Calcium-9.5 Phos-4.0 Mg-2.6* . >>General Chemistries<< VitB12-982 Folate-14.3 Ammonia-32 TSH-0.96 HIV-negative CK- 3 Trop- 0.01 . >>Immunology/Rheumatology<< [**Doctor First Name **]-negative Anti-TPO- <10 IgA-96 ACA IgG-3.1 ACA IgM-5.4 ESR-30 CRP-43.9 [**2180-11-18**] ESR-90 CRP-260 [**2180-11-27**] . Anti-Ma 1&2 [**Location (un) **] 3 Anti-NMDA . >>Miscellaneous Chemistries << BETA-2-GLYCOPROTEIN 1 ANTIBODIES-NEGATIVE Bartonella hensalae/[**Last Name (un) 7570**]-NEGATIVE HERPES 6-NEGATIVE ARYLSULFATASE A-NEGATIVE ANAPLASMA PHAGOCYTOPHILUM-NEGATIVE West Nile Virus-NEGATIVE EASTERN EQUINE ENCEPHALITIS-NEGATIVE RIBOSOMAL P [**Last Name (un) **]-NEGATIVE PURKINJE CELL (YO) ANTIBODIES-NEGATIVE NEURONAL NUCLEAR ([**Doctor Last Name **]) ANTIBODIES-NEGATIVE GLUTAMIC ACID DECARBOXYLASE-NEGATIVE VGKC [**Doctor Last Name **]-NEGATIVE PARANEOPLASTIC PANEL-pending RABIES-pending . >>CSF Studies<< WBC RBC Polys Lymphs Monos Mesothe TotProt GLU [**2180-11-10**] 12:10PM 71 3* 0 98 2 18 [**2180-11-10**] 12:10PM 14 148 0 90 10 [**2180-10-31**] 11:30AM [**Telephone/Fax (1) 58351**] 2 96 1 1 61 62 [**2180-10-31**] 11:30AM [**Numeric Identifier 58352**]5 30 0 [**2180-10-20**] 06:30PM 486 740 24 66 10 31 60 [**2180-10-20**] 06:30PM [**Telephone/Fax (1) 58353**]3 5 . EBV-NEGATIVE HERPES 6-NEGATIVE HERPES SIMPLEX VIRUS-NEGATIVE [**Male First Name (un) 2326**] VIRUS-NEGATIVE LACTATE- 8 LYME-NEGATIVE TB-NEGATIVE VARICELLA-NEGATIVE WEST NILE VIRUS-Negative Bartonella-NEGATIVE 143-3 (prion disease)- NEGATIVE EEE- NEGATIVE . >>Other<< HISTOPLASMA ANTIGEN-NEGATIVE CSF CYTOLOGY-NEGATIVE FOR MALIGNANT CELLS ([**2180-11-10**]) . >>Microbiology<< BLOOD SMEAR-NEGATIVE FOR INTRACELLULAR/EXTRACELLULAR PARASITES Blood Culture, Routine (Final [**2180-11-14**]): STAPHYLOCOCCUS, COAGULASE NEGATIVE. FINAL SENSITIVITIES. Blood Culture, Routine (Final [**2180-11-13**]): STAPHYLOCOCCUS, COAGULASE NEGATIVE. FINAL SENSITIVITIES. . MRSA SCREEN (Final [**2180-11-16**]):No MRSA isolated. . URINE CULTURES(x8)-NO GROWTH . TOXOPLASMA IgG [**Month/Day/Year **] (Final [**2180-11-3**]): NEGATIVE FOR TOXOPLASMA IgG [**Month/Day/Year **] BY EIA. TOXOPLASMA IgM [**Month/Day/Year **] (Final [**2180-11-3**]): NEGATIVE FOR TOXOPLASMA IgM [**Month/Day/Year **] BY EIA. CMV IgG [**Month/Day/Year **] (Final [**2180-11-7**]): NEGATIVE FOR CMV IgG [**Month/Day/Year **] BY EIA. CMV IgM [**Month/Day/Year **] (Final [**2180-11-7**]): NEGATIVE FOR CMV IgM [**Month/Day/Year **] BY EIA. CRYPTOCOCCAL ANTIGEN(Final [**2180-11-10**]): CRYPTOCOCCAL ANTIGEN NOT DETECTED. LYME SEROLOGY (Final [**2180-11-6**]): NO [**Month/Day/Year **] TO B. BURGDORFERI DETECTED BY EIA. . CSF;SPINAL FLUID GRAM STAIN (Final [**2180-10-20**]): NO POLYMORPHONUCLEAR LEUKOCYTES SEEN. NO MICROORGANISMS SEEN. FLUID CULTURE (Final [**2180-10-23**]): NO GROWTH. VIRAL CULTURE (Final [**2180-11-20**]): NO VIRUS ISOLATED. . [**2180-11-10**] 12:10 pm CSF;SPINAL FLUID Source: LP. QUANTITY NOT SUFFICIENT FOR ACID FAST SMEAR (MAW). PENDING . >>IMAGING<< MRI/MRV Head [**2180-10-24**]: 1. Motion-limited study with particularly limited postcontrast images. 2. Confluent symmetric high T2 signal in the posterior body and splenium of the corpus callosum, without mass effect or obvious contrast enhancement. Smaller T2 hyperintensities in the supratentorial white matter and in the pons. While nonspecific, these findings are compatible with demyelination, which could be due to multiple sclerosis, Lyme disease, sarcoidosis, or other etiologies. Vasculitis could also be considered. 3. Nonvisualization of flow in the right transverse sinus could be related to its nondominant status and motion artifact. If there is a persistent clinical concern for thrombosis of the right transverse sinus, then further evaluation could be performed by a CT venogram. . EEG [**2180-10-22**]: This is an abnormal extended routine EEG due to persistent left focal theta/delta slowing and sharp transients phase reversing in the right parasagittal central regions. These findings suggest a deep abnormality affecting projections to the left hemisphere and a possible focus of cortical irritability in the right central parasagittal region. There were no electrographic seizures in the record. . EEG [**2180-10-26**]: This EEG monitoring captured 13 pushbutton activations for clinical events that did not have any EEG correlate of epileptiform activity. There was no ictal or interictal epileptiform activity. The background activity was slow some of the time suggestive of a mild encephalopathy with slower activity seen sometimes more over the left than the right hemisphere suggestive of a deep subcortical dysfunction more in the left than the right hemisphere. . EEG [**2180-10-27**]: This telemetry captured 26 pushbutton activations for several seconds of repetitively bending forward and backwards when sitting in a chair or laying down in bed with no epileptiform activity seen during these events. There was no ictal or interictal epileptiform activity seen during this recording. The background activity was diffusely slow, more so over the left than the right hemisphere. In addition, the background activity was not well-sustained bilaterally. . EEG [**2180-10-28**]: This telemetry captured 42 pushbutton activations for different events of shaking, unresponsiveness, and blinking. Most of them were not correlated with any change in the background behavior; however, a few of them were correlated with some more rhythmic delta activity seen predominantly over the left fronto-temporal area. Similar rhythmic activity was also sometimes captured by the automatic seizure detection programs, not always with a clear clinical correlate. The background activity was slow with slower activity seen over the left than the right hemisphere. . EEG [**2180-10-29**]: This telemetry captured 20 pushbutton activations for different events of agitation and shaking with no clear EEG correlate. The background activity was slow with slower activity seen over the left than the right hemisphere. In addition, there were runs of more rhythmic 2.5 Hz activity seen predominantly over the left fronto-temporal area and sometimes with no clinical correlate. This rhythmic activity could represent ongoing electrographic seizures. . EEG [**2180-10-30**]: This telemetry captured 10 pushbutton activations for different episodes of posturing, agitation, shaking, and blinking with no clear EEG correlate; however, with the EEG, there were several runs of rhythmic delta activity seen predominantly in the left fronto-temporal area lasting for up to 20 seconds and suggestive of electrographic seizure activity. The background activity was slow with slower frequencies seen over the left than right hemisphere. . EEF [**2180-11-9**]: This telemetry captured six pushbuttons as described above. During portions of the routine, seizure and pushbutton files, there are periods of rhythmic delta activity, left frontal greater than right, that appear to evolve and are suggestive of possible epileptiform activity. On at least one occasion, this occurred following an episode of facial twitching. Although there are no clear spike wave discharges on this recording, the periods of rhythmic left frontal predominant delta activity are suspicious for epileptiform discharges. Overall, the background is very disorganized, consisting of a [**3-14**] Hz delta activity with slowing more prominent on the left hemisphere. . EEG [**2180-11-29**]: IMPRESSION: This is an abnormal routine EEG due to slowing and disorganization of the background rhythm with delta slowing in the left temporal region and asymmetry of spindle activity which is more pronounced in the left parasagittal to central regions. These findings are consistent with a severe encephalopathy with possible subcortical dysfunction in the left temporal region. The asymmetry of the spindle activity may reflect a breach artifact in the left parasagittal to central regions. There were no electrographic seizures noted during this recording. . EEG [**2180-12-18**]: FINDINGS: ABNORMALITY #1: There was excessive focal slowing in the [**5-15**] Hz range in the left fronto-central region. The background in this area was also very irregular and mildly sharp. ABNORMALITY #2: There were a few bursts of bifrontal paroxysmal theta with sharp features. BACKGROUND: Appeared to represent drowsiness in early sleep. There was no normal waking background activity. HYPERVENTILATION: Could not be performed. INTERMITTENT PHOTIC STIMULATION: Produced no activation of the record. SLEEP: The patient appeared to remain drowsy or in early sleep throughout most of the recording. CARDIAC MONITOR: Showed a generally regular tachycardia with a rate of approximately 110. IMPRESSION: Abnormal EEG, largely in drowsiness, due to the left frontal theta slowing and due to the infrequent bursts of bifrontal theta with some sharp features. The first abnormality suggests a focal dysfunction in the left anterior quadrant, but it cannot specify the etiology. The irregular sharp background in the same area suggests the presence of a skull defect at some point. The bursts of focal slowing were paroxysmal and had some sharp features raising concern for epileptogenesis, but there were no definitely epileptiform abnormalities in this recording. There were no electrographic seizures. A tachycardia was noted. . CTA CHEST W&W/O C&RECON [**2180-11-3**]: Widespread bilateral pulmonary emboli. Mild dilatation of the main pulmonary artery is compatible with elevated pulmonary arterial pressure. . MRI Spine [**2180-11-14**]: 1. No definite evidence for intramedullary abnormal enhancement or abnormal T2 hyperintensity to suggest multiple sclerosis plaques. 2. Left psoas muscles and right posterior paraspinal muscle fluid-fluid levels, likely represent intramuscular hematomas with surrounding inflammation of the muscles. In presence of signs of infection, hemorrhagic abcesses cannot be excluded. 3. New large cystic lesion within the perisplenic region, incompletely characterized on this examination. This can represent the stomach, however, cystic lesion other than this cannot be excluded. CT scan of the abdomen is recommended. 4. New right upper lobe opacification. Differential diagnostic considerations would include right upper lobe atelectasis or pneumonia. Given the acuity of this lesion, mass lesion is unlikely. Right basilar lower lobe segmental dependent atelectasis versus aspiration pneumonia.CT . CT Abdomen/Pelvis ([**2180-11-16**]): Cystic structure as seen on MR examination from [**2180-3-17**] can be correlated to the fundus of the stomach. Left psoas hematoma with small focus of active extravasation. Hemorrhage tracking down left paracolic gutter with small amount of pelvic hematoma. No discrete fluid collections that would be concerning for abscess formation. . CT Head ([**2180-11-17**]): No acute hemorrhage. Diffuse hypoattenuation of the subcortical white matter, in particular posterior to the lateral ventricles, consistent with overlying disease seen on the prior MRI study. Slightly prominent ventricles for patient age, unchanged from MRI exam . CT HEAD ([**2180-11-23**]) s/p biopsy: FINDINGS: Left-sided craniotomy defect subcutaneous and small amount of pneumocephalus is new since prior exam. No large intracranial hemorrhage is seen. There is no mass effect or [**Doctor Last Name 352**]-white matter differentiation, abnormality. Left inferior basal ganglia sub-cm hypodensity likely represents a dilated Virchow -[**Doctor First Name **] space. The visualized ventricles and extra-axial spaces are within normal limits. Pneumocephalus in the left frontoparietal region is seen, this likely represents the site of biopsy. There is no fracture. IMPRESSION: Pneumocephalus and post-surgical changes related to recent biopsy. No large intracranial hemorrhage. . UNILAT UP EXT VEINS US LEFT ([**2180-11-28**]): HISTORY: Left upper extremity swelling with PICC line in place. FINDINGS: There is non-compressibility as well as echogenic thrombus filling the left axillary vein and both brachial veins. Thrombus surrounds the PICC line in one of the brachial veins. There is normal flow and waveforms in the bilateral subclavian veins. The left internal jugular, basilic, and cephalic veins are patent. IMPRESSION: Thrombosis of the left axillary and both left brachial veins. . Brief Hospital Course: [**Known firstname **] [**Known lastname 58354**] is an 18 year old female with MS/NMO spectrum who initially presented with headache, who then had a prolonged hospitalization with evidence of severe encephalitis, as described in detail below. LEUKOENCEPHALITIS: When initially being evaluated for the headache, the patient underwent a lumbar puncture (see results section). She was started on a course of acyclovir which was discontinued when CSF HSV was negative. She underwent MRI/MRV of the head which showed demyelination but did not demonstrate venous sinus thrombosis. There was also concern that her presentation could have been consistent with seizures. On admission she was continued on Keppra and was also started on Zonegran. Keppra was eventually weaned due to concerns that it could be exacerbating the behavioral problems. She had several EEGs which showed non specific delta slowing that was not clearly epileptic. MRI showed evidence of demyelination, as above. . Patient became inceasingly non-verbal, disinhibited, and disoriented over the course of her hospitalization. A host of serum and CSF labs were obtained evaluating for various infectious, immunologic, paraneoplastic,and rheumatologic sources of her condition, however, work up was pan-negative(see results section). . LPs showed a lymphocytic predominance but no organisms were ever isolated. Dilantin ([**2180-10-31**]) was added to the zonisamide for question of seizure and worsening encephalopathy. ID was consulted [**11-1**] and recommended WNV, EEE, Cryptococcal, Toxo, Lyme Ehrlichiosis, Bartenella,histoplasma, HH6 and CSF culture which were negative (see results). HIV serum [**Month/Year (2) 41770**] test was negative. Patient began to have stereotyped facial twiches and UE stiffening that was concerning for seizure although this was never clear. She was empirically started on solumedrol but her metal status continued to decline. She became non verbal and not responsive to noxious stimulus. But, she continued to intermittently developed facial twiching and UE tremors concerning for seizure. [**11-10**] Clonazepam started for rhythmic delta slowing on EEG. It became unclear whether her worsening mental status was related to her history of demyelinating disorder or a new process. A brain biopsy was obtained on [**11-22**] which showed leukoencephalitis but was otherwise negative. Additional samples from the brain biopsy were sent to the [**Hospital1 **] for additional research. Serum was sent to the [**Last Name (un) 58355**] lab at [**State 43840**] for examination for anti-NMDA receptor antibodies, a paraneoplastic syndrome. . On [**12-1**] she showed dramatic improvement, and was much more alert and interactive, talking in sentences. After having pulled out her NG tube (below), she underwent a swallow evaluation and was started on soft diet. She had waxing and [**Doctor Last Name 688**] levels of alertness and interaction, but gradually advanced her diet and became on average somewhat more interactive in the last week of [**Month (only) 359**] and first week of [**Month (only) **]. Of note, by [**Month (only) **] she was eating very vigorously and quickly, grabbing at food in front of her. . In terms of her behavior, it was difficult to tell the various contributions to the patient's behavior of encephalopathy, a possible underlying psychiatric condition, or medications. Overall, encephalopathy was likely the biggest contributor; taken as a whole, her behaviors could be globally described as consistent with frontal lobe dysfunction, with poor ability to initiate positive behaviors other than grabbing at food, and poor ability to process information, but a clear ability to comprehend and respond to language as well as to react to stimuli and defend herself against perceived threats. On mental status exam she appeared confused and disoriented. Psychiatry was consulted and followed her during the admission. Initially the patient was placed on ativan/Zyprexa PRN. Standing Zyprexa was then added. However, the patient developed progressively worsening encephalopathy but with continued behavioral outbursts. . At that point, ativan was discontinued and Zyprexa was given PO/IM for behavioral outbursts. Keppra was also tapered off, as above. She was put on dilantin for seizure control. In the longer run, psychiatry suggested that Depakote or Trileptal might be better choices for seizure medicines in the setting of her behavioral issues, but a transition was deferred for outpatient follow-up or rehab monitoring, with an imminent transfer to rehab in mind. Psychiatry also suggested anti-psychotics, but the patient's mother was quite concerned about an earlier phase of the patient's admission in which she felt that a decline in the patient's function was associated with Zyprexa, and asked that the team not administer these medications. Active discussion with the mother on this topic continued, although the team did not insist on this given the appearance of slow gradual albeit not dramatic improvement in the patient's mental status. Pre-medication with small doses of IM ativan was tried for physical therapy activities; it was difficult to tell how helpful this was, and was undertaken with the understanding of a risk of further disinhibition. Further work on behavioral strategies will surely be an important part of her rehabilitation stay. . MICU STAY s/p BRAIN BIOPSY: She was transferred to the MICU s/p brain biopsy on [**11-23**] [**3-13**] difficulty with extubation. Ms [**Known lastname 58354**] remained intubated overnight, in the morning her sedation was weaned and ventilator decreased to PSV intermittnatly. In the evening, she was successfully extubated. She was monitored overnight and was tachypnic and tachycardic, but breathing comfortably and maintained O2 sats in the high 90s on RA. She was ultimately transferred back to the floor where she remained thereafter. . TACHYCARDIA AND HYPERTENSION: Patient was admitted with a low grade tachycardia 90s-100s and elevated BPs. She was eventually found to have bilateral pulmonary emboli. An EKG, ECHO, and cardiac enzymes were obtained, which were within normal limits. Patient subsequently developed hypertensive episodes to 150-180 and captopril was started on [**11-7**] for BPS <130. She was started on metoprolol later in [**Month (only) 359**]; then discontinued and replaced with lisinopril to see if this would improve hypertension; unfortunately, she then had systolic blood pressures to the 180s and became tachycardic to the 120s-130s; metoprolol 25 [**Hospital1 **] was restarted on [**12-13**] and blood pressures became mildly hypertensive and heart rates came down to 100s-110s. Toradol was tried as a trial to see if pain was driving these vital signs but seemed to have little effect. A lovenox level was checked and was within therapeutic range. . PULMONARY EMBOLISM: On [**11-2**], a PE-protocol CT scan was obtained to evaluate for persistent tachycardia and tachypnea. She was found to widespread bilateral PEs and heparin gtt was started. She was eventually transitioned to lovenox. She had good oxygenation though her tachycardia persisted. She had some difficulty with extubation after her brain biopsy but was extubated after an overnight stay in the MICU and soon after was having room air oxygen saturations in the high 90s. Later in her stay, a Factor Xa level was ordered to evaluate her lovenox level and showed this was therapeutic as of [**12-14**]. . BLOOD LOSS ANEMIA: Patient was found to have PEs as above. She was initially started on heparin gtt (PTT goal 60-80). However she was then found to have a psoas hematoma on [**11-16**] after noting a precipitous decline in her hematocrit. She was tranfused and hematocrit stabilized. She underwent an IR guided embolization but imaging showed no active extravasation. Given tenous coagulation status, an IVC filter was considered. At that time, bilateral LENIs were negative so it was felt she was not benefit from the procedure. Her heparin PTT goal was decreased 50-60. Ultimately she was transitioned to therapeutic lovenox and her hematocrit remained stable without further evidence of bleeding. . FEVER AND LEUKOCYTOSIS: On hospital day 12, patient begain spiking temperatures to 101. ID was consulted as above (see neuro section). She was also treated empirically for a UTI with ceftriaxone [**11-6**] x3days. [**11-7**] she developed fever to 100.7 and a luekocytosis WBC 17.0. She was started on vanco and zosyn emperically. She was subsequently found to have a coag negative staph bacteremia. She was treated for 2 weeks with vanco. Her lines were pulled and replaced. She had a temperature of 100.6 on [**12-14**] and blood cultures were drawn, labs were drawn, and an abdominal ultrasound was performed; this revealed... . IV ACCESS: Her initial PICC line was pulled in the setting of her apparent line infection, and a central right IJ line was placed. This was discontinued and ultimately replaced with a new PICC on the left. This PICC was later found to have a left upper extremity DVT associated with it and was pulled, and a RUE PICC was placed. The patient then ultimately pulled this PICC line out and it was not replaced, and in the last week of her admission, medical care was given without IV access and labs were drawn selectively and with the safety of phlebotomy and nursing staff in mind. . CONSTIPATION: The patient developed constipation during the hospitalization. This was treated with standing Senna/Colace, as well as lactulose PRN. On [**11-2**] tube feeds were started because of worsening encephalopathy and decreased PO intake. She did not tolerate tube feeds and pulled out her NG tube. She had some constipation in early [**Month (only) **] which was treated with . HYPERGLYCEMIA: Developed episodes of hyperglycemia while on tube feed and Solumedrol, for which she received sliding scale insulin. This was not necessary when she was not on steroids and she had no evidence of diabetes. . Medications on Admission: Keppra 500mg [**Hospital1 **] Discharge Medications: 1. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal HS (at bedtime) as needed for constipation. 2. Senna 8.6 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 3. Polyethylene Glycol 3350 17 gram/dose Powder Sig: One (1) packet PO DAILY (Daily) as needed for constipation. 4. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 5. Lactulose 10 gram/15 mL Syrup Sig: Thirty (30) ML PO TID (3 times a day) as needed for PRN constipation. 6. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 7. Acetaminophen 160 mg/5 mL Solution Sig: Six [**Age over 90 1230**]y (650) mg PO Q6H (every 6 hours) as needed for pain: do not give for fever or fever symptoms until discussing with MD. 8. Phenytoin 125 mg/5 mL Suspension Sig: Four Hundred (400) mg PO Q12H (every 12 hours): Please mix with breakfast and dinner and time so that this is given with meals. Please follow-up dilantin levels 1 day after admission, and notify MD for further orders for following levels. 9. Enoxaparin 100 mg/mL Syringe Sig: One (1) injection Subcutaneous Q12H (every 12 hours). 10. Prochlorperazine Maleate 10 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for nausea. 11. Ativan 2 mg/mL Solution Sig: One (1) mg Injection once daily; avoid unless absolutely necessary as needed for agitation. 12. Haldol 5 mg/mL Solution Sig: One (1) mg Injection once a day as needed for agitation, psychosis: give for emergent issues, consult w MD for further PRN orders as encephalopathy resolves/changes. Discharge Disposition: Extended Care Facility: [**Hospital6 85**] - [**Location (un) 86**] Discharge Diagnosis: Multiple sclerosis/NMO spectrum, with acute leukoencephalitis of unclear origin Pulmonary emboli [**Name (NI) **] staph bacteremia Discharge Condition: Fair Discharge Instructions: Ms. [**Known lastname 58354**] had a lengthy hospital stay for a neurologic syndrome shown by biopsy to be leukoencephalitis, but of unknown type. Most studies are negative; a few further outside studies are pending. Her mental status appears to be slowly improving but further rehabilitation will be necessary. If she fails rehabilitation, she should likely be readmitted to a neurology service either at the [**Hospital1 18**] or another area academic tertiary care hospital. Followup Instructions: NEUROLOGY FOLLOW-UP . She should have a follow-up appointment scheduled with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 8760**] at [**Hospital1 18**] [([**Telephone/Fax (1) 11088**]] within two weeks of being placed in rehab, to be scheduled for appropriate and safe transport to and from rehabilitation; and then within 1-2 weeks after discharge. . Lab results being followed up by [**Hospital1 18**] staff include NMDA receptor antibodies ([**Initials (NamePattern4) **] [**Last Name (NamePattern4) **]) and brain biopsy ([**Hospital3 14659**]) which are being evaluated by research laboratories. It is possible if NMDA receptor is negative that an LP will need to be performed. In her current state, this would need to be a planned procedure likely under anesthesia, so it has been deferred given that anesthesia has possibly contributed to over sedation and encephalopathy post-procedure earlier in her course. . PRIMARY CARE . She should have a primary care appointment made for her to be attended within one week of discharge from the rehabilitation facility. She should make a transition from pediatric to adult care. . To facilitate this transition, she should have an appointment with Dr. [**First Name4 (NamePattern1) 1060**] [**Last Name (NamePattern1) 1520**] in our [**Hospital 1944**] clinic as her first post-discharge appointment. Dr. [**Last Name (STitle) 1520**] saw Ms. [**Known lastname 58354**] as an inpatient. She is not a primary care physician but will be able to organize and facilitate Ms. [**Known lastname 58356**] outpatient care immediately post-discharge. If for some reason Dr. [**Last Name (STitle) 1520**] is not available, please ask for another [**Hospital 1944**] clinic appointment at [**Hospital3 **]. . She should then have two follow-up appointments for primary care. She should have a final pediatric appointment with Dr. [**First Name (STitle) **] [**Name (STitle) **], [**Street Address(2) **], [**Hospital1 **],[**Numeric Identifier 58357**]; [**Telephone/Fax (1) 58358**]. She should then have an adult internal medicine appointment shortly thereafter with a physician at [**Hospital1 **] Center's [**Hospital3 **]. Please bring Ms. [**Known lastname 58356**] pediatric records from Dr.[**Name (NI) 58359**] office to this first appointment. Physicians in this practice who currently have availability include Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], who we recommend as an excellent and caring physician. [**Name10 (NameIs) 2772**], if Dr. [**Last Name (STitle) **] does not have an appointment available, she should have another primary care physician assigned to her. Dr. [**Last Name (STitle) 1520**] can help with this if it is not resolved to your satisfaction by the time of your post-discharge appointment. . If there are problems with outpatient follow-up, please call Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 4427**] at [**Telephone/Fax (1) 250**]. Because he may not be working at [**Hospital3 **] after [**Month (only) **], he may not be the best primary care physician for Ms. [**Known lastname 58354**] at this point, but because he knows her from her inpatient stay, he can ensure that there is good follow-up. ICD9 Codes: 7907, 5990, 2851, 5119, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8318 }
Medical Text: Admission Date: [**2193-12-11**] Discharge Date: [**2193-12-14**] Date of Birth: [**2113-3-25**] Sex: M Service: MEDICINE Allergies: Penicillins / Sulfa (Sulfonamide Antibiotics) Attending:[**First Name3 (LF) 1973**] Chief Complaint: Upper GI Bleed Major Surgical or Invasive Procedure: EGD [**2193-12-12**] - Several ulcers and erosions in the duodenal bulb History of Present Illness: Mr [**Known lastname 110987**] is an 80 year old man who per the VA pharmacy is on warfarin, digoxin and insulin as well as anti-hypertensives, and who himself is a somewhat unclear medical historian, who presents with a two day history of dark stools. He says that on Tuesday he had a "major black bowel movement" and was alarmed by this but did not know what to do so he drank water and went to bed. He says that he then had a black stool with additional red blood in the bowl today, and he called 911. He requested to go to the VA which is where he gets all his care but was brought to the [**Hospital1 18**] because it was closer. On review of systems he said that he had gotten light-headed on trying to get up from bed and was very weak and sometimes had to call 911 for this; he appears to have had several falls. Denied chest pain, palpitations, or shortness of breath; he said that he sometimes has nausea which gets better when he drinks ice water. In the Emergency Department his initial vitals were 97.5, 114/70, 88, RR 14, 100% on room air. He was NG lavaged and by the ED resident's report did have some blood on the return which appeared to clear. He received 10 mg vitamin K and 2 units of FFP. He got 2 L NS. He had some intermittent systolic blood pressure in the 80s and 90s which responded well to IV fluid boluses and his hemodynamics were otherwise stable in the ED by report. He was also nauseous in the ED and received 2 doses of 4 mg IV zofran for this. He was transferred to the MICU for further management. In the MICU, he received no blood products. He underwent EGD, which was remarkable for superficial ulcers in the duodenal bulb. He did not require pressors or intubation. He was transferred to the floor in stable condition. Past Medical History: Atrial Fibrillation Hypertension Diabetes Hypercholesterolemia Sleep Apnea, on CPAP Congestive Heart Failure, unspecified Social History: Occupation: retired mechanical engineer; WWII veteran of Air Force, was translator of Japanese Drugs: denies Tobacco: 30 py hx, quit 3 years ago Alcohol: likes a bottle of wine a day, "But I keep running out of wine"; denies any hx of withdrawals Other: Lives alone, wife left him 3 years ago, not in [**Hospital 4382**] Family History: NC Physical Exam: Temp 35.5 ??????C HR: 83 BP: 108/44(58) RR: 16 SpO2: 100% in 2L GENERAL: NAD SKIN: warm and well perfused, no excoriations or lesions, no rashes HEENT: AT/NC, EOMI, PERRLA, anicteric sclera, pink conjunctiva, patent nares, MMM, poor dentition, nontender supple neck, no LAD, no JVD CARDIAC: irregularly irregular, S1/S2, 2/6 SEM at base LUNG: CTAB ABDOMEN: nondistended, +BS, nontender in all quadrants, no rebound/guarding, no hepatosplenomegaly M/S: moving all extremities well, no cyanosis, clubbing or edema, no obvious deformities PULSES: 2+ DP pulses bilaterally NEURO: CN II-XII intact Pertinent Results: IMAGING: ======= RADIOLOGY CXR PA/LAT [**12-12**]: FINDINGS: The patient's condition required AP positioning. There is a slight increase in density in the lateral portion of the right lower lobe which may be partly due to patient's gynecomastia and a small right pleural effusion. Cardiomegaly is unchanged. Right-sided ICD leads in appropriate position remain unchanged. IMPRESSION: No significant change in the right lower lobe opacification. Part of this density may be due to overlying gynecomastia. . EGD [**12-12**]: Several superficial non-bleeding ulcers and erosions were found in the duodenal bulb. There was also duodenitis. Ulcers appeared to be low risk for rebleeding, thus procedures were not performed for hemostasis. LABS: ==== [**2193-12-11**] 10:30AM BLOOD WBC-8.2 RBC-3.17* Hgb-9.4* Hct-27.5* MCV-87 MCH-29.7 MCHC-34.3 RDW-15.2 Plt Ct-329 [**2193-12-12**] 02:37AM BLOOD WBC-7.9 RBC-2.84* Hgb-8.6* Hct-24.3* MCV-85 MCH-30.3 MCHC-35.5* RDW-16.9* Plt Ct-269 [**2193-12-12**] 02:40PM BLOOD Hct-26.2* [**2193-12-13**] 06:30AM BLOOD WBC-8.7 RBC-2.93* Hgb-8.8* Hct-25.4* MCV-87 MCH-30.0 MCHC-34.5 RDW-16.7* Plt Ct-277 [**2193-12-13**] 05:45PM BLOOD Hct-25.5* [**2193-12-14**] 11:51AM BLOOD Hct-27.9* [**2193-12-11**] 10:30AM BLOOD PT-19.2* PTT-27.6 INR(PT)-1.8* [**2193-12-11**] 04:39PM BLOOD PT-17.4* PTT-26.2 INR(PT)-1.6* [**2193-12-12**] 02:37AM BLOOD PT-15.8* PTT-23.1 INR(PT)-1.4* [**2193-12-13**] 06:30AM BLOOD PT-14.8* PTT-23.8 INR(PT)-1.3* [**2193-12-14**] 07:45AM BLOOD PT-15.9* PTT-26.3 INR(PT)-1.4* [**2193-12-11**] 10:30AM BLOOD Glucose-188* UreaN-65* Creat-1.5* Na-135 K-4.2 Cl-98 HCO3-23 AnGap-18 [**2193-12-11**] 04:39PM BLOOD Glucose-221* UreaN-59* Creat-1.3* Na-139 K-4.4 Cl-103 HCO3-26 AnGap-14 [**2193-12-12**] 02:37AM BLOOD Glucose-204* UreaN-50* Creat-1.2 Na-140 K-4.3 Cl-106 HCO3-26 AnGap-12 [**2193-12-13**] 06:30AM BLOOD Glucose-147* UreaN-31* Creat-1.1 Na-141 K-3.9 Cl-108 HCO3-26 AnGap-11 [**2193-12-14**] 07:45AM BLOOD Glucose-131* UreaN-28* Creat-1.2 Na-140 K-3.7 Cl-104 HCO3-27 AnGap-13 [**2193-12-11**] 04:39PM BLOOD ALT-14 AST-19 LD(LDH)-228 AlkPhos-46 Amylase-88 TotBili-0.6 [**2193-12-13**] 06:30AM BLOOD ALT-8 AST-17 AlkPhos-48 TotBili-0.8 [**2193-12-12**] 02:37AM BLOOD Calcium-8.3* Phos-3.0 Mg-2.2 [**2193-12-13**] 06:30AM BLOOD Calcium-8.4 Phos-2.5* Mg-2.1 [**2193-12-14**] 07:45AM BLOOD Calcium-8.4 Phos-3.5 Mg-1.8 [**2193-12-12**] 02:37AM BLOOD TSH-0.79 [**2193-12-11**] 04:39PM BLOOD Digoxin-0.7* [**2193-12-11**] 04:39PM BLOOD Ethanol-NEG MICRO: ===== Blood Cultures: NGTD RPR: negative H. pylori: pending Brief Hospital Course: 80 yo male with history of CHF, CAD, a-fib on Coumadin, pacer/ICD placement with melena s/p EGD without obvious source. Duodenitis and Gastritis: He was initially started on IV PPI and received 2U pRBCs. He remained hemodynamically stable while in-house with a stable Hct, and his EGD revealed evidence of duodenal ulcerations. He remained on IV PPI for ~72 hours and then transitioned to PO PPI [**Hospital1 **], that of which he will require for 6 weeks. Also, given that this may be due to H. pylori, serologies were sent and he was started empirically on triple therapy may need to contact[**Name (NI) **] if the serologies are negative, as he will not require treatment. RLL CONSOLIDATION: Pt was initially started on levofloxacin in unit for concern of pneumonia, although the lack of fevers, cough or white count suggested the absence of infection and this was held. He remained hemodynamically stable with this change. CAD Native Vessle, Benign Hypertension, Atrial Fibrillation: - CAD - His ASA and Coumadin were held initially but restarted without complications prior to discharge. He was kept on his statin throughout the hospitalization. - Pump - Given the ongoing bleeding on admission his anti-hypertensives were held and then restarted 24 hours after the EGD. He tolerated this well. - Rhythm - Pt has a-fib, on coumadin as an outpt. INR on admission was 1.4. His Coumadin was restarted at 5mg, which is change in his basline of 5 mg alternating daily with 7.5 mg, and this will need to be followed in [**Hospital3 **]. The INR also may be affected due to the initiation of antibiotics. It is suggested that the patient go to the VA [**Hospital 3052**] on the Monday following discharge. He was maintained on his home digoxin dosing throughout the hospitalization. Obstructive SLEEP APNEA: Continued on CPAP Diabetes type II Uncontrolled: Continue NPH 9 units [**Hospital1 **] + humalog sliding scale AlcoholDependence: The patient reports that he drinks a bottle of wine a day and serum tox was negative on admission. He was maintained on a Valium CIWA Scale although did not require treatment for withdrawal. He was given MVI, Thiamine and Folate and educated about the risks of continued alcohol use. FALLS: Patient reports a history of falls that appear may be a result of medications. He reports them as happening when he stands quickly from a seated position, and denies any associated chest pain, diaphoresis or SOB. He was seen by Physical Therapy who suggested home physical therapy. Medications on Admission: PER VA PHARMACY absorbase topical ointment cyanacobalamin 1000 mcg/ml inj 1x/month digoxin 0.125 mg daily enalapril maleate 2.5 mg [**Hospital1 **] furosemide 40 mg [**Hospital1 **] insulin NPH 18 units breakfast and HS; insulin regular 5 units at breakfast and dinner metoprolol succinate 100 mg daily simvastatin 40 mg daily warfarin 5 mg Sat/Sun/Tues/Thurs, 7.5 mg daily MWF miconazole powder nystatin cream Discharge Medications: 1. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Digoxin 125 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Enalapril Maleate 5 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). 7. Furosemide 40 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 8. Metoprolol Succinate 100 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO DAILY (Daily). 9. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*3* 10. Metronidazole 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) for 14 days. Disp:*28 Tablet(s)* Refills:*0* 11. Clarithromycin 250 mg Tablet Sig: Two (2) Tablet PO Q12H (every 12 hours) for 14 days. Disp:*64 Tablet(s)* Refills:*0* 12. Warfarin 5 mg Tablet Sig: One (1) Tablet PO Once Daily at 4 PM. Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: Primary Diagnosis: UGIB secondary to duodenal ulcerations. . Secondary Diagnoses: Atrial Fibrillation Hypertension Diabetes Hypercholesterolemia Sleep Apnea, on CPAP Congestive Heart Failure, unspecified Discharge Condition: Afebrile, stable vital signs, tolerating POs, ambulating without assistance. Discharge Instructions: You were admitted with an upper GI bleed that may be due to ulcerations that were seen in your small bowel. This may be due to a bacterial infection and we have started you on acid blockers that you'll need to take twice a day, and you've also been empirically started on a 2-week course of antibiotics and you will be contact[**Name (NI) **] if you can stop these earlier. . 1. Please take all medication as prescribed. 2. Please make all medical appointments. 3. Please return to the Emergency Room if you have any concerning symptoms. Followup Instructions: Please follow-up with your PCP as previously scheduled. Completed by:[**2193-12-16**] ICD9 Codes: 2851, 4280
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8319 }
Medical Text: Admission Date: [**2180-8-4**] Discharge Date: [**2180-8-14**] Date of Birth: [**2138-10-7**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 297**] Chief Complaint: Transfer for outside hospital with SBP secondary to HCV cirrhosis Major Surgical or Invasive Procedure: Paracentesis Central venous line placement History of Present Illness: 41yo female with a h/o end-stage liver disease from hepatitis C, normally followed by Dr. [**Last Name (STitle) 10285**]. She has refractory ascites & has weekly paracenteses with ~10L fluid removal with administration of albumin. Pt admitted to [**Hospital3 3583**] on [**8-2**] due to increasing ascites & SOB following dietary non-compliance. In [**Hospital1 **] [**Last Name (NamePattern1) **] she became increasingly O2 dependent & was admitted to their ICU. She had paracentesis with 11L removed & subsequently became hypotensive. Ascitic fluid demonstrated SBP which eventually grew out alpha strep (not enterococcus). Several hours later, pt aspirated & became hypotensive/bradycardic with increasing SOB -> subsequently intubated. CXR demonstrated a LLL infiltrate. Pt required multiple pressors to maintain her BP. She was started on Zosyn for her SBP & aspiration pneumonia. She also developed acute renal failure with rising creatinine levels at [**Hospital1 46**]. Past Medical History: End-stage liver disease - HCV s/p transplant eval -> not candidate due to excessive BMI Refractory ascites Hyponatremia Esophagitis & portal gastropathy Neuropathy Breast mass h/o RLE cellulitis Obesity Social History: Widowed. [**Name (NI) 1094**] mother, [**Name (NI) 622**], is health care proxy & her partner, [**Name (NI) **] [**Name (NI) 780**], is alternate health care proxy. h/o prior IVDU & ETOH abuse - currently in methadone program. Family History: Non-contributory Physical Exam: VS - 98.7, 91, 123/64, 17, 95% on AC 550x14/100%/8 Gen - ill appearing female, intubated/sedated HEENT - NC/AT, PERRL, +icteric sclerae, ETT/OGT in place CV - RRR, s1s2, no m/r/g Lungs - course BS bilat, L base rhonchi/crackles Abd - markedly distended, obsese, +BS Ext - 2+ pitting edema BUE/BLE Skin - jaundiced Neuro - intubated/sedated, non-responsive Pertinent Results: [**2180-8-4**] 10:56PM GLUCOSE-76 UREA N-46* CREAT-2.1*# SODIUM-132* POTASSIUM-4.0 CHLORIDE-96 TOTAL CO2-24 ANION GAP-16 [**2180-8-4**] 10:56PM ALT(SGPT)-1591* AST(SGOT)-2288* CK(CPK)-1292* ALK PHOS-102 TOT BILI-9.6* [**2180-8-4**] 10:56PM CK-MB-17* MB INDX-1.3 cTropnT-<0.01 [**2180-8-4**] 10:56PM ALBUMIN-3.2* CALCIUM-8.4 PHOSPHATE-6.3* MAGNESIUM-2.2 [**2180-8-4**] 10:56PM CORTISOL-13.7 [**2180-8-4**] 10:56PM WBC-14.9*# RBC-4.16* HGB-13.2 HCT-39.7 MCV-96 MCH-31.8 MCHC-33.3 RDW-16.3* [**2180-8-4**] 10:56PM NEUTS-67 BANDS-17* LYMPHS-7* MONOS-2 EOS-7* BASOS-0 ATYPS-0 METAS-0 MYELOS-0 [**2180-8-4**] 10:56PM HYPOCHROM-1+ ANISOCYT-1+ POIKILOCY-1+ MACROCYT-2+ MICROCYT-NORMAL POLYCHROM-1+ BURR-1+ TEARDROP-1+ [**2180-8-4**] 10:56PM PLT SMR-LOW PLT COUNT-125* [**2180-8-4**] 10:56PM PT-22.5* PTT-44.0* INR(PT)-3.4 [**2180-8-4**] 10:56PM FIBRINOGE-179 [**2180-8-4**] 11:52PM TYPE-ART TEMP-36.7 RATES-14/ TIDAL VOL-550 PEEP-10 O2-100 PO2-87 PCO2-54* PH-7.26* TOTAL CO2-25 BASE XS--3 AADO2-577 REQ O2-94 INTUBATED-INTUBATED VENT-CONTROLLED [**2180-8-4**] 11:52PM LACTATE-3.5* [**2180-8-4**] 10:57PM URINE HOURS-RANDOM CREAT-146 SODIUM-<10 [**2180-8-4**] 10:57PM URINE OSMOLAL-311 [**2180-8-4**] 10:57PM URINE COLOR-Amber APPEAR-SlCldy SP [**Last Name (un) 155**]-1.020 [**2180-8-4**] 10:57PM URINE BLOOD-SM NITRITE-NEG PROTEIN-TR GLUCOSE-NEG KETONE-NEG BILIRUBIN-SM UROBILNGN-NEG PH-5.0 LEUK-SM [**2180-8-4**] 10:57PM URINE RBC-60* WBC-13* BACTERIA-RARE YEAST-MANY EPI-2 Brief Hospital Course: 41yo female transferred from OSH to [**Hospital1 18**] MICU on [**2180-8-4**] with hypoxic/hypercapneic respiratory failure, aspiration pneumonia, septic shock, end-stage liver disease, SBP, refractory ascites, acute renal failure, coagulopathy, and mixed metabolic/respiratory acidosis. Pt continued on pressors & antibiotics. Hepatology & renal consulted and assisted in management of patient. Pt underwent multiple diagnostic/therapeutic paracenteses with albumin replacement. Pt also required multiple transfusions of FFP & PRBC's to correct coagulopathy & anemia. Pt noted to have adrenal insufficiency by [**Last Name (un) 104**]-stim test, placed on steroids. Pt was able to be weaned off pressors on [**8-9**] although had to be restarted on [**8-13**]. Following discussion of care with family by the MICU team, it was determined that patient would be extubated & maintained with comfort measures only. Following asystolic arrest, pt was pronounced dead at 1445 on [**2180-8-14**] by Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 28438**]. Medications on Admission: Outpatient Meds: lasix, spironolactone, propranolol, MDI Transfer Meds: dopamine drip, neosynephrine drip, zosyn, propranolol, spironolactone, lasix, methadone, protonix, vitamin K Discharge Medications: N/A Discharge Disposition: Expired Discharge Diagnosis: Spontaneous bacterial peritonitis Aspiration pneumonia Hepatitis C with cirrhosis Refractory ascites Septic shock requiring pressors Adrenal insufficiency Hyponatremia Coagulopathy requiring transfusions Anemia requiring transfusions Discharge Condition: Deceased Discharge Instructions: N/A Followup Instructions: N/A ICD9 Codes: 0389, 2761, 5070
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8320 }
Medical Text: Admission Date: [**2123-7-8**] Discharge Date: [**2123-7-9**] Service: NEUROLOGY Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 618**] Chief Complaint: left sided weakness Major Surgical or Invasive Procedure: none History of Present Illness: The pt is a [**Age over 90 **] year-old right-handed woman with a-fib on coumadin and history of stroke with residual minimal L-sided weakness who presents with acute worsening of left-sided weakness and new left facial droop. Per the patient and her family, she was feeling well yesterday. This morning she woke up and was unable to get out of bed due to being unable to move her left side. Her daughter [**Name (NI) **] was staying at her home and brought her to [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **]. Her family notes that the left side of her face is droopy and she is having much more difficulty getting words out than usual, both in the sense that they are slurred and poor verbal output. On neuro ROS, the pt reports posterior pressure headache (typical of chronic HAs). She denies loss of vision, blurred vision, diplopia, dysarthria, dysphagia, lightheadedness, vertigo, tinnitus or hearing difficulty. Denies difficulties producing or comprehending speech. No bowel or bladder incontinence or retention. On general review of systems, the pt denies recent fever or chills. No night sweats or recent weight loss or gain. Denies cough, shortness of breath. Denies chest pain or tightness, palpitations. Denies nausea, vomiting, diarrhea, constipation or abdominal pain. No recent change in bowel or bladder habits. No dysuria. Denies arthralgias or myalgias. Denies rash. Past Medical History: -atrial fib on coumadin - discovered 1 yr ago -stroke - [**9-/2122**] - at time of a-fib discovery. Left-sided hemibody (excluding face) weakness, recovered almost fully; 2nd stroke with worsening of left-sided sx in [**4-/2123**] when she was taken off coumadin briefly for skin cancer removal. - HTN - HL - osteoarthritis - "leaky" heart valve - chronic headaches - posterior, pressure x years, responds to acetaminophen Social History: Her family reports that her baseline is very sharp mentally, doing crosswords and soduku daily. She typically has full functional use of both hands. She uses a walker to walk. She lives alone but children live close-by and she has additional help daily. She takes her own medications using a timer and a schedule. Never smoked tobacco, drank significant alcohol, or used drugs. Has 3 grown children in the area. Retired nurse. Family History: non contributory Physical Exam: Physical Exam on Admission: Vitals: T: 98.4 P: 87 R: 22 BP: 112/63 SaO2: 95% on 3L General: Lying in bed, cooperative, NAD. HEENT: NC/AT, no scleral icterus, MMM, no lesions in oropharynx Neck: Supple, no carotid bruits appreciated. No nuchal rigidity Pulmonary: Lungs CTA bilaterally without R/R/W Cardiac: irreg irreg, 2/6 systolic murmur Abdomen: soft, NT/ND, normoactive bowel sounds, no masses or organomegaly noted. Extremities: No C/C/E bilaterally, 2+ radial, 1+DP pulses bilaterally. Skin: no rashes or lesions Neurologic: -Mental Status: Alert, oriented x 3 (self, hospital, month and year). Somewhat attentive, able to count forwards and backwards. Paucity of speech, does not achieve fluency. Intact repetition and comprehension. + paraphasic errors ("hand" for "glove" Names [**2-16**] (key, glove, chair - all high frequency) on stroke card correctly but does not attempt to name other objects. Does not attempt [**Location (un) 1131**] when given stimulus. Abulic. Speech dysarthric. Able to follow both midline and appendicular commands. Left sided neglect with R gaze deviation. -Cranial Nerves: I: Olfaction not tested. II: PERRL 2 to 1.5mm and brisk. VF difficult to assess given inattention and R gaze preference, appears to have full visual fields with extinction on left. Funduscopic exam unable to be completed well due to small pupils and patient inattention. III, IV, VI: Eyes do not cross midline to left. Conjugate. V: Facial sensation intact to light touch. VII: Left lower facial droop. VIII: Hearing intact to finger-rub bilaterally. IX, X: Palate elevates symmetrically. [**Doctor First Name 81**]: 5/5 strength in trapezii. XII: Tongue clumsy with movements, appears to have more difficulty with moving to left. -Motor: Normal bulk. Left hemibody has dense flaccid hemiplegia. R hemibody appears to have full strength, patient unable to cooperate fully with formal strength testing. No adventitious movements. No asterixis. -Sensory: No deficits to light touch, pinprick, cold sensation, vibratory sense throughout. Unable to cooperate with proprioception. Extinction to DSS on left. -DTRs: [**Name2 (NI) **] Tri [**Last Name (un) 1035**] Pat Ach L 2 2 2 2 0 R 2 2 2 2 0 Plantar response was extensor bilaterally. -Coordination: No dysmetria on FNF in RUE. RAMs intact in RUE -Gait: deferred Physical Exam on Discharge: expired Pertinent Results: Relevant Labs: [**2123-7-8**] 09:00PM GLUCOSE-298* UREA N-18 CREAT-0.8 SODIUM-136 POTASSIUM-3.7 CHLORIDE-99 TOTAL CO2-23 ANION GAP-18 [**2123-7-8**] 09:00PM CALCIUM-8.9 PHOSPHATE-4.6* MAGNESIUM-1.4* [**2123-7-8**] 09:00PM OSMOLAL-285 [**2123-7-8**] 09:00PM PT-16.2* PTT-79.0* INR(PT)-1.5* [**2123-7-8**] 06:43PM URINE HOURS-RANDOM [**2123-7-8**] 06:43PM URINE bnzodzpn-NEG barbitrt-NEG opiates-NEG cocaine-NEG amphetmn-NEG mthdone-NEG [**2123-7-8**] 06:43PM URINE COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.037* [**2123-7-8**] 06:43PM URINE BLOOD-SM NITRITE-NEG PROTEIN-TR GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-6.5 LEUK-SM [**2123-7-8**] 06:43PM URINE RBC-5* WBC-6* BACTERIA-NONE YEAST-NONE EPI-3 [**2123-7-8**] 06:43PM URINE MUCOUS-RARE [**2123-7-8**] 03:59PM ALT(SGPT)-26 AST(SGOT)-77* CK(CPK)-224* ALK PHOS-86 TOT BILI-1.0 [**2123-7-8**] 03:59PM CK-MB-3 cTropnT-<0.01 [**2123-7-8**] 03:59PM ALBUMIN-3.9 [**2123-7-8**] 03:59PM OSMOLAL-284 [**2123-7-8**] 01:43PM LACTATE-1.7 IMAGING: CT SCAN (POST-HEMORRHAGIC EVENT) - IMPRESSION: Interval development of massive hemorrhagic conversion of a large right frontoparietal ischemic stroke, resulting in subfalcine and downward transtentorial herniation, associated with significant edema and 2.7 cm of midline shift to the left, effacing the right lateral ventricle and entrapping the left occipital [**Doctor Last Name 534**]. Brief Hospital Course: Ms. [**Known lastname 31394**] was known to have suffered a large right sided anterior frontal MCA stroke, possibly with an additional left ACA component as well, in the setting of a history of atrial fibrillation on warfarin with a subtherapeutic INR. She was placed on a heparin infusion initially in the setting of likely cardioembolic stroke. As part of her expected management plan, she was transferred to the Neurology Step Down Unit with q2 hour neurochecks - no change in neurologic examination or clinical status was seen overnight except that she was more sleepy and didn't answer questions at 0130 - of note, she remained arousable and followed commands. Around 0425, Ms. [**Known lastname 31394**] was noted to have fixed pupils with right at 6mm and left at 3mm, with extensor posturing with her left arm to noxious stimulus and continued flexion withdrawal in the other arm. Both the ICU attending and chief resident were updated at this time, and the family was contact[**Name (NI) **]. The patient's daughter (health care proxy) reaffirmed keeping her DNR/DNI as previously established as per the patient's wishes. Intervention was initiated with Mannitol administration, stopping the Heparin infusion, support her respiratory status without intubation, and transfer her to the Neurology ICU. The patient was stabilized, but repeat non-contrast head CT revealed hemorrhagic conversion of her MCA and ACA ischemic stroke with extension into the lateral ventricles, as well as up to 27mm of right to left midline shift. In the setting of this change and in discussion with her daughter/HCP, she was made comfort measures only and expired at 0910 on [**2123-7-9**]. Medications on Admission: coumadin 5mg daily 6 times a week, 2.5mg on the 7th day synthroid 37.5mcg daily atenolol 25mg po daily amlodipine 5mg po daily lasix 20mg po daily occuvite acidophilius pravastatin 40mg po daily quinipril 40mg po daily Discharge Medications: Expired Discharge Disposition: Expired Discharge Diagnosis: Expired Discharge Condition: Expired Discharge Instructions: Expired Followup Instructions: Expired [**Name6 (MD) **] [**Name8 (MD) **] MD, [**MD Number(3) 632**] Completed by:[**2123-7-9**] ICD9 Codes: 431, 4019, 2724, 2449
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8321 }
Medical Text: Admission Date: [**2112-5-17**] Discharge Date: [**2112-5-24**] Date of Birth: [**2112-5-17**] Sex: M Service: NB DIAGNOSES AT DISCHARGE: Prematurity. Presumed sepsis, resolved. Hyperbilirubinemia, resolved. Feeding immaturity, resolved. HISTORY: Patient is an 1835 gram male born at 34 1/7 weeks admitted to the Neonatal Intensive Care Unit for prematurity. He was born to a 25 year-old gravida III, para I to II mother with an estimated date of confinement of [**2112-6-27**]. Prenatal laboratories included blood type B positive, antibody negative, hepatitis B surface antigen negative, RPR nonreactive, rubella immune and GBS unknown. Pregnancy was reported to be unremarkable until night of delivery when mother presented in spontaneous labor. Intrapartum course was notable for spontaneous rupture of membranes 20 minutes prior to delivery with one dose of intrapartum antibiotic prophylaxis 10 minutes prior to delivery and rapid progression of labor. He was born via spontaneous vaginal delivery emerging vigorous with Apgar scores of 8 and 9. He was brought to the Neonatal Intensive Care Unit in room air without evidence of respiratory distress. PHYSICAL EXAMINATION ON ADMISSION: Weight 1835 grams, 25th percentile, length 43 cm, 25th percentile, length 43 cm, 25th percentile, head circumference 29.5 cm, 10th to 25th percentile. Vital signs on admission: Temperature 98, heart rate 150, respiratory rate 40, blood pressure 61/31 and mean of 48, O2 saturation 97% on room air. The baby was active and vigorous with no distress, somewhat small appearing for gestational age. Skin was warm, pink, well perfused, no rash. Head, eyes, ears, nose and throat: Normocephalic, fontanelle soft and flat, palate intact, nondysmorphic. Neck supple, no lesions. Chest clear to auscultation, no grunting, flaring or retracting. Cardiac: Regular rate and rhythm, no murmurs, rubs or gallops. Femoral pulses 2+. Abdomen soft, no masses. Three vessel cord, quiet bowel sounds. No hepatosplenomegaly. Genitourinary: Normal male testes palpable. Anus patent. Extremities no lesions. Hips and back: Normal. Neurologic: Grossly normal tone and activity. Intact grasp and Moro. HOSPITAL COURSE BY SYSTEMS: RESPIRATORY: Patient remained comfortable on room air throughout hospitalization with no episodes of apnea. CARDIOVASCULAR: Patient remained hemodynamically stable through hospitalization. At the end after starting on an initial amount of fluid at 50 cc per kilo per day with 10% dextrose infusion [**Known lastname **] was quickly able to take all of his feeds by mouth reaching 150 cc per kilo per day at the time of discharge with breast milk or Enfamil 24 calorie per ounce formula. His D sticks remained stable throughout hospitalization. HEMATOLOGY: Initial hematocrit was 49 with a repeat of 45 on day of life 6. Platelets were 190. INFECTIOUS DISEASE: Initial white count was 7.2 with a left shift. Differential of 22 polys and 12 bands. Given the left shift a lumbar puncture was performed at day of life 2. Results were reassuring for no infection. Antibiotics were discontinued after 48 hours as cultures, blood and cerebrospinal fluid cultures remained negative. On day of life 5 [**Known lastname **] transiently dropped his temperature and required temperature control with an Isolette for 24 hours. At that time he had a CBC and blood culture drawn with a reassuring differential of 35 polys and no bands. No antibiotics were started. GASTROINTESTINAL: [**Known lastname **] was started on phototherapy on day of life 3 for a bilirubin of 9.9 and a direct component of .4. Phototherapy was discontinued on day of life 5 with a rebound of 5.4/0.3. RENAL: Given the history of hydronephrosis seen on prenatal ultrasounds [**Known lastname **] received a renal ultrasound on day of life 3 with normal results. ROUTINE HEALTH CARE MANAGEMENT: He received his hepatitis B vaccine. He passed his car seat test and he passed his bears. [**First Name11 (Name Pattern1) 449**] [**Last Name (NamePattern1) **], [**MD Number(1) 54604**] Dictated By:[**Last Name (NamePattern1) 61635**] MEDQUIST36 D: [**2112-5-23**] 16:40:44 T: [**2112-5-23**] 17:42:50 Job#: [**Job Number **] ICD9 Codes: 7742, V053, V290
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8322 }
Medical Text: Admission Date: [**2126-11-16**] Discharge Date: [**2126-11-22**] Date of Birth: [**2047-2-18**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 3266**] Chief Complaint: Hepatic failure Major Surgical or Invasive Procedure: None History of Present Illness: Mrs. [**Known lastname 56774**] is a 79 year-old woman with a history of essential thrombocytosis, chronic anemia, and recently diagnosed ([**9-21**]) cirrhosis, ascites, and splenomegaly who presents with a several day history of black tarry stools and one episode of brown emesis. Mrs. [**Known lastname 56774**] first began feeling fatigued 2 weeks prior to admission, and missed a full week of work ([**2044-11-2**]) secondary to this fatigue. On [**11-10**] she continued to feel tired and lightheaded, but went to work anyway. On [**11-14**] she returned home from bingo in the evening and threw-up watery brown emesis with food. Though she cannot specify which day it began, at some point over this week her stools began to appear black and tarry, as they had when she was on iron therapy for anemia. On [**11-15**] she came home from work so tired that she was unable to climb the stairs in her home, and her family brought her to an outside hospital later that evening. Of note, per her medical record, in [**9-21**] Mrs. [**Known lastname 56774**] presented to her PCP with [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 19341**] history of bilateral lower extremity swelling and increased abdominal girth. Abdominal CT ([**9-21**]) at an outside institution was read as massive ascites with a small nodular liver and splenomegal. Endoscopy ([**2-20**]) report includes hiatal hernia but no varices. Colonoscopy at this time was reportedly negative. Therapeutic paracentesis revealed a transudate suggestive of portal hypertension, with negative cytology. Serology for Hep B and C were negative, the patient does not drink alcohol or use tylenol regularly. Work-up for autoimmune hepatitis was started. She was started on lasix and aldactone, but could not tolerate the aldactone since she felt ??????dry??????. At the outside hospital on [**11-15**] Mrs. [**Known lastname 56774**] was found to have an elevated INR and HCT of 28.6 on admission that dropped to 21.5. She could not be immediately transfused secondary to difficulty matching packed red blood cells. She was given four units of fresh frozen plasma, 2 units of packed red blood cells, and started on prednisone 80 mg for supposed autoimmune hemolysis, as well as folic acid. On [**11-16**] she was admitted to the [**Hospital1 18**] MICU, where her intial HCT post-transfusion was 28.5. The MICU course included banding of esophageal varices and medical treatment with octreotide, pantoprazole, and sucralfate. Prophylactic antibiotics were started (metronidazole and levofloxacin, then changed to ciprofloxacin at 500 mg PO q12 hours) to try to avoid spontaneous bacterial peritonitis. EKGs were followed secondary to a slight increase in troponin at outside hospital thought to be due to demand ischemia secondary to blood loss, and an echo was done secondary to a newly perceived heart murmur. The labs sent from the MICU course are listed below. Past Medical History: 1. Essential thrombocytosis 2. Anemia 3. Hepatosplenomegaly with ascites 4. Cystocele Social History: 1. Cook at local school 2. No tobacco, EtOH, IVDA Family History: 1. Mother - metastatic abdominal cancer 2. Father - bone cancer 3. Sister - breast cancer 4. Brother - stroke 5. Sister - liver transplant Physical Exam: T 97.1 HR 54 BP 110/60 RR 18 Sat 91% RA GEN: Alert, awake, oriented, chatty, sitting in chair talking with daughter. Thin [**Name2 (NI) 56775**] face not in proportion with swollen appearance of extremities and abdomen. HEENT: Head NC/AT. Sclerae anicteric, conjunctiva pale. PERRLA, EOMs intact, VFs full. Nasal mucosa pink, without polyps. No sinus tenderness. Oropharynx clear and nonerythematous. Mucous membranes moist. Trachea midline. Neck supple. Thyroid not enlarged and without nodules. No LAD. CARDIO: JVP 4 cm above the sternal angle at 30?????? elevation. Carotid pulses 2+ bilat.; upstrokes brisk; without bruits. PMI appreciated at 4th-5th IC space on midaxillary line. Holosystolic murmur obscuring S1 best heard at right upper sternal border and lower left sternal border. Otherwise, S1 & S2 normal. No rubs, gallops, heaves or thrills. PULM: Soft crackles at bases bilaterally. No wheezes or rhonchi. [**Last Name (un) **]: Distended/obese, nontender. BS present in all 4 quadrants. No bruits. Shifting dullness. Liver edge not felt, but abdomen firm throughout right upper quadrant. Spleen tip felt at umbilicus with splenic body extending to pelvic brim. Bandages covering site of peritoneal tap. No CVA tenderness. EXTR: Warm and well perfused bilaterally. Radial pulses 2+. Post tib. and DP pulses 1+ bilat. Good capillary refill bilat. 1+ pitting lower extremity edema to mid-calf bilaterally. Thickened DIP joints consistent with osteoarthritis bilaterally. NEURO: AOx3. Rest of MMSE not performed. CNs II-XII intact to direct testing. Light touch intract UEs and [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) **]. No asterixis. No clonus. SKIN: Skin fragile, warm, and moist. Facial skin appears tanned, but difficult to assess presence of jaundice in overhead lighting. Nails without clubbing or cyanosis. Hair of average texture. No spider angiomata. No suspicious nevi. No rashes or petechiae. Several large ecchymoses on arms, burn on right inner wrist. No palmar erythema. Pertinent Results: [**2126-11-16**] 11:11PM BLOOD WBC-6.4 RBC-2.92* Hgb-9.6* Hct-28.5* MCV-98 MCH-32.9* MCHC-33.6 RDW-20.3* Plt Ct-553* [**2126-11-18**] 04:44AM BLOOD WBC-8.4 RBC-3.26* Hgb-10.7* Hct-32.8* MCV-101* MCH-33.0* MCHC-32.7 RDW-19.8* Plt Ct-538* [**2126-11-16**] 11:11PM BLOOD Neuts-92.0* Bands-0 Lymphs-6.5* Monos-1.0* Eos-0.3 Baso-0.2 [**2126-11-16**] 11:11PM BLOOD PT-15.1* PTT-33.1 INR(PT)-1.4 [**2126-11-18**] 04:44AM BLOOD PT-15.5* PTT-31.2 INR(PT)-1.5 [**2126-11-18**] 04:44AM BLOOD Glucose-121* UreaN-41* Creat-0.8 Na-141 K-4.0 Cl-102 HCO3-33* AnGap-10 [**2126-11-16**] 11:11PM BLOOD Glucose-119* UreaN-41* Creat-0.8 Na-140 K-3.5 Cl-101 HCO3-32* AnGap-11 [**2126-11-18**] 04:44AM BLOOD ALT-27 AST-33 LD(LDH)-238 AlkPhos-65 TotBili-1.5 DirBili-0.6* IndBili-0.9 [**2126-11-16**] 11:11PM BLOOD ALT-30 AST-41* LD(LDH)-256* CK(CPK)-62 AlkPhos-69 TotBili-2.8* DirBili-1.0* IndBili-1.8 [**2126-11-18**] 04:44AM BLOOD Calcium-8.6 Phos-2.8 Mg-2.1 [**2126-11-16**] 11:11PM BLOOD Albumin-3.1* Calcium-8.9 Phos-3.0 Mg-1.9 UricAcd-7.9* Iron-87 Brief Hospital Course: Mrs. [**Known lastname 56774**] is a 79 year-old woman with history of essential thrombocytosis, chronic anemia, and recently diagnosed ([**9-21**]) cirrhosis, ascites, and splenomegaly who presents with a several day history of black tarry stools and one episode of brown emesis. 1. GI bleed, source unknown, but thought to be secondary to esophageal varices. After receiving packed red blood cells and fresh frozen plasma, her hematocrit has stabilized. EGD revealed varices, subsequently banded, but no active bleeding. Negative colonsopy reported from [**2-20**]. HCT over past 24 hours have been stable > 29. She was treated with sucralfate, nadolol, octreotide and antibiotic prophylaxis. She remained stable in that respect throughout her stay. 3. Decompensated chronic liver failure, unknown etiology: The patient has cirrhosis diagnosed by CT, ascites, esophageal varices, decreased synthetic function (increased INR, low albumin). THe patient underwent a diagnostic/therapeutic paracentesis on [**11-17**], [**2082**] cc of fluid consistent with ascites (no malignant cells, serum-ascites albumin gradient = 2.0). Various diagnoses were excluded both during this stay and prior to arrival. These included infectious, alcoholic, NASH, autoimmune, metabolic. A liver biopsy was performed on [**2126-11-20**] which revealed cirrhosis but no evident causes. She underwent a second therapeutic paracentesis prior to her discharge which produced large amounts of fluid and relieved her mild shortness of breath and hypoxia (sats. 91-92). 4. Anemia: There are multiple possible origins to Mrs. [**Known lastname 56774**]?????? anemia. Her anemia diagnosed in [**2-20**] was treated with iron and transfusion, and is now exacerbated by her GI bleed. In contradiction to her original treatment with iron and labs at the outside hospital that indicate iron deficiency anemia, her current anemia is macrocytic, the differential diagnosis of which primarily includes deficiencies of folate or B12 secondary to malnutrition or absorption disorders; however, Mrs. [**Known lastname 56774**]?????? lab values for both folate and B12 are elevated, most likely due to supplementation. It is also possible that the macrocytosis and elevated RDW were secondary to liver failure. Her reticulocyte level is not high enough (2.9%) to cause such a high MCV. Another possible cause of her anemia could be her ten-year treatment with hydroxyurea. Data from the OSH included a positive Coombs antibody test combined with the elevated indirect bilirubin could indicate hemolysis, but in the setting of cirrhosis with a normal haptoglobin level and normal LDH significant hemolysis is unlikely. Thus, for treatment we deferred from continuing the prednisone and folate started at the OSH. As her iron levels are low, we restarted iron supplementation. 5. Essential thrombocytosis: Has been taking hydroxyurea for at least ten years. Platelets 538 on admission. The hematologist advised to hold her hydroxyurea until her platelet count reached 800. 6. New murmurs: New murmurs of mitral and tricuspid regurgitation and aortic stenosis auscultated and validated by echocardiography. Mrs. [**Known lastname 56774**] was discharged after an uncomplicated [**Hospital 56776**] hospital stay with a diagnosis of decompensated liver failure and gastrointestinal bleed. She was sent home in stable condition and with close follow up with the GI service. Medications on Admission: 1. Hydroxyurea 10 mg once daily 2. Aspirin 81 mg once daily 3. Lasix 4. Multivitamins Discharge Medications: 1. Sucralfate 1 g Tablet Sig: One (1) Tablet PO QID (4 times a day): Please stop sunday night [**11-24**]. Disp:*20 Tablet(s)* Refills:*0* 2. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 3. Nadolol 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*30 Tablet(s)* Refills:*2* 4. Spironolactone 25 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 5. Lactulose 10 g/15 mL Syrup Sig: Thirty (30) ML PO DAILY (Daily) as needed for PRN bowel mov't: Please ttitrate to [**2-19**] bowel mov't per day if patient is showing signs of confusion. Disp:*qs bottle* Refills:*1* 6. Ferrous Sulfate 325 (65) mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 7. Furosemide 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Decompensation of liver failure with GI bleed Discharge Condition: good Discharge Instructions: Please take all medications as directed. Sucralfate should be taken through Sunday [**11-24**], and Pantoprazole until your procedure with Dr. [**Last Name (STitle) **]. Otherwise, the prescriptions are on-going. Continue with incentive spirometry and ambulation at home. Please call Dr. [**Last Name (STitle) **] and return to the ED immediately if there you have vomit with dark material or blood, dark tarry stools or blood per rectum, confusion that is not relieved by lactulose, shortness of breath, dizziness, or any other concerning symptoms. Please maintain a low-salt diet and restrict fluids to 1.5L max per day. Your medications will need to be adjusted in the near future by Dr. [**Last Name (STitle) **] according to how much fluid you are retaining and future procedures. Followup Instructions: Please follow-up with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] on [**2126-11-24**] for EGD/banding procedure. Her office will call you with the time of the appointment. Please follow-up with PCP within [**Name9 (PRE) 56777**] of discharge. Completed by:[**2126-12-11**] ICD9 Codes: 5715
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Medical Text: Admission Date: [**2176-1-1**] Discharge Date: [**2176-1-7**] Date of Birth: [**2134-11-23**] Sex: M Service: ADMISSION DIAGNOSIS: 1. Marfan's syndrome. 2. Aortic dilatation. 3. Possible aortic regurgitation. DISCHARGE DIAGNOSES: 1. Marfan's syndrome. 2. Status post ascending aortic root repair. HISTORY OF PRESENT ILLNESS: The patient is a 41-year-old male with a strong family medical history of Marfan's disease. He has a [**7-14**] year history of heart palpitations and is placed on Lopressor by his cardiologist, whom he has been following for the last 10 years. The patient experienced new chest and back pain in [**2175-11-5**] and underwent echocardiogram and CTA, which revealed a dilated aortic root for which the patient is referred for operative management. PAST MEDICAL HISTORY: 1. Marfan's syndrome. 2. Gastroesophageal reflux disease. 3. Borderline hypertension. 4. Right elbow surgery in [**2154**]. MEDICATIONS: 1. Lopressor 25 mg [**Hospital1 **]. 2. Prilosec 20 mg q day. 3. Lotrisone cream [**Hospital1 **]. ALLERGIES: Penicillin and Demerol. PHYSICAL EXAMINATION: The patient is a middle-age man who appears well nourished and well developed in no acute distress. Vital signs: Heart rate 60 normal sinus, blood pressure 136/104, respirations 16. Height is 6 foot 3 inches, weight 220 pounds. HEENT: Atraumatic, normocephalic. Extraocular movements are intact. Pupils are equal, round, and reactive to light. Anicteric. Throat is clear. Neck is supple, midline. No masses or lymphadenopathy. Chest was clear to auscultation bilaterally. Cardiovascular is regular, rate, and rhythm with 2-3/6 systolic ejection murmur. No rubs. Abdomen is soft, nontender, nondistended. No guarding or rebound. No masses or organomegaly. Extremities: Warm, not cyanotic, nonedematous x4. Neurologic is alert and oriented times three. No focal motor or sensory deficits are noted. LABORATORIES: Patient had preoperative laboratories done on [**2175-12-27**] as follows: Complete blood count: 6.7/14.7/42.7/192. PT 12.5, INR 1.0, PTT of 34.9. Chemistries: 141/4.1/102/27/18/0.7/81. ALT 27, AST 19, alkaline phosphatase 87, bilirubin 0.6. Type and screen was performed at that time. Preoperative chest x-ray was unremarkable. HOSPITAL COURSE: The patient was admitted for semi-elective repair of his aortic root aneurysm. Patient underwent procedure which was valve sparing without complication. In the postoperative period, the patient was taken to the Intensive Care Unit for closer monitoring. He was initially maintained on the ventilator overnight while he was weaned. Patient was also begun on a nitroglycerin drip to maintain the systolic blood pressure of less than 120. The patient was eventually started on Nipride and the nitroglycerin was weaned off. The patient did receive three units of packed red blood cells for a hematocrit of 20, and his post-transfusion hematocrit was 27. Cardiac index was 2.9 to 3.1 with the normal infusing at 0.5 mcg/kg/minute. Patient was subsequently extubated on postoperative day #1 without incidence. His sats did well postextubation maintaining sats about 95% on 3 liters nasal cannula. Patient remained in sinus rhythm and with blood pressure stable 120/60s. Insulin drip was weaned off and the patient was begun on sliding scale insulin. The patient was transferred to the floor on postoperative day #2. Physical Therapy was begun, and the patient did have significant complaints of incisional pain. Patient's floor course was fairly unremarkable. Patient's chest tubes and pacing wires were discontinued on postoperative day #3. His Foley was also removed without complication. The patient had some mild issues with weaning lower levels of supplemental oxygen. He is still having oxygen requirement on postoperative day #5 sating 93% on 2 liters. Chest x-ray was obtained which showed a small left sided pleural effusion and right basilar atelectasis. Pulmonary toilet was encouraged. The patient was discharged on postoperative day #6 with no oxygen requirement. He was switched to Dilaudid for pain control secondary to his belief that Percocet was not working as well anymore. Patient was discharged to home, tolerating regular diet, and adequate pain control with po pain medications, and without any cardiac events or further episodes of palpitations or chest pain. PHYSICAL EXAMINATION ON DISCHARGE: General: In no acute distress. Chest was clear to auscultation bilaterally. Sternal incision is clean and dry without drainage. His cardiovascular is regular, rate, and rhythm without murmurs, rubs, or gallops. There are some slightly decreased breath sounds at the left base. Abdomen is soft, nontender, nondistended. Extremities are warm and well perfused without edema or cyanosis x4. Neurologic is intact. DISCHARGE MEDICATIONS: 1. Lopressor 25 mg [**Hospital1 **]. 2. Colace 100 mg [**Hospital1 **]. 3. Aspirin 325 mg q day. 4. Percocet 5/325 mg [**12-7**] q4h prn. 5. Dilaudid 4 mg 1-2 tablets q4h prn. 6. Ibuprofen 400 mg q6h. 7. Lasix 20 mg [**Hospital1 **] x7 days. 8. Potassium chloride 20 mEq [**Hospital1 **] x7 days. FO[**Last Name (STitle) **]: The patient is to followup in [**12-7**] weeks with Cardiology and address the diuresis and adjustment of cardiac medications at that time. The patient should follow up with Dr. [**Last Name (Prefixes) **] in one month. DISCHARGE CONDITION: Good. DISPOSITION: Home. DIET: Ad lib. [**Doctor Last Name 412**] [**Last Name (Prefixes) 413**], M.D. [**MD Number(1) 414**] Dictated By:[**Last Name (NamePattern1) **] MEDQUIST36 D: [**2176-1-7**] 16:28 T: [**2176-1-9**] 06:21 JOB#: [**Job Number 46907**] ICD9 Codes: 5180, 5119, 4019
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Medical Text: Admission Date: [**2124-10-1**] Discharge Date: [**2124-10-6**] Date of Birth: [**2059-8-11**] Sex: F Service: CARDIOTHORACIC Allergies: Morphine Attending:[**First Name3 (LF) 922**] Chief Complaint: Chest and jaw pain Major Surgical or Invasive Procedure: Ascending aorta replacement (26MM Gelweave graft) Resuspension of aortic valve History of Present Illness: this 62 year old caucasian female presented to the emergency room with the sudden onset o fchest pain readiating to her jaw at 1100 hours the day of admission. The pain resolved, however, she developed epigastric discomfort and general malaise. A CTA demonstrated mural thrombus with some contrast within the clot. This involved the ascending and descending aorta tothe renal arteries. She was seen by cardiac surgery and taken emergently to the operating room. Past Medical History: raynaud's disease ADHD s/p laminectomy for spinal stenosis s/p TAH brachial plexus injury-left Social History: 1.5 oz Vodka/D lactose intolerance nonsmoker retired psychiatrist Family History: Mother had [**Name (NI) 2481**] Father had [**Name2 (NI) 499**] cancer Physical Exam: Admission VS T HR70 BP93/42 RR16 02sat 99%RA Gen comfortable HEENT NCAT/EOMI, OP-wnl Pulm CTA CV RRR, nl S1-S2 Abdm soft, NT/ND Ext no C/C/E Neuro speach fluent sternum stable Pertinent Results: [**2124-10-1**] 09:47PM WBC-10.9 RBC-2.69*# HGB-8.2* HCT-23.8* MCV-88 MCH-30.6 MCHC-34.6 RDW-13.6 [**2124-10-1**] 09:47PM PLT COUNT-261 [**2124-10-1**] 09:47PM PT-15.3* PTT-49.4* INR(PT)-1.3* [**2124-10-1**] 12:30PM ALT(SGPT)-17 AST(SGOT)-25 CK(CPK)-123 ALK PHOS-62 TOT BILI-0.5 [**2124-10-1**] 12:30PM GLUCOSE-121* UREA N-28* CREAT-1.1 SODIUM-135 POTASSIUM-4.2 CHLORIDE-101 TOTAL CO2-24 ANION GAP-14 [**2124-10-1**] 12:30PM cTropnT-<0.01 [**Known lastname 107018**],[**Known firstname 107019**] [**Medical Record Number 107020**] F 65 [**2059-8-11**] Radiology Report CTA CHEST W&W/O C&RECONS, NON-CORONARY Study Date of [**2124-10-1**] 1:39 PM [**Last Name (LF) 4758**],[**First Name3 (LF) 2353**] EU [**2124-10-1**] SCHED CTA CHEST W&W/O C&RECONS, NON-; CTA ABD W&W/O C & RECONS; CTA PELVIS W&W/O C & RECONS Clip # [**Clip Number (Radiology) 107021**] Reason: Please evaluate for aortic dissection Contrast: OPTIRAY [**Hospital 93**] MEDICAL CONDITION: 65 year old woman with no sig PMH, present with acute onset of severe chest pain, radiating to the back, started with valsalva. REASON FOR THIS EXAMINATION: Please evaluate for aortic dissection CONTRAINDICATIONS FOR IV CONTRAST: None. Wet Read: JXKc SUN [**2124-10-1**] 2:42 PM Acute intramural hematoma that begins at the aortic origin, involving the ascending and descending aortas. Emergent surgical eval recommended. d/w Dr. [**Last Name (STitle) **]. Final Report HISTORY: 65-year-old female with no significant past medical history who presents with acute onset of severe chest pain radiating to the back, started with Valsalva. Evaluate for aortic dissection. No prior studies available for comparison. TECHNIQUE: MDCT axial images were obtained from the thoracic inlet to the symphysis pubis with administration of IV contrast. Coronal and sagittal reformations were obtained. CTA AORTA: There is an acute intramural hematoma, originating from the aortic root, and extending to involve the thoracic ascending aorta as well as the descending aorta to the level of the aortic bifurcation in the abdomen. There is a focal puddling of contrast within an intramural location (3:15) in the descending thoracic aorta, as well as at the level of the renal arteries (3:54) on the right. The celiac artery, SMA, and renal arteries originate from the true lumen. CT OF THE CHEST WITH IV CONTRAST: The heart and pericardium reveal no evidence of a hemopericardium or pericardial effusion. There are no pathologically enlarged mediastinal, hilar, or axillary lymph nodes. Within the lungs, there is a focus of ill-defined airspace opacity anteriorly within the right upper lobe (3:19), likely infectious or inflammatory in nature. In addition, there is a 4-mm nodule within the right upper lobe (3:27), as well as a tiny pleural-based nodule within the right middle lobe (3:38). Otherwise, the lungs are clear. CT OF THE ABDOMEN WITH IV CONTRAST: The liver, gallbladder, spleen, pancreas, adrenal glands, and left kidney are normal. Peripheral wedge shaped hypodensities in the right kidney are concerning for renal infarcts. The stomach, small bowel, and large bowel are within normal limits. There is no free air, free fluid or pathologic adenopathy. CT OF THE PELVIS WITH IV CONTRAST: Urinary bladder, rectum, and uterus are unremarkable. There is no pelvic free fluid or adenopathy. OSSEOUS STRUCTURES: There are severe multilevel degenerative changes of the lumbar spine, with scoliosis and a Grade 2 anterolisthesis of L4 on L5. IMPRESSION: 1. Acute intramural hematoma involving the ascending and descending aorta, originating from the aortic root. A focus of contrast is seen in an intramural location within the descending thoracic aorta as well as at the level of the renal arteries. Emergent surgical evaluation recommended. 2. Segmental right renal infarct. Findings were discussed immediately with Dr. [**Last Name (STitle) **] and immediately posted to the ED dashboard. The study and the report were reviewed by the staff radiologist. DR. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] DR. [**First Name (STitle) 3934**] [**Name (STitle) 3935**] [**Hospital1 18**] ECHOCARDIOGRAPHY REPORT [**Known lastname 107018**], [**Known firstname 107019**] [**Hospital1 18**] [**Numeric Identifier 107022**] (Complete) Done [**2124-10-1**] at 6:33:39 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: [**2059-8-11**] Age (years): 65 F Hgt (in): 69 BP (mm Hg): / Wgt (lb): 123 HR (bpm): BSA (m2): 1.68 m2 Indication: Aortic dissection. Chest pain. ICD-9 Codes: 441.00, 786.51 Test Information Date/Time: [**2124-10-1**] at 18:33 Interpret MD: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 5209**], MD Test Type: TEE (Complete) Son[**Name (NI) 930**]: [**Last Name (NamePattern5) 9958**], MD Doppler: Full Doppler and color Doppler Test Location: Anesthesia West OR cardiac Contrast: None Tech Quality: Adequate Tape #: 2008AW5-: Machine: Echocardiographic Measurements Results Measurements Normal Range Left Ventricle - Ejection Fraction: 40% to 50% >= 55% Aorta - Sinus Level: 3.6 cm <= 3.6 cm Aorta - Ascending: 3.2 cm <= 3.4 cm Aorta - Arch: 2.0 cm <= 3.0 cm Aortic Valve - Peak Velocity: *9.2 m/sec <= 2.0 m/sec Aortic Valve - Peak Gradient: 7 mm Hg < 20 mm Hg Aortic Valve - Mean Gradient: 4 mm Hg Aortic Valve - Valve Area: *2.0 cm2 >= 3.0 cm2 Findings The is an ascending aortic intramural hematoma beginning at the origin of the coronary arteries and extending at least to the level of the takeoff of the subclavian arteries. Flow in the RCA and LMCA was verified by using color doppler. There was no dissection flap seen. LEFT ATRIUM: Normal LA size. RIGHT ATRIUM/INTERATRIAL SEPTUM: Normal RA size. LEFT VENTRICLE: Wall thickness and cavity dimensions were obtained from 2D images. Normal regional LV systolic function. Overall normal LVEF (>55%). RIGHT VENTRICLE: Normal RV chamber size and free wall motion. AORTA: Normal aortic diameter at the sinus level. Normal ascending aorta diameter. Normal aortic arch diameter. Normal descending aorta diameter. Simple atheroma in descending aorta. Ascending aortic intimal flap/dissection.. Thickened aortic wall c/w intramural hematoma. AORTIC VALVE: Normal aortic valve leaflets (3). No AS. Moderate (2+) AR. MITRAL VALVE: Normal mitral valve leaflets. No MS. [**Name13 (STitle) **] MR. TRICUSPID VALVE: Normal tricuspid valve leaflets with trivial TR. PULMONIC VALVE/PULMONARY ARTERY: Normal pulmonic valve leaflets. PERICARDIUM: No pericardial effusion. GENERAL COMMENTS: A TEE was performed in the location listed above. I certify I was present in compliance with HCFA regulations. The patient was under general anesthesia throughout the procedure. No TEE related complications. REGIONAL LEFT VENTRICULAR WALL MOTION: N = Normal, H = Hypokinetic, A = Akinetic, D = Dyskinetic Conclusions PRE BYPASS 1. The left atrium is normal in size. 2. Regional left ventricular wall motion is normal. Overall left ventricular systolic function is normal (LVEF>55%). 3. Right ventricular chamber size and free wall motion are normal. 4. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion. There is no aortic valve stenosis. Moderate (2+) aortic regurgitation is seen. 5. The mitral valve leaflets are structurally normal. No mitral regurgitation is seen. 6. There is no pericardial effusion. POST BYPASS 1. There is mild to moderate aortic regurgitation. 2. The synthetic graft is seen with its origin at the sinotubular junction. There is no apparent leak. 3. Left ventricular function is unchanged. I certify that I was present for this procedure in compliance with HCFA regulations. Electronically signed by [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 5209**], MD, Interpreting physician [**Last Name (NamePattern4) **] [**2124-10-2**] 15:27 Brief Hospital Course: After evaluation and review of studies, the patient was taken emergently to the OR where circumferential clot was found in the ascending aorta, with out an obvious intimal tear. The ascending aorta was replaced with a 26mm Gelweave graft and the aortic valve was resuspended. Circulatory arrest was utilized for a 20 minute period. See operative note for details. She weaned from CPB easily and Propofol alone. She was coagulopathic and was corrected with slowing of bleeding. She remained hemodynamically stable after surgery. On the morning after surgey she self-extubated. Her chest tubes and epicardial wires were removed. She was transferred to the surgical step-down floor. Her beta-blockade was titrated up as tolerated. She was ready for discharge to home on post-operative day 5. Medications on Admission: Estratest, Adderall, ibuprofen Discharge Medications: 1. Metoprolol Tartrate 25 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* 2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 3. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 4. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO every 4-6 hours as needed for pain. 5. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 6. Amphetamine-Dextroamphetamine 5 mg Tablet Sig: Four (4) Tablet PO daily (). 7. Estratest 1.25-2.5 mg Tablet Sig: One (1) Tablet PO once a day. 8. Ibuprofen 400 mg Tablet Sig: Two (2) Tablet PO Q8H (every 8 hours) as needed for pain. 9. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig: One (1) Tab Sust.Rel. Particle/Crystal PO once a day for 5 days. Disp:*5 Tab Sust.Rel. Particle/Crystal(s)* Refills:*0* 10. Lasix 40 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: [**Hospital 119**] Homecare Discharge Diagnosis: Type A Thoracic aortic dissection s/p Asc Ao replacement Raynaud's disease brachial plexus injury attention deficit hyperactivity disorder s/p hysterectomy s/p spinal stensosis surgery Discharge Condition: good Discharge Instructions: no lifting more than 10 pounds for 10 weeks no driving for 4 weeks and off all narcotics shower daily, no baths or swimming no lotions, creams or powders to incisions report any temperature greater than 100.5. report anyredness or drainage from incisions take all medications as directed Followup Instructions: [**Hospital 409**] clinic in 2 weeks Dr [**First Name (STitle) **] [**Name (STitle) 107023**] (PCP) ([**Telephone/Fax (1) 107024**] in [**2-6**] weeks Dr. [**Last Name (STitle) 914**] in 3 months with a CT scan with MMS protocol and en echocardiogram ([**Telephone/Fax (1) 170**]) Completed by:[**2124-10-6**] ICD9 Codes: 5119
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Medical Text: Admission Date: [**2172-3-14**] Discharge Date: [**2172-4-20**] Date of Birth: [**2172-3-14**] Sex: F Service: NEONATAL DISCHARGE DIAGNOSIS: 1. Premature female infant, 33 5/7 weeks gestation. 2. Rh incompatibility. 3. Hyperbilirubinemia. 4. Apnea and bradycardia of prematurity. 5. Feeding immaturity. 6. S/P PPS murmur and flow. [**Known lastname **] is the former 2.630 kilogram female infant born at 33 5/7 weeks gestation to a 31 year-old gravida III, para I, now II, SAB I, A negative, Rh sensitized female whose remaining prenatal screens were noncontributory. Group B strep status was unknown. Pregnancy was complicated by preterm labor treated with bed rest and terbutaline at 32 weeks gestation. She had known Rh isoimmunization from a previous loss at 20 weeks gestation that was not recognized until a time frame in which RhoGAM could no longer be given. In this pregnancy the fetus did not require an in utero transfusion. There was no hydrops on ultrasound but the delta OD on a [**3-11**] amnio was near zone 3 and therefore the mother was admitted for induction. She was beta complete and intrapartum antibiotic prophylaxis was administered. Because of failed induction mother was delivered by cesarean section. As indicated above, her previous history was notable for a 20 weeks loss in [**2167**] and a term infant in [**2168**]. That baby required phototherapy and an exchange transfusion times one. The infant was delivered with Apgars of 8 and 8 and admitted to the Newborn Intensive Care Unit at [**Hospital1 190**]. On admission the baby weighed 2.630 kilograms at the 90th percentile, head circumference 31.5 cm at the 50th percentile and height 46 cm at the 75th percentile. An initial D stick was 37 and the infant received a bolus of D10W and repeat sugar was 42. The infant was maintained on intravenous for several days and by [**3-17**] was off intravenous and remained euglycemic at that time. 1. Respiratory: The infant remained in room air throughout her hospital course. She had episodes of apnea and bradycardia that were insufficient to start her on caffeine. Because of ongoing episodes which were all self resolved, with parents consent, we sent her home on an apnea monitor. 2. Cardiovascular: Infant had a soft intermittent murmur, that is heard at LSB, out to apex, over both scapula, without bounding pulses and appears to be consistant with PPS. At one point during her stay when she had a drop in hematocrit to 24 a murmur was quite audible at that time and with transfusion it became softer and at times difficult to appreciate. It reappeared as Hct was in mid 20 range. 3. Feeding and nutrition: The infant was being breast fed twice a day or bottle fed with mother's expressed milk at 20 calories per ounce.As she improved in the volume amount she was taking she began to have some episodes of choking and desats. The nipple was changed to [**First Name8 (NamePattern2) **] [**Last Name (un) **] medium feeder after the slow flow was tried and she had difficulty with the very slow flow. Mother was most comfortable with the [**Name (NI) **] low flow nipple and that was she went home on. On [**4-7**] she was seen by the feeding team who recommended a fluroscopic swallow study at CHMC, which was done on [**4-8**] and showed no anatomic abnormalities and no aspiration using the medium flow [**Last Name (un) **] nipple.These episodes are being attributed to immature suck/swallow and breathing coordination. Her weight prior to discharge was 3.570kg. 4. Hematologic: Mother A negative, baby O positive, [**Name (NI) 36243**] was positive. The initial bilirubin was 4.0/0.2 and she was placed under phototherapy. Her peak bilirubin on day of life 4 was 16. Her peak bilirubin was on [**3-18**] at 16.9. The infant was placed under four phototherapy lights and bilirubin slowly decreased thereafter. The direct bilirubin never rose above 0.3. She was slowly weaned off of phototherapy and by [**3-25**] was down to single phototherapy with the bilirubin of 7.3/0.2. On [**3-26**] phototherapy was discontinued and a 24 hour rebound bilirubin was 6.2 with a 48 hour rebound bilirubin at 6.8. On [**4-14**] her bili was 2.2. On [**3-18**] and [**3-19**] the infant was given 1 gram per kilogram of IVIG in the hopes of binding some of the antibody and that the coated cells would not hemolyze as rapidly. Hematocrit at first was 42 and by [**3-21**] it had come down to 24.3. At that time she received 20 cc per kilogram of packed red blood cells, O negative, with negative C. She responded well to that and her follow up hematocrit on [**3-23**] was 34.9. She had several hematocrits thereafter and on [**4-14**] her hematocrit was 24.7 and her reticulocyte count 4.4, however because of tiring with feeds and ongoing choking episodes she had her second PRB transfusion on [**4-16**] with her last Hcton [**4-20**] of 39. Her peak reticulocyte count was 11.4 but her earlier reticulocyte counts were ranging between 2 and 11.8. Hearing screen performed on [**4-1**] was normal. Immunizations: Hepatitis B vaccine was administered on [**3-29**]. DISCHARGE MEDICATIONS; FerInSol 0.3 cc PO QD PolyViSol 1cc PO QD Infant is to be followed up at [**Hospital1 **] [**First Name4 (NamePattern1) 392**] [**Last Name (NamePattern1) **] by Dr. [**First Name4 (NamePattern1) 2048**] [**Last Name (NamePattern1) **] within five days of discharge. VNA to go to home day post discharge. Weekly hematocrits to be followed until the infant is approximately 6 weeks of age and at that time most maternal antibody should no longer be present in a significant amount. Infant to remain on home monitor for 1 month or at discretion of pediatrician. Because of transfusions, infant will need a repeat state screen in [**1-7**] months. DR.[**Last Name (STitle) **],[**First Name3 (LF) **] 50-393 Dictated By:[**Last Name (NamePattern1) 38304**] MEDQUIST36 D: [**2172-4-20**] 08:40 T: [**2172-4-20**] 08:42 JOB#: [**Job Number 54699**] ICD9 Codes: 7742
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Medical Text: Admission Date: [**2117-6-8**] Discharge Date: [**2117-6-28**] Date of Birth: [**2030-12-30**] Sex: M Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 9160**] Chief Complaint: Weakness and falls Major Surgical or Invasive Procedure: EGD History of Present Illness: The patient is an 86 year old male with multiple medical issues including previously treated follicular lymphoma, diastolic CHF, paroxysmal atrial fibrillation, COPD no longer on home O2, and CKD who was admitted to OSH on [**2117-6-6**] with weakness and falls at home. . On that admission, he was found to be in atrial fibrillation with labs notable for CK 500-600s, Calcium 12.5, PTH not elevated, Creatinine 1.4, and HCT 27 (baseline in mid 30s). His head CT head showed no acute process. He was given 1500 ml IV fluids with improvement in his calcium to 10.7. He converted to sinus rhythm at 70 bpm with vital signs stable. He was recently being evaluated here for possible Nissen fundoplication, and was transferred to [**Hospital1 18**] for further management of his anemia and hypercalcemia. . On reaching the floor, he reported some recent dyspnea on exertion and dizziness when standing. He denied any other acute complaints. He notes that his activiy level has been declining, and he no longer likes to walk around his home due to fatigue and dyspnea. he uses a walker when he does ambulate. He was previously on home oxygen for COPD, but no longer uses it. He lives alone with support from his neighbors for shopping. . REVIEW OF SYSTEMS: (+) Per HPI (-) Denies fever, chills, night sweats, recent weight loss or gain. Denies headache, sinus tenderness, rhinorrhea, or congestion. Denies cough. Denies chest pain, pressure, tightness, or palpitations. Denies nausea, vomiting, diarrhea, constipation, or abdominal pain. No recent change in bowel or bladder habits. No dysuria or hematuria. No rashes or concerning skin lesions. Denies arthralgias or myalgias. Review of systems was otherwise negative. Past Medical History: # Follicular Lymphoma -- advanced disease with pulmonary, pleural, kidney involvement -- s/p 1.5 cycles of Bendamustine/Rituxan, last [**2116-1-2**] -- complicated by acute CHF and rapid AFib during treatment -- treatment held since then, but clinically stable # Chronic diastolic CHF -- prior systolic CHF as well -- most recent LVEF 55% ([**2116-4-13**]), prior TTE with LVEF 15% ([**2115**]) # Paroxysmal Atrial Fibrillation -- during chemotherapy # Hypertension # Chronic pleural effusions # COPD -- previously on home oxygen # Chronic Kidney Disease # Renal Mass -- related to lymphoma # BPH # Hypothyroidism # Paraesophageal hernia -- present for 10 years # UGIB History # Chronic Anemia -- requiring transfusions # GERD # Spinal compression fractures # Right Inguinal Hernia Repair # Macular degeneration # Posterior vitrious detachment # Cataracts s/p surgery # compression fracutre T11, L1-L2 (s/p fall in [**Month (only) **]) Social History: # Home: Lives alone, does not ambulate much in home. Uses walker when he does. Neighbors help with shopping. Eats mostly premade meals, does not cook much. VNA 1x per week on tues. puts meds in boxes. 2 sons- [**Known firstname **], lawyer in [**Name2 (NI) **], hcp, full code. other son in NJ is Urologist. # Work: Retired # Tobacco: Smoked 3 PPD for 25 years, quit in [**2075**] # Alcohol: None # Drugs: None Family History: No family history of early MI, arrhythmia, cardiomyopathies, or sudden cardiac death. # Mother: Died from cancer, unsure of type. # Father: Tuberculosis # Sister: Unsure how she is doing. Physical Exam: ADMISSION VS: T 98.4, BP 150/76, HR 74, RR 22, SpO2 95% on RA Gen: Elderly male in NAD. Oriented x3. Mood, affect appropriate. Hard of hearing. HEENT: Sclera anicteric. Left pupil slightly smaller than right but both reactive to light. Slight left lid ptosis. EOMI. MMM, OP benign. Neck: JVP not elevated. No cervical lymphadenopathy. No carotid bruits noted. CV: RRR with normal S1, S2. No M/R/G. Chest: Respiration unlabored. Coarse breath sounds and few scattered crackles without focal findings. Abd: Bowel sounds present. Soft, NT, ND. No organomegaly or masses. Ext: WWP. Digital cap refill <2 sec. No C/C/E. Distal pulses intact radial 2+, DP 2+, PT 2+. Skin: No rashes, ulcers, or other lesions noted. Neuro: CN II-XII grossly intact. Strength 4/5 in left arm, [**5-22**] in other limbs. No pronator drift. Normal rapid alternating movements on right, slower on left. Performance of finger-to-nose worse on left than right. Normal speech. DISCHARGE: VS: RR 16 Gen: Elderly male in NAD. Oriented x3.Hard of hearing. appears comfortable HEENT: Sclera anicteric. Left sided Horner's syndrome. OP - moist w/ brownish plaque on tongue Neck: JVP not elevated. CV: RRR with normal S1, S2. soft systolic murmur across precordium. ?diastolic murmur + S3 gallop Abd: Bowel sounds present. Soft, NT, ND. No organomegaly or masses. Ext: WWP. No C/C/E. 2+ DP Pertinent Results: ADMISSION [**2117-6-9**] 01:58AM BLOOD WBC-6.2 RBC-3.44* Hgb-10.0* Hct-31.7* MCV-92# MCH-28.9 MCHC-31.4 RDW-13.1 Plt Ct-231 [**2117-6-9**] 01:58AM BLOOD Neuts-72.8* Lymphs-12.5* Monos-8.5 Eos-5.4* Baso-0.7 [**2117-6-9**] 01:58AM BLOOD Glucose-97 UreaN-17 Creat-1.3* Na-139 K-4.0 Cl-106 HCO3-20* AnGap-17 [**2117-6-9**] 01:58AM BLOOD ALT-19 AST-33 LD(LDH)-263* CK(CPK)-115 AlkPhos-67 TotBili-0.5 [**2117-6-9**] 01:58AM BLOOD Albumin-3.5 Calcium-10.7* Phos-3.2 Mg-1.4* . PERTINENT [**2117-6-9**] 01:58AM BLOOD ALT-19 AST-33 LD(LDH)-263* CK(CPK)-115 AlkPhos-67 TotBili-0.5 [**2117-6-10**] 07:50AM BLOOD LD(LDH)-222 [**2117-6-9**] 11:00AM BLOOD CK-MB-4 cTropnT-<0.01 [**2117-6-9**] 01:58AM BLOOD CK-MB-5 cTropnT-<0.01 [**2117-6-9**] 01:58AM BLOOD TSH-3.1 [**2117-6-9**] 04:10AM BLOOD PTH-<6* . CHEST (PA & LAT) Study Date of [**2117-6-9**] 9:14 PM As compared to the previous radiograph from [**2117-6-6**], there is no relevant change. The known left apical mass is obliterated by the soft tissues of the neck. Unchanged evidence of moderate cardiomegaly with moderate pulmonary edema and signs of interstitial fluid overload. Presence of a small left pleural effusion cannot be excluded. No newly appeared parenchymal opacities. . CT CHEST W/O CONTRAST Study Date of [**2117-6-10**] 1. Left apical mass, substantially progressed since [**2117-3-21**] and chest radiograph from [**2117-1-17**], progressing into the neck with multiple pulmonary metastases and liver hypodensities, highly concerning for metastatic disease. Findings are most likely representing Pancoast tumor, primary lung malignancy. Lymphoma will be substantially less likely. 2. Unusual appearance of the left kidney, partially imaged with this technique which is not tailored for evaluation of renal disease. If clinically warranted, correlation with ultrasound or dedicated CT or MR might be considered. Correlation with urine cytology might also be beneficial. Brief Hospital Course: PRIMARY REASON FOR HOSPITALIZATION: ==================================== Mr. [**Known lastname 88299**] is an 86 year old male with multiple medical issues including previously treated follicular lymphoma, paraesophageal hernia, diastolic CHF, afib, COPD who was admitted to OSH on [**2117-6-6**] with weakness and falls, during workup at [**Hospital1 18**] found to have new diagnosis of metastatic cancer likely from the lung. ACTIVE ISSUES: ================== # L upper lung malignancy (Pancoast tumor): Discovered on work-up of hypercalcemia with CT scan on [**6-13**]. Oncology consult thought likely primary lung cancer that has metastasized to liver and R lung, less likely lymphoma. Oncology gave a 6-month prognosis and recommended that pt would not be a good candidate for treatment as he is too weak, did not tolerate chemotherapy in the past, and biopsy would not be helpful as treatment would not change despite the type of cancer. Palliative care was consulted and contributed to his care. # Goals of care: Patient was made DNR/DNI during his stay. Multiple family meetings were held throughout the admission with patient's son [**Name (NI) **] (also healthcare proxy), Dr. [**Last Name (STitle) **] (palliative care), Dr. [**First Name (STitle) 3459**] (oncologist), and medical team. Given the patient's prognosis and after extensive discussion with the patient and his son, his code status was change to "comfort measures only." # Coffee ground emesis in setting of GERD with paraesophageal hernia: Pt began to experience symptoms during [**Date range (1) 88300**]. Differential included gastritis, GERD causing upper GI bleed, hiatal hernia (ulceration/gastritis/erosions), cancer metastasis invading into upper GI mucosa, gastric outlet obstruction, or tumor impinging on the emesis nerve tract (i.e. C3-5). NG tube was inserted, but pt pulled it out in the MICU and refused to have it replaced. Sucralfate and PPI were given to treat upper GI bleed. Aspirin was discontinued. Pt was recently undergoing evaluation by Thoracic Surgery for repair of a large paraesophageal hernia - Dr. [**First Name (STitle) **] was peripherally involved in goals of care discussions and decided not to operate in light of patient's current clinical status and risk of possibly reducing the patient's quality of life post-operatively and inability to wean off the ventilator. - Continue PPI and sucralfate for comfort - Standing tylenol and fentanyl patch for pain control. Hydromorphone PRN for breakthrough pain. - Anti-emetics as needed for comfort (promethazine and zofran) # Dyspnea in setting of aspiration pneumonitis: Complicated by untreated COPD, hiatal hernia, and pulmonary mass causing pulmonary compression from mass effect. He desaturated on [**6-13**] and required MICU transfer and non-rebreather. However his respiratory status improved rapidly suggesting aspiration. In the MICU there was concern for HCAP, for which he was treated with IV vancomycin and cefepime for 8 days. When vital signs were last checked he was saturating in the low-mid 90s on 3L nasal cannula. - Continue Oxygen as needed for comfort # Weakness and Falls: His recent weakness and falls are most likely multifactorial. His recent fall may have been related to atrial fibrillation, weakness from hypercalcemia or anemia, and mechanical fall from tripping. Orthostatics were negative. # Hypercalcemia: He was hypercalcemic at outside hospital with reportedly low PTH. His hypercalcemia is likely related to new malignancy given his known history of follicular lymphoma, ongoing anemia, and elevated LDH. Fluids were given for hypercalcemia, which improved during admission. Last checked Ca was 8.8 on [**6-16**]. No further interventions were done since hypercalcemia did not appear to be symptomatic. # Hiccups: Pt had recurrent hiccups making him extremely uncomfortable. He is currently asymptomatic. Most likely from hiatal hernia affecting diaphragm or mass pushing on vagus nerve. We treated him with chlorpromazine 5 mg PO TID, which improved his hiccups. - Continue chlorpromazine to reduce hiccups for comfort. Can stop if patient is over-sedated or hiccups resolve. # Anemia: His hematocrit was roughly stable 25-30 without receiving any transfusions during this admission. Transfusion was decided to not be in lines with goals of care and labs were not drawn as of [**2117-6-16**]. # Left Hand/Arm Pain: Most likely from brachial plexus compression from pancoast tumor. - Standing tylenol and fentanyl patch for pain control. Hydromorphone PRN for breakthrough pain. CHRONIC ISSUES: ================== # Chronic Diastolic CHF: Throughout his stay he appeared euvolemic with minimal LE edema or crackles. [**3-/2117**] EF of 50%. Sodium restriction was eased as consistent with goals of care. # Paroxysmal Atrial Fibrillation: He was initially in AFib at OSH, which may have precipitated his recent weakness and falls. He converted spontaneously at OSH and was in sinus rhythm on arrival. He had negative troponins. He is not currently on anticoagulation, and is likely not a good candidate given his recent falls, poor functional capacity, and goals of care. Aspirin was discontinued in setting of GI bleed. Telemetry was discontinued as consistent with goals of care but patient was in sinus rhythm prior to that. - His metoprolol was stopped since not contributing to comfort. If patient is having symptomatic palpitations, could consider restarting metoprolol in the future. # Hypertension: He was somewhat hypertensive on arrival, most likely due to his pain. His metoprolol was stopped since not contributing to hs comfort. # Hypothyroidism: We continued his home Levothyroxine 50 mcg PO DAILY. Can consider discontinuing this later if not contributing to comfort. TRANSITIONAL ISSUES: ===================== # Dispo: being discharged to inpatient hospice. # Contacts: hcp/son [**Known firstname **] [**Telephone/Fax (3) 88301**]; # Code Status: DNR/DNI, Comfort Measures Only. Medications on Admission: Aspirin 81 mg PO DAILY - on hold x months Metoprolol Tartrate 50 mg PO TID Hydralazine 20 mg PO TID Furosemide 40 mg PO DAILY - on hold x months Isosorbide Mononitrate ER 30 mg PO DAILY Levothyroxine (LEVOXYL) 50 mcg PO DAILY Omeprazole 20 mg PO BID -- unsure why two PPIs Sucralfate 1 gram PO Q6H Colace 100 mg PO BID PRN constipation Multivitamin 1 tab PO DAILY Discharge Medications: 1. hydromorphone 2 mg Tablet Sig: One (1) Tablet PO Q3H (every 3 hours) as needed for pain. 2. fentanyl 12 mcg/hr Patch 72 hr Sig: One (1) Patch 72 hr Transdermal Q72H (every 72 hours). 3. pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 4. chlorpromazine 10 mg Tablet Sig: 0.5 Tablet PO TID (3 times a day). 5. acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO TID (3 times a day). 6. promethazine 25 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for nausea. 7. ondansetron HCl 4 mg Tablet Sig: Two (2) Tablet PO Q8H (every 8 hours) as needed for nausea. 8. bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal HS (at bedtime) as needed for constipation. 9. sucralfate 1 gram Tablet Sig: One (1) Tablet PO QID (4 times a day). 10. levothyroxine 50 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). Discharge Disposition: Extended Care Facility: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] House - [**Location (un) 13588**] Discharge Diagnosis: Primary diagnosis: lung malignancy, hypercalcemia, fall Secondary diagnosis: diastolic heart 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 Mr. [**Known lastname 88299**], You were admitted to the hospital for evaluation of falls, weakness, and high calcium levels. Unfortunately, we found that the underlying cause of this was a lung tumor. After much discussion, it was decided to focus on comfort and discharge you to hospice. Take care. Followup Instructions: N/A [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 9162**] ICD9 Codes: 5070, 2851, 4254, 2930, 5119, 4280, 496, 5859, 2449
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Medical Text: Admission Date: [**2140-1-18**] Discharge Date: [**2166-2-26**] Date of Birth: [**2102-12-24**] Sex: M Service: Cardiac [**Doctor First Name **] HISTORY OF PRESENT ILLNESS: This is a 63 year-old gentleman with a known history of aortic valve disease, atrial fibrillation and nonsustained ventricular tachycardia with recent worsening of congestive heart failure. The patient underwent cardiac catheterization on [**2166-1-17**] which showed severe aortic regurgitation, mild aortic stenosis, left ventricular ejection fraction of 20% with an elevated left ventricular and diastolic pressure and no significant coronary artery disease. The patient was admitted on [**2166-2-14**] for elective aortic valve replacement with Dr. [**Last Name (STitle) 1537**]. PAST MEDICAL HISTORY: 1. Aortic valve disease. 2. Rheumatic heart disease. 3. History of nonsustained ventricular tachycardia. 4. History of congestive heart failure with decreased ejection fraction. 5. Asthma. 6. Obesity. 7. Sleep apnea. 8. Osteoarthritis. 9. History of syncope thought to be due to arrhythmias. 10. Questionable Amiodarone toxicity. PREOPERATIVE MEDICATIONS: 1. Aspirin 325 milligrams po q day. 2. Nasacort two puffs q day. 3. Dulcolax q day. 4. Colace q day. 5. Flomax 0.8 milligrams po q HS. 6. Flovent two puffs [**Hospital1 **]. 7. Lasix 40 milligrams po q day. 8. Lisinopril 5 milligrams po q day. 9. Naprosyn prn. 10. Potassium Chloride 20 milliequivalents po q day. 11. Serevent q day. ALLERGIES: NKDA. PREOPERATIVE PHYSICAL EXAMINATION: Pulse 80 regular rate and rhythm. Blood pressure 120/60. The patient is awake, alert and oriented times three. Neck - full range of motion. Chest is clear. Cardiac - regular rate and rhythm. Neurologically the patient is within normal limits. LABORATORY DATA: EKG is sinus rhythm with elevated PR interval. Hematocrit 42.1, sodium 141, potassium 4.9, chloride 99, bicarb 30, BUN 14, creatinine 0.9. HOSPITAL COURSE: The patient was taken to the operating room on [**2166-2-14**] for an aortic valve replacement with a #[**Street Address(2) 15189**]. [**Male First Name (un) 923**] with Dr. [**Last Name (STitle) 1537**]. Transesophageal echocardiogram intraoperatively after the valve was replaced showed an ejection fraction of 50%. Please see operative note for further details. The patient was transferred to the Intensive Care Unit on Dobutamine, lidocaine which was started intraoperatively for ventricular ectopy, Neo-Synephrine and Propofol infusion in stable condition. The patient was weaned and extubated on first postoperative night. The patient continued on Dobutamine and lidocaine infusion. Lidocaine was discontinued on his first postoperative day. Dobutamine infusion was weaned off. The patient remained in the Intensive Care Unit on postoperative day one for hemodynamic monitoring. On postoperative day two the patient was off all of his infusions. The patient was started on Coumadin for anticoagulation. The patient's chest tubes were removed. The patient was transferred out of the Intensive Care Unit to [**2-22**]. On postoperative day three electrophysiology service was consulted due to the patient's history of nonsustained ventricular tachycardia as well as atrial fibrillation. IT was decided at that time since the patient had a history of questionable Amiodarone toxicity with decreased pulmonary function, Amiodarone would not be started. The patient will be started on Digoxin for rate control of atrial fibrillation. The patient had episode of rapid atrial fibrillation which was treated with Amiodarone. The patient also had multiple episodes of nonsustained ventricular tachycardia for which the patient was asymptomatic. Electrophysiology service was consulted. It was decided to continue the patient on beta-blocker and Digoxin. On postoperative day three Neurology was consulted as the patient had noticed right eyelid drooping. The patient also reported having sensation of tingling in his right hand that had resolved since surgery. When the patient was examined by Neurology he was found to have no visual changes. It was thought that the right ptosis could be due to a hematoma on the right side of his neck where his central line was placed. He was also noted to have right finger extension abductor weakness and right ulnar sensory loss which subsequently improved. It was felt thought to be a mild peripheral neuropathy. Neurology continued to follow him over several subsequent days and felt that the patient continued to improve. The patient continued to have rhythm disturbances with nonsustained ventricular tachycardia and paroxysmal atrial fibrillation. The patient remained hemodynamically stable throughout. The patient was presented with the options of medications for rate control versus electrophysiology study and potential defibrillator. The patient was in favor of rate control with medications and to be monitored with [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] of Hearts monitor. To be followed up by the electrophysiology team and his cardiologist at a later date. The patient was started on Heparin infusion on postoperative day four as the patient was subtherapeutic with his anticoagulation. The patient converted into sinus rhythm on postoperative day seven. Although the patient continued to have episodes of paroxysmal atrial fibrillation as well as nonsustained ventricular tachycardia which the patient was asymptomatic. The patient remained in the hospital on a Heparin infusion as he continued to be subtherapeutic on his anticoagulation from Coumadin. The patient was ambulating on his own, working with Physical Therapy. On postoperative day 12 the patient's INR was 2.2. The patient was cleared for discharge to home. DISCHARGE PHYSICAL EXAMINATION: Tmax 96.9F, pulse 60 sinus rhythm, blood pressure 138/78, respiratory rate 18. Oxygen saturation on room air 96%. The patient is awake, alert and oriented times three. The patient has mild ptosis of the right eye. The patient reports improved weakness and numbness in his right hand. Otherwise the patient is grossly, neurologically intact. Breath sounds are clear bilaterally without wheezes or rhonchi. Heart is regular rate and rhythm with sharp click, no murmur. Abdomen is obese, soft, nontender. The patient is tolerating a regular diet. Sterile incision has Steri strips intact. The wound is clean and dry, no erythema or drainage. LABORATORY DATA FROM [**2166-2-18**]: White blood cell count 6.6, hematocrit 24, sodium 138, potassium 4.5, chloride 102, bicarb 28, BUN 19, creatinine 0.8, glucose 93. On [**2166-2-26**] the patient's PT is 17.6, INR 2.2. DISCHARGE MEDICATIONS: 1. Lopressor 75 milligrams po bid. 2. Lasix 40 milligrams po q day. 3. KCL 20 milliequivalents po q day. 4. Colace 100 milligrams po bid. 5. Enteric coated aspirin 325 milligrams po q day. 6. Serevent two puffs [**Hospital1 **]. 7. Flovent two puffs [**Hospital1 **]. 8. Multi vitamin q day. 9. Flomax 0.8 milligrams po q day. 10. Digoxin 0.375 milligrams po q day. 11. Percocet 5/325 one to two tablets po q four hours prn. 12. Coumadin. The patient is to receive 15 milligrams on the evening of [**2166-2-26**] and the evening of [**2166-2-27**]. The patient is to have a PT INR drawn on [**2166-2-28**] and Coumadin dosing is to be done by his primary care physician, [**Last Name (NamePattern4) **]. [**Last Name (STitle) **]. DISCHARGE INSTRUCTIONS: The patient is to be discharged with [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] of Hearts monitor per the recommendations of the electrophysiology service. Results will be called to his cardiologist, Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 120**]. The patient is to follow up with his primary care physician in two weeks. The patient is to follow up with Dr. [**Last Name (STitle) 1537**] in three to four weeks. The patient is to follow up with his cardiologist, Dr. [**Last Name (STitle) 120**] in three to four weeks. The patient is to continue to use his BiPAP machine for his obstructive sleep apnea as he did preoperatively. DISCHARGE DIAGNOSIS: 1. Status post aortic valve replacement. 2. History of atrial fibrillation. 3. Nonsustained ventricular tachycardia. 4. Decreased left ventricular ejection fraction. 5. Asthma. 6. Obstructive sleep apnea requiring BIPAP. 7. Obesity. 8. Osteoarthritis. [**First Name11 (Name Pattern1) 275**] [**Last Name (NamePattern4) 1539**], M.D. [**MD Number(1) 1540**] Dictated By:[**Last Name (NamePattern1) 3870**] MEDQUIST36 D: [**2166-2-26**] 10:33 T: [**2166-2-26**] 11:08 JOB#: [**Job Number 15190**] ICD9 Codes: 4271
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Medical Text: Admission Date: [**2197-6-14**] Discharge Date: [**2197-6-20**] Date of Birth: [**2125-5-6**] Sex: F Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1556**] Chief Complaint: 1. Abdominal pain 2. Shortness of breath Major Surgical or Invasive Procedure: [**2197-6-14**]: Cecectomy History of Present Illness: 72yo F presents with a 2-day history of abdominal pain. Pain initially developed on [**6-12**] in a periumbilical distribution. Since that time, the pain has localized to the LUQ; though she complains of generalized severe pain throughout her abdomen, the pain is interrupted by especially painful knife-like sensations in the LUQ. She has noted worsening nausea in the past few hours, but has not yet vomited. Her last meal was at onset of pain 2 days ago. She does not recall her last passing of flatus or stool, but believes she did not have a bowel movement in the last 24 hours. Her last colonoscopy was two years ago, and negative. Denies fevers or chills. Past Medical History: COPD (emphysema and chronic bronchitis, not on home O2), hypercholesterolemia, breast cancer (T2N0, ER positive), brain aneurysm PSH: R breast lumpectomy '[**81**] Social History: + Tob, 2.5ppd x55y. social EtOH. patient is retired, works as volunteer. Family History: Mother with lung cancer and MI, maternal uncle with [**Name2 (NI) 499**] cancer, and maternal aunt with MI. maternal GM with breast cancer Physical Exam: On Admission: 98.4 / 98.4 92 132/52 18 97% on 2L NC Patient oriented x3, NAD but uncomfortable Lungs have bilateral diminished breath sounds, slight wheezing on expiration. RRR, mild tachycardia Abdominal exam showed soft, non-distended abdomen, with voluntary guarding. Pain elicited most notably on moderate palpation in LUQ and periumbilical region. no rebound nor guarding. DRE found no palpable abnormalities, nl tone, trace stool in vault, guaiac negative. WWP sans C/C/E On Discharge: VS: 96.6, 80, 126/64, 16, 96 4L n/c Gen: NAD CV: RRR with occasional Sinus tachycardia Lungs: B/l diminished throughout Abd: Midline incision with surgical staples, c/d/i Ext: Warm, no c/c/e Neuro: AO x 3 Pertinent Results: [**2197-6-14**] 07:35AM GLUCOSE-133* UREA N-6 CREAT-0.4 SODIUM-139 POTASSIUM-4.2 CHLORIDE-105 TOTAL CO2-29 ANION GAP-9 [**2197-6-14**] 07:35AM CALCIUM-7.6* PHOSPHATE-3.5 MAGNESIUM-1.5* [**2197-6-14**] 07:35AM HCT-41.5 [**2197-6-14**] 04:36AM PT-11.9 INR(PT)-1.0 [**2197-6-14**] 03:50AM URINE COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.021 [**2197-6-14**] 03:50AM URINE BLOOD-NEG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-6.5 LEUK-NEG [**2197-6-14**] 12:00AM GLUCOSE-141* UREA N-11 CREAT-0.5 SODIUM-134 POTASSIUM-4.7 CHLORIDE-95* TOTAL CO2-28 ANION GAP-16 [**2197-6-14**] 12:00AM estGFR-Using this [**2197-6-14**] 12:00AM LIPASE-14 [**2197-6-14**] 12:00AM ALBUMIN-4.2 Pathology Examination Name Birthdate Age Sex Pathology # [**Hospital1 18**] [**Known lastname 9320**],[**Known firstname 420**] [**2125-5-6**] 72 Female [**-1/2209**] [**Numeric Identifier 9321**] Report to: DR. [**Last Name (STitle) **]. [**Doctor Last Name **] Gross Description by: DR. [**Last Name (STitle) **]. ALMASHAT/dif SPECIMEN SUBMITTED: [**Last Name (STitle) **]. Procedure date Tissue received Report Date Diagnosed by [**2197-6-14**] [**2197-6-14**] [**2197-6-16**] DR. [**Last Name (STitle) **]. SEPEHR/ttl Previous biopsies: [**Numeric Identifier 9322**] SIGMOID [**Numeric Identifier **] POLYP/ok. [**Numeric Identifier 9323**] SIGMOID POLYP. [**Numeric Identifier 9324**] (Not on file) DIAGNOSIS: [**Numeric Identifier **], cecum, cecectomy: - Unremarkable [**Numeric Identifier 499**]. - Unremarkable small intestine. - One unremarkable lymph node. [**2197-6-13**] EKG: Normal sinus rhythm. RSR' pattern in leads V1-V2 with QRS duration of 78 milliseconds. Compared to the previous tracing of [**2197-3-7**] no diagnostic interval change. [**2197-6-14**] CT ABD: IMPRESSION: 1. Cecum appears to be flipped and is in the left upper abdominal quadrant concerning for cecal volvulus in appropriate clinical setting. Surgical consult recommended. 2. Diverticulosis with no evidence of diverticulitis. 3. Left adrenal nodule, incompletely characterized. MRI recommended in a nonurgent setting. 4. Gallbladder fundal thickening, likely adenomyomatosis. 5. Calcified fibroid uterus. [**2197-6-15**] Chest CTA: IMPRESSION: 1. New bilateral small- to moderate-sized pleural effusions with interlobular thickening suggest a degree of volume overload. In addition, area of bronchial plugging involving the right lower lobe with nonspecific consolidation that could relate to atelectasis and aspiration, though early pneumonia is not excluded. 2. Severe emphysema. 3. No evidence of pulmonary embolism to the subsegmental levels. [**2197-6-15**] EKG: Atrial fibrillation with rapid ventricular response at approximately 150. Borderline low voltage. Delayed precordial R wave progression, possibly normal variant. Non-specific repolarization abnormalities. Compared to the previous tracing of [**2197-6-15**] sinus tachycardia at a rate of 115 has given way to atrial fibrillation at a rate of 150. [**2197-6-17**]: CHEST XRAY: Cardiomediastinal contours are normal. Small bilateral pleural effusions larger on the left side are unchanged. The component of the pulmonary edema has resolved. Persistent, unchanged opacities in the left lower lobe and lingula are consistent with infectious process. It is unchanged though from prior study. Test Name Value Reference Range Units [**2197-6-20**] 06:35 COMPLETE BLOOD COUNT White Blood Cells 8.2 4.0 - 11.0 K/uL PERFORMED AT WEST STAT LAB Red Blood Cells 3.95* 4.2 - 5.4 m/uL PERFORMED AT WEST STAT LAB Hemoglobin 12.1 12.0 - 16.0 g/dL PERFORMED AT WEST STAT LAB Hematocrit 38.0 36 - 48 % PERFORMED AT WEST STAT LAB MCV 96 82 - 98 fL PERFORMED AT WEST STAT LAB MCH 30.7 27 - 32 pg PERFORMED AT WEST STAT LAB MCHC 31.9 31 - 35 % PERFORMED AT WEST STAT LAB RDW 13.0 10.5 - 15.5 % PERFORMED AT WEST STAT LAB BASIC COAGULATION (PT, PTT, PLT, INR) Platelet Count 300 150 - 440 K/uL PERFORMED AT WEST STAT LAB [**2197-6-20**] 06:35 RENAL & GLUCOSE Glucose 101* 70 - 100 mg/dL IF FASTING, 70-100 NORMAL, >125 PROVISIONAL DIABETES PERFORMED AT WEST STAT LAB Urea Nitrogen 6 6 - 20 mg/dL PERFORMED AT WEST STAT LAB Creatinine 0.3* 0.4 - 1.1 mg/dL PERFORMED AT WEST STAT LAB Sodium 139 133 - 145 mEq/L PERFORMED AT WEST STAT LAB Potassium 4.2 3.3 - 5.1 mEq/L PERFORMED AT WEST STAT LAB Chloride 99 96 - 108 mEq/L PERFORMED AT WEST STAT LAB Bicarbonate 34* 22 - 32 mEq/L PERFORMED AT WEST STAT LAB Anion Gap 10 8 - 20 mEq/L CHEMISTRY Calcium, Total 8.3* 8.4 - 10.3 mg/dL PERFORMED AT WEST STAT LAB Phosphate 3.7 2.7 - 4.5 mg/dL PERFORMED AT WEST STAT LAB Magnesium 1.8 1.6 - 2.6 Brief Hospital Course: General Brief Hospital Course: The patient was admitted to the General Surgical Service for evaluation and treatment. On [**2197-6-14**], the patient underwent cecectomy, which went well without complication (reader referred to the Operative Note for details). After a brief, uneventful stay in the PACU, the patient arrived on the floor NPO, on IV fluids and antibiotics, with a foley catheter, and epidural analgesia for pain control. The patient was hemodynamically stable. Neuro: The patient received Dilaudid PCA with good effect and adequate pain control. When tolerating oral intake, the patient was transitioned to oral pain medications. Patient continue to take 2-6 mg Dilaudid PO. CV: Patient was stable from cardiac standpoint after surgery, with RRR and occasional sinus tachycardia. On [**6-18**] patient developed an onset of rapid a-fib with HR up to 150s. Patient was started on IV Metoprolol, and she was reversed to regular rhythm. After been transitioned to PO Lopressor on [**6-19**], patient had several episodes of sinus tachycardia, which was resolved with IV Lopressor. Since [**2197-6-19**] the patient remained stable from a cardiovascular standpoint. She continued on Metoprolol 25 mg TID. Pulmonary: Patient had a long history of COPD and smoking. She denies use of supplemental O2 at home, but reported feeling SOB with minimal activities. Post surgery patient was on 3-4L O2 and on POD# 1 desaturated to 80s. Patient was transferred in ICU to r/o PE. Chest CT was negative for emboli, but revealed b/l pulmonary edema. Patient was started on nebulizers and chest PT. Her pulmonary function improved and she was transferred back to the floor. Currently patient continue to use 3-4L via nasal cannula with stable O2 Sats 95-97%. Patient advised to follow up with her PCP regarding home O2 use. GI/GU/FEN: Post-operatively, the patient was made NPO with IV fluids. Diet was advanced when appropriate, which was well tolerated. Patient's intake and output were closely monitored, and IV fluid was adjusted when necessary. Electrolytes were routinely followed, and repleted when necessary. ID: The patient's white blood count and fever curves were closely watched for signs of infection. Wound has staples, which need to be removed on [**6-24**] and replaced with steri strips. Endocrine: The patient's blood sugar was monitored throughout his stay; insulin dosing was adjusted accordingly. Hematology: The patient's complete blood count was examined routinely; no transfusions were required. Prophylaxis: The patient received subcutaneous heparin and venodyne boots were used during this stay; was encouraged to get up and ambulate as early as possible. At the time of discharge, the patient was doing well, afebrile with stable vital signs. The patient was tolerating a regular diet, ambulating, voiding without assistance, and pain was well controlled. The patient received discharge teaching and follow-up instructions with understanding verbalized and agreement with the discharge plan. Medications on Admission: Lipitor Discharge Medications: 1. Ipratropium Bromide 0.02 % Solution Sig: One (1) INH Inhalation Q6H (every 6 hours) as needed for wheezing/sob. 2. Levalbuterol HCl 0.63 mg/3 mL Solution for Nebulization Sig: One (1) INH Inhalation q6h () as needed for wheezing. 3. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for pain, fever. 4. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 5. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed for constipation. 6. Fluticasone-Salmeterol 250-50 mcg/Dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). 7. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal [**Hospital1 **] (2 times a day) as needed for constipation. 8. Hydromorphone 2 mg Tablet Sig: 1-3 Tablets PO Q3H (every 3 hours) as needed for pain. Disp:*90 Tablet(s)* Refills:*0* 9. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 10. Lipitor 10 mg Tablet Sig: One (1) Tablet PO at bedtime. Discharge Disposition: Extended Care Facility: [**Hospital1 **] House Rehabilitation & Nursing Center - [**Location (un) 5087**] Discharge Diagnosis: 1. Cecal volvulus 2. COPD Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: Please resume all regular home medications , unless specifically advised not to take a particular medication. Also, please take any new medications as prescribed. Please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. Avoid lifting weights greater than [**5-22**] lbs until you follow-up with your surgeon, who will instruct you further regarding activity restrictions. Avoid driving or operating heavy machinery while taking pain medications. Please follow-up with your surgeon and Primary Care Provider (PCP) as advised. Incision Care: *Please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *Avoid swimming and baths until your follow-up appointment. *You may shower, and wash surgical incisions with a mild soap and warm water. Gently pat the area dry. *If you have staples, they will be removed in Rehab on [**2197-6-24**] *If you have steri-strips, they will fall off on their own. Please remove any remaining strips 7-10 days after surgery Please call your doctor or nurse practitioner if you experience the following: *You experience new chest pain, pressure, squeezing or tightness. *New or worsening cough, shortness of breath, or wheeze. *If you are vomiting and cannot keep down fluids or your medications. *You are getting dehydrated due to continued vomiting, diarrhea, or other reasons. Signs of dehydration include dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. *You see blood or dark/black material when you vomit or have a bowel movement. *You experience burning when you urinate, have blood in your urine, or experience a discharge. *Your pain is not improving within 8-12 hours or is not gone within 24 hours. Call or return immediately if your pain is getting worse or changes location or moving to your chest or back. *You have shaking chills, or fever greater than 101.5 degrees Fahrenheit or 38 degrees Celsius. *Any change in your symptoms, or any new symptoms that concern you. Followup Instructions: Follow up with your primary care doctor regarding a nodule on the upper part of your right lung that was seen on chest x-ray in [**2-15**] weeks after discharge. . Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 9325**], MD Phone:[**Telephone/Fax (1) 3201**] Date/Time:[**2197-7-7**] 2:00. [**Hospital Ward Name 23**] 3, [**Hospital Ward Name 516**] . Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2038**], MD Phone:[**Telephone/Fax (1) 22**] Date/Time:[**2197-8-7**] 11:00 Completed by:[**2197-6-20**] ICD9 Codes: 9971, 2720, 3051, 2768
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Medical Text: Admission Date: [**2145-8-28**] Discharge Date: [**2145-9-12**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 7223**] Chief Complaint: Pre-syncope Major Surgical or Invasive Procedure: 1.Pacemaker placement 2. Surgical evacuation of Hematoma at pacemaker site History of Present Illness: The patient is a [**Age over 90 **]-year-old male with a past medical history of atrial fibrillation, Hypertension and has a mechanical aortic valve which was placed approximately 30 years ago for a "leaky" aortic valve per patient. The patient is on home Coumadin therapy for his atrial fibrillation and valve. He presented to the emergency room complaining of multiple presyncopal episodes. The patient describes these episodes as sudden occurences of lightheadedness while sitting at the table. He would then set his head down on the table and within seconds the symptoms would resolve. These episodes occur at rest and never happen when the patient is walking or up and about and more active. He denies palpitations, chest pain, shortness of breath, and he has no associated nausea or vomiting. These episodes have occurred [**12-27**] x in the past week. No related orthopnea, PND, or edema. . Pt was recently admitted to the cardiology service for similar episodes. It was felt that his episodes were due to bradycardia secondary to severe HTN up to SBP 220s. The patient was started on lisinopril, amlodipine and HCTZ. Upon discharge, HR ranged in 70s, SBP in 130s. Of note, the patient has been inadvertently taking [**11-25**] his prescribed dose of amlodipine prescribed over the past week. . In the ED, initial vital signs were: Temp 97.1 F, Pulse Rate 48, BP 180/72 and RR 18, oxygen saturation 100% RA. His HR ranged from 40-60 in slow atrial fibrillation. On telemetry, he reportedly had occasional pauses of up to 3-5 seconds, but he remained asymptomatic during these pauses. . On the floor the patient promptly triggered for marked nursing concern and persistent HR < 40. Patient had multiple [**2-27**] second pasuses on telemetry with narrow junctional escape beats. Cardiology was consulted who recommended deferring temporary pacing wire given elevated INR and history of mechanical valve. Patient was transferred to CCU for closer observation and monitoring overnight. On arrival to CCU patient denied chest pain, SOB, PND, orthopnea, LE Swelling, syncope or other complaints. Past Medical History: 1. CARDIAC RISK FACTORS:: Hypertension 2. CARDIAC HISTORY: No interventions in past. 3. OTHER PAST MEDICAL HISTORY: - Atrial fibrillation, on coumadin, no beta-blocker - HTN - Aortic valve replacement 30 years ago on coumadin - Chronic Kidney Disease, Baseline Cr 1.5-1.8 - Emphysema by CXR - no O2 requirement, no medical therapy. Social History: Patient lives in [**Location 47**] with his wife in his own home. 45 pack year smoking history. Quit 30 years ago. Family History: non contributory Physical Exam: Vitals: T 97.8, BP 147/78, HR 59, RR 18, O2 sat: 98% on RA Gen: Well appearing, NAD. HEENT: NCAT.Sclera anicteric. No pallor or cyanosis. Neck: Supple. No [**Doctor First Name **], no JVD. Cardiac: no rubs/gallops, systolic murmur with audible mechanical click Lungs: Breathing comfortably at rest, No crackles or wheezes. Abdomen: Soft, NT, ND. No masses. No rebound or guarding. Extremities: Warm, well perfused. No edema. Good distal pulses. Neuro: A+Ox3. CN 2-12 intact and symmetric. Grossly non focal. Able to move all extremities. Pulses: dopplerable LE pulses, femoral 1+ b/l, radial 2+ b/l Carotids: Audible mechanical murmur, no bruits. . At time of discharge: Pt's Exam is unchanged except for extensive erythema and edema of left arm secondary to tracking of blood associated with pace maker insertion. He has a palpable, but small hematoma surrounding his pacer site which is bandaged. Pertinent Results: [**2145-8-28**] : EKG: Atrial fibrillation with bradycardia HR 40-50bpm, left axis, no hypertrophy, mildly peaked T-waves, no acute ST-T changes . TELEMETRY [**2145-8-28**]: Bradycardia with junctional escape, frequent pauses of [**2-27**] seconds duration . [**2145-8-30**] TTE / ECHO : (no priors for comparison) The left atrium is elongated. There is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (LVEF>55%). Tissue Doppler imaging suggests an increased left ventricular filling pressure (PCWP>18mmHg). Right ventricular chamber size and free wall motion are normal. The ascending aorta is mildly dilated. A mechanical aortic valve prosthesis is present. The discs appear to move, but the transaortic gradient is higher than expected for this type of prosthesis (unless very small prosthesis - details unknown). . Mild (1+) aortic regurgitation is seen. [The amount of regurgitation present is normal for this prosthetic aortic valve.] The mitral valve leaflets and supporting structures are thickened. No mitral stenosis. Moderate (2+) mitral regurgitation is seen. [Due to acoustic shadowing, the severity of mitral regurgitation may be significantly UNDERestimated.] There is borderline pulmonary artery systolic pressure. There is no pericardial effusion. IMPRESSION: Mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. Well seated aortic valve prosthesis with slightly increased gradient. Increased PCWP. Moderate mitral regurgitation. Borderline pulmonary artery systolic hypertension. [**2145-8-31**] CXR post-pacemaker placement: Single-chamber pacemaker lead ending in the right ventricle. The rest of the study is grossly unchanged compared to the previous scan. [**2145-8-28**] 05:40PM BLOOD WBC-4.9 RBC-3.22* Hgb-10.8* Hct-32.3* MCV-100* MCH-33.5* MCHC-33.5 RDW-13.9 Plt Ct-140* [**2145-8-29**] 05:55AM BLOOD WBC-4.9 RBC-2.79* Hgb-9.9* Hct-27.5* MCV-99* MCH-35.6* MCHC-36.0* RDW-13.8 Plt Ct-117* [**2145-9-10**] 01:25PM BLOOD WBC-4.7 RBC-2.64* Hgb-8.8* Hct-25.7* MCV-98 MCH-33.2* MCHC-34.1 RDW-17.6* Plt Ct-253 [**2145-9-11**] 05:50AM BLOOD WBC-5.7 RBC-2.74* Hgb-9.1* Hct-26.8* MCV-98 MCH-33.0* MCHC-33.7 RDW-17.2* Plt Ct-240 [**2145-8-29**] 12:46AM BLOOD PT-23.1* PTT-35.7* INR(PT)-2.2* [**2145-9-8**] 07:00AM BLOOD PT-15.2* PTT-29.7 INR(PT)-1.3* [**2145-9-11**] 05:50AM BLOOD PT-23.6* INR(PT)-2.3* [**2145-8-28**] 05:40PM BLOOD Glucose-87 UreaN-40* Creat-1.8* Na-138 K-4.9 Cl-103 HCO3-28 AnGap-12 [**2145-9-11**] 05:50AM BLOOD Glucose-86 UreaN-39* Creat-1.6* Na-142 K-4.5 Cl-109* HCO3-26 AnGap-12 [**2145-8-29**] 05:55AM BLOOD CK-MB-NotDone cTropnT-0.02* [**2145-8-28**] 05:40PM BLOOD VitB12-791 Folate-GREATER TH [**2145-9-9**] 05:10PM BLOOD Triglyc-54 HDL-50 CHOL/HD-2.7 LDLcalc-73 [**2145-8-29**] 05:55AM BLOOD TSH-2.5 [**2145-8-28**] 05:40PM BLOOD Digoxin-<0.2* Brief Hospital Course: In summary, Mr. [**Known lastname 11679**] is a [**Age over 90 **]-year-old male with PMH atrial fibrillation, HTN, and s/p AVR on coumadin who presented with pre-syncope, bradycardia and prolonged pauses on telemetry/EKG and was referred to the EP team at [**Hospital1 18**]. Ultimately, after evaluation it was felt that Mr. [**Known lastname 11679**] would benefit from a pacemaker. He underwent surgery on [**2145-8-31**] and had a local complication of a left anterior subclavian and anterior shoulder region small hematoma after his procedure with some additional ecchymotic tracking down his left arm. He was given a pressure dressing and warm compresses for comfort after the procedure. Throughout this time he had a slight dip in his Hct levels from 29-30 range to 25-26 range but was hemodynamically stable and did not require transfusion. Discharge delayed by hematoma and by subtherapeutic INR. Pt has a INR goal of 2.5 to 3.0 given his atrial fibrillation, advanced age, hypertension, and mechanical valve. . # Rhythm: pt persistently in Atrial fibrillation. Ventricular rate maintained in the 60-70 range by pacer. Pt not orthostatic or lightheaded. Will need to maintain INR of 2.5 to 3.0 given Atrial-fib and valve. INR will be followed by PCP who followed INR prior to this admission. - Pt will f/u with Dr. [**First Name (STitle) 1075**] at [**Hospital1 **]. . # CAD: No known CAD, no e/o active ischemia by EKG and no prior infarcts on ECG. - Ruled out MI, 2 sets cardiac enzymes negative . #Presyncope: Likely [**12-26**] to bradycardia. No syncope or falls. - Negative w/u for other causes with U/A, UCx, CXR, ECHO, B12, TSH level . # HTN: adequately controlled at the time of discharge in the SBP range of 110 to 135 . # s/p Aortic Valve Replacement: INR goal 2.5-3 as above . # Chronic renal failure: Cr at baseline of 1.5-1.8 during hospitalization . # Follow-up: Pt has appt's with Cardiology and PCP. [**Name10 (NameIs) **] family is actively involved in his healthcare and is aware of these appts and the need for close follow-up of INR. Medications on Admission: HCTZ 25 mg Amlodipine 10 mg dialy Lisinopril 40 mg daily Warfarin 2.5 mg daily Lanoxin 0.125 mg daily Discharge Medications: 1. Hydrochlorothiazide 12.5 mg Capsule Sig: Two (2) Capsule PO DAILY (Daily). 2. Amlodipine 5 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 3. Lisinopril 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 4. Bacitracin-Polymyxin B 500-10,000 unit/g Ointment Sig: One (1) Appl Ophthalmic Q6H (every 6 hours): continue until you see your opthamologist. Disp:*1 tube* Refills:*2* 5. Warfarin 2.5 mg Tablet Sig: One (1) Tablet PO once a day. 6. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q12H (every 12 hours) as needed for pain. 7. Cephalexin 500 mg Capsule Sig: One (1) Capsule PO Q12H (every 12 hours): Stop taking after [**2145-9-15**]. Disp:*8 Capsule(s)* Refills:*0* 8. Erythromycin 5 mg/g Ointment Sig: One (1) Ophthalmic QHS (once a day (at bedtime)). 9. Outpatient Lab Work Please check INR, Hct on [**2145-9-13**] and call results to Dr. [**Name (NI) 79783**] office.([**Telephone/Fax (1) 79784**] Discharge Disposition: Home With Service Facility: [**Company 1519**] Discharge Diagnosis: Atrial Fibrillation and Bradycardia requiring pacemaker placement Mechanical AVR Hypertension Infected left tear duct Discharge Condition: The patient was stable at time of discharge with no complaints of left pacemaker site pain, no chest pains, dizziness or palpitations. Hematoma site improved. INR 2.5 Hct 26.5 BUN 33 and Cr 1.5 Discharge Instructions: You had a very low heart rate and required a pacemaker. Please don't move your left arm over your head or tuck in your shirt for the next 6 weeks. No lifting more than 5 pounds for 6 weeks. Keep the bandage dry, no showers until after you see the [**Hospital **] Clinic physicians at [**Hospital1 18**] for a follow-up pacemaker appointment on [**2145-9-14**]. You can also follow-up with Dr. [**First Name (STitle) 1075**] for ongoing pacemaker management. You may take a bath as long as the pacer dressing stays dry. You had some bleeding around the pacer site and into your left arm and needed some fluid and blood to keep your blood pressure up. . New medicines: You can . Please stop these medicines: You can stop taking your previous Lanoxin medication. Followup Instructions: Cardiology: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 1075**], MD Phone: [**Telephone/Fax (1) 6256**] Date/Time: 3:30pm on [**9-17**], please call the office if this time is not possible, but you must see Dr. [**First Name (STitle) 1075**] at some point next week. [**Hospital1 18**] EP Follow-up appointment : Please return to the [**Location (un) 436**] of the [**Hospital 23**] Clinic Building at [**Hospital1 18**] on [**2145-9-14**] at 10am for a follow-up appointment to check your pacemaker and hematoma. . Primary Care: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 17234**], MD Phone: ([**Telephone/Fax (1) 79784**] Date/time: pt's family will call for an appt. Please continue to follow your INR level with your Coumadin therapy with a goal INR of 2.5-3.5. . Opthamology: Provider: [**Name10 (NameIs) 6131**] [**Name11 (NameIs) **], MD Phone:[**Telephone/Fax (1) 253**] Date/Time:[**2145-9-13**] 2:30pm at the [**Hospital 18**] [**Hospital **] Clinic Completed by:[**2145-9-20**] ICD9 Codes: 5849, 2851
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Medical Text: Unit No: [**Numeric Identifier 70342**] Admission Date: [**2181-11-10**] Discharge Date: [**2181-12-7**] Date of Birth: [**2181-11-10**] Sex: F Service: Neonatology IDENTIFICATION: [**Known lastname 45731**] [**Known lastname **]-[**Known lastname **] is a 27 day old former 32 [**12-30**] wk infant who is being discharged from the [**Hospital1 18**] NICU. HISTORY: The patient is a 32 and [**12-30**] week baby who was delivered at 1350 grams who was admitted to the neonatal ICU for prematurity. She was delivered to a 31 year old G3, P1, now 2 mother with the following prenatal screens: Maternal [**Month/Day (4) 41770**] positive with anti-[**Doctor Last Name **] B. Maternal blood type was AB+, hep B surface antigen negative, RPR nonreactive, rubella immune, GBS status unknown. Pregnancy was complicated by pregnancy induced hypertension and fetal IUGR first noted at 28 weeks of pregnancy. She was betamethasone complete on [**2181-10-14**]. Mom has a history of HSV with the last recorded outbreak in [**2180-11-23**]. Maternal obstetric history is also notable for a prior fetal loss at 25 weeks gestation in [**2177**]. She has a history of a 34 week male infant delivered 10 years ago in [**Country 6171**]. This infant was delivered via C-section for concerning fetal decelerations and breech fetal positioning. In the delivery room, the patient's Apgars were 6 and 8. She received PPV in the OR. In the NICU, her weight was noted to be 1350 grams, 10-25th percentile, length 39.5 cm, 10-25% percentile, head circumference 28 cm, 10-25% percentile. There were no other dysmorphologies noted. HOSPITAL COURSE BY SYSTEMS: RESPIRATORY: The infant received blow-by oxygen in the delivery room and then transitioned quickly to RA. Since that time, she has been stable in RA without significant work of breathing. She did experience apnea of preamturity, not requiring caffeine therapy, and by the time of discharge, she had been without spells for greater than 5 days (last [**11-30**]). CARDIOVASCULAR: She never received any pressors. A soft intermittent murmur was heard over the course of hospitalization. Evaluation on [**12-3**] with EKG, CXR, 4-extremity blood pressures, and pre/post-ductal saturations was unremarkable. If the murmur persists, outpatient evaluation with cardiology can be considered. FEN/GI: The patient was initially maintained on IVF and parenteral nutrition. An umbilical venous catheter was placed after birth and removed day of life 7. She was begun on enteral feedings on day of life [**12-25**], advanced to full enteral feeding by day of life 9 without difficulty, and was subsequently advanced to breast milk supplemented to 28 calories per oz. On day of life 16, [**11-26**], she developed significant abdominal distension with increased aspirates, but otherwise remained well-appearing. CBC and cx were done, which were unremarkable. KUB was notable for mildly distended loops. She was made NPO for approximately 24 hours, with improvement in exam following large stool. Feedings were restarted and advanced to breast milk 26 calories/oz supplemented with HMF and MCT oil. Infant was gradually transitioned from PG feeds to PO feeds, achieving all PO feeds by [**Date range (1) 70343**]. In anticipation of discharge, feedigns were changed to breast milk 26 calories/oz supplemented with neosure powder. On [**11-9**], however, infant developed guiac + stools; no visible blood was seen, although some stools were noted to have mucous. Infant remained well-appearing with no other signs of feeding intolerance, and feedings were changed to breast-milk 26 supplemented with nutramigen powder for presumed protein intolerance. Mother's diet has very limited dairy. By the time of discharge, infant continues to appear well with adequate intake, although stools remain guiac positive. Further monitoring in hospital for [**12-25**] additional days to insure feeding tolerance was discussed with mother, but family preferred discharge on [**12-7**] with outpatient follow-up. Discharge weight was 1835 grams. HEME: Last hematocrit was drawn on [**11-26**] and was 32.6. Infant did not receive any transfusions, and was maintained on supplemental iron. Her max bilirubin was 6.3 noted on day of life 3. She received phototherapy for 4 days. As mentioned previously, maternal blood type is AB+ with anti-[**First Name7 (NamePattern1) **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 41770**]. Baby's blood type was A-/Coombs-. ID: Infant underwent sepsis evaluation after birth and again on day of life 16, with cultures negative on both occasions. NEURO: Day of life 9 head ultrasound was performed which was normal on [**11-19**]. SENSORY: She passed her hearing screen on [**2181-12-4**]. OPHTHALMOLOGY: Eyes were examined most recently on [**11-26**] revealing immaturity of the retinal vessels in zone III, but no ROP. A follow up exam has been scheduled for [**12-25**]. DISCHARGE DISPOSITION: Home. Primary pediatrician will be Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], [**Hospital2 70344**] [**Hospital3 37830**]. The phone number there is [**Telephone/Fax (1) 70345**]. Fax number is [**Telephone/Fax (1) 37833**]. CARE RECOMMENDATIONS: DIET: Feeds at discharge will be mother's milk 20 supplemented to 26 kcal with Nutramigen powder. MEDICATIONS: 1. Iron O.3 mL (25 mg/mL) po qd. 2. Goldmine multivitamins 1 mL po qd. RHCM: Car seat safety screening passed [**12-5**]. Hepatitis B vaccine #1 given [**12-6**]. Synagis given [**12-7**]. Newborn screens were sent per protocol, last on [**11-25**]; no abnormal results have been reported to date. IMMUNIZATIONS RECOMMENDED: Synagis RSV prophylaxis should be considered from [**Month (only) **] through [**Month (only) 958**] for infants who meet any of the following 3 criteria: 1. Born at less than 32 weeks. 2. Born between 32 and 35 weeks with 2 of the following: Daycare during RSV season, smoker in the household, neuromuscular disease, airway abnormalities, or school age siblings. 3. Chronic lung disease. Influenza immunization is recommended annually in the fall for all infants once they reach 6 months of age. Before this age and for the first 24 months of the child's life, immunization against influenza is recommended for household contacts and out of home caregivers. FOLLOW UP APPOINTMENTS RECOMMENDED: 1. VNA in [**12-25**] days. 2. Primary pediatrician in 3 days. 3. Dr. [**Last Name (STitle) **], ophthalmology, [**12-25**]. DISCHARGE DIAGNOSES: 1. Prematurity at 32 weeks. 2. Intrauterine growth retardation, small for gestation age infant. 3. Sepsis evaluation. 4. Apnea of prematurity. 5. Presumed protein intolerance. [**First Name8 (NamePattern2) **] [**Name8 (MD) **], MD [**MD Number(2) 56682**] Dictated By:[**Last Name (NamePattern1) 66322**] MEDQUIST36 D: [**2181-12-6**] 17:16:24 T: [**2181-12-6**] 18:34:00 Job#: [**Job Number 70346**] ICD9 Codes: 7742, V290, V053
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Medical Text: Admission Date: [**2126-4-12**] Discharge Date: [**2126-4-14**] Service: MEDICINE Allergies: No Drug Allergy Information on File Attending:[**First Name3 (LF) 1515**] Chief Complaint: EKG changes Major Surgical or Invasive Procedure: Cardiac catheterization [**2126-4-12**] History of Present Illness: 86 yo female with COPD, pulm HTN, TR who presented to OSH after a stranger knocked into her at her [**Hospital3 **] facility causing her to fall and fracture her left hip. She did not have any LOC. In addition, she sustained a laceration to her right lower leg and received 6 stiches at OSH. At OSH, pt had CT scan of Left hip which showed a cervical neck fracture of the left proximal femur. She had a routine pre-op evaluation; however her pre-op EKG showed ST elevations in V2-V4. The patient was completely asymptomatic. She denied chest pain or pressure. Her SOB was at baseline. She did have some nausea, vomiting and diaphoresis at the OSH. She was transferred to [**Hospital1 18**] for cardiac cath. Her cardiac cath earlier today showed clean coronaries. The patient tolerated the procedure without complication. The orthopedic team was consulted for management of her hip fracture. . The patient denies any chest pain or pressure currently. She reports that she does not want to undergo hip repair despite being informed of the risks. She refuses to go to get x-rays for further evaluation. . ROS: She denies any prior history of stroke, TIA, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, or hemoptysis. She denies recent fevers, chills or rigors. She denies exertional buttock or calf pain. Has occasional abdominal pain, alternating diarrhea and constipation but has not had a colonoscopy, occasional blood in stool with straining. . 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: Pulmonary HTN Tricuspid regurgitation CPD Osteoporosis c/b thoracic spine fracture resulting in chronic mid back pain Hypertension h/o pyelonephritis h/o left hydronephrosis of uncertain eitology h/o pneumonia - required stay in rehab prior to transfer to [**Hospital3 **] s/p appendectomy s/p oophrectomy Social History: She lives in an [**Hospital3 **] facility at [**Location (un) 582**]. Had been living independently until 3 months ago when she had a pneumonia and required inpatient rehab prior to her transfer to [**Hospital 4382**]. Son is an administrator and internist at [**Hospital1 3325**]. Has 2 daughters who live locally. -Tobacco history: She started smoking as a teenager and quit smoking 3 months ago. -ETOH: denies -Illicit drugs: denies Family History: No family history of early MI, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. Physical Exam: ADMISSION PHYSICAL EXAM VS: T=98.1 BP=102/49 HR=63 RR=15 O2 sat=96% 4L GENERAL: thin elderly female in NAD. Oriented x3. Mood, affect appropriate. HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. No xanthalesma. NECK: Supple with no JVD. CARDIAC: PMI located in 5th intercostal space, midclavicular line. RR, normal S1, S2. No m/r/g. No thrills, lifts. No S3 or S4. LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp were unlabored, no accessory muscle use. CTAB, no crackles, wheezes or rhonchi. ABDOMEN: Soft, NTND. No HSM or tenderness. Abd aorta not enlarged by palpation. No abdominial bruits. EXTREMITIES: LLE shortened and externally rotated. 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: [**2126-4-12**] 09:28PM BLOOD WBC-10.4 RBC-3.87* Hgb-12.0 Hct-36.9 MCV-95 MCH-31.0 MCHC-32.5 RDW-13.5 Plt Ct-259 [**2126-4-13**] 03:58AM BLOOD WBC-10.5 RBC-3.75* Hgb-11.7* Hct-35.4* MCV-94 MCH-31.2 MCHC-33.1 RDW-13.4 Plt Ct-235 [**2126-4-12**] 09:28PM BLOOD Glucose-123* UreaN-27* Creat-1.2* Na-132* K-5.5* Cl-101 HCO3-26 AnGap-11 [**2126-4-13**] 03:58AM BLOOD Glucose-105 UreaN-28* Creat-1.2* Na-133 K-5.5* Cl-101 HCO3-28 AnGap-10 [**2126-4-13**] 01:24PM BLOOD Glucose-158* UreaN-27* Creat-1.1 Na-135 K-4.2 Cl-103 HCO3-25 AnGap-11 [**2126-4-12**] 09:28PM BLOOD CK(CPK)-52 [**2126-4-13**] 03:58AM BLOOD CK(CPK)-41 [**2126-4-13**] 01:24PM BLOOD proBNP-[**Numeric Identifier 82170**]* [**2126-4-12**] 09:28PM BLOOD Mg-1.9 [**2126-4-13**] 03:58AM BLOOD Calcium-9.0 Phos-3.7 Mg-2.0 [**2126-4-13**] 01:24PM BLOOD Mg-1.8 [**2126-4-12**] 02:26PM BLOOD Type-ART O2 Flow-100 pO2-319* pCO2-58* pH-7.26* calTCO2-27 Base XS--1 [**2126-4-12**] 02:46PM BLOOD Type-ART pO2-74* pCO2-54* pH-7.27* calTCO2-26 Base XS--2 Intubat-NOT INTUBA . Cardiac Catheterization [**2126-4-12**] 1. Coronary angiography in this right-dominant system revealed: --the LMCA had no angiographically apparent disease --the LAD had no angiographically apparent disease --the LCX had no angiographically apparent disease --the RCA had a calcified proximal 50% stenosis. 2. Limited resting hemodynamics revealed elevated systemic arterial systolic pressures, with SBP 156 mmHg. FINAL DIAGNOSIS: 1. No obstructive CAD 2. Moderate systemic arterial systolic hypertension. . [**2126-4-12**] TTE Echocardiographic Measurements Results Measurements Normal Range Left Atrium - Four Chamber Length: 4.7 cm <= 5.2 cm Right Atrium - Four Chamber Length: 4.3 cm <= 5.0 cm Left Ventricle - Septal Wall Thickness: 0.9 cm 0.6 - 1.1 cm Left Ventricle - Inferolateral Thickness: 0.8 cm 0.6 - 1.1 cm Left Ventricle - Diastolic Dimension: 3.1 cm <= 5.6 cm Left Ventricle - Systolic Dimension: 1.8 cm Left Ventricle - Fractional Shortening: 0.42 >= 0.29 Left Ventricle - Ejection Fraction: 70% >= 55% Left Ventricle - Lateral Peak E': 0.10 m/s > 0.08 m/s Left Ventricle - Septal Peak E': *0.07 m/s > 0.08 m/s Left Ventricle - Ratio E/E': 9 < 15 Aortic Valve - Peak Velocity: 1.3 m/sec <= 2.0 m/sec Mitral Valve - E Wave: 0.8 m/sec Mitral Valve - A Wave: 1.3 m/sec Mitral Valve - E/A ratio: 0.62 Mitral Valve - E Wave deceleration time: 235 ms 140-250 ms TR Gradient (+ RA = PASP): *59 to 66 mm Hg <= 25 mm Hg Findings LEFT ATRIUM: Normal LA size. RIGHT ATRIUM/INTERATRIAL SEPTUM: Normal RA size. Increased IVC diameter (>2.1cm) with <35% decrease during respiration (estimated RA pressure (10-20mmHg). LEFT VENTRICLE: Normal LV wall thickness. Small LV cavity. Overall normal LVEF (>55%). No resting LVOT gradient. RIGHT VENTRICLE: RV hypertrophy. Dilated RV cavity. Borderline normal RV systolic function. Abnormal systolic septal motion/position consistent with RV pressure overload. AORTA: Normal aortic diameter at the sinus level. Focal calcifications in aortic root. AORTIC VALVE: Moderately thickened aortic valve leaflets. Minimal AS. No AR. MITRAL VALVE: Mildly thickened mitral valve leaflets. No MVP. Moderate mitral annular calcification. Mild thickening of mitral valve chordae. Calcified tips of papillary muscles. No MS. LV inflow pattern c/w impaired relaxation. TRICUSPID VALVE: Mildly thickened tricuspid valve leaflets. Normal tricuspid valve supporting structures. No TS. Moderate to severe [3+] TR. Severe PA systolic hypertension. PERICARDIUM: No pericardial effusion. Conclusions The left atrium is normal in size. The estimated right atrial pressure is 10-20mmHg. Left ventricular wall thicknesses are normal. The left ventricular cavity is small. Overall left ventricular systolic function is normal (LVEF 70%). The right ventricular free wall is hypertrophied. The right ventricular cavity is dilated with borderline normal free wall function. There is abnormal systolic septal motion/position consistent with right ventricular pressure overload. The aortic valve leaflets are moderately thickened. There is a minimally increased gradient consistent with minimal aortic valve stenosis. 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. The tricuspid valve leaflets are mildly thickened. Moderate to severe [3+] tricuspid regurgitation is seen. There is severe pulmonary artery systolic hypertension. There is no pericardial effusion. . [**2126-4-13**] CXR The lung volumes are near normal, the hemidiaphragms are relatively low, but not flattened. Moderate scoliosis leads to asymmetry of the rib cage. In both lungs, right more than left, a reticular pattern of opacities is seen in both perihilar regions and in the right upper region. Without comparison, the nature of these lesions is difficult to determine, they could be the result of fibrotic or a chronic inflammatory process, but could also result from chronic overhydration. Moderately enlarged cardiac silhouette, slightly enlarged right and left hilus, potentially suggesting pulmonary hypertension. No evidence of pleural effusions, no acute overhydration. Bilateral apical thickening. . [**2126-4-13**] Lower extremity doppler U/S Preliminary Report !! WET READ !! no dvt seen in either lower extremity . [**2126-4-13**] CTA CHEST Preliminary Report !! PFI !! Pulmonary embolus within the right middle lobe segmental artery. Bilateral pleural effusions. Extensive COPD, cardiomegaly, vascular calcifications. Areas of increased opacity in the right upper lobe may represent infection. Additional areas of opacity in the right middle lobe may represent infarct or atelectasis. Brief Hospital Course: 1) EKG changes - Perioperative EKG prior to transfer to [**Hospital1 18**] showed ST elevations in V3-V4 and to a lesser extent in II,III,F,V5-V6. TnI was 1.9 with normal CK. She was given aspirin, plavix, lovenox, and lopressor. A similar EKG was obtained upon transfer to [**Hospital1 18**]. Cardiac cath [**4-12**] revealed a right-dominant system with a calcified 50% proximal stenosis in the RCA but no angiographically apparent disease in the LMCA, LAD, and LCX. TTE [**2126-4-12**] revealed normal left atrial size with an estimated right atrial pressure 10-20mmHg, normal left ventricular wall thickness and a small left ventricular cavity, normal left ventricular systolic function (LVEF 70%), hypertrophied right ventricular free wall, dilated right ventricular cavity with borderline normal free wall function, abnormal systolic septal motion/position consistent with right ventricular pressure overload, moderately thickened aortic valve leaflets with a minimally increased gradient consistent with minimal aortic valve stenosis, mildly thickened mitral valve leaflets, left ventricular inflow pattern suggesting impaired relaxation, mildly thickened tricuspid valve leaflets with moderate to severe [3+] tricuspid regurgitation, and severe pulmonary artery systolic hypertension. Cardiac enzymes were trended with no elevation in her CK's threfore this was felt not to be cardiac ischemia. . 2) Pulmonary Embolus - On hospital day 2, the patient had low-grade fever, tachycardia, worsening hypoxemia with resting oxygen saturation in the mid 90's on 6 L NC, new T-wave inversions in V3 and deeper T-wave inversions in V4. CTA of the chest revealed right middle lobe segmental pulmonary emboli, right middle lobe pulmonary infarct vs. atelectasis, moderate bilateral pleural effusions, and volume overload. Heparin and lasix infusions were started. Lower extremity doppler ultrasound was negative for DVT. . 3) Left femoral neck fracture - Seen in consultation by orthopaedic surgery who recommended proceeding with ORIF. However, based on the preference of the patient and her family, she was transferred to [**Hospital3 3583**] for further management. Medications on Admission: Celexa 10mg PO daily Omeprazole 20mg PO daily Senna 2 tabs daily at 4pm Lisinopril 5 mg PO daily Lidoderm 5% patch, one patch to lower back 12 hrs each day Calcium with Vit D 600mg PO BID Tylenol 650mg Q4hrs PRN for pain Compazine 10mg PO BID PRN nausea/vomiting Ibuprofen prn Discharge Medications: 1. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours): do not exceed 4 grams in 24 hours. 2. Citalopram 20 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 3. Senna 8.6 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 4. Lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: One (1) Adhesive Patch, Medicated Topical DAILY (Daily): place on between 8 AM and 8 PM then remove. 5. Heparin (Porcine) in NS 10 unit/mL Kit Sig: ASDIR units Intravenous every six (6) hours: Diagnosis: Pulmonary Embolism Patient Weight: 40.824 kg Initial Bolus: 1000 units IVP Initial Infusion Rate: 750 units/hr Target PTT: 60 - 100 seconds PTT <40: 1600 units Bolus then Increase infusion rate by 150 units/hr PTT 40 - 59: 800 units Bolus then Increase infusion rate by 100 units/hr PTT 60 - 100*: PTT 101 - 120: Reduce infusion rate by 100 units/hr PTT >120: Hold 60 mins then Reduce infusion rate by 150 units/hr. 6. Furosemide 10 mg/mL Solution Sig: 2.5 mg Injection INFUSION (continuous infusion). 7. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. 8. Calcium Carbonate 500 mg (1,250 mg) Capsule Sig: One (1) Capsule PO once a day. 9. Vitamin D 400 unit Tablet Sig: Two (2) Tablet PO once a day. Discharge Disposition: Extended Care Discharge Diagnosis: 1) Left femoral neck fracture 2) Pulmonary embolus 3) Pleural effusions 4) Pulmonary hypertension 5) Tricuspid regurgitation 6) Emphysema Discharge Condition: Transfer to [**Hospital3 3583**]. Discharge Instructions: You were admitted to the hospital following a fall and left hip fracture. You declined surgery at [**Hospital1 18**] and were transferred to [**Hospital3 3583**] at your request. You were diagnosed with blood clots in the lung, also known as pulmonary emboli, and were started on blood thinning medication. Followup Instructions: Please follow the recommendations of your medical and orthopaedic doctors [**First Name (Titles) **] [**Hospital3 3583**]. Completed by:[**2126-4-14**] ICD9 Codes: 5119, 4168, 4019, 2767
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Medical Text: Admission Date: [**2168-7-18**] Discharge Date: [**2168-7-22**] Service: MEDICINE Allergies: Penicillins Attending:[**First Name3 (LF) 7333**] Chief Complaint: Bradyarrhythmia, transfer for evaluation of PPM Major Surgical or Invasive Procedure: Pacemaker placement on [**2168-7-19**]: [**Company 1543**] Sensia History of Present Illness: Mr. [**Known lastname **] is a 89 year old male with PMH significant for chronic lymphocytic leukemia, IDDM, CAD s/p CABG ([**2141**]) who is transferred from [**Hospital **] hospital for bradycardia. . Patient experienced fatigue and weakness for the past few days. On [**7-16**] he fell out of a chair onto the floor when adjusting himself. He states that his head got stuck in the legs of the desk. He denies losing consciousness but he states that he "fell asleep." His He denies CP, nausea, diaphoresis, shortness of breath. His daughter found him on the groud ~4hours later. In the ED at [**Location (un) **], his VS T 98.3, HR 73, RR 20, BP 141/60, O2 96% RA. Labs were notable for trop 8.58, CK 618, CK-MB 28.3, hct 24.8, plt 80, Cr 1.6. The patient was given aspirin, but not started on heparin gtt. . ECG showed Wenckebach block with bradycardia. Per OSH records, he had multiple runs of NSVT, the longest 10-15sec and was given lidocaine iv. Per nursing report, however, patient was stated to have 15-20 sec pause. He had persistent bradycardia with HR of 30s and a temporary pace wire was placed. He was also transfused 2 pRBC while there (hct improved to 29). An echocardiogram was done that showed mild MR/TR, biatrial enlargement, EF 50%, dyssynergic septum with RV temp pacing. His Trop per nursing report peaked to 10.3. . 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. S/he denies exertional buttock or calf pain. All of the other review of systems were negative. . Cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. Past Medical History: 1. CARDIAC RISK FACTORS: +Diabetes, -Dyslipidemia, -Hypertension 2. CARDIAC HISTORY: -CABG: s/p CABG [**2141**] -PERCUTANEOUS CORONARY INTERVENTIONS: -PACING/ICD: None 3. OTHER PAST MEDICAL HISTORY: - Chronic lymphocytic leukemia, on procrit - DMII, insulin dependent - CAD, s/p CABG [**2141**] - BPH - Bl cataract surgery - SCC of the scalp - H/o bradycardia, PPM not recommended Social History: Lives independently. Retired broadcast engineer. Has eight children. -Tobacco history: None -ETOH: None -Illicit drugs: None Family History: Mother w/ [**Name2 (NI) 499**] cancer. Physical Exam: GENERAL: Elderly male, thin, in NAD. Oriented x3. Mood, affect appropriate. HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. Dry MMM. No xanthalesma. NECK: Supple with flat JVP. Guaze covering area of excised SCC c/d/i. CARDIAC: PMI located in 5th intercostal space, midclavicular line. RR, normal S1, S2. No m/r/g. No thrills, lifts. No S3 or S4. LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp were unlabored, no accessory muscle use. CTAB, no crackles, wheezes or rhonchi. ABDOMEN: Soft, NTND. No HSM or tenderness. Abd aorta not enlarged by palpation. No abdominial bruits. EXTREMITIES: No c/c/e. No femoral bruits. SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. PULSES: Right: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ Left: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ Pertinent Results: Pt with thyroid nodule this admission which needs f/u [**2168-7-18**] 09:42PM PT-12.0 PTT-25.2 INR(PT)-1.0 [**2168-7-18**] 09:42PM PLT SMR-LOW PLT COUNT-96* [**2168-7-18**] 09:42PM HYPOCHROM-NORMAL ANISOCYT-OCCASIONAL POIKILOCY-1+ MACROCYT-2+ MICROCYT-NORMAL POLYCHROM-NORMAL OVALOCYT-1+ [**2168-7-18**] 09:42PM NEUTS-25* BANDS-2 LYMPHS-73* MONOS-0 EOS-0 BASOS-0 ATYPS-0 METAS-0 MYELOS-0 [**2168-7-18**] 09:42PM WBC-8.6 RBC-3.28* HGB-11.1* HCT-33.2* MCV-101* MCH-33.7* MCHC-33.3 RDW-17.3* [**2168-7-18**] 09:42PM TSH-1.4 [**2168-7-18**] 09:42PM CALCIUM-8.1* PHOSPHATE-2.9 MAGNESIUM-2.1 [**2168-7-18**] 09:42PM CK-MB-4 cTropnT-0.34* [**2168-7-18**] 09:42PM ALT(SGPT)-19 AST(SGOT)-30 LD(LDH)-241 CK(CPK)-288 ALK PHOS-83 TOT BILI-0.6 DIR BILI-0.2 INDIR BIL-0.4 [**2168-7-18**] 09:42PM estGFR-Using this [**2168-7-18**] 09:42PM GLUCOSE-311* UREA N-29* CREAT-1.3* SODIUM-138 POTASSIUM-4.1 CHLORIDE-108 TOTAL CO2-24 ANION GAP-10 Brief Hospital Course: 89 year old male with PMH significant for chronic lymphocytic leukemia, IDDM, CAD s/p CABG ([**2141**]) who is transferred from [**Hospital **] hospital for PPM for symptomatic bradycardia. # Symptomatic Bradycardia: Patient's fall was suspected to be secondary to symptomatic bradyarrhythmia. His ECG from the OSH showed Wenckebach and CHB. Per report, as an outpatient patient had sinus pauses on Holter monitor. Patient underwent placement of PPM and tolerated this procedure well. He was treated with antibiotics for 48hours. His pacemaker was interrogated and working well. Patient will follow up in device clinic next week. Please see page 1 for pacer site care and activity restrictions. . # Non ST Elevation Myocardial Infarction: Patient has a history of CABG (anatomy unknown). His cardiac markers were elevated at OSH and at [**Hospital1 18**]. While here he denied any chest pain. Patient was limited to receiving anti-aggregation therapy (see below). He was started on lisinopril, metoprolol after PPM was placed, ASA 325. Lipitor was started at discharge. His lipid panel is pending at this time. There was a discussion at discharge about persuing stress testing but given his CLL, it was thought that medical management was most appropriate at this time. . # Acute on Chronic Kidney Disease: Patient's Cr was 1.6 at OSH. His urine was notable for large blood and there was a concern for rhabdo. On arrival to [**Hospital1 18**] patient's Cr was 1.4, which remained stable. He also had protein in his urine which suggested likely underlying renal insufficiency likely secondary to diabetes. His metformin and glipizide were held, but restarted on discharge. . # CLL: With likely bone marrow involvement: thrombocytopenia and anemia. ANC 2150. His counts were monitored and procrit was held. Platelets decreased to 64 on day of discharge, Hct stable at 30. No signs of overt bleeding. Given the patient will not be able to f/u with his home Hematologist (Dr. [**First Name (STitle) 12795**] in [**Location (un) **] VT) an appt was made wth Dr. [**Last Name (STitle) **] at [**Hospital1 **] [**Location (un) 620**] for further monitoring. Dr. [**Last Name (STitle) **] will decide when to restart Procrit and arrange for monitoring of labs. FeSo4 was continued. Please check labs on Monday [**7-25**]. . # IDDM: Held metformin and glipizide, but restarted on discharge. Patient continued on home lantus. . # BPH: Continued terazosin . # Thyroid nodule: An incidental thyroid nodule was seen on CT scan, which needs to be followed as an outpatient. . # S/P Mohs Surgery for Squamous Cell CA on scalp on [**7-14**]. His daughter has been changing the dressing daily. Sutures can be removed on [**7-26**], then a non-occlusive dressing to the site until there is only pink skin visible. Medications on Admission: MEDICATIONS: Folic acid 1mg daily metformin 500mg [**Hospital1 **]; 250mg at noon ecotrin 81mg daily glipizide 10mg [**Hospital1 **] terazosin 10mg daily MVI iron tab daily lantus 10U daily procrit . MEDICATIONS ON TRANSFER: aspirin 325 daily lipitor 80mg daily metoprolol 25mg [**Hospital1 **] MVI terazosin 10mg qhs tylenol 650mg Q4prn SLN prn ISS HSC Discharge Medications: 1. Metoprolol Succinate 50 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO once a day. 2. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Lisinopril 5 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily): Hold SBP < 100. 4. Lantus 100 unit/mL Solution Sig: Ten (10) units Subcutaneous at bedtime. 5. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed for pain. 6. Metformin 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 7. Metformin 500 mg Tablet Sig: 0.5 Tablet PO NOON (At Noon). 8. Glipizide 5 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 9. Clindamycin HCl 150 mg Capsule Sig: Two (2) Capsule PO Q6H (every 6 hours) for 1 days. 10. Terazosin 5 mg Capsule Sig: Two (2) Capsule PO HS (at bedtime). 11. Atorvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 12. Ferrous Sulfate 300 mg (60 mg Iron) Tablet Sig: One (1) Tablet PO DAILY (Daily). 13. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 14. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day): Hold for diarrhea. 15. Outpatient Lab Work Please check CBC and chem-7 on Monday [**2074-7-23**]. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO once a day. 17. Multiple Vitamin Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Extended Care Facility: Newbridge on the [**Doctor Last Name **] Discharge Diagnosis: Primary Diagnosis: Acute systolic Dysfunction: EF 30% Non ST Elevation Myocardial Infarction Complete Heart Block Acute on chronic Kidney Disease . Secondary Diagnosis: Chronic lymphocytic leukemia Diabetes Mellitus on Insulin Coronary Artery Disease s/p CABG [**2141**] Benign Prostatic Hypertrophy Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: You had a fall at home and was brought to [**Hospital **] Hospital with a heart attack. You were then transferred here to [**Hospital1 18**] for treatment. You were also very anemic and had some dangerous heart rhythms. We placed a pacemaker to fix your heart rhythms and gave you some blood. You blood count and platelet counts are still quite low, you should consider seeing a hematologist/oncologist for this within the next month. You can return to your doctor [**First Name (Titles) **] [**Last Name (Titles) 3914**] or you can go to a doctor close to Newbridge: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], MD [**Hospital1 **] Hospital - [**Location (un) 620**] [**Street Address(2) 3001**] [**Location (un) 620**], [**Numeric Identifier 3002**] Phone: [**Telephone/Fax (1) 38619**] Fax: [**Telephone/Fax (1) 85425**] Date/time: Wednesday [**7-27**] at 1:30pm . Medication changes: 1. Increase aspirin to 325 mg to prevent another heart attack 2. Start Lisinopril to help your heart pump better 3. Start Tylenol for pain at the pacer site as needed 4. Start Clindamycin to prevent an infection at the pacer site, you have one more day left 5. Start Atorvastatin to lower your cholesterol 6. Start Colace and senna to prevent constipation. . Weigh yourself every morning, call Dr. [**Last Name (STitle) **] if weight goes up more than 3 lbs. Followup Instructions: Provider: [**Name10 (NameIs) 676**] CLINIC Phone:[**Telephone/Fax (1) 62**] Date/Time:[**2168-7-26**] 4:00pm [**Hospital Ward Name 23**] Clinical Center, [**Location (un) 436**]. [**Location (un) **], [**Hospital Ward Name 5074**] [**Hospital1 18**]. . Primary Care: Provider: [**Name10 (NameIs) 14218**], [**Name11 (NameIs) **] Phone:([**Telephone/Fax (1) 85426**] Date/Time: [**2168-7-29**] 8:30am This appt needs to be cancelled if pt is still in MA . Cardiology: [**8-8**] at 11:20am with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **]. [**Hospital Ward Name 23**] Clinical Center, [**Location (un) 436**]. [**Location (un) **], [**Hospital Ward Name 516**] [**Hospital1 18**] . Hematology/Oncology: [**Last Name (LF) **], [**First Name3 (LF) **] H., MD [**Hospital1 **] Hospital - [**Location (un) 620**] [**Street Address(2) 3001**] [**Location (un) **], across from Medical Day care. Please stop at registration first. [**Location (un) 620**], [**Numeric Identifier 3002**] Phone: [**Telephone/Fax (1) 38619**] Fax: [**Telephone/Fax (1) 85425**] Date/time: Wednesday [**7-27**] at 1:30pm ICD9 Codes: 5849, 5859, 4280
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8333 }
Medical Text: Admission Date: [**2105-3-20**] Discharge Date: [**2105-3-25**] Date of Birth: [**2026-6-26**] Sex: F Service: MEDICINE Allergies: A.C.E Inhibitors Attending:[**First Name3 (LF) 2234**] Chief Complaint: Syncope Major Surgical or Invasive Procedure: NG tube placement History of Present Illness: 78 yo female with h/o DM,HTN, PVD, who presented with two days of feeling unwell. She was unable to urinate x2 days and has not had a BM in the last day. Today she stood up and syncopized after attempting to have BM and was unresponsive. EMS was called and SBP was in the 90s with HR initially in the 60s and trending down to the 50s. She was also c/o epigastric pain. On arrival to the [**Hospital1 18**] ER, the pt immediately syncopized. Her HR decreased to the 30s-40s and SBPs decreased to the 50s-70s. EKG demonstrated a junctional rhythm. She received 0.5 mg of atropine x 2, glucagon 5 mg x1 and IVFs wide open, for a total of 6L NS. This resulted in improvement of HR and BPs. Labs demonstrated an elevated lactate as high as 5.2 and potssium of 8.2. She was treated with sodium bicarb, calcium gluconate, insulin and D50 x2. She also received 30 mg PO kayexalate. Repeat K was 6. Renal was called and UA appeared c/w pre-renal etiology. Of note, when foley was placed initially, only 100 cc of urine was drained. She later had a total of 200-300 cc of UOP after 6L of NS. Additionally, she was on a NRB during her time in the ER and then her sats dropped to the 70s-80s. She was thought to be volume overloaded,so started on bipap with improvement in sats. She was also started on cefepime, flagyl and levofloxacin to cover PNA and possible abdominal infection. Of note, she had a non-contrast CT of the abdomen, which demonstrated possible thrombosis of the SMA and heterogenous attenuation of the liver. CT of the chest demonstrated possible b/l PNA. She was evaluated by surgery who did not think there was any surgical intervention indicated at the time. She was stable on bipap and trasnferred to the MICU. . Upon speaking with pt in the MICU (grandson translating), she has been feeling crampy abd pain for several days. Her biggest complaint is that she tried to have a BM but was unable. Upon questioning she stated she had worse lower back pain and some substernal CP over the lsat week. CP is a substernal, pressure that improved with exertion and was intermittent. She denied diaphoresis, SOB, f/c. . Upon further discussion with the patient and family, it was discovered the patient had been taking high dose NSAIDS for several days prior to admission. Past Medical History: 1. Non-insulin-dependent diabetes mellitus. 2. Hyperlipidemia. 3. Hypertension. 4. Gastroesophageal reflux disease. 5. Backpain-lumbar radiculopathy 6. Osteoporosis 7. PVD: s/p right leg angiogram 6. Admit in [**2099**], s/p syncopal event and fall, after which she had backpain, constipation, abdominal distention and urinary incontinence. Had spinal MRI with T1/T2 lesions c/w hemangioma and T12 compression fx. Several disc bulges were noted but no cord compression. Also had narcotic ileus. Social History: The patient denies alcohol or tobacco use. She lives in [**Location 686**] with her family. She is [**Location 11543**] and speaks Creole dialect. Family History: N/C Physical Exam: VS: T: 98.9 BP: 141/65 HR: 59 RR: 21 O2 sat: 94% on 6L NC Gen: well appearing, pointing to her abdomen HEENT: anicteric, dry MM Neck: supple, obese Pulmonary: exp wheezes b/l, moving air well Cardio: bradycardic with regular rate Abd: soft, very distended, NT, +BS Ext: 1+ edema b/l Neuro: pt mentating and moving all extremities Pertinent Results: Echo [**7-2**]: The left atrium is normal in size. 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 (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. The mitral valve leaflets are mildly thickened. Physiologic mitral regurgitation is seen (within normal limits). There is borderline pulmonary artery systolic hypertension. There is no pericardial effusion. . CT abd/chest w/out contrast (PRELIM READ): Limited study for evaluation of bowel ischemia in the absence of IV contrast. Heterogenous attenuation of the liver, with large geographic areas of low attenuation, may reflect fatty change but in the appropriate clinical setting, ischemia or inflammation are alternative possibilities. Focal hyperdense segment of SMA, occasionally associated with acute thrombus. [**Month (only) 116**] be further evaluated with mesenteric vessel doppler, considering patient's clinical status does not permit contrast administration. Bibasilar pulmonary consolidation, aspiration versus bilateral pneumonia. . C. cath [**12-1**]: 1. Central aortic hypertension 2. Moderarate celiac artery lesion 3. Severe LTPT and PA lesion with one vessel run off to the L foot via PA 4. successful atherectomy and PTA of the L TPT lesion 5. Successful PTA of the L PA lesion . EKG: narrow junctional rhythm with rate of 59, RBBB Brief Hospital Course: 78 yo female with DM II, HTN, PVD, admitted to MICU ([**Date range (1) 17717**]) with ARF and resulting syncope in setting of high dose ibuprofen. . # Acute Renal Failure: Admitted with a creatnine of 2.4 and severe hyperkalemia. FENa 0.23% c/w pre-renal etiology. Also in setting of high dose NSAID use, with likely resultant decrease of renal blood flow. Resolved with IVF. She will have a renal function check in 1 week. If her renal function is stable at that time, she will resume her [**Last Name (un) **]. She received clear instructions to avoid NSAIDs in the future. . # Syncope: Likely secondary to high junctional rhythm and multiple metabolic derranagements on admission. With high junctional rhythm at the time of syncope in ED, with hyperkalemia to 8, treated with atropine, gluccagon, insulin, bicarb and calcium. No further events on telemetry in the MICU. BB and CCB initially held in the MICU, BB reintroduced and tolerated well. CCB being held in the setting of bradycardia. . # Hypoxia: In the ED with desaturation to 70-80%, requiring facemask. Treated initially with levofloxacin and flagyl until [**3-22**]. Also diuresed with concern for volume overload. On room air throughout the remainder of her hospitalizaiton. Suspect that acute desaturation in ED is secondary to aspiration pneumonitis (bilateral infiltrates seen on CT scan) in setting of syncope and altered mental status. ECHO for w/u of syncope revealed e/o RV hypokinesis. Subsequent CTA was negative for PE. . # Hypertension: In MICU with SBP 170s. Reintroduced home regimen of BB without complications. However, she was noted to have junctional rhythm on admission (see below) and thus her diltiazem was discontinued. Her [**Last Name (un) **] was held in the setting of renal failure. Norvasc was started for BP control. . # Pulmonary Hypertension: Unclear etiology. No smoking history, no evidence of PE on CTA. Clinical history not suggestive of sleep apnea. She would benefit from a pulmonary follow up as outpt for further w/u of her pulmonary hypertension. . # Abdominal Distension: With self-reported constipation, and abdominal distension in the MICU. NGT placed and discontinued in MICU. Abdominal exam remained benign. Treated initially with levofloxacin and flagyl empirically ([**Date range (1) 17717**]); all antibiotics discontinued since then. Her distension likely reflects ileus versus constipation. She tolerated a regular diet on discharge. . # Transaminitis: AST/ALT 400s on admission, continued to trend down. Suspect component of ischemic hepatopathy with junctional rhythm and hypotension. But also with question of fatty liver on CT scan. If her LFTs continue to be elevated, further w/u with [**Name (NI) 5283**] son[**Name (NI) **] as an outpt is recommended. . # Question of SMA thrombosis: Question of SMA thrombosis on CTA scan on admission. Clinical picture did not seem c/w acute mesenteric artery thrombosis. She remained abdominal pain free and without changes in her bowel habits. She was continued on her outpt regimen of ASA, plavix, statin for her history of PVD. Medications on Admission: Amitriptyline 20 mg qhs Atenolol 25 m daily Atorvastatin 10 mg daily Plavix 75 mg daily Diltizaem 120 mg q12 hour Gabapentin 300 mg [**Hospital1 **] Glucophage 1000 mg [**Hospital1 **] Vicodin 5-500 mg tab q 6-8 hrs prn Ibuprofen 600 mg q6 hours prn Insulin SS Lantus 68 units sc daily Lyrica 50 mg TID Protonix 40 mg qod Valsartan 160 mg daily ASA 325 mg daily Discharge Medications: 1. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO once a day. 2. Plavix 75 mg Tablet Sig: One (1) Tablet PO once a day. 3. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 5. Insulin Glargine Subcutaneous 6. Gabapentin 300 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 7. Pregabalin 25 mg Capsule Sig: Two (2) Capsule PO tid (). 8. Glucophage 1,000 mg Tablet Sig: One (1) Tablet PO twice a day. 9. Senna 8.6 mg Tablet Sig: One (1) Tablet PO bid prn as needed. Disp:*30 Tablet(s)* Refills:*0* 10. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed. Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 11. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 12. Amlodipine 5 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Disp:*60 Tablet(s)* Refills:*2* 13. Atenolol 25 mg Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Home With Service Facility: [**Hospital 17718**] Health Care Discharge Diagnosis: Primary Acute renal failure Hyperkalemia Ileus Transaminitis Bradycardia, junctional rhythm Secondary Anemia Hypertension Type II Diabetes mellitus Peripheral vascular disease Hyperlipidemia Vertigo Discharge Condition: good, tolerating POs, saturating on room air Discharge Instructions: You were admitted with kidney failure. You were found to have elevated levels of potassium. You were treated with hydration and your kidney function normalized. You also had a low heart rate from an elevated potassium. All of these issues normalized once your kidney function improved. It is very important that you discontinue your pain medications including ibuprofen, tylenol and other pain medications such as vicodin with opioid properties (such as oxycodone, percocet, etc). Your amitriptyline was also discontinued. Your lorsartan was discontinued because of your recent contrast administration with CT scan. This should be restarted by Dr. [**Last Name (STitle) **] as an outpt. Your diltiazem was also discontinued. You were started on a medication called norvasc. Please take all of your other medications as directed. Please return to the emergency room or see your PCP if you have any of the following symptoms: Chest pain, difficulty breathing, palpitations, loss of consciousness or any other serious concerns. Followup Instructions: We have scheduled the following appointment for you with Dr. [**Last Name (STitle) **]: Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 7978**], MD Phone:[**Telephone/Fax (1) 7976**] Date/Time:[**2105-4-3**] 12:45 It is important that you have the following labs drawn at your appointment with Dr. [**Last Name (STitle) **]: Chem 7 and LFTs. You are being given a requisition to have these labs drawn. You should also schedule an appointment with pulmonary clinic in the next 1-2 months. They can be reached at ([**Telephone/Fax (1) 513**]. Completed by:[**2105-4-9**] ICD9 Codes: 5849, 5070, 2762, 2760, 2767, 4019, 2724, 4439
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8334 }
Medical Text: Admission Date: [**2195-3-5**] Discharge Date: [**2195-3-13**] Date of Birth: [**2124-2-1**] Sex: F Service: MEDICINE Allergies: Tetracycline Analogues / Zinc / Optiray 350 Attending:[**First Name3 (LF) 30**] Chief Complaint: Respiratory distress Major Surgical or Invasive Procedure: Intubation History of Present Illness: 70F w/ esophageal dysmotility, parkinson's, chronic aspiration PNA w/ J-tube in place, p/w respiratory distress. Per caretaker, her respiratory distress began this morning when she found the patient to be lethargic and with a 02sat of 56%. The [**Last Name (un) 105578**] notes that, for the last 2 days, the patient was complaning of a sore throat, productive cough and denied any fever or chills,hemoptosis, no diarrhea or vomitting. The caretaker notes that the patient admitted to swallowing a mint this morning. [**Last Name (un) 4273**] any recent sick contact or change in weight. Caretaker [**Last Name (un) **] patient had any chest pain and was oriented to self during the episode. She reports the patient last apiration pneumonia in [**2193**]. The patient was brought to the emergency departement with EMS. . In the ED VS were: T:99.2 HR:103 BP:151/62 RR:22 O2 sat26%. Labs were notable for: Blood gas:7.32/52/430/28 BaseXS=0, Lacate 2.1, and troponinT: <0.01. CXR showed a LLL opacity, which may represent atelectasis, though superimposed infection cannot be excluded. Pulmonary vasculature is mildly prominent. She received cefepime and levofloxacin. She was found to be in respiratory distress with thick secretions and was intubated and transfered to the MICU. Past Medical History: 1. Castleman's disease: unicentric. Found incidentally on splenectomy done for "splenic pain" around [**2176**]. Has had lymph nodes sampled in past to r/o lymphoma but all have shown reactive lymph tissue only. Followed by Dr. [**Last Name (STitle) 410**]. (Heme/Onc) 2. anaplastic thyroid cancer s/p radical neck dissection, at age 15 3. Esophageal webs and esophageal dysmotility. Has had numerous esophageal dilatations. 4. Recurrent aspiration pneumonias sputum Cx growing Pseudomonas, MRSA 5. Chronic pulmonary disease 6. MRSA osteomyelitis of olecranan s/p multiple debridements 7. Hx Bipolar d/o 8. GERD 9. Osteoporosis: has broken both hips, left in [**11-7**], right with failed ORIF and redo at [**Hospital1 2025**] 10. Hx zoster 11. Hx depression, chronic pain 12. HTN 13. Parkinson's disease Social History: Retired social worker. [**Name (NI) 6934**] with walker and assistance at baseline. No Etoh, [**Name (NI) **], drugs. Lives at home w/ 24 hour health aid. POA = [**Name (NI) **] [**Name (NI) 105568**] (a lawyer). Family History: 1. Father: HTN, DM, depression, died MI, age 59. 2. Mother: HTN, hypercholesterolemia, died MI, age 82. 3. Sister: HTN Physical Exam: ADMISSION EXAM: VS: T: HR:63 BP:95/41 O2 sat92% GEN: intubated, sedated. responsive to voice HEENT: Neck supple, no LAD, JVD below clavicle. CV:RRR distant heart sound. No murmur rubs or gallops LUNGS: coarse breath sounds troughout. ABD:soft, tender to palpation. no rebound, no [**Last Name (un) **]. Jtube site surrounded by erythematous base,not warm to touch,without exudates or ulcers of fistula. EXT: warm and Well perfused,no edema or cyanosis . DISCHARGE EXAM: General: Awake and alert HEENT: Sclera anicteric, dry MM, 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 Ext: Warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Skin: erythma and excoriations surrounding j-tube dressing. patient with new j-tube Pertinent Results: ADMISSION LABS: [**2195-3-5**] 11:00AM BLOOD WBC-19.7*# RBC-3.59* Hgb-10.8* Hct-33.0* MCV-92 MCH-30.1 MCHC-32.7 RDW-15.0 Plt Ct-432 [**2195-3-5**] 11:00AM BLOOD Neuts-68 Bands-1 Lymphs-27 Monos-1* Eos-2 Baso-0 Atyps-1* Metas-0 Myelos-0 [**2195-3-5**] 11:00AM BLOOD Glucose-148* UreaN-24* Creat-1.3* Na-137 K-5.2* Cl-100 HCO3-29 AnGap-13 [**2195-3-5**] 11:00AM BLOOD ALT-4 AST-17 AlkPhos-83 TotBili-0.3 [**2195-3-5**] 11:00AM BLOOD Lipase-21 [**2195-3-5**] 11:00AM BLOOD PT-12.9 PTT-21.4* INR(PT)-1.1 [**2195-3-5**] 11:00AM BLOOD Albumin-3.2* [**2195-3-5**] 11:05AM BLOOD Lactate-1.5 . DISCHARGE LABS: [**2195-3-13**] 05:45AM BLOOD WBC-11.4* RBC-3.56* Hgb-10.5* Hct-31.3* MCV-88 MCH-29.6 MCHC-33.6 RDW-16.1* Plt Ct-380 [**2195-3-8**] 04:28AM BLOOD Neuts-65 Bands-2 Lymphs-16* Monos-9 Eos-7* Baso-1 Atyps-0 Metas-0 Myelos-0 [**2195-3-12**] 06:42AM BLOOD Glucose-84 UreaN-13 Creat-0.7 Na-140 K-4.5 Cl-102 HCO3-32 AnGap-11 . MICROBIOLOGY: [**2195-3-5**] Blood Cx: pending [**2195-3-5**] Sputum Cx: STAPH AUREUS COAG + | CLINDAMYCIN----------- =>8 R ERYTHROMYCIN---------- =>8 R GENTAMICIN------------ <=0.5 S LEVOFLOXACIN---------- =>8 R OXACILLIN------------- =>4 R RIFAMPIN-------------- <=0.5 S TETRACYCLINE---------- <=1 S TRIMETHOPRIM/SULFA---- <=0.5 S VANCOMYCIN------------ 1 S . Blood Culture, Routine (Final [**2195-3-11**]): NO GROWTH . IMAGING: Several CXR please refer to OMR for full list. Admission [**2195-3-5**] CXR: 1. New left lower lobe opacity, concerning for pneumonia. 2. Small left pleural effusion. . Following extubation CXR [**2195-3-10**]: In comparison with the study of [**3-9**], the endotracheal tube and nasogastric tube have been removed. Little overall change in the diffuse bilateral pulmonary opacifications, consistent with elevation of pulmonary venous pressure with bilateral pleural effusions and compressive atelectasis. The possibility of supervening pneumonia at the bases cannot be excluded on this image in the appropriate clinical setting. Brief Hospital Course: 71 F w/ esophageal dysmotility, parkinson's, chronic aspiration PNA w/ J-tube in place, p/w respiratory distress c/w aspiration PNA. . While in the MICU, the patient was treated for: # RESPIRATORY DISTRESS: likely [**2-4**] aspiration event. Patient has a history of aspiration PNA, her CXR shows new LLL opacity, elevated WBC 19. The patient most likely diagnosis is an aspiration pneumonitis which could progress to an aspiration pneumonia. Patient had a history of PNA with pseudomonas, MRSA and ESBL and was covered with Vancomycin([**3-5**]-) and Cefepime. Patient also had an history of UTI with ESBL and cefepime replaced by Meropenem ([**3-7**]-). The patient remained afebrile while on drug regimen and WBC trended down from 21.4 to 9.47. Patent passed SBT and RSBI and was extubated on [**3-9**] and is stable on nasal canula. During her stay, she developed bilateral pleural effusion which do not require diuresis at this point. . #J-be leak. Patient with a fistula lateral to her Jtube and has declined surgical intervention. Currently on tube feeds. . # Anemia: Hct is 33.0 from a baseline of 38 in [**2194**]. Hemodynamically stable. There was no sign of active bleed . # Renal failure: Creatinine increased to 1.3 from a baseline of 1.0 after first dose of vancomycin and stabelize down to 0.9. . Course on the medical floor: # Aspiration pneumonia: Sputum culture grew MRSA. Patient was treated with Vancomycin and Meropenum for total 8 day course. She was afebrile throughout her stay. Patient is a very high aspiration risk. She was instructed not to take anything by mouth. This was also explained to her health aide. She was instructed that taking anything by mouth she would aspirate which could result in death. She was discharged on home O2 NC for O2 sat > 90% (she already has O2 at home). . # J-tube: There was a leak in her j-tube consequently this was changed by IR. Patient has a fistula lateral to her J-tube and has declined surgical intervention. Wound care saw her during her stay and recommendations where made on discharge. Medications on Admission: ALBUTEROL SULFATE - Entered by MA/[**Name2 (NI) **] Staff - 2.5 mg/3 mL (0.083 %) Solution for Nebulization - 1 ampule(s) via nebulizer three to four times a day as needed for shortness of breath or wheezing ATROPINE - 1 % Drops - 2 drops(s) under tongue every 4 hours as needed for prn for sucretions being administered by VNA CARBIDOPA-LEVODOPA [SINEMET] - 25 mg-100 mg Tablet - 1 Tablet(s) by mouth q4hours while awake Please give at 8 am, noon, 4 pm, and 8 pm daily ESCITALOPRAM [LEXAPRO] - (Prescribed by Other Provider) - 20 mg Tablet - 1 Tablet(s) by mouth once a day ESOMEPRAZOLE MAGNESIUM [NEXIUM PACKET] - 40 mg Susp,Delayed Release for Recon - 1 packet by mouth once a day use as directed FENTANYL [DURAGESIC] - 100 mcg/hour Patch 72 hr - apply one patch every 72 hours FENTANYL [DURAGESIC] - 25 mcg/hour Patch 72 hr - 1 q 72 horly GABAPENTIN - 300 mg Capsule - 1 Capsule(s) by mouth at bedtime HYDROMORPHONE [DILAUDID] - 2 mg Tablet - 1 Tablet(s) by mouth four times a day as needed for for pain IRON POLYSACCH COMPLEX-B12-FA [FERREX 150 FORTE] - 150 mg-25 mcg-1 mg Capsule - 1 Capsule(s) by mouth once a day LAMOTRIGINE [LAMICTAL] - (Prescribed by Other Provider) - 200 mg Tablet - 1 Tablet(s) by mouth daily LEVOTHYROXINE - 75 mcg Tablet - 1 Tablet(s) by mouth daily LORAZEPAM - (Prescribed by Other Provider) - 1 mg Tablet - 1 Tablet(s) by mouth 1 tablet in a.m. and 2 tablets at H.S ONDANSETRON HCL - 4 mg Tablet - 1 Tablet(s) by mouth three times a day as needed for FOR NAUSEA PRIMIDONE - 50 mg Tablet - 0.5 (One half) Tablet(s) by mouth daily PROMETHAZINE - (Prescribed by Other Provider) - 25 mg Suppository - 1 (One) Suppository(s) rectally three times a day QUETIAPINE [SEROQUEL] - 200 mg Tablet - 1 Tablet(s) by mouth at bedtime SODIUM POLYSTYRENE SULFONATE - Powder - 15 grams by mouth every other day CALCIUM CARBONATE - 200 mg (500 mg) Tablet, Chewable - 1 (One) Tablet(s) by mouth twice a day ERGOCALCIFEROL (VITAMIN D2) [VITAMIN D] - (OTC) - 400 unit Capsule - 1 Capsule(s) by mouth twice a day FERROUS SULFATE [IRON (FERROUS SULFATE)] - (OTC) - 325 mg (65 mg) Tablet - 1 Tablet(s) by mouth once a day NUTRITIONAL SUPPLEMENT - FIBER [FIBERSOURCE] - (Prescribed by Other Provider) - Liquid - 1200 calories via tube daily Discharge Medications: 1. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization [**Name2 (NI) **]: One (1) Inhalation Q6H (every 6 hours) as needed for SOB. 2. carbidopa-levodopa 25-100 mg Tablet [**Name2 (NI) **]: One (1) Tablet PO QID (4 times a day). 3. escitalopram 10 mg Tablet [**Name2 (NI) **]: Two (2) Tablet PO DAILY (Daily). 4. fentanyl 100 mcg/hr Patch 72 hr [**Name2 (NI) **]: One [**Age over 90 **]y Five (125) mcg Transdermal Q72H (every 72 hours). 5. gabapentin 250 mg/5 mL Solution [**Age over 90 **]: Three Hundred (300) mg PO HS (at bedtime). 6. lamotrigine 100 mg Tablet [**Age over 90 **]: Two (2) Tablet PO DAILY (Daily). 7. primidone 50 mg Tablet [**Age over 90 **]: 0.5 Tablet PO DAILY (Daily). 8. Seroquel 200 mg Tablet [**Age over 90 **]: One (1) Tablet PO at bedtime. 9. hydromorphone 2 mg Tablet [**Age over 90 **]: One (1) Tablet PO Q6H (every 6 hours) as needed for pain. 10. levothyroxine 75 mcg Tablet [**Age over 90 **]: One (1) Tablet PO DAILY (Daily). 11. lorazepam 1 mg Tablet [**Age over 90 **]: One (1) Tablet PO DAILY (Daily). 12. lorazepam 1 mg Tablet [**Age over 90 **]: Two (2) Tablet PO HS (at bedtime). 13. ondansetron 4 mg Tablet, Rapid Dissolve [**Age over 90 **]: One (1) Tablet, Rapid Dissolve PO Q8H (every 8 hours) as needed for nausea. 14. promethazine 25 mg Suppository [**Age over 90 **]: One (1) Suppository Rectal Q8H (every 8 hours). 15. cholecalciferol (vitamin D3) 400 unit Tablet [**Age over 90 **]: One (1) Tablet PO BID (2 times a day). 16. ferrous sulfate 300 mg (60 mg Iron) Tablet [**Age over 90 **]: One (1) Tablet PO DAILY (Daily). 17. iron-vitamin B complex Oral 18. sodium polystyrene sulfonate 15 g/60 mL Suspension [**Age over 90 **]: One (1) PO every other day. 19. calcium carbonate Oral 20. esomeprazole magnesium 40 mg Susp,Delayed Release for Recon [**Age over 90 **]: One (1) PO once a day. 21. atropine 1 % Drops [**Age over 90 **]: Two (2) drops Ophthalmic every four (4) hours as needed for secretions. 22. nystatin 100,000 unit/g Cream [**Age over 90 **]: One (1) Appl Topical [**Hospital1 **] (2 times a day). 23. Fibersource Tube Feeds Advance tube feeds to cycle @ 80/hr x 18hrs overnight. If she tolerates increase to 120/hr x 12 hrs. Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: Aspiration pneumonia Aspiration Dementia Discharge Condition: Mental Status: Confused - always. Level of Consciousness: Lethargic but arousable. Activity Status: Bedbound. Discharge Instructions: You developed a pneumonia after aspirating a mint. Due to severe difficulty breathing you required a breathing tube (called intubation) and was in the ICU for several days. Once your pneumonia improved your breathing tube was removed. You were treated with strong antibiotics for 8 days total. . DO NOT TAKE ANYTHING BY MOUTH. YOU WILL ASPIRATE AGAIN WHICH COULD RESULT IN DEATH. . When you were here your feeding tube was changed by [**Hospital **]. . Follow your medication list as printed. Followup Instructions: Department: [**State **]When: THURSDAY [**2195-3-19**] at 12:00 PM With: [**First Name8 (NamePattern2) 8741**] [**Name8 (MD) **], MD [**Telephone/Fax (1) 2205**] Building: [**State **] ([**Location (un) **], MA) [**Location (un) **] Campus: OFF CAMPUS Best Parking: On Street Parking . Department: NEUROLOGY When: WEDNESDAY [**2195-5-6**] at 3:00 PM With: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 43**], M.D. [**Telephone/Fax (1) 541**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 858**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Completed by:[**2195-3-16**] ICD9 Codes: 5070, 5119, 5849, 4019, 2449, 311
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Medical Text: Admission Date: [**2163-1-3**] Discharge Date: [**2163-2-2**] Date of Birth: [**2089-6-9**] Sex: F Service: SURGERY Allergies: Sulfa (Sulfonamides) / Rocephin Attending:[**First Name3 (LF) 1556**] Chief Complaint: Abdominal pain Major Surgical or Invasive Procedure: [**2163-1-24**]: Percutaneous (bronchoscopic guided) tracheostomy tube placement. [**2163-1-12**]: Pleural fluid tap bilaterally [**2163-1-3**]: Exploratory laparotomy, Resection of sigmoid colon. End colostomy, mobilization of splenic flexure, gastrostomy tube. History of Present Illness: Ms. [**Known lastname **] is a 73-year-old woman, who 10 days ago underwent a resection of a sigmoid polyp at an outside institution. She subsequently developed an abdominal wall dehiscence necessitating return to the OR with repair of the fascia and placement of retention sutures. Today she presented with feculent drainage from her wound, leukocytosis, and gross peritonitis. Surgical intervention was required. Past Medical History: H/o pneumonia, Polymyalgia rheumatica, HTN Surgical Hx: TAH (benign disease) Social History: Lives with husband, former school teacher. Has 2 grown children and 2 granddaughters. Denies tobacco, EtOH. Family History: NC Physical Exam: HR 110, RR 34 Alert female in moderate discomfort Non-icteric sclera, flushed face Coarse breath sounds bilaterally Sinus tachycardia Abdomen diffusely tender, +rebound and guarding, feculant material arising from lower aspect of wound Pertinent Results: [**2163-1-3**] 06:00PM BLOOD WBC-23.7* RBC-4.13* Hgb-11.4* Hct-33.9* MCV-82 MCH-27.7 MCHC-33.7 RDW-15.4 Plt Ct-362 [**2163-1-8**] 03:29AM BLOOD Neuts-88* Bands-6* Lymphs-2* Monos-1* Eos-0 Baso-0 Atyps-0 Metas-2* Myelos-1* [**2163-1-3**] 06:00PM BLOOD PT-14.5* PTT-31.3 INR(PT)-1.3* [**2163-1-3**] 06:00PM BLOOD Glucose-57* UreaN-41* Creat-0.9 Na-135 K-5.1 Cl-100 HCO3-26 AnGap-14 Radiology [**1-28**]: CXR/KUB-improving edema, minimal atelectasis, small effusions, NJ in position [**1-24**]: CT [**Last Name (un) 103**]: [**Month (only) **]. perihepatic, LLQ collections. Mod. bilat. effusions [**1-24**]: CXR mildly improved opacities [**1-21**] : CXR worsening multifocal opacities [**1-20**]: CXR with no significant change [**1-20**]: KUB no bowel dilation or evidence of obstruction [**1-19**]: Echo: EF 75%, no Wall motion abnormalities, hyperdynamic, tricuspid regurgitation 1+ [**1-18**]: CT abdomen: Drainage of 5cc of serous fluid from LLQ. Dilated loops of bowel, [**1-18**]: CXR bilateral multifocal alveolar opacities c/w ARDS & Denser bibaslar consilidation, potentially pneuomia or aspiration. [**1-12**]: CT head: no acute process PATHOLOGY [**2163-1-3**] Colon, segmental resection: Acute perforation with acute serositis and reaction to fecal material. Organizing peritonitis with fibrous peritoneal adhesions and submucosal suture reaction. There is no intrinsic colitis or neoplasm. Brief Hospital Course: Ms [**Known lastname **] was taken directly to the OR on [**2163-1-3**] for fecal peritonitis. She underwent sigmoid colectomy with end colostomy and g tube placement, see op report for details. She tolerated the procedure well. She recovered in the PACU, was extubated and transferred to TSICU for further recovery. She remained on Ampicillin/Cipro/Flagyl, steroid taper with foley catheter, NPO, wound care and TPN. ID was consulted for assistance with anitbiotic regimen. In TSICU she was afebrile, with leukocytosis but continued to improve clinically with PT/OT. She had bowel sounds and was weaned to nasal cannula oxygen. . POD#4 she was transferred to a telemetry post-surgical unit. She was noted to have some mental status changes and narcotic regimen was adjusted. . Cardiovascular: POD#5 she developed hypertension and was aggressively beta blocked. CXR and CT imaging was obtained every few days for follow up. POD#6 imaging revealed bilateral pleural effusions. Respiratory: She was noted to have worsening breath sounds POD#[**2-25**], and inability to wean from NC oxygen. POD#9 she underwent right thoracentesis in IR with good result. Post procedure she developed decreased level of consciousness and decreased respiratory rate. She was transferred to TSICU for closer monitoring. She received PRBCs, cardiac enzymes were cycled and IV lasix. CE's remained negative. POD#10 LLQ thoracentesis done with good result. Gastrointestinal: Trophic TFs were initiated on POD#8 and were advanced daily to goal on POD#11. POD#12 she failed her swallow exam, she remained NPO. GU: Urine culture positive for MRSA on POD#9. . Leukocytosis/Peritonitis: Leukocytosis persisted and was monitored closely. She was changed to Vanc/Cipro/Flagyl IV. Blood cultures, & urine cultures were followed which remained negative. Her Central line was removed and replaced, culture tip was negative. Foley catheter was changed. POD#7, white count was 46. Fluconazole was added for yeast in her urine. POD# 10 Meropenem was added. Leukocytosis improved POD#[**8-4**]. . She remained in the TSICU until POD#13, when she was transferred again to [**Hospital Ward Name 121**] 9 after being weaned to room air. POD#14 she developed a low grade fever, with worsening abdominal pain. POD#15 she developed worsening breath sounds and required frequent yankaur suctioning. Chest x ray revealed recurrent pleural effusions. She was taken to CT for follow up of abdominal fluid collections with oral contrast placed in the G tube. She had an aspiration event of tubefeeding and oral contrast upon returning to the floor. A chest xray was obtained immediately which appeared similar to the one earlier in the day. Her respiratory status deteriorated throughout the afternoon, requiring O2 on 4L for spo2 94%. She was transported to IR for evacuation of an abdominal fluid collection. A pigtail drain was left in place. Upon return from the procedure she developed respiratory distress. She was transferred to the TSICU and was intubated. Subsequent CXR revealed infiltrates diffusely throughout lung fields, consistent with ARDS. CV: Required pressors for support POD#16. Weaned POD#17. Remains on high dose beta blockers for tachycardia. Respiratory: Remains ventilator dependent. Was unable to wean off Assist control. Due to inability to wean, tracheostomy was placed POD#22. She has tolerated trials of CPAP. CXRs improved. Currently no opacities. Vent settings: CPAP + PS Fi02:40 Vt 380, Rate 23, Peep 5, PS 8. GI: Her TFs were adjusted several times due to high residuals. POD#22-23 she developed vomiting. [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 1372**]-Jejunal tube was placed for feeding. She has tolerated NJ feedings with no nausea or vomiting. G tube has been to gravity since NJ placed. Ostomy has produced soft brown stool and measurable loose green stools throughout admission. C diff remains negative. Abdomen: Her abdomen has remained intact, soft and nontender. She was closed with retention sutures and has required [**Hospital1 **] abdominal wet to dry dressing changes. No positive cultures in abdominal wound. GU: Foley catheter remains intact. She remains on precautions for MRSA and VRE in her urine. Nutrition: She was supplemented with TPN for her entire admission, she was weaned from TPN on POD# 24. Remains on TFs per NJ tube, tolerating well. Peritionitis: remains on broad spectrum antibiotics for peritonitis and pulmonary coverage. Leukocytosis improved, now 15. Infectious disease consultation recommended a course of antibiotics (vanco, meropenem, fluconazole) to continue for 2 weeks post-drain removal ([**2162-1-25**]). She was discharged to rehab with a 6day course remaining. Medications on Admission: prednisone 2, Evista 60, lisinopril 10, omeprazole 20, advair 250/50, folate, ASA 81 Discharge Medications: 1. Miconazole Nitrate 2 % Powder Sig: One (1) Appl Topical TID (3 times a day) as needed. 2. Ipratropium Bromide 17 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation QID (4 times a day). 3. Albuterol 90 mcg/Actuation Aerosol Sig: One (1) Puff Inhalation Q6H (every 6 hours) as needed for wheezing. 4. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) mL Injection TID (3 times a day). 5. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 6. Prednisone 1 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 7. Clonidine 0.1 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 8. Clonidine 0.1 mg Tablet Sig: One (1) Tablet PO QPM (once a day (in the evening)). 9. Famotidine 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 10. Oxycodone-Acetaminophen 5-325 mg/5 mL Solution Sig: 5-10 MLs PO Q4-6H (every 4 to 6 hours) as needed. 11. Metoprolol Tartrate 50 mg Tablet Sig: 1.5 Tablets PO TID (3 times a day). 12. Zolpidem 5 mg Tablet Sig: 1-2 Tablets PO HS (at bedtime). 13. Docusate Sodium 50 mg/5 mL Liquid Sig: Ten (10) mL PO BID (2 times a day) as needed. 14. Heparin Lock Flush (Porcine) 100 unit/mL Syringe Sig: Two (2) ML Intravenous DAILY (Daily) as needed. 15. Meropenem 500 mg Recon Soln Sig: Five Hundred (500) mg Intravenous Q6H (every 6 hours) for 6 days. 16. Fluconazole in Saline(Iso-osm) 400 mg/200 mL Piggyback Sig: One (1) dose Intravenous Q24H (every 24 hours) for 6 days. 17. Erythromycin Lactobionate 500 mg Recon Soln Sig: Two Hundred Fifty (250) Recon Soln Intravenous [**Hospital1 **] (2 times a day). 18. Vancomycin in Dextrose 1 g/200 mL Piggyback Sig: One (1) gram Intravenous once a day for 6 days. 19. Insulin Per sliding scale. Administer as directed. 20. Aspirin 81 mg Tablet Sig: One (1) Tablet PO once a day. 21. Evista 60 mg Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Extended Care Facility: [**Hospital3 7**] & Rehab Center - [**Hospital1 8**] Discharge Diagnosis: 1. Large bowel perforation/prior polypectomy wound breakdown s/p repair with colectomy 2. resolving peritonitis/sepsis 3. ARDS and subsequent respiratory failure 4. Pleural effusions Discharge Condition: stable. Discharge Instructions: Please call your surgeon or return to the emergency department if you develop chest pain, shortness of breath, fever greater than 101.5, foul smelling or colorful drainage from your incisions, redness or swelling, severe abdominal pain or distention, persistent nausea or vomiting, inability to eat or drink, or any other symptoms which are concerning to you. No tub baths or swimming. You may shower. A mild amount of clear/reddish drainage from your incisions is normal. You should report any dark, thick, or purulent drainage. The wound will continue to need damp dressings changed twice daily. Activity: No heavy lifting of items [**9-5**] pounds until the follow up appointment with your doctor. Medications: Continue medications on your discharge instructions. Followup Instructions: You have an appointment to see Dr. [**Last Name (STitle) **] in the [**Hospital Ward Name 23**] Clinical Center [**Location (un) 470**] surgical services on [**2-18**] 1:15. Please make arrangements for her to be transported by ambulance if necessary for this appointment. Completed by:[**2163-2-2**] ICD9 Codes: 5990, 5119, 5070, 4019
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Medical Text: Admission Date: [**2176-7-1**] Discharge Date: [**2176-7-7**] Date of Birth: [**2115-8-12**] Sex: M Service: [**Last Name (un) **] PREOPERATIVE DIAGNOSIS: End-stage liver disease secondary to alcoholic cirrhosis. PAST MEDICAL HISTORY: 1. History of encephalopathy. 2. Grade I varices. 3. History of gout. 4. History of depression. 5. Status post exploratory laparotomy and left-sided colectomy for perforated diverticulitis in [**Month (only) 956**] of [**2175**]. PRINCIPAL PROCEDURE: Orthotopic liver transplant on [**2176-7-1**]. HOSPITAL COURSE: Mr. [**Known lastname **] is a 60-year-old gentleman with a history of end-stage liver disease secondary to alcoholic cirrhosis. He was admitted to the transplant surgery service on [**2176-7-1**] for a workup for an orthotopic liver transplant. On [**2176-7-1**] he received an orthotopic liver transplant, and postoperatively was admitted to the surgical intensive care unit. He did quite well in the surgical intensive care unit. LFTs were trending downward. He received a liver transplant ultrasound which showed good flow within his hepatic veins, portal vein, as well as his hepatic artery. On postoperative days #1 and #2, he was weaned off the ventilator towards extubation. He was extubated without complication. On postoperative day #2, Mr. [**Known lastname **] was doing well in the ICU and was transferred to floor status. He continued to do well. His diet was advanced to a regular diet, which he tolerated without difficulty. He was seen and evaluated by physical and occupational therapy and worked well with them. Additionally, he was seen and evaluated by ostomy care nurses for assistance with management of his colostomy status post transplant surgery. On postoperative day #6 - on [**2176-7-7**] - Mr. [**Known lastname **] was ambulating well on his own, he was tolerating a regular diet, had appropriate output from his ostomy, and was ready for discharge home; per the transplant surgery service and per physical and occupational therapy. DISCHARGE STATUS: Mr. [**Known lastname **] was discharged home from [**Hospital1 **] Hospital on [**2176-7-7**]. DISCHARGE INSTRUCTIONS: 1. He was instructed to follow up with the Transplant Surgery Clinic on this coming Thursday; or to call or follow up sooner if he has any concerns or questions. 2. He was instructed on appropriate care for his ostomy, and will be seen and evaluated by our visiting nurse assistance for management of this. He has taken care of this before, but will need some assistance status post transplant. DISCHARGE MEDICATIONS: 1. Colace 100 mg p.o. b.i.d.. 2. Famotidine 20 mg p.o. b.i.d.. 3. Clozaril 400 mg p.o. daily. 4. Mycophenolate 1 gram p.o. b.i.d.. 5. Oxycodone 1 to 2 tablets p.o. q.4-6h. p.r.n. pain. 6. Prednisone 20 mg p.o. daily. 7. Senna 1 tablet p.o. p.r.n.. 8. Tacrolimus ______ mg p.o. b.i.d.; he is to follow up for level checks - this was arranged with the transplant coordinator. 9. Valcyte 900 mg p.o. daily. 10. Bactrim 1 tablet p.o. daily. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 816**], M.D. [**MD Number(2) 6727**] Dictated By:[**Name8 (MD) 57264**] MEDQUIST36 D: [**2176-7-7**] 16:23:48 T: [**2176-7-7**] 17:21:25 Job#: [**Job Number 63239**] ICD9 Codes: 2749, 4019, 311
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Medical Text: Admission Date: [**2117-12-6**] Discharge Date: [**2117-12-24**] Date of Birth: [**2067-4-25**] Sex: M Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1556**] Chief Complaint: s/p Pedestrian Struck by Auto Major Surgical or Invasive Procedure: s/p ORIF-IM nail Left Tib/Fib Fracture [**12-6**] s/p Closed Reduction and ORIF Bilateral Mandible Fracture History of Present Illness: 50 yo male pedestrian struck by auto at high speed; +ETOH. Patient found down by EMS and was transferred to [**Hospital1 18**] for trauma care. Past Medical History: PTSD Social History: Married; employed in construction field Family History: Noncontributory Physical Exam: Admission VS: BP135/palp HR 104 T 98 po Gen: Combative HEENT: Hematoma forehead; unstable mandible; blood in airway Neck; c-collar Chest: Equal BS Cor: RRR Abd: soft NT/ND Extr: MAE except LLE; abrasions LUE/LLE; deformity LLE Pertinent Results: [**2117-12-6**] 11:37PM TYPE-ART PO2-376* PCO2-38 PH-7.39 TOTAL CO2-24 BASE XS--1 [**2117-12-6**] 11:37PM LACTATE-3.4* [**2117-12-6**] 11:21PM GLUCOSE-102 UREA N-9 CREAT-0.9 SODIUM-144 POTASSIUM-3.2* CHLORIDE-112* TOTAL CO2-22 ANION GAP-13 [**2117-12-6**] 11:21PM CALCIUM-6.8* PHOSPHATE-2.8 MAGNESIUM-1.2* [**2117-12-6**] 09:16PM HGB-11.3* calcHCT-34 [**2117-12-6**] 08:08PM LACTATE-2.0 [**2117-12-6**] 07:53PM CK(CPK)-937* [**2117-12-6**] 07:53PM PLT COUNT-163 [**2117-12-6**] 07:53PM PT-12.0 PTT-28.2 INR(PT)-1.0 [**2117-12-6**] 05:55PM URINE bnzodzpn-NEG barbitrt-NEG opiates-NEG cocaine-NEG amphetmn-NEG mthdone-NEG [**2117-12-6**] 04:45PM ASA-NEG ETHANOL-309* ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG TIB/FIB (AP & LAT) LEFT [**2117-12-6**] 5:28 PM TIB/FIB (AP & LAT) LEFT; KNEE (AP, LAT & OBLIQUE) LEFT Reason: eval for fracture [**Hospital 93**] MEDICAL CONDITION: 50 year old man with open tib fib REASON FOR THIS EXAMINATION: eval for fracture INDICATION: 50-year-old in motor vehicle accident with open tibial-fibular fracture. Two views of the left knee, one view of the left tibia and fibula, and two views of the left ankle. FINDINGS: There is a transverse fracture through the mid tibial diaphysis with medial displacement of the distal fracture fragment. A curvilinear lucency is also seen in the more proximal tibial diaphysis, also likely representing a fracture line. Two oblique fractures are seen fibular diaphysis. The first is within the proximal third, and the second in the mid fibula. The free fragment between these two fracture lines is medially displaced relative to the proximal fibular diaphysis, and the distal fibular fracture fragment is slightly medially angulated. Views of the right knee demonstrate no fracture or dislocation within the knee joint. No knee effusion is present. Views of the ankle demonstrate a normal- appearing mortise with no ankle fracture or dislocation. Gauze is seen overlying the soft tissues around the tibial fracture. IMPRESSION: Multiple fractures of the tibia and fibula as described above. TIB/FIB (AP & LAT) IN O.R. LEFT IN O.R. [**2117-12-6**] 10:08 PM TIB/FIB (AP & LAT) IN O.R. LEF; -77 BY DIFFERENT PHYSICIAN Reason: ORIF LT TIBIA FX HISTORY: 50-year-old male with ORIF of left tibia fracture. FINDINGS: 13 intraoperative fluoroscopic spot images were obtained without a radiologist present and compared with [**2117-12-6**]. There has been interval placement of an intramedullary rod within the tibia with proximal and distal cortical screws fixating the transverse fracture of the mid-diaphysis. There has been reduction of the medial displacement of the distal fracture fragment and there is now near anatomic alignment. Also noted is the oblique fracture line of the more proximal tibial diaphysis. Two oblique fractures are again seen through the fibular diaphysis. The ankle mortise is congruent. IMPRESSION: Status post ORIF of tibia fracture as described. CT SINUS/MANDIBLE/MAXILLOFACIAL W/O CONTRAST [**2117-12-6**] 4:59 PM CT SINUS/MANDIBLE/MAXILLOFACIA; CT RECONSTRUCTION Reason: eval for fx [**Hospital 93**] MEDICAL CONDITION: 50 year old man with ped struck, combative. unstable mandible REASON FOR THIS EXAMINATION: eval for fx CONTRAINDICATIONS for IV CONTRAST: None. INDICATION: Status post struck by car. TECHNIQUE: Axial non-contrast images through the facial bones were obtained. Coronal and sagittal reformatted images were obtained. CT FACIAL BONES: Slightly to the left of midline is a minimally displaced fracture through the anterior mandible. Slightly to the right of midline is a mildly comminuted fracture through the right anterior mandible. Small foci of air are seen about the fracture fragments. Associated malocclusion of the teeth is identified. No other fractures are identified. The surrounding soft tissue structures are unremarkable. IMPRESSION: Mandibular fractures as described above. CT HEAD W/O CONTRAST [**2117-12-6**] 4:58 PM CT HEAD W/O CONTRAST Reason: eval for ich [**Hospital 93**] MEDICAL CONDITION: 50 year old man with ped struck, combative REASON FOR THIS EXAMINATION: eval for ich CONTRAINDICATIONS for IV CONTRAST: None. INDICATION: Pedestrian struck by car. TECHNIQUE: Routine non-contrast CT. FINDINGS: There is an, approximately, 5- x 4-mm hyperdense focus within the right frontal lobe. There is no mass effect, shift of normally midline structures, or hydrocephalus. Other than this hyperdense focus the density values of the brain parenchyma are within normal limits. The [**Doctor Last Name 352**]-white matter differentiation is preserved. The ventricles and sulci are normal in size. The surrounding osseous and soft tissue structures are unremarkable. There is no evidence for fracture. The visualized paranasal sinuses are well aerated. IMPRESSION: Small hematoma within the right frontal lobe. No fractures identified. CT HEAD W/O CONTRAST [**2117-12-7**] 8:57 AM CT HEAD W/O CONTRAST Reason: please eval interval change in head bleed [**Hospital 93**] MEDICAL CONDITION: 50 year old man with SAH REASON FOR THIS EXAMINATION: please eval interval change in head bleed CONTRAINDICATIONS for IV CONTRAST: None. INDICATION: Subarachnoid hemorrhage vs. intraparenchymal hemorrhage, evaluate for change. COMPARISON: Non-contrast head CT from [**2117-12-6**]. TECHNIQUE: Non-contrast head CT. FINDINGS: Again seen is a small focus of high density in the right frontal lobe, measuring approximately 4 mm in diameter and unchanged in appearance since the prior study. Additionally, there is a newly apparent focus of high density seen only on series 2, image 24 in the right parietal lobe. Given that this is only seen on a single image, it may represent artifact, but could also represent a separate area of small intraparenchymal hemorrhage. No other intra or extra-axial hemorrhages are identified. There is no shift of normally midline structures, no hydrocephalus, no intracranial mass lesion, and no evidence of vascular territorial infarction. The [**Doctor Last Name 352**] white matter differentiation is well preserved and the density values of the brain parenchyma are within normal limits. No fractures are identified. The visualized paranasal sinuses and mastoid air cells are well pneumatized. Soft tissue structures appear unremarkable. IMPRESSION: Stable appearance to the intraparenchymal hemorrhage in the right frontal lobe, possible new focus of intraparenchymal hemorrhage in the right parietal lobe. These findings were discussed with the surgical intern taking care of the patient at the time of interpretation. MANDIBLE (PANOREX ONLY) PORT [**2117-12-9**] 9:12 PM MANDIBLE (PANOREX ONLY) PORT Reason: AP only, postop eval [**Hospital 93**] MEDICAL CONDITION: 50 year old man s/p ORIF b/l mandible REASON FOR THIS EXAMINATION: AP only, postop eval INDICATION: 50-year-old status post ORIF bilateral mandibular fracture. Single frontal view of the mandible demonstrates two plates with screws transfixing the mandibular fracture. There are also numerous wires seen along the mandible and the maxilla fixing the fracture. Brief Hospital Course: Patient admitted to Trauma Service. Orthopedic, Neurosurgery and OMFS were consulted. He was taken to the operating room on [**12-6**] for ORIF-IM nail left tib/fib fracture. Neurosurgery recommended non-surgical approach for his IPH; repeat head CT stable. Patient taken to the operating room on [**2117-12-9**] by OMFS where he underwent closed reduction; ORIF bilateral mandible fractures; he was also trached with a PEG being placed during that time. His jaw is wired shut; the plan is for removal of these wires by OMFS in 2 weeks. He was placed on CIWA protocol for ETOH withdrawal; he did require sitters; restraints and antipsychotics for increased agitation during his initial hospitalization. These have all been discontinued as of [**12-15**]. Patient has been cooperative with his care; working with PT. He is ambulating with rollling walker and has begun crutch training. Speech therapy has evaluated patient for Passy Muir valve; his trach was down sized on [**12-15**] to a #7 and again on [**12-23**] to a #4. He is currently tolerating the Passy Muir valve with good oxygen saturations. He is taking in a full liquid diet and started on calorie counts. Patient was originally screened for rehab and was deemed at a too high of a level of functioning by his insurance reviewers. Patient and caregiver [**First Name (Titles) 66458**] [**Last Name (Titles) **] for discharge to home. He will require home skilled nursing, PT, OT, Speech & Respiratory therapy at home. On [**12-24**] PT gave clearance for the patient to go home w/ crutches, supervision by his wife, and home physical therapy. Discharge Medications: 1. Oxycodone-Acetaminophen 5-325 mg/5 mL Solution Sig: 5-10 MLs PO Q4-6H (every 4 to 6 hours) as needed. Disp:*350 ML* Refills:*0* 2. Docusate Sodium 150 mg/15 mL Liquid Sig: One (1) PO BID (2 times a day). Disp:*500 ML* Refills:*0* 3. Metoprolol Tartrate 50 mg Tablet Sig: Two (2) Tablet PO TID (3 times a day): [**Month (only) 116**] be crushed. Hold fror HR <60 and SBP < 110. Disp:*90 Tablet(s)* Refills:*2* 4. Chlorhexidine Gluconate 0.12 % Mouthwash Sig: One (1) ML Mucous membrane TID (3 times a day). Disp:*350 ML* Refills:*2* 5. Milk of Magnesia 800 mg/5 mL Suspension Sig: One (1) PO twice a day as needed for constipation. Discharge Disposition: Home With Service Facility: [**Location (un) 86**] VNA Discharge Diagnosis: s/p Pedestrian Struck by Auto Small Right Frontal Intraparenchymal Hematoma Mandible Fracture Grade I Open Left Tibia/Fibula Fracture Discharge Condition: Stable Discharge Instructions: Follow up in Trauma Clinic in [**3-26**] weeks. Follow up in [**Hospital **] Clinic in 1 month Follow up with Oral Facial Maxillo Surgery in 2 weeks for removal of jaw wires. Followup Instructions: Call [**Telephone/Fax (1) 1228**] for an appointment in [**Hospital **] Clinic Call [**Telephone/Fax (1) 6439**] for an appointment in Trauma Clinic Call [**Telephone/Fax (1) 66459**] for an appointment with OMFS for removal of jaw wires Completed by:[**2117-12-24**] ICD9 Codes: 5185
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Medical Text: Admission Date: [**2122-2-21**] Discharge Date: [**2122-2-25**] Date of Birth: [**2052-4-10**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 12**] Chief Complaint: Right Lower Quadrant Pain, Hypotension Major Surgical or Invasive Procedure: Embolization of the left hepatic artery. History of Present Illness: Mr. [**Known lastname 1968**] is a 69 year old male with a history of HIV (CD4 238), hepatitis C and multifocal hepatocellular carcinoma with admission in [**9-/2121**] for hemoperitoneum from bleeding cancer focus who presents from home with right lower quadrant abdominal pain which began approximately thirty minutes after he bent down to pick up a crate at the supermarket. The pain continued to worsen and became more diffuse with enlargement of his abdomen. The pain is now severe and [**8-29**]. It was associated with nausea, vomiting. It was not associated with diarrhea, constipation, dysuria or hematuria. It was not associated with lightheadedness or dizziness. He presented to the emergency room. . In the emergency room his initial vitals were T: 99.2 HR: 94 BP: 66/36 RR: 16 O2: 100% on RA. He received a total of 4L normal saline and 2 unit PRBCs with stabilization of his blood pressure to the 120s systolic. He transiently required levophed but this was quickly turned off. He received vancomycin 1 gram IV and zosyn 4.5 mg IV as well as fentanyl 50 mcg x 1 and dilaudid 1 mg x 1. He underwent a diagnostic paracentesis which showed a calculated hematocrit of 18.5 with 2278 WBCs. He underwent a CT scan with IV contrast which showed a large amount of new perihepatic hemorrhage with evidence for active extravasation at site of previous liver capsular rupture. Moderate amount of abdominal pelvic hemorrhage. New segment VIII low attenuation concerning for metastasis. Increased metstatic disease burden in left lobe. No distant metastasis. He was seen by the surgical consult service who recommended that he undergo emergent IR embolization of bleeding region. . On arrival to the floor his blood pressure is in the 130s sytolic and his heart rate was in the 110s. He continued to note pain in his abdomen. He endorses pain with deep inspiration and mild dyspnea. He denies nausea, vomiting, dysuria, hematuria, lightheadedness, dizziness, melena, hematochezia, leg pain or swelling. All other review of systems negative in detail. . Pateint's HCT was stable for 24 hours in the unit in 30s. It bumped appropiately after 2 RBC units. Antibiotics were stopped. Patient has been afebrile. Now he is transfered to the OMED service to further management of his bleeding and to discuss treatment options. Past Medical History: Past Medical History: -HIV on HAART - last CD4 238, viral load 334 on [**2122-2-15**] -Hepatitis C (genotype 1), last viral load 693,000 on [**2120-12-3**] -Hepatocellular Carcinoma with multifocal disease, not a ressection candidate complicated by hemoperitoneum in [**9-27**] requiring IR embolization Social History: Patient is single and rents a room from an elderly woman and acts as her caretaker. [**Name (NI) **] was born in Bermuda. Has 3 daughters and 1 son. Smokes [**Name2 (NI) **] 1 pack every 3-4 days for the past 15 years. No ETOH in 8 years. Prior heavy use in past. No IVDU in 15 years. Prior to this used IV heroin and cocaine. Family History: Diabetes. No known history of malignancy. Physical Exam: Vitals: T: 100.3 HR: 103 BP: 148/95 RR: 18 O2: 98% on 2L . General: Awake, alert, speaking in full sentences, wheezes HEENT: Sclera anicteric, MM moist, oropharynx clear, no lymphadenopathy, parotid gland enlargement Neck: JVP not elevated Cardiac: Tachycardic, regular rhythm, s1 + s2, SEM RUSB [**2-23**], rubs, gallops Lungs: expiratory wheezes, no rales or ronchi. Pt has ginecomastia. GI: firm, distended, tender diffusely, present bowel sounds, no rebound tenderness, + guarding GU: foley draining red urine, small testes Ext: Warm and well perfused, 1+ pulses, no clubbing, cyanosis or edema Neurologic: No asterixis, grossly intact, A&Ox3, cerebelar exam intact, adequate strenght. Pertinent Results: On Admission: [**2122-2-21**] 06:40PM WBC-13.5*# RBC-3.47* HGB-10.6* HCT-33.1* MCV-96 MCH-30.7 MCHC-32.1 RDW-18.4* [**2122-2-21**] 06:40PM NEUTS-79.9* LYMPHS-15.6* MONOS-3.9 EOS-0.3 BASOS-0.3 [**2122-2-21**] 06:40PM PLT COUNT-436 [**2122-2-21**] 06:40PM PT-13.2 PTT-26.9 INR(PT)-1.1 [**2122-2-21**] 06:40PM GLUCOSE-238* UREA N-13 CREAT-1.5* SODIUM-132* POTASSIUM-4.2 CHLORIDE-98 TOTAL CO2-20* ANION GAP-18 [**2122-2-21**] 06:40PM ALT(SGPT)-65* AST(SGOT)-55* ALK PHOS-108 TOT BILI-0.5 [**2122-2-21**] 06:40PM ALBUMIN-3.0* [**2122-2-21**] 06:55PM URINE COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.019 [**2122-2-21**] 06:55PM URINE BLOOD-NEG NITRITE-NEG PROTEIN-TR GLUCOSE-NEG KETONE-TR BILIRUBIN-NEG UROBILNGN-NEG PH-7.0 LEUK-NEG [**2122-2-21**] 06:55PM URINE RBC-0-2 WBC-[**4-29**]* BACTERIA-FEW YEAST-NONE EPI-0-2 TRANS EPI-0-2 [**2122-2-21**] 11:57PM LACTATE-1.6 [**2122-2-21**] 11:57PM TYPE-ART TEMP-36.6 PO2-73* PCO2-39 PH-7.34* TOTAL CO2-22 BASE XS--4 INTUBATED-NOT INTUBA [**2122-2-21**] 11:44PM HCT-26.8* [**2122-2-21**] 11:44PM PT-14.0* PTT-28.4 INR(PT)-1.2* . EKG: sinus tachycardia at 101, left axis deviation, left anterior fascicular block, no acute ST segment changes. . Imaging: CXR: Lung volumes are mildly diminished. No consolidation or edema is noted. The mediastinum is unremarkable. The cardiac silhouette is within normal limits for size. A small hiatal hernia is incidentally noted. No effusion or pneumothorax or free intraperitoneal air identified. The osseous structures are grossly unremarkable. . CT Abdomen with contrast: 1. Increase in the extent of metastatic disease, likely hepatocellular carcinoma, involving the left lobe of the liver and evidence of capsular rupture and large volume of hemoperitoneum. A new 8 mm hypoattenuating focus within the right lobe of the liver is now seen. An area of increased attenuation within the center of the hemoperitoneum adjacent to the liver is concerning for active extravasation. Overall, the amount of hemoperitoneum has increased in size when compared back to the initial presentation of this condition on the CT of [**2121-10-4**]. Surgical consultation advised. 2. Moderate hiatal hernia. 3. Left renal cyst. . Upon Discharge: [**2122-2-25**] 05:35AM BLOOD WBC-11.8* RBC-3.56* Hgb-10.7* Hct-32.1* MCV-90 MCH-30.1 MCHC-33.4 RDW-17.6* Plt Ct-266 [**2122-2-25**] 05:35AM BLOOD Plt Ct-266 [**2122-2-25**] 05:35AM BLOOD Glucose-79 UreaN-12 Creat-0.6 Na-133 K-3.1* Cl-101 HCO3-25 AnGap-10 [**2122-2-25**] 05:35AM BLOOD ALT-413* AST-141* LD(LDH)-836* AlkPhos-280* TotBili-3.0* DirBili-1.8* IndBili-1.2 [**2122-2-25**] 05:35AM BLOOD Albumin-2.8* Brief Hospital Course: Impression: 69 year old male with history of HIV (CD4 238), hepatitis C and multifocal hepatocellular carcinoma who presents with abdominal pain found to have hemoperitoneum with associated shock likely from bleeding liver malignancy. . Hemoperitoneum: Patient with evidence of active extravasation of contrast on abdominal CT scan and calculated peritoneal fluid hematocrit of 18. Hemodynamically stable s/p 4L normal saline and two units PRBCs in ED. He underwent IR embolization of the left hepatic artery. He was monitored 24 hours in the ICU with frequent HCT that were stable. He did not require further transfusions. His pain was controlled with IV dilaudid and then switched to an oral regimen. . Hypotension/Hemorrhagic Shock: Related to acute blood loss in the setting of hemoperitoneum. . Acute Renal Failure: Patient's creatinine upon presentation was 1.5 and improved up to 0.6 upon discharge after IVF and stopping hemorrhage. It was thought to be pre-renal renal failure since patient improved rapidly and there were no cast suggesting ATN. He had good UOP. . Hyperglycemia: No documented history of hyperglycemia but blood glucose on chemistry panel is 238. He was started on ISS. He had minimal requirements during hospitalization. . HIV: CD4 count 238 with viral load of 334 on [**2122-2-11**]. HAART was continued. . Hepatocellular Carcinoma: Patient is not good candidate for resection and has already failed hepatic artery embolization in the past. He now bleed into the abdomen and most likely has metastatic disease (not proven). Extensive discussions took place between Dr. [**Last Name (STitle) **] and him and decided to give a 2-week break and then meet to evaluate for either continuing hospice care or oral chemotherapy regimen with sorafenib. . FEN: Regular diet. . Access: 2 16 g peripheral IVs. . Prophylaxis: pneumoboots, home PPI. . Code: DNR/DNI. . Contact: Proxy name: [**Name (NI) 23548**] [**Name (NI) **] (sister) Phone: [**Telephone/Fax (1) 23549**]. . Disposition: Home with hospice. Medications on Admission: Senna 8.6 mg [**Hospital1 **]:PRN Combivir 150 mg-300 mg [**Hospital1 **] Kaletra 200 mg-50 mg 2 Tablets [**Hospital1 **] Methadone 5 mg TID:PRN Tylenol 325 mg TID:PRN Omeprazole 20 mg daily Ibuprofen 400 mg TID:PRN Lactulose 30 mls TID:PRN for constipation Oxycodone 5 mg Tab Q4:PRN Discharge Medications: 1. Nicotine 21 mg/24 hr Patch 24 hr Sig: One (1) Patch 24 hr Transdermal DAILY (Daily). 2. Lamivudine-Zidovudine 150-300 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 3. Lopinavir-Ritonavir 200-50 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 4. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed. 5. Methadone 5 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 6. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 7. Hydromorphone 2 mg Tablet Sig: One (1) Tablet PO every six (6) hours as needed for pain: Then continue your regular oxycodone, once the pain improves. Do not drive or do high risk activities. This medication has sedative effects. Disp:*15 Tablet(s)* Refills:*0* 8. Lactulose 10 gram/15 mL Syrup Sig: Thirty (30) ML PO once a day as needed for constipation. 9. Ibuprofen 400 mg Tablet Sig: One (1) Tablet PO three times a day as needed for pain. 10. Tylenol 325 mg Tablet Sig: 1-2 Tablets PO every six (6) hours as needed for pain. Discharge Disposition: Home With Service Facility: All Care VNA of Greater [**Location (un) **] Discharge Diagnosis: Primary Diagnosis: Abdominal Hemhorrage secondary to hepatocelular carcinoma. . Secondary Diagnosis: Hepatocellular Carcinoma Hepatitis C Cirrhosis HIV Discharge Condition: Stable, tolerating PO, pain controlled, ambulating. Discharge Instructions: You were seen at the [**Hospital1 18**] for abdominal pain. You had a CT scan of your abdomen that showed signs of bleeding. Some fluid from your abdomen was obtained and it showed blood corroborating the prior clinical impression. You bleed from your liver massess, therefore you underwent ebolization of one of the arteries of your liver to stop the bleeding. You required multiple blood transfusions to replete the loss. We followed closely your blood level and it was stable and you did not further require any transfusions. You had exacerbation of your abdominal pain that was controlled with dilaudid. You will meet with Dr. [**Last Name (STitle) **] and Dr. [**Last Name (STitle) 4613**] (see below) to discuss further oral chemotherapy and other ways we can help you. . If you have chest pain, shortness of [**Last Name (LF) 1440**], [**First Name3 (LF) 691**] changes in the abdominal pain, [**Last Name (un) 23550**] stools, blood in your stools, or anything else that concerns you please come back to our ER. . We started you on a nicotine patch. You can use if if you want to stop smoking. Do not use the patch and smoke at the same time. Followup Instructions: Provider: [**Name10 (NameIs) **] [**Name8 (MD) **], MD Phone:[**Telephone/Fax (1) 22**] Date/Time:[**2122-3-13**] 10:00 Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 23551**], MD Phone:[**Telephone/Fax (1) 447**] Date/Time:[**2122-3-13**] 10:00 . Please follow with oyour PCP within [**Name Initial (PRE) **] month of discharge. ICD9 Codes: 5849, 5715, 2851, 3051
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Medical Text: Admission Date: [**2105-12-26**] Discharge Date: [**2105-12-28**] Date of Birth: [**2034-10-28**] Sex: F Service: MEDICINE Allergies: lisinopril Attending:[**First Name3 (LF) 9965**] Chief Complaint: angioedema Major Surgical or Invasive Procedure: intubation History of Present Illness: 71-year-old female with history of HTN on lisinopril, NIDDM who presents with angioedema and was intubated for airway protection. . The patient had a URI the past 3 weeks but was otherwise well. Last PM she was noted to have poor control of secretions and nausea. She went to bed and awoke in the AM with increased tongue swelling, unable to speak, and poor secretion control. Her daughter brought her to [**Name (NI) 4199**] Hospital. At [**Last Name (un) 4199**] she was treated with decadron, famotidine and benadryl. She was transferred to [**Hospital1 18**] for further care. . In the ED, initial VS were: T 98.1, HR 74, BP 172/80, RR 18, SvO2 100% 2L NC. In the EW, they attempted oropharyngotracheal intubation three times without success. She underwent nasotracheal intubation using fiberoptic scope. Per report there was significant swelling of the larynx and vocal cords. She was sedated with propofol. . Per report, within the past year she had lip swelling which was attributed to lisinopril (however, this medication was continued). The daughter denies any recent shellfish or peanuts. No new foods or medications (other than ibuprofen and colace 2 weeks ago). Daughter denies fever, night sweats, headache, shortness of breath, wheezing, palpitations, weakness, diarrhea, constipation, dysuria, rashes. She did note nausea, chest discomfort and tongue swelling. Past Medical History: - Myopia - NIDDM c/b proliferative diabetic retinopathy - HTN - HLD - h/o vitreous hemorrhage - s/p cataract removal Social History: Lives with daughter. Independent ADLs. Born in [**Country 2045**]. To US in [**2082**]. - Tobacco: Never - Alcohol: None - Illicits: None Family History: Sister and brother with DM, HLD. Otherwise no known history. No allergy history. Physical Exam: Vitals: T: 99.8 BP: 150/64 P: 86 R: 14 O2: 100% intubated Vent Settings: FiO2 0.5, PEEP 5, Vt 450, rate 14 General: Sedated, intubated, occassionally with gag, not responsive, moving all extremities spontaneously HEENT: Sclera anicteric, MMM, swollen tongue, secretions pouring out side of mouth, pupils constricted Neck: supple, JVP not elevated, no LAD CV: RR, nl rate, nl S1, S2, no murmurs, rubs, gallops Lungs: CTAB, anterior examination, no wheezes, rales, ronchi Abdomen: soft, non-tender, non-distended, bowel sounds present GU: foley in place Ext: warm, well perfused, 2+ pulses, no edema Neuro: Sedated, minimally responsive. Spontaneously moving extremities, gag reflex intact. Pertinent Results: [**2105-12-27**] 08:07AM BLOOD WBC-12.0*# RBC-3.75* Hgb-11.2* Hct-33.8* MCV-90 MCH-29.8 MCHC-33.1 RDW-13.6 Plt Ct-230 [**2105-12-26**] 06:43AM BLOOD WBC-4.4 RBC-4.11* Hgb-12.1 Hct-36.2 MCV-88 MCH-29.5 MCHC-33.4 RDW-13.8 Plt Ct-244 [**2105-12-26**] 06:43AM BLOOD Neuts-57.1 Lymphs-37.7 Monos-3.3 Eos-1.6 Baso-0.3 [**2105-12-26**] 06:43AM BLOOD PT-10.9 PTT-28.1 INR(PT)-1.0 [**2105-12-27**] 08:07AM BLOOD UreaN-24* Creat-1.2* Na-142 K-4.1 Cl-109* HCO3-20* AnGap-17 [**2105-12-26**] 06:43AM BLOOD Glucose-126* UreaN-18 Creat-1.1 Na-142 K-4.3 Cl-106 HCO3-24 AnGap-16 [**2105-12-26**] 08:32AM BLOOD Rates-14/ Tidal V-450 pO2-484* pCO2-39 pH-7.38 calTCO2-24 Base XS--1 -ASSIST/CON CXR [**12-26**]: FINDINGS: The patient has received an endotracheal tube. The tip of the tube projects 4 cm above the carina. The tube could be advanced by 1 cm. No evidence of complications, notably no pneumothorax. Borderline size of the cardiac silhouette without pulmonary edema. No pleural effusions. No focal parenchymal opacities suggesting pneumonia. Labs on discharge: [**2105-12-28**] 07:45AM BLOOD WBC-7.6 RBC-4.02* Hgb-11.8* Hct-35.8* MCV-89 MCH-29.3 MCHC-32.9 RDW-13.7 Plt Ct-215 [**2105-12-28**] 07:45AM BLOOD Glucose-90 UreaN-22* Creat-1.0 Na-143 K-3.5 Cl-111* HCO3-23 AnGap-13 [**2105-12-28**] 07:45AM BLOOD ALT-10 AST-18 AlkPhos-35 TotBili-0.7 [**2105-12-28**] 07:45AM BLOOD Calcium-8.6 Phos-3.4 Mg-1.7 Brief Hospital Course: Patient is a 71-year-old female with PMH of HTN on lisinopril who presented with angioedema requiring brief intubation. Patient had a traumatic intubation requiring nasopharyngeal intubation in the emergency room. At time of intubation by report there was significant tongue edema and laryngeal edema consistent with angioedema. At the time of transfer to the general medicine floor this tongue edema had entirely resolved. # Angioedema: Likely secondary to lisinopril. Less likely NSAIDs and aspirin which were restarted at time of discharge. She was treated with famtotidine and methylprednisolone 40 mg IV Q8H x 24hours. Famotidine and steroids were discontinued after 24 hours and she was extubated. SLisinopril was added as an allergy. She was restarted on her home H2-blocker. # Hypertension: She was started on metoprolol as calcium channel blockers are also associated with angioedema. No ACEi or [**Last Name (un) **] should be given in the future given the risk of angioedema. # pain: Likely MSK in nature given tenderness to palpation of back, scapula, flank and epigastrum. Per patient and family, had extensive work-up as an outpatient. We do not currently have access to those reports. EKG was not significant for cardiac pathology. She was given tylenol and restarted on home NSAIDs and oxycodone at time of discharge. # fever: Patient with mild temperature elevation to 100.5 in the ICU which did not recur while on the general medicine floor. This was thought most likely due to inflammation from angioedema and airway trauma. Her leukocytosis was likely from steroids as this was trending down at discharge. She had a negative urinalysis and chest x-ray without infiltration. Throat pain was likely secondary to intubation and not an infectious process as it did not start until after extubation. # cough: The patient and her family reported a cough of 1 month duration. This was likely a post-viral syndrome as she had previously had a URI vs a cough secondary to lisinopril. Lisinopril had been discontinued and supportive care was provided for the cough. Chest x-ray was without infiltrate. # NIDDM: She is on metformin at home but was given insulin sliding scale while inpatient. #CODE: Full (confirmed) #Contact: daughter [**Name (NI) 92271**] [**Telephone/Fax (1) 92272**]; [**Name2 (NI) **] [**Telephone/Fax (1) 92273**] Medications on Admission: - Metformin XR 1500mg PO daily - Aspirin 81mg PO daily - Atorvastatin 40mg PO daily - Ranitidine 300mg PO daily - Lisinopril 20mg PO daily - Diclofenac Sodium 75mg PO daily - Alendronate 70mg PO daily (not on med list) - Colace 100mg PO BID - Ibuprofen 600mg PO q8H prn pain - Multivitamin Discharge Medications: 1. metformin 1,000 mg Tablet Extended Rel 24 hr Sig: One (1) Tablet Extended Rel 24 hr PO once a day: combine with 500mg to equal 1500mg daily. 2. metformin 500 mg Tablet Extended Rel 24 hr Sig: One (1) Tablet Extended Rel 24 hr PO once a day: combine with 1000mg to equal 1500mg daily. 3. aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. 4. atorvastatin 40 mg Tablet Sig: One (1) Tablet PO once a day. 5. ranitidine HCl 150 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 6. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed for pain. 7. metoprolol succinate 25 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* 8. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 9. guaifenesin 100 mg/5 mL Syrup Sig: 5-10 MLs PO Q6H (every 6 hours) as needed for cough. Disp:*QS1month ML(s)* Refills:*0* 10. Tessalon Perles 100 mg Capsule Sig: One (1) Capsule PO three times a day as needed for cough. Disp:*60 Capsule(s)* Refills:*0* 11. ibuprofen 600 mg Tablet Sig: One (1) Tablet PO every eight (8) hours as needed for pain. 12. multivitamin Tablet Sig: One (1) Tablet PO once a day. 13. tramadol 50 mg Tablet Sig: One (1) Tablet PO three times a day as needed for pain. Disp:*20 Tablet(s)* Refills:*0* Discharge Disposition: Home Discharge Diagnosis: Primary: -angioedema secondary to lisinopril Secondary: - hypertension Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: You were admitted to [**Hospital1 69**] because of swelling of your tongue and throat. You were intubated with a breathing tube down your throat and your were diagnosed with angioedema (swelling of the throat) likely caused by lisinopril. You should NEVER take lisiopril or other ace-inhibitors or angiotensin receptor blockers in the future for blood pressure due to the risk of throat swelling. While you were here, some of your medications were changed. STOP lisinopril STOP Diclonfenac STOP oxycodone START guafenesin and tesselon pearls if needed for cough START metoprolol for blood pressure START tramadol (ultram) for pain Followup Instructions: You should call your primary care doctor's officer tomorrow for a follow-up appointmnent this week. Please bring these papers to your visit. Completed by:[**2105-12-28**] ICD9 Codes: 4019, 2724
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Medical Text: Unit No: [**Numeric Identifier 69098**] Admission Date: [**2172-9-22**] Discharge Date: [**2172-10-19**] Date of Birth: [**2172-9-22**] Sex: M Service: Neonatology HISTORY OF PRESENT ILLNESS: Baby boy [**Known lastname 44129**] is a 31 and [**1-14**]-week boy born to a 27-year-old G1/P0 (to 1) mother with [**Name2 (NI) **] type O+, antibody negative, hepatitis B surface antigen negative, rubella immune, RPR nonreactive, GBS unknown with rupture of membranes at delivery. The baby was beta complete on [**2172-9-17**]. Mother received magnesium prior to delivery. Delivery was performed primarily due to severe maternal pregnancy-induced hypertension (PIH). Apgar scores were 8 and 8. The patient was also with a history of intrauterine growth restriction. The patient was born by C- section due to the maternal indications. PHYSICAL EXAMINATION ON ADMISSION: Patient was premature, small for gestational age male with good respiratory effort, color, and tone. Initial birth weight was 838 grams, which is less than 10 percentile, length 34 cm less than 10th percentile, head circumference 26 cm approximately 10th percentile. Patient had anterior fontanelle soft, flat, and open, mildly low set and posterior rotated ears. Palate intact. No distress. Three-vessel cord. No hepatosplenomegaly. Normal male external genitalia. Both testes descended in the scrotum. No hip click. Patent anus. No sacral dimple. Normal tone. Moving all extremities. Extremities: Warm and well perfused and active. D-stick on admission was 46. SUMMARY OF HOSPITAL COURSE BY SYSTEM: 1. RESPIRATORY: The patient was on room air from time of birth with very little/brief respiratory support necessary. Has had no significant desaturations or oxygen requirement during his life. Is now day of life 26. 2. CARDIOVASCULAR: No history of pressor requirement. The patient with heart rates consistently in the 130 to 150 or 160 range. No significant issues. No murmur noted for this patient during stay. 3. FLUIDS, ELECTROLYTES, AND NUTRITION: The patient was transitioned from central parenteral nutrition to enteral feeds, reaching full feeds of breast milk at 20- kilocalories per ounce and 150 mL/kg/day on [**2172-10-10**]. Since that time the patient's calories have been increased to today, [**2172-10-19**]; at which time the patient is at breast milk supplemented to 30 kilocalories per ounce with Beneprotein at 150 mL/kg/day. No history of electrolyte abnormalities. 4. GI: The patient with normal stool. No history of heme positivity. Peak bilirubin for patient was on day of life 1, and was 6.5. Since that time the patient underwent phototherapy, which was discontinued on day of life 6 with a rebound bilirubin of 3.1. 5. HEMATOLOGY: The patient's last CBC on [**2172-10-2**] was a white count of 13; hematocrit of 43; platelets of 130k. 6. INFECTIOUS DISEASE: The patient is status post 1-week course of vancomycin and gentamicin initiated on [**10-2**], [**2171**], on day of life 10, due to a significant increase in spells as well as pustule noticed at waist. No organism detected. The patient treated for 1 week with vancomycin and gentamicin with resolution of symptoms and has been off antibiotics since [**2172-10-10**]. 7. NEUROLOGY: Normal head ultrasound on [**2172-9-29**]. 8. SENSORY: 1. AUDIOLOGY: Screening not performed. 2. OPHTHALMOLOGY: Eye exam performed on [**2172-10-12**] noted immature zone 3 with followup recommended in 3 weeks. CONDITION ON TRANSFER: Stable. DISCHARGE DISPOSITION: Transferred to [**Hospital3 417**] Hospital NICU. NAME OF PRIMARY PEDIATRICIAN: Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 19419**]. CARE RECOMMENDATIONS: 1. Feeds at time of transfer: Breast milk 30 kilocalories with Beneprotein at 150 mL/kg/day. At this point, the majority of the feed is being given with nasogastric tube, with minimal oral efforts from baby at this time. 2. Car seat position screening not performed. 3. Medications are iron and vitamin E. Caffeine discontinued on [**2172-10-11**] without significant apnea of prematurity at this point. IMMUNIZATIONS RECOMMENDED: No immunizations noted on chart at this time. IMMUNIZATIONS RECOMMENDED: Synagis RSV prophylaxis should be considered from [**Month (only) **] through [**Month (only) 958**] for infants who meet any of the following 3 criteria: (1) born at less than 32 weeks; (2) born between 32 and 35 weeks with 2 of the following -- Daycare during RSV season, a smoker in the household, neuromuscular disease, airway abnormalities, or school-age siblings; or (3) with chronic lung disease. In addition, 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 APPOINTMENTS: Will be scheduled at the time of discharge from transfer hospital. DISCHARGE DIAGNOSES: 1. Prematurity. 2. Small for gestational age (SGA). 3. Rule out sepsis. 4. Feeding immaturity. 5. Hyperbilirubinemia. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], [**MD Number(1) 55780**] Dictated By:[**Name8 (MD) 69099**] MEDQUIST36 D: [**2172-10-19**] 15:13:29 T: [**2172-10-19**] 15:56:47 Job#: [**Job Number 69100**] ICD9 Codes: 7742
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Medical Text: Admission Date: [**2114-1-2**] Discharge Date: [**2114-1-27**] Date of Birth: [**2039-2-18**] Sex: F Service: General Surgery ADMITTING DIAGNOSIS: Chest pain. DISCHARGE DIAGNOSIS: Chest pain, status post cardiac stent complicated by retroperitoneal bleed with repair and postoperative small bowel obstruction. PROCEDURES: 1. Cardiac catheterization with stent of LAD. 2. Exploration and repair of right external iliac artery laceration. 3. Re-exploration and repair of retroperitoneal bleeder. HISTORY OF PRESENT ILLNESS: The patient is a 74-year-old female transferred to [**Hospital1 69**] on [**2114-1-2**] with new onset angina. The patient was taken to the cardiac catheterization lab on [**2114-1-3**] and was noted to have an 80% stenosis of the mid LAD that was stented. The procedure was complicated by a large retroperitoneal bleed and the patient was taken emergently to the operating room, underwent a right external iliac repair. Postoperatively the patient had ongoing hypotension and transfusion requirement and was taken back to the operating room for re-exploration and repair of a retroperitoneal bleeder. She stabilized hemodynamically. The patient was extubated on postoperative day #6 and was transferred to the floor and required aggressive pulmonary toilet. She started on Levo and Flagyl for presumptive aspiration pneumonia. She was also noted to have increased total bilirubin to 3.1, direct bilirubin to 2 and alkaline phosphatase to 496. A right upper quadrant ultrasound showed gallbladder sludge but no stones. There was no intra or extrahepatic ductal dilatation. Subsequently the patient was noted to develop abdominal distention and emesis as well as a white blood cell count of 15,000. On [**1-14**] the patient underwent a CAT scan that showed a small bowel obstruction and an NG tube was placed with 1-2 liters output in 24 hours. PAST MEDICAL HISTORY: 1) MI status post left circumflex stent [**11-4**] with an EF of 50-55%. PAST SURGICAL HISTORY: 1) Right total hip replacement. 2) Hernia repair. 3) Appendectomy. ALLERGIES: No known drug allergies. MEDICATIONS: On admission, Aspirin 325 mg po q d, Lopressor 12.5 mg po bid, Plavix - patient had completed course. PHYSICAL EXAMINATION: The patient is afebrile, vital signs are stable. She is confused and oriented only to person. Heart is regular rate and rhythm. There are decreased breath sounds at her bases bilaterally. Her abdomen is soft, distended, nontender, her incision is clean, dry and intact. Extremities are soft and warm, well perfused. HOSPITAL COURSE: As noted in the history of present illness, the patient was admitted on [**1-2**] and was taken to the cath lab. She underwent a mid LAD stent and post procedure noted to have a large retroperitoneal bleed. She was taken emergently to the OR. This was repaired. The right external iliac artery was repaired. She had ongoing hypotension and transfusion requirement postoperatively. She was taken back to the operating room for re-exploration and repair of a retroperitoneal bleeder. Hemodynamically she stabilized and was extubated on postoperative day #6. She was then transferred to the floor and was started on Levo and followed for presumptive aspiration pneumonia. Her LFTs were noted to be elevated and right upper quadrant ultrasound only revealed gallbladder sludge, no stones, no intra or extra hepatic ductal dilatation. She subsequently developed abdominal distention, emesis and a white blood cell count to 15,000. CT scan on [**1-14**] showed distal small bowel obstruction and NG tube was placed with approximately 2 liters output. The patient was then transferred to the general surgery service for further management. The patient's NG tube continued to have high output. As the patient's urine output was low, she was aggressively hydrated, she was kept npo, she was started on Somatostatin. She was also started on a Heparin drip in place of her Plavix for her cardiac stents. Her TPN was continued. From a vascular standpoint the patient had an essentially uneventful postoperative course as well. The patient remained npo until she was noted to have some return of bowel function at which time her diet was advanced, her Heparin drip was stopped, she was started on her outpatient cardiac meds. As she was tolerating this well and her abdominal exam remained benign, it was decided that she would be discharged to rehab on [**2114-1-27**] in stable condition. DISCHARGE MEDICATIONS: Lopressor 12.5 mg po bid, Serevent MDI 2 puffs [**Hospital1 **], Albuterol nebs q 4 hours prn wheezing, Aspirin 325 mg po q d, Plavix 75 mg po q d to be taken through [**2-4**], Haldol 1 mg po q h.s., Tylenol 650 mg po q 4-6 hours prn, Colace 100 mg po bid. The patient was told to call Dr.[**Name (NI) 5695**] office for follow-up as well as to call Dr.[**Name (NI) 10946**] office for follow-up and to call her primary care doctor as well as her cardiologist for follow-up. She was told to call or return for any questions or problems. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], M.D. [**MD Number(1) 11126**] Dictated By:[**Last Name (NamePattern1) 4985**] MEDQUIST36 D: [**2114-1-26**] 17:07 T: [**2114-1-26**] 19:54 JOB#: [**Job Number 37241**] ICD9 Codes: 5070, 5990, 2930
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Medical Text: Admission Date: [**2168-12-21**] Discharge Date: [**2169-1-2**] Date of Birth: [**2100-11-27**] Sex: F Service: ADDENDUM DISCHARGE MEDICATIONS: Coumadin titrated to INR of 3.0-3.5, Calcium Carbonate 500 mg p.o. t.i.d., Lasix 20 mg p.o. b.i.d. X 10 days, Potassium 20 mEq p.o. b.i.d. x 10 days, then change to just Lasix 20 mg p.o. q.d. with 20 mEq q.d. for her stat prior dose, Glucophage 500 mg p.o. t.i.d., Avandia 4 mg p.o. q.d., Digoxin 0.5 mg q.d., Amaril 2 mg p.o. q.d., ................ p.r.n., .............. suppository p.r.n., Aspirin 325 mg p.o. q.d., regular Insulin sliding scale 150-200 3 U, 201-250 6 U, 251-300 9 U. FOLLOW-UP: The patient is to follow-up with Dr. ................. after discharge from rehabilitation in regards to coumadinization. He is to follow-up with Dr. [**Last Name (STitle) **] for cardiothoracic issues. She is to follow-up with Dr. [**Last Name (STitle) **] for cardiology issues. DISPOSITION: She is being discharged to rehabilitation. [**Last Name (STitle) **] DR. [**Last Name (Prefixes) 413**],[**First Name3 (LF) 412**] 02-351 Dictated By:[**Name8 (MD) 16758**] MEDQUIST36 D: [**2169-1-2**] 10:39 T: [**2169-1-2**] 10:40 JOB#: [**Job Number 31546**] ICD9 Codes: 4280, 9971, 4019, 2720
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Medical Text: Admission Date: [**2146-10-30**] Discharge Date: [**2146-11-1**] Date of Birth: [**2091-6-5**] Sex: F Service: NEUROLOGY Allergies: Penicillins / Ambien / Metronidazole Attending:[**First Name3 (LF) 2569**] Chief Complaint: Agitation/ speech disturbance Major Surgical or Invasive Procedure: Intubation/ extubation History of Present Illness: Patient is a 55 y/o female with a PMHx of DM complicated by neuropathy, HTN, hypercholesterolemia, hepatitis C and h/o polysubstance use who presents with concerns for a stroke. Patient was at her usual baseline yesterday evening and went to bed at her usual time of ~11pm. At 05:30 her son also spoke to her describing her as having normal speech. However at ~7am she was then noted to be aphasic and moaning in bed found by her son. EMS was contact[**Name (NI) **] and she was brought to [**Hospital1 18**]. Of note, she likely vomited en route. Here she was noted to follow simple comands but was combative prompting sedation and intubation. Past Medical History: CAD and question of history of old inferior MI based upon EKG, partially reversible defect on MIBI [**6-16**] Chronic dizziness and gait disorder Hearing loss L ear x past year Diabetes mellitus - on Lamictal for neuropathy HTN Cataract [**Doctor First Name **] Hepatitis C Hyperlipidemia GERD Atypical migraines - on Topamax Social History: -Tobacco: recently quit smoking; smoked since age 12, one ppd -ETOH: hx of alcohol abuse -IVDA: hx of heroin and cocaine abuse Family History: Alcoholism, diabetes Physical Exam: PE on admition HEENT: NCAT, mucous membranes moist and pink, sclera non-icteric, OP clear - Neck: Supple, no thyromegaly, no lymphadenopathy, no bruits - Lungs: Clear bilaterally, good aeration, no wheezing/crackles - Cardiac: Normal S1 and S2, no murmur - Abdomen: S/NT/obese, normoactive BS - Extremities: warm, no C/C/E Neurologic Examination: - MS: Unintelligible / dysarthric speech, per report able to say "no" but did not witness - Cranial Nerves: I: not tested II: Blinks to visual threat, pupils 3->1.5mm bilaterally III, IV, VI: eyes midline, no nystagmus, doesn't follow commands for VFFTC testing, turns whole head in direction of sounds / questions V: unable to assess VII: Facial movements grossly symmetric, unable to assess for subtle facial droop VIII: unable to assess IX, X: gag intact [**Doctor First Name 81**]: unable to assess XII: unable to assess - Motor: Normal bulk and tone, restrained, full grasp with both hands, attempts to pull out ETT symmetrically, withdrawals legs from restraints with good strenght - Coordination: unable to assess - Reflexes: No clonus, toes downgoing bilatrally [**Hospital1 **] Tri [**Last Name (un) 1035**] Pat Ach C5-6 C7-8 C5-6 L3-4 S1-2 Right 2 2 2 1 1 Left 2 2 2 1 1 Pertinent Results: [**2146-10-30**] 10:57PM ALT(SGPT)-64* AST(SGOT)-55* LD(LDH)-200 ALK PHOS-100 AMYLASE-136* TOT BILI-0.2 [**2146-10-30**] 10:57PM CK-MB-5 cTropnT-<0.01 [**2146-10-30**] 10:57PM %HbA1c-5.7 eAG-117 [**2146-10-30**] 10:57PM TRIGLYCER-166* HDL CHOL-43 CHOL/HDL-2.9 LDL(CALC)-49 [**2146-10-30**] 08:59PM LACTATE-1.5 NA+-140 K+-3.7 CL--106 ct head: IMPRESSION: 1. No evidence of hemorrhage or loss of [**Doctor Last Name 352**]-white matter differentiation or mass effect on CT head without contrast. 2. CT perfusion demonstrates no evidence of asymmetric perfusion to indicate acute ischemia or infarct. 3. CT angiography of the neck demonstrates 50% narrowing of the right and 25 to 50% narrowing on the left near the carotid bifurcation. 4. CT angiography of the head demonstrates no vascular occlusion, stenosis or aneurysm greater than 3 mm in size. Vascular calcifications are seen at cavernous carotids bilaterally. 5. Retained secretions in the nasopharynx likely due to intubation. MRI head: Wet read. No acute process Brief Hospital Course: Mrs [**Known lastname 6330**] was admitted as a code stroke. She was seen in the ED and was noted to be agitated and had a speech disturbance that was not described in detail. A complete neurologic examination was not completed in ED. The patient was intubated in the ED and had a STAT CT head done. This was negative. She then proceeded to get an MRI of the brain done. This was also negative. She was extubated the next day without problems. She was awake interactive, oriented and had not known what had occurred the day before. She denies any fever/chills/headache. She states she has never had a seizure and takes Lamictal for her peripheral neuropathy secondary to DM II. Medications on Admission: -Humalog 75-25 17U q am and 20U q pm -Lamictal 200mg [**Hospital1 **] -Lisinopril 5mg daily -Metformin 500mg [**Hospital1 **] -Omepraxole 20mg daily -Simvastatin 80mg daily -Sumatriptan 50mg daily -Tramadol 50mg q 8hrs prn headaches -ASA 81mg daily -IB 800mg prn -Aleve -Nicotine patch Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: Primary - Acute/transient altered Mental status (etiology unknown) Secondary -DM, insulin dependent - followed at [**Last Name (un) **] in the past but has not been see recently -HTN -Hypercholesterolemia - last lipids checked in [**2141**] -Hep C - per notes in remission -Diabetic neuropathy -Atypical Meniere's disease x 5 years - characterized by imbalance and lightheadedness Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: You were admitted for workup of your speech disorder and altered mental status. You were intubated in the ER for tests to rule out stroke. You had a CT of your head and an MRI of your brain which did not show any evidence of stroke. You were extubated the next day. You had an EEG which did not show any seizure activity. We are not sure what had caused this but it could have been a seizure. Followup Instructions: Please follow up with your primary care physician in the next 2-3 weeks. Call [**Telephone/Fax (1) 250**] for an appointment. Provider: [**First Name8 (NamePattern2) **] [**First Name8 (NamePattern2) 275**] [**Last Name (NamePattern1) **], MD Phone:[**Telephone/Fax (1) 250**] Date/Time:[**2146-12-21**] 3:50 Provider: [**Name10 (NameIs) 1382**] [**Name11 (NameIs) 1383**], MD Phone:[**Telephone/Fax (1) 2422**] Date/Time:[**2147-1-9**] 11:30 [**First Name8 (NamePattern2) **] [**Name8 (MD) 162**] MD [**MD Number(2) 2575**] ICD9 Codes: 3572, 2724, 2720, 4019, 3051
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Medical Text: Admission Date: [**2110-8-8**] Discharge Date: [**2110-8-8**] Date of Birth: [**2067-6-17**] Sex: F Service: MEDICINE Allergies: lisinopril / hydrochlorothiazide Attending:[**First Name3 (LF) 2712**] Chief Complaint: hoarseness Major Surgical or Invasive Procedure: None History of Present Illness: Ms. [**Known lastname 91708**] is a 43 yo female h/o discoid lupus and hypertension who presented to the ED with hoarseness, sensation of throat closing, and nausea and vomiting that started this evening. Patient had been on lisinopril, although perhaps not taking this consistantly. She was switched to lisinopril-HCTZ combination pill at her NP[**MD Number(3) **] [**2110-8-6**]. She took 1 dose of the new medication [**2110-8-7**]. She awoke at 2 am this morning with sensation of shortness of breath and nausea, and had emesis x 7 times. She drove herself to the ED. She reports no chest pain, rash, abdominal pain, or diarrhea. Physical exam in the ED shows no stridor or adventitious sounds in the lung fields, but presence of uvular hydrops and some respiratory distress, although the pt remained on roomn air with good O2 sats. Patient symptomatically improved after Epipen, solumedrol 125mg, Benadryl 50mg IV, and famotidine 60mg IV. She is being admitted to the MICU for observation x 24 hours . On the floor, pt is quite tired. She c/o sore throat. No emesis since 3 or 4am. No nausea currently. Past Medical History: DEPRESSIVE DISORDER TUBERCULOSIS ([**2086**]; tx meds x 2 yrs-neg cxray x 2 THROAT PAIN feels like something in throat-gags freq URINARY, INCONTINENCE, STRESS FEMALE ALOPECIA (dx by derm biopsy cutaneous lupus) PYELONEPHRITIS, ACUTE ([**2083**]) DYSMENORRHEA, MENORRHAGIA HTN Social History: Mother dies from stomach CA. Uncle died from tongue CA (smoker). Family History: - Tobacco: Current smoker, 1ppd x 15 years - Alcohol: Drinks 2 drinks 3xs per week, no Hx of withdrawl Sx Physical Exam: On Admission: General: Alert, oriented, appears fatigued but otherwise comfortable HEENT: Sclera anicteric, MMM, no lip swelling 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, no clubbing, cyanosis or edema On discharge: Angioedema of the uvula much improved. Pertinent Results: [**2110-8-8**] 05:47AM BLOOD WBC-6.6 RBC-4.77 Hgb-10.7* Hct-33.3* MCV-70* MCH-22.5* MCHC-32.2 RDW-17.7* Plt Ct-240 [**2110-8-8**] 05:47AM BLOOD Neuts-49.5* Lymphs-44.4* Monos-3.8 Eos-2.0 Baso-0.3 [**2110-8-8**] 05:47AM BLOOD Glucose-100 UreaN-13 Creat-0.8 Na-137 K-3.5 Cl-102 HCO3-25 AnGap-14 Brief Hospital Course: 43yo F with HTN whose antihypertensive was swuitched from lisinopril to lisinopril-HCTZ who presents with feeling as if her throat was closing. # Angioedema: Likely ACEi-related angioedma given the absence of any other systemic symptoms and the fact that angioedema can occur any time while on the drug. She was treated with IV solumedrol in the ED, converted to PO prednisone on the floor, benadryl, famotidine, and an epipen. Her edema was greatly improved at time of discharge and she was tolerating a diet. She was discharged on amlodipine 10mg, epipen and prednisone 40mg x 5 days. She was told to follow-up with her PCP [**Last Name (NamePattern4) **] [**2-15**] days and to be referred to allergy. She was told to avoid both HCTZ and ACEi. Both drugs were added to her allergy list. # HTN: Discharged on amlodipine 10mg daily and told to follow-up with her PCP. Medications on Admission: Lisinopril-Hydrochlorothiazide 20-25 mg Oral Tablet TAKE ONE TABLET DAILY Ibuprofen 800 mg Oral Tablet TAKE 1 TABLET THREE TIMES A DAY AS NEEDED take WITH FOOD Hydroquinone 4 % Topical Cream apply to face TWICE DAILY Clobetasol 0.05 % Topical Solution Apply sparingly twice daily Ammonium Lactate (LAC-HYDRIN) 12 % Topical Lotion APPLY TO BOTH FEET QD NUQUIN HP 4 % TOPICAL CREAM (DIOXYBENZONE/PDO/HYDROQUINONE) apply TWICE DAILY to TO AFFECTED AREA Discharge Medications: 1. prednisone 20 mg Tablet Sig: Two (2) Tablet PO once a day for 5 days. Disp:*10 Tablet(s)* Refills:*0* 2. amlodipine 5 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Disp:*60 Tablet(s)* Refills:*2* 3. hydroquinone 4 % Cream Sig: One (1) application Topical twice a day: apply to the face twice a day. 4. clobetasol 0.05 % Cream Sig: One (1) apply Topical once a day: apply to affected area. Do not apply to the face. 5. ammonium lactate 12 % Lotion Sig: One (1) application Topical twice a day: apply to feet. 6. epinephrine 0.15 mg/0.15 mL Combo Pack Sig: One (1) Intramuscular Once as needed for allergic reaction, trouble breathing for 1 doses: Use in extreme case of difficulty breathing/ throat closing. Disp:*1 pen* Refills:*3* Discharge Disposition: Home Discharge Diagnosis: Primary: Angioedema Hypertension Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Ms. [**Last Name (Titles) 91709**], It was a pleasure taking part in your care. You were admitted to [**Hospital1 18**] for difficulty breathing and throat swelling. This was likely a reaction to one of your blood pressure medications. You were treated with medications including epinephrine, steroids, and benadryl, and your breathing and swelling improved. You were monitored in the ICU prior to discharge home. The following changes to your medications were made: - STOP lisinopril - STOP hydrochlorothiazide - START Prednisone 40mg daily for 5 days - START amlodipine 10mg by mouth daily - Please fill, and carry, an epinephrine pen with you at all times so that you may use it in the event that you have this reaction again Please take all other medications as prescribed. Followup Instructions: Please follow-up with your PCP [**Last Name (NamePattern4) **] [**2-15**] days. Please have your primary care doctor refer you to an allergy specialist. Completed by:[**2110-8-8**] ICD9 Codes: 3051
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Medical Text: Admission Date: [**2142-1-13**] Discharge Date: [**2142-1-15**] Date of Birth: [**2067-3-17**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 4760**] Chief Complaint: Bleeding from mouth/nose Major Surgical or Invasive Procedure: Nasal packing placement NGT placement Transfusion of blood products History of Present Illness: Mr. [**Known lastname 21006**] is a Spanish-speaking 74 yoM (son is translating in the [**Name (NI) **]) with a h/o CAD (s/p stent [**12-18**]), CVA, GERD and asthma who presented to the ED from home with 2+ hours of "spitting up" blood. Per patient and family, this was not [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) 104845**] or hemoptysis, but rather blood in the OP. He denied emesis, cough, ENT pain, abd/chest pain, melena/brbpr and SOB. . In the ED, VS were T 99.2, P 79, BP 176/76, RR 14, 99% RA. NG tube was attempted to be placed twice w/o success; thus, NG lavage was not performed. He was noted to have bleeding from his NP and the right nares was packed (around 5 pm pm on [**2142-1-13**]). By 8 pm, the packing had been soaked through; the patient was then given affrin and a balloon was put in place to tamponade the bleed. Hct was 32.9 on admission with a baseline in low 40's as of [**10-18**] (MCV unchanged). Given he was not tachycardic or orthostatic, he did not receive an RBC transfusion in the ED. . Of note, the patient is on warfarin for stroke/TIA (?); ED notes say had a DVT in RLE one month ago and has been on Coumadin since that time, though has older rxn in OMR. His INR was noted to be 14.1 on admission. He was given 10 mg IV Vit K; two units of FFP have been ordered but not yet administered. The ED staff also spoke with the cards fellow given the recent stent placement (in right ? LE artery for PVD); they advised to keep on ASA and plavix currently. . ENT saw him in the ED and did a flex scope and standard anterior rhinoscopy. They noted several areas of oozing along the septum bilaterally w/o a clear single, brisk source. Gauze soaked in bacitracin was placed in the right nares. Left nares was packed with gelfoam and surgicell packing. Oral cavity clear. . The ED staff spoke with the GI fellow, who is deferring EGD tonight and is recommending IV PPI overnight. Low suspicion for UGIB. Past Medical History: TIA, on Coumadin Asthma Hyperlipidemia Hypertension Diabetes GERD H/O prostate cancer CAD, s/p MI with LV dysfunction, EF 45-50% PVD s/p CABG x2 in [**2132**] with SVG-PDA occluded s/p RCA stent x 2 (in [**2137**] (?[**2138**]), [**2139**]); with Cypher [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) **]/p bilateral renal artery stenting followed by redo left renal artery stent for in-stent restenosis in [**2138-7-11**] H/O right occipital infarct with residual lest sided visual impairment H/O cataract of left eye Macular hole in left eye S/P phacoemulsificatiion, posterior chamber intraocular lens placement, pars plana vitrectomy, membrane peel of left eye Social History: -- He lives with his signficant other [**First Name8 (NamePattern2) 46975**] [**Last Name (NamePattern1) 3234**] ([**Telephone/Fax (1) 104846**]). -- He does not smoke or drink. -- He is retired from maintenance and previously worked as a bricklayer in [**Male First Name (un) 1056**]. -- He emmigrated to the US 35 years ago. Family History: - not contributory Physical Exam: General: well appearing; somewhat restless in bed HEENT: nose packed in ED (did not remove to examine); OP clear w/o evidence of bleeding Lungs: CTA b/l Cardio: III/VI ?SEM, loudest at LUSB; no m.r.g. Abd: soft, NTND, no suprapubic tenderness EXTREMITIES: no edema SKIN: no rashes, no cyanosis NEURO: AA, OX3; CN II - XII in tact Pertinent Results: [**2142-1-13**] 05:15PM BLOOD WBC-14.8*# RBC-4.22* Hgb-11.3* Hct-32.9* MCV-78* MCH-26.8* MCHC-34.4 RDW-14.7 Plt Ct-186 [**2142-1-13**] 05:15PM BLOOD Neuts-87.6* Lymphs-8.9* Monos-2.9 Eos-0.4 Baso-0.2 [**2142-1-13**] 05:15PM BLOOD PT-105.1* PTT-96.9* INR(PT)-14.1* [**2142-1-13**] 05:15PM BLOOD Glucose-221* UreaN-34* Creat-1.5* Na-139 K-4.8 Cl-101 HCO3-32 AnGap-11 [**2142-1-13**] 05:15PM BLOOD ALT-27 AST-28 AlkPhos-141* TotBili-0.4 [**2142-1-14**] 05:02AM BLOOD CK-MB-3 cTropnT-<0.01 [**2142-1-14**] 12:45PM BLOOD CK-MB-3 cTropnT-<0.01 [**2142-1-14**] 05:02AM BLOOD Calcium-8.8 Phos-2.4* Mg-1.9 . ECG: NSR 78, nml axis, first degree AVB, no new ST changes Brief Hospital Course: ASSESSMENT/PLAN: 74 y/o spanish speaking M with h/o PVD s/p stenting of RLE in [**12-18**], CVA, GERD and asthma who presented to the ED with gross epistaxis and hct drop in setting of elevated INR. . #) Epistaxis/Bleed: Initially unknown source, however ENT scoped the patient and visualized bleeding. There were several areas of oozing along the septum bilaterally w/o a clear single, brisk source. Gauze soaked in bacitracin was placed in the right nares. Left nares was packed with gelfoam and surgicell packing. Pt was reversed with Vitamin K and FFP, treated with Keflex and monitored overnight in the ICU. Bleeding was felt to be secondary to extremely supratherapeutic INR. Patient reported taking his coumadin twice a day which likely led to increased levels. Hct decreased from 38 to 29, however it remained stable after packing. He was called out to the floor on the 2nd hospital day and Hct remained stable. His coumadin was held and on the day of discharge INR was 1.2. He will continue Keflex while packing in place and this will remain in for 5 days. He will follow up with Dr. [**Last Name (STitle) **] (ENT) for packing removal. Given recent stent placement he was continued on ASA and plavix. . #) ARF: BUN 34, Cr 1.5 on admission; baseline Cr 1.0-1.1. BUN:Cr ratio suggested pre-renal etiology. Cr returned to baseline with IVF. . #) LEUKOCYTOSIS: WBC was 14 on admission. Patient was afebrile. Felt to be stress response given no localized signs of infection. He was treated with Keflex prophylactically and WBC normalized on day of discharge. . #) CAD/recent stent: The ED staff spoke with the cardiology service given the recent stent placement in RLE; they advised to keep on ASA and plavix. . #) GERD: Initially on protonix [**Hospital1 **] given concern for possible GI source of bleed. This was then stopped and patient was discharged on his usual outpatient ranitidine. . #) DIABETES: Patient is on metformin and NPH as outpatient. His metformin was held while in house. He was placed on a insulin SS while inpatient. He will resume his outpatient regimen on discharge. . #) HYPERLIPIDEMIA: Continued statin. . #) ASTHMA: Continued albuterol and advair. . #) HTN: On amlodipine and lisinopril at home. Antihypertensives were initially held given bleeding. These were restarted at discharge. . #) CODE: full (confirmed with son) . #) COMMUNICATION: son [**Name (NI) **] [**Name (NI) 1071**] [**Telephone/Fax (1) 104847**]; PCP [**Last Name (NamePattern4) **]. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] [**Telephone/Fax (1) 608**] Medications on Admission: Nitroglycerin 0.3 SL prn Aspirin 325mg daily Albuterol IH 2 puff Q6H prn ALbuterol 4mg tab PO Q12 Amlodipine 5mg po daily Albuterol 100mg Daily Atorvastatin 80mg Daily Clonidine 0.1 mg PO BID Advair 100-50 IH [**Hospital1 **] Lisinopril 20mg PO daily Singulair 10mg po Daily Ranitidine 150mg PO daily Iron 325 po Daily Fexofenadine 60mg PO daily Plavix 75 mg Daily Warfarin 5mg PO Daily Insulin NPH 35 units QAM Loratadine 10mg PO daily Discharge Medications: 1. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Albuterol 90 mcg/Actuation Aerosol Sig: Two (2) puffs Inhalation every six (6) hours as needed for shortness of breath or wheezing. 3. Amlodipine 5 mg Tablet Sig: One (1) Tablet PO once a day. 4. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Clonidine 0.1 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 6. Fluticasone-Salmeterol 100-50 mcg/Dose Disk with Device Sig: One (1) puff Inhalation [**Hospital1 **] (2 times a day). 7. Lisinopril 20 mg Tablet Sig: One (1) Tablet PO once a day. 8. Montelukast 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO once a day. 10. Ferrous Sulfate 325 mg (65 mg Iron) Tablet Sig: One (1) Tablet PO DAILY (Daily). 11. Fexofenadine 60 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 12. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 13. Insulin NPH Human Recomb 100 unit/mL Suspension Sig: Thirty Five (35) units Subcutaneous once a day: please resume your home dose of insulin. 14. Loratadine 10 mg Tablet Sig: One (1) Tablet PO once a day. 15. Cephalexin 500 mg Capsule Sig: One (1) Capsule PO Q8H (every 8 hours) for 4 days. Disp:*12 Capsule(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Location (un) 86**] VNA Discharge Diagnosis: Primary: Epistaxis s/p nasal packing Elevated INR Secondary: Coronary artery disease CVA GERD Asthma Hypertension Diabetes Discharge Condition: Stable, no further bleeding, INR normalized Discharge Instructions: You were admitted to the hospital for bleeding from your nose. This was felt to be due to your coumadin level being too high. You should NOT take your coumadin until your nasal packing is removed and you follow up with Dr. [**Last Name (STitle) **]. Please stop your coumadin. You will need to complete a course of antibiotics to prevent infection at the packing site. You can continue your other medications as prescribed. You should keep your follow up appointments as below. Please avoid straining and bending over to prevent recurrent bleeding. Please call your doctor if you have recurrent bleeding, chest pain, difficulty breathing, high fevers or other concerning symptoms. Followup Instructions: Provider: [**Name10 (NameIs) **] STUDY Phone:[**Telephone/Fax (1) 327**] Date/Time:[**2142-1-25**] 10:30 Provider: [**Name10 (NameIs) **] STUDY Phone:[**Telephone/Fax (1) 327**] Date/Time:[**2142-1-25**] 11:00 Provider: [**Last Name (NamePattern5) 7224**], [**MD Number(3) 1240**]:[**Telephone/Fax (1) 62**] Date/Time:[**2142-1-25**] 1:30 . Please follow up with Dr. [**Last Name (STitle) **] on Thursday, [**1-18**] at 9am to have your packing removed. His office is located at [**Last Name (NamePattern1) 10357**]. ([**Hospital **] medical building) on the [**Location (un) **], suite E. Call [**Telephone/Fax (1) 41**] if you have any questions. . Please follow up with Dr. [**Last Name (STitle) **] in one week. ICD9 Codes: 5849, 2859, 4019, 412, 2724
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Medical Text: Admission Date: [**2168-11-16**] Discharge Date: [**2168-11-23**] Date of Birth: [**2097-9-4**] Sex: M Service: MEDICINE Allergies: Penicillins / Amoxicillin Attending:[**First Name3 (LF) 3276**] Chief Complaint: shortness of breath Major Surgical or Invasive Procedure: bronchoscopy History of Present Illness: CC: SOB, cough . HPI: 71 yo M with recent diagnosis of metastatic nonsmall cell lung cancer (unresectable stage IV) s/p first treatment of taxol, carboplatin, and zometa on [**2168-11-15**] presents with worsening SOB, cough, and fever. Pt underwent his first round of chemotherapy yesterday. Per report he had intermittent desaturations to 89-92% during chemo. This am he awoke with fever to 100.6 and worsening productive cough. He took tessalon pearls and Robitussin with codeine without relief. . In the ED his temp was 102, HR 100-120's, BP 160-180's, RR 26-34, satting 95% on NRB. He was given Levo/Flagyl/Vanco/Azithro. A Chest CT revealed a large left pleural effusion and LLL/lingular/portions of LUL collapse (worsened significantly compared to [**2168-10-22**]). He was transferred to the [**Hospital Unit Name 153**] for further management. . Upon arrival to the [**Hospital Unit Name 153**] he was noted to have a RR of 40 with a gas of 7.47/32/68. He was intubated. His BP's dropped to the 80's with sedation/intubation and he was started on levophed. An A-line and central line were placed. . Past Medical History: - metastatic nonsmall cell lung cancer (unresectable stage IV) s/p Taxol, Carboplatin, and Zometa on [**2168-11-15**] - gout Social History: quit smoking 53 years ago, smoked 20 pack years. asbestos exposure while in military lives with wife, is retired employed previously as electrician Daughter [**Name8 (MD) **] RN @ [**Hospital1 18**] Family History: father died 83years lung cancer mother died of liver cancer, ? age sister CAD, s/p CABG Physical Exam: Tm 102 Tc 101.4 BP 80/45 HR 95 RR 14 Sat 100% AC Vt 550/RR 14/PEEP 12/FiO2 100% Gen: intubated, sedated HENNT: MMM, anicteric Neck: no LAD, no JVD CV: tachy, regular, nl S1S2, No M/R/G Lungs: coarse breath sounds, bibasilar crackles, no wheezes Abd: soft, NT/ND, +BS, No HSM Ext: no edema, strong DP/PT pulses bilaterally Neuro: moving all extremeties Pertinent Results: [**2168-11-16**] 10:51PM TYPE-[**Last Name (un) **] TEMP-38.4 RATES-16/ PO2-155* PCO2-42 PH-7.37 TOTAL CO2-25 BASE XS-0 -ASSIST/CON INTUBATED-INTUBATED [**2168-11-16**] 09:47PM PLEURAL TOT PROT-4.3 GLUCOSE-185 LD(LDH)-273 [**2168-11-16**] 09:47PM PLEURAL HCT-2.5* [**2168-11-16**] 09:47PM PLEURAL WBC-2922* RBC-[**Numeric Identifier 62249**]* POLYS-17* LYMPHS-37* MONOS-18* EOS-2* ATYPS-7* MESOTHELI-2* MACROPHAG-2* OTHER-15* . Studies: - CT chest [**2168-11-16**]: 1. No evidence of pulmonary embolism. 2. large left pleural effusion and collapse of left lower lobe, lingula and portions of the left upper lobe have worsened significantly compared to [**2168-10-22**]. Occlusion of the left lower lobe and lingular bronchi 3. Bulky mediastinal and bilateral hilar adenopathy. 4. New pathological fracture of the left seventh rib. Lytic foci within the T1 vertebral body and right fifth rib are unchanged. 6. Patchy opacity within the right lower lobe, likely reflecting an infectious or inflammatory process. . - CXR [**2168-11-16**]: Interval increased left pleural effusion, and increasing parenchymal opacities in left lower lobe and lingula. Given the known lesions in the left hila, this is concerning for postobstructive pneumonia/atelectasis. Mediastinal and hilar lymphadenopathy. Left rib met. . - MRI head [**2168-11-5**]: Mild-to-moderate brain atrophy. No enhancing lesions are seen. No evidence of mass effect or hydrocephalus. . - PET CT scan: 1. Intense FDG avidity in the partially collapsed left lower lobe extending to the hilum. The intensity of this uptake is greater than expected for postobstructive inflammatory change alone and is consistent with the given history of non-small cell lung cancer. 2. FDG-avid bilateral hilar adenopathy and widespread bilateral mediastinal adenopathy. 3. Multiple foci of FDG-avid lytic metastases involving the left scapula, the left lamina of T1, the right 5th rib (with pathologic fracture), the left 7th rib, the right sacrum and right acetabulum. Asymmetric activity associated with the right L5 pars defect may be degenerative. . - Chest CT [**2168-10-22**]: bulky, bilateral mediastinal lymphadenopathy as well as bilateral hilar adenopathy, the largest lymph nodes include a subcarinal node or mass measuring approximately 2.5 cm x 3.5 cm in diameter. There are also bilateral calcified pleural plaques present. The lower lobe is partially collapsed, and within the area of enhancing atelectatic lung, there is a low-density rounded area measuring 2.0 cm x 1.8 cm in diameter. The lungs also demonstrate emphysematous changes, also was found to have a small-to-moderate pleural effusion and a small pericardial effusion. Additional central peri-bronchovascular thickening in the left lower lobe was found which could be related to lymphatic obstruction or localized lymphangitic spread of tumor. Brief Hospital Course: A/P: 71 yo M with recently diagnosed metastatic non small cell lung cancer (unresectable stage IV) s/p first treatment of Taxol, Carboplatin, and Zometa on [**2168-11-15**] presents with worsening cough and fever. . Patient's shortness of breath, cough and fever were likely secondary to a post-obstructive pneumonia in setting of a known malignancy. Patient was started on empiric broad spectrum coverage with vancomycin/levofloxacin/metronidazole. CT chest revealed a large left pleural effusion and collapse of left lower lobe, lingula and portions of the left upper lobe. Shortly after transfer to the ICU patient became hypoxic and required intubation. Tap of left pleural effusion on [**11-16**] was positive for non-small cell carcinoma. A left sided chest tube was placed. Bronchial washings, subcarinal mass, and paratracheal lymph node obtained on [**11-19**] were again consistent with malignancy. Repeated blood, sputum, and urine cultures did not identify etiology of infection; viral screen also negative. Course was further complicated by developing neutropenia (s/p chemotherapy). Aztreonam and AmBisome were both added for broader coverage. The oncology service was following along throughout his ICU course. Patient received Neupogen 300 mcg SC daily for neutropenia. Despite the placement of a second chest tube, patient continued to have hypoxic respiratory failure, secondary to large malignant pleural effusion and left lung collapse. Patient became hypotensive, likely secondary to sepsis, and required pressors and fluid boluses to maintain his CVP and urine output. The patient's primary oncologist Dr. [**Last Name (STitle) 3274**] had a discussion with the patient's family regarding goals of care and the patient's prognosis and a decision was made to make him CMO. The patient passed away at 1:55 am on [**2169-11-23**]. Medications on Admission: 1. Allopurinol 300 mg PO DAILY 2. Tessalon Perles 200 mg t.i.d. 3. Robitussin With Codeine cough syrup Discharge Medications: none Discharge Disposition: Expired Discharge Diagnosis: Patient expired on [**2169-11-23**]. Discharge Condition: Discharge Instructions: Followup Instructions: [**First Name8 (NamePattern2) 251**] [**Name8 (MD) **] MD [**MD Number(1) 3282**] ICD9 Codes: 486, 5180, 0389
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Medical Text: Admission Date: [**2172-6-22**] Discharge Date: [**2172-7-1**] Date of Birth: [**2099-7-21**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 11217**] Chief Complaint: Left hip fracture, atrial fibrillation Major Surgical or Invasive Procedure: ORIF Left femur History of Present Illness: This is a 79 year old man who resides in a nursing home, with a history of dementia, CAD, a-fib on coumadin, DM2, who had an unwitnessed fall and fractured his hip. It is unclear, due to the patient's mental status, if there was any lightheadedness, or near syncope prior to the fall. Orthopaedics was consulted and requested a medicine admission because of some changes on the EKG demonstrating ST depression. . The patient was diagnosed with prostate cancer ([**Doctor Last Name **] [**2-28**]) in [**2164**] and his guardian at that time decided on conservative management. He has been followed by Dr. [**Last Name (STitle) 4229**], but has not had any treatment. A bone scan in [**5-2**] showed increased uptake in bilateral femurs and multiple ribs. His guardian has recently changed, and due to recent general health deterioration, the question of aggressive treatment is being revisited. A bone scan in [**5-2**] demonstrated uptake in bilateral proximal femurs and multiple ribs. Further history cannot be obtained secondary to patient's mental status. . In the ED, vital signs on admission were T:99.6 BP159/88 HR101 RR 14 and O2sat 94%RA. Fingerstick blood glucose 133. The patient had multiple imaging studies and was seen by orthopaedics felt he was a surgical candidate. Past Medical History: dementia with delusions CAD atrial fibrillation on coumadin hypertension Anemia (baseline HCT 23) cardiomyopathy sick sinus syndrome with pacemaker prostate cancer [**Doctor Last Name **](3+3) depression Social History: Mr. [**Known lastname **] lives at nursing home. No known family members. [**Name (NI) **] a guardian. [**Name (NI) **] other social history elicited. Family History: unknown Physical Exam: VS:T99.2, BP160/90, HR140 RR20 o2sat 94%on 4L Gen: Lethargic, arousable by tapping only, incomprhensible language Neck: in C-collar. No JVD CV: irregular rhythm, tachycardic, no murmurs Lungs: clear anteriorly, unable to auscultate posterior seconday to C-spine precautions Abd: soft, non-tender, +bowel sounds Ext: warm, intact dp and tp pulses bilaterally. L lower extremity externally rotated Neuro: opened eyes to verbal stimulation. Very confused, answered questions with incomprehensible answers. Unable to cooperate with exam for cranial nerves. Moving upper extremities and lower Right extremity spontaneously. Pertinent Results: ADMITTING LABS [**2172-6-22**] 10:05AM WBC-5.9 RBC-3.43* HGB-9.0* HCT-27.6* MCV-80* MCH-26.4* MCHC-32.8 RDW-15.6* [**2172-6-22**] 10:05AM PLT COUNT-276# [**2172-6-22**] 10:05AM NEUTS-81.3* LYMPHS-15.5* MONOS-2.9 EOS-0.3 BASOS-0.1 [**2172-6-22**] 10:05AM PT-18.4* PTT-29.2 INR(PT)-1.7* [**2172-6-22**] 10:05AM CK(CPK)-41 [**2172-6-22**] 10:05AM cTropnT-<0.01 [**2172-6-22**] 10:05AM GLUCOSE-141* UREA N-16 CREAT-0.7 SODIUM-143 POTASSIUM-4.6 CHLORIDE-104 TOTAL CO2-29 ANION GAP-15 [**2172-6-22**] 10:19AM HGB-10.2* calcHCT-31 [**2172-6-22**] 06:56PM LACTATE-2.1* OTHER PERTINENT LABS: [**2172-6-22**] 09:35PM CK(CPK)-43 [**2172-6-22**] 09:35PM CK-MB-NotDone cTropnT-<0.01 [**2172-6-23**] 06:00AM BLOOD CK(CPK)-36* [**2172-6-23**] 06:00AM BLOOD CK-MB-NotDone cTropnT-<0.01 [**2172-6-23**] 06:00AM BLOOD WBC-7.7 RBC-2.97* Hgb-7.8* Hct-23.5* MCV-79* MCH-26.3* MCHC-33.1 RDW-15.7* Plt Ct-261 Radiology: CT Head ([**2172-6-22**]): No bleed. Chronic sm vessel ischemic changes, lacunar infarcts, and atrophy. Slight asymmetry of lateral ventricles, left larger than right, prob related to atrophy and of questionable clinical significance . CT C-Spine ([**2172-6-22**]):Multiple possible dystrophic nuchal ligament calcification/ossification versus post-traumatic sequelae. Other abnormalities as noted above. In view of the extensive spinal stenosis, the possibility for post-traumatic cord injury needs to be considered. . HIP X-ray ([**2172-6-22**]):There is a intertrochanteric fracture without significant displacement of the bony fragments. Additionally, there is a large lytic lesion involving the proximal femur extending into the intertrochanteric region. There is a endosteal scalloping present. This makes the fracture a pathologic fracture . CXR([**2172-6-22**]): Left lower lobe opacity, which may be due to atelectasis, aspiration or contusion. Suspected right lateral sixth rib fracture. . . OLD STUDIES: -bone scan ([**5-2**]) The described findings are consistent with possible metastases to the ribs. Bilateral femoral and right humeral metaphyseal uptake is of uncertain etiology and significance. Left T12 activity could be metastatic or degenerative in nature. . -echo ([**7-/2166**]) Overall left ventricular systolic function is severely depressed with some sparing of the basal posterolateral wall. Right ventricular systolic function appears depressed. The aortic root is moderately dilated. The ascending aorta is mildly dilated. The aortic leaflets (3) are mildly thickened. No definite aortic regurgitation is seen except with ectopic beats. The mitral valve leaflets are mildly thickened. Mild mitral regurgitation is seen. EKG: afib low 100s. [**Street Address(2) 1766**] depression in V4-V5 and TWI in V4-V6. No olds for comparison. Brief Hospital Course: 79 yo man s/p ORIF for pathologic L hip fracture likely secondary to prostate CA, immediate post-op course complicated by an episode of apnea in setting of fluid overload and Afib with RVR. . Since his admission, the patient has had difficulty with control of his Afib, which prompted a trigger on [**6-22**] PM for HR 130-150. It was determined that he missed a dose of atenolol on the day of transfer. He responded to 10mg of metoprolol, with HR decreasing to 90-100 bpm. The pt was to go to OR for ORIF of left femur on [**6-23**], but due to difficulty contacting his legal guardian until late in the day, he went to the OR [**6-24**]. Because his INR was elevated from the coumadin, he received 2u FFP initially, then another 5u FFP in the OR. His hct had also come down since admit, so he was given 2u PRBCs on [**6-23**] and an additional 3u PRBCs in the OR. Also in the OR, he had about 600cc IV crystalloid in, 200cc EBL + 640cc urine out. He received 8mg IV morphine, and 2u regular insulin for a FS 163. . Upon return to the medical floor, he was found to be somnolent and in rapid Afib with VS of T 97.3, BP 140/80, HR 160 irreg, RR 22, 100% on 3LNC. He was noted to have a non-productive cough, lungs with crackles. He received 5mg IV metoprolol twice with no HR response, then another 10mg IV metoprolol still without decrease in HR. He had a NGT to allow for PO meds, given his poor mental status. During the placement, he had minimal gag but was not fighting or appropriately agitated. Thereafter, the RN noted that the pt was apneic 3 times for 30-60 seconds each time. When he stopped breathing the fourth time, a code was called. . In the code, he was found to have electrical HR 150-200 bpm, though only perfusing at a pulse rate of around 60 bpm. His pressure was maintained with SBP 130-140 mmHg. It was difficult to obtain a pulse ox [**Location (un) 1131**], and by the time one was obtained he was satting 100% on a NRB face mask. His lungs sounded wheezy and with crackles, and once the OR record was reviewed, he was ordered for a CXR and 40mg IV lasix (on 20mg PO at baseline). An ABG was obtained on the NRB: 7.50/32/180. Initially, he was to receive Narcan, but after the ABG, deep suctioning, and a venous blood draw, he became more alert and no longer apneic. CXR showed increased pulm edema on L side. He was transferred to the MICU overnight for observation and transferred to the floor the next day. . Mr. [**Known lastname **] developed an E. coli urinary tract infection which was found to be pansensitve and a course of antibiotics were completed on the floor. A repeat UA will need to be done by the nursing home. At the time of transfer to the floor, he was responsive to his name and stimulation. He was cleared of his C spine officially from neurosurgery after flex/ex films. According to the attending physician, [**Name10 (NameIs) **] was back to his baseline mental status. His blood pressures remained stable and Lisinopril was titrated up to 40mg. Metoprolol was titrated for rate control of Afib, aspirin for coronary artery disease, and an insulin sliding scale for DM. The surgical site is healing well. Pain was treated with tylenol. Over the course of the hospitalization pt had been fluid overloaded and then diuresed aggressively. He required careful monitoring of fluid status and urine output. . In terms of his prostate cancer, Mr. [**Known lastname **] is not currently receiving treatment although he has a new guardian who is considering more aggressive treatment options. It is not documented as metastatic, though recent ([**5-2**]) bone scan has concerning lesions. The results of the ortho biopsy are still pending at discharge. . Code status: Full code. Confirmed with legal guardian [**Name (NI) **] [**Name (NI) **] on [**6-25**] at 1430. Medications on Admission: coumadin 6mg QHS MVI poly iron 150mg QDay lipitor 10mg QOD nitro-dur patch 0.3mg on at 9am, off at 9pm colace 100mg [**Hospital1 **] metformin 500mg [**Hospital1 **] doxazosin 4mg Qpm remeron 15mg Qhs asa 81mg daily atenolol 100mg Qday buproprion 75mg Qday furosemide 20mg Qday glipizide 2.5mg XR Qday Lisinopril 20mg Qday Discharge Medications: 1. Polysaccharide Iron Complex 150 mg Capsule Sig: One (1) Capsule PO DAILY (Daily). 2. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 3. Multivitamin Capsule Sig: One (1) Cap PO DAILY (Daily). 4. Bupropion 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO EVERY OTHER DAY (Every Other Day). 6. Enoxaparin 30 mg/0.3 mL Syringe Sig: One (1) Subcutaneous Q12H (every 12 hours) for 4 weeks. 7. Warfarin 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4-6H (every 4 to 6 hours) as needed. 9. Doxazosin 4 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 10. Docusate Sodium 150 mg/15 mL Liquid Sig: One (1) PO BID (2 times a day). 11. Polyvinyl Alcohol-Povidone 1.4-0.6 % Dropperette Sig: [**12-30**] Drops Ophthalmic PRN (as needed). 12. Metoprolol Tartrate 50 mg Tablet Sig: Two (2) Tablet PO TID (3 times a day) as needed for Afib. 13. Lisinopril 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Discharge Disposition: Extended Care Facility: [**Location (un) 16662**] - [**Street Address(1) **] Discharge Diagnosis: Atrial fibrillation with RVR Dementia Anemia Prostate Cancer ------------------- CAD s/p MI HTN Discharge Condition: Stable. Discharge Instructions: Please take all medications as prescribed. INR needs to be monitored while at the nursing home. Once you are therapeutic (INR 2.0-3.0), the lovenox may be discontinued. The result of the orthopedic biopsy is still pending. Please follow up. As you have just finished a course of antibiotics for a UTI, a follow up UA is necessary to ensure that the UTI is resolved. Followup Instructions: Please obtain a repeat UA, as pt has just finished a course of antibiotics for a urinary tract infection. INR needs to be monitored while at the nursing home. Once you are therapeutic (INR 2.0-3.0), the lovenox may be discontinued. The result of the orthopedic biopsy is still pending. Please follow up. [**Doctor First Name **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **], M.D. Phone:[**Telephone/Fax (1) 10941**] [**2172-7-2**] 11:00 DEVICE CLINIC Phone:[**Telephone/Fax (1) 59**] [**2172-11-4**] 9:00 ICD9 Codes: 5990, 4254, 2851, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8348 }
Medical Text: Admission Date: [**2183-9-11**] Discharge Date: [**2183-9-22**] Service: MED Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 905**] Chief Complaint: BRBPR Major Surgical or Invasive Procedure: -s/p hemoclip of duodenal vessel -s/p embolization of gastroduodenal artery -s/p hemoclip of jejunal vessel and epinephrine injection into gastric mucosa History of Present Illness: The patient is an 81 year old female with a PMH of hemorrhoidal and diverticular bleeding, HTN, CAD s/p 3 vessel CABG, and recently diagnosed MDS. The patient lives in [**Location **], and she was recently hospitalized there from mid [**Month (only) **] until [**8-31**] for management of a GI bleed. During her hospitalization, she was found to have AVMs. Given her low platelets, the GI team was unable to cauterize her AVMs. She was given IVIG, platelets, and Amicar; after a bump in her platelets, her AVMs were cauterized. The patient notes that during her hospitalization, she received blood transfusions every 2-3 days. She was discharged from that hospital on [**9-10**]. This past weekend, she moved to [**Location (un) 86**] to live with her son and daughter-in-law. Since she has been in [**Location (un) 86**], she has continued to have some rectal bleeding. She has seen Dr. [**Last Name (STitle) 1407**], her new PCP, [**Name10 (NameIs) **] Dr. [**Last Name (STitle) **], her hematologist. Today, she was referred for outpatient colonoscopy and EGD. Colonoscopy disclosed diverticulosis of the colon, grade 3 internal hemorrhoids, and melena in the cecum and ascending colon. EGD disclosed a site of active bleeding in the fourth portion of the doudenum. The actual source could not be localized and apeared to be behind a fold laterally. A hemoclip was placed and the area was tattooed with [**Country 11150**] ink. The patient was referred to Interventional Radiology for emergent mesenteric angiogram. During the procedure, no active bleeding was visualized. The gastroduodenal artery was embolized distal and proximal to the clip placed by GI. The pateint tolerated the angiogram well. Following the procedure, she had labs drawn and was found to have a HCT=22 (despite receiving 2 U PRBCs yesterday for a HCT of 22). She will be transferred to the MICU for further observation. Past Medical History: 1) CAD s/p 3 vessel CABG 2) CHF 3) Osteoarthritis 4) High cholesterol 5) Hypothyroidism 6) HTN 7) Heart murmurs since age 10, when she was diagnosed with scarlet fever and diptheria. She reports some neck surgery around the time of this diagnosis. 8) MDS, diagnosed in [**5-18**]. Bone marrow biopsy was consistent with MDS and refractory anemia with excess blasts. The bone marrow showed 11% blasts. 9) Hemorrhoidal and diverticular bleeding, diagnosed when the patient was admitted to a hospital in [**Location (un) **] in [**3-19**]. Social History: The patient has an 80-pack year smoking history. She quit in [**2162**]. She currently does not drink alcohol, but she was a social drinker in the past. Her husband died of [**Name (NI) 2481**] disease. She is a retired social worker. She recently moved from [**Location (un) 19061**] to [**Location (un) 86**] so that she may be with her family. Family History: No family history of cancer. Her mother died at age [**Age over 90 **] of a MI. Physical Exam: General: Pleasant elderly female lying in bed in NAD. VS: 98.9 191/38 89 18 97% RA HEENT: NC/AT. PERRL. EOMI. Sclerae anicteric. MMM. No petechiae. Neck: Supple. No cervical lymphadenopathy. No JVD. No carotid bruits. Lungs: CTAB. No rales, wheezes, or crackles. CVS: RRR. S1, S2. III/VI systolic murmur at LUSB, radiating to carotids. Abd: Obese, NT, ND, +BS. Extr: Trace LE edema. Warm. R groin site w/ small amt of bleeding. L PICC line in place. Skin: Scattered ecchymoses. Neuro: AxOx3. CN II-XII grossly intact. Strength 5/5 in all extremities. Motor function and sensation intact. Pertinent Results: [**2183-9-11**] 06:15PM BLOOD WBC-1.9* RBC-2.61* Hgb-7.5* Hct-22.3* MCV-85 MCH-28.7 MCHC-33.7 RDW-18.7* Plt Ct-19* [**2183-9-21**] 05:16AM BLOOD WBC-3.5* RBC-3.48* Hgb-10.4* Hct-30.9* MCV-89 MCH-29.9 MCHC-33.7 RDW-19.0* Plt Ct-43* [**2183-9-11**] 06:15PM BLOOD Neuts-43* Bands-3 Lymphs-50* Monos-3 Eos-1 Baso-0 Atyps-0 Metas-0 Myelos-0 NRBC-1* [**2183-9-16**] 10:30AM BLOOD Neuts-50 Bands-1 Lymphs-38 Monos-4 Eos-0 Baso-0 Atyps-0 Metas-3* Myelos-4* NRBC-1* [**2183-9-16**] 10:30AM BLOOD Hypochr-NORMAL Anisocy-2+ Poiklo-2+ Macrocy-2+ Microcy-NORMAL Polychr-1+ Ovalocy-2+ [**2183-9-11**] 06:15PM BLOOD Plt Smr-RARE Plt Ct-19* [**2183-9-11**] 06:15PM BLOOD PT-13.3 PTT-22.9 INR(PT)-1.2 [**2183-9-19**] 06:28AM BLOOD PT-12.7 PTT-21.8* INR(PT)-1.1 [**2183-9-18**] 11:53AM BLOOD Plt Ct-67*# [**2183-9-21**] 05:16AM BLOOD Plt Ct-43* [**2183-9-11**] 06:15PM BLOOD Fibrino-390 [**2183-9-12**] 08:00AM BLOOD Gran Ct-820* [**2183-9-12**] 08:00AM BLOOD Glucose-97 UreaN-47* Creat-1.1 Na-145 K-4.4 Cl-113* HCO3-26 AnGap-10 [**2183-9-21**] 05:16AM BLOOD Glucose-129* UreaN-44* Creat-1.4* Na-142 K-3.7 Cl-115* HCO3-18* AnGap-13 [**2183-9-11**] 06:15PM BLOOD ALT-9 AST-15 AlkPhos-40 TotBili-0.5 [**2183-9-14**] 06:45AM BLOOD LD(LDH)-180 TotBili-0.6 [**2183-9-11**] 06:15PM BLOOD Albumin-2.5* Calcium-6.5* Phos-3.2 Mg-1.7 UricAcd-8.7* [**2183-9-21**] 05:16AM BLOOD Calcium-8.2* Phos-2.6* Mg-1.8 [**2183-9-22**] 05:30AM BLOOD WBC-5.1 RBC-3.61* Hgb-11.0* Hct-31.1* MCV-86 MCH-30.5 MCHC-35.4* RDW-19.0* Plt Ct-31* [**2183-9-22**] 05:30AM BLOOD Plt Ct-31* [**2183-9-22**] 05:30AM BLOOD Glucose-122* UreaN-43* Creat-1.5* Na-140 K-3.8 Cl-115* HCO3-18* AnGap-11 EGD ([**9-11**]): -Schatzki's ring -Thick gastric folds, biopsied. -In the fourth portion of the doudenum, there was a site of active bleeding. The actual source could not be localized and appeared to be behind a fold laterally. A hemoclip was placed and the area was tattooed with [**Country 11150**] ink. Otherwise normal EGD to second part of the duodenum and jejunum. Colonoscopy ([**9-11**]): -Diverticulosis of the colon. -Grade 3 internal hemorrhoids. -Blood in the cecum and ascending colon. -Otherwise normal Colonoscopy to cecum. Angiography ([**9-11**]): (Prelim) -Patient underwent embolization to gastroduodenal artery proximal and distal to hemoclip. EGD ([**9-18**]): -Hemorrhagic AVM in proximal jejunum identified and clipped with endoclip. -Epinephrine injected into region of severe gastritis. Brief Hospital Course: 81 yo F patient was admitted on [**2183-9-11**] and a summary of her hospital course will be done by system: 1.) GI bleeding - On day of admission, pt underwent EGD with hemoclip placement on bledding AVM in 4th portion of duodenum and embolization of gastroduodenal artery. Subsequently, pt had an appropriate HCT response to 2 units PRBCs from 23 to 29. Thereafter, pt had episodes of 100-200cc melena on [**8-9**], [**9-15**] and [**9-17**]. After each, HCT decreased by [**3-20**] points and was treated with transfusion as indicated below under "treatment of anemia." In addition to these episodes of melena, pt was likely experiencing continuous GI bleeding as BUN was elevated from baseline of 0.8 to 1.3-1.8 during most of hospital course. Following 2 episodes of melena on [**9-15**], patient underwent a Bleeding Study which revealed a faint area of increased tracer accumulation in LUQ that was possibly related to a slow bleed at 3rd-4th portion of duodenum. Following melena on [**9-17**], pt underwent repeat EGD, during which a hemorrhagic AVM in the proximal jejunum was identified and an endoclip was placed; additionally, severe gastritis was observed and 7cc of epinephrine was injected into the most severe region. Following this procedure, the patient recevied 2 units of pRBCs and has had no further melena; HCT has been stable at > 29.8. 2.) MDS - Mr. [**Known lastname 58415**] has a lifelong Hx of anemia w/ superimposed MDS and refractory anemia and thrombocytopenia with excess blast type II (11% blasts and trisomy 8). She has required pRBC transfusions since [**5-18**] about once weekly despit Procrit. At admission, in addition to her GI bleeding, she was having intermittent, persistent bleeding from her nasal mucosa. In hospital, PLT goal was > 20 due to ongoing bleeding and HCT goal was > 25 given CAD. Transfusions were given as needed as indicated below. Patient was followed closely by hematology, with followup by Dr. [**Last Name (STitle) **] as an outpatient. #Treatment of thrombocytopenia: on [**9-15**], prednisone was initiated at 80mg po qd, amicar was increased to 2g q6h and danazol was begun at 200mg q12h and titrated up to 400mg q12h at d/c; additionally, 30g IVIG was given for 5 days from [**9-15**] to [**9-19**]. Danazol can cause fluid retention, sun-sensitivity and fluctations in glucose levels; therefore, Given Hx of cardiac disease, she needs close following for fluid overload. Plan is to decrease prednisone dose at 1st outpatient visit with hematology, scheduled for [**9-30**]. In total, patient received 42 units of platelets. All platelets must be HLA matched. PLT 67-57-41-43 4 days prior to discharge and 31 at discharge. Given this trend downwards, will need close follow up of PLT count s/p d/c. Range while inpatient = 17 (on [**9-14**] & [**9-15**]) to 67. #Treatment of anemia: patient recieved a total of 9 units of pRBCs while an inpatient to maintain HCT > 25. Transfusions were given followed by 20mg IV LASIX. Most recent transfusion of 2 U pRBC given 4 days prior to discharge. HCT stable for 3 days prior to discharge at >29.8, and = 31.1 at d/c. Range during inpatient = 22.3 ([**9-11**]) to 31.1. 3.) Cardiac: EKG at admission: Sinus bradycardia with nonspecific lateral ST-T changes w/ no previous tracing for comparison. Patient remained hemodynamically stable throughout course with pulse range 42-72 and BP range 100-160/50-77. #HTN: Tends to be refractory. Large pulse pressure differential. Pt. continued on outpatient regimen of metoprolol, losartan, amlodipine, terazosin and clonidine. Lopressor maintained at 50mg po bid, may be titrated back to 100mg [**Hospital1 **] as outpatient. #Pump: Echo (TTE) on [**9-12**]: moderate [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) 1915**], LV EF = 60-65%. 4.)Access: Pt has PICC line in place from [**Location (un) 19061**], approx 2wk PTA. Heme consulted who recommended PICC can remain in place for up to 3 months. PICC kept in place and will be removed as an outpatient by hematology. If long term access needed for regular transfusions, consider Hickman placement. 5.)Renal: on [**9-14**], cr bumped from 1.1 to 1.7, despite good urine production. This may have been due to increased amnt intra-luminal bleeding. Additionally, a prerenal state may have contributed from the setting of GIB. Patient was given 2U pRBC and Cre trended downward to 1.2 on [**9-19**]. Range during course 1.1-1.7. 6.)PUML: CXR at admission: well placed L PICC with L lung base atelectasis. Patient maintained good oxygen saturation throughout course with range=94-99% RA. 7.)ID: WBC count low throughout course with range 1.1 ([**9-16**]) to 4.1. Pt maintained on neutropenic precautions beginning [**9-16**]. Patient remained afebrile throughout course with Tmax=99.6 and no antibiotics were given. Neupogen not indicated as PMN remained >500. Severe gastritis was observed on EGD and H. pylori serology was +. Therefore, initiating therapy on day of d/c: amoxicillin + clarithromycin + PPI. 8.)FEN: patient was maintained on liquid to soft-solid diet for much of course given ongoing GI bleeding. Patient tolerated 3 days of regular diet prior to d/c. Lytes were repleted as needed. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 12738**] HMS4 for [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] MD. Medications on Admission: Protonix 40 mg PO qd Amicar 2 g PO q6h Synthroid 25 mcg PO qd Zocor 80 mg PO qd Danazol 200 mg PO bid Clonidine .1 mg PO bid Terazosin 2 mg PO qd Cozaar 100 mg PO qd Lopressor 100 mg PO bid Norvasc 10 mg PO qAM, 5 mg PO qPM Caltrate 600 mg PO qd MVI 1 tab PO qd Lasix 40 mg PO bid Colace 100 mg PO bid Discharge Medications: 1. Levothyroxine Sodium 25 mcg Tablet Sig: One (1) Tablet PO QD (once a day). 2. Multivitamin Capsule Sig: One (1) Cap PO QD (once a day). 3. Amlodipine Besylate 5 mg Tablet Sig: Two (2) Tablet PO QAM (once a day (in the morning)). 4. Amlodipine Besylate 5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 5. Losartan Potassium 50 mg Tablet Sig: Two (2) Tablet PO QD (once a day). 6. Terazosin HCl 2 mg Capsule Sig: One (1) Capsule PO HS (at bedtime). 7. Simvastatin 40 mg Tablet Sig: Two (2) Tablet PO QD (once a day). 8. Clonidine HCl 0.1 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 9. Aminocaproic Acid 500 mg Tablet Sig: Four (4) Tablet PO Q6H (every 6 hours). Disp:*480 Tablet(s)* Refills:*2* 10. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). 11. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 12. Caltrate 600 Oral 13. Colace 100 mg Capsule Sig: One (1) Capsule PO twice a day: Don't take if having diarrhea. 14. Prednisone 20 mg Tablet Sig: Four (4) Tablet PO QD (once a day). Disp:*40 Tablet(s)* Refills:*2* 15. Danazol 200 mg Capsule Sig: Two (2) Capsule PO BID (2 times a day). Disp:*112 Capsule(s)* Refills:*2* 16. Clarithromycin 500 mg Tablet Sig: One (1) Tablet PO twice a day for 14 days. Disp:*28 Tablet(s)* Refills:*0* 17. Amoxicillin 500 mg Tablet Sig: Two (2) Tablet PO twice a day for 14 days. Disp:*56 Tablet(s)* Refills:*0* 18. Heparin Flush (Porcine) in NS 100 unit/mL Kit Sig: Two (2) ml Intravenous once a day: PICC care: 10ml NS followed by 2ml of 100Units/ml heparin (200units heparin) each lumen QD and PRN. Inspect Site every shift. Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - Acute Rehab Discharge Diagnosis: -Gastrointestinal bleeding -Duodenal and jejunal arterio-venous malformations. -CAD, s/p 3 v. CABG -osteoarthritis -Mylodysplastic syndrome (MDS): associated with anemia and thrombocytopenia -hypercholesterolemia Discharge Condition: stable Discharge Instructions: Please call your doctor if you have any further bleeding from your rectum, chest pain, lightheadedness, abdominal pain, nausea, vomiting, fevers or chills. You will need to have your hematocrit and platelet count checked on Tuesday, [**2183-9-23**] at your visit with your primary care physician. [**Name10 (NameIs) **] will need to take an ambulance to your doctor's office before your scheduled appointment. Followup Instructions: Please follow-up with your PCP, [**Name10 (NameIs) **],[**Name11 (NameIs) 20**] [**Name Initial (NameIs) **]. ([**Telephone/Fax (1) 1408**]) on Tuesday, [**9-23**] at 2:00PM. Please be sure to have your blood drawn for a complete blood count (CBC) at that time. Please follow up with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] and his fellow Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] in the department of hematology on Tuesday, [**9-30**] at 10AM. Call [**Telephone/Fax (1) 15328**] with any questions. Please make an appointment to see Dr. [**First Name (STitle) **] [**Name (STitle) 11326**] in the department of gastroenterology in [**3-19**] weeks. Provider: [**Name10 (NameIs) 17515**] CHAIR 1A Date/Time:[**2183-9-18**] 10:00 Provider: [**Name10 (NameIs) **] [**Name8 (MD) **], RN Where: [**Hospital6 29**] HEMATOLOGY/ONCOLOGY Phone:[**Telephone/Fax (1) 22**] Date/Time:[**2183-9-18**] 10:00 Provider: [**Name10 (NameIs) **] Where: [**Hospital6 29**] CARDIAC SERVICES Phone:[**Telephone/Fax (1) 128**] Date/Time:[**2183-10-8**] 10:00 [**Name6 (MD) 251**] [**Name8 (MD) **] MD [**MD Number(1) 910**] ICD9 Codes: 5849, 4280, 2720, 2449
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8349 }
Medical Text: Admission Date: [**2185-9-14**] Discharge Date: [**2185-9-23**] Service: MEDICINE Allergies: Codeine / Penicillins / Aspirin / Fentanyl Attending:[**First Name3 (LF) 2605**] Chief Complaint: Foreign body aspiration Major Surgical or Invasive Procedure: Bronchoscopy History of Present Illness: 81yo F w/ MMP including lung cancer s/p RML and LUL lobectomies, with new L hilar mass and R base mass, who was eating lunch at her [**Hospital3 **] facility today when she aspirated what she thought was a piece of lamb. She was seen in the nursing station at her [**Hospital3 **] facility and was felt to be doing OK, so was sent to her room. However 15 mins later, the pt's aide noted that she had a lot of frothy white sputum, was abdominal breathing, and was not talking much. Her color also looked off. Her O2 sats were only 70% at the time and she was unable to talk (her speech was very garbled). She was taken to the [**Hospital1 18**] ER for evaluation by EMS. EMS had her on 15L by NRB. On arrival to the hospital, her sats were only in the 60s on a NRB. She was given another combivent nebulizer w/o improvement. CXR revealed no radioopaque objects in her trachea. Her sats began to drop into the 50s and she was tachypneic to the 30s, usuing accessory muscles of respiration. She was noted to be AAOx3 and agreed to be intubated. She was given ativan, etomidate, and succinylcholine. After intubation, her sats improved to the 90s and she was stabilized on the vent. She was transferred to the MICU for bronchoscopy and retrieval of the foreign body. Bronchoscopy revealed an object lodged in the R main bronchus. Multiple attempts were made at obtaining the food particles, but 2 mushrooms were eventually dislodged. She continued to do well post-bronchscopy but the decision was made to keep her intubated in case repeat bronchoscopy was needed in the AM to insure that all food particles had been retrieved. Past Medical History: # Lung cancer - s/p RUL lobectomy in [**2169**] for bronchoalveolar carcinoma - s/p segemental resection of posterior segment of LUL in [**2173**] - path = adenoca NOS, moderately differentiated features, neg LN - repeat mass found in LUL in [**2183**] -> bronchoscopy -> developed resp failure post bronch requiring ventilation (? [**1-20**] muscle rigidity from fentanyl) - path of [**2184-1-22**] mass = infiltrating adenoca w/ papillary features - then found L hilar mass -> 6 cycles chemo w/ navelbine + XRT - L hilar mass enlarged, plus new mass at R lung base (20 x 13mm) - opted for no further treatment # COPD - last PFTs in [**2173**] - FEV1 1.80, FVC 2.05, FEV1/FVC 88 (125%) # hypothyroidism # h/o TIA/CVA - MRA in [**2172**] showed 80%+ stenosis of [**Doctor First Name 3098**], 90%+ of [**Country **] - s/p L CEA in [**2172**] (h/o R CEA in past) - [**2182**]: R ICA w/ 70-79% stenosis L ICA w/ 60-69% stenosis - MRA in [**2182**] showed subacute vs. acute infarct L internal capsule - per neuro notes, strokes have been bilateral and had residual L sided hemiparesis (though not noted on neuro exams) # Parkinson's # PVD and claudication # Cervical stenosis - s/p anterior cervical disk excision and fusion of screws # HTN # Osteoarthritis and osteoporosis # s/p R THR in [**2171**] for OA - then had R hip dislocation in [**2181**], s/p closed reduction # OSA - not on CPAP # h/o PUD # Depression # CRI - baseline Cr is 1.7 - 3.2 in last 2 yrs Social History: Lives at [**Location 5583**] House x 2 yrs. 90 pack-yr smoker. h/o EtOH abuse. Widowed, husband died in [**2171**]. Family History: NC Physical Exam: VS - T 97.2, BP 173/73, HR 86, RR 26, sats 100% on AC 450x12, PEEP 10, FiO2 60% Gen: Thin, cachetic elderly female, sedated and intubated. HEENT: Sclera anicteric. L pupil 5mm, reactive, R pupil 3mm, reactive. Neck supple, no JVD. CV: RR, normal S1, S2. No m/r/g. Lungs: CTA anteriorly, no wheezes/rhonchi/crackles. Unable to sit pt up to listen posteriorly. Abd: Soft, NTND. + BS. No masses. Ext: 2+ DP, radial pulses bilaterally. Neuro: Sedated. Withdraws all 4 extremities to painful stimuli. Upgoing toes bilaterally. Pertinent Results: LABS on admission: WBC 9.7, Hct 36.8, Plt 351, MCV 93 (diff: 83.9N, 12.6L, 2.8M, 0.6E, 0.1B) PT 11.9, PTT 29.1, INR(PT) 1.0 Na 142, K 4.3, Cl 102, HCO3 26, BUN 30, Cr 1.9, Glu 145 CK(CPK) 12*, CK-MB NotDone, trop <0.01 ABG pO2-32* pCO2-46* pH-7.39 calTCO2-29 Base XS-1 EKG: sinus, rate 90, normal intervals, normal axis, LAE (biphasic P waves in V1-V2), no Q waves, no ST or TW changes . CXR [**2185-9-14**]: Compared with [**2184-12-8**], the patchy infiltrates in the right lung have cleared, but the region of clustered linear opacities in the left upper lung field are still present, either more confluent or smaller in size. No acute infiltrates or obvious CHF or effusions. The patient is status post lower anterior cervical spine fusion, with her chin somewhat low in position at this time. Whether this is a fixed posture or not is uncertain. . CXR [**2185-9-14**]: (my read) R line clear, L hilar mass, ETT 2 mm above carina, normal heart size . [**2185-9-14**] 02:35PM BLOOD WBC-9.7 RBC-3.94* Hgb-12.4 Hct-36.8 MCV-93 MCH-31.4 MCHC-33.7 RDW-14.7 Plt Ct-351 [**2185-9-15**] 06:03AM BLOOD WBC-9.3# RBC-3.48* Hgb-11.1* Hct-33.2*# MCV-95 MCH-32.0 MCHC-33.6 RDW-14.6 Plt Ct-282 [**2185-9-16**] 04:31AM BLOOD WBC-9.7 RBC-3.34* Hgb-10.9* Hct-31.3* MCV-94 MCH-32.5* MCHC-34.7 RDW-14.7 Plt Ct-256 [**2185-9-18**] 04:34AM BLOOD WBC-9.7 RBC-3.71* Hgb-12.2 Hct-35.3* MCV-95 MCH-32.9* MCHC-34.6 RDW-14.9 Plt Ct-292 [**2185-9-19**] 07:05AM BLOOD WBC-7.2 RBC-3.57* Hgb-11.5* Hct-33.8* MCV-95 MCH-32.2* MCHC-34.0 RDW-14.9 Plt Ct-341 [**2185-9-20**] 05:35AM BLOOD WBC-7.4 RBC-3.38* Hgb-10.9* Hct-31.7* MCV-94 MCH-32.3* MCHC-34.5 RDW-15.3 Plt Ct-326 [**2185-9-21**] 09:44AM BLOOD WBC-7.4 RBC-3.36* Hgb-11.2* Hct-31.5* MCV-94 MCH-33.2* MCHC-35.4* RDW-15.1 Plt Ct-319 [**2185-9-14**] 02:35PM BLOOD PT-11.9 PTT-29.1 INR(PT)-1.0 [**2185-9-14**] 02:35PM BLOOD Glucose-145* UreaN-30* Creat-1.9* Na-142 K-4.3 Cl-102 HCO3-26 AnGap-18 [**2185-9-15**] 03:47AM BLOOD Glucose-77 UreaN-25* Creat-1.2* Na-143 K-3.0* Cl-115* HCO3-19* AnGap-12 [**2185-9-15**] 06:03AM BLOOD Glucose-93 UreaN-29* Creat-1.8* Na-142 K-3.9 Cl-108 HCO3-25 AnGap-13 [**2185-9-16**] 04:31AM BLOOD Glucose-87 UreaN-19 Creat-1.5* Na-145 K-3.5 Cl-112* HCO3-23 AnGap-14 [**2185-9-17**] 04:55AM BLOOD Glucose-96 UreaN-19 Creat-1.5* Na-145 K-3.5 Cl-109* HCO3-21* AnGap-19 [**2185-9-18**] 04:34AM BLOOD Glucose-97 UreaN-21* Creat-1.5* Na-145 K-3.9 Cl-109* HCO3-22 AnGap-18 [**2185-9-19**] 07:05AM BLOOD Glucose-110* UreaN-17 Creat-1.2* Na-144 K-3.3 Cl-107 HCO3-25 AnGap-15 [**2185-9-20**] 05:35AM BLOOD Glucose-96 UreaN-17 Creat-1.3* Na-139 K-3.6 Cl-105 HCO3-26 AnGap-12 [**2185-9-21**] 09:44AM BLOOD Glucose-134* UreaN-20 Creat-1.6* Na-148* K-3.9 Cl-105 HCO3-26 AnGap-21* [**2185-9-21**] 05:00PM BLOOD Glucose-95 UreaN-23* Creat-1.5* Na-138 K-4.1 Cl-105 HCO3-21* AnGap-16 [**2185-9-14**] 02:35PM BLOOD CK(CPK)-12* [**2185-9-14**] 02:35PM BLOOD cTropnT-<0.01 [**2185-9-14**] 02:35PM BLOOD CK-MB-NotDone [**2185-9-15**] 03:47AM BLOOD Calcium-6.1* Phos-2.7 Mg-1.6 [**2185-9-16**] 04:31AM BLOOD Calcium-8.2* Phos-4.2 Mg-1.7 [**2185-9-18**] 04:34AM BLOOD Calcium-9.6 Phos-3.0 Mg-1.9 [**2185-9-19**] 07:05AM BLOOD Calcium-9.3 Phos-2.9 Mg-1.5* [**2185-9-14**] 02:47PM BLOOD pO2-30* pCO2-58* pH-7.31* calTCO2-31* Base XS-0 [**2185-9-14**] 02:49PM BLOOD pO2-32* pCO2-46* pH-7.39 calTCO2-29 Base XS-1 Brief Hospital Course: 81 yo F w/ h/o lung cancer not amenable to treatment, dementia and prior CVAs s/p mult. aspirations, htn, CRI presented w/ hypoxic respiratory failure [**1-20**] aspiration now moving towards palliative care management. In the MICU, she continued to do well post-bronchoscopy and was extubated on [**2185-9-15**]. She has had excellent O2 saturations averaging 96% on room air during the day. However, she has required 2L NC overnight while in the MICU. Her MICU course has been significant for hypertension. She has been NPO with h/o recurrent aspirations in the past and has had an NG tube in which she has removed several times, not because she is delerius but because she doesn't like it. When she is given her po blood pressure medications, her BP runs in the 130s. However, when NG is not in, she has required IV hydralazine and SL isordil with BPs in the 150s-180s. She has not yet had a speech and swallow evaluation as her mental status would not tolerate until recently. HTN: Patient's MICU stay was complicated by hypertension as she was NPO for aspiration risk and would not maintain an NG tube. On IV hydralazine, SL isosorbide, BPs were in the 160s-180s. IV lopressor was added and BPs decreased slightly but persisted in 180s at times. Patient failed video swallow again and a family meeting was held with the geriatrics team. [**Hospital **] healthcare proxy along with patient and family input decided that patient should be made DNR/DNI and should be allowed to be fed for improved quality of life. Patient's diet was advanced and patient did well without evidence of respiratory compromise. Her affect greatly improved after starting to eat again. All of her IV blood pressure medications were stopped and she was started back on her home dose norvasc and isosorbide dinitrate. She had improved BP control back on her oral medication regimen. . # ASPIRATIONS: She failed repeat swallow evaluation but family determined that patient's code status should be changed and patient should be allowed to eat and take medications as described above given her poor prognosis to improve the quality of her life. Staff were instructed to take comfort measures only if patient were to aspirate including O2, suctioning, nebulizers, and morphine. All medications given were crushed. As well, all unnecessary medications including fexofenadine, donepazil, flonase, simvastatin, and pletal were discontinued. Palliative care was consulted and were actively involved in the goals of her care. . # INCREASED SECRETIONS- patient has had increased secretions post extubation in MICU which persisted on the floor. These were managed with bedside suctioning, frequent suctioning by nurses, and hyoscyamine which was changed from prn to QID standing doses. . # HYPOXIC RESPIRATORY FAILURE: Likely due to foreign body aspiration.(2 mushrooms were found in the R main bronchus). Extubated on [**9-15**] and then saturated well on room air with only occasional dips into the low 90s overnight when not on her CPAP machine. . # OSA: She normally uses CPAP outside of hospital and was started on CPAP [**9-18**] with improved overnight O2 saturations. . # h/o TIA/STROKE: No change in neurologic exam. No active issues. Pletal was d/c'ed as above . # CRI- baseline Creatinine in last year seemed to be between 1.5-2.0. Patient persisted at former baseline with infrequent gentle IV hydration to supplement po intake. . # DEMENTIA: No acute issues. Aricept d/c'ed as above. . # HYPOTHYROIDISM: No active issues. She was restarted on her home dose levothyroxine once po medications restarted. . # DEPRESSION: She initially had a flattened affect which improved once patient's diet was advanced. She was continued on her lexapro throughout admission. . # PUD- No acute issues. She was initially managed on protonix which was changed to her home med prevacid once diet was advanced as patient was receiving crushed meds and protonix could not be crushed Medications on Admission: MVI 1 tab PO QD Flonase 1 spray INH QD Levsin elixir .125mg PO Q4-6 prn Norvasc 10mg PO QHS Aricept 10mg PO QHS Prevacid 30mg PO BID Albuterol inhalers 1-2 puffs INH Q4 prn Tessalon perles 100mg PO TID Lexapro 20mg PO QD Levoxyl 50mcg PO QD Cilostazol (pletal) 100mg PO QD simvastatin 40mg PO QHS Isosorbide 10mg PO TID Loratidine 10mg PO QD . ** only med NOT on list is Ritalin 10mg PO TID - ordered [**8-23**], reordered [**7-24**] ** Discharge Medications: 1. Amlodipine 5 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime). 2. Albuterol 90 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation Q4H (every 4 hours) as needed for shortness of breath or wheezing. 3. Escitalopram 10 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 4. Levothyroxine 50 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Acetaminophen 500 mg Tablet Sig: One (1) Tablet PO Q4-6H (every 4 to 6 hours) as needed. 6. Docusate Sodium 100 mg Tablet Sig: One (1) Tablet PO twice a day as needed for constipation: hold for loose stools. Disp:*60 Tablet(s)* Refills:*2* 7. Senna 8.6 mg Tablet Sig: One (1) Tablet PO twice a day as needed for constipation. Disp:*120 Tablet(s)* Refills:*2* 8. Isosorbide Dinitrate 10 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 9. Lansoprazole 30 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO twice a day. 10. Hyoscyamine Sulfate 0.125 mg Tablet, Sublingual Sig: One (1) Tablet, Sublingual Sublingual QID (4 times a day). Disp:*120 Tablet, Sublingual(s)* Refills:*2* 11. CPAP at night per previous settings 12. Morphine Concentrate 20 mg/mL Solution Sig: 1-20 mg PO Q1hr SL as needed for pain or respiratory distress. Disp:*qs * Refills:*0* Discharge Disposition: Home With Service Facility: Hospice of the good [**Doctor Last Name 9995**] Discharge Diagnosis: Primary: 1. hypoxic respiratory failure 2. aspiration 3. dysphagia . Secondary 1. lung cancer 2. hypertension 3. hypothyroidism 4. COPD 5. hyperlipidemia 6. obstructive sleep apnea 7. depression 8. chronic renal failure Discharge Condition: stable Discharge Instructions: Please take all medications as prescribed. . Please follow up with Dr. [**First Name8 (NamePattern2) 712**] [**Name (STitle) 713**] as listed below. . Please call your doctor or return to the hospital if you experience chest pain, shortness of breath, difficulty swallowing, fevers, chills, abdominal pain, or any other concerns. Followup Instructions: Please follow up with Dr. [**Last Name (STitle) 713**] as below: Provider: [**First Name8 (NamePattern2) **] [**Name11 (NameIs) **], MD Phone:[**Telephone/Fax (1) 719**] Date/Time:[**2185-10-4**] 8:30 . Provider: [**First Name8 (NamePattern2) **] [**Name11 (NameIs) **], MD Phone:[**Telephone/Fax (1) 719**] Date/Time:[**2185-11-22**] 2:00 . . Please follow up with orthopedics as below: Provider: [**Name10 (NameIs) **],[**First Name7 (NamePattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 7145**] ORTHOPEDIC PRIVATE PRACTICE Date/Time:[**2186-7-7**] 11:00 [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 2608**] MD, [**MD Number(3) 2609**] ICD9 Codes: 496, 5859, 2449, 311
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Medical Text: Admission Date: [**2124-9-14**] Discharge Date: [**2124-10-14**] Date of Birth: [**2063-12-6**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2009**] Chief Complaint: Seizure, brain mass Major Surgical or Invasive Procedure: Intubation, central line placement and removal, arterial line placement and removal, tracheostomy placement and removal, PEG placement, lumbar puncture x 2, PICC placement, Bronchoscopy x 2, Laryngoscopy History of Present Illness: Patient is a 60 year old female with auto-immune hepatitis who was found to be unresponsive by her family, and seizing after a fall. . She was first seen for evaluation of her liver disease in [**State 4565**] and [**State 8780**] in [**2124-5-21**]. At that time she had recently returned from a trip to [**Country 651**] from [**Month (only) 547**] to [**2124-5-21**]. During that travel she developed severe itching associated with extremity swelling and edema. These subsequently subsided but when she returned she sought medical attention. On laboratories she was noted to have elevated liver function tests and subsequently progressed to "near fulminant liver failure." In mid [**Month (only) **] her INR was 1.6 (peaked at 2.0), bilirubin was 23 and her transaminases were 300-400. Her WBC count was 6.8, hct 31.2, platelets 125, total bilirubin 23, AST 441, ALT 306 Alkaline phosphatase 297, albumin 2.5, INR 1.6. Her electrolytes were within normal limits. Her lipase was 367. Her [**Doctor First Name **] was positive at 1:80. Her hepatitis B surface angigen, hepatitis C antibody, hepatitis A IgG and IgM were negative. She underwent a liver biopsy on [**2124-6-13**] which showed reactive hepatocytes, cholestasis, and inflammatory infiltrate. The biopsy was felt to be consistent with autoimmune hepatitis, drug reaction or extra-hepatic obstruction. She was started on immuran and prednisone on [**2124-6-21**] for presumed autoimmune hepatitis with plans to also undertake an MRCP to assess for sclerosing cholangitis. Per OSH notes she did have an MRCP but report not available to us at [**Hospital1 18**]. Between [**2124-6-21**] and [**2124-7-14**] her total bilirubin decreased from 21 to 17 (direct 9.8) with a decrease in her transaminases to AST 176 and ALT 223 with alkaline phosphatase of 213. Lipase at that time was 595 and INR was 1.7. She was scheduled to complete a prednisone taper starting at 30 mg and tapering over one month to 10 mg daily. She was also started on ursodiol in late [**Month (only) 205**]. There are no additional laboratory values between then and her admission here on [**2124-9-14**] although per the patient's family she was under the care of a naturopath while in [**Location (un) 86**] in [**Month (only) 216**] who was administering a number of naturopathic supplements (including iron) to help with her liver disease, and laboratory work was taken. The patient reported that despite improvement in her laboratory values she continued to feel fatigued and had swelling of her legs. . The patient lives in [**State 8780**] but immediately prior to this admission was visiting family in [**Location (un) 3844**]. Per family report, over the last several days the patient was lethargic, had difficulty with movement, swelling, foot numbness, and fatigue. On the day prior to admission, she complained of fever and chills and had a recorded temperature of 102. On the morning of admission on [**2124-9-14**], her family found the patient on the floor with reported seizure activity. EMS responded and administered valium, which did not break the seizure fully. In the field, she had a HR of 120s and was breathing spontaneously. She was taken to an outside hospital, where her seizure was broken with fosphenytoin and ativan. Due to concerns over airway protection and unresponsiveness, she was intubated at that time. A CT of head, by report, demonstrated a left frontal mass and left frontal subarachnoid hemorrhage. She was transferred to [**Hospital1 18**] for further management. In the [**Hospital1 18**] emergency room, she was given Vitamin K, 2 units of FFPs, and decadron 10 mg IV. Upon arrival to [**Hospital1 18**], she was found to be hypothermic and hypotensive, and was placed on pressors. A repeat head CT confirmed the above findings. She was initially admitted to the neurosurgial ICU, when decision was made not to operate she was transfered to the medical service for continued work up and treatment. Past Medical History: 1. Autoimmune hepatitis - Diagnosed [**2124-5-21**]. 2. Bronchitis 3. per report, evaluated at [**Doctor Last Name 21721**] for arthritis in [**2124-4-20**] Social History: Patient lives in [**State 8780**] and was visiting family members in [**Name2 (NI) **] [**Name (NI) **]. Per report, there is no history of tobacco or alcohol use. She lives alone, works as an education consultant for a chartered school. She has a law degree. She visited [**Country 12602**] 8 months ago. She has also visited [**Country 3399**], [**Country 15800**], and other Subsaharan countries for work and as a tourist. She visited [**Country 651**] in [**Month (only) 547**] and spent 21 days there. This trip was part of an educational exchange program, for which she serves on the board of directors. As noted elsewhere, she toured various parts of [**Country 651**] and stayed mainly in hotels; she did visit rural areas, however. Family History: Non-contributory. No history of liver disease, infections or auto-immune diseases. Physical Exam: (At time of admission to MICU) General: Intubated, opens eyes spontaneous at times. NAD. HEENT: NC/AT. No scleral icterus. Pupils reactive bilaterally. No scleral icterus or conjunctival pallor. No facial asymmetry noted. Neck: C-collar in place. IJ in place. Lungs: Rhoncerous sounding bilaterally. No wheezes. Bilateral breath sounds. Cardiac: Borderline tachycardic, regular, no m/g/r Abdomen: Soft, NT, ND, +BS Extr: Warm, 2+ pitting edema to just above ankle bilaterally. A-line in place over right radial. Neuro: Opens eyes occasionally, no purposeful movements noted. Withdraws feet R>L to noxious stimuli. Reflexes 3+ right patella, 2+ left, 3+ bilaterally at bicesp. PERRL. Skin: 1 cm erythemaous lesion over left 3rd finger. No other lesions noted. Lines appear c/d/i. Pertinent Results: [**2124-9-16**] 08:36AM CEREBROSPINAL FLUID (CSF) WBC-79 RBC-1280* Polys-58 Lymphs-24 Monos-0 Atyps-4 Macroph-14 [**2124-9-16**] 08:36AM CEREBROSPINAL FLUID (CSF) WBC-101 RBC-732* Polys-57 Lymphs-26 Monos-0 Atyps-4 Macroph-13 [**2124-9-16**] 08:36AM CEREBROSPINAL FLUID (CSF) TotProt-257* Glucose-8 [**2124-9-28**] 12:39PM CEREBROSPINAL FLUID (CSF) WBC-14 RBC-634* Polys-2 Lymphs-89 Monos-0 Atyps-3 Macroph-6 [**2124-9-28**] 12:39PM CEREBROSPINAL FLUID (CSF) WBC-33 RBC-656* Polys-1 Lymphs-96 Monos-0 Macroph-3 [**2124-9-28**] 12:39PM CEREBROSPINAL FLUID (CSF) TotProt-89* Glucose-58 LD(LDH)-48 Blood Culture, Routine (Final [**2124-9-21**]): REPORTED BY PHONE TO [**Doctor First Name 80500**] [**Doctor Last Name **] -CC6C- @ 14:45 [**2124-9-17**]. LISTERIA MONOCYTOGENES. FINAL SENSITIVITIES. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ LISTERIA MONOCYTOGENES | AMPICILLIN------------<=0.12 S PENICILLIN G---------- 0.12 S TRIMETHOPRIM/SULFA---- 0.5 S Anaerobic Bottle Gram Stain (Final [**2124-9-16**]): REPORTED BY PHONE TO [**Doctor First Name 26**] [**Doctor Last Name **] @ 1700 ON [**9-16**] - CC6C. GRAM POSITIVE ROD(S). [**2124-9-15**] 8:23 pm URINE Source: Catheter. **FINAL REPORT [**2124-9-18**]** URINE CULTURE (Final [**2124-9-18**]): ENTEROCOCCUS SP.. 10,000-100,000 ORGANISMS/ML.. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ ENTEROCOCCUS SP. | AMPICILLIN------------ <=2 S NITROFURANTOIN-------- <=16 S TETRACYCLINE---------- <=1 S VANCOMYCIN------------ 2 S [**2124-9-16**] 8:36 am CSF;SPINAL FLUID Source: LP TUBE 3. **FINAL REPORT [**2124-10-6**]** GRAM STAIN (Final [**2124-9-16**]): THIS IS A CORRECTED REPORT 2105, [**2124-9-16**]. REPORTED BY PHONE TO [**Name6 (MD) 3688**] [**Name8 (MD) **] MD (#[**Numeric Identifier 80501**]) AT 2100 ON [**2124-9-16**]. 2+ (1-5 per 1000X FIELD): POLYMORPHONUCLEAR LEUKOCYTES. 1+ (<1 per 1000X FIELD): GRAM POSITIVE ROD(S). This is a concentrated smear made by cytospin method, please refer to hematology for a quantitative white blood cell count.. PREVIOUSLY REPORTED AS AT 1215 ON [**2124-9-16**]. 2+ (1-5 per 1000X FIELD): POLYMORPHONUCLEAR LEUKOCYTES. NO MICROORGANISMS SEEN. This is a concentrated smear made by cytospin method, please refer to hematology for a quantitative white blood cell count.. FLUID CULTURE (Final [**2124-9-19**]): LISTERIA MONOCYTOGENES. SPARSE GROWTH. SULFA X TRIMETH <=0.5/9.5 UG/ML. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ LISTERIA MONOCYTOGENES | AMPICILLIN------------<=0.12 S PENICILLIN G----------<=0.06 S TRIMETHOPRIM/SULFA---- S FUNGAL CULTURE (Final [**2124-10-6**]): NO FUNGUS ISOLATED. [**2124-9-22**] 3:51 pm BRONCHIAL WASHINGS GRAM STAIN (Final [**2124-9-22**]): NO POLYMORPHONUCLEAR LEUKOCYTES SEEN. NO MICROORGANISMS SEEN. SMEAR REVIEWED; RESULTS CONFIRMED. RESPIRATORY CULTURE (Final [**2124-9-25**]): OROPHARYNGEAL FLORA ABSENT. ACINETOBACTER SP.. >100,000 ORGANISMS/ML.. sensitivity testing performed by Microscan. SENSITIVE TO Levofloxacin <= 2 UG/ML. SENSITIVE TO Cefepime <= 2 UG/ML. SENSITIVE TO MEROPENEM <= 1 UG/ML. YEAST. 10,000-100,000 ORGANISMS/ML.. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ ACINETOBACTER SP. | CEFTAZIDIME----------- <=2 S CIPROFLOXACIN--------- <=0.5 S GENTAMICIN------------ <=1 S IMIPENEM-------------- <=1 S PIPERACILLIN---------- 16 S PIPERACILLIN/TAZO----- 16 S TOBRAMYCIN------------ <=1 S TRIMETHOPRIM/SULFA---- <=2 S POTASSIUM HYDROXIDE PREPARATION (Final [**2124-9-25**]): TEST CANCELLED, PATIENT CREDITED. if pulmonary Histoplasmosis, Coccidioidomycosis, Blastomycosis, Aspergillosis or Mucormycosis is strongly suspected, contact the Microbiology Laboratory (7-2306). FUNGAL CULTURE (Final [**2124-10-6**]): YEAST. VIRAL CULTURE (Preliminary): No Virus isolated so far. VIRAL CULTURE: R/O CYTOMEGALOVIRUS (Final [**2124-9-25**]): SPECIMEN NOT PROCESSED DUE TO: DUPLICATE REQUEST. REFER TO VIRAL CULTURE FOR RESULTS. PATIENT CREDITED. [**2124-10-11**] 9:47 am URINE Source: CVS. **FINAL REPORT [**2124-10-12**]** URINE CULTURE (Final [**2124-10-12**]): NO GROWTH. [**2124-10-12**] 07:16AM BLOOD WBC-3.1* RBC-2.38* Hgb-8.5* Hct-24.8* MCV-105* MCH-35.8* MCHC-34.2 RDW-23.3* Plt Ct-120* [**2124-10-11**] 06:01AM BLOOD WBC-3.1* RBC-2.40* Hgb-8.3* Hct-25.0* MCV-104* MCH-34.7* MCHC-33.3 RDW-23.9* Plt Ct-107* [**2124-10-10**] 06:10AM BLOOD WBC-3.8* RBC-2.40* Hgb-8.6* Hct-24.9* MCV-103* MCH-35.6* MCHC-34.4 RDW-24.6* Plt Ct-133* [**2124-10-12**] 07:16AM BLOOD Plt Ct-120* [**2124-10-12**] 07:16AM BLOOD PT-15.9* PTT-39.2* INR(PT)-1.4* [**2124-10-11**] 06:01AM BLOOD Plt Ct-107* [**2124-10-11**] 06:01AM BLOOD PT-15.4* PTT-36.7* INR(PT)-1.4* [**2124-10-10**] 06:10AM BLOOD Plt Ct-133* [**2124-10-10**] 06:10AM BLOOD PT-15.1* PTT-38.7* INR(PT)-1.3* [**2124-9-29**] 04:03AM BLOOD Ret Aut-5.4* [**2124-9-15**] 04:47PM BLOOD ACA IgG-22.0* ACA IgM-11.8 [**2124-9-15**] 04:47PM BLOOD Lupus-NEG [**2124-10-12**] 07:16AM BLOOD Glucose-98 UreaN-9 Creat-0.4 Na-139 K-3.1* Cl-111* HCO3-26 AnGap-5* [**2124-10-11**] 10:08PM BLOOD K-3.4 [**2124-10-11**] 03:20PM BLOOD K-3.1* [**2124-10-11**] 06:01AM BLOOD Glucose-105 UreaN-10 Creat-0.5 Na-141 K-2.5* Cl-110* HCO3-27 AnGap-7* [**2124-10-10**] 06:10AM BLOOD Glucose-111* UreaN-12 Creat-0.5 Na-141 K-2.7* Cl-109* HCO3-26 AnGap-9 [**2124-10-9**] 05:56AM BLOOD Glucose-117* UreaN-12 Creat-0.4 Na-138 K-2.9* Cl-108 HCO3-27 AnGap-6* [**2124-10-8**] 06:18AM BLOOD Glucose-100 UreaN-11 Creat-0.4 Na-141 K-3.6 Cl-112* HCO3-27 AnGap-6* [**2124-10-7**] 05:48PM BLOOD K-2.8* [**2124-10-12**] 07:16AM BLOOD ALT-32 AST-33 LD(LDH)-288* AlkPhos-414* TotBili-0.9 [**2124-10-11**] 06:01AM BLOOD ALT-35 AST-37 LD(LDH)-284* AlkPhos-453* TotBili-1.1 [**2124-10-10**] 06:10AM BLOOD ALT-39 AST-40 LD(LDH)-281* AlkPhos-528* TotBili-1.1 [**2124-10-9**] 05:56AM BLOOD ALT-46* AST-47* LD(LDH)-289* AlkPhos-604* Amylase-187* TotBili-1.2 [**2124-10-8**] 06:18AM BLOOD ALT-55* AST-54* LD(LDH)-262* AlkPhos-657* Amylase-199* TotBili-1.0 [**2124-10-12**] 07:16AM BLOOD Albumin-2.0* Calcium-7.6* Phos-2.5* Mg-1.9 [**2124-10-11**] 06:01AM BLOOD Calcium-7.6* Phos-2.9 Mg-2.0 [**2124-10-10**] 06:10AM BLOOD Calcium-7.8* Phos-3.3 Mg-2.0 [**2124-10-9**] 05:56AM BLOOD Calcium-7.5* Phos-2.4* Mg-2.0 [**2124-10-8**] 06:18AM BLOOD Albumin-1.7* Calcium-7.4* Phos-2.6* Mg-2.2 Iron-61 [**2124-10-8**] 06:18AM BLOOD calTIBC-146* Ferritn-371* TRF-112* [**2124-9-24**] 04:08AM BLOOD Hapto-<20* [**2124-9-19**] 04:06AM BLOOD calTIBC-139* Ferritn-760* TRF-107* [**2124-9-19**] 10:05AM BLOOD AMA-NEGATIVE [**2124-9-15**] 04:47PM BLOOD [**Doctor First Name **]-POSITIVE Titer-1:160 [**2124-9-15**] 04:47PM BLOOD CRP-34.3* [**2124-9-29**] 03:42PM BLOOD PEP-POLYCLONAL IgG-2451* IgA-441* IgM-212 IFE-NO MONOCLO [**2124-9-19**] 10:05AM BLOOD IgG-1783* RT APPROVED DATE: [**2124-9-19**] SPECIMEN RECEIVED: [**2124-9-18**] [**-7/3756**] SPINAL FLUID SPECIMEN DESCRIPTION: Received 2ml pale yellow fluid. Prepared 1 ThinPrep slide. CLINICAL DATA: 60 y/o female with fevers, brain lesion. REPORT TO: DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **]. [**Last Name (NamePattern1) **] DIAGNOSIS: Cerebrospinal fluid: NEGATIVE FOR MALIGNANT CELLS. DIAGNOSED BY: [**First Name8 (NamePattern2) 5335**] [**Last Name (NamePattern1) 5336**], CT(ASCP) [**First Name11 (Name Pattern1) 636**] [**Last Name (NamePattern4) 5337**], M.D. Cardiology Report ECG Study Date of [**2124-9-14**] 7:47:22 AM Sinus bradycardia. Non-specific ST-T wave changes. No previous tracing available for comparison. TRACING #1 Read by: [**Last Name (LF) **],[**First Name3 (LF) **] Intervals Axes Rate PR QRS QT/QTc P QRS T 56 100 110 462/455 13 -55 -1 CXR [**9-14**]: INDICATION: 60-year-old woman intubated for subarachnoid hemorrhage and seizure. [**Month/Year (2) **] ET tube, NG tube and for pneumonia or CHF. COMPARISON: None available. The ET tube tip is 2.7 cm from the carina, would recommend pulling back approximately 1-2cms. The NG tube tip is in the stomach. The lungs are clear, without evidence of pneumonia or CHF. There is bibasilar atelectasis amd a probable small left basal effusion. There is mild degenerative change in the thoracic spine. IMPRESSION: No acute intrathoracic process. Suggest pulling back ET tube [**12-22**] cms as discussed with Dr [**Last Name (STitle) **]. [**9-14**] CT HEAD WITHOUT CONTRAST INDICATION: Subarachnoid hemorrhage, with new mass, seizure, [**Month/Year (2) 4656**] for interval change and please compare with outside hospital CT. TECHNIQUE: MDCT-acquired contiguous axial images of the head were obtained without intravenous contrast. COMPARISON: Outside hospital CT from 5:30 a.m. from the same date. FINDINGS: There is a 4.3 x 2 cm area of low attenuation in the left frontal lobe with minimal surrounding edema and mild mass effect. There is bilateral fronto-parietal subarachnoid hemorrhage. There is loss of the adjacent [**Doctor Last Name 352**]- white matter differentiation without midline shift. There is no intraventricular hemorrhage. There are no fractures. The paranasal sinuses and mastoid air cells are clear. IMPRESSION: Large area of left frontal low attenuation lesion, which may represent acute infarct or tumor. In addition there is bilateral fronto- parietal subarachnoid hemorrhage without significant midline shift This is not significantly changed since the study at 5:30 a.m. from the same date. An MRI would be more sensitive for assesment of the left frontal lesion. [**9-14**] MRI OF THE HEAD WITHOUT AND WITH CONTRAST, [**2124-9-14**]; MRA OF THE HEAD, [**2124-9-14**] INDICATION: 60-year-old woman with new intracranial mass, hemorrhage, and seizures. [**Year (4 digits) **] for mass or aneurysm. TECHNIQUE: MRI of the brain was performed with axial gradient echo, T2- weighted, FLAIR, diffusion-weighted sequences. Additionally, multiplanar pre- and post-gadolinium T1-weighted sequences were obtained. MRA was performed with 3D time-of-flight imaging through the head. Multiple MIP reconstructions were created on a separate workstation. COMPARISON: Head CT of [**2124-9-14**]. FINDINGS: Within the left frontal lobe, there is a heterogeneous region containing focal regions of peripheral enhancement. Centrally, there are regions of blood products. There is surrounding edema. Portions of this focus demonstrate restricted diffusion. The focus of abnormal signal encompasses approximately 4.2 x 2.7 cm. In addition to this dominant focus, there are several punctate foci of high signal on diffusion-weighted sequences, including the right frontal lobe, lateral to the right caudate, left temporal, and right parietal lobes. While no definite low signal can be demonstrated on the ADC reconstructions, these foci may also represent small infarcts. Septic emboli are a differential consideration. As demonstrated on the recent CT, there is subarachnoid blood layering within the sulci bilaterally. There are bifrontal subdural collections, most prominent in the frontal regions, where they measure up to 6 mm in thickness. There is heterogeneous FLAIR signal intensity, which could suggest the presence of blood products. There is a prominent vessel coursing along the surface of the right frontal lobe, with a prominent parenchymal focus of linear enhancement. This likely represents a developmental venous anomaly. MRA: The ICAs are of normal caliber, course, and contour bilaterally. The right vertebral artery is dominant. There is no significant intracranial stenosis. There is no aneurysm. The major vessels of the anterior and posterior circulation demonstrate normal caliber, contour, and course. There is no midline shift. Ventricles and cisterns are patent. Globes and orbits and extracranial soft tissues are unremarkable. IMPRESSION: 1. Large abnormality within the left frontal lobe characterized by peripheral enhancement, surrounding edema, blood products, and restricted diffusion. Differential considerations for this lesion would include an abscess with associated hemorrhage versus an infarct with hemorrhage. There are numerous punctate foci of abnormal signal bilaterally which may also represent either small infarcts or septic emboli. 2. Subarachnoid hemorrhage, as see on the recent CT. 3. Bilateral subdural fluid collections, most prominent in the frontal regions, where they measure up to 6 mm in thickness. There is heterogeneous signal within it, which could suggest the presence of acute blood product. 4. Right frontal developmental venous anomaly. 5. Normal MRA. [**2124-9-19**] EEG: FINDINGS: ABNORMALITY #1: Focal and lateralized slowing was noted toward the end of the record with 1-2 Hz slower theta and faster delta from the left mid-temporal, central, posterior temporal, and parietal regions. No associated sharp or spike activity was seen. The runs of slowing tended to last several seconds. ABNORMALITY #2: A slowed and disorganized background was seen both posteriorly and anteriorly. The posterior rhythm was relatively low to moderate voltage and of a pseudoperiodic nature verging on a burst-voltage reduction pattern not as extreme as a burst suppression pattern. The faster rhythms were in the faster delta and slower theta range. The anterior-posterior voltage gradient was not preserved. BACKGROUND: No normal background rhythms for age were seen. HYPERVENTILATION: Not performed. INTERMITTENT PHOTIC STIMULATION: Not performed. SLEEP: Not obtained. CARDIAC MONITOR: No arrhythmias noted. IMPRESSION: Abnormal EEG due to a burst-reduction and pseudoperiodic record overall with marked slowing in the theta and delta range with additional focal and lateralized slowing in the left mid to posterior head regions without associated spike or sharp discharges. This would suggest a diffuse encephalopathy of a moderate to moderately severe degree with accentuated slowing over the left hemisphere from the mid to posterior regions suggestive of a possible structural or destructive process in that area. No epileptiform abnormalities were noted, however. [**2124-9-19**] Echocardiogram: The left atrium is normal in size. 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. There is focal thickening of the right coronary cusp of the aortic valve which measures 0.5 x 0.5 cm; cannot exclude valvular vegetation. There is no aortic valve stenosis. No aortic regurgitation is seen. The mitral valve leaflets are structurally normal. There is no mitral valve prolapse. No mass or vegetation is seen on the mitral valve. No mitral regurgitation is seen. The estimated pulmonary artery systolic pressure is normal. There is a trivial/physiologic pericardial effusion. IMPRESSION: Focal thickening of the right coronary cusp of the aortic valve without aortic regurgitation. Cannot exclude aortic valve vegetation. If clinically indicated, a TEE would better assess for endocarditis. Preserved regional and global biventricular systolic function. [**2124-9-29**] MRI IMPRESSION: 1. Increased enhancement and mild increase in surrounding edema in the left frontal lesion, which now demonstrates intrinsic slow diffusion, consistent with an abscess. 2. Additional areas of new enhancement are seen in the right frontal lobe and in the region of right caudate head. 3. New small bilateral frontal hypointense effusions. 4. Diffuse in meningeal enhancement which could be due to meningeal inflammation. 5. Bilateral extensive mastoid middle ear and sphenoid sinus soft tissue changes. [**2124-10-3**] Echocardiogram 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. The interatrial septum is aneurysmal. No atrial septal defect or patent foramen ovale is seen by 2D, color Doppler or saline contrast with maneuvers. Overall left ventricular systolic function is normal (LVEF>55%). The aortic valve leaflets (3) are mildly thickened. No masses or vegetations are seen on the aortic valve. There are filamentous strands on the aortic leaflets consistent with Lambl's excresences (normal variant). No aortic regurgitation is seen. The mitral valve appears structurally normal with trivial mitral regurgitation. No mass or vegetation is seen on the mitral valve. No vegetation/mass is seen on the pulmonic valve. There is a trivial/physiologic pericardial effusion. IMPRESSION: No vegetations or clinically-significant regurgitant valvular disease. No PFO, ASD, or cardiac source of embolism seen. Compared with the prior study (images reviewed) of [**2124-9-20**], the localized lucency in near the crux of the heart is likely a coronary artery. MRCP, [**2124-10-7**] INDICATION: 60-year-old woman with history of autoimmune hepatitis. TECHNIQUE: Multiplanar T1- and T2-weighted breath-hold independent imaging was performed on a 1.5 Tesla magnet, including dynamic sequential images obtained prior to, during, and after the uneventful administration of 0.1 mmol/kg of gadolinium-DTPA. COMPARISON: Correlation is made with abdominal ultrasound dated [**2124-10-3**] and abdominal CT dated [**2124-9-18**]. FINDINGS: There is a right pleural effusion. Atelectasis is noted at both bases. The liver is nodular in contour. There is multifocal abnormal, patchy, linearly-oriented T2 signal abnormality throughout the liver, in a pattern suggestive of bridging fibrosis. There are no focal lesions. The regions of fibrosis are associated with capsular retraction. There is no intra- or extra-hepatic biliary dilatation. The gallbladder is thick-walled, likely relating to the patient's underlying liver disease. No definite gallstones are identified. Spleen, pancreas, kidneys, and adrenals are grossly normal, allowing for limitations of non-breath-hold technique. There is ascites. Bowel is normal in caliber. Bone marrow signal is grossly normal. Subcutaneous edema is noted. Note is made of Tarlov cysts associated with several sacral nerve roots. IMPRESSION: Morphologic changes and diffuse abnormal signal throughout the liver, in keeping with hepatitic fibrosis. No biliary dilatation. [**2124-10-9**]: VIDEO OROPHARYNGEAL SWALLOW STUDY The study was performed in conjunction with the speech pathology department. Continuous fluoroscopic observation was provided during administration of multiple consistencies of barium. The patient displayed moderate to severe oral phase swallow dysfunction with decreased tongue propulsion, and delayed swallow initiation. Once swallow initiation was started, however, the pharyngeal phase appeared unremarkable. A single episode of frank aspiration, which was silent was demonstrated during straw sip administration of thin liquid barium consistency which appeared to improve with chin tuck maneuvers. Mild residue was also noted within the valleculae bilaterally with nectar and puree consistencies. Focused examination of the vocal cords was not possible as no phonation was able to be elicited from the patient. [**2124-10-10**]: MRI Head IMPRESSION: 1. Mild decrease in the size of the small enhancing lesion, in the head of the caudate nucleus on the right side and a few smaller lesions noted in the right centrum semiovale and in the left centrum semiovale adjacent to the largest lesion in the left frontal lobe, which itself has not signficantly changed. No new lesions. 2. Bilateral moderate subdural fluid collections are unchanged. 3. Unchanged diffuse fluid/mucosal thickening in the mastoid air cells on both sides. [**2124-10-11**] CXR (AP) FINDINGS: In comparison with the study of [**10-5**], the patient has taken a much better inspiration. There is still mild indistinctness of pulmonary vessels, though the vascular status is certainly improved from the previous examination. PICC line remains in place. Probable mild atelectatic change in the retrocardiac region at the left base. ADMISSION LABS [**2124-9-14**] 04:34PM CK(CPK)-57 [**2124-9-14**] 04:34PM CK-MB-NotDone cTropnT-<0.01 [**2124-9-14**] 04:34PM PHENYTOIN-10.8 [**2124-9-14**] 04:34PM PT-16.4* PTT-33.9 INR(PT)-1.5* [**2124-9-14**] 04:11PM TYPE-ART PO2-223* PCO2-33* PH-7.47* TOTAL CO2-25 BASE XS-1 [**2124-9-14**] 12:49PM VoidSpec-CLOTTED SP [**2124-9-14**] 08:09AM TYPE-[**Last Name (un) **] COMMENTS-GREEN TOP [**2124-9-14**] 08:09AM LACTATE-1.6 [**2124-9-14**] 08:00AM GLUCOSE-129* UREA N-12 CREAT-0.6 SODIUM-131* POTASSIUM-3.2* CHLORIDE-105 TOTAL CO2-22 ANION GAP-7* [**2124-9-14**] 08:00AM estGFR-Using this [**2124-9-14**] 08:00AM ALT(SGPT)-35 AST(SGOT)-45* LD(LDH)-342* CK(CPK)-53 ALK PHOS-86 TOT BILI-2.5* [**2124-9-14**] 08:00AM LIPASE-112* [**2124-9-14**] 08:00AM CK-MB-NotDone cTropnT-<0.01 [**2124-9-14**] 08:00AM ALBUMIN-2.2* CALCIUM-6.6* PHOSPHATE-2.1* [**2124-9-14**] 08:00AM WBC-3.1* RBC-2.30* HGB-9.8* HCT-28.1* MCV-122* MCH-42.5* MCHC-34.8 RDW-17.7* [**2124-9-14**] 08:00AM PLT COUNT-82* [**2124-9-14**] 08:00AM PT-20.0* PTT-39.6* INR(PT)-1.9* [**2124-9-14**] 08:00AM FIBRINOGE-221 DISCHARGE LABS: [**2124-10-13**] 05:12AM BLOOD WBC-3.4* RBC-2.45* Hgb-8.6* Hct-25.9* MCV-106* MCH-35.3* MCHC-33.4 RDW-23.4* Plt Ct-98* [**2124-10-13**] 05:12AM BLOOD PT-15.3* PTT-37.4* INR(PT)-1.4* [**2124-10-13**] 05:12AM BLOOD Glucose-95 UreaN-8 Creat-0.3* Na-138 K-2.6* Cl-114* HCO3-19* AnGap-8 [**2124-10-13**] 02:01PM BLOOD K-3.2* [**2124-10-13**] 05:12AM BLOOD ALT-23 AST-30 LD(LDH)-263* AlkPhos-312* TotBili-0.7 [**2124-10-13**] 12:41AM BLOOD Genta-1.0* Brief Hospital Course: Patient is a 60 year old female with past medical history of autoimmune disease, who presented on [**9-14**] with seizure, found to have Listeria bacteremia, meningitis, and likely Listeria brain abscess, s/p prolonged intubation, now s/p tracheostomy and removal, now awake and alert and breathing comfortably on room air. . #) Listeria bacteremia and meningitis/encephalitis/abscess and resultant altered mental status: . Listeria noted in blood and CSF cultures from [**9-15**] and [**9-16**] respectively. Her recently immuno-suppressed state secondary to steroid and azathioprine treatment for auto-immune hepatitis may have pre-disposed her to infection. Initial imaging revealed small SAH and large mass, likely abscess with several satellite lesions. Serial head CT??????s and MRIs have been stable showing large left hemisphere lesion and and interval resoluton of bleed and multiple septic emboli. TTE and TEE completed as noted (abnormal, but no definite abscess or vegetation). EEG was not suggestive of convulsive status. Repeat LP and blood cultures all show no growth. - ID service consulted. Ampicillin and gentamicin were started on [**9-17**]. ID recommends 6 week course then repeat head MRI to reassess. Tentative date of completion of abx is [**2124-10-28**]. - Neurology service consulted for initial seizure presentation, recommend Levetiracetam 1500 [**Hospital1 **] indefinitely for seizure prevention. . #) Respiratory failure: Patient intubated for airway protection in setting of altered mental status, and underwent tracheostomy on [**2124-9-22**] due to persistent altered mental status. Over her hospital course her mental status improved and she was able to be weaned off trach mask and supplemental oxygen. Her trach was decannulated by the interventional pulmonology service on [**10-9**]. . #) Hemoptysis: Patient had episodes of significant hemoptysis and blood around her trach site. Bronchoscopy demonstrated an erosion that was felt to likely be the source of her bleeding. CTA was negative for fistula. No further bleeding noted. Repeat bronchoscopy after latest episode of hemoptysis on [**10-5**] found a bleeding lesion in the trachea, which was coagulated with good hemostasis. Since then, there have been no repeat episodes and her hematocrit and respiratory status have remained largely stable. . #) Pancytopenia: Pt was pancytopenic on admission and remained so throughout hospital stay. All cell counts stable at time of discharge. Pt admitted on prednisone and imuran for autoimmunie hepatitis, initially immunosuppressants thought to be culprits, but were held throughout admission without resolution of pancytopenia; other possibilities included stress of acute infection, viral process. Hematology service consulted. Hemolytic work up negative. Flow cytometry negative for malignancy, bone marrow bx deferred this admission. TPMT returned positive, consistent with heterozyogous state, which suggests increased risk of myelosuppression with Imuran treatment. Throughout her stay, the patient's hematocrit was closely monitored, and she did require several blood transfusions. . #) Elevated Coagulation Studies: Stable. Her elevated INR had been felt to be secondary to nutritional deficiencies and liver disease. Per hematology and laboratory values, DIC appears to be less likely, but still will continue to monitor for this possibility. The patient was continued on pneumoboots for DVT prophylaxsis given her increased coagulation studies, as well as the uncertainty regarding continued bleeding around her brain heparin SC was deferred. . #) Elevated LFTs: On admission her LFTs were essentially normal. During her stay had an elevation most notable in alk phos as well as a mild elevation in transaminases which are again trending down. The hepatology team was consulted. RUQ ultrasound consistent with liver disease, no other concerning pathology (no ductal dilation or gall bladder abnormalities noted). There was concern that her autoimmune hepatitis could be returning, but the team was hesitant to start her on any immunosupressive therapies given the severe comorbid infection in this patient. Hepatology recommended a MRCP, which showed findings c/w cirrhosis, as well as some ascites. Hepatology also recommended starting ursodiol, but no Imuran or prednisone given her acute infection. She should follow up with her liver team upon completion of antibiotics for consideration of restarting treatment for her autoimmune hepatitis. . #) Pt had acinetobacter growing in her sputum sample during ICU stay. Decision made not to treat due to abscence of clinical disease. As above pt tolerated vent and 02 weaning without addition of antibiotics. . #) During initial decompensated illness, there was concern for systemic fungal infection. A B-glucan test was positive and pt was transiently treated with amphotericin. Fungal cultures of blood and CSF were persistently negative and this was discontinued. Currently it is thought that this may have been a false positive in setting of listeria infection or possibly her ampicillin. Our ID consultants recommend that this be repeated after completion of antibiotic treatment for confirmation of this. . #) Hypokalemia: On the medical floor, the patient was noted to be persistently hypokalemic, with a low of 2.5 on [**2124-10-14**]. Various causes were considered including medication effects from Gentamycin or Keppra. Of note, her creatinine has consistently been 0.4-0.6. Potassium was repleted daily. A TTKG calculated [**10-12**] was 10.33, which was inconsistent with the measured hypokalemia and suggestive of renal losses. The patient's potassium will need close monitoring and repletion. She is at risk to develop renal failure due to cumulative gent dosing, her renal function should be monitored closely for this reason and to prevent developmement of hyperkalemia in face of aggressive repletion. On discharge she was ordered for 60 mEq of potassium [**Hospital1 **] but this dose will likely need to be adjusted and would recommend [**Hospital1 **]-TID potassium monitoring. . #) ENT - ENT service was consulted when pt developed partial vocal cord paralysis after extubation and trach decannulation seen by laryngoscope. It is hoped that this may resolve as pt recovers. The ENT team recommends [**Hospital1 **] PPI to prevent any GERD associated laryngeal edema complicating her recovery and follow up with their service in [**12-22**] months. . #) FEN: When the patient was unresponsive, a PEG tube was placed, and she was receiving tube feeds on transfer to the floor. These feeds were continued. When the patient had a swallow study on [**2124-10-6**], there was concern for aspiration, so a video swallow study was scheduled for [**2124-10-9**]. These results are listed above. At this time, she was cleared to take ground solids, and thin liquids with a chin tuck. Her tube feeds were continued, as she was taking in only a relatively small amount PO. At time of discharge nutrition services were obtaining calorie counts to assess possibility of PEG removal. Pt is profoundly malnourished perhaps in part due to her personal dietary choices of an organic diet which has limited her voluntary PO in-hospital intake. . On day of discharge [**Known firstname 12705**] vital signs are stable, she has no oxygen requirement. Her dense right sided hemiplegia has improved markedly since presentation and she is now able to move and grip with her right hand and wiggle her toes. She is alert and oriented x 3. She does have some persistent attention deficits and difficulty with complex tasks (see neurology consult note for full details of current functional neurologic status). Medications on Admission: Potassium, Imuran 50 mg daily, Ursodiol, Prednisone 10 mg (being tapered). Dosages unavailable. "Naturopath" supplements started in [**2124-7-21**]: (from the D'Adamo Institute) Formula O, B6-B2, B12-B2, Folic Acid, C, Iron, Selenium, Liver, cod liver oil, NAC, Bonerneal/Support, Pancreas, Chromium, Zinc, Magnesium & Zinc, Adrenal, Potassium, Whey Protein Powder, Psyllium Seed Blend, Stractan, Flax seed oil, Kidney herbal tea, Liver disease/cc/stomac 601, licorice solid extract, Bronchial drops, boswellia. Discharge Medications: 1. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) [**Year (4 digits) **]: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 2. Acetaminophen 160 mg/5 mL Solution [**Year (4 digits) **]: [**10-9**] mL PO Q6H (every 6 hours) as needed: Do not exceed 4 g Acetaminophen daily. 3. Senna 8.6 mg Tablet [**Month/Year (2) **]: One (1) Tablet PO BID (2 times a day) as needed for constipation. 4. Docusate Sodium 50 mg/5 mL Liquid [**Month/Year (2) **]: Ten (10) mL PO BID (2 times a day). 5. Levetiracetam 100 mg/mL Solution [**Month/Year (2) **]: 1500 (1500) mg PO BID (2 times a day). 6. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization [**Month/Year (2) **]: One (1) neb Inhalation Q6H (every 6 hours) as needed for shortness of breath or wheezing. 7. Folic Acid 1 mg Tablet [**Month/Year (2) **]: Two (2) Tablet PO DAILY (Daily). 8. Ursodiol 250 mg Tablet [**Month/Year (2) **]: Two (2) Tablet PO BID (2 times a day). 9. Guaifenesin 100 mg/5 mL Syrup [**Month/Year (2) **]: 5-10 MLs PO Q6H (every 6 hours) as needed for cough. 10. Lansoprazole 30 mg Tablet,Rapid Dissolve, DR [**Last Name (STitle) **]: One (1) Tablet,Rapid Dissolve, DR PO BID (2 times a day): give 30 min before breakfast and dinner. 11. Cyanocobalamin 100 mcg Tablet [**Last Name (STitle) **]: 0.5 Tablet PO DAILY (Daily). 12. Lorazepam 2 mg/mL Syringe [**Last Name (STitle) **]: One (1) mg Injection PRN (as needed) as needed for seizure activity: to be administered prn seizure activity up to 4 mg over 15 minutes. 13. Sodium Chloride 0.9 % 0.9 % Syringe [**Last Name (STitle) **]: Three (3) ML Injection PRN (as needed) as needed for line flush: Flush every 8 hours and prn. 14. Ampicillin Sodium 2 gram Recon Soln [**Last Name (STitle) **]: Two (2) gram Recon Soln Injection Q4H (every 4 hours): day 1 = [**9-17**]. 15. Gentamicin 40 mg/mL Solution [**Month/Year (2) **]: 200 mg Injection Q18H (every 18 hours): overall day 1 = [**9-17**], 160 q 12h [**10-3**], then 200 q12h, then 200 mg q 18 hrs [**10-12**]. 16. Heparin, Porcine (PF) 10 unit/mL Syringe [**Month/Year (2) **]: Two (2) ML Intravenous PRN (as needed) as needed for line flush: Flush with 10 mL NS followed by Heparin as above daily and prn per lumen. 17. Potassium Chloride 20 mEq Packet [**Month/Year (2) **]: Sixty (60) mEq PO twice a day: This dose will need to be adjusted according to twice daily potassium checks. Discharge Disposition: Extended Care Facility: [**Hospital 80502**] Hospital Discharge Diagnosis: Primary: Listeria Brain Abscess and Cerebritis Pancytopenia Seizures Secondary: Autoimmune Hepatitis Discharge Condition: Fair, tolerating ground diet and thin liquids with chin tuck, transferring to chair with lift. Discharge Instructions: You were admitted to the hospital after a seizure. You had a head CT and lumbar puncture which showed that you had an infection around your brain. The neurosurgery team decided that you did not need surgery. You were started on IV antibiotics, which have continued for several weeks. You had a breathing tube, and also a tracheostomy placed to help you breathe. You also were unable to eat, and had a tube placed into your stomach to give you food. You were very ill and stayed in the ICU, but eventually recovered to the point were you could be transferred to the medical floor. . Take your medications as prescribed. It is important that continue treatment with Ampicillin and Gentamicin as prescribed. They need to be continued for at least 6 weeks (Day 1 [**2124-9-16**], 6 wks on [**2124-10-28**]). You will need to have an MRI of your brain performed prior to stopping antibiotics to ensure that your infection has been appropriately treated. Whether or not to stop these antibiotics should be discussed with your new Infectious disease doctor once you have set up follow up. . Please call your doctor or return to the ED for any of the following: - Seizures - Changes in strength, sensation, or mental status - Fever/chills - Shortness of breath or coughing up blood - Black or bloody bowel movements - Any other new or concerning symptoms Followup Instructions: Please call your Primary Care Doctor [**First Name (Titles) **] [**Last Name (Titles) **] a follow up appointment. . You will need to be followed by an infectious disease doctor as well as a Neurologist. Please call your Primary Care Doctor to help [**Last Name (Titles) **] appointments with a new Neurologist and Infectious Disease specialist. Your PCP or new Infectious disease doctor can call Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] at [**Hospital1 18**] to discuss the case at [**Telephone/Fax (1) 457**] if there are any questions. . Please follow up with your regular liver doctor. . You should discuss with your Primary doctor about having flow cytometry checked in [**12-22**] months if it is felt to be clinically indicated given your low blood counts. This may also need to be discussed with a Hematologist. . Please set up a new patient visit with an ENT doctor [**First Name (Titles) **] [**Last Name (Titles) 4656**] your vocal cord dysfunction if your voice does not improve. ICD9 Codes: 2760
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Medical Text: Admission Date: [**2132-1-21**] Discharge Date: [**2132-2-7**] Date of Birth: [**2080-12-23**] Sex: M Service: [**Last Name (un) **] REASON FOR ADMISSION: The patient is admitted for a potential liver transplant. HISTORY OF PRESENT ILLNESS: The patient is a 51-year-old male with HIV diagnosed in [**2115**] with advanced HCC who was recently evaluated for a hepatic mass. He was status post chemoembolization of hepatic mass at [**Hospital1 2177**] in the setting of elevated AFP. CT scans have shown hepatic mass with question of thrombus in adjacent hepatic vein. CT-guided biopsy of the involved area did not show tumor. Repeat CT in [**2131-11-18**] was unchanged. He was subsequently listed for liver transplant for advanced liver cirrhosis and unresectable HCC. PAST MEDICAL HISTORY: HIV, well controlled, undetectable viral load. On [**2131-12-19**], CD4 count was 245. HCV was diagnosed 5-6 years ago. History of upper GI bleed, hypertension, hypercholesterolemia, polysubstance abuse, sober since [**2128**]. History of CVA in [**2129-8-17**] with residual right leg weakness. DVT. Per report, able to walk 1- 2 blocks prior to claudication. MEDICATIONS ON ADMISSION: Pravachol 10 mg daily, Diovan 40 mg daily, aspirin 81 mg daily, Reyataz 300 mg daily, Pletal 150 mg b.i.d., Viread 300 mg daily, Pepcid 20 mg daily, cilostazol 50 mg daily, thalidomide 50 mg q.h.s., Videx 250 mg daily, vitamin E 400 international units daily, vitamin C and multivitamins. ALLERGIES: Lisinopril with which the patient gets mouth and lip swelling. SOCIAL HISTORY: He lives alone, no children. He smokes half a pack per day. No alcohol since [**2128**]. No IV drug use since [**2115**]. REVIEW OF SYSTEMS: He denies recent infections including fevers, chills, rigors. He denies a change in bowel function. No change in urinary symptoms. He denies headaches, visual changes. He reports right leg weakness which is baseline. He denies chest pain shortness of breath. Recent echocardiogram in [**2131-7-19**] demonstrated ejection fraction of greater than 60%, no ventricular septal defects, mild pulmonary artery systolic hypertension. EXAMINATION: General: The patient is comfortable in no acute distress. HEENT anicteric. No nystagmus. Mucosa are clear, no lesions,. No lymphadenopathy. Lungs are clear to auscultation bilaterally, no CVA tenderness. CV is regular rate and rhythm, normal S1 and S2 without murmurs, rubs or gallops. Abdomen is soft, nontender and nondistended, no organomegaly. Extremities - no C/C/E, no calf tenderness. Pulses are 2+ AT and dorsalis pedis. Neuro exam - cranial nerves II through XII are intact. Upper extremities are [**3-21**] throughout bilaterally. Right lower extremity is [**1-20**] proximally. No deficits in the left lower extremity. LABORATORY DATA: On admission, his labs were the following: WBC of 4.1, hematocrit 33.8, platelets 145, sodium 137, 3.3, 105, 23, BUN and creatinine of 16 and 1.6, glucose 90. AST was 118 and ALT 72. Alkaline phosphatase was 229. Total bilirubin is 1.5. INR is 1.5. HOSPITAL COURSE: The patient went to the OR on [**2132-1-21**] in which the patient had a cadaveric liver transplant, piggyback, portal vein to portal vein anastomosis, common hepatic artery to common hepatic artery, QDA branch patch, bile duct to bile duct performed by Doctors [**Last Name (Titles) 816**], [**Name5 (PTitle) **] and Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 3446**]. Please see operative note for more details of the surgery. The patient had 2 [**Doctor Last Name 406**] drains placed to the right quadrant area, one underneath the right lobe of the liver and one underneath the liver hilum. The drains were secured to skin with nylon sutures. The skin was closed with staples. The patient was transferred, still intubated, to the intensive care unit in stable condition. The patient was kept intubated, placed on insulin, Unasyn, ganciclovir, heparin, MMF and Solu-Medrol 500 IV x1. Ultrasound was performed the same day demonstrating unremarkable duplex Doppler ultrasound of the transplanted liver. The patient had a chest x-ray status post liver transplant for NG tube placement which demonstrated moderate layering right pulmonary effusion and a small left pleural effusion. There was a left lower lobe atelectasis/consolidation. On the following day, the patient had another ultrasound with confirmed vascular flow which demonstrated a 13.7 x 7 x 11 cm subhepatic hematoma, moderate ascites, patent hepatic vasculature, no evidence of hydronephrosis. The patient was extubated on postop day 1. LFTs on [**2132-1-22**] were the following: AST 1324, ALT 566, alkaline phosphatase 126. The patient was on a Lasix drip. The patient was waiting for clears. HIV medications were held and subcutaneous heparin was restarted. It was noted on the chest x-ray on [**2132-1-26**] that the patient had a new right lower lobe infiltrate, most likely representing pneumonia. In the appropriate clinical setting, could also represent aspiration or pulmonary hemorrhage. The patient was started on caspo, levo and the patient was reintubated for a gas of 7.45, 28, 60, 18 and -4. Dobbhoff was placed for tube feeds. The patient's antibiotics were changed to Zosyn and vancomycin. Renal and ID were consulted. On [**2132-1-26**], a bronchoscopy was performed in the ICU for a presumed diagnosis of pneumonia. The patient continued to be intubated, sedated with propofol, p.r.n. morphine, treated for right pneumonia. The patient continued on tube feeds. Caspo and levofloxacin were started. The patient extubated on [**2132-1-28**]. The bronchial washings on [**2132-1-26**] demonstrated that the Gram stain showed 1+ polymorphonuclear leukocytes, no microorganisms seen. Respiratory culture was negative with no growth. Legionella culture was not isolated. Fungus culture was not isolated. There was no acid-fast bacilli seen on direct smear nor concentrated smear. Viral culture for cytomegalovirus is pending. The patient was seen by physical therapy who felt that the patient would be an excellent candidate for rehab. On [**2132-1-30**], the patient had the following labs: WBC of 15.1, hematocrit of 36.6, platelets 222, sodium 146, 3.7, 111, 21, BUN and creatinine of 69 and 2.9, glucose 106. AST was 35, ALT 63, alkaline phosphatase 101, total bilirubin of 4.0. The patient had an AFP of 711. On [**2132-1-30**], the patient had an ERCP demonstrating that there was a normal distal pancreatic duct. The cholangiogram revealed a non- dilated native and donor bile duct. A bile leak was seen at the level of the anastomosis. The intrahepatic ducts appeared normal. A 10-French 8 cm Cotton-[**Doctor Last Name **] biliary stent was placed successfully across the anastomosis into the donor bile duct and bile was seen draining into the duodenum. On [**2132-2-1**], the patient returned to the OR for re- exploration after liver transplant, abdominal washout, Roux- en-Y hepaticojejunostomy and a wedge biopsy of the liver performed by Doctors [**Last Name (Titles) **], [**Name5 (PTitle) 816**] and [**Name5 (PTitle) **]. Please see operative note for more details of the procedure. Of note, the old JP drains were removed and two fresh [**Doctor Last Name 406**] drains were placed, one directly underneath the right lobe of the liver and the other below the biliary anastomosis. The patient was transferred still intubated to the postop recovery area. The patient was seen on [**2132-1-31**] by neurology because of residual right leg weakness and difficulty with ambulation. They felt that his weakness could be mechanical due to irritation from pneumo boots. However, he does have significant weakness in his distal right leg and they felt that because of the liver transplant, it is possible to have worsening of old deficits like his residual stroke. There were no other recommendations per neurology and they had signed off from the consult. On [**2132-2-6**], the patient had a routine postop cholangiogram demonstrating patent hepaticojejunostomy and anastomosis with normal appearance of the hepatic ducts. There was no extravasation of the contrast. The patient had continued with TPN post- surgery from [**2132-2-1**]. On [**2132-2-6**], the patient was introduced to clears, tolerated it well, and was advanced to a regular diet. So, post-cholangiogram procedure, the T-tube was capped. On [**2132-2-5**], the patient continued his vanco, Zosyn, caspo and levo. The patient was on MMF 1000, prednisone 20 mg daily and tacrolimus 0.5 and hold for a level of 3.6. The patient was afebrile and vital signs were stable, good I's and O's, JP drains medial put out 15 and lateral put out 50. Labs on [**2132-2-5**] were the following: The patient had a WBC of 13.8, 30.6, 276, sodium 142, 3.4, 112, 19, BUN and creatinine 65 and 3.1, glucose 127. AST was 30, alkaline phosphatase 84, ALT 34, total bilirubin 1.2 and INR 1.1. On [**2132-2-7**], hospital day 18, continued on vancomycin, Zosyn, levofloxacin, fluconazole, MMF, prednisone. The patient is afebrile and vital signs are stable. The T-tube is capped. The patient is awake and alert. Lungs are clear to auscultation bilaterally. CVA - regular rate and rhythm. Abdomen - well-healed incision, distended. Extremities - the patient had +3 edema bilaterally in lower extremities. Lasix was increased from 20 b.i.d. to 20 t.i.d. The patient was placed on a regular diet. Labs on [**2132-2-7**] were the following: WBC of 19.9, hematocrit of 32.6, platelets 397, sodium 142, 3.2, 109, 19, BUN and creatinine 61 and 2.7 with a glucose of 207. ALT was 33, AST 28, alkaline phosphatase 97, total bilirubin 1.1 and albumin 2.4. So, the patient is potentially going to rehab to [**Hospital1 **] on the following medications: albuterol nebs, 1 neb q.4 hours p.r.n., didanosine chewable 125 mg daily, Anzemet 12.5 IV q.8 hours p.r.n., fluconazole 200 mg q.24, Lasix 40 mg IV t.i.d., Valcyte 450 mg every other day, heparin 5000 units subcutaneously b.i.d., insulin sliding scale, levofloxacin 250 p.o. q.48 hours p.r.n., lopinavir-ritonavir 2 tablets p.o. b.i.d., Percocet 1-2 tablets q.4-6 hours p.r.n., MMF 1000 mg p.o. b.i.d., nystatin oral suspension 5 ml q.i.d., Protonix 20 mg daily, Bactrim SS one tablet 3 times a week, tacrolimus potentially should be 0.5 b.i.d., tenofovir 300 mg b.i.d. on Sunday, Wednesday. The patient is to follow up with Dr. [**Last Name (STitle) **] on the following dates: [**2132-2-14**] at 11:20 a.m., [**2132-2-21**] at 10 a.m., [**2132-2-28**] at 11:40 a.m. The patient is to call transplant surgery immediately at [**Telephone/Fax (1) 28347**] if any fevers, chills, nausea, vomiting, abdominal pain. Also, if the patient is not able to drink or eat or having difficulty with urination. The patient should also call if there is any increased redness to incision, any discharge or any edema from the incision. The patient should have labs every Monday and Thursday in which a CBC, Chem-10, AST, ALT, alkaline phosphatase, albumin, total bilirubin and Prograf level to be drawn. The patient has been eating well, urinating without difficulty, and also using the commode and getting out of bed with physical therapy. So, the patient is ready to go to rehab. FINAL DIAGNOSIS: A 51-year-old male with HIV/HCV, cirrhosis, end-stage liver disease with HCC status post liver transplant on [**2132-1-21**]. SECONDARY DIAGNOSIS: Biliary leak, biliary aspiration, right infiltrate seen on the x-rays, treated for pneumonia. [**Name6 (MD) **] [**Name8 (MD) **], [**MD Number(1) 4841**] Dictated By:[**Last Name (NamePattern1) 4835**] MEDQUIST36 D: [**2132-2-7**] 09:18:22 T: [**2132-2-7**] 11:18:04 Job#: [**Job Number 97502**] ICD9 Codes: 486, 5845, 0389, 3051, 2930
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Medical Text: Admission Date: [**2115-7-24**] Discharge Date: [**2115-8-3**] Date of Birth: [**2061-12-7**] Sex: M Service: CARDIOTHORACIC Allergies: Latex Attending:[**First Name3 (LF) 1505**] Chief Complaint: Dyspnea and chest pain Major Surgical or Invasive Procedure: [**7-29**] s/p Coronary Artery Bypass Graft x 2 (Lima->LAD/SVG-> OM) History of Present Illness: 53 yo M with history of VF arrest while working out at gym [**1-12**] and is s/p LAD PCI. He presented with dyspnea and new chest pain. Had a +ETT and was taken urgently to the cath lab. He was found to have 2VD and he was referred for surgery. Past Medical History: Coronary Artery Disease w/ VFib arrest [**1-12**]->PCI to LAD, Diverticulitis, Hypertension, Hyperlipidemia PSH: s/p Hip replacement x2, s/p Appendectomy, s/p Right knee surgery x 2, Left knee surgery, Tonsillectomy Social History: Social history is significant for the absence of current tobacco use. There is no history of alcohol abuse. He works as a custodian and is married with children. He denies any IVDU. Family History: His mother and several maternal uncles had cardiac disease in their 50-60s. His mother died suddenly on vacation in her early 50s. Physical Exam: Admission: HR 76 RR 18 BP 178/99 Gen: NAD HEENT: EOMI, PERRL, NCAT Neck: Supple, FROM, -JVD Lungs: CTAB -c/r/m/g Heart: RRR -w/r/r Abd: NT/ND +BS Ext: Warm, well-perfused, no edema, 2+pp Neuro: A&O x 3, MAE, non-focal Discharge: VS: T: 98.6 HR: 70's SR BP: 98-112/50-70 Sats: 96% RA General: NAD Cardiac: RRR normal S1,S2 no murmur/gallop or rub Resp: Decreased breath sounds otherwise clear GI: bowel sounds positive, abdomen soft non-tender/non-distended Extre: warm no edema Wound: sternal & left lower extremity c/d/i no erythema Neuro: non-focal Pertinent Results: [**2115-7-24**] WBC-5.1 RBC-4.95 Hgb-15.0 Hct-44.4 MCV-90 MCH-30.3 MCHC-33.8 RDW-13.1 Plt Ct-255 [**2115-7-31**] WBC-8.4 RBC-3.24* Hgb-10.0* Hct-28.5* MCV-88 MCH-30.9 MCHC-35.1* RDW-12.6 Plt Ct-175 [**2115-7-24**] PT-12.9 PTT-26.6 INR(PT)-1.1 [**2115-7-29**] PT-13.9* PTT-35.5* INR(PT)-1.2* [**2115-7-24**] Glucose-86 UreaN-13 Creat-1.1 Na-142 K-3.9 Cl-102 HCO3-28 AnGap-16 [**2115-7-31**] Glucose-107* UreaN-16 Creat-0.9 Na-136 K-4.2 Cl-97 HCO3-33* AnGap-10 [**2115-8-1**] BLOOD UreaN-19 Creat-0.8 K-3.9 [**7-24**] Cath: 1. Selective coronary angiography of this right dominant system revealed 2 vessel coronary artery disease. The LMCA was very short with an approximately 50% narrowing. The LAD had an ostial 80% stenosis. The mid-LAD was widely patent in the region of the previously placed stent with a tubular segment of disease to 50% distally. The LCx and RCA had minimal disease. 2. Resting hemodynamics revealed normal systemic systolic and diastolic arterial blood pressures with SBP 130 mmHg and DBP 85 mmHg. [**7-24**] CARDIAC PERFUSION: 1. Reversible, large, severe perfusion defect involving the LAD territory. 2. Transient cavity dilation, consistent with mulit-vessel, left main, or proximal LAD disease. 3. Mild systolic dysfunction with apical akinesis, consistent with stunning. Compared with the study of [**2115-3-7**], the findings are new. [**7-25**] Vein mapping: 1. Focal areas of non-compressibility, suggestive of chronic thrombosis in the right greater saphenous vein at the level of the knee and in the left greater saphenous vein, at the level of the saphenofemoral junction. 2. Patent bilateral lesser saphenous veins. [**7-25**] Carotid U/S: There is less than 40% stenosis within the internal carotid arteries bilaterally. [**7-29**] Echo: PRE CPB No spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. No atrial septal defect is seen by 2D or color Doppler. Left ventricular wall thicknesses are normal. The left ventricular cavity size is top normal/borderline dilated. There is mild to moderate regional left ventricular systolic dysfunction with moderate hypokinesis of the mid distal anterior, mid-distal septal, distal anterolateral, and apical segments. The right ventricle displays borderline normal free wall function. There are simple atheroma in the ascending aorta. 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. No aortic regurgitation is seen. The mitral valve appears structurally normal with trivial mitral regurgitation. There may be a redundant chord intermittently seen billowing into the left atrium. Physiologic mitral regurgitation is seen (within normal limits). There is a trivial/physiologic pericardial effusion. Dr. [**Last Name (STitle) **] was notified in person of the results in the operating room at the time of the study. POST CPB Low normal right ventricular systolic function. Initially, after separating from CPB, there was very severe hypokinesis of the mid to distal septal, anterior, anterolateral walls and apical segment, bordering on akinesis. The ejection fraction approximated 25%. About 10 minutes after CPB, these same segments showed much improved function to the point where there was only very mild hypokinesis. Ejection fraction improved to 45-50%. Valvular function remained unchanged from the pre-CPB study. The thoracic aorta appeared intact. [**Hospital1 18**] ECHOCARDIOGRAPHY REPORT [**Known lastname **], [**Known firstname **] [**Hospital1 18**] [**Numeric Identifier 99926**] (Complete) Done [**2115-7-29**] at 3:42:48 PM FINAL Referring Physician [**Name9 (PRE) **] Information [**Name9 (PRE) **], [**First Name3 (LF) **] R. Division of Cardiothoracic [**Doctor First Name **] [**Hospital Unit Name 4081**] [**Location (un) 86**], [**Numeric Identifier 718**] Status: Inpatient DOB: [**2061-12-7**] Age (years): 53 M Hgt (in): BP (mm Hg): / Wgt (lb): HR (bpm): BSA (m2): Indication: Intraoperative TEE for CABG ICD-9 Codes: 440.0 Test Information Date/Time: [**2115-7-29**] at 15:42 Interpret MD: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 4901**], MD Test Type: TEE (Complete) Son[**Name (NI) 930**]: [**Name Initial (MD) **] [**Name8 (MD) 4901**], MD Doppler: Full Doppler and color Doppler Test Location: Anesthesia West OR cardiac Contrast: None Tech Quality: Adequate Tape #: 2008AW2-: Machine: AW1 Echocardiographic Measurements Results Measurements Normal Range Left Ventricle - Inferolateral Thickness: 1.0 cm 0.6 - 1.1 cm Left Ventricle - Diastolic Dimension: 5.6 cm <= 5.6 cm Left Ventricle - Ejection Fraction: 35% to 40% >= 55% Aorta - Sinus Level: *3.8 cm <= 3.6 cm Aorta - Sinotubular Ridge: *3.1 cm <= 3.0 cm Aorta - Ascending: 3.2 cm <= 3.4 cm Aorta - Descending Thoracic: 2.3 cm <= 2.5 cm Aortic Valve - LVOT diam: 2.3 cm Findings LEFT ATRIUM: No spontaneous echo contrast or thrombus in the LA/LAA or the RA/RAA. Good (>20 cm/s) LAA ejection velocity. All four pulmonary veins identified and enter the left atrium. RIGHT ATRIUM/INTERATRIAL SEPTUM: No spontaneous echo contrast or thrombus in the body of the RA or RAA. A catheter or pacing wire is seen in the RA and extending into the RV. No ASD by 2D or color Doppler. LEFT VENTRICLE: Wall thickness and cavity dimensions were obtained from 2D images. Normal LV wall thickness. Top normal/borderline dilated LV cavity size. Mild-moderate regional LV systolic dysfunction. RIGHT VENTRICLE: Borderline normal RV systolic function. AORTA: Focal calcifications in aortic root. Normal ascending aorta diameter. Simple atheroma in ascending aorta. Normal descending aorta diameter. Simple atheroma in descending aorta. AORTIC VALVE: Normal aortic valve leaflets (3). No AS. No AR. MITRAL VALVE: Normal mitral valve leaflets with trivial MR. Mild mitral annular calcification. No MS. Physiologic MR (within normal limits). TRICUSPID VALVE: Normal tricuspid valve leaflets with trivial TR. PULMONIC VALVE/PULMONARY ARTERY: Normal pulmonic valve leaflets. Physiologic (normal) PR. PERICARDIUM: Trivial/physiologic pericardial effusion. GENERAL COMMENTS: A TEE was performed in the location listed above. I certify I was present in compliance with HCFA regulations. The patient was under general anesthesia throughout the procedure. No TEE related complications. The patient appears to be in sinus rhythm. Results were personally reviewed with the MD caring for the patient. Conclusions PRE CPB No spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. No atrial septal defect is seen by 2D or color Doppler. Left ventricular wall thicknesses are normal. The left ventricular cavity size is top normal/borderline dilated. There is mild to moderate regional left ventricular systolic dysfunction with moderate hypokinesis of the mid distal anterior, mid-distal septal, distal anterolateral, and apical segments. The right ventricle displays borderline normal free wall function. There are simple atheroma in the ascending aorta. 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. No aortic regurgitation is seen. The mitral valve appears structurally normal with trivial mitral regurgitation. There may be a redundant chord intermittently seen billowing into the left atrium. Physiologic mitral regurgitation is seen (within normal limits). There is a trivial/physiologic pericardial effusion. Dr. [**Last Name (STitle) **] was notified in person of the results in the operating room at the time of the study. POST CPB Low normal right ventricular systolic function. Initially, after separating from CPB, there was very severe hypokinesis of the mid to distal septal, anterior, anterolateral walls and apical segment, bordering on akinesis. The ejection fraction approximated 25%. About 10 minutes after CPB, these same segments showed much improved function to the point where there was only very mild hypokinesis. Ejection fraction improved to 45-50%. Valvular function remained unchanged from the pre-CPB study. The thoracic aorta appeared intact. I certify that I was present for this procedure in compliance with HCFA regulations. Electronically signed by [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 4901**], MD, Interpreting physician [**Last Name (NamePattern4) **] [**2115-7-29**] 16:01 Brief Hospital Course: He was admitted to cardiology. He underwent preoperative work up and awaited Plavix washout before going to the operating room. On [**7-29**] he was brought to the operating room where he underwent a coronary artery bypass graft x 2. Please see operative report for surgical details, in summary he had CABG x2 with LIMA-LAD and SVG-OM. Following surgery he was transferred to the CVICU for invasive monitoring in stable condition. He did well in the immediate post-op period, was weaned from sedation, awoke neurologically intact and extubated. On post-op day one he was started on beta blockers and diuretics and gently diuresed towards his pre-op weight. Later on this day he was transferred to the telemetry floor. Chest tubes and epicardial pacing wires were removed per protocol. He worked with physical therapy while recovering his strength and mobility. On post-op day 5 he appeared to be doing well and was discharged home with VNA and the appropriate follow-up appointments. Medications on Admission: Atorvastatin 40, Plavix 75, Metoprolol 25(2), ASa 325, Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*0* 2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 3. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 4. Atorvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 5. Hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO Q3H (every 3 hours) as needed. Disp:*40 Tablet(s)* Refills:*0* 6. Toprol XL 50 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO twice a day. Disp:*60 Tablet Sustained Release 24 hr(s)* Refills:*2* Discharge Disposition: Home With Service Facility: tba Discharge Diagnosis: Coronary Artery Disease s/p Coronary Artery Bypass Graft x 2 PMH: VFib arrest [**1-12**]->PCI to LAD, Diverticulitis, Hypertension, Hyperlipidemia PSH: s/p Hip replacement x2, s/p Appendectomy, s/p Right knee surgery x 2, Left knee surgery, Tonsillectomy 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 lifting more than 10 pounds for 10 weeks. No driving until follow up with surgeon. Followup Instructions: Dr. [**First Name4 (NamePattern1) 1312**] [**Last Name (NamePattern1) 31097**] [**Telephone/Fax (1) 15825**] 2 weeks Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1008**], M.D. Phone:[**Telephone/Fax (1) 285**] Date/Time:[**2115-8-28**] 1:40 Dr. [**Last Name (STitle) **] 4 weeks, pt to call to schedule appt Completed by:[**2115-8-3**] ICD9 Codes: 4111, 4019, 2724
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8353 }
Medical Text: Admission Date: [**2159-9-15**] Discharge Date: [**2159-9-17**] Date of Birth: [**2081-1-28**] Sex: M Service: MEDICINE Allergies: Ace Inhibitors Attending:[**Last Name (NamePattern4) 290**] Chief Complaint: abdominal pain Major Surgical or Invasive Procedure: paracentesis History of Present Illness: 78 M CAD, CHF EF (20%), on pred for gout, h/o leukocytosis to 24-50's, polycythemia, s/p repair of incarcerated RIH [**2159-9-10**] presents with worsening abdominal pain x4 days. He describes the pain as severe, crampy pain over his lower abdomen. He denies having had a BM since Monday and believes his pain is a result of constipation. He is not sure when he last passed flatus. He denies nausea, vomiting, fevers or chills. . In ED, initial vitals were: T 97.8 R 65 BP 100/39 RR 18 SpO2 97% RA. Incision c/d/i with surrounding erythema, tender over incision and throughout abdomen. Patient was given Readi-Cat 2, Fentanyl Citrate, MethylPREDNISolone Sodium Succ, Ciprofloxacin, MetRONIDAZOLE, and IV bolus. ARF to 3.4 (baseline 1.9), 1500cc of fluid, systolic Blood pressure 80-111. Prior to transfer found to have T 98 HR 62, BP 93/55 RR 22 Sat 96% 4L. CXR showed increased opacity in LLL. . On the floor, patient is stable in mild distress. . Review of systems: (+) Per HPI Past Medical History: CAD, s/p CABG [**59**] years ago Chronic systolic heart failure, EF 20% Atrial fibrillation, on coumadin, s/p Pacer DDD HTN Hyperlipidemia Chronic kidney disease, baseline creatinine 1.5-1.7 GERD Chronic shoulder pain Polycythemia [**Doctor First Name **] Colonic polyps Social History: Lives at home with his daughter in [**Name (NI) 3146**], retired sheet metal worker, Korean war veteran. Has smoked his entire life, and has cut back to 4 cigarettes daily. No current ETOH or other drug use. Daughter is in charge of his medications Family History: There is no family history of premature coronary artery disease or sudden death. Physical Exam: Vitals: T: 98 BP:92/43 P: 61 R: 18 O2: 98% on 5L General: Alert, oriented, in mild 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, diffusely tender and distended, bowel sounds present, no organomegaly GU: foley Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Pertinent Results: ADMISSION LABS [**2159-9-14**] 01:00PM BLOOD WBC-53.5* RBC-5.00 Hgb-11.1* Hct-37.7* MCV-75* MCH-22.1* MCHC-29.3* RDW-20.2* Plt Ct-900* [**2159-9-14**] 01:00PM BLOOD Neuts-84* Bands-13* Lymphs-1* Monos-1* Eos-0 Baso-0 Atyps-1* Metas-0 Myelos-0 [**2159-9-14**] 01:00PM BLOOD Hypochr-3+ Anisocy-2+ Poiklo-3+ Macrocy-NORMAL Microcy-3+ Polychr-1+ Spheroc-1+ Ovalocy-3+ Schisto-1+ Tear Dr[**Last Name (STitle) **]1+ [**2159-9-14**] 01:00PM BLOOD Plt Smr-VERY HIGH Plt Ct-900* [**2159-9-14**] 02:00PM BLOOD PT-18.3* PTT-38.2* INR(PT)-1.7* [**2159-9-14**] 01:00PM BLOOD Glucose-100 UreaN-107* Creat-3.4*# Na-137 K-5.4* Cl-95* HCO3-27 AnGap-20 [**2159-9-14**] 01:00PM BLOOD ALT-5 AST-18 AlkPhos-181* TotBili-1.2 [**2159-9-14**] 01:00PM BLOOD Lipase-43 DISCHARGE LABS [**2159-9-16**] 04:29AM BLOOD WBC-53.6* RBC-4.93 Hgb-10.9* Hct-37.4* MCV-76* MCH-22.2* MCHC-29.2* RDW-20.1* Plt Ct-946* [**2159-9-16**] 04:29AM BLOOD Neuts-94* Bands-4 Lymphs-0 Monos-2 Eos-0 Baso-0 Atyps-0 Metas-0 Myelos-0 [**2159-9-16**] 04:29AM BLOOD Hypochr-2+ Anisocy-3+ Poiklo-2+ Macrocy-NORMAL Microcy-3+ Polychr-OCCASIONAL Spheroc-1+ Ovalocy-2+ Target-OCCASIONAL Schisto-1+ Burr-1+ Tear Dr[**Last Name (STitle) **]2+ Acantho-OCCASIONAL Ellipto-2+ [**2159-9-16**] 04:29AM BLOOD Plt Smr-VERY HIGH Plt Ct-946* [**2159-9-16**] 04:29AM BLOOD PT-18.5* PTT-35.2* INR(PT)-1.7* [**2159-9-16**] 04:29AM BLOOD Fibrino-623* [**2159-9-16**] 09:50AM BLOOD Na-135 K-5.5* Cl-99 [**2159-9-16**] 04:29AM BLOOD Glucose-92 UreaN-114* Creat-3.8* Na-135 K-6.0* Cl-99 HCO3-19* AnGap-23* [**2159-9-16**] 04:29AM BLOOD ALT-8 AST-17 LD(LDH)-288* AlkPhos-141* TotBili-1.0 [**2159-9-16**] 04:29AM BLOOD Albumin-3.0* Calcium-7.9* Phos-7.6* Mg-2.1 UricAcd-11.7* [**2159-9-16**] 04:29AM BLOOD HBsAg-NEGATIVE HBsAb-NEGATIVE HBcAb-NEGATIVE [**2159-9-16**] 04:29AM BLOOD Vanco-11.5 [**2159-9-16**] 09:54AM BLOOD Lactate-2.2* [**2159-9-16**] 05:20AM BLOOD Type-[**Last Name (un) **] Comment-GREEN TOP LABS FROM PARACENTESIS [**2159-9-15**] 08:50PM ASCITES WBC-[**Numeric Identifier 11039**]* RBC-2300* Polys-92* Lymphs-1* Monos-6* Eos-1* [**2159-9-15**] 08:50PM ASCITES TotPro-2.6 Glucose-67 LD(LDH)-2086 Amylase-40 TotBili-0.6 Albumin-1.7 CT Scan 1. 25 x 32 mm gas/fluid collection subjacent to the hernia repair site. Correlate with surgical implants in this region. Abscess cannot be excluded. 2. Seroma with air overlying the hernia repair site. There more air than expected at POD 4. An infectious process in this region cannot be excluded. There appears to be a small fascial defect underneath this seroma. 3. Small foci of air within the right inguinal canal. 4. Large amount of intra-abdominal and intra-pelvic ascites. 5. Mild fecalization within the distal small bowel. no evidence of obstruction. 6. Mild pneumomediastinum may reflect post-surgical changes, however, this much air is unusual given the type of repair. Brief Hospital Course: # Abdominal Pain/Infection: Significant concern for surgical site infection given CT scan findings and temporal onset of pain. Pt also had declined surgery as an option. A paracentesis was done which was consistent with an SBP (organism grown was enterococcus). He continued to have significant abdominal distension and tenderness most severe in lower abdomen near surgical wound. The patient also had 2 of 2 Blood Cultures for the ED + Gram Negative Rods. The patient's pain was kept under control with Morphine gtt 4 mg/hr with frequent pain reassessment. When the patient was changed to CMO status, morphine and scopolamine were used for symptom control and comfort measures. . # Hypotension: Concerning for septic shock in the setting of GNR bacteremia. Minimal improvement to fluid boluses. These were stopped when the patient was made comfort measures only (CMO). . # Hypoxemia: New O2 requirement, CXR in ED showed increased opacity in the left lung fields. Now with aggressive fluid repletion, likely [**3-20**] to pulmonary edema. This intervention was also stopped [**3-20**] CMO status. . # Acute on Chronic Renal Failure: Baseline around 1.7 Likely due to relative hypoperfusion in the setting of sepsis. Oliguric an d hyperkalemic. FeNa <1%. Work up and treatment stopped [**3-20**] CMO status. . # Leukocytosis with bandemia: slightly increased from prior, with bandemia. Peritoneal fluid growing out enterococcus. Labs were stopped [**3-20**] CMO status. Medications on Admission: 1. Torsemide 100 mg Tablet PO once a day. 2. Metolazone 2.5 mg Tablet PO q M,W,F. 3. Aspirin 81 mg Tablet, Chewable PO DAILY. 4. Multivitamin PO DAILY. 5. Simvastatin 40 mg Tablet PO DAILY. 6. Sodium Bicarbonate 650 mg PO BID. 7. Calcitriol 0.25 mcg Capsule PO QTUTHUR. 8. Omeprazole 20 mg PO DAILY. 9. Allopurinol 100 mg PO EVERY OTHER DAY. 10. Sevelamer Carbonate 1600 mg Tablet PO TID W/MEALS . 11. Prednisone 5 mg Tablet PO DAILY 12. Levothyroxine 25 mcg Tablet PO DAILY 13. Metoprolol Succinate 200 mg SR PO once a day. 14. Warfarin 2.5 mg PO q Sun/Tue/Thurs/Sat. 15. Warfarin 5 mg PO q Mon/Wed/Fri. 16. Docusate Sodium 100 mg PO BID PRN constipation. 17. Senna 8.6 mg Tablet PO twice a day as needed for constipation. Discharge Medications: none Discharge Disposition: Expired Discharge Diagnosis: deceased Discharge Condition: deceased Discharge Instructions: not applicable, patient deceased Followup Instructions: not applicable, patient deceased [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**Name8 (MD) **] MD [**MD Number(1) 292**] Completed by:[**2159-9-18**] ICD9 Codes: 5845, 2762, 5715, 4280, 2767, 2724, 2749, 3051
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8354 }
Medical Text: Admission Date: [**2114-1-25**] Discharge Date: [**2114-2-3**] Date of Birth: [**2036-5-10**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2972**] Chief Complaint: shortness of breath Major Surgical or Invasive Procedure: PICC line placement History of Present Illness: 77M with hx of COPD, recent admit for COPD flare, ARF (d/c [**1-20**]), afib, CHF sent to ED from [**Hospital1 1501**] with severe shortness of breath and desaturation to 86%. Pt states that this am, he woke up and was feeling well. He got up to go the bathroom but needed to take his oxygen off because it would not reach. When he got back from the bathroom, he was severely short of breath. He put his oxygen back on but it did not help. He states that he could hear himself wheezing. Later, he again got up to go to the bathroom and had to take off his O2. Once again, he became severely short of breath. This time, he sat in his chair because that makes his breathing better but his O2 does not reach to the chair. He felt very short of breath and [**Doctor Last Name **] for his nurse. His O2 sat was checked and found to be 86% on RA. Nursing home notes state that pt has been coughing up blood tinged sputum. pt states he has a chronic cough productive of dark brown sputum. Her cannot walk more than 3 feet without stopping to rest. He denies chest pain, palpitations. . In ED, CXR showed RUL pneumonia and pt was given levaquin and nebs. Past Medical History: * COPD: no PFTs on record, on home O2 3L/m for past 2 weeks * Interstitial lung disease * atrial fibrillation (formerly on coumadin; stopped during last admission) * CHF: last echo [**12-31**] with LVEF >55%, 2+ MR, 3+ TR, mild AV stenosis, severe pulm art HTN * severe pulm art HTN by echo * DM type II * CRI: baseline creat 1.6 * BPH * known bladder mass since [**2108**] * ? lung mass * anemia Social History: lives with his wife in a 2 story house but is now at a [**Hospital1 1501**] since recent hospitalization; smoked 150 pack-years, quit 7 years ago; formerly worked in a battery factory and may have been exposed to hazardous chemicals during this time; has a h/o asbestos exposure; no alcohol or illicit drug use. One daughter lives down the street. Family History: Father with CAD. Physical Exam: temp 98.2, BP 130/60, HR 102, R 20, O2 94% 4L; wt 187lbs Gen: NAD, pleasant; moderate resp distress after moving about in bed; AO x 2 HEENT: EOMI, MMM; +accessory muscle use with resp distress Neck: no JVD, no bruit CV: tachy, irreg irreg; difficult to ascultate heart sounds due to breath sounds; no murmurs detected Chest: diffuse exp wheezes with prolonged exp phase; crackles at bilateral bases Abd: +BS, soft, mildly distended, nontendner; multiple bruises Ext: venous stasis skin changes; 2+ DP Skin: multiple abrasions on arms, abdomen, lower ext; on LLE, 4cm area of raw skin; on RLE, 3cm area of raw skin; on top of right foot, large area of raw skin, tender Pertinent Results: [**2114-1-25**] 02:28PM URINE RBC-0-2 WBC-0 BACTERIA-RARE YEAST-FEW EPI-0 [**2114-1-25**] 02:28PM URINE BLOOD-MOD NITRITE-NEG PROTEIN-NEG GLUCOSE-250 KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-NEG [**2114-1-25**] 02:28PM URINE COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.007 [**2114-1-25**] 04:05PM PLT COUNT-278 [**2114-1-25**] 04:05PM NEUTS-83* BANDS-2 LYMPHS-3* MONOS-9 EOS-3 BASOS-0 ATYPS-0 METAS-0 MYELOS-0 NUC RBCS-2* [**2114-1-25**] 04:05PM WBC-16.5*# RBC-3.14* HGB-9.3* HCT-27.5* MCV-88 MCH-29.8 MCHC-33.9 RDW-18.6* [**2114-1-25**] 04:05PM CK-MB-4 cTropnT-0.05* proBNP-969* [**2114-1-25**] 04:05PM CK(CPK)-144 [**2114-1-25**] 04:05PM GLUCOSE-165* UREA N-45* CREAT-1.5* SODIUM-138 POTASSIUM-5.0 CHLORIDE-98 TOTAL CO2-29 ANION GAP-16 [**2114-1-25**] 05:05PM LACTATE-1.2 . Micro: - BCX ([**2114-1-25**]) 4/4 bottles No Growth (final) - Sputum cx ([**2114-1-27**]) contaminated with resp secretions - Urine legionella Ag negative (final) . CXR ([**2114-1-30**]): There is no significant interval change in multifocal patchy opacities bilaterally since multiple prior exams, including chest CT dated [**2114-1-26**]. The pulmonary vasculature is normal. There is no pneumothorax. Tiny bilateral pleural effusions are slightly smaller than one day earlier. The cardiac silhouette, mediastinal and hilar contours are stable. The surrounding soft tissue and osseous structures are unremarkable. . [**2114-1-26**] CT-chest w/o contrast. IMPRESSION: 1. Poorly defined patchy and nodular airspace opacities seen bilaterally suggesting multifocal pneumonia. Followup imaging following treatment to document resolution is recommended. 2. Small bilateral pleural effusions, right greater than left. 3. Pleural calcifications bilaterally, suggesting prior asbestos exposure. 4. Diffuse coronary artery calcifications and atherosclerotic calcifications noted within the aorta. . ECHO [**2114-1-16**]: The left and right atria are moderately dilated. The estimated right atrial pressure is 16-20 mmHg. Left ventricular wall thickness, cavity size, and systolic function are normal (LVEF>55%). Regional left ventricular wall motion is normal. The right ventricular cavity is dilated. Right ventricular systolic function is normal. There are three aortic valve leaflets. The aortic valve leaflets are moderately thickened. There is mild aortic valve stenosis (area 1.2-1.9cm2). No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Moderate (2+) mitral regurgitation is seen. The mitral regurgitation jet is eccentric. Moderate to severe [3+] tricuspid regurgitation is seen. There is severe pulmonary artery systolic hypertension. . EKG ([**2114-1-29**]): afib at 87 bpm, LAD, flattened T waves in I, borderline IVCD with left bundyloid pattern; flipped T waves in avL; no ST changes; overall unchanged from prior tracing [**2114-1-28**]. Brief Hospital Course: 77-yo-man w/ COPD, afib, diastolic CHF, anemia, CKD, admitted with PNA. He had recently been discharged [**2114-1-19**] after a COPD exacerbation treated with steroids. He is status post MICU stay for hypoxia/respiratory distress. . # Hypoxia/Resp distress: This was though to be multifactorial, due to PNA, COPD, and diastolic CHF. His acute dyspnea that resulted in ICU transfer was felt due to volume overload, and improved after diuresis with IV lasix. He was diuresed with IV lasix, treated with IV antibiotics (see below), and round the clock nebulizers. . # PNA: This was multilobar, noted both on chest x-ray and non-contrast CT scan of the chest. Blood cultures had no growth (final). Initial sputum culture was contaminated and repeat grew oropharyngeal flora (not speciated). Initially he was placed on levofloxacin, with vancomycin added 24 hours later. The pneumonia was complicated by CHF and COPD exacerbations, so his progress was slow. After 6 days of levofloxacin and 5 days of vancomycin, his coverage was broadened to Zosyn instead of Levofloxacin for presumed nosocomial pneumonia, acquired at the nursing home. Vanco was continued. He remains afebrile and his WBC normalized. He should receive an additional 7 days of Vancomycin and Zosyn. He should follow up with Dr. [**Last Name (STitle) **] (his primary care physician) in [**12-26**] weeks. . # COPD: The patient has no PFTs on record, but he has had a constant O2 requirement since his last discharge on [**1-19**] of 3L nasal cannula. His COPD was likely exacerbated by his PNA. He was continued on Advair and placed on a more extended prednisone taper (he should begin 20mg x 7 days on [**2114-2-4**], tapered to 10mg daily for 7 days, then to 5mg daily x 7 days, then off). He should continue nebulizers, atrovent q6H and albuterol q4H). Once his acute flair has improved, he should be referred for outpatient PFTs. . # Atrial fibrillation: The patient was rate controlled on diltiazem which was continued. Coumadin was stopped during his last admission due to hematuria. He was continued on aspirin. B-blocker was not given as not to exacerbate his COPD. . # DM type 2: The patient was diet controlled until his prior hospitalization in [**Month (only) 404**]. Since he has been on steroids, he has required insulin. His fingersticks should be checked four times a day. He should receive 20 units of NPH insulin each morning and at bedtime, along with a sliding scale. His doses of insulin may need to be decreased as his steroids are tapered. . # CRI: This is likely from HTN and DM nephropathy. The patient was at baseline (creat ~ 1.6). His medications were renally dosed. He has an appointment with his nephrologist in [**Month (only) 958**] as noted on the discharge paperwork. . # Anemia - This is a combination of blood loss and chronic inflammation. His baseline HCT 26-28. He had hematuria (see below) and received 4 units total of packed RBCs. His Hct was stable post transfusion, and he is currently at baseline Hct. He was noted to have guiac positive stools, and will need outpatient colonoscopy once his acute respiratory issues have improved sufficiently. He was started on iron supplements. . # Hematuria: Pt has known bladder mass and BPH. Urology was consulted during last admission, and recommended stopping his coumadin and outpt Urology followup. Urology was re-consulted for hematuria after foley insertion. They again recommended outpatient workup and cystoscopy. Proscar was started as per Urology and urine cytology sent (can be followed up by Urology at the outpatient appointment.) The patient had continuous bladder irrigation and his urine cleared. Bladder irrigation was stopped 36 hours prior to discharge and the patient's urine remained clear. On the day of discharge the foley was changed from a 3-way to an 18-french 2 way catheter. Some hematuria was again noted but this was felt due to the trauma of foley replacement. He should follow up with Urology on [**2114-2-27**] as previously scheduled. He can have a voiding trial in [**12-26**] days as the catheter is no longer required for medical management. . # LE Wounds: The patient had skin ulcers on his lower extremities likely secondary to blisters and excoriation by patient. There was good perfusion on exam and no evidence of ulcer progression or superinfection. He was followed by the wound nurse [**First Name (Titles) **] [**Last Name (Titles) 106675**] were changed daily (wound gel and adaptic, covered with kerlix). The wound care should continue at rehab and his wounds monitored closely for sign of infection. . # FEN: Diabetic/cardiac diet. Electrolytes were stable. . # Prophylaxis: SC heparin, bowel regimen, diet . # Full code . # Communication: [**Name (NI) **] [**Name (NI) 4427**] (Wife) [**Telephone/Fax (1) 106676**] Medications on Admission: * Ipraptropium * Senna/colace * Levalbuterol prn * Prednisone 20mg until [**1-27**] * Furosemide 40 mg qMWF * Aspirin 325 mg qd * Lisinopril 2.5 mg qd * Diltiazem HCl 240 qd * Tamsulosin 0.4 mg qhs * Insulin SS Discharge Medications: 1. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 2. Albuterol Sulfate 0.083 % Solution Sig: One (1) nebulized treatment Inhalation Q4H (every 4 hours). 3. Aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 4. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for constipation. 5. Diltiazem HCl 240 mg Tablet Sustained Release 24HR Sig: One (1) Tablet Sustained Release 24HR PO once a day. 6. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 7. Finasteride 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. Fluticasone-Salmeterol 100-50 mcg/Dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). 9. Heparin Flush PICC (100 units/ml) 2 ml IV DAILY:PRN 10 ml NS followed by 2 ml of 100 Units/ml heparin (200 units heparin) each lumen Daily and PRN. Inspect site every shift. 10. Insulin NPH Human Recomb 100 unit/mL Cartridge Sig: Twenty (20) units Subcutaneous qAM. 11. Insulin NPH Human Recomb 100 unit/mL Cartridge Sig: Twenty (20) units Subcutaneous at bedtime. 12. Ferrous Sulfate 325 (65) mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 13. Furosemide 20 mg Tablet Sig: Three (3) Tablet PO DAILY (Daily). 14. Ipratropium Bromide 0.02 % Solution Sig: One (1) nebulizer Inhalation Q6H (every 6 hours). 15. Metolazone 2.5 mg Tablet Sig: One (1) Tablet PO 3X/WEEK (MO,WE,FR). 16. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) injection Injection TID (3 times a day). 17. Piperacillin-Tazobactam Na 2.25 gm IV Q6H 18. Vancomycin HCl 1000 mg IV Q 24H 19. Tamsulosin 0.4 mg Capsule, Sust. Release 24HR Sig: One (1) Capsule, Sust. Release 24HR PO HS (at bedtime). 20. Prednisone 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily) for 7 days: Then decrease dose to 10mg x 7 days, then 5mg x 7 days, then off. 21. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed for constipation. 22. Oxycodone 5 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for For pain with dressing changes. Discharge Disposition: Extended Care Facility: [**Hospital3 7**] & Rehab Center - [**Hospital1 8**] Discharge Diagnosis: Primary: 1. Pneumonia, nosocomial 2. COPD (Chronic Obstructive Pulmonary disease) 3. CHF (congestive heart failure) . Secondary: 1. Bladder Mass 2. Diabetes 3. Atrial Fibrillation Discharge Condition: Afebrile, breathing improved. Stable. Discharge Instructions: Please take all your medications as prescribed. You were admitted with pneumonia and need another week of IV antibiotics. You should continue to use oxygen (3L nasal cannula) at all times). . Call your doctor or return to the hospital if you have fever, shortness of breath, chest pain, or any other concerning symptom. Followup Instructions: Please call your primary doctor, Dr. [**Last Name (STitle) **], for an appointment within 1-2 weeks. . You should follow up with your kidney doctor, Dr. [**Last Name (STitle) **] as noted below. You have an appointment with a urologist, Dr. [**First Name (STitle) **], on [**2114-2-27**] as noted below for work up of your bladder mass. . Provider: [**Known firstname **] [**Last Name (NamePattern4) 8941**], MD Phone:[**Telephone/Fax (1) 6317**] Date/Time:[**2114-2-27**] 10:15 Provider: [**First Name11 (Name Pattern1) 177**] [**Last Name (NamePattern4) 720**], M.D. Phone:[**Telephone/Fax (1) 435**] Date/Time:[**2114-3-8**] 9:00 Completed by:[**2114-2-3**] ICD9 Codes: 4280, 486, 496, 5119, 2859
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Medical Text: Admission Date: [**2163-12-20**] Discharge Date: [**2163-12-28**] Date of Birth: [**2100-1-19**] Sex: M Service: NEUROSURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1835**] Chief Complaint: CC:[**CC Contact Info 75401**] Major Surgical or Invasive Procedure: craniotomy for tumor resection History of Present Illness: HPI: Pt. is a 63 year old with a history of hypercholesterolemia who presents for further work up of gait ataxia and mass seen on Head CT. He reports that he has been seeing his doctor [**First Name (Titles) **] [**Last Name (Titles) **] that have been attributed to depression since [**2163-12-6**]. He noted trouble concentrating at work, making wrong turns when driving home from work and getting lost, forgetting to turn off the lights or turn off the TV at home, and problems with his penmanship, with small, illegible handwriting. He's felt sad, and he feels that his speech is "flat" with no intonation. He was started on Celexa for these [**Year (2 digits) **] on [**12-15**], but feels that this has made no impact. Then starting yesterday he started feeling unsteady on his feet. When he bent forwards to tie his shoes he'd list to the left and would have to catch himself from falling. He's not actually fallen. He feels that his left calf is "stiff" and sore, but not actually weak that he's noticed. He had a constant, non-throbbing bifrontal headache at [**Location (un) **] today, but has not been bothered by headaches prior to that. He's not had any nausea or vomiting. He presented to his PCP because of the gait unsteadiness today, and was referred to the ED in [**Location (un) **]. There a Head CT was performed and showed a 4.3x3.2 complex mass in R parietal area with contrast enhancement and central necrosis, and additional R frontal mass with surrounding edema, and minimal midline shift. He received Dilantin 1 g load, and was transferred here. He received 10 mg Decadron here at 18:45. Past Medical History: PMHx: Hypercholesterolemia Significant rise in PSA Social History: SH: Financial consultant (took a leave of absence in the end of [**11-18**] trouble driving), lives with wife and 16 y/o daughter, one daughter in college, 2 grown children live in the area, no tobacco, occ wine with dinner Family History: FH: Brother with DVT, no FH of stroke, seizure, CAD, or cancer Physical Exam: PHYSICAL EXAM: T: BP: 160/96 HR:60 R:16 O2Sats: 98% RA Gen: WD/WN, comfortable, NAD. HEENT: Pupils: [**5-20**],bilat EOMs: intact, no nystagmus Neck: Supple. Lungs: CTA bilaterally. Cardiac: RRR. S1/S2. Abd: Soft, NT, BS+ Extrem: Warm and well-perfused. Neuro: Mental status: Awake and alert, cooperative with exam, normal affect, delayed processing. Orientation: Oriented to person, place, and date. Recall: [**2-19**] words at 5 minutes. Language: Speech delayed, conversant with good comprehension and repetition. Naming intact. No dysarthria or paraphasic errors. Cranial Nerves: I: Not tested II: Pupils equally round and reactive to light, 5 to 4mm bilaterally. Visual fields are full to confrontation. III, IV, VI: Extraocular movements intact bilaterally without nystagmus. V, VII: Facial strength and sensation intact and symmetric. VIII: Hearing intact to voice. IX, X: Palatal elevation symmetrical. [**Doctor First Name 81**]: Sternocleidomastoid and trapezius normal bilaterally. XII: Tongue midline without fasciculations. Motor: Normal bulk bilaterally. Tone normal. No observed myoclonus or tremor +Left pronator drift [**Doctor First Name **] Tri [**Hospital1 **] WF WE FE FF IP H Q DF PF TE TF R 5 5 5 5 5 5 5 5 5 5 5 5 5 5 L 4+ 4 4+ 5 4+ 4+ 5 4+ 4+ 5 5- 5 5- 5 Sensation: Intact to light toucH Reflexes: +2 and symmetric throughout. Toes downgoing bilaterally Coordination: normal on finger-nose-finger on Right, decreased ability on Left Pertinent Results: Labs: WBC 7.3 Hgb 14.6 Plt 168 Hct 41.7 N:66.2 L:26.2 M:6.1 E:1.2 Bas:0.3 PT: 12.9 PTT: 23.3 INR: 1.1 CT: Pending OSH CT: 4.3x3.2 complex mass in R parietal area with contrast enhancement and central necrosis, and additional smaller R frontal mass, and minimal midline shift POSTOP MRI MR HEAD W & W/O CONTRAST [**2163-12-24**] 9:29 AM Reason: follow up on postop residual brain tumor. pls do before midn Contrast: MAGNEVIST [**Hospital 93**] MEDICAL CONDITION: 63 year old man with craniotomy for tumor resection REASON FOR THIS EXAMINATION: follow up on postop residual brain tumor. pls do before midnight [**12-24**] CONTRAINDICATIONS for IV CONTRAST: None. EXAM: MRI of the brain. CLINICAL INFORMATION: Patient status post surgery for post-operative evaluation. TECHNIQUE: T1 sagittal and axial and FLAIR T2 susceptibility and diffusion axial images of the brain were acquired before gadolinium. T1 sagittal, axial and coronal images were obtained following gadolinium. Comparison was made with the previous MRI examinations of [**2163-12-21**] and [**2163-12-23**]. FINDINGS: Since the previous MRI examination the patient has undergone craniotomy in the right frontal region for right frontal lobe enhancing mass lesions. There are blood products seen near the convexity along the midline with foci of air consistent with recent surgery. Some residual enhancement is identified on the anterior aspect and also the posterolateral aspect of the mass. The other enhancing mass lesion seen more laterally is again visualized unchanged. There is no significant change in the brain edema identified. There is continued mass effect on the right lateral ventricle identified without significant midline shift. There is no hydrocephalus. Pneumocephalus is identified in the frontal region. IMPRESSION: Status post resection of frontal mass. Residual enhancement is seen anteriorly and posterolateral aspect of the mass with blood products in the region of resection. Pneumocephalus is identified. No acute infarct is seen. Previously noted smaller enhancing mass laterally in the right frontal lobe is again identified unchanged. **************** postop head CT CT HEAD W/O CONTRAST [**2163-12-25**] 10:45 AM CT HEAD W/O CONTRAST Reason: r/o inc MLS / Mass effect [**Hospital 93**] MEDICAL CONDITION: 63 year old man with s/p crani for tumor resection REASON FOR THIS EXAMINATION: r/o inc MLS / Mass effect CONTRAINDICATIONS for IV CONTRAST: None. INDICATION: 63-year-old man with status post crani for tumor resection. Rule out increased midline shift/mass effect. COMPARISONS: [**2163-12-23**] CT. CT HEAD WITHOUT CONTRAST: Patient is status post right frontal craniotomy for tumor resection. There is interval decrease in pneumocephalus. There is no new intracranial hemorrhage. No midline shift. No evidence of major vascular territorial infarct. Size of ventricles and cisterns is stable. IMPRESSION: Status post right frontal craniotomy with stable expected post- surgical changes. **************** Brain tissue pathology 1. Brain, right frontal, biopsy (including intraoperative frozen section and smear): High grade glial neoplasm. 2. Brain, "deep right frontal", biopsy (including frozen section and smear): High grade glial neoplasm. 3. Brain, "right frontal deep", resection: Glioblastoma (WHO grade IV). Brief Hospital Course: Mr [**Known lastname 75402**] was admitted to neurosurgery service on [**2163-12-20**] with diagnosis of brain mass. Upon admission, he was oriented x 3, but with delayed speech; he has mild left-sided weakness. He underwent craniotomy for tumor resection on [**2163-12-23**]. No intra- or postop complications are encountered. He was observed in surgical ICU postop. Postop CT showed slight bleeding; postop MRI showed residual brain tumor. He was transferred out of ICU to regular floor on POD#3. Neurologically he remained stable with mild left-sided weakness postoperatively. He is able to ambulate with assistance; his diet is advanced. He has bladder incontinence. PT/OT are consulted and he was recommended to be discharged to rehab facility. Neuro-oncology is consulted and outpatient followup is recommended and scheduled. Upon discharge, neurologically he is oriented times 3, following commands; mild left-sided weakness (UE/LE, motor 3 to 5-/5); motor [**5-21**] with RUE/RLE. His brain tumor pathology reported Glioblastoma (WHO grade IV). Medications on Admission: Medications prior to admission: Aspirin 325 mg QD Celexa 10 mg QD- started [**12-15**] Crestor 5 mg QD Discharge Medications: 1. Rosuvastatin 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Famotidine 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 3. Hexavitamin Tablet Sig: Five (5) ML PO DAILY (Daily). 4. Oxycodone-Acetaminophen 5-325 mg/5 mL Solution Sig: 5-10 MLs PO Q4H (every 4 hours) as needed. 5. Senna 8.6 mg Tablet Sig: One (1) Tablet PO QAM (once a day (in the morning)). 6. Docusate Sodium 50 mg/5 mL Liquid Sig: One (1) PO BID (2 times a day). 7. Acetaminophen 160 mg/5 mL Solution Sig: One (1) PO Q6H (every 6 hours) as needed. 8. Insulin Regular Human 100 unit/mL Solution Sig: One (1) Injection ASDIR (AS DIRECTED). 9. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection TID (3 times a day). 10. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 11. Levetiracetam 500 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). Discharge Disposition: Extended Care Facility: [**Hospital6 1293**] - [**Location (un) 1294**] Discharge Diagnosis: brain mass Discharge Condition: neurologically stable Discharge Instructions: DISCHARGE INSTRUCTIONS FOR CRANIOTOMY/HEAD INJURY ?????? Have a family member check your incision daily for signs of infection ?????? Take your pain medicine as prescribed ?????? Exercise should be limited to walking; no lifting, straining, excessive bending ?????? You may wash your hair only after 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: Follow-up with Dr. [**Last Name (STitle) 10840**] at [**Hospital3 3765**] for radiation planning. [**Hospital 75403**] Cancer Center, 131 ORNAC, [**Location (un) **], [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) 75404**] Building Please call [**Telephone/Fax (1) 75405**] to make an appointment. Make sure you bring a CD of your CT images, the CT report and your final pathology report when you see Dr. [**Last Name (STitle) 10840**]. PLEASE CALL [**Telephone/Fax (1) **] TO SCHEDULE AN APPOINTMENT WITH DR. [**Last Name (STitle) **] TO BE SEEN NEXT TUESDAY in clinic. You will have your staples removed at that time. PLEASE FOLLOW UP WITH NEURO-ONCOLOGIST DR [**First Name (STitle) 5005**] [**Last Name (NamePattern4) 5342**], MD ON Date/Time:[**2164-1-2**] 2:00 (Phone:[**Telephone/Fax (1) 44**]). PLEASE CALL FOR OFFICE LOCATION. Completed by:[**2163-12-28**] ICD9 Codes: 2720, 311
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Medical Text: Admission Date: [**2101-12-1**] Discharge Date: [**2101-12-5**] Date of Birth: [**2055-5-18**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 465**] Chief Complaint: Alcohol intoxication, Suicidal ideation Major Surgical or Invasive Procedure: None History of Present Illness: 46 M with PMHx significant for nephrectomy, and prior admissions for alcohol intoxication, who presents with suicidal ideation. Patient has prior history of ED visits with both of these presentations. Patient reports that he has been on a drinking binge (vodka & listerine) for the past 2 months, with his last drink 2 days prior to admission. Patient denies ever having EtOH withdrawal seizures and just reports having "shakes". Since stopping alcohol on day prior to admission, he has been feeling anxiety, depression, nausea with nonbloody bilious emesis, headache, chills, & tremors. he also reports lightheadedess and dizziness. He denies any methanol or ethylene glycol ingestions, fevers, abdominal pain, diarrhea. He does reports that his last meal was 3 days prior to admission, and he has consumed essentially nothing but alcohol since. Patient reports that he's been feeling suicidal for the past couple days after stopping alcohol. he reports that he has significant financial, occupational and familial stressors. He called 911 this am and was brought to the ED. . . . ROS: Positive: chest rash Negative: change in vision, oral ulcerations, neck stiffness, chest pain, abdominal pain, diarrhea, constipation In the ED, vitals signs were T:96.7, HR:130, BP: 72/44. The patient was also found to have a significant ETOH intoxication, as well as an AG acidosis (anion gap 35)and ARF. Tox screen was positive for only EtOH and LFTs were mildly elevated. he was given Ativan, 2L fluids, phenergan for nausea, one dose of ceftriaxone and sent to the floor. Past Medical History: 1. Alcohol abuse. 2. Right nephrectomy for a mass in his kidney. 3. HTN 4. Dyslipidemia Social History: Patient reports that he drinks 1 quart of vodka or listerine per day. Has been doing this lately for 2 months. Long-standing drinking history. Patient has had prior visits to [**Hospital1 18**] ED for suicide attempt and EtOH intoxication. Patient reports smoking 1 pack per week, denies any other illicit drugs. Family History: No family history of cancer, no bleeding diathesis Father - deceased - MI age 70 Mother - recent CVA Physical Exam: Physical Exam: Vitals - T: 100.3 BP: 100/62 HR: 123 RR: 12 02 sat:96RA Gen: NAD, anxious, cooperative SKIN: redness to face and upper chest, no excoriations or lesions HEENT: AT/NC, bilateral scleral injection without exudate, pink conjunctiva, PERRL, EOMI, dry MM, poor dentition, no evidence of oral ulceration Neck: no masses, no LAD, no JVD, no carotid bruit CV: tachycardic, S1/S2, flow murmur @ RUSB, nondisplaced PMI Chest: cta b/l, no crackles or wheezes. Abd: soft, nd, +bs, no organomegaly, no rebound, no guarding Extr: no cyanosis, no clubbing; no edema, 2+ pulses b/l. Neuro: awake, alert, a&ox3, cn ii-xii intact; strength 4/5 bilaterally Pertinent Results: [**2101-12-1**] 02:01PM WBC-6.5 RBC-4.65 HGB-15.9 HCT-46.0 MCV-99*# MCH-34.2* MCHC-34.6 RDW-16.0* [**2101-12-1**] 02:01PM NEUTS-74.4* LYMPHS-14.3* MONOS-10.9 EOS-0.1 BASOS-0.3 [**2101-12-1**] 02:01PM ASA-NEG ETHANOL-296* ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**2101-12-1**] 02:01PM CALCIUM-7.8* PHOSPHATE-7.5*# MAGNESIUM-2.1 [**2101-12-1**] 02:01PM CK-MB-21* MB INDX-3.1 cTropnT-<0.01 [**2101-12-1**] 02:01PM LIPASE-71* [**2101-12-1**] 02:01PM ALT(SGPT)-99* AST(SGOT)-156* CK(CPK)-688* ALK PHOS-122* AMYLASE-92 TOT BILI-0.4 [**2101-12-1**] 02:01PM GLUCOSE-118* UREA N-37* CREAT-2.1* SODIUM-141 POTASSIUM-4.5 CHLORIDE-91* TOTAL CO2-15* ANION GAP-40* . [**2101-12-1**] CXR: IMPRESSION: No acute pulmonary process. . CT HEAD: IMPRESSION: No intracranial hemorrhage or fracture. No mass effect. Brief Hospital Course: Patient is a 46 M with suicidal ideation, EtOH withdrawal, hypotension, elevated lactate, ARF, metabolic acidosis, & tachycardia. . # EtOH Withdrawal: Patient ceased drinking approximately 24 hours prior to admission. Load with Valium 10mg until confortable, then Q1hprn per CIWA > 10. the patient initially required high doses. MVI/Thiamine/Folate were also given. . # Hypotension: due to volume depletion in the context of poor po intake, responded well to fluids. . # Tachycardia - Likely due to a combination of etoh withdrawal hypovolemia. Patient's HR has decreased with fluid challenge. Fluid hydration. . # Fevers - Likely in the setting of alcohol withdrawal. Cultures negative. . # ARF- Cr on admission to 2.0. Baseline is 0.8. Likely pre-renal renal failure, responded well to fluids. No evidence of secondary ingestions. Renal was consulted to help with management. . # Metabolic Acidosis: Patient with metabolic acidosis. Likely due to alcoholic and starvation ketoacidosis as well as renal failure. Lactate minimally elevated. No evidence of seconday ingestion. Resolved with IVF hydration. . # Suicide attempt- patient currently with 1:1 sitter. Consulted Psychiatry. Recommended inpatient psychiatry admission. . FULL CODE Medications on Admission: Paxil Lipitor 20 Norvasc 20 "Something to stop Alcohol cravings" Discharge Disposition: Extended Care Facility: [**Hospital3 8063**] - [**Location (un) **] Discharge Diagnosis: EtOH withdrawal Suicide Attempt Discharge Condition: Stable Discharge Instructions: Please return to the hospital if you experience shortness of breath, chest pain, fevers/chills. . Followup Instructions: Please follow up with your primary care physician [**Name Initial (PRE) 176**] 3 weeks of discharge. On this admission, it was noted that you have a small amount of red blood cells in your urine. This will need to be followed up with your primary care physician upon discharge. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] MD [**MD Number(2) 472**] ICD9 Codes: 5849, 2762, 4019
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Medical Text: Admission Date: [**2131-10-19**] Discharge Date: [**2131-10-27**] Date of Birth: [**2064-7-16**] Sex: M Service: MEDICINE Allergies: Levofloxacin / Cefazolin / Coreg / Dopamine Attending:[**First Name3 (LF) 134**] Chief Complaint: fatigue, shortness of breath Major Surgical or Invasive Procedure: Right thoracentesis History of Present Illness: A 67 year old gentleman recently discharged [**10-5**] from [**Hospital1 1516**] service for sepsis [**1-27**] R. BKA site complicated by Refractory VT s/p ablation with a history of DM, CAD s/p PCI distal RCA '[**03**], ischemic cardiomyopathy EF 20% who was admitted with lethargy and fatigue from [**Hospital3 **]. He reports an increase in fluid collection in his upper extremities, shortness of breath and constipation and general fatigue over past 4 days. At [**Hospital1 **], it was presumed that this was an exacerbation of his CHF so Lasix increased from 20mg PO to 80mg IV BID x2 days. His UOP was negative 1.5 Liters yesterday but he failed to respond and was persistantly short of breath. However, on further review he has not recieved any Lasix over past 18 hours. (pharmacy error per report). He was subsequently transferred for further managment. PT was directly transferred to the floor from [**Hospital1 **] where his VS: 97.3 77 105/66 17 100% 4L. An initial evaluation was begun on the floor. EKG showed V paced @69 and no ischemic changes. CXR revealed evidence of pulmonary edema and possible pneumonia. CT Chest showed large right pleural effusion and no evidence of pneumonia, BNP 55, 000. CK 36, Trop 0.35. Cr 2.0 (up from baseline 1.7) Pt was subsequently transferred to CCU for further management. On ROS, He denies chest pain, palpitations, N/V, abdominal pain. Denies PND or orthopnea. Denies cough, fever or chills. He does report some constipation x2 days but had some BM today. Reports mild dysuria 2 days ago now resolved. Denies flank pain. He endorses poor appetite and PO intake over past 3 days. He reports a pressure ulcer on coccyx. Past Medical History: *CARDIAC HISTORY: -MI [**2103**]- C.CATH [**2121**] showed 60% distal RCA stenosis at recanalization site -Systolic Heart Failure- ECHO [**10-3**] with EF 20% -Refractory VT (dx [**10-3**] in setting of sepsis) now s/p VT ablation; currently on Mexilitine and Amiodarone -Atrial Fibrillation s/p ablation, pacemaker *Hypertension *Hyperlipidemia *DMII *SMA thrombosis: small&large bowel resection and short gut *Bacterial peritonitis *PVD s/p R BKA c/b stump infection- completed 10d Vanc/Zosyn *Hypercoagulable state, DVTs on Lovenox *Peripheral neuropathy *Plantar fasciitis *CVA *PV/MDS, baseline 20s *Nonhealing anal fissure Social History: Currently lives at [**Hospital3 **], he is a retired systems programmer for a management consulting firm. He is married with no children. He denies alcohol, tobacco or drug use. Prior 3 yrs of tobbaco use. Family History: Family history is negative for hypercoagulable state, PVD Physical Exam: PE: VS: 97, BP 96/609 HR 74, RR 18 97% 1.5L Gen: Cachectic male, fatigued appearing, conversing in full sentences Neck: JVP 10cm Pulm: Rales in Bilateral lower lobes, decreased sounds on right Cards: S1 & S2 regular without murmur Abd: Soft, mildly distended, tympanitic, non-tender, no rebound/guarding Ext: B upper extremity edema. R BKA, stump with no open wounds or erythema. Wound on L foot, healing well. 1+ DP on L foot. Neuro: AAO x3 Pertinent Results: Admission: [**2131-10-19**] 05:10PM BLOOD WBC-20.4* RBC-5.22 Hgb-12.4* Hct-39.7* MCV-76* MCH-23.8* MCHC-31.3 RDW-20.9* Plt Ct-382 [**2131-10-19**] 05:10PM BLOOD Neuts-91.4* Lymphs-5.1* Monos-1.8* Eos-1.4 Baso-0.3 [**2131-10-19**] 05:10PM BLOOD PT-20.5* PTT-51.4* INR(PT)-1.9* [**2131-10-19**] 05:10PM BLOOD Glucose-85 UreaN-82* Creat-2.0* Na-140 K-4.8 Cl-101 HCO3-25 AnGap-19 [**2131-10-19**] 05:10PM BLOOD CK(CPK)-36* [**2131-10-19**] 05:10PM BLOOD CK-MB-NotDone cTropnT-0.35* proBNP-[**Numeric Identifier 103666**]* [**2131-10-19**] 05:10PM BLOOD Calcium-8.0* Phos-6.8*# Mg-2.0 [**2131-10-20**] 12:09PM BLOOD Lactate-0.9 Admission Chest X-ray: 1) New focal opacity overlying the left mid lung field, which could represent an area of developing pneumonia. Dedicated PA and lateral views of the chest is recommended. 2) Persistent large right pleural effusion and mild congestive heart failure. 3) Unchanged bibasilar atelectasis. CT CHEST W/O CONTRAST [**2131-10-19**]: 1. Severe right pleural effusion and small left pleural effusion. The left pleural effusion is loculated and corresponds to the described density on the recent chest radiographs. 2. No pericardial effusion is noted. 3. Diffuse ground glass opacities of the lungs is most likely related to pulmonary edema. More focal patchy opacities at left apex may represent asymmetric pulmonary edema although superimposed infectious or inflammatory process cannot be excluded. 4. Bibasilar pulmonary calcifications or aspirated barium, unchanged since [**2129**]. ECHO [**2131-10-20**]: The left atrium is moderately dilated. No left atrial mass/thrombus seen (best excluded by transesophageal echocardiography). Left ventricular wall thicknesses are normal. The left ventricular cavity is moderately dilated. There is severe global left ventricular hypokinesis with relative preservation of the anterolateral wall (LVEF = 20 %). The right ventricular cavity is moderately dilated with severe global free wall hypokinesis. The aortic root is mildly dilated at the sinus level. The aortic valve leaflets (3) are mildly thickened. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. Moderate (2+) mitral regurgitation is seen. There is at least mild pulmonary artery systolic hypertension. There is a trivial/physiologic pericardial effusion. Compared with the prior study (images reviewed) of [**2131-10-1**], the findings are similar. CLOSTRIDIUM DIFFICILE TOXIN A & B TEST (Final [**2131-10-27**]): Feces negative for C.difficile toxin A & B by EIA. Brief Hospital Course: 67 year old gentleman with h/o ischemic cardiomyopathy EF 20%, Refractory VT s/p ablation, CAD s/p MI'[**03**], who presented from rehab with increasing SOB c/w acute on chronic systolic heart failure. # Systolic CHF exacerbation and dyspnea: On admission, clinical exam revealed bilateral basilar crackles, JVD 12-13cm and peripheral edema all consistent with volume overload. BNP 55,260 (previous BNP 22,000). CXR showed effusions (right >left) and left likely loculated fluid per CT. Pt was also hypotensive, requiring dobutamine drip which was quickly weaned off. Pt initially was SOB, attributed to largle right pleural effusion. Symptoms improved with diuresis to good sats on 2L NC. After anticoagulation was adequately reversed (Vit K, Lovenox held, heparin bridge until several hours before procedure), pt was tapped 2.1L of serous fluid, with LDH and TP consistent with transudate with additional symptomatic improvement. Pt was aggresively diuresed with Lasix drip and responded well symptomatically. PO intake was restricted to low salt and 1L fluid. He was transitioned to PO lasix at 80 mg [**Hospital1 **]. On discharge, his oxygen saturation was 98 % on room air. # Rhythm: Pt has history of VF on recent admission in setting of sepsis (s/p ablation) and afib (also ablated). Pt was monitored on telemetry and V Paced with no arrhythmias. He was continued on Mexilitine and Amiodarone. Anticoagulation was held for thoracentesis (with a heparin drip for bridging) and restarted after procedure. - It was noted that he has a pacemaker rather than an ICD. Although, there are multiple reasons why he might not be a good candidate for ICD placement, this issue could be readdressed in the future. #CAD: h/o MI. Pt was continued on a statin. BB held while diuresing since initially was hypotensive, and restarted prior to DC. Although pt had previous history of bleed while on Lovenox and [**Hospital1 **], after discussion with his PCP, [**Name10 (NameIs) **] was restarted as the risk of CAD would exceed the risks of bleeding on [**Name10 (NameIs) **]. #[**Name (NI) **] Pt was initially very somnolent. Lyrica was DCed given impaired renal function, Oxycodone was decreased to 10mg q12hrs, and psychotropic meds were held. He quickly returned to his baseline level of full alertness and remained there for the rest of the hospital stay. #Diarrhea/Constipation: Pt has history of short gut syndrome and constipation, on psyllum, cholestyramine at home. He was continued on these and had colace, senna, MOM prn, all separated by 2 hours from antiarrhythmic meds. Pt initially reported constipation and after a dose of colace had 7 BMs and then remained without BM for several days. C Diff was negative and thus he was started on Immodium. PO intake continued to be adequate. #CRI: Pt's baseline creatinine is 1.6-1.8, on presentation BUN/Cr was 81/2.2. Renal function improved as pt was diuresed and electrolytes remained stable. Renal team was consulted and followed. #Hyperphosphatemia: Pt's phosphate was elevated at 5-6s, likely a consequence of his CKD and question of vitamin D deficiency. Levels were sent off but pending at time of discharge an pt started on weekly vit D supplementation empirically. #DMII: Blood sugars were well controlled on home dose of NPH and insulin sliding scale # Leukocytosis: Pt had a WBC of ~20 throughout admission with infectious workup initially negative (afebrile, UA neg, no cough or URI sx, urine and blood cultures negative). Diff with neutrophil dominance but no early forms. Leukocytosis attributed to MDS. Prior to discharge, pt's WBCs increased to 30, and UA showed WBCs and leuk esterase so pt was started on Augmentin for 7 day course and simultaneous PO Vancomycin given history of recurrent C Diff colitis on antibiotics. ****** Please recheck pt's WBCs, urine analysis and urine cultures after finishing 1 week course of antibiotics. If continues to have elevated WBCs after UTI resolves, could evaluate foot ulcer for possible osteomyelitis.******** # Hypercoagulability Disorder: Pt has a history of multiple embolic events leading to amputation and GI surgery complicated by short gut syndrome. He had previously failed coumadin, and was on lovenox but no aspirin (h/o bleed with lovenox and [**Name (NI) **]) at time of admission. Lovenox was held for thoracentesis and pt anticoagulated with heparin drip. After thoracentesis, pt was switched back to lovenox. Prior to discharge, pt was restarted on [**Name (NI) **] (after discussion with PCP) for cardiovascular risk. # Depression: Pt initially continued on Citalopram 40mg PO daily as per rehab records, but was noted to be on 60mg based on outpt OMR records and increased to 60mg daily. # Sacral decubetous ulcer: He was seen by wound care who recommended DuoDerm wound gel to wound bed, to assist with debriding and to change coccyx dressing q3 days, place Allevyn foam dressing. # Neuropathy: Patient has been on neurontin in the past, but was changed to lyrica and then stopped for volume concerns. Pt had worsening leg pain but refused Neurontin saying that it did not sufficiently help in the past. He preferred Oxycontin/Oxycodone which provided adequate relief but Neurontin could be reconsidered and uptitrated in the future. Medications on Admission: 1. Citalopram 40 mg PO DAILY 2. Folic Acid 1 mg PO DAILY 3. Ranitidine HCl 150 mg PO Daily 4. Amiodarone 200 mg PO DAILY 5. Enoxaparin 50mg SQ Q12 6. Hydrocodone-Acetaminophen 5-500 mg [**12-27**] PO Q6h PRN Pain 7. Lyrica 200 mg PO Q8h 9. Psyllium 1.7 g Wafer PO Daily 10. NPH 20U SQ QAM 11. Lidocaine HCl 2 % Gel PRN 12. Oxycodone 20 mg PO Q12 13. Lorazepam 0.5 mg [**12-27**] PO QHS PRN Insomnia 14. Metorprolol Succinate 12.5mg PO Q24 15. Mexiletine 200 mg PO Q8hours 16. Cholestyramine-Sucrose 4 gram PO BID 17. Atorvastatin 10 mg PO QDay 18. Miconazole Nitrate 2 % Cream Sig: One (1) Appl Topical [**Hospital1 **] 20. Lasix 20 mg PO Daily 21. Fluconazole 200 mg PO Q24hours until [**10-19**] 22. Maalox 30mL PO Q6h PRN . Allergies: Levofloxacin, Cefazolin, Coreg, Dopamine Discharge Medications: 1. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Citalopram 40 mg Tablet Sig: 1.5 Tablets PO once a day. 3. Folic Acid 1 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 4. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO twice a day. 5. Psyllium 1.7 g Wafer Sig: One (1) Wafer PO once a day. Wafer(s) 6. Lorazepam 0.5 mg Tablet Sig: 1-2 Tablets PO HS (at bedtime) as needed for Insomnia. 7. Mexiletine 200 mg Capsule Sig: One (1) Capsule PO Q8H (every 8 hours). 8. Cholestyramine-Sucrose 4 gram Packet Sig: One (1) Packet PO BID (2 times a day). 9. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 10. Miconazole Nitrate 2 % Cream Sig: One (1) Appl Topical [**Hospital1 **] (2 times a day). 11. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 12. Oxycodone 10 mg Tablet Sustained Release 12 hr Sig: One (1) Tablet Sustained Release 12 hr PO Q12H (every 12 hours). 13. Oxycodone 5 mg Tablet Sig: One (1) Tablet PO four times a day as needed for pain: for breakthrough pain. 14. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO at bedtime as needed. 15. Ergocalciferol (Vitamin D2) 50,000 unit Capsule Sig: One (1) Capsule PO QTHUR (every Thursday). 16. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO TID (3 times a day). 17. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 18. Metoprolol Succinate 25 mg Tablet Sustained Release 24 hr Sig: 0.5 Tablet Sustained Release 24 hr PO DAILY (Daily). 19. Furosemide 80 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 20. Enoxaparin 60 mg/0.6 mL Syringe Sig: Fifty (50) mg Subcutaneous Q12H (every 12 hours). 21. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours). 22. Oxycodone 5 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for pain. 23. Vancomycin 250 mg Capsule Sig: One (1) Capsule PO Q6H (every 6 hours) for 7 days. 24. Augmentin 250-125 mg Tablet Sig: One (1) Tablet PO every eight (8) hours for 7 days: Take with food. 25. Loperamide 2 mg Capsule Sig: One (1) Capsule PO QID (4 times a day) as needed. Discharge Disposition: Extended Care Facility: [**Hospital6 85**] - [**Location (un) 86**] Discharge Diagnosis: Primary: Acute on Chronic systolic CHF exacerbation Secondary: Pulmonary effusion, Hypercoagulability, Short gut syndrome, Diabetes Mellitus type 2, Hypertension, Discharge Condition: Stable Na 135, K 4.9. BUN creat Hct Pt's dry weight is 49.7 kilos. Discharge Instructions: You were admitted to the hospital with an exacerbation of your heart failure causing back up of fluid in your lungs, which made it difficult to breathe. You breathing improved with diuresis of this fluid as well as a thoracentesis (drainage of the fluid around your lung). Also as the fluid was taken off, your heart was able to pump more efficiently and your kidneys showed signs of better perfusion. Prior to discharge your bloodwork and urine studies showed signs of urinary infection so you were given a 7 day course of Augmentin and started on oral Vancomycin simultaneously to prevent C Diff diarrhea. We made the following changes in your medications: 1) Start Augmentin 2) Start Vancomycin 3) Start Lasix at 80mg twice a day 4) Start Aspirin 81mg daily 5) Start Vitamin D 6) Start Oxycontin 7) Start Tylenol 8) Stop Lyrica 9) Stop Percocet 10) Change oxycodone dose Please weigh yourself every morning, [**Name8 (MD) 138**] MD if weight > 3 lbs, adhere to 2 gm sodium diet, and restrict your fluid intake to 1L per day. If you have worsening shortness of breath, chest pain, lightheadedness or any other concerning symptoms please call your doctor or return to the hospital. It was a pleasure taking care of you, we wish you the best! Followup Instructions: Primary Care: Dr [**First Name8 (NamePattern2) 449**] [**Last Name (NamePattern1) **] Phone:[**Telephone/Fax (1) 250**] Date/Time: Friday [**11-2**] at 2:00pm. With [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], NP Cardiology: Provider: [**Name Initial (NameIs) 2169**]: [**Name6 (MD) 251**] [**Last Name (NamePattern4) 677**], M.D. Phone:[**Telephone/Fax (1) 62**] Date/Time:[**2131-11-23**] 2:00 Provider: [**Name10 (NameIs) **] Phone:[**Telephone/Fax (1) 62**] Date/Time:[**2131-11-23**] 1:00 Provider: [**Name10 (NameIs) 676**] CLINIC Phone:[**Telephone/Fax (1) 59**] Date/Time:[**2131-11-23**] 12:30 Provider: [**First Name4 (NamePattern1) 122**] [**Last Name (NamePattern1) **], MD Phone: [**Telephone/Fax (1) 5068**] Date/Time: [**2131-11-15**] at 10:30am. Completed by:[**2131-10-27**] ICD9 Codes: 5849, 5119, 4271, 5990, 4280, 3572, 2724, 412
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Medical Text: Admission Date: [**2131-7-21**] Discharge Date: [**2131-7-27**] Date of Birth: [**2071-12-12**] Sex: M Service: Trauma Surgery HISTORY OF PRESENT ILLNESS: A 49-year-old male transferred from outside hospital to the [**Hospital1 188**] status post motorcycle accident with right hip dislocation and second to third-degree burns to the extremities. PAST MEDICAL HISTORY: (Significant for) 1. Paroxysmal atrial fibrillation, status post mitral valve replacement with [**Doctor Last Name 4726**]-Tex valve. 2. The patient is also status post a right femur fracture open reduction, internal fixation in [**2115**]. 3. Status post Achilles tendon surgery. 4. Status post an appendectomy in [**2079**]. MEDICATIONS ON ADMISSION: The patient was taking aspirin 325 mg p.o. q.d. ALLERGIES: The patient has no known drug allergies. PHYSICAL EXAMINATION ON ADMISSION: Temperature of 100.8, pulse of 112, blood pressure 142/109. [**Location (un) 2611**] Coma Scale was 15. Head and neck examination revealed pupils were equal, round, and reactive, 3 mm to 2 mm bilaterally. There was periorbital ecchymosis and left forehead swelling. There was blood in both nares, tenderness over the right mandible and over the nasal bones. Neck was in a cervical collar. Trachea was midline. Chest revealed there was no bony tenderness or crepitus, and lung sounds/breath sounds were clear and equal bilaterally. Cardiac examination was irregular. Abdominal examination was soft, nontender, and nondistended. Rectal examination had normal tone and heme-positive. Extremities showed left arm second-degree burn over 1% to 3% of total body surface area in the left lower extremity with a third-degree burn to approximately 1% of total body surface area. Neurologic examination revealed the patient was alert and oriented times three, [**Location (un) 2611**] Coma Scale of 15 as previously stated. Back revealed no stepoff or tenderness. Pelvis was stable. Right lower extremity was obviously dislocated, internally rotated, and shorter than the left lower extremity. LABORATORY ON ADMISSION: The patient's laboratories were significant for a toxicology screen positive for ethanol at a level of 192. Creatine kinase was 508. Troponin was 0.07. Chem-7 was within normal limits. White blood cell count was 13.3, hematocrit 42.3, and platelets 294. Blood gas was 7.37/36/145/20 and negative 4.5. Coagulations were normal. Amylase was 73, lactate 4.6, fibrinogen 288. RADIOLOGY/IMAGING: The patient underwent a trauma series which showed right posterior hip dislocation and no pelvic fracture. A CT of the abdomen was negative. CT of the chest showed bilateral aspiration pneumonia. The facial CT showed multiple nasal fractures. Head CT was questionable for right frontal contusion; however, on a repeat CT 24 hours later this was felt to be negative for intracranial injury. HOSPITAL COURSE: In the trauma bay, the patient had the right hip dislocation reduced by Orthopaedic Surgery Service who were consulted immediately. Post reduction films showed good reduction. Examination also significant for left peroneal nerve injury and foot drop. Neurosurgery was consulted for the question of frontal contusions on head CT. They recommended repeating head CT in 24 hours with frequent neurologic checks. His repeat head CT 24 hours later showed no change, and Neurosurgery signed essentially stating that they did not think there was any intracranial injury. The patient was admitted to the Cardiothoracic Intensive Care Unit for close monitoring. He remained hemodynamically stable. He was noted to be in and out of atrial fibrillation. He was started on amiodarone. He was also started on Lopressor. Plastic Surgery was consulted for the burns to the left arm and left leg. No debridement was done to the wounds or to the burns. Essentially, all that was done were dressing changes with xeroform, gauze, and dry sterile dressings. Plastic Surgery decided that skin grafting would not be necessary during this hospitalization and instructed us to have him follow up with them in the clinic to follow the burn healing. The patient had TLS films done which were read as negative. He was taken off precautions at that time. His cervical spine was cleared. It should be noted that when the patient was transferred from the outside hospital, during ambulance ride, the patient became apneic secondary to narcotic administration. He received Narcan with good results. The patient was also electively intubated in the Emergency Department for reduction of his right hip dislocation. He remained intubated in the Cardiothoracic Intensive Care Unit, on hospital day two, and then was extubated without difficulty on the night of [**2131-7-22**]. Plastic Surgery recommended repeat head CT with facial cuts to evaluate for orbital injury. This was obtained with coronal cuts which again showed the nasal fractures previously described, but there was no evidence of orbital fracture. Orthopaedics recommended films of the left hip to rule out fracture secondary to the peroneal nerve injury. These were obtained with no evidence of fracture. The patient was transferred to the floor on [**2131-7-24**]. He again remained hemodynamically stable and afebrile for the rest of his hospital course. Orthopaedics recommended partial weightbearing with crutches of the right lower extremity with posterior dislocation hip precautions. He was instructed to follow up with his own orthopaedist in approximately two weeks after discharge. The patient was seen by Physical Therapy who felt he ambulated reasonably well with crutches, although he had some minor difficulty getting use to his left foot drop. Physical Therapy constructed a special brace for his left lower extremity to assist with this and to facilitate ambulation. It was felt that he was ready for discharge on [**2131-7-27**], (hospital days seven). CONDITION AT DISCHARGE: He was discharged in stable condition. DISCHARGE DIAGNOSES: 1. Status post motorcycle accident with right posterior hip dislocation. 2. Status post reduction. 3. Left upper and lower extremity burns (second-degree and third-degree, respectively). 4. Nasal fractures. 5. Left peroneal nerve injury with resultant left foot drop. MEDICATIONS ON DISCHARGE: 1. Lopressor 25 mg p.o. b.i.d. 2. Amiodarone 400 mg p.o. q.d. 3. Percocet one to two tablets p.o. q.4-6h. p.r.n. 4. Colace 100 mg p.o. b.i.d. while taking narcotics. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2213**], M.D. [**MD Number(1) 2214**] Dictated By:[**Last Name (NamePattern1) 33441**] MEDQUIST36 D: [**2131-7-27**] 08:23 T: [**2131-7-28**] 07:02 JOB#: [**Job Number 34070**] ICD9 Codes: 5070
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Medical Text: Admission Date: [**2158-2-22**] Discharge Date: [**2158-2-27**] Date of Birth: [**2087-6-4**] Sex: M Service: CARDIOTHORACIC Allergies: Morphine Attending:[**First Name3 (LF) 922**] Chief Complaint: Symptomatic Atrial Fibrillation - Shortness of breath, fatigue, syncope Major Surgical or Invasive Procedure: [**2158-2-22**] Bilateral mini thoracotomy with Maze procedure and resection of left atrial appendage History of Present Illness: 70 y/o male with a history of paroxysmal atrial fibrillation. This occurs roughly once per week and last anywhere from 1 to 24 hours. With these episodes he experiences shortness of breath, fatigue and had one episode of syncope. Now presents for surgical evaluation for surigcal management. Past Medical History: Paroxysmal Atrial Fibrillation, Hypertension, Hemorrhoids, Benign Prostatic Hypertrophy, s/p Appendectomy, s/p anal abscess I&D, s/p finger and toe surgery, low testosterone Social History: Patient lives with his wife. [**Name (NI) **] is a former tobacco user, quit in [**2136**], used to smoke ~ 1 PPD x 30 years. Occasional ETOH. No drugs. Family History: Non-contributory Physical Exam: VS: 70, 12, 146/90, 72", 210# General: WDWN male in NAD Skin, Warm, dry, multiple nevi HEENT: EOMI, PERRL, OP benign Neck: Supple, FROM, -JVD, -carotid bruits Chest: CTAB -w/r/r Heart: RRR, -c/r/m/g Abd: Soft, NT/ND. +BS Ext: Warm, well-perfused, -edema Neuro: A&O x 3, MAE, non-focal Discharge Vitals A/O x3, nonfocal Pulm CTA SQ emphysema right and left chest into left shoulder Cardiac RRR no murmur/rub/gallop Abd soft, NT, ND +BS Ext warm pulses palpable no edema Inc rt and lt mini thoracotomy healing, old ct sites with DSD maintain until [**3-1**] then OTA Pertinent Results: [**2158-2-26**] 04:20AM BLOOD WBC-6.6 RBC-4.19* Hgb-12.9* Hct-36.9* MCV-88 MCH-30.7 MCHC-34.9 RDW-13.4 Plt Ct-160 [**2158-2-22**] 04:58PM BLOOD WBC-14.3*# RBC-4.78 Hgb-14.3 Hct-41.6 MCV-87 MCH-29.9 MCHC-34.3 RDW-13.4 Plt Ct-172 [**2158-2-27**] 10:05AM BLOOD PT-16.9* INR(PT)-1.6* [**2158-2-22**] 04:58PM BLOOD PT-12.9 PTT-30.6 INR(PT)-1.1 [**2158-2-22**] 04:58PM BLOOD Plt Ct-172 [**2158-2-26**] 04:20AM BLOOD Glucose-132* UreaN-24* Creat-1.2 Na-135 K-4.1 Cl-101 HCO3-31 AnGap-7* [**2158-2-22**] 04:58PM BLOOD UreaN-21* Creat-0.9 Na-140 Cl-106 HCO3-24 [**2158-2-26**] 04:20AM BLOOD Calcium-8.2* Phos-3.7 Mg-2.7* CHEST (PA & LAT) [**2158-2-26**] 10:45 AM CHEST (PA & LAT) Reason: PTX evaluation [**Hospital 93**] MEDICAL CONDITION: 70 year old man s/p mini maze REASON FOR THIS EXAMINATION: PTX evaluation CHEST, TWO VIEWS ON [**2-26**]. HISTORY: Mini maze, followup pneumothorax. FINDINGS: Again noted are bilateral pneumothoraces, left greater than right, with a large amount of subcutaneous emphysema left greater than right. There is increased opacity in the right mid lung laterally that is similar compared to the prior study. There are small bilateral effusions. DR. [**First Name (STitle) **] [**Doctor Last Name **] Approved: SUN [**2158-2-26**] 12:28 PM Sinus rhythm Probable left atrial abnormality Early precordial QRS transition - may be normal variant Consider pericarditis Since previous tracing of [**2158-2-22**], findings suggestive of pericarditis now present Read by: [**Last Name (LF) **],[**First Name3 (LF) 177**] W. Intervals Axes Rate PR QRS QT/QTc P QRS T 71 164 92 378/400.14 20 -15 6 PATIENT/TEST INFORMATION: Indication: Pulmonary vein isolation and Left atrial appendage ligation. Intraoperative echocardiography Height: (in) 72 Weight (lb): 210 BSA (m2): 2.18 m2 BP (mm Hg): 125/78 HR (bpm): 65 Status: Inpatient Date/Time: [**2158-2-22**] at 11:19 Test: TEE (Complete) Doppler: Full Doppler and color Doppler Contrast: None Tape Number: 2007AW000-0:0 Test Location: Anesthesia West OR cardiac Technical Quality: Adequate REFERRING DOCTOR: DR. [**First Name8 (NamePattern2) 177**] [**Last Name (NamePattern1) **] MEASUREMENTS: Left Atrium - Long Axis Dimension: *5.7 cm (nl <= 4.0 cm) Left Atrium - Four Chamber Length: 4.0 cm (nl <= 5.2 cm) Right Atrium - Four Chamber Length: *5.7 cm (nl <= 5.0 cm) Left Ventricle - Inferolateral Thickness: 1.1 cm (nl 0.6 - 1.1 cm) Left Ventricle - Diastolic Dimension: 5.1 cm (nl <= 5.6 cm) Left Ventricle - Systolic Dimension: 4.4 cm Left Ventricle - Fractional Shortening: *0.14 (nl >= 0.29) Left Ventricle - Ejection Fraction: 55% to 65% (nl >=55%) Aorta - Valve Level: 3.4 cm (nl <= 3.6 cm) Aorta - Ascending: *3.6 cm (nl <= 3.4 cm) Aortic Valve - Peak Velocity: 0.7 m/sec (nl <= 2.0 m/sec) Aortic Valve - Peak Gradient: 2 mm Hg Aortic Valve - Mean Gradient: 1 mm Hg Aortic Valve - Valve Area: 4.5 cm2 (nl >= 3.0 cm2) Mitral Valve - Peak Velocity: 0.5 m/sec Mitral Valve - E Wave: 0.5 m/sec Mitral Valve - A Wave: 0.5 m/sec Mitral Valve - E/A Ratio: 1.00 Mitral Valve - E Wave Deceleration Time: 203 msec INTERPRETATION: Findings: LEFT ATRIUM: Moderate LA enlargement. No spontaneous [**Last Name (NamePattern1) 113**] contrast is seen in the LAA. Depressed LAA emptying velocity (<0.2m/s) No thrombus in the LAA. All four pulmonary veins identified and enter the left atrium. RIGHT ATRIUM/INTERATRIAL SEPTUM: Mildly dilated RA. Lipomatous hypertrophy of the interatrial septum. No ASD by 2D or color Doppler. LEFT VENTRICLE: Wall thickness and cavity dimensions were obtained from 2D images. Normal LV wall thicknesses and cavity size. Normal LV wall thickness. Normal LV cavity size. Overall normal LVEF (>55%). RIGHT VENTRICLE: Normal RV chamber size and free wall motion. AORTA: Normal aortic diameter at the sinus level. Focal calcifications in aortic root. Mildly dilated ascending aorta. Normal aortic arch diameter. Normal descending aorta diameter. AORTIC VALVE: Normal aortic valve leaflets (3). No AS. Trace AR. MITRAL VALVE: Normal mitral valve leaflets. No MS. Trivial MR. TRICUSPID VALVE: Normal tricuspid valve leaflets. Mild [1+] TR. PULMONIC VALVE/PULMONARY ARTERY: Normal pulmonic valve leaflets with 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. No TEE related complications. The patient was under general anesthesia throughout the procedure. The patient appears to be in sinus rhythm. The patient has runs of a supraventricular tachycardia. Results were personally reviewed with the MD caring for the patient. Conclusions: Pre-Ablation: The left atrium is moderately dilated. No spontaneous [**Last Name (NamePattern1) 113**] contrast is seen in the left atrial appendage. No thrombus is seen in the left atrial appendage. All 4 pulmonary veins are seen with normal flow profile in each. The right atrium is mildly dilated. No atrial septal defect is seen by 2D or color Doppler. Left ventricular wall thicknesses and cavity size are normal. Left ventricular wall thicknesses are normal. The left ventricular cavity size is normal. Overall left ventricular systolic function is normal (LVEF>55%). Right ventricular chamber size and free wall motion are normal. The ascending aorta is mildly dilated. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion. There is no aortic valve stenosis. Trace aortic regurgitation is seen. The mitral valve leaflets are structurally normal. Trivial mitral regurgitation is seen. There is no pericardial effusion. Post Ablation: Flow is seen in all 4 pulmonary veins. The left atrial appendage is no longer visible s/p ligation. Biventricular function is unchanged. Remaining exam is unchanged. All findings discussed with surgeons at the time of the exam. Electronically signed by [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], MD on [**2158-2-22**] 15:28. [**Location (un) **] PHYSICIAN: Brief Hospital Course: Mr. [**Known lastname 3597**] was a same day admit and underwent all pre-operative work-up as an outpatient. On day of admission he was brought to the operative room where he underwent bilateral mini thoracotomy with Maze procedure and resection of left atrial appendage. Please see operative report for details. Following surgery he was transferred to the CSRU for invasive monitoring in stable condition. Later on op day he was weaned from sedation, awoke neurologically intact and was extubated. On post-op day one his right chest tube was removed and he was transferred to the telemetry floor. There appeared to be a very small left apical pneumothorax and therefore his left chest tube was removed on post-op day two. He continued to do well but remained for evaluation of sq emphysema and apical pneumothorax. He was ready for discharge home POD 5 with plan for f/u CXR [**3-7**] and wound check. Medications on Admission: Aspirin 325mg qd, Toprol XL 75mg qd, Lisinopril 2.5mg qd, Flomax 0.4mg qd, Androderm 5mg patch qd, HCTZ 25mg qd, Peiostat 20mg [**Hospital1 **] Discharge Medications: 1. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 2. Tamsulosin 0.4 mg Capsule, Sust. Release 24 hr Sig: One (1) Capsule, Sust. Release 24 hr PO HS (at bedtime). Disp:*30 Capsule, Sust. Release 24 hr(s)* Refills:*0* 3. Ibuprofen 600 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours) for 10 days: please take with food. Disp:*30 Tablet(s)* Refills:*0* 4. Hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO Q3-4H (Every 3 to 4 Hours) as needed. Disp:*60 Tablet(s)* Refills:*0* 5. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* 6. Metoprolol Succinate 25 mg Tablet Sustained Release 24 hr Sig: Three (3) Tablet Sustained Release 24 hr PO DAILY (Daily). Disp:*30 Tablet Sustained Release 24 hr(s)* Refills:*0* 7. Warfarin 3 mg Tablet Sig: Two (2) Tablet PO once a day: please take 6mg [**2-27**] and [**2-28**] - have INR checked [**3-1**] results to Dr [**Last Name (STitle) 5444**] goal INR 2-2.5. . Disp:*60 Tablet(s)* Refills:*0* 8. Outpatient [**Name (NI) **] Work PT/INR as needed goal 2-2.5 first check [**3-1**] with results to Dr [**First Name8 (NamePattern2) 233**] [**Last Name (NamePattern1) 5444**] ([**Telephone/Fax (1) 250**]) Discharge Disposition: Home With Service Facility: [**Hospital **] Hospice and VNA Discharge Diagnosis: Paroxysmal Atrial Fibrillation s/p Bilateral mini thoracotomy with Maze procedure and resection of left atrial appendage PMH: Hypertension, Hemorrhoids, Benign Prostatic Hypertrophy, s/p Appendectomy, s/p anal abscess I&D, s/p finger and toe surgery, low testosterone Discharge Condition: Good Discharge Instructions: Follow medications on discharge instructions. Do not drive if you take pain medications. Shower daily, let water flow over wounds, pat dry with a towel. Leave dressing on until wednesday Am and then remove and leave open to air Do not use lotions, powders, or creams on wounds. Call our office for temp>101.5, drainage from incision, or shortness of breath Followup Instructions: Please schedule the following: Dr. [**Last Name (STitle) 914**] in 4 weeks Dr. [**Last Name (STitle) **] in [**12-24**] weeks Dr. [**Last Name (STitle) 6955**] in [**11-22**] weeks Wound check and Xray Tuesday [**3-7**] at 1300 - please go to radiology Clinical center [**Location (un) 470**] for xray then to [**Hospital Ward Name **] 2 for wound check PT/INR goal 2-2.5 first check [**3-1**] with results to Dr [**First Name8 (NamePattern2) 233**] [**Last Name (NamePattern1) 5444**] ([**Telephone/Fax (1) 250**]) Already scheduled appointments: Provider: [**Name10 (NameIs) **] [**Name10 (NameIs) **] TESTING Phone:[**Telephone/Fax (1) 128**] Date/Time:[**2158-3-1**] 10:00 Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 5447**], M.D. Date/Time:[**2158-5-19**] 9:30 Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1008**], M.D. Phone:[**Telephone/Fax (1) 285**] Date/Time:[**2159-1-3**] 2:40 Completed by:[**2158-3-1**] ICD9 Codes: 5119, 4019, 3051
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Medical Text: Admission Date: [**2140-9-2**] Discharge Date: [**2140-9-18**] Date of Birth: [**2098-11-11**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 10644**] Chief Complaint: Abdominal pain. Major Surgical or Invasive Procedure: 1) US guided paracentesis 2) right IJ 3) ERCP History of Present Illness: Ms. [**Known lastname 18323**] is a 41 year old female with history of metastatic melanoma status post recent spinal fusion surgery for multiple metastatic spinal lesions, recently discharged from the surgical service on [**2140-8-31**], who was transferred from an OSH today with severe abdominal pain. On [**8-31**] (the day of discharge), at around midnight she was awoken from sleep by the sudden onset of LLQ abdominal pain which she cannot quantify or qualify, but states that it felt as though her abdomen was bursting open. Her pain then migrated to the LUQ and has remained a diffuse pain in the epigastric region. The pain does not radiate to her back and she cannot report a certain position which makes the pain better. She did experience some nausea upon arrival to the ED but she does not report emesis. She has been constipated, and has received suppositories. At home she had sweats but not fever per her sister. She denies cough, chest discomfort, difficulty urinating, worsening of her back pain, focal weakness, change in bowel or bladder habits. She presented to [**Hospital 1562**] Hospital where she was found to have a WBC = 26K and ALP = 182, amylase = 283, lipase = 772. She recived NS x 1L, dilaudid 3 mg IV, zofran 4 mg IV, and 4.5 mg IV zosyn. She was then transferred to the [**Hospital1 18**] ED for further management. In the ED her vitals on presentation were: 99, 113, 175/103, RR = 20, 97% O2 on room air. She received 8 mg IV dilaudid, promethiazine, lorazepam 2mg IV, and zosyn 4.5 gm IV x 1. She was also given 4.5 L NS. An NGT was placed. A CT scan of the abdomen demonstrated a dramatic worsening of disease. She was evaluated by general surgery who thought that the patient required ICU monitoring but did not see her as a surgical patient. She was thus transferred to the [**Hospital Unit Name 153**] for closer monitoring, pain control and fluid resuscitation. She had an MRI of her spine prior to transfer, the result of which is still pending. Past Medical History: Oncologic history: 1) Melanoma: s/p wide local excision of melanoma of the left groin on 02/[**2136**]. Path demonstrated superficial spreading melanoma, max depth of 1.3 mm, [**Doctor Last Name **] level IV with no ulceration and lymphovascular invastions. Tumor involved the lateral deep margins. s/p re-excision on [**2136-3-23**] - no residual melanoma [**4-18**] LN negative. Developed back pain 4 mths ago which did not resolve with pain meds and MRI demonstrated on [**8-9**] demonstrated signal change @ L3 and L4 and a paraspinal mass R iliac creast and metastatic lesion in S2 vertebral body. Medial LL mass, [**2140-8-12**]- negative CT of head, bone scan demonstrated increased uptake. 2) Reflux 3) otosclerosis 4) Anorexia Social History: She is single, living with her mother. She was living in [**State 108**], but came to [**Location (un) 86**] recently for further treatment of her melanoma. She has a long drinking history, but hasn't drank recently. Family History: Non-contibutory Physical Exam: Vitals: Tm = 100.4, BP = 154/95, P 125, RR = 22, 97% on RA. Gen: Slim caucasian female appearing uncomfortable, slightly obtunded: Falling asleep while talking. HEENT: Dry mucous membranes, anicteric sclerae, NGT in place. eEck: Tender to palpation on R aspect of her neck. Firm, fixed nodule in R lobe of thyroid, approximately 3x3cm. Additionally tender R anterior cervical LAD. Small LN felt on L lateral side. Lungs: Rales at bases b/l. Cor: RR, tachycardic, no m/r/g. ABD: Hypoactive bowel sounds, tender to palpation in LUQ/LLQ. No guarding, mild rebound. Oblique incision with intact sutures extending across L flank - mild erythema, no exudate. EXT: No c/c/e, DP present b/l. NEURO: Moving all extremities. Pertinent Results: [**2140-9-1**] 11:00PM BLOOD WBC-31.9*# RBC-3.27* Hgb-10.2* Hct-31.1* MCV-95 MCH-31.3 MCHC-32.9 RDW-13.6 Plt Ct-691* [**2140-9-2**] 07:55AM BLOOD Hypochr-NORMAL Anisocy-1+ Poiklo-NORMAL Macrocy-NORMAL Microcy-NORMAL Polychr-NORMAL [**2140-9-1**] 11:00PM BLOOD PT-13.0 PTT-23.7 INR(PT)-1.1 [**2140-9-16**] 12:10AM BLOOD Fibrino-750* [**2140-9-1**] 11:00PM BLOOD Glucose-99 UreaN-11 Creat-0.4 Na-137 K-4.4 Cl-103 HCO3-22 AnGap-16 [**2140-9-1**] 11:00PM BLOOD ALT-47* AST-38 AlkPhos-159* Amylase-198* TotBili-0.3 [**2140-9-1**] 11:00PM BLOOD Lipase-489* [**2140-9-2**] 07:55AM BLOOD Calcium-8.0* Phos-3.2 Mg-1.3* [**2140-9-1**] 11:00PM BLOOD Albumin-3.3* [**2140-9-2**] 07:55AM BLOOD Triglyc-140 [**2140-9-1**] 11:19PM BLOOD Lactate-1.3 [**2140-9-2**] 12:15AM URINE Color-Straw Appear-Clear Sp [**Last Name (un) **]-1.018 [**2140-9-2**] 12:15AM URINE Blood-LG Nitrite-NEG Protein-TR Glucose-NEG Ketone-150 Bilirub-NEG Urobiln-NEG pH-5.0 Leuks-NEG [**2140-9-2**] 12:15AM URINE RBC-[**12-4**]* WBC-0-2 Bacteri-OCC Yeast-NONE Epi-0-2 [**2140-9-2**] 08:50AM URINE UCG-NEGATIVE . MRI Spine [**9-2**]: Soft tissue mass involving L4, L5 and R psoas, extending into retroperitoneum. spinal canal cannot be assessed properly due to artifact from metal fusion device. CT abd/pelvis [**9-2**]: IMPRESSION: 1. Findings consistent with mild pancreatitis by CT with no drainable collections. 2. Interval laminectomies and spinal fusion hardware spanning the region of the previously identified pathological fracture of L4. There is a large amount of associated fluid and foci of gas anterior to the spine at this level along the left psoas muscle and in the periaortic region. This is presumably postoperative in nature but the possibility of infection cannot be entirely excluded. 3. Redemonstration of numerous metastatic lesions with evidence for disease progression given slight interval increase in size over the short time interval. This is best demonstrated by the increase in size of the pancreatic head mass. 4. Interval increase in development of multiple cysts within the kidneys. Presumably physiologic follicles. CXR [**9-2**]: ?LLL infiltrate. Brief Hospital Course: ## Pancreatitis - pt found to have pancreatitis with elevation of amylase and lipase. MRCP was done which showed proximal pancreatic duct obstruction by tumor with distal dilation. Pt was made NPO and given IVF. After some improvement in abdominal pain and decrease in amylase and lipase, an ERCP was performed with stenting of her pancreatic duct. Pt's abdominal pain gradually improved and amylase and lipase normalized. Patient's diet was advanced as tolerated however she took in minimal PO. . ## Pain control - pt was on a dilaudid PCA. An attempt was made to transition her to a fentanyl patch and PO morphine for breakthrough in preparation for discharge to rehab however, patient did not tolerate the change. Patient was resumed on the PCA. . ## Abdominal distention - pt developed increasing abdominal distension thought to be secondary to narctoics for pain control and bed rest. She was encouraged to ambulate and given an aggressive bowel regimen. Also patient had ascites thought to be secondary to malignant spread. Patient was given IV lasix with good diuresis and underwent US guided paracentesis with drainage of 1.4 liters of bloody ascitic fluid. . ## Fever, leukocytosis: pt experienced sporadic low grade fevers which were attributed to her pancreatitis. Labs did not reveal a left shift or bandemia. She remained without cough despite question of pneumonia on a portable X-ray. Initially she was started on levofloxacin, but this was discontinued due to abscence of symptoms and she remained without any cough or clinical worsening following this. Blood cx's were persistently normal. A UTI with enteroccocus on previous admission resolved and urine cx was negative. Pt's prior spine surgeyr sites were monitored and no evidence of infection was found. Urine grew yeast, foley was removed and patient was encouraged to ambulate. Patient was restarted on empiric coverage with IV levoquin. Blood cultures remained negative. Patient's foley was discontinued secondary to yeast which grew on urine cultures x2. Repeat urinanalysis was negative for yeast. . ## Melanoma: patient with dramatic spread of disease over several weeks since prior hospitalization. Some R neck fullness initially noted, neck U/S with heterogeneous masses consistent with metastases. Patient was intially followed in preparation for initiating biologics however patient was not interested in rehab in order to regain strength prior to treatment. Plan for biologics were held off until patient was more stable. . ## F/E/N: pt initially given IVF with dextrose. Central line was placed and TPN initiated. Following pancreatic stenting, pt started taking clear sips and diet was advanced slowly as tolerated. Triple lumen was placed and was receiving TPN due to insufficient PO. . ## Hypertension: Patient was started on PO antihypertensives. Labetalol was titrated up and the clonidine patches were transitioned off. Patient's hypertension was thought to be related to melanoma involvement of her adrenal gland as seen previously on abdominal CT. . ## s/p spine surgery - Continued to monitor for possible infection. Pain was not well controlled on fentanyl patches and patient was resumed on original dilaudid PCA dosing from [**9-13**] prior to conversion. . ## PPx: SQ heparin, bowel regimen. . ## Family meeting was held with health proxy and oncology team and patient was made CMO. Patient subsequently passed away with her family at the bedside [**2140-9-18**]. Medications on Admission: 1. Fentanyl 100 mcg/hr Patch 72HR 2. Lorazepam 0.5 mg Tablet 3. Oxycodone-Acetaminophen 5-325 mg 4. Pantoprazole Sodium 40 mg Tablet, Delayed Release 5. Cyclobenzaprine 10 mg Tablet 6. Zolpidem Tartrate 5 mg Tablet 7. Nystatin 100,000 unit/mL Suspension 8. Docusate Sodium 100 mg Capsule 9. Senna 8.6 mg Tablet 10. Bisacodyl 10 mg Suppository Discharge Disposition: Expired Discharge Diagnosis: metastatic melanoma Discharge Condition: deceased Completed by:[**2140-10-8**] ICD9 Codes: 486, 5990, 4019
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Medical Text: Admission Date: [**2153-12-18**] Discharge Date: [**2154-1-1**] Date of Birth: [**2082-7-24**] Sex: F Service: UROLOGY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 11304**] Chief Complaint: Elective nephrectomy for metastatic renal cell carcinoma Major Surgical or Invasive Procedure: Left radical nephrectomy History of Present Illness: This is a 71 year-old woman with metastatic renal cell carcinoma diagnosed in [**3-22**] and COPD being transferred to the [**Hospital Unit Name 153**] s/p left radical nephrectomy for respiratory monitoring. Patient was hypoxic to the 80's prior to intubation and therefore aneasthesia and surgery preferred monitoring in ICU with likely extubation tomorrow AM. History obtained largely from providers and their notes, patient intubated, sedated. As per anaesthesia and surgery, surgery was uneventful, no complications. On arrival, patient easily arousable, denies pain. Past Medical History: Metastatic renal cell carcinoma COPD, FEV1 2.17-67%predicted Cholecystectomy. Status post surgical repair of uterine prolapse, TAH/BSO Obesity Heavy Smoker H/o DVT s/p IVC filter implantation Social History: The patient lives with her daughter in [**Name (NI) 8391**]. She formally worked in a factory, however, denies any chemical or radiation or asbestos exposure to her knowledge. She also worked at stop-and-shop briefly. She reports a 80-pack-year history of tobacco. She quit approximately 9 years ago. She reports occasional alcohol use, however, none currently Family History: Her mother died in her 50s from a postoperative pulmonary embolus. Father died in his 70s from congestive heart failure. She reports having 5 siblings. Her brother with esophageal cancer and there is a prominent family history of type 2 diabetes. She is of Irish descent. She has 6 children all of whom are in good health. There is no family history of breast, GYN, colonic, or renal cell cancer in the family. Physical Exam: VS: Temp: 98.1 BP:124 /66 HR:75 RR:12 99% O2sat I/O: 2750/540--last 24 hours/Weight 106.7 Vent setting: AC 12x700 (no spont breaths) FiO2 of 60% PEEP:5 ABG:7.34/51/233 general: intubated, sedated, easily arousable HEENT: PERLLA, EOMI, anicteric, no sinus tenderness, MMM, op without lesions, no supraclavicular or cervical lymphadenopathy, no jvd lungs: CTA b/l with good air movement throughout heart: RR, S1 and S2 wnl, distant heart sounds, no murmurs, rubs or gallops appreciated abdomen: obese, large ventral hernia, +b/s, soft, nt, left flank: large dressing in place, NT, without signficant bleeding extremities: no edema, pneumoboots skin/nails: no rashes/no jaundice neuro: sedated, easily arousable, responsive to commands, moves all four extremities, wiggles toes and squeezes fingers to command Brief Hospital Course: ICU and hospital course: Mrs. [**Known lastname **] is a 71 yo F with a PMH of metastatic renal cell carcinoma, COPD, chronic kidney disease, h/o DVT who presented to the ICU after a nephrectomy. Prior to the nephrectomy, she was mildly hypoxic, and it was felt that she would not be easy to extubate. ## Respiratory failure: The pt arrived to the ICU intubated and sedated. Her sedation was slowly weaned and she was extubated successfully on the day after admission. She continued to require oxygen by nasal canula to maintain O2 sats in the 90s. Her hypoxia was likley secondary to chronic insufficiecny in the context of atelectasis and volume overload. She was continued on her fluticasone/salmeterol 500/50 and albuterol and ipatropium nebulizer treatments prn. She will need supplemental O2 on discharge. On discharge she was sating at 95% on 2L (pre-op 88-92% on RA). ## s/p nephrectomy: pt tolerated the procedure well. She initially had pain at the surgical site which slowly resolved. Her wound was C/D/I at discharge after staples were removed. Her final pathology revealed conventional (clear cell) renal cell carcinoma pT3a: tumor directly invades adrenal gland or perirenal and/or renal sinus fat but not beyond Gerota's fascia; spoke with Dr. [**Last Name (STitle) **] regarding her follow-up and the results of the lung biopsy, which after review are consistent with metastatic disease obviating the need for a lung biopsy. She will follow-up with Dr. [**Last Name (STitle) **] in the next week in clinic and is instructed to call to confirm this appt; in addition she is scheduled for CT Chest [**1-2**]. ## ileus/SBO: patient stopped passing flatus and had worsening abdominal distention. She then had bilious emesis x 2 for a total of 600 cc. An NG tube was placed which returned 200 cc of bilious, nonbloody fluid. Abdominal imaging showed evidence of small bowel dilation consistent with ileus vs. obstruction. As patient's operation was not within the peritoneal cavity but retroperitoneal, it was believed to be more likely ileus in the setting of increased pain med requirements. Indeed her prolonged hospital course was secondary to a prostracted ileaus that was initially managed with NGT/decompression however by POD [**11-28**] the NG was remvoed, her diet was advanced and she tolerated it well. Of note, she consistently passed flatus and had BMs throughout the ileus. Also, C Diff was sent which was negative. Interval KUBs would show dilated small loops with AFLs, no free air that would resolve thorughout her course. She was placed on RTC Reglan toward the end of her course to expedite resolution; GI was curbsided and beleived she has a protracted ileus that was responded to conservative measures. In addition surgery was consulted and recommended similar conservative measures. By the end of her hospital course she was tolerating a regular diet and having regular bowel movements. ## CKD: Baseline Cr 1.2-1.4. Normal increase in Cr after nephrectomy is approximately 30-40%. Her creatinine was 1.6 on discharge from the ICU. This had settled at 1.3 at time of discharge. Her lytes were otherwise stable throughout; her potassim was optimized. ## Hyperglycemia: Likely in setting of stress from surgery and mild underlying insulin resistance. Was no longer requiring insulin at time of discharge from the ICU. ## h/o DVT: Should likely be on life-long anticoagulation given she had a malignancy-associated DVT. Was maintained on heparin SC TID while in house. Will need to restart warfarin 1-2 weeks post-op. ## Dispo: PT worked throughout her course and she successfully ambulated with assistance. She will need to continue aggressive PT at rehab. Medications on Admission: see H&P Discharge Medications: 1. Albuterol-Ipratropium 103-18 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation Q6H (every 6 hours). 2. Fluticasone-Salmeterol 500-50 mcg/Dose Disk with Device Sig: [**12-18**] Disk with Devices Inhalation [**Hospital1 **] (). 3. Acetaminophen 650 mg Suppository Sig: [**12-18**] Suppositorys Rectal Q6H (every 6 hours) as needed for fever, pain. 4. Ipratropium Bromide 0.02 % Solution Sig: One (1) Inhalation Q6H (every 6 hours) as needed for wheeze. 5. Albuterol Sulfate 0.083 % Solution Sig: One (1) Inhalation Q6H (every 6 hours) as needed for wheeze. Discharge Disposition: Extended Care Facility: [**Hospital6 85**] - [**Location (un) 86**] Discharge Diagnosis: Metastatic Renal Cell Carcinoma Discharge Condition: Good Discharge Instructions: Please see the nephrectomy discharge instructions * Increasing pain or persistent pain that is not relieved by pain medications *Inability to urinate * Fever (>101.5 F) *Nausea or Vomiting that last longer than 24 hours * Inability to pass gas or stool * Other symptoms concerning to you Followup Instructions: Please follow up with Dr [**Last Name (STitle) 3748**] in [**1-20**] weeks. Call ([**Telephone/Fax (1) 39050**] to make an appointment. Please follow up with Hematology Oncology, Dr. [**Last Name (STitle) **] at [**0-0-**]. You have an appt. for next week. This was confirmed with Dr. [**Last Name (STitle) **]. She is scheduled for CT Chest [**1-2**] coordinated with Heme-Oncology. Completed by:[**2154-1-1**] ICD9 Codes: 496, 5180, 5859
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Medical Text: Admission Date: [**2191-7-3**] Discharge Date: [**2191-7-14**] Date of Birth: [**2155-6-10**] Sex: M Service: SURGERY Allergies: Cortisone / Prednisone / Adhesive Tape Attending:[**First Name3 (LF) 1**] Chief Complaint: BRBPR Major Surgical or Invasive Procedure: Total Colectomy History of Present Illness: 36 yo with UC pan colitis found recently to have rectosigmoid adenocarcinoma, with local extension planned for total colectomy has been undergoing neoadjuvant chemotherapy, on day 4 of 5FU and 3 days of XRT presents after significant BRBPR and lightheadedness. . He states that he has had relatively poorly controlled UC over the past 10 years, complications of rash and perianal fistula in past but not currently, on salicylates (not tolerated), steroids (not effective and steroid psychosis) and remicaide in past- now on rifaximin as well as [**Doctor First Name 130**] and cromolyn to control his GI symptoms. His UC has been relatively stable recently, a "few" painful bowel movements in the a.m. with some blood and mucous. Baseline mild nausea. . This morning he awoke and began having LLQ and RLQ abdominal pain in addition to profusely bloody bowel movements- initially slightly formed stool then progressing to stool consisting mainly of blood. He describes it as bright red, without clots, and roughly 1 liter in total. He felt very lightheaded with the BMs and needed to lay on the ground to prevent passing out. By the time he was admitted he states he had about 50 bowel movements and the bleeding had significantly decreased and his RLQ and LLQ abd pain was subsiding. Mild nausea. Pain was cramping and would fluctate in severity. . No chest pain, shortness of breath, fevers, chills, or other symptoms. Currently feels very mildly lightheaded Past Medical History: Rectosigmoid Adenocarcinoma- T3 lesion on MRI and enlarged lymph nodes (not clearly mets vs. IBD associated)- extensive local extension into mesorectal fat- planned for neoadjuvant chemo and concurrent chemoradiation. 5FU and XRT with plans for subsequent surgery- began 5FU on [**6-29**]. Ulcerative Colitis- diagnosed 10 years ago- c/b perianal fistula Colon CMV infection Mitral Valve Prolapse Migraines Osteoporosis- secondary to steroids Hyperparathyroidism Social History: Lives alone, has PhD in biomedical engineering and molecular biology, post doc studies at BU. No tob, ETOH or drug use. Family History: Father with Ulcerative Colitis. Father w/ CAD, stroke at 69. Died at 69. Mother alive, hypothyroidism and migraines. Healthy Brother. Physical Exam: Tmax: 37.9 ??????C (100.2 ??????F) Tcurrent: 37.9 ??????C (100.2 ??????F) HR: 97 (87 - 97) bpm BP: 147/66(88) {130/66(85) - 147/71(88)} mmHg RR: 16 (15 - 16) insp/min SpO2: 100% Physical Examination General Appearance: Well nourished, Thin Eyes / Conjunctiva: PERRL Head, Ears, Nose, Throat: Normocephalic Cardiovascular: (S1: Normal), (S2: Normal), No(t) S3, No(t) S4, (Murmur: No(t) Systolic, No(t) Diastolic) Peripheral Vascular: (Right radial pulse: Not assessed), (Left radial pulse: Not assessed), (Right DP pulse: Not assessed), (Left DP pulse: Not assessed) Respiratory / Chest: (Expansion: Symmetric), (Breath Sounds: Clear : ) Abdominal: Soft, Bowel sounds present, No(t) Distended, Tender: RLQ tenderness without rebound, no masses or organomegaly Extremities: Right: Absent, Left: Absent Skin: Not assessed Neurologic: Responds to: Not assessed, Movement: Not assessed, Tone: Not assessed . At Discharge: AVSS Gen: NAD, A/Ox3 CV: RRR RESP: CTAB ABD: +BS, soft, ND, appropriately TTP, RLQ stoma beefy red, viable with liquid brown stool, +flatus Incision: midline OTA CDI Extrem: no c/c/e Pertinent Results: [**2191-7-3**] 11:10AM WBC-4.4 RBC-5.38 HGB-12.7* HCT-41.6 MCV-77* MCH-23.7* MCHC-30.7* RDW-14.4 [**2191-7-3**] 11:10AM NEUTS-80.1* LYMPHS-18.0 MONOS-0.6* EOS-1.1 BASOS-0.2 [**2191-7-3**] 11:10AM PLT COUNT-446* [**2191-7-3**] 11:10AM PT-12.5 PTT-26.2 INR(PT)-1.1 [**2191-7-3**] 11:10AM LIPASE-22 [**2191-7-3**] 11:10AM ALT(SGPT)-12 AST(SGOT)-24 ALK PHOS-115 TOT BILI-1.9* DIR BILI-0.2 INDIR BIL-1.7 [**2191-7-3**] 11:10AM GLUCOSE-167* UREA N-15 CREAT-1.1 SODIUM-137 POTASSIUM-4.7 CHLORIDE-102 TOTAL CO2-20* ANION GAP-20. [**2191-7-12**] 04:39AM BLOOD WBC-5.3 RBC-4.00* Hgb-10.3* Hct-31.6* MCV-79* MCH-25.7* MCHC-32.5 RDW-17.1* Plt Ct-422 [**2191-7-11**] 05:14AM BLOOD Glucose-96 UreaN-6 Creat-0.8 Na-141 K-3.8 Cl-105 HCO3-26 AnGap-14 [**2191-7-11**] 05:14AM BLOOD Calcium-8.1* Phos-3.8 Mg-2.0 . [**2191-7-3**] CXR - SINGLE UPRIGHT VIEW OF THE CHEST AT APPROXIMATELY 1:40 P.M.: IMPRESSION: No free air under the diaphragm. No acute cardiopulmonary abnormalities. . Pathology Examination Procedure date [**2191-7-5**] DIAGNOSIS: Colon, abdominal colectomy: 1. Well-differentiated colonic adenocarcinoma, see synoptic report. 2. Chronic active and inactive colitis, consistent with ulcerative colitis, with diffuse epithelial atypia, favor reactive. 3. Focal active enteritis with villous atrophy. 4. Multiple fissures of distal colon with focal perforation and peri-colic abscess formation. 5. Appendix with fibrous obliteration and focal surface epithelium with atypia, favor reactive. Colon and Rectum: Resection Synopsis MACROSCOPIC Specimen Type: Colonic resection. Location: Abdominal. Specimen Size Greatest dimension: 70.5 cm. Additional dimensions: 6 cm. Tumor Site: Rectum. Tumor configuration: Infiltrative. Tumor Size Greatest dimension: at least 5.2 cm. Additional dimensions: 0.6 cm; see comment. MICROSCOPIC Histologic Type: Adenocarcinoma. Histologic Grade: Low-grade (well or moderately differentiated). EXTENT OF INVASION Primary Tumor: At least pT1: Tumor invades submucosa; see comments. Regional Lymph Nodes: pN2: Metastasis in 4 or more lymph nodes. Lymph Nodes Number examined: 27. Number involved: 5. Distant metastasis: pMX: Cannot be assessed. Margins Proximal margin: Uninvolved by invasive carcinoma: Distance of tumor from closest margin: 700 mm. Distal margin: Involved by invasive carcinoma. Circumferential (radial) margin: Uninvolved by invasive carcinoma: Distance of tumor from closest margin: 35 mm. Lymphatic Small Vessel Invasion: Absent. Venous (large vessel) invasion: Absent. Perineural invasion: Absent. Tumor border configuration: Infiltrating. Additional Pathologic Findings: Two tumor nodules are found in peri-colic adipose tissue that lack residual nodal architecture or capsule. Comments: The exact size and depth of invasion (T stage) cannot be determine as the tumor is present at the distal margin and the entire tumor is not examined. Clinical: Clinical diagnosis and data: Lower GI bleed. Patient with history of ulcerative colitis and rectal carcinoma. Brief Hospital Course: 36 yoM w/ a h/o ulcerative colitis and recent diagnosis of rectosigmoid adenocarcinoma on neoadjuvant chemo (5FU and XRT x 3-4 days) presents with profuse BRBPR and lightheadedness. Plan for colectomy but leaving tumor ?????? colectomy will allow for chemotherapy in setting of severe UC. . 1. GI bleed: s/p total colectomy- sparing rectum and colon CA for further neoadjuvand chemo. Hartmanns pouch and ileostomy on [**2191-7-5**] with Dr. [**Last Name (STitle) **]. Operative course uncomplicated. Patient remained in [**Hospital Unit Name 153**] for close monitoring of Hct's, and associated hypotension. -+ ostomy output and rectal ouput post-op -hypoactive bowel sounds, no nausea -pain moderate, not very well controlled, per surgery switched to morphine pca for more long acting pain control with better control. Pain control switched to oral agents once tolerating clear liquids. Reported pain <[**6-11**]. Dishcarged home with pain medications. -Diet advanced as bowel function resumed. Tolerated regular diet without nausea/vomiting prior to discharge. -Hct followed closely. Treated accordingly with transfusions. HCT's remained stable for many days prior to discharge. No further evidence of GI bleeding. . 2. Ulcerative colitis: patient on a regimen of [**Doctor First Name 130**] 360mg daily, rifaximin 800mg daily and cromolyn 400mg daily (when he eats), -GI and Onc following: Per GI recommendations, d/c'd rifaximin & restarted on home dose of [**Doctor First Name 130**] & Cromolyn for management of rectal bleeding. . 3. Fever -no clinical evidence of DVT, high fever w/o leukocytosis however s/p chemo, not neutropenic, continue to follow ANC -on cipro / flagyl, remained afebrile with normal WBC, discontinued prior to discharge home. -Blood cultures all with no growth. Urine cx from [**7-4**] grew enterococcus which was treated with IV Cipro. -Medical & radiation Oncology involved-recommended follow-up Monday after discharge for re-assessment. Plan to resumes Chemo/XRT depending on physical exam, and labowrk data. . Physical Therapy: Due to prolonged ICU stay, and deconditioning, patient was evaluated by PT. PT worked with patient for a few sessions, and cleared him for discharge home without PT services. He continued to ambulate halls of 12 [**Hospital Ward Name **] independently. . Ostomy: Patient followed by ostomy RN specialists during admission. Competent with emptying pouch. Visiting RN services set up for home to continue teaching, and assessment of stoma/surgical wound. In addition to follow-up with Med/Rad Oncology, patient advised to follow-up with Dr. [**Last Name (STitle) **] in [**3-6**] weeks. Medications on Admission: Zinc Vitamin D B complex Codeine 7.5mg daily prn diarrhea Cromolyn 400mg daily [**Doctor First Name **] 360mg daily Rifaximin 800mg daily Vitamin D 6000 units qod MVI daily Discharge Medications: 1. Cromolyn 100 mg/5 mL Solution Sig: One (1) 20mL PO daily (): Take with food. 2. [**Doctor First Name **] 180 mg Tablet Sig: Three (3) Tablet PO once a day: Prevention of rectal bleeding. 3. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for fever or pain: Do not exceed 4000mg/24hrs. 4. Zofran 8 mg Tablet Sig: One (1) Tablet PO every eight (8) hours as needed for nausea. 5. Centrum 0.4-162-18 mg Tablet Sig: One (1) Tablet PO once a day. 6. Vitamin D 1,000 unit Tablet Sig: Six (6) Tablet PO every other day. 7. Morphine 15 mg Tablet Sustained Release Sig: One (1) Tablet Sustained Release PO Q12H (every 12 hours) as needed for pain for 2 weeks: Take with food. Disp:*35 Tablet Sustained Release(s)* Refills:*0* 8. Morphine 15 mg Tablet Sig: One (1) Tablet PO Q3-4H () as needed for breakthrough pain for 2 weeks: Take with food. Disp:*45 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: Primary: Flared ulcerative colitis with low abdominal peritonitis (perforation of the rectum) Anemia . Secondary: UC, rectosigmoid adenoca w/CEA 1.9, [**5-25**] sig w/nodular heaped up mucosa seen in the proximal rectum, PATHT well diff adenoca, mitral valve prolapse, migraines Discharge Condition: Stable Tolerating a regular diet Adequate pain control with oral medication 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. * 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 becoming progressively worse, or inadequately controlled with the prescribed pain medication. * 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. Incision Care: *You may shower. Pat incision dry. *Avoid swimming and baths until further instruction at your followup appointment. *Leave the steri-strips on. They will fall off on their own, or be removed during your followup. *Please call the doctor if you have increased pain, swelling, redness, or drainage from the incision sites. Monitoring Ostomy Output / Prevention of Dehydration: *Keep well hydrated. *Replace fluid loss from ostomy daily. *Avoid only drinking plain water. Include Gatorade and/or other vitamin drinks to replace fluid. *Try to maintain ostomy output between 500mL to 1000mL per day. *If Ostomy output exceeds 1 liter, take 4mg of Imodium, repeat 2mg with each episode of loose stool. Do not exceed 16mg in 24 hours. Followup Instructions: Please call the office of Dr. [**Last Name (STitle) **] to make a follow up appointment in [**3-6**] weeks. [**Telephone/Fax (1) 9**] . Please make a follow-up appointment with your PCP, [**Last Name (NamePattern4) **]. [**First Name4 (NamePattern1) 3613**] [**Last Name (NamePattern1) 5085**] [**Telephone/Fax (1) **] in 1 week and as needed. . You have an appointment on Monday [**7-18**] with Radiation Oncology service ([**Telephone/Fax (1) 8082**] at 8:30am located in [**Hospital Ward Name 332**] basement. . Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 6050**], MD Phone:[**Telephone/Fax (1) 22**] Date/Time:[**2191-7-25**] 11:00 Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 593**], MD Phone:[**Telephone/Fax (1) 22**] Date/Time:[**2191-7-25**] 11:00 Completed by:[**2191-7-18**] ICD9 Codes: 2762, 4240
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Medical Text: Admission Date: [**2131-9-21**] Discharge Date: [**2131-10-2**] Date of Birth: [**2074-12-18**] Sex: F Service: MEDICINE Allergies: Iodine / Sulfa (Sulfonamide Antibiotics) / vancomycin Attending:[**First Name3 (LF) 2782**] Chief Complaint: Hypoglycemia Major Surgical or Invasive Procedure: Intubation with mechanical ventilation History of Present Illness: Ms. [**Known lastname 6105**] is a 56 year-old woman with developmental delay, diabetes, asthma, Crohn's disease on prednisone, latent TB on INH and hepatitis B on lamivudine with recent MRSA bacteremia initially on vancomycin and transitioned recently transitioned to daptomycin secondary to drug rash who presented today after being found unresponsive at her facility with a blood sugar of 40s. Of note 2 days prior to admission, her oral hypoglycemics including Actos and glipizide were doubled. . Initial vital signs in the ED were 97.5 100 97/64 18 100% BG 43. She received glucagon and 1 amp of D50 and repeat BG was 80. She then ate dinner and repeat BG was 78. Prior to transfer the patient was started on D5 1/2 NS at 125mL/hr. Vitals on transfer were 98.0 84 14 100/49 14 98% on RA. . On the medical floor the patient appear comfortable and was without additional complaint. . ROS: Denied fever, chills, night sweats, headache, vision changes, rhinorrhea, congestion, sore throat, cough, shortness of breath, chest pain, abdominal pain, nausea, vomiting, diarrhea, constipation, BRBPR, melena, hematochezia, dysuria, hematuria. Past Medical History: Crohns Disease, newly diagnosed, on prednisone Asthma - never been intubated glaucoma DM2 - not on insulin Barretts Esophagus Systolic murmur ? s/p cholecystectomy s/p jaw surgery Social History: Pt has cognitive delay; she lives alone and attends an adult day program at Triangle Day Care (Telephone: [**Telephone/Fax (1) 90811**]) in [**Location (un) 3786**] 5 days a week. Her case manager from Nexus Inc, [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 28003**] (office [**Telephone/Fax (1) 90812**], cell [**Telephone/Fax (1) 90813**]) has known her for >20 years and is her HCP. Pt reportedly can shop and cook for herself, but [**First Name8 (NamePattern2) **] [**Doctor First Name **], the agency that [**Doctor First Name **] works for will often step in and help with cooking. Even when they help her cook, she winds up eating out -- mostly tuna subs, macaroni, and donuts. She has a boyfriend of 11 years who is also developmentally delayed, and she is very close to him. Family History: Her father died of heart disease around age 60; her mother was reportedly an alcoholic and is still alive, but they have not been in touch since Ms. [**Known lastname 6105**] was very young. She has many siblings (5 or 6), and at least 3 of them are also developmentally delayed / special needs. Physical Exam: PHYSICAL EXAM ON ADMISSION: Vitals: 98.3 87 70 14 100% on RA GENERAL: Comfortable in NAD, answers questions appropriately HEENT: Pupils equal, round, reactive to light. Extraocular muscles intact. Sclerae are anicteric. Mucous membranes moist. Oropharynx is clear. No oral ulcers. NECK: No lymphadenopathy. LUNGS: Clear to auscultation bilaterally. No wheezing or rhonchi noted. CARDIOVASCULAR: Regular rate, [**4-4**] holosystolic murmur, loudest at left upper sternal border. Normal S1, S2. ABDOMEN: Soft, nontender, nondistended, active bowel sounds. EXTREMITIES: Warm and well perfused. SKIN: Diffuse morbilliform rash, most prominent on the posterior aspect of her arms bilaterally. Consistently blanchable. Mild edema in lower extremities. No ulcers appreciated. PHYSICAL EXAM ON DISCHARGE: Unchanged from prior, except with mild degree of bilateral diffuse wheezing Pertinent Results: ADMISSION LABS: [**2131-9-21**] 12:55AM WBC-14.8* RBC-3.32* HGB-9.4* HCT-28.7* MCV-87 MCH-28.2 MCHC-32.6 RDW-17.6* [**2131-9-21**] 12:55AM NEUTS-84.3* LYMPHS-10.3* MONOS-2.2 EOS-2.8 BASOS-0.3 [**2131-9-21**] 12:55AM PLT COUNT-419 [**2131-9-21**] 12:55AM GLUCOSE-61* UREA N-55* CREAT-1.8*# SODIUM-136 POTASSIUM-5.8* CHLORIDE-106 TOTAL CO2-22 ANION GAP-14 [**2131-9-21**] 12:55AM ALT(SGPT)-12 AST(SGOT)-14 CK(CPK)-22* ALK PHOS-68 TOT BILI-0.1 [**2131-9-21**] 12:55AM LIPASE-33 [**2131-9-21**] 12:55AM CORTISOL-8.3 . PERTINENT LABS: [**2131-9-21**] 12:55AM BLOOD Glucose-61* UreaN-55* Creat-1.8*# [**2131-9-28**] 07:00AM BLOOD Glucose-171* UreaN-26* Creat-1.1 [**2131-9-24**] 01:46AM BLOOD CK-MB-26* MB Indx-4.2 cTropnT-0.05* proBNP-[**Numeric Identifier 37727**]* [**2131-9-27**] 03:13AM BLOOD proBNP-7626* [**2131-9-23**] 03:25PM BLOOD Type-ART pO2-62* pCO2-35 pH-7.33* calTCO2-19* Base XS--6 [**2131-9-26**] 11:43AM BLOOD Type-ART Temp-36.7 Rates-/15 FiO2-50 pO2-84* pCO2-35 pH-7.41 calTCO2-23 Base XS--1 Intubat-NOT INTUBA Comment-OPEN FACE [**2131-9-23**] 03:25PM BLOOD Lactate-2.6* [**2131-9-24**] 04:36AM BLOOD Lactate-1.3 . . DISCHARGE LABS: [**2131-10-2**] 06:35AM BLOOD WBC-13.1* RBC-2.99* Hgb-8.7* Hct-27.3* MCV-91 MCH-29.0 MCHC-31.7 RDW-17.7* Plt Ct-289 [**2131-10-2**] 06:35AM BLOOD Plt Ct-289 [**2131-10-1**] 06:35AM BLOOD Glucose-96 UreaN-21* Creat-0.7 Na-144 K-4.3 Cl-110* HCO3-23 AnGap-15 [**2131-10-1**] 06:35AM BLOOD ALT-72* AST-32 LD(LDH)-332* AlkPhos-118* TotBili-0.3 [**2131-10-1**] 06:35AM BLOOD Calcium-9.0 Phos-3.6 Mg-1.7 . . MICROBIOLOGY: [**2131-9-23**] 12:33 am URINE Source: CVS. **FINAL REPORT [**2131-9-26**]** URINE CULTURE (Final [**2131-9-26**]): ESCHERICHIA COLI. >100,000 ORGANISMS/ML.. Piperacillin/tazobactam sensitivity testing available on request. KLEBSIELLA PNEUMONIAE. 10,000-100,000 ORGANISMS/ML.. Piperacillin/tazobactam sensitivity testing available on request. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ ESCHERICHIA COLI | KLEBSIELLA PNEUMONIAE | | AMPICILLIN------------ <=2 S AMPICILLIN/SULBACTAM-- <=2 S 4 S CEFAZOLIN------------- <=4 S <=4 S CEFEPIME-------------- <=1 S <=1 S CEFTAZIDIME----------- <=1 S <=1 S CEFTRIAXONE----------- <=1 S <=1 S CIPROFLOXACIN---------<=0.25 S <=0.25 S GENTAMICIN------------ <=1 S <=1 S MEROPENEM-------------<=0.25 S <=0.25 S NITROFURANTOIN-------- <=16 S <=16 S TOBRAMYCIN------------ <=1 S <=1 S TRIMETHOPRIM/SULFA---- <=1 S <=1 S . [**2131-9-24**] 3:06 pm BRONCHOALVEOLAR LAVAGE BRONCHIAL LAVAGE. GRAM STAIN (Final [**2131-9-24**]): 2+ (1-5 per 1000X FIELD): POLYMORPHONUCLEAR LEUKOCYTES. NO MICROORGANISMS SEEN. RESPIRATORY CULTURE (Final [**2131-9-26**]): NO GROWTH, <1000 CFU/ml. Immunoflourescent test for Pneumocystis jirovecii (carinii) (Final [**2131-9-25**]): NEGATIVE for Pneumocystis jirovecii (carinii).. FUNGAL CULTURE (Preliminary): YEAST. ACID FAST SMEAR (Final [**2131-9-25**]): NO ACID FAST BACILLI SEEN ON CONCENTRATED SMEAR. ACID FAST CULTURE (Preliminary): [**2131-9-24**] 3:06 pm Rapid Respiratory Viral Screen & Culture BRONCHIAL LAVAGE. **FINAL REPORT [**2131-9-27**]** Respiratory Viral Culture (Final [**2131-9-27**]): No respiratory viruses isolated. Culture screened for Adenovirus, Influenza A & B, Parainfluenza type 1,2 & 3, and Respiratory Syncytial Virus.. Detection of viruses other than those listed above will only be performed on specific request. Please call Virology at [**Telephone/Fax (1) 6182**] within 1 week if additional testing is needed. Respiratory Viral Antigen Screen (Final [**2131-9-25**]): Less than 60 columnar epithelial cells;. Specimen inadequate for detecting respiratory viral infection by DFA testing. Interpret all negative results from this specimen with caution. Negative results should not be used to discontinue precautions. Refer to respiratory viral culture results. Recommend new sample be submitted for confirmation. Reported to and read back by DR [**Last Name (STitle) 90814**] [**Name (STitle) **] [**2131-9-25**] 11:33AM. [**2131-10-1**] BLOOD CULTURE Blood Culture, Routine-PENDING [**2131-10-1**] BLOOD CULTURE Blood Culture, Routine-PENDING [**2131-9-28**] STOOL CLOSTRIDIUM DIFFICILE TOXIN A & B TEST-FINAL NEGATIVE [**2131-9-24**] CATHETER TIP-IV WOUND CULTURE-FINAL NEGATIVE [**2131-9-24**] URINE Legionella Urinary Antigen -FINAL NEGATIVE [**2131-9-24**] SPUTUM GRAM STAIN-FINAL; RESPIRATORY CULTURE-FINAL {YEAST} [**2131-9-24**] BLOOD CULTURE Blood Culture, Routine-FINAL NEGATIVE [**2131-9-23**] BLOOD CULTURE Blood Culture, Routine-FINAL NEGATIVE [**2131-9-21**] URINE URINE CULTURE-FINAL NEGATIVE [**2131-9-21**] BLOOD CULTURE Blood Culture, Routine-FINAL NEGATIVE VIRAL CULTURE: R/O CYTOMEGALOVIRUS (Final [**2131-9-27**]): No Cytomegalovirus (CMV) isolated. REFER TO VIRAL CULTURE FOR FURTHER INFORMATION. VIRAL CULTURE (Final [**2131-9-27**]): RHINOVIRUS. PRESUMPTIVE IDENTIFICATION. Reported to and read back by DR [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 28089**] [**2131-9-27**] 11:20 AM. . DIAGNOSTICS =========== PA/LAT CXR [**2131-10-1**] AP and lateral radiographs of the chest were reviewed in comparison to [**2131-9-27**] as well as several prior studies dating back to [**2131-7-23**]. As compared to the most recent prior radiograph from [**9-27**] and [**2131-9-26**], there is significant improvement in widespread parenchymal opacities with the current study representing mild interstitial pulmonary edema. There is small focal opacity in the left upper lung and left lower lobe which might reflect partial resolution of the infectious process. Hilar enlargement is bilateral, unchanged and might potentially correspond to hilar lymphadenopathy, although pulmonary enlargement might be another possibility. There is no appreciable pleural effusion, and there is no pneumothorax. . Portable TTE (Complete) Done [**2131-9-24**] at 3:06:14 PM IMPRESSION: Moderate aortic valve stenosis. Pulmonary artery hypertension. Right ventricular cavity enlargement with free wall hypokinesis. Normal left ventricular cavity sizes with preserved global systolic function. Increased PCWP. Compared with the prior study (images reviewed) of [**2131-8-17**], the severity of aortic stenosis has progressed, right ventricular cavity size is now dilated with free wall hypokinesis and the estimated PA systolic pressure is much higher. The severity of mitral regurgitation seems reduced. These findings are suggestive of an interim acute pulmonary process, e.g., pulmonary embolism or other acute pulmonary process.. . Brief Hospital Course: A/P: 56 year old woman with a history of cognitive delay, DMII, recently diagnosed Crohn's disease on prednisone, probable latent TB on INH, MRSA bacteremia from PICC on daptomycin (last dose [**2131-9-24**]), who was admitted with hypoglycemia related to an increase in her antihypoglycemic medications, with course complicated by viral pneumonia and respiratory distress, now resolved. . ACTIVE ISSUES: . # Hypoglycemia: Her presentation was related to aggressive increase in oral hypoglycemics, after her hypoglycemic medication dosages had been recently increased. She was treated with D50 IV and her anti-hypoglycemics were held, glucose normalized and her mental status returned to baseline. She was maintained on a sliding scale insulin while in hospital. She was discharged on antihypoglycemic regimen from prior to medication increases prior to admission. We recommend continued monitoring of her finger glucose and gradually increase glipizide or pioglitazone as needed. . # Viral Pneumonia: On [**2131-9-23**], the patient was triggered for tachypnea and increased work of breathing. Her CXR was concerning for HCAP as well as vascular congestion. Patient received 20mg of IV lasix as well as nebs. Antibiotics broadened to cefepime, but had persistent tachypnea, with CXR demonstrating worsening bilateral infiltrates. Again received nebs, Lasix 20mg IV (last dose at MN) with UOP 1L. She continued to have worsening respiratory function and was transferred to the MICU in obvious respiratory distress with accessory muscle use and audible grunting. The decision was made to electively intubate with anesthesia/respiratory at bedside. During intubation patient paralyzed with succ with initial transient hypotension to the 70s. Uncomplicated intubation performed and patient sedated with propofol and fentanyl. The cause of her respiratory decompensation was probably multifactorial. Her antibiotics were broadened to linezolid/cefepime/levofloxacin for possible multifocal pneumonia. Given CXR evidence of bilateral pulmonary edema, cardiogenic source was suspected and she was diuresed. TTE revealed normal left ventricular function but right ventricular overload thought to be related to her acute pneumonic process. She underwent bronchoscopy on [**2131-9-24**] which revealed +yeast, +PMN, and +rhinovirus, but no PCP or bacteria. Her rhinovirus may have contributed to her diffuse inflammatory process. PCP was [**Name Initial (PRE) **] concern due to her unprophylaxed chronic steroid load of 30mg prednisone daily, and indeed a beta glucan was positive, though this was felt to represent her candidida from her lung. Her linezolid and cefepime were discontinued, and she was continued on levofloxacin 8d course for possible bacterial suprainfection. She was successfully extubated on [**9-26**] and transferred to the medicine service on [**9-27**], where she completed levofloxacin course, oxygen staturation remained in the upper 90's on room air, she ambulated the [**Doctor Last Name **] without dyspnea. She was discharged with dextromethorphan-guaifenesin as needed for cough. . # Acute kidney injury: Baseline creatinine 0.7, she was admitted with creatinine 1.8 related to dehydration. Lisinopril was held, she was treated with intervenous fluids and her creatinine improved. Lisinopril was resumed. . # Rash: Diffuse livido reticularis appearing rash. She was seen by dermatology and it was felt to be a reaction to her vancomycin, and she was switched to daptomycin and started on topical triamcinolone and hydrocortisone and the rash improved. . # Urinary Tract Infection: Her urine culture revealed pan-sensitive E. coli and Klebsiella, which was treated with her levofloxacin regimen she took for possible bacterial suprainfection of her viral pneumonia. . # MRSA bacteremia: High-grade bacteremia believed to be [**1-31**] to prior PICC now removed or endocarditis for which she was to complete a 6 weeks of vancomycin on [**2131-9-24**]. She was switched to daptomycin on [**9-17**] following the onset of a new rash that was believed to be vancomycin-related, and completed daptomycin course on [**9-24**]. . # Leukocytosis: Throughout hospital course, WBC ranged 9-19, the day prior to discharge, WBC had trended up to 15 from 13. She was kept an additional night and a basic infectious workup was performed. Chest xray looked improved, UA was negative, and blood cultures showed no growth in 24 hours. The following morning ([**2131-10-2**]), WBC trended to 13, she was clinically well appearing and was discharged. Leukocyutosis is likely related to prednisone. # Crohns disease: Increased prednisone to 40mg, and have since resumed home 30mg dose. Started on atovaquone for PCP [**Name Initial (PRE) 1102**]. . # TB treatment: Prior to admission, patient had indeterminant QuantiFERON Gold test.Patient was continued on treatment for LTBI with isoniazid/B6 Day #1 = [**2131-8-16**] for 9 months. These medicaitons should be discontinued after the 9 month course is complete. . # Depression: Held home sertraline while on linezolid to prevent serotonin syndrome. She became progressively anxious and tearful. Resumed sertraline 250mg after confirming dose with health care proxy and [**Name2 (NI) **] improved. No signs of serotonin syndrome. . # Hepatitis B: Patient is Hep B surface antigen positive. Continued home dose lamivudine 100 mg daily. . # Hypertension: Held lisinopril briefly due to [**Last Name (un) **]. Lisinopril was resumed prior to discharge with adequate control. . # Asthma: Continued home fluticasone-salmeterol and started on albuterol nebulizers. . # Glaucoma: Continued home Latanoprost . . TRANSITIONAL ISSUES: -routine follow-up with GI for Crohn's, infliximab treatment -titration of her diabetes regimen with careful monitoring of her blood glucose level -follow-up with hepatology - Follow up blood cultures [**2131-10-1**] which had shown no growth in 24 hours at the time of d/c - Follow up acid fast culture from BAL [**2131-9-24**] Medications on Admission: Isoniazid 300 mg daily Day #1 = [**2131-8-16**] for 9 months Pyridoxine 50 mg daily Day #1 = [**2131-8-16**] for 9 months Omeprazole 20 mg daily Lamivudine 100 mg daily Day #1 = [**2131-8-14**] Sertraline 250 mg daily Daptomycin for MRSA bacteremia Day 1 = [**2131-8-12**] to be complete [**2131-9-22**] Lisinopril 10 mg daily Fluticasone-salmeterol 100-50 mcg 1 puff [**Hospital1 **] Latanoprost 0.005 % OU HS Metformin 1000 mg [**Hospital1 **] Metoprolol succinate ER 75 mg daily Januvia 100 mg daily Pioglitazone 30 mg Glipizide 10 mg daily Prednisone 30 mg dialy Pancrealipiase TID Zyrtec 10 mg daily Trazodone 50 mg QHS Discharge Medications: 1. isoniazid 300 mg Tablet Sig: One (1) Tablet PO DAILY (Daily): for 9 months, day 1 [**2131-8-16**]. 2. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 3. sertraline 50 mg Tablet Sig: Five (5) Tablet PO DAILY (Daily): total dose 250mg. 4. fluticasone-salmeterol 100-50 mcg/dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). 5. latanoprost 0.005 % Drops Sig: One (1) Drop(s) in each eye Ophthalmic HS (at bedtime). 6. prednisone 20 mg Tablet Sig: 1.5 Tablets PO DAILY (Daily): total dose 30mg daily. 7. lipase-protease-amylase 5,000-17,000 -27,000 unit Capsule, Delayed Release(E.C.) Sig: One (1) Cap PO TID W/MEALS (3 TIMES A DAY WITH MEALS). 8. lisinopril 10 mg Tablet Sig: One (1) Tablet PO once a day. 9. trazodone 50 mg Tablet Sig: One (1) Tablet PO at bedtime. 10. lamivudine 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily): Day #1 = [**2131-8-14**]. 11. atovaquone 750 mg/5 mL Suspension Sig: 1500 (1500) mg daily PO DAILY (Daily): For PCP [**Name Initial (PRE) 1102**]. Disp:*250 mL* Refills:*2* 12. dextromethorphan-guaifenesin 10-100 mg/5 mL Liquid Sig: [**5-8**] MLs PO Q4H (every 4 hours) as needed for cough. Disp:*250 mL* Refills:*0* 13. cetirizine 10 mg Tablet Sig: One (1) Tablet PO once a day. 14. metformin 1,000 mg Tablet Sig: One (1) Tablet PO twice a day. 15. Januvia 100 mg Tablet Sig: One (1) Tablet PO once a day. 16. pioglitazone 30 mg Tablet Sig: One (1) Tablet PO once a day. 17. Metoprolol succinate ER 75 mg daily 18. glipizide 10 mg Tablet Extended Rel 24 hr Sig: One (1) Tablet Extended Rel 24 hr PO DAILY (Daily). 19. pyridoxine 50 mg Tablet Sig: One (1) Tablet PO once a day: Day #1 = [**2131-8-16**] for 9 months . Discharge Disposition: Extended Care Facility: Able Home Care Discharge Diagnosis: PRIMARY DIAGNOSIS: Iatrogenic Hypoglycemia SECONDARY DIAGNOSES: Pneumonia Urinary Tract Infection Acute Kidney Injury Dehydration Drug Rash Depression Discharge Condition: Mental Status: Coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: Dear Ms. [**Known lastname 6105**], You were admitted for treatment of low blood sugars, dehydration and renal failure. You were treated with glucose infusions and given fluids, and your condition improved. You were also seen by our dermatologists who thought your rash might be due to medication allergy to vancomycin, we treated you symptomatically with creams and benadryl and your symptoms improved. While in the hospital you had trouble breathing and had to be placed on a ventilator. We determined that you had pneumonia, we treated you with antibiotics and you improved. . While in the hospital you completed a 6 week course of antibiotics for MRSA infection. Please follow up with infectious disease for your MRSA infection, we have made an appointment for you. . Please also keep your appointment for gastroenterology follow up of your chron's disease. The following changes were made to your medications: - START Atovaquone - START Albuterol inhaled as needed for wheezing - START dextromethorphan-guaifenesin as needed for cough . - STOP Daptomycin . Please continue the rest of your medications without change. Followup Instructions: Please follow-up with your PCP at extended care facility . Please call ([**Telephone/Fax (1) 8132**] on Monday morning for follow-up appointment with [**Last Name (LF) **], [**First Name7 (NamePattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] within one week of your discharge. . Please call([**Telephone/Fax (1) 4170**] on Monday morning for follow-up appointment with [**Last Name (LF) **], [**Name8 (MD) **] MD within one week of your discharge. . Please also keep the following appointments: . Department: LIVER CENTER When: WEDNESDAY [**2131-10-3**] 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 Department: INFUSION/PHERESIS UNIT When: WEDNESDAY [**2131-10-3**] at 2:00 PM [**Telephone/Fax (1) 14067**] Building: GZ [**Hospital Ward Name **] BUILDING (FELBEERG/[**Hospital Ward Name **] COMPLEX) [**Location (un) **] Campus: EAST Best Parking: Main Garage Department: INFECTIOUS DISEASE When: WEDNESDAY [**2131-10-17**] at 10:30 AM With: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 8021**], MD [**Telephone/Fax (1) 457**] Building: LM [**Hospital Ward Name **] Bldg ([**Last Name (NamePattern1) **]) [**Hospital 1422**] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage Name: [**Doctor Last Name **],PINKY Location: [**Hospital **] MEDICAL ASSOCIATES Address: [**Apartment Address(1) 90815**], [**Location (un) **],[**Numeric Identifier 90816**] Phone: [**Telephone/Fax (1) 60787**] ****Please discuss with the staff at the facility a follow up appointment with your PCP when you are ready for discharge Department: DIV. OF GASTROENTEROLOGY When: WEDNESDAY [**2131-10-24**] at 3:00 PM With: [**First Name8 (NamePattern2) 4503**] [**Last Name (NamePattern1) 4504**], MD [**Telephone/Fax (1) 463**] Building: Ra [**Hospital Unit Name 1825**] ([**Hospital Ward Name 1826**]/[**Hospital Ward Name 1827**] Complex) [**Location (un) **] Campus: EAST Best Parking: Main Garage ICD9 Codes: 5849, 5990, 7907, 311, 4019, 2859
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Medical Text: Admission Date: [**2138-3-20**] Discharge Date: [**2138-4-7**] Date of Birth: [**2091-2-17**] Sex: M Service: Medicine HISTORY OF PRESENT ILLNESS: The patient is a 47-year-old gentleman with hepatitis C cirrhosis who is high up on the transplant list, who for the last five days prior to admission had been having decreased appetite, fatigue, nausea, and occasional vomiting. The patient's diuretics were recently increased prior to admission to Lasix 40 and Aldactone 100, but they were decreased to Lasix 20 and Aldactone 50 for elevated creatinines. The patient was found to have acute renal insufficiency by laboratories in clinic and was asked to come to the Emergency Department for further evaluation. In the Emergency Department, laboratories revealed a potassium of 6.7 and a creatinine of 4.3. PAST MEDICAL HISTORY: (Significant for) 1. Hepatitis C cirrhosis; requiring liver transplantation, the patient is currently on liver transplant list. 2. Hypertension. 3. History of nephrolithiasis. MEDICATIONS ON ADMISSION: 1. Aldactone 50 mg. 2. Lasix 20 mg. 3. Flagyl 250 mg three times per day. 4. Quinine 325 mg once per day. 5. Protonix 40 mg once per day. 6. Magnesium oxide 800 mg twice per day. 7. Oxycodone 2 mg to 4 mg as needed. ALLERGIES: The patient has allergies to CODEINE (which causes gastrointestinal upset). SOCIAL HISTORY: He lives at home with his wife. [**Name (NI) **] is a past alcohol abuser who now works as a substance abuse counselor. FAMILY HISTORY: Significant for father who died of a myocardial infarction at the age of 38. PHYSICAL EXAMINATION ON PRESENTATION: On admission, the patient was afebrile. He had a blood pressure of 130/58, a pulse of 70, a respiratory rate of 20, and was saturating 97% on room air. He was in no apparent distress. He was anicteric. His pupils were reactive. His extraocular movements were intact. The lungs were clear bilaterally. His cardiac examination showed normal first heart sounds and second heart sounds with a 2/6 systolic murmur at the right upper sternal border. His abdomen was soft, mildly distended, and nontender. He had no peripheral edema. PERTINENT LABORATORY VALUES ON PRESENTATION: He had a white blood cell count of 5.6, his hematocrit was 28.4, and he had platelets of 101. He had an INR of 1.9. Chemistry-7 showed an initial creatinine of 4.2 with a potassium of 6.7. After gentle fluids and treatment for his potassium, he had a repeat potassium of 5.7 and a creatinine of 3.9. He had an alanine-aminotransferase of 57, his aspartate aminotransferase was 166, his alkaline phosphatase was 101, and his total bilirubin was 3.7. PERTINENT RADIOLOGY/IMAGING: An electrocardiogram showed a normal sinus rhythm. There were no peaked T waves. Otherwise, his electrocardiogram was normal. BRIEF SUMMARY OF HOSPITAL COURSE: The patient was admitted for his acute renal insufficiency. His Lasix and his Aldactone were held. His hyperkalemia responded well to his Kayexalate therapy. The patient was noted to have some mild periorbital erythema and edema on the right side of his face. He was initially started on doxycycline for this presumed preseptal cellulitis. The patient's creatinine did initially improve; however, it started to increase again slowly during the course of his hospital stay. Initially, it was felt that the patient's initial presentation of acute renal insufficiency was secondary to aggressive diuresis; however, in the setting of his diuretics being held and his continued increase in his creatinine, it was possible that he could have the initial stages of hepatorenal syndrome. The patient has had elevated creatinines on previous hospitalizations, presumed to be related to hepatorenal syndrome. The patient was started on octreotide and midodrine. Also in the setting of his acute renal insufficiency, his tetracycline was held as it was possible that this could be a contributing factor. An Ophthalmology consultation was obtained which showed just some very mild preseptal cellulitis with no orbital signs or symptoms suggestive of an orbital cellulitis. The patient's doxycycline was discontinued in favor of Keflex. The patient did have urine eosinophils and sediment checked. He had bland sediment which was not consistent with an acute tubular necrosis type picture. The patient was also transfused with 2 units of packed red blood cells for a low hematocrit early on during the course of his hospital stay. The patient did not have any upper endoscopy as his anemia was not suspected to be secondary to esophageal varices. The patient's creatinine continued to rise in the setting of his octreotide and midodrine therapy. Because of this, albumin 25 grams intravenously once per day was also started. On [**2138-3-29**], the patient became encephalopathic. Blood cultures and urine cultures were sent, and he did have an episode of occult-blood positive stools. In the setting of his encephalopathy, his renal function did improve; however, he was transferred to the Unit for further observation. A nasogastric lavage was done in the setting of his occult-blood positive stool. The nasogastric lavage was negative for blood. He did have a STAT head computed tomography which was negative for bleed. All sedatives were discontinued, and he was started on lactulose therapy. A chest x-ray there was negative for a pneumonia. The patient did have serial blood cultures done. He did have a total of [**6-26**] blood cultures positive for methicillin-resistant coagulase-negative Staphylococcus. His mental status did improve on lactulose therapy. The origin of his staphylococcal bacteremia was still uncertain. In this setting, he did have a diagnostic paracentesis done which was negative for spontaneous bacterial peritonitis. The patient was started on vancomycin for his high-grade bacteremia. He did have a transesophageal echocardiogram done which was negative for endocarditis. Per the Infectious Disease staff, it was recommended that he be treated with four to six weeks of vancomycin from the date of his last positive blood cultures which were [**2138-3-30**]. The patient was transferred back to the floor with an improved mental status and improved renal function. He did well on the floor. His hematocrit remained stable. He remained afebrile on vancomycin. The patient also completed a course of levofloxacin for his preseptal cellulitis. For his preseptal cellulitis, he received a total of 10 days of antibiotics which included doxycycline, Keflex, and levofloxacin. The patient did have good nutritional intake while on the floor. His creatinine remained in the 1.6 to 1.9 range on the floor and stable. His baseline creatinine is around 1. He was not started on diuretics at discharge. A peripherally inserted central catheter line was placed for administration of intravenous vancomycin for his high-grade methicillin-resistant Staphylococcus epidermitis bacteremia. The patient was seen by Physical Therapy and was discharged from their service as he had no acute physical therapy needs. The patient did have a candidal infection of his groin area which was treated with topical anti-fungal medications, to which he responded well to. Toward the end of his hospital stay, the patient did have increased diarrhea. His lactulose was held which improved his diarrhea somewhat; however, he did complain of increased diarrhea. He did have Clostridium difficile toxins times three days which were sent. These were negative for Clostridium difficile. The patient was discharged on no diuretics; however, the possibility of restarting Aldactone 50 mg will be considered as an outpatient. He will be discharged with a total course of four to six weeks of vancomycin. The start date on his vancomycin was [**2138-3-30**]. CONDITION AT DISCHARGE: Fair. DISCHARGE STATUS: To home. DISCHARGE DIAGNOSES: 1. Hepatitis C cirrhosis; awaiting liver transplantation. 2. Acute renal failure. 3. Methicillin-resistant coagulase-negative staphylococcal bacteremia; on vancomycin. MEDICATIONS ON DISCHARGE: 1. Miconazole nitrate powder applied three times per day as needed to groin rash. 2. Protonix 40 mg q.12h. 3. Lactulose 30 mL by mouth three times per day (titrated to four to five bowel movements per day). 4. Vancomycin 1 gram intravenously q.12h. (for a total of six weeks); his vancomycin dose will be changed per trough levels and his renal function. DISCHARGE INSTRUCTIONS/FOLLOWUP: The patient was to follow up in the Liver Clinic in two days from discharge. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 8507**], M.D. [**MD Number(2) 22654**] Dictated By:[**Last Name (NamePattern1) 11207**] MEDQUIST36 D: [**2138-4-7**] 15:21 T: [**2138-4-9**] 07:33 JOB#: [**Job Number 25451**] ICD9 Codes: 5849, 7907, 2767, 5715
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Medical Text: Admission Date: [**2137-6-8**] Discharge Date: [**2137-6-18**] Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 5810**] Chief Complaint: Right hip pain s/p fall Major Surgical or Invasive Procedure: Nasogastric tube insertion History of Present Illness: Ms. [**Known lastname 69629**] is an 89 year-old woman with a past history of total hip replacement, osteoporosis, hypothyroidism and Zencker's diverticulum that initially presented to the ED after a fall in the grocery store on [**6-7**]. In the ED she denied loss of consciousness, head strike and other neurological deficits (headache, seizures). She complained of headache and R hip pain. Exam showed normal VS, limited ROM R hip, multiple ecchymoses and chipped teeth. Negative head CT. Initial x-rays of R hip and knee showed no evidence of fracture. Urinalysis was positive for white cells; given 1 dose of ciprofloxacin. She was admitted to medicine for workup of mechanical fall vs. possible syncope. Past Medical History: 1. GERD 2. Hypothyroidism 3. [**Doctor Last Name 933**] disease 4. Incontinence 5. Osteoporosis 6. Spinal stenosis 7. Carpal tunnel syndrome 8. R hip replacement 9. Previous episodes of small bowel obstruction 10. Zencker's diverticulum Social History: Lives alone, retired; used to work in medical records department at [**Hospital1 18**]. Denies ETOH, Tobacco, or recreational drug use. She walks with a cane at baseline and lives at home and is fairly independent. Family History: Son is handicapped and lives in a group home. No known family history of heart disease or malignancy. Physical Exam: Admission Exam: Vitals: T=96.7, BP=136/66, HR=80, RR=21, O2sat=93% on nasal CPAP General: Alert, oriented, no acute distress on nasal CPAP. The patient had several bruises on her face (over right eye and right side of chin) and damaged teeth (post-fall) on the left side. HEENT: Sclera anicteric, dry mucous membranes, oropharynx clear Neck: supple, JVP not elevated, no LAD Lungs: Bibasilar crackles posteriorly R>L, with no wheezes, rales, ronchi. No use of accessory muscles. CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops. Capillary refill was normal. Abdomen: Distended, soft, non-tender with little to no bowel sounds present, no rebound tenderness or guarding, no organomegaly GU: Foley's catheter not inserted Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema . ICU-->Floor Transfer Exam: Vitals: T 97.2, BP 102/47, HR 73, RR 15, O2sat=96%/4L x nasal cannula General: Alert, oriented, no acute distress. ecchymoses over right eye and chin, chipped teeth. NGT in place. HEENT: Sclera anicteric, dry mucous membranes, oropharynx clear. Neck: supple, JVP not elevated, no LAD Lungs: Bibasilar crackles posteriorly R>L and bronchial breath sounds heard mostly in the posterior left lower lung. No wheezes, rales, ronchi. No use of accessory muscles. CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops. Capillary refill was normal. Abdomen: Distended (decreased from admission), soft, non-tender with some bowel sounds present, no rebound tenderness or guarding, no organomegaly GU: Foley catheter inserted Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Pertinent Results: Hematology COMPLETE BLOOD COUNT WBC RBC Hgb Hct MCV MCH MCHC RDW Plt Ct [**2137-6-14**] 05:10 7.6 4.06* 12.9 37.7 93 31.7 34.1 12.6 185 [**2137-6-13**] 04:19 8.2 3.95* 12.8 36.3 92 32.3* 35.2* 12.9 216 [**2137-6-12**] 04:55 10.7 4.80 15.4 44.0 92 32.0 34.9 12.8 253 [**2137-6-11**] 05:45 8.0 4.55 14.4 41.2 91 31.7 35.1* 12.9 239 [**2137-6-9**] 06:30 6.3 4.32 13.9 39.3 91 32.3* 35.5* 12.8 189 [**2137-6-7**] 23:50 9.6 4.94 15.4 44.51 90 31.2 34.6 13.5 228 DIFFERENTIAL Neuts Bands Lymphs Monos Eos Baso Atyps Metas [**2137-6-7**] 23:50 77.4* 17.2* 3.7 1.0 0.6 BASIC COAGULATION (PT, PTT, PLT, INR) PT PTT Plt Ct INR(PT) [**2137-6-14**] 05:10 185 [**2137-6-13**] 04:19 216 [**2137-6-12**] 13:00 52.3* heparin dose: 650 [**2137-6-12**] 04:55 253 [**2137-6-12**] 04:55 13.0 23.7 1.1 [**2137-6-11**] 05:45 239 [**2137-6-9**] 06:30 189 [**2137-6-7**] 23:50 228 LAB USE ONLY [**2137-6-14**] 05:10 Chemistry RENAL & GLUCOSE Glucose UreaN Creat Na K Cl HCO3 AnGap [**2137-6-15**] 07:05 120*1 9 0.4 137 3.6 103 23 15 [**2137-6-14**] 05:10 981 12 0.5 138 3.6 103 29 10 [**2137-6-13**] 04:19 113*1 31* 0.7 136 4.2 104 28 8 [**2137-6-12**] 04:55 166*1 35* 0.8 137 4.5 100 26 16 [**2137-6-11**] 05:45 158*1 21* 0.7 139 4.0 99 29 15 [**2137-6-9**] 06:30 101*1 20 0.8 139 4.2 105 28 10 [**2137-6-8**] 01:10 114*1 18 0.7 139 3.4 103 29 10 IF FASTING, 70-100 NORMAL, >125 PROVISIONAL DIABETES ESTIMATED GFR (MDRD CALCULATION) estGFR [**2137-6-15**] 07:05 Using this1 Using this patient's age, gender, and serum creatinine value of 0.4, Estimated GFR = >75 if non African-American (mL/min/1.73 m2) Estimated GFR = >75 if African-American (mL/min/1.73 m2) For comparison, mean GFR for age group 70+ is 75 (mL/min/1.73 m2) GFR<60 = Chronic Kidney Disease, GFR<15 = Kidney Failure ENZYMES & BILIRUBIN ALT AST LD(LDH) CK(CPK) AlkPhos Amylase TotBili DirBili [**2137-6-13**] 04:19 14 15 20*1 35 0.5 [**2137-6-12**] 07:29 16 17 361 47 0.7 [**2137-6-11**] 18:13 421 [**2137-6-11**] 05:45 14 16 561 47 0.4 NEW REFERENCE INTERVAL AS OF [**2135-11-28**];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 [**2137-6-12**] 07:29 19 [**2137-6-11**] 05:45 20 CPK ISOENZYMES CK-MB cTropnT [**2137-6-13**] 04:19 2 <0.011 [**2137-6-12**] 07:29 3 <0.011 [**2137-6-11**] 18:13 3 <0.011 [**2137-6-11**] 05:45 3 <0.011 <0.01 CTROPNT > 0.10 NG/ML SUGGESTS ACUTE MI CHEMISTRY TotProt Albumin Globuln Calcium Phos Mg UricAcd Iron [**2137-6-15**] 07:05 1.7* 2.1 LAB USE ONLY LtGrnHD GreenHd HoldBLu [**2137-6-7**] 23:50 HOLD1 [**2137-6-7**] 23:50 HOLD [**2137-6-7**] 23:50 HOLD2 HOLD DISCARD GREATER THAN 24 HRS OLD HOLD DISCARD GREATER THAN 4 HOURS OLD Blood Gas BLOOD GASES Type Temp Rates Tidal V PEEP FiO2 O2 Flow pO2 pCO2 pH calTCO2 Base XS Intubat [**2137-6-12**] 06:43 ART 65* 42 7.43 29 2 NOT INTUBA1 NOT INTUBATE WHOLE BLOOD, MISCELLANEOUS CHEMISTRY Lactate [**2137-6-13**] 11:35 1.1 . Micro - URINE CULTURE (Final [**2137-6-10**]): MIXED BACTERIAL FLORA ( >= 3 COLONY TYPES), CONSISTENT WITH SKIN AND/OR GENITAL CONTAMINATION. . Imaging: [**6-7**] - CT Head: IMPRESSION: 1. No acute intracranial traumatic injury. No acute intracranial hemorrhage. 2. Minimal fluid in the right mastoid air cells. . [**6-7**] - Knee/Hip X-ray: IMPRESSION: 1. Status post total hip arthroplasty, without periprosthetic fracture or other evidence of traumatic sequelae. 2. Degenerative changes at the lumbosacral junction and right knee . [**6-10**] - CT Pelvis:IMPRESSION: 1. Nondisplaced periprosthetic fracture of the right femur extending from the intertrochanteric to the subtrochanteric region. 2. Right trochanteric bursitis. . [**6-11**] - Abdomen X-ray:IMPRESSION: 1. No evidence of free air. 2. Small and large bowel dilation which could be consistent with obstruction or ileus. . [**6-12**] - CT Chest:IMPRESSION: 1. No CT evidence of simple pulmonary embolism 2. Collapsed bilateral lower lobes with dilated bronchi having irregular walls - suggestive of bronchiectasis with chronicity 3. Zenker's diverticulum 4. Diffuse wall thickening of the cervical and mid thoracic esophagus 5. Grossly distended and fluid filled stomach . [**6-12**] - Chest X-ray:IMPRESSION: - Severe bibasilar atelectasis and low lung volumes persist. There is no pneumoperitoneum. The degree of gastric distension cannot be assessed. The large Zenker's diverticulum shown on the chest CTA is not evident on conventional radiographs. No pneumothorax. . [**6-12**] IMPRESSION: 1. Interval worsening of bibasilar atelectasis. 2. No evidence of acute cardiac decompensation. 3. Severely distended stomach. 4. Possible pneumoperitoneum. Findings and need for additional imaging discussed with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] by telephone at the time of dictation. . EKG:IMPRESSION: - Sinus rhythm. First degree A-V delay. Probable left atrial abnormality. Non-specific anterolateral ST-T wave changes. No change compared to [**2136-9-6**] . Echo:IMPRESSION: - Normal global and regional biventricular systolic function. No pulmonary hypertension or pathologic valvular disease seen. - Compared with the resting images of the prior study of [**2133-5-14**], the findings are similar. . CT abdomen-IMPRESSION: 1. Incomplete partial/early small-bowel obstruction, with a transition point in the right lower quadrant of the abdomen, could be related to adhesions. The transition point is in a similar level as the prior study. No evidence of ischemia or free air. 2. Bibasilar consolidations, likely represent atelectasis. . EKG-[**Known lastname **],[**Known firstname 94790**] [**Age over 90 94791**] F 89 [**2047-9-27**] Cardiology Report ECG Study Date of [**2137-6-13**] 11:26:44 PM Sinus rhythm. Borderline P-R interval prolongation. Diffuse T wave flattening which is non-specific. Compared to the previous tracing of [**2137-6-12**] there is no significant diagnostic change. Brief Hospital Course: Brief Hospital Course: . #R hip injury s/p fall Pt suffered multiple injuries during her fall. In addition to broken teeth (some cemented in the ED) and ecchymoses over her chin and R temple, there was persistent concern for R hip fracture given limited range of motion on exam. Therefore, despite initial negative plain films of her R hip and leg in the ED, a follow-up CT was obtained and showed a peri-prosthetic proximal femur fracture. Ortho trauma recommended non-operative management of her right hip fracture, with outpatient follow-up with [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] in [**12-27**] weeks with repeat x-rays of her right hip. Pain was controlled with standing tylenol and a lidocaine patch. Initially anticoagulated with Sq heparin alone, changed to lovenox per discussions with ortho. . #Small Bowel Obstruction On the medicine service on hospital day 4 the pt developed acute epigastric pain associated with nausea, nonbloody vomiting, and dyspnea. Abdominal x-ray showed a distended stomach and small bowel with multiple air-fluid levels with no free air, consistent with possible small bowel obstruction. In the ICU, an NGT tube was placed (required left lateral decubitus positioning given known Zenker's diverticulum) with >2L bilious gastric fluid drainage. Surgery was consulted to evaluate her recurrent small bowel obstruction; they recommended non-operative management, keeping patient NPO with NGT/IV fluids. She also received an agressive bowel regimen to relieve obstruction, and was passing gas within 24 hours. Her symptoms improved, NGT was removed on [**6-14**] and her diet advanced to regular. #Acute Hypoxia/severe atelectasis with lung collapse. Vital signs obtained at the onset of nausea/vomiting showed oxygen desaturation to 84% with tachypnea to RR 24. Pt denied chest pain and palpitations. ABG pH 7.43 pCO2 42 pO2 65. Supplemental oxygen via non-rebreather improved O2sats to 91-94%. SErial EKG's were monitored. EKG performed at 3am on morning prior to hypoxic episode showed possible STE in v3-v4 (performed as pre-op for possible OR but not reviewed by overnight physician). Repeat EKG at 6am did not show this finding. However, serial cardiac enzymes ruled out MI. Reviewed EKG with cardiology. Pt was empirically started on heparin gtt, PR aspirin, statin and beta-blocker and transferred to the ICU for stabilization of her respiratory status. She was afebrile, without elevated WBC or consolidation/infiltration on CXR or cough. Negative CTA ruled out pulmonary emboli, but showed bilateral lower lobe collapse due to lobar atelectasis. Echo showed normal biventricular function and no evidence of pulmonary hypertension. Cardiac enzymes were negative. As ACS and PE were ruled out, BB, statin, heparin were discontinued. After transfer to the ICU she denied SOB but continued to require 5-6L supplemental oxygen to keep O2 sats>90%. Used frequent incentive spirometry to promote re-inflation of collapsed lower lobes. Pt required no further oxygen on day of discharge and had clinical improvement in crackles in right base *******PT SHOULD HAVE STRESS TESTING AS AN OUTPT GIVEN ISOLATED TRANSIENT V3-4 STE ON EKG*** . # Hypothyroid - Treated with home levothyroxine. . # GERD - Treated with home omeprazole. #UTI-s/p course of PO cipro x3 days. Cx with mixed flora. . #osteoporosis-continued calcium . FEN:adat to clears . PPX: hep SC, bowel regimen (PR dulcolax/enemas) . #CODE: Full (confirmed) . #Contact: [**Name (NI) **] (handicapped. per patient he is not able to make decisions for the patient. Patient has no one who she says can make decisions for her. Medications on Admission: levothyroxine 88mcg po daily oxybutynin chloride 5mg po daily ASA 325mg po daily Calcium carbonate 750mg po TID MVI Discharge Medications: 1. levothyroxine 88 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. oxybutynin chloride 5 mg Tablet Sig: One (1) Tablet PO once a day. 3. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. calcium carbonate 200 mg calcium (500 mg) Tablet, Chewable Sig: One (1) Tablet, Chewable PO BID (2 times a day). 5. lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: One (1) Adhesive Patch, Medicated Topical DAILY (Daily). Disp:*30 Adhesive Patch, Medicated(s)* Refills:*2* 6. acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO Q8H (every 8 hours) as needed for pain. 7. polyethylene glycol 3350 17 gram/dose Powder Sig: One (1) PO DAILY (Daily). 8. senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 9. bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for constipation. 10. docusate sodium 50 mg/5 mL Liquid Sig: One (1) PO BID (2 times a day). 11. multivitamin Tablet Sig: One (1) Tablet PO once a day. 12. Lovenox 40 mg/0.4 mL Syringe Sig: One (1) Subcutaneous once a day for 3 weeks. Discharge Disposition: Extended Care Facility: [**Hospital1 599**] Senior Healthcare of [**Location (un) 55**] Discharge Diagnosis: Urinary tract infection Fall periprosthetic hip fracture severe atelectasis bowel obstruction and markedly dilated stomach zenkers diverticulum hypothyroidism Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Discharge Instructions: You were admitted with Right hip pain after a fall and found to have a fracture near your hip replacement. For this, you were evaluated by the orthopedic surgery team who felt that you did not require a surgery, but would need continued follow up in orthopedic clinic. In addition, you were found to have a bowel obstruction and low oxygen levels. For your bowel obstruction, you initially had an NG tube and were given bowel rest with improvement in your symptoms. The NG tube was removed and your diet was advanced. Your low oxygen levels were likely due to lung collapse related to your distended stomach. This was also improving with using incentive spirometry and getting up to a chair. please discuss the need for a stress test with your PCP after discharge. . Please take all of your medications as prescribed and follow up with the appointments below. Followup Instructions: Department: [**Hospital3 1935**] CENTER When: THURSDAY [**2137-7-11**] at 3:00 PM With: [**Doctor Last Name **] OPTOMETRY [**Telephone/Fax (1) 253**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: CARDIAC SERVICES When: TUESDAY [**2137-7-2**] at 3:00 PM With: [**First Name11 (Name Pattern1) 125**] [**Last Name (NamePattern4) 126**], M.D. [**Telephone/Fax (1) 62**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: [**Hospital3 249**] When: FRIDAY [**2137-8-9**] at 11:20 AM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 5447**], M.D. [**Telephone/Fax (1) 250**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 895**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage ICD9 Codes: 5990, 5180, 2449
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Medical Text: Admission Date: [**2142-1-29**] Discharge Date: [**2142-1-30**] Date of Birth: [**2088-10-16**] Sex: M Service: NEUROSURGERY Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 78**] Chief Complaint: Worst Headache of Life Major Surgical or Invasive Procedure: [**1-29**] Conventional Cerebral Angiogram History of Present Illness: Pt is a 53M who experienced sudden onset of the worse headached of his life at 4pm yesterday. Headache was occiptal and accompanied by some neck stiffness. He was evaluated at an OSH where a non-contrast head CT was reportedly negative but LP was bloody and did not clear through 4 tubes with cell counts as follows: tube 1- rbcs 125,920 wbcs 80 diff 87 polys 1 band p lymphs 2 monos 1 eo; tube 4- rbcs 75,920 wbcs 80. He was transferred to [**Hospital1 18**] for further evaluation. He is neurologically with a mild occipital headache at present. Past Medical History: HLD Social History: Works as a production manager does use alcohol Family History: NC Physical Exam: Vitals: 100.5 84 141/93 16 96% Gen: WD/WN, comfortable, NAD. HEENT: Pupils: PERLA Gen: WD/WN, comfortable, NAD. HEENT: atraumatic, normocephalic Pupils: bilaterally 4-3mm EOMs: intact Neuro: Mental status: Awake and alert, cooperative with exam, normal affect. Orientation: Oriented to person, place, and date. Recall: [**2-24**] 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, 4 to 3 mm bilaterally. Visual fields are full to confrontation. III, IV, VI: Extraocular movements intact bilaterally without nystagmus. V, VII: Facial strength and sensation intact and symmetric. VIII: Hearing intact to voice. IX, X: Palatal elevation symmetrical. [**Doctor First Name 81**]: Sternocleidomastoid and trapezius normal bilaterally. XII: Tongue midline without fasciculations. Motor: Normal bulk and tone bilaterally. No abnormal movements, tremors. Strength full power [**4-28**] throughout. No pronator drift Sensation: Intact to light touch Handedness Right On Discharge: Nonfocal Pertinent Results: [**2142-1-29**] CTA head and neck: Again noted prepontine density possibly representing subarachnoid hemorrhage. No evidence of aneurysm or AVM. [**2142-1-29**] MRI cervical spine: 1. Degenerative changes of the cervical spine as described in detail above,worse at C3-4 and C4-5. 2. Limited evaluation of the vasculature demonstrates no gross evidence of vascular malformation. Brief Hospital Course: Patient presented to [**Hospital1 18**] from an OSH with the Worst Headache of his life. At the OSH he had a lumbar puncture which showed gross blood which was the impetus for the trasnfer. Imaging of the head and neck has been negative. On mornign rounds on [**1-29**] he was neurologically intact and awaiting conventional angiogram to assess his vessels and r/o vascular anomaly. Cerebral angiogram was negative for aneurysm or vascular malformation. His exam remained stable and intact and on [**1-29**] he was deemed stable for trasnfer to the floor. He was awaiting a bed into [**1-30**]. His exam remained stable and after discussion with patient and team it was determined he could be discharged from the Intensive Care unit to home. He was given instructions for post-discharge. Medications on Admission: Lovastatin Discharge Medications: 1. acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for fever/pain. 2. butalbital-acetaminophen-caff 50-325-40 mg Tablet Sig: [**12-25**] Tablets PO Q4H (every 4 hours) as needed for Headache. Disp:*45 Tablet(s)* Refills:*0* 3. lovastatin 20 mg Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Home Discharge Diagnosis: Headache Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Medications: ?????? Continue all other medications you were taking before surgery, unless otherwise directed ?????? You make take Tylenol or prescribed pain medications for any post procedure pain or discomfort. What activities you can and cannot do: ?????? When you go home, you may walk and go up and down stairs. ?????? You may shower (let the soapy water run over groin incision, rinse and pat dry) ?????? Your incision may be left uncovered, unless you have small amounts of drainage from the wound, then place a dry dressing or band aid over the area that is draining, as needed ?????? No heavy lifting, pushing or pulling (greater than 5 lbs) for 1 week (to allow groin puncture to heal). ?????? After 1 week, you may resume sexual activity. ?????? After 1 week, gradually increase your activities and distance walked as you can tolerate. ?????? No driving until you are no longer taking pain medications What to report to office: ?????? Changes in vision (loss of vision, blurring, double vision, half vision) ?????? Slurring of speech or difficulty finding correct words to use ?????? Severe headache or worsening headache not controlled by pain medication ?????? A sudden change in the ability to move or use your arm or leg or the ability to feel your arm or leg ?????? Trouble swallowing, breathing, or talking ?????? Numbness, coldness or pain in lower extremities ?????? Temperature greater than 101.5F for 24 hours ?????? New or increased drainage from incision or white, yellow or green drainage from incisions ?????? Bleeding from groin puncture site *SUDDEN, SEVERE BLEEDING OR SWELLING (Groin puncture site) Lie down, keep leg straight and have someone apply firm pressure to area for 10 minutes. If bleeding stops, call our office. If bleeding does not stop, call 911 for transfer to closest Emergency Room! Followup Instructions: You do not require neurosurgical follow-up. We recommend contacting your PCP and being seen in the near future especially if you continue with your minor headaches. Completed by:[**2142-1-30**] ICD9 Codes: 2724
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Medical Text: Admission Date: [**2110-9-23**] Discharge Date: [**2110-9-24**] Date of Birth: [**2038-6-5**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 106**] Chief Complaint: dyspnea Major Surgical or Invasive Procedure: none History of Present Illness: Mr. [**Known lastname 3646**] is a 71 year old man with a history of diastolic heart failure (EF 40-45%), critical aortic stenosis, multiple myeloma, amyloidosis, and chronic renal insufficiency who presents with exertional dyspnea worsening over the last 2 weeks or so. He has noticed increased abdominal girth over this period, without any abdominal discomfort. He has had some associated poor energy, limited appetite, and nausea. He vomited once yesterday, and has had some loose stools without melena or hematochezia. He thinks he has gained weight but is unsure of the amount. He can ascend [**1-28**] flights of stairs before having to stop due to dyspnea which he says is his baseline. His wife however notes that he seems out of breath just walking across a small room. He has stable 3 pillow orthopnea, but denies any PND. He denies any difficulties with taking his medications as prescribed, or any increased salt intake. He denies fevers, chills, sweats, palpitations, lightheadedness/fainting, chest discomfort, wheezing, leg pains or history of thrombosis. He does have a chronic cough not recently worse productive of white sputum, without any hemoptysis. . In the ED, his triage vitals were T98.1, P 98, Bp 104/64, RR 18, 99% on RA. He received 80mg lasix IV x1. On the floor, he was noted to be "extremely short of breath" tachypneic to the 30's and wheezing with O2 saturation dipping to 79. He was placed on a non-rebreather facemask, given 2mg morphine, started on a nitroglycerin drip, and subsequently transferred to the CCU. Past Medical History: CHF EF 40-45%, diastolic HF AS - valve area <0.8cm2 on [**2110-8-25**] echo CAD DM2 HTN CKD Hyperlipidemia Left atrial appendage thrombus Social History: The patient is married, lives with wife has children. Retired from working for Polaroid. Social history is significant for the absence of current tobacco use, previous use x 50 years, quit 5 years ago. There is no history of alcohol abuse. There is no family history of premature coronary artery disease or sudden death. Family History: M: suicide. F: died at age 51, is unsure of what cause. No family history of premature coronary artery disease or sudden death. Physical Exam: T101.8 P 132 BP 108/55 RR 22 O2 100% on nonrebreather General: Thin elderly man in mild respiratory distress. Able to speak in short sentences Neck: JVP 10cm. Carotid upstroke brisk bilaterally Pulm: Lungs with slightly decreased breath sounds on R, +wheezes without rales CV: Regular rate S1 S2 II/VI SEM base Abd: Soft +BS, +fluid wave, nontender Extrem: Warm, well perfused with 1+ pitting edema. 2+ distal pulses bilaterally. Neuro: Alert and oriented Lines: Has R PICC Pertinent Results: [**2110-9-23**] 11:46AM WBC-15.0*# RBC-3.17* HGB-10.5* HCT-33.0* MCV-104* MCH-33.1* MCHC-31.8 RDW-17.3* [**2110-9-23**] 11:46AM PLT SMR-NORMAL PLT COUNT-184 [**2110-9-23**] 11:46AM NEUTS-93* BANDS-3 LYMPHS-1* MONOS-3 EOS-0 BASOS-0 ATYPS-0 METAS-0 MYELOS-0 [**2110-9-23**] 11:46AM PT-29.8* PTT-33.9 INR(PT)-3.1* [**2110-9-23**] 11:46AM ALBUMIN-3.3* CALCIUM-9.3 [**2110-9-23**] 11:46AM proBNP-[**Numeric Identifier 71895**]* [**2110-9-23**] 11:46AM ALT(SGPT)-90* AST(SGOT)-167* ALK PHOS-236* AMYLASE-110* TOT BILI-2.4* [**2110-9-23**] 11:46AM GLUCOSE-99 UREA N-52* CREAT-2.7* SODIUM-131* POTASSIUM-4.1 CHLORIDE-96 TOTAL CO2-24 ANION GAP-15 [**2110-9-23**] 12:45PM URINE COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.011 [**2110-9-23**] 12:45PM URINE BLOOD-TR NITRITE-NEG PROTEIN-TR GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-NEG [**2110-9-23**] 12:45PM URINE RBC-0 WBC-[**3-31**] BACTERIA-RARE YEAST-NONE EPI-0-2 [**2110-9-23**] 06:42PM LACTATE-10.6* . CXR [**9-23**] Right-sided pleural effusion, possibly slightly decreased in size compared to the previous study. Patchy density at the right lung base likely reflects atelectasis. . RUQ Ultrasound [**9-23**] IMPRESSION: Moderate to large ascites with no ultrasound evidence suggestive of acute cholecystitis. There is, however re-demonstration of previously noted gallbladder sludge. Moderate to large amount of ascites again noted. Doppler waveform consistent with right heart failure. . EKG [**9-23**] Sinus rhythm 94bpm. Upper limits of normal rate. P-R interval prolongation. Marked left axis deviation. Low voltage throughout. Borderline intraventricular conduction delay. Late R wave progression. ST-T wave abnormalities. Since the previous tracing of [**2110-8-27**] probably no significant change. Clinical correlation is suggested. . Renal Ultrasound [**9-24**] 1. Limited. Right kidney not visualized. The left kidney appears normal. 2. Abundant ascites. . MICROBIOLOGY [**2110-9-23**] 9:14 pm BLOOD CULTURE Source: Line-PICC SET #2. **FINAL REPORT [**2110-9-28**]** AEROBIC BOTTLE (Final [**2110-9-27**]): REPORTED BY PHONE TO FA6B [**Last Name (NamePattern4) 71896**] [**2110-9-24**] 930AM. ESCHERICHIA COLI. FINAL SENSITIVITIES. PSEUDOMONAS AERUGINOSA. FINAL SENSITIVITIES. STAPHYLOCOCCUS, COAGULASE NEGATIVE. FINAL SENSITIVITIES. Staphylococcus species may develop resistance during prolonged therapy with quinolones. Therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. Testing of repeat isolates may be warranted. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ ESCHERICHIA COLI | PSEUDOMONAS AERUGINOSA | | STAPHYLOCOCCUS, COAGULASE N | | | AMPICILLIN------------ =>32 R AMPICILLIN/SULBACTAM-- 8 S CEFAZOLIN------------- <=4 S CEFEPIME-------------- <=1 S 2 S CEFTAZIDIME----------- <=1 S 4 S CEFTRIAXONE----------- <=1 S CEFUROXIME------------ 4 S CIPROFLOXACIN---------<=0.25 S <=0.25 S CLINDAMYCIN----------- <=0.25 S ERYTHROMYCIN---------- <=0.25 S GENTAMICIN------------ <=1 S <=1 S <=0.5 S IMIPENEM-------------- <=1 S <=1 S LEVOFLOXACIN---------- <=0.12 S MEROPENEM-------------<=0.25 S <=0.25 S OXACILLIN------------- <=0.25 S PENICILLIN------------ =>0.5 R PIPERACILLIN---------- <=4 S PIPERACILLIN/TAZO----- <=4 S 8 S TOBRAMYCIN------------ <=1 S <=1 S TRIMETHOPRIM/SULFA---- =>16 R ANAEROBIC BOTTLE (Final [**2110-9-27**]): ESCHERICHIA COLI. IDENTIFICATION AND SENSITIVITIES PERFORMED FROM AEROBIC BOTTLE. PSEUDOMONAS AERUGINOSA. IDENTIFICATION AND SENSITIVITIES PERFORMED FROM AEROBIC BOTTLE. STAPHYLOCOCCUS, COAGULASE NEGATIVE. SENSITIVITIES PERFORMED FROM AEROBIC BOTTLE. AEROBIC BOTTLE (Final [**2110-9-27**]): REPORTED BY PHONE TO FA6B [**Last Name (NamePattern4) 71896**] [**2110-9-24**] 930AM. ESCHERICHIA COLI. IDENTIFICATION AND SENSITIVITIES PERFORMED ON CULTURE # 236-2195B [**2110-9-23**]. PSEUDOMONAS AERUGINOSA. SENSITIVITIES PERFORMED ON CULTURE # 236-2195B [**2110-9-23**]. STAPHYLOCOCCUS, COAGULASE NEGATIVE. FINAL SENSITIVITIES. Staphylococcus species may develop resistance during prolonged therapy with quinolones. Therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. Testing of repeat isolates may be warranted. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ STAPHYLOCOCCUS, COAGULASE NEGATIVE | CLINDAMYCIN-----------<=0.25 S ERYTHROMYCIN----------<=0.25 S GENTAMICIN------------ <=0.5 S LEVOFLOXACIN----------<=0.12 S OXACILLIN-------------<=0.25 S PENICILLIN------------ =>0.5 R ANAEROBIC BOTTLE (Final [**2110-9-27**]): ESCHERICHIA COLI. IDENTIFICATION AND SENSITIVITIES PERFORMED ON CULTURE # 236-2195B [**2110-9-23**]. PSEUDOMONAS AERUGINOSA. SENSITIVITIES PERFORMED ON CULTURE # 236-2195B [**2110-9-23**]. Brief Hospital Course: 1. Septic shock, likely secondary to spontaneous bacterial peritonitis: The patient was transferred to the CCU for dyspnea, initially thought to be due primarily to heart failure. He had received intravenous furosemide in the emergency room as well as empiric levofloxacin. The CCU team was concerned about the presence of spontaneous bacterial peritonitis, therefore we broadened his antibiotic coverage and planned to do a diagnostic paracentesis. This was not performed immediately due to concern for an elevated INR, as well as hemodynamic instability with systolic blood pressures in the 80's. In addition, his urine output was poor, so he was administered fluid boluses. He had a limited renal ultrasound that did not visualize the left kidney adequately, but showed no evidence of ureteral obstruction or hydronephrosis on the right that wound account for his poor urine output. It became clear that his poor urine output was likely due to poor renal perfusion in the setting of sepsis. His tachynea had been somewhat improved following admission to the CCU, but was worsened by the next morning. Given his elevated lactate, it is likely his tachypnea was at least in part a compensatory response to his lactic acidosis. A discussion with the patient and his family resulted in the decision not to place him on mechanical ventilation. He was started on a morphine drip and his status was changed to Care Measures Only. The patient passed away on [**2110-9-24**]. The family declined an autopsy. Medications on Admission: Toprol Xl 25 mg PO daily Allopurinol 100 mg PO daily Calcitriol 0.25 mcg PO daily Prilosec 20 mg PO daily Lasix 80 mg IV daily Ambien 5 mg PO QHS prn insomnia Warfarin 5 mg PO daily Insulin NPH 6 units QAM Discharge Medications: N/A, patient deceased Discharge Disposition: Expired Discharge Diagnosis: Primary 1. Septic shock, likely secondary to spontaneous bacterial peritonitis 2. Congestive heart failure, diastolic, acute on chronic 3. Acute on chronic renal failure Secondary 4. Amyloidosis in setting of multiple myeloma 5. Aortic stenosis, severe Discharge Condition: Deceased Discharge Instructions: Not applicable Followup Instructions: Not applicable ICD9 Codes: 5849, 4241, 5859, 4280
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Medical Text: Admission Date: [**2169-3-14**] Discharge Date: [**2169-3-23**] Date of Birth: [**2085-6-22**] Sex: F Service: MEDICINE Allergies: Penicillins Attending:[**First Name3 (LF) 9853**] Chief Complaint: Fevers, altered mental status Major Surgical or Invasive Procedure: - ERCP - Placement of PICC line History of Present Illness: Mrs. [**Known lastname 10840**] is a pleasant 83 year old female, followed by biliary service at [**Hospital1 18**] for biliary obstruction status-post stenting for likely malignancy, though not biopsy proven, as well as a history of cholangitis. She was at home with her husband, who noted on morning of admission she was much less responsive than usual, and that she felt warm to the touch. He describes that she was slightly more somnolent the day prior to admission. He was concerned and called EMS. She was brought to [**Hospital3 3583**]. There, she was noted to have a white blood cell count of 26 with bands, a total bilirubin of 2.4, no acute chest process on chest x-ray, and a mildly positive urine analysis with 1+ LE. She was given vancomycin, ceftriaxone, and flagyl over concern of cholangitis. Her INR was over 8, and she was given 10 mg of intravenous vitamin K. Blood and urine cultures were drawn prior to administration of antibiotics. She was then transferred to [**Hospital1 18**]. . In the [**Hospital1 18**] [**Last Name (LF) **], [**First Name3 (LF) **] abdominal ultrasound was completed, which demonstrated no change in known intrahepatic dilatation, two common bile duct stents in place, and no obvious abscesses. Her vitals at that time were: temperature of 101.4 rectal, stable blood pressure (never hypotensive, lowest 120/40) 160/70, RR 24, Sat 98% on NRB. She was noted to be rigoring and was somnolent but somewhat arousable. Her laboratories were notable for a transaminitis AST >ALT, lactate 2.4, INR 7.7. She received more vitamin K, was seen by surgery and was admitted to [**Hospital Unit Name 153**] for plan to ERCP in AM. . Of note, patient had recent admission to [**Hospital Unit Name 153**] for polymicrobial sepsis in setting of biliary stent obstruction due to tumor. She underwent ERCP with successful flushing of stents. Her course was complicated by afib with RVR, DVT and liver abscesses not amenable to drainage. . Blood cultures at that time grew: enterococcus sensitive to gent and streptomycin; E.coli sensitive to gent, imipenem, and cephalosporins; Klebsiella pansensitive except to amp. . Upon arrival to the [**Hospital Unit Name 153**], she would open her eyes to tactile stimuli and would squeeze her hand when ask; she was not otherwise interactive. Past Medical History: Biliary obstruction/malignant stricture s/p ERCP X 2 and 2 metal stents--last placed in [**9-12**]. Thought to be cholangiocarcinoma, no clear pathologic diagnosis made. By report, evaluated by surgical team, thought not to be a surgical candidate. Now with peritoneal carcinomatosis. -Diabetes mellitus, type 2 -Hypertension -Coronary artery disease -Parkinson's disease -diastolic CHF -Vaginal Carcinoma -s/p Cholecystectomy -Urosepsis d/t E. coli and Proteus -Bacteremia due to VRE in [**9-12**] treated with 2 week course of Linezolid -Bacteremia due to E. coli in [**9-12**] treated with 2 week course of Ceftriaxone. -Atrial fibrillation -Hyperlipidemia Social History: She lives with husband in [**Name (NI) 3320**], and has no children. Dependent for ADLs--has VNA and husband cares for her, no tobacco or drugs, occassional alcohol. Retired tax examiner for the state. At baseline, she eats pureed foods with some assistance from her husband depending on how bad her Parkinsons tremor is. Her primary care physician describes she has a good baseline quality of life. Family History: Per records, her mother died of heart disease. Physical Exam: On Admission: T= 101.9 axillary BP=125/59 HR=103 RR=? O2= 100% on 50% shovel mask Gen: elderly female, very warm, somnolent but follows with eyes. HEENT: Dry mucous membranes, OP clear Neck: No JVP Car: Tachycardic, irregular, no murmurs appreciated Resp: course BS bilaterally transmitted from O2. Abd: soft, +BS, ND, unclear if tenderness pain in [**Name (NI) 25714**] - pt opens eyes wide. Ext: strong distal pulses, bilateral edema Neuro: somnolent, unable to participate in neuro exam. Skin: No rashes or lesions noted Pertinent Results: Ultrasound: IMPRESSION: 1. No significant interval change in intrahepatic biliary duct dilatation, most severe within the left lobe. 2. Echogenic material within both common bile duct stents is nonspecific, and could represent debris, but tumor involvement is not excluded. 3. Patent main portal vein, however, the patient's known right posterior portal venous branch occlusion is not visualized on current examination. 4. Small amount of perihepatic fluid. 5. 1.1-cm pancreatic mid body lesion, stable from the prior studies. 6. No new hepatic abscess identified. Chest x-ray: IMPRESSION: No acute cardiopulmonary abnormality. Patchy opacity within the retrocardiac region is felt to represent atelectasis and/or scarring. Brief Hospital Course: Mrs. [**Known lastname 10840**] is an 83 year old female with history of biliary obstruction, polymicrobial bacteremia from cholantitis presenting with fever, altered mental status concerning for ascending cholangitis. #. Sepsis: Pt presented with altered mental status, fevers, tachycardia and leukocytosis. Symptoms were presumed to be due to cholangitis and obstruction of known biliary stent, given elevated white blood cell count, fevers, and elevated liver function tests. There were no other clear sources of infection on admission. A RUQ ultrasound showed no change in biliary dilitation but ERCP showed sludge and stones obstructing the stent which were successfully cleared out. Pt was initially empirically treated linezolid, ceftriaxone and flagyl given prior h/o VRE and resistent bacteria, and transitioned to only high dose ceftriaxone once blood cultures grew Klebsiella. She was also treated with IVF boluses via PICC and did not require a CVL or pressors. The biliary surgery and ERCP team followed along during her stay. The infectious disease team helped guide appropriate antibiotic choice: as she did not have evidence of active hepatic abscesses on abdominal CT, a 2 week course was deemed sufficient (last day [**3-28**]). Her mental status returned to baseline, and her fevers resolved within a few days of hospitalization. Her blood cutlures checked after the initial positive results remained sterile. #. Coagulopathy: On presentation pt's INR was 8, likely in setting of poor hepatic clearance of coumadin. She had no signs of active bleeding. She recieved several doses of Vitamin K and FFP to reverse her INR for ERCP and was NOT restarted on anticoagulation post procedure, out of concern for needing future procedures. Benefits and downsides of anticoagulation can be discussed with pt's PCP given ongoing goals of care. #. [**Name (NI) 20472**] Pt's home home glyburide was held and pt was monitored and treated with a sliding scale of insulin. This was not restarted after her procedures due to generally good blood sugar control; however, this can be restarted when necessary at rehab depending on her blood sugars. #. Coronary artery disease: Patient's last echo was in [**Month (only) 404**] [**2169**], which demonstrated an EF of >55%, normal systolic function, mild MR. She was continued on her home statin, while her home anti-hypertensives were initially held in the setting of concern of hypotension while septic. Her metoprolol was started after her BP recovered. #. Atrial fibrillation: Pt supratherpeutic on coumadin on arrival. This was not restarted due to ongoing discussions about goals of care. Metoprolol was restarted and titrated up to 50mg tid given episodes of afib with RVR in the ICU. This was backed down to 25mg [**Hospital1 **] after she was noted to be in sinus brady in the 50s on the floor. Digoxin was not restarted. #. HTN: held home BP regimen on admission. Metoprolol was added back as above and lisinopril and HCTZ were added and titrated up after she became hypertensive on the floor. This can continue to be titrated as needed at rehab. #. Parkinsons: continued Sinimet and Pramipexole #. Concern for aspiration/goals of care: the patient failed a video speech and swallow study after being called out of the ICU. The speech and swallow team discussed the possibility of a feeding tube with the patient and family in order to be able to provide adequate nutrition, but she and her husband were adamantly against this, as quality of life and being able to have the comfort of eating food were deemed to be more important; thus, speech and swallow recommended nectar thick liquids and pureed solids per her husband's request. The patient and husband acknowledged the risks that she will likely aspirate. Goals of care should continue to be discussed at rehab and any concern for aspiration should be discussed with the patient and husband before she is sent to the hospital in the event that she does aspirate, to see if they may decide not to hospitalize her in that situation. ## CODE STATUS: DNR/DNI EMERGENCY CONTACT: [**Name (NI) 4906**] [**Name (NI) **] [**Telephone/Fax (1) 105717**] Medications on Admission: Albuterol Sinemet 25-100 TID Lasix 40 mg [**Hospital1 **] glyburide 5 mg daily lisinopril 5 mg [**Hospital1 **] singulair 10 mg daily protonix 40 mg daily pramipexole 0.375 mg tid prazosin 2 mg [**Hospital1 **] simvastatin 10 mg daily (Although not confirmed with patient at time of admission--per discharge from [**1-/2169**], was also on digoxin, metoprolol, and coumadin) Discharge Medications: 1. Ipratropium Bromide 0.02 % Solution Sig: One (1) neb Inhalation Q6H (every 6 hours) as needed. 2. Carbidopa-Levodopa 25-100 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 3. Furosemide 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Lisinopril 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Singulair 10 mg Tablet Sig: One (1) Tablet PO once a day. 6. Pantoprazole 40 mg Recon Soln Sig: One (1) Recon Soln Intravenous Q24H (every 24 hours). 7. Pramipexole 0.125 mg Tablet Sig: Three (3) Tablet PO TID (3 times a day). 8. Prazosin 2 mg Capsule Sig: One (1) Capsule PO twice a day. 9. Simvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 10. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 11. Acetaminophen 650 mg Suppository Sig: One (1) Suppository Rectal Q6H (every 6 hours) as needed for fever. 12. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed. 13. Heparin, Porcine (PF) 10 unit/mL Syringe Sig: One (1) ML Intravenous PRN (as needed) as needed for line flush. 14. Ceftriaxone in Dextrose,Iso-os 2 gram/50 mL Piggyback Sig: Two (2) g Intravenous Q24H (every 24 hours) for 5 days. 15. Insulin Lispro 100 unit/mL Solution Sig: per sliding scale Subcutaneous ASDIR (AS DIRECTED). 16. Aspirin 81 mg Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Extended Care Facility: [**Hospital 169**] Center Discharge Diagnosis: Primary: biliary obstruction, bacteremia Secondary: likely cholangiocarcinoma, hypertension, atrial fibrillation, diabetes mellitus Type 2, coronary artery disease, Parkinson's disease, chronic diastolic CHF Discharge Condition: good, stable, at baseline mental status, afebrile Discharge Instructions: You were evaluated for fevers and lethargy and improved after ERCP. You are being treated for a bloodstream infection and will continue IV antibiotics for a few more days. You were evaluated by speech and swallow and were found to be at risk for aspiration; however, after discussion you declined a feeding tube and would rather eat despite the risk of aspiration. If you have fevers, chills, chest pain, shortness of breath, confusion, episodes of loss of consciousness, or any other concerning symptoms, have the doctors at rehab [**Name5 (PTitle) 4656**] you. Followup Instructions: Follow up with your primary care physician 1-2 weeks after discharge from rehab. ICD9 Codes: 4280
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Medical Text: Admission Date: [**2111-4-16**] Discharge Date: [**2111-4-23**] Date of Birth: [**2111-4-16**] Sex: M Service: NB HISTORY: Baby [**Name (NI) **] [**Known lastname 60813**] was born at 32 4/7 weeks with respiratory and issues of prematurity. The mother is a 37 year-old gravida 6, para 3 woman with prenatal screens; B positive, hepatitis B surface antigen negative, RPR nonreactive, Rubella immune, antibody negative. Prenatal course significant for the following: 1. Severe polyhydramnios with a maximum AFI of 53. Normal stomach was noted and a normal abdominal wall was noted. 2. Large for gestational age. Fetal ultrasound results were as follows. Ultrasound at 20 showed an AFI for 20 with an estimated fetal weight of the 84th percentile. At 23 weeks AFI was 45 with an estimated fetal weight in the 94th percentile. At 26 weeks AFI of 40, estimated fetal weight of 87th percentile. At 29 weeks AFI of 46, estimated fetal weight in 98th percentile. 3. Mild ventriculomegaly noted at 26 week ultrasound with lateral ventricles measuring 11 mm. A 29 week ultrasound also showed mild ventriculomegaly with lateral ventricles measuring 13 mm bilaterally and a prominent cavum septum pellucidum. An MRI on [**3-3**] which was at 29 weeks was consistent with ultrasound report and frontal horns were noted to be slightly squared in appearance. There was an unclear etiology of the ventriculomegaly. No other abnormal brain findings were noted. 4. Mother was on bed rest at 27 weeks and admitted at 28 weeks with preterm labor. At that point she received magnesium and was made betamethasone complete and the preterm labor stopped. 5. Advanced maternal age. However, declined triple screen and amniocentesis. 6. Anticardiolipin antibody weekly positive and treated with heparin until 14 weeks gestation followed by baby aspirin until 24 weeks gestation. Mother now presents with lower abdominal pain with an ultrasound showing bulging membranes elected to deliver infant in the setting of severe polyhydramnios. Infant was admitted to the NICU: PHYSICAL EXAMINATION: On admission weight 2680 grams, length 48 cm, head circumference 33.25 cm. These are all over the 90th percentile. Heart rate 160s, respiratory rate in the 60's, oxygen saturation on room air 75%, blood pressure of 83/47 with temperature of 97.8. Infant is pink and active, nondysmorphic facies. Anterior fontanelle is open and full. Palate is intact. Petechiae were noted on the hands. There is normal S1 and S2, no murmur. Moderate to severe intercostal and subcostal retractions with poor aeration, grunting. Abdomen was slightly distended yet soft, no masses. Three vessel cord was noted. Very large umbilical cord. Extremities were well perfused. Tone was slightly increased in legs. Anus was patent. Testes descended bilaterally. Spine was intact and no bruising was noted. HOSPITAL COURSE BY SYSTEMS: 1. RESPIRATORY: Patient was intubated and received 2 doses of surfactant due to severe respiratory distress. On day of li fe #1 patient was extubated to room air and has remained on room air since day of life #1 with saturations greater than 93%. 2. CARDIOVASCULAR: The patient has been hemodynamically stable throughout his admission. 3. FLUID, ELECTROLYTES AND NUTRITION: Patient was initially n.p.o. on total fluid of 60 cc per kilo per day. Over the course of the first three days of life patient was noted to have an approximately 20 percent weight loss with urine output between 5 to 7 cc per kilo per hour. On day of life #2 the infant was started on feeding of 30 cc per kilo per day. Total fluids were advanced by day of life #4 to 160 cc per kilo per day due to persistent weight loss. Patient is currently on full feedings of breast milk 20 at 160 cc per kilo per day. Over the past three days he has had good weight gain, (currently is 2200 grams) and the polyuria has improved. Because of the weight loss and polyuria a renal consult was obtained. A renal ultrasound was performed which showed a dual collecting system but was otherwise normal. On day of life #6 a set of electrolytes were obtained and t he potassium was found to be 6.9. At that point endocrine consult was obtained due to concerns of congenital adrenal hyperplasia. On repeat testing of the electrolytes they wer e found to be normal with a potassium of 5.4. Repeat again th is morning showed a potassium of 5.1. State screen, however, h as returned with a 17-hydroxyprogesterone value above the cutoff value and therefore the state screen was resent. A 17-hydroxyprogesterone as well as plasma renin activity and aldosterone were also sent to [**Hospital3 1810**] for [**Doctor Last Name **] er investigation. These results are pending at time of dictation. 4. GASTROINTESTINAL: Patient was started on phototherapy on day of life #3 for a bilirubin of 14.0/0.5. Phototherapy was stopped on day of life #6 and rebound bilirubin was 8.5/0.3. 5. INFECTIOUS DISEASE: Patient was initially started on ampicillin and Gentamicin due to preterm labor. CBC and blood culture were obtained. CBC was benign and blood culture was negative at 48 hours and therefore antibiotics were discontinued. 6. NEUROLOGIC: Due to ventriculomegaly noted on prenatal ultrasound a head ultrasound was performed on day of #1 and was essentially normal with the exception of a large septum cavum pellucidum. CONDITION ON DISCHARGE: Good. NAME OF PRIMARY CARE PEDIATRICIAN: Unknown at this time. FEEDINGS AT DISCHARGE: Patient is currently on break milk 20 calories per ounce at 160 cc per kilo per day. MEDICATIONS: Patient is currently receiving no medications. STATE NEWBORN SCREENING: Initial newborn screen returned with an elevated 17-hydroxyprogesterone and therefore screening was resent on day of this dictation. DISCHARGE DIAGNOSIS: 1. Prematurity at 32 4/7 weeks. 2. Polyhydramnios. 3. Respiratory distress syndrome, resolved. 4. Hyperbilirubinemia, resolved. 5. Rule out sepsis, resolved. 6. Weight loss of nearly 20 percent from birth. [**First Name4 (NamePattern1) 487**] [**Last Name (NamePattern1) 37305**], MD [**MD Number(2) 59540**] Dictated By:[**Last Name (NamePattern1) 58671**] MEDQUIST36 D: [**2111-4-23**] 12:15:05 T: [**2111-4-23**] 14:09:46 Job#: [**Job Number 60814**] ICD9 Codes: 769, 7742, V290
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Medical Text: Admission Date: [**2129-4-8**] Discharge Date: [**2129-4-15**] Date of Birth: [**2059-3-27**] Sex: F Service: HISTORY OF PRESENT ILLNESS: Patient is a 70-year-old female with a history of coronary artery disease suffered an acute myocardial infarction in [**2128-4-14**], and she was taken to catheterization laboratory and found three vessel disease with successfully stented left anterior descending artery, found to have left ventricular diastolic dysfunction with a preserved ejection fraction of 57% with anterior apical dyskinesis and anterolateral hypokinesis. In [**2128-11-14**], the patient returned to [**Hospital3 **] for chest pain. Catheterization revealed totally occluded left anterior descending artery with brachytherapy. Echocardiogram in [**2128-11-14**] showed an ejection fraction of 50%, mild symmetric left ventricular hypertrophy with hypokinetic anterior wall and kinetic anteroseptal wall, hypokinetic anterior apex, akinetic septal apex, and lateral apex and akinetic apex, 1+ mitral regurgitation. The patient was admitted to an outside hospital for a GI bleed, where aspirin and Plavix were discontinued upon the outside hospital. The patient is found to have "several ulcers". EGD performed with cauterization of lesions. The patient is discharged home 48 hours. On the morning of admission, she awoke, had a bowel movement, and shortly after that, she developed severe substernal chest pain [**6-23**] radiating to the back, positive diaphoresis, no nausea or vomiting. The patient took nitroglycerin x3 with no relief and called EMS. Electrocardiogram was 3-[**Street Address(2) 1755**] elevations in leads V2 through V4. Morphine, Heparin drip, and nitroglycerin drip were started. REVIEW OF SYSTEMS: The patient with one pillow orthopnea. No change in weight. She has dyspnea on exertion with walking one block, no stairs. FAMILY HISTORY: Mother has diabetes. Father has coronary artery disease. Died at age 56 of a myocardial infarction. SOCIAL HISTORY: A half pack per day smoker. No alcohol, seven children, divorced, former telephone operator. PAST MEDICAL HISTORY: 1. Coronary artery disease in [**2129-11-14**], received brachytherapy through a restented left anterior descending artery, instent restenosis in [**2128-4-14**], stented left anterior descending artery. 2. Lower back pain. 3. Congestive obstructive pulmonary disease/asthma, O2 dependent at night. 4. Gastrointestinal bleed status post esophagogastroduodenoscopy with cauterization. 5. Hyperlipidemia. 6. Peripheral vascular disease status post aorto-bifemoral bypass. 7. Congestive heart failure. 8. Hypothyroidism. 9. Hypertension. ALLERGIES: She has no known drug allergies. MEDICATIONS ON ADMISSION: 1. Aspirin 325 mg po q day. 2. Prednisone 10 mg po q day. 3. Atenolol 25 mg po q day. 4. Lisinopril 5 mg po q day. 5. [**Year (4 digits) **] prn. 6. Flovent two puffs q hs. 7. Serevent two puffs [**Hospital1 **]. 8. Diltiazem. 9. Lipitor 10 mg q day. 10. Compazine. 11. Plavix 75 mg q day. 12. Lasix 25 mg q day. 13. Vicodin. 14. Buthalital. 15. Isosorbide 30 mg q day. 16. Trazodone 100 mg q hs. 17. Prevacid 40 mg [**Hospital1 **]. LABORATORY VALUES ON ADMISSION: White blood cell count 16.5, hematocrit 29.7, platelets 250. Sodium 140, potassium 3.8, chloride 107, CO2 23, BUN 11, creatinine 0.6, glucose 97, calcium 8, phosphate 4, magnesium 1.6. On coronary artery catheterization, she had a 60% right coronary artery proximal lesion, 60% right coronary artery distal lesion, right posterolateral 100% stenosis, left anterior descending artery 100% occlusion proximal to previous stent, LCX without significant lesion. A postcatheterization electrocardiogram showed atrial flutter/fibrillation, left axis deviation, [**Street Address(2) 4793**] elevations in V2 through V4, T-wave inversions in V2 through VI, poor R-wave progression. VITALS ON ADMISSION: Temperature 99.0, heart rate is 82, blood pressure 98/48, respiratory rate 16, and oxygen 94% on 4 liters nasal cannula. In general, this is a frail appearing woman in no apparent distress, alert and oriented times three. HEENT: No lymphadenopathy, no jugular venous distention. Pupils are equal, round, and reactive to light. Cardiovascular: Faint heart sounds. Pulmonary: Bivalve sounds secondary to emphysematous changes. Abdomen is soft, nontender, nondistended no hepatosplenomegaly. Extremities: No edema, no pulses, dopplerable, no cyanosis or clubbing. HOSPITAL COURSE BY SYSTEMS: 1. Coronary artery disease/ischemia: The patient was found to have a large acute myocardial infarction. She received successful cardiac catheterization with stenting of the left anterior descending artery. In the post myocardial infarction period, she did have a period of tachycardia to 160s, which was found to be VT. For this she was bolused with lidocaine and put on a lidocaine drip. EP was consulted to assess the need for further EP studies and also defibrillator placement. The patient was talked to extensively and declined EP study, and pacemaker, and AICD placement at this time. To lower the risk of recurrent VT, she was placed on amiodarone 400 mg po q day, and additionally, she was sent home with [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] of Hearts monitor for which strips will be examined over the next two weeks by EP. She has an outpatient with this EP in approximately four weeks from discharge for followup and further discussion of risk of morbidity and mortality from cardiac arrhythmias. Nevertheless, after the first 24 hours, she did not have any recurrence of ventricular arrhythmias. She was kept on the lidocaine for the first 48 hours. The lidocaine drip was weaned off for 72+ hours prior to discharge, she was off lidocaine and had no further arrhythmic events. Pump: The patient had repeat echocardiogram in-house, which showed an ejection fraction of 25-35% reduced from the 50% before. This should be followed up. It is unclear how much of this is from damage versus myocardial stunning. It is possible the patient will recover from significant amount of ejection fraction in the future. Other systems: GI: She has a history of gastrointestinal bleed. We followed her hematocrit. There was no drop in hematocrit. No recurrent gastrointestinal bleed. She was kept on proton-pump inhibitor, and stool softeners. Heme: The patient did receive 1 unit of packed red blood cells for a decreased hematocrit, which was most likely secondary to the prior gastrointestinal bleed. She had no need for blood and her hematocrit was stable. Renal: The patient's renal function was stable. No acute issues. DISCHARGE MEDICATIONS: 1. Aspirin 325 mg po q day. 2. Plavix 75 mg po q day. 3. Prednisone 10 mg po q day. 4. Atenolol 25 mg po q day. 5. Lisinopril 5 mg po q day. 6. Fluticasone two puffs [**Hospital1 **]. 7. Salmeterol 1-2 puffs [**Hospital1 **]. 8. Lipitor 10 mg po q day. 9. Lasix 20 mg po q day. 10. Lansoprazole 30 mg po q day. 11. Levothyroxine 75 mcg po q day. 12. Spironolactone 12.5 mg po q day. 13. Amiodarone 400 mg po q day. 14. Levofloxacin 250 mg po q day for three days. 15. Prochlorperazine 25 mg prn. 16. Vicodin prn. 17. Bubatol prn. 18. Ativan prn. DISCHARGE DIAGNOSES: 1. Coronary artery disease. 2. Acute anterior myocardial infarction. 3. Congestive heart failure. 4. Ventricular arrhythmia. 5. Congestive obstructive pulmonary disease. 6. Hypertension. 7. Hyperlipidemia. [**First Name11 (Name Pattern1) 420**] [**Last Name (NamePattern4) 421**], M.D. [**MD Number(1) 422**] Dictated By:[**Last Name (NamePattern1) 1737**] MEDQUIST36 D: [**2129-4-14**] 15:24 T: [**2129-4-20**] 08:53 JOB#: [**Job Number 34496**] ICD9 Codes: 5990, 4280, 4271, 496, 4439
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Medical Text: Admission Date: [**2125-4-4**] Discharge Date: [**2125-4-25**] Date of Birth: [**2057-12-8**] Sex: M Service: CARDIOTHORACIC SURGERY HISTORY OF THE PRESENT ILLNESS: The patient is a 67-year-old gentleman transferred from [**Hospital 1474**] Hospital after a cardiac catheterization performed at that institution demonstrated severe aortic stenosis. He was initially seen there for increased shortness of breath over the past two months that was progressive with just about any activity, including tying his shoes. He was not complaining of chest pain but stated that he does have chest pressure that occasionally awakes him from sleeping. He has a two to three pillow orthopnea. He has not seen a doctor in a number of years prior to this presentation. PAST MEDICAL HISTORY: He, therefore, has no known past medical history of significance. REVIEW OF SYSTEMS: Negative for syncope, palpitations, shortness of breath at rest, stroke. He has no diabetes. No hypertension. No history of cancer. At the outside hospital, he underwent an echocardiogram that demonstrated an aortic valve area of 0.8 cm squared and a peak gradient of 79. The EF was 10-20%, mild left ventricular hypertrophy, moderate aortic stenosis, and moderate aortic regurgitation. He also had moderate mitral regurgitation and pulmonary hypertension. Cardiac catheterization demonstrated normal coronaries with PA pressures of 83/36 and a wedge of 52. By catheterization, his [**Location (un) 109**] was 0.5 cm squared with a peak gradient of 88 and a mean gradient of 61. At the outside hospital, his white count was 8.4, hematocrit 47.2, platelets 265,000. Coagulation studies were within normal limits as were his chemistries. He had a carotid ultrasound that demonstrated no lesions. The patient was subsequently transported to the [**Hospital6 2018**] for further workup. TRANSFER MEDICATIONS: 1. Enteric coated aspirin 325 mg p.o. q.d. 2. Lansoprazole 30 mg p.o. q.d. 3. Lasix 60 mg IV q.d. 4. Colace 100 mg p.o. b.i.d. PHYSICAL EXAMINATION ON ADMISSION: Vital signs: Afebrile at 97.8, heart rate 72, blood pressure 120/70, respiratory rate 18, saturating 95% on 2 liters nasal cannula. General: The patient was in no acute distress. HEENT: The mucous membranes were moist. There was no erythema. The pupils were equal, round, and reactive to light and accommodating, anicteric. Neck: Supple with no lymphadenopathy or jugular venous distention. Lungs: Clear. Heart: Regular. He had a III/IV systolic murmur radiating to the carotids. Abdomen: Soft, nontender, nondistended. Extremities: Warm, well perfused with trace edema. HO[**Last Name (STitle) **] COURSE: The patient was initially admitted to the Medical Service where he was optimized on his cardiac medications prior to going to the Operating Room on [**2125-4-6**] with Dr. [**Last Name (Prefixes) **] where he underwent an uncomplicated aortic valve replacement with a #23 pericardial tissue valve as well as a mitral valve repair with a #20 annuloplasty band. The intraoperative echocardiogram demonstrated mild to moderately depressed right ventricle. He was transported to the CRSU intubated on milrinone at 0.5 and Levophed at 0.04. He stayed intubated and his pressors were slowly weaned but he remained on the milrinone. The first couple of days postoperatively, he had several episodes of atrial fibrillation for which he was started on an Amiodarone drip. By postoperative day number three, he was just on the Amiodarone as well as Lasix to help with his diuresis. At one point, he actually required nitroprusside in order to bring down his pressure. He developed a high fever and without an identifiable source the Infectious Disease Service was consulted. They determined that one possible source could be an infected tooth and, therefore, recommended a Dental consult. The decision was made to anticoagulate the patient. [**Doctor Last Name 412**] [**Last Name (Prefixes) 413**], M.D. [**MD Number(1) 414**] Dictated By:[**Last Name (NamePattern1) 3801**] MEDQUIST36 D: [**2125-4-25**] 04:10 T: [**2125-4-25**] 18:30 JOB#: [**Job Number 49543**] ICD9 Codes: 4280, 9971, 5119, 5849, 7907
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Medical Text: Admission Date: [**2126-11-13**] Discharge Date: [**2126-12-4**] Date of Birth: [**2072-5-27**] Sex: M Service: MEDICINE Allergies: Rocephin Attending:[**First Name3 (LF) 2485**] Chief Complaint: transfer from outside ICU Major Surgical or Invasive Procedure: none History of Present Illness: 54 yo gentleman with a history of DM type I, recent pna, and probable lymphoma who presented to OSH after being d/c'd on home oxygen and abx on [**10-26**] for pna, during that admission large axillary and supraclavicular lymph nodes were noted and biopsied [**10-21**] (frozen section w/reactive ln's, final path still pending?), represented on [**11-4**] after 4 days of fatigue, dyspnea and cough, also having loose stools. Was admitted on [**11-4**] with ? post obstructive pna, treated with gatiflox. CXR showed bilateral infiltrates with left effusion and wbcc of 23. Sputum cx showed rare normal flora and yeast, repeat stain showed rare gram positive rods. Ambisome was started [**11-7**] for yeast in sputum. Was tx to ICU on [**11-10**] and intubated on [**11-11**] after desating 80%'s on 100% NRB and tiring, he also had increased secretions at that time, tachycardic. On [**11-11**] after intubation and sedation w/propofol, bp had to be supported with neo, abx zosyn and vanomycin were added with steroids. Was paralyzed with norcuron [**1-7**] to labile sats w/motion and for bronch done [**11-12**], BAL pending. Per OSH they were concerned with PIP's in the high 30's low 40's and started pressure control ventilation, with rate of 14, pressure of 28, peep 10, FiO2 0.9 was as low as 0.6 at one point, hct dropped from 31.8 to 25.2 and recieved 1 u prbc's. High glucose likely [**1-7**] steroids and was briefly on insulin gtt. Tx to [**Hospital1 **] ICU for "more intensive care". Past Medical History: diabetes b total knee replacements abdominal wall abcesses drained Social History: smoked two packs of cigarettes qd for 35 years quit on 2nd admission, words as courier, no h/o EtOH or illicits documented. One dtr w/[**Name2 (NI) **] bifida in nursing home, finace [**Doctor First Name **] is hcp [**Telephone/Fax (1) 59440**]. Family History: mother w/ br ca, father w/ [**Name2 (NI) **]a and cad Physical Exam: VS: 98.3, 130, 143/69, 18, 97% on PCV of 30, PEEP 8, rr 18, FiO2 0.6, TV's 490's Gen: intubated, paralyzed HEENT: scleral edema, perrl, mmd Neck: L supraclavicular lymph node palpable, RIJ in place, dressing c/d/i CV: rrr, tachycardic, no m/r/g Pulm: coarse bs bilaterally, very decreased on L as compared to R Abd: s, nd, no bowel sounds Groin: R inguinal lymph nodes palpable Extr: trace edema to feet bilaterally, warm, +2 dp bil Skin: rash to inner thighs and interrigenous folds Neuro: paralyzed Pertinent Results: [**2126-11-13**] 11:14PM BLOOD WBC-29.0* RBC-4.62 Hgb-11.7* Hct-38.5* MCV-83 MCH-25.4* MCHC-30.4* RDW-15.9* Plt Ct-394 [**2126-11-13**] 11:14PM BLOOD Neuts-96.2* Lymphs-2.4* Monos-1.3* Eos-0 Baso-0.1 [**2126-11-13**] 11:14PM BLOOD Plt Ct-394 [**2126-11-13**] 11:14PM BLOOD PT-14.3* PTT-22.4 INR(PT)-1.3 [**2126-11-13**] 11:14PM BLOOD Ret Man-PND [**2126-11-13**] 11:14PM BLOOD ALT-50* AST-55* LD(LDH)-303* CK(CPK)-24* AlkPhos-128* Amylase-25 TotBili-1.0 [**2126-11-13**] 11:14PM BLOOD Lipase-14 [**2126-11-13**] 11:14PM BLOOD Albumin-2.9* Calcium-9.1 Phos-6.1* Mg-2.5 Iron-123 [**2126-11-13**] 11:14PM BLOOD calTIBC-176* Ferritn-1342* TRF-135* [**2126-11-13**] 11:14PM BLOOD TSH-0.66 [**2126-11-14**] 02:58AM BLOOD Type-ART Rates-26/4 Tidal V-400 PEEP-8 FiO2-100 pO2-127* pCO2-62* pH-7.31* calHCO3-33* Base XS-3 AADO2-534 REQ O2-88 -ASSIST/CON Intubat-INTUBATED [**2126-11-13**] 11:55PM BLOOD Type-ART Temp-37 Rates-14/ Tidal V-600 PEEP-10 FiO2-97 pO2-88 pCO2-77* pH-7.26* calHCO3-36* Base XS-3 AADO2-536 REQ O2-88 Intubat-INTUBATED * Brief Hospital Course: A: 54 yo man with h/o type I diabetes mellitus and 50pack year tobacco use transferred from outside hospital with hypoxic respiratory failure. During hospitalization the following problems were addressed: 1) respiratory distress: The cause of his respiratory failure remains undiagnosed, but his presentation is concerning for infection vs. malignancy with lymphangetic spread. Lymph node biopsy from the OSH was read as polyclonal T cell proliferation consistent with reactive lymphadenopathy. Later, the pleural fluid from the OSH came back as concerning for malignancy. He underwent bronchoscopy 3 times, which showed no infection, cytology negative. Bacterial, AFB cultures negative, stain for PCP and AFB were also negative. He had CT scan of his abdomen, chest, and pelvis, which showed diffuse lymphadenopathy but of only modestly enlarged size and not typical of lymphoma, chest wall hypodensities of unknown etiology, abdominal wall hypodensities c/w hematoma, and a small right adrenal hyperdensity. On day 7 of hospitalization after the pleural fluid came back concerning for malignancy, a bone marrow biopsy was done. He was treated with a ______ day course of levofloxacin, vancomycin, and azithromycin for a possible post-obstructive pneumonia. Although he continued to produced copious thick sputum, cultures were nondiagnostic. On day 6 of hospitalization, and day 8 on the ventilator he was evaluated for tracheostomy. He did not recieve one as his resp status contiued to decline and is overall prognosis was poor 2. Hypotension: On day two of hospitalization the patient became acutely hypotensive requiring pressor support. Echocardiogram showed increased pulmonary artery pressure and a lesion in the PA that was confirmed by CT. PA-gram was done to rule out an evolving PE; it was negative. He was treated initially with levophed, then for a day with neosynephrine and vasopressin on day #3 when he became acutely tachycardic and went transiently into A-fib. He converted back to sinus rhythm, neosynephrine was weaned off and levophed started. Cardiac output as determined by mixed venous O2 saturation was found to be adequate, suggesting his hypotension was due more to distributive physiology than cardiogenic shock, despite his obvious right sided failure due to pulmonary artery hypertension. It was felt that the PAH resulted from the intrapulmonary process. 3. Lymphadenopathy: biopsy from [**2126-10-21**] at [**Hospital 1474**] Hospital showed reactive nodes of polyclonal T cell morphology. RPR was nonreactive, HIV negative, HTLV pending. Oncology was consulted for recommendations of further work-up and treatment. 4. Tachycardia: The patient was tachycardic on day 2 and transiently in atrial fibrillation. On day 5 of admission, he developed transient episodes of multifocal atrial tachycardia. 5. Type I diabetes mellitus: He was maintained on an insulin gtt 6. Nutrition: he received tubefeeds by OG tube. On day ___ he had a PEG placed for continued tubefeeds. 7. Communication: the patient's fiance [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 9418**] is his designated health care proxy, official documentation noted. 8. Sedation: he was maintained on versed and fentanyl. Initially off sedation the patient became very agitated resulted in tachycardia and decreased oxygen saturation. 9. Access: the patient came with a R IJ from the OSH. A-line placed on the morning following admission. 10. Skin rash: On day 2 the patient developed what appeared to be a drug reaction on his abdomen. The rash spread to his thighs bilaterally, feet and hands. On day 4 he was found to have pustular lesions on his right foot, and desquamation on his thighs and backside. Dermatology was consulted and suggested he had tinea cruris. He was treated with topical antifungals and improved. 11. Care Plan: The family and attending had a meeting on [**12-3**] and decided to make the paitent CMO since his overall prognosis was poor. He was extubated in the presence of his family on [**12-4**] and expired shortly thereafter. Medications on Admission: tequin 400 mg iv qd zosyn 3.375 mg iv q 6 vanco 1.5g iv q 12 pepcid 20 mg iv q 12 solumedrol 80 mg iv q 8 propofol gtt to sedation vecuronium gtt to paralysis ambisome 300 mg iv qd MSO4 2 mg iv q4 hr prn regular insulin sliding scale Discharge Disposition: Expired Discharge Diagnosis: respiratory failure diffuse large B cell lymphoma Discharge Condition: expired Followup Instructions: none ICD9 Codes: 486, 4280, 4271, 5180, 2760, 4589, 4168, 2768
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Medical Text: Admission Date: [**2128-10-21**] Discharge Date: [**2128-10-23**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 99**] Chief Complaint: Change in mental status Major Surgical or Invasive Procedure: None History of Present Illness: Patient is a [**Age over 90 **] year old gentleman with a history of high blood pressure and possible lung cancer who presented from his nursing home today with change in mental status. The patient was noted to be lethargic at his nursing home today. His grandson came to visit him and reported the patient could not speak. He was sent to the ED where a blood sugar was 25. Patient was given one amp of D50 and a subsequent blood sugar was 300. Potassium was 6.3 and the patient was given one amp of D50, 10 units of insulin, calcium gluconate and bicarbonate. One hour later her blood sugar was 37. He received one amp of D50 and his blood sugar was 113. He was started on D10 at 150 an hour. One hour later his blood sugar was 80. His nursing home was called and reported that his roomate took sulfonylureas. In the ED the patient also received vancomycin, ceftazadime, one liter of normal saline and kayexalate. [**Hospital1 336**] was called and gave the patient's pmhx and med list. [**Name (NI) **] grandson reports that the patient has been living in a nursing home since [**Month (only) **]. Prior to that he lived with his daughter, but he has become harder to care for at home, and his family does not feel that he is safe at home without constant supervision. According to his grandson his memory is good, but he is sometimes forgetful. He does not wander. He feeds himself but does not cook or prepare food. He has been walking less and less. He is DNR/DNI and would not want any aggressive measures or surgery. He has had several recent hospitalizations at [**Hospital1 336**] for GI bleed and hyponatremia. ROS: Denies abdominal pain, fevers, shortness of breath. Past Medical History: 1. Hypertension 2. Probable lung cancer (not biopsy proven) 3. Bronchitis 4. Hyponatremia 5. Dementia 6. GI bleed [**7-9**] Social History: Lives in a nursing home. Widowed. Has two children who are very supportive. No alcohol. Remote tobacco use. Family History: Noncontributory Physical Exam: VS: T 97.3 HR 82 BP 184/81 RR 18 O2 sat 100% RA Gen: Well appearing, thin, comfortable, lying in bed in NAD. HEENT: PERRL, EOMI, sclera anicteric, MMM. Neck: No LAD, JVD or thyromegly. CV: RRR with no m/r/g Lungs: CTA bilaterally Abd: soft, NT, ND active BS, no hepatosplenomegly. ext: No clubbing, cyanosis or edema. Neuro: back to baseline per daughter Pertinent Results: [**2128-10-21**] 04:46PM BLOOD WBC-12.8* RBC-3.85* Hgb-12.1* Hct-34.9* MCV-91 MCH-31.4 MCHC-34.6 RDW-16.0* Plt Ct-299 [**2128-10-21**] 04:46PM BLOOD Plt Ct-299 [**2128-10-21**] 04:46PM BLOOD PT-12.0 PTT-24.2 INR(PT)-1.0 [**2128-10-21**] 04:46PM BLOOD Fibrino-503* [**2128-10-21**] 04:46PM BLOOD UreaN-47* Creat-2.5* K-6.3* [**2128-10-21**] 04:46PM BLOOD ALT-14 AST-23 LD(LDH)-226 CK(CPK)-21* AlkPhos-113 Amylase-258* TotBili-0.2 [**2128-10-21**] 04:46PM BLOOD Lipase-108* [**2128-10-21**] 04:46PM BLOOD CK-MB-NotDone cTropnT-<0.01 [**2128-10-21**] 04:46PM BLOOD Albumin-3.7 Calcium-9.3 Phos-3.1 Mg-2.2 [**2128-10-21**] 04:46PM BLOOD ASA-NEG Ethanol-NEG Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG [**2128-10-23**] 05:00AM BLOOD WBC-11.7* RBC-2.89* Hgb-9.6* Hct-26.7* MCV-92 MCH-33.3* MCHC-36.0* RDW-17.3* Plt Ct-235 [**2128-10-23**] 05:00AM BLOOD Plt Ct-235 [**2128-10-23**] 05:00AM BLOOD Glucose-153* UreaN-35* Creat-1.7* Na-134 K-4.2 Cl-101 HCO3-24 AnGap-13 LIVER OR GALLBLADDER US (SINGLE ORGAN) [**2128-10-21**] 6:43 PM: RIGHT UPPER QUADRANT ULTRASOUND: Examination limited secondary to patient's inability to follow breath-hold instructions. The liver is grossly normal in echotexture and contour. No focal liver lesions are identified. There is no intrahepatic biliary ductal dilatation. The gallbladder is not distended. Several gallstones are identified. There is no gallbladder wall edema. There is no pericholecystic fluid or ascites identified. The common bile duct measures 6 mm which in a patient of age [**Age over 90 **] is normal. Limited assessment of the hepatic vasculature shows patent hepatic and portal veins with normal direction of flow. The visualized pancreas shows a 2-mm pancreatic duct. IMPRESSION: 1. Limited examination secondary to patient's inability to hold his breath. 2. Patent hepatic vasculature as described above. 2. Cholelithiasis without evidence for cholecystitis. CHEST (PORTABLE AP) [**2128-10-21**] 5:20 PM: FINDINGS: Cardiac and mediastinal contours are normal. The aorta is tortuous and calcified. Patchy opacity is seen at the left lung base with obscuration of the medial left hemidiaphragm. Pulmonary vasculature appears normal. There is no pneumothorax. Osseous structures are unremarkable. IMPRESSION: Patchy left lower lobe opacity may represent atelectasis or early pneumonia. CT HEAD W/O CONTRAST [**2128-10-21**] 4:46 PM: FINDINGS: No acute intra- or extra-axial hemorrhage is identified. There is no mass lesion, shift of normally midline structures, or evidence for major vascular territorial infarction. There is prominence of the ventricles and sulci consistent with age-appropriate involutional change. Hypodensities are seen in the periventricular white matter consistent with chronic small vessel infarction. A small hypodensity is seen in the right side of the pons consistent with old infarction. The remainder of the brain parenchyma has normal density with preservation of the [**Doctor Last Name 352**]-white matter differentiation. No fractures are identified. There is bilateral maxillary sinus mucosal thickening versus fluid. The remaining visualized paranasal sinuses and mastoid air cells are well pneumatized. The soft tissue structures are unremarkable. IMPRESSION: No evidence for intracranial hemorrhage or mass lesion. Old right pontine infarction. Periventricular small vessel ischemic changes. CHEST (PORTABLE AP) [**2128-10-22**] 5:06 AM: The patient's right arm obscures the lower chest. There is a suggestion of consolidation at the right lung base, which may represent an evolving pneumonia. Upper lungs are clear. The heart is top normal size. There is no large pleural effusion or indication of pneumothorax or central adenopathy. Leftward deviation of the trachea at the thoracic inlet could be due to tortuous head and neck vessels and/or enlargement of the right lobe of the thyroid gland. Brief Hospital Course: [**Age over 90 **] year old man with history of hypertension and possible lung cancer presents with change in mental status and persistent hypoglycemia. 1) Change in mental status: Most likely due to hypoglycemia. Head CT was negative for any acute intracranial process. Resolved quickly with glucose replacement. Patient is Cantonese peaking and was able to communicate effectively with his family members and through the translator. 2) Persistent hypoglycemia: Differential includes erroneous medications (patient may have taken his roomate's sulfonylurea or insulin), paraneoplastic phenomenon, salicylates, tumor producing insulin like growth factor, sepsis, adrenal insufficiency, or insulinoma. Most likely would be a medication error resulting in sulfonylurea dosing. Would expect this to cause prolonged hypoglycemia since the patient has renal impairment. Pt was treated with octreotide to reverse hypoglycemia. Hypoglycemia corrected over the next 10 hours. As patient remained stable, additional labs such as serum insulin, C peptide, and proinsulin levels to evaluate for insulinoma vs surreptitious insulin dosing were not obtained. Sulfonylurea levels were not sent. [**Last Name (un) **] stim test to r/o sepsis and adrenal insufficiency was not performed as patient's hypoglycemia resolved. Patient will be discharged back to his skilled nursing facility. Extra precautions should be taken to avoid medication errors. 3) Renal insufficiency: Patient's Cr was 2.5 on admission, however, it was unclear if this is patient's baseline. BUN/creatinine ratio c/w pre renal etiology. Pt was hydrated; urine lytes were obtained. FeNa based on the urine electrolytes was 1.5%. Patient's Cr trended down during his admissiona and was 1.7 on day of discharge. Unfortuntely we were not able to speak to patient's PCP about his baseline renal function prior to discharge, but patient should be directed to follow-up with his PCP after he returns to the skilled nursing facility and have a serum creatinine level checked. 4) Hypertension: Chronic. Restarted outpatient medications. Patient's BP remained slightly elevated so we added HCTZ 25 mg po qd for tighter control. 5) Prophylaxis: Patient received pantoprazole for GI prophylaxis and wore pneumoboots for DVT prophylaxis while in-patient. Medications on Admission: 1. Aspirin 2. Llidocaine 3. Cardizem 4. Lopressor 5. Potassium 6. moxifloxacin Discharge Medications: 1. Metoprolol Tartrate 50 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 2. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 3. Lidocaine HCl 2 % Solution Sig: Ten (10) ML Mucous membrane DAILY (Daily). 4. Multivitamin Capsule Sig: One (1) Cap PO DAILY (Daily). 5. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 6. Ferrous Sulfate 325 (65) mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. Calcium Carbonate 1,250 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 9. Diltiazem HCl 120 mg Capsule, Sustained Release Sig: One (1) Capsule, Sustained Release PO DAILY (Daily). 10. Hydrochlorothiazide 25 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). Discharge Disposition: Extended Care Facility: [**Hospital1 2670**] - [**Location (un) **] Discharge Diagnosis: Primary diagnosis: Hypoglycemia Secondary diagnosis: Question of new renal insufficiency Hypertension Dementia Discharge Condition: Stable Discharge Instructions: 1. Please keep all follow up appointments. 2. Please take all medications as prescribed. 3. Seek medical attention for fevers, chills, chest pain, shortness of breath, change in mental status, or any other concerning symtpoms. Followup Instructions: Please follow up with the physician at your nursing home within one week of discharge. ICD9 Codes: 5849, 486, 4019
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Medical Text: Admission Date: [**2112-6-1**] Discharge Date: [**2112-6-8**] Date of Birth: [**2039-7-15**] Sex: F Service: HISTORY OF PRESENT ILLNESS: This is a 72-year-old female with a history of type 2 diabetes mellitus and hypertension who presented with confusion, lightheadedness, and malaise. The patient reported some visual hallucinations for approximately 10 months which were not mentioned during her earlier hospitalization in [**2111-12-12**]. She reports feeling thirsty but not urinating frequently. She admits to a 50-pound weight loss, increased fatigue, weak legs with minimal ambulation during the past two months. By report, the patient was a somewhat poor historian on initial evaluation. Initially, the patient was thought to have significant mental status changes, lethargy, and borderline unresponsiveness. In the Emergency Department, she was noted to be in acute renal failure with a creatinine increased to 5.8 from a baseline of 0.7. Her arterial blood gas was notable for a bicarbonate of 8. The patient was initially transferred to the Intensive Care Unit for immediate care and management. In the Intensive Care Unit, the patient was treated with Kayexalate with resolution of her hyperkalemia. The Renal team was consulted for acute renal failure and acidosis. Initially, there was some question if the patient had a renal tubular acidosis, specifically type 1, given her metabolic derangements. However, the patient responded immediately to intravenous fluids with her creatinine decreasing from 5.8 to 2 quickly, making prerenal acute renal failure the most likely diagnosis. Further history revealed the patient had some question of increased ostomy output, although there was no reported decrease in oral intake. Gastroenterology was consulted, .................... nongap acidosis possibly related to increased ostomy output. In addition, the patient had been on an ACE inhibitor prior to admission. PAST MEDICAL HISTORY: 1. Type 2 diabetes mellitus times 12 years. 2. Hypertension. 3. Lower gastrointestinal bleed secondary to diverticulosis; failed embolization requiring subtotal colectomy with ileostomy in [**2111-12-12**]. 4. Uterine fibroids. 5. Colonic polyps. MEDICATIONS ON ADMISSION: 1. Glipizide 10 mg once per day. 2. Glucophage 500 mg twice per day. 3. Lisinopril 5 mg once per day. PHYSICAL EXAMINATION ON PRESENTATION: Vital signs on initial presentation revealed a temperature of 98.1, her blood pressure was 125/52, her heart rate was 78, her respiratory rate was 11, and 97% on room air. An elderly female, lethargic. Head, eyes, ears, nose, and throat examination revealed atraumatic. The pupils were equal, round, and reactive to light. The mucous membranes were moist. The neck was supple. No lymphadenopathy. No thyromegaly. No jugular venous distention. Cardiovascular examination revealed a regular rate and rhythm. Normal first heart sounds and second heart sounds. A [**2-16**] diastolic murmur. Her lungs were clear to auscultation bilaterally. No crackles, wheezes, or rhonchi. Her abdomen was soft, nontender, and nondistended. Active bowel sounds. The ostomy was clean and intact. There was no costovertebral angle tenderness bilaterally. Her extremities were without edema. Her skin showed several seborrheic keratoses over the back, face, and chest. Her neurological examination was alert and oriented times three without asterixis. PERTINENT LABORATORY VALUES ON PRESENTATION: Notable for a creatinine of 5.8, her potassium was 7.5, and her lactate was 0.8. Urinalysis showed a specific gravity of 1.000, leukocyte esterase was negative, nitrites were negative, protein was negative, and glucose was negative. The patient's serum osmolalities were 322. Her urine creatinine was 0, sodium was less 10, urine osmolalities were 3. Her fractional excretion of sodium was initially greater than 1. RADIOLOGY/IMAGING FINDINGS: The patient had an electrocardiogram with a normal sinus rhythm in the 60s, normal axis, first-degree AV block, flat T waves in aVL, biphasic in V5 and V6. No ST segment changes. Read as unchanged from prior. Her renal ultrasound showed no hydronephrosis, stones, or masses. BRIEF SUMMARY OF HOSPITAL COURSE: This is a 72-year-old female with a past medical history of hypertension and type 2 diabetes times 12 years who presented with confusion and was noted to have acute renal failure. 1. ACUTE RENAL FAILURE ISSUES: The patient was initially evaluated in the Intensive Care Unit. There was some concern the patient had type 1 renal tubular acidosis; however, the patient responded quickly to intravenous hydration, and it was felt that this picture was most likely consistent with prerenal acute renal failure. The patient's creatinine returned to the 1.3 to 1.4 range from a peak of 5.8 quite quickly over several days with intravenous fluids. The patient was deemed stable enough to be transferred to the general medical floor on [**2112-6-3**]. At the time of transfer, her creatinine had improved to 2. The patient had several kidney studies including the renal ultrasound which was negative for obstruction. She had a serum protein electrophoresis and urine protein electrophoresis sent which were normal; to rule out multiple myeloma. In addition, she had urine eosinophils sent to evaluate for allergic interstitial nephritis which were negative. The patient had a urinalysis sent and a urine culture which was no growth to date. It was felt that the prerenal state was likely induced secondary to increased ostomy output. The ostomy output was followed closely and was noted to be in the normal range; approximately 1 liter to 1.5 liters per day. It was felt that the patient was likely just not keeping up with the by mouth fluid requirements given her ostomy output. The patient was encouraged to continue to take adequate by mouth hydration. The Gastroenterology Service had been consulted to further evaluate the ostomy. This will be discussed further down. 2. EXCESSIVE OSTOMY OUTPUT ISSUES: There was a concern raised that the patient was actually having excessive ostomy output which was causing her prerenal state. However, further observation revealed that the patient was simply not keeping up with her output. Gastroenterology did evaluate the patient with an ileoscopy and did not note any abnormalities. In addition, the patient had an endoscopy performed which noted several duodenal ulcerations. The patient was begun on a higher dose of Protonix 40 twice per day for eight weeks. She will continue this medication for eight weeks and then decrease to 40 mg by mouth every day. 3. TYPE 2 DIABETES MELLITUS ISSUES: The patient's by mouth hypoglycemics were discontinued on admission given her acute renal failure. As her renal failure improved, the patient was restarted on glipizide at initially 5 mg and then titrated up to 10 mg by mouth once per day. At the time of discharge, the patient was not taking her metformin. Her primary care physician, [**Last Name (NamePattern4) **]. [**Last Name (STitle) 10208**], was contact[**Name (NI) **] and was aware that the patient will need to have her fingerstick glucoses followed and will likely need to restart her Glucophage as an outpatient. 4. HYPERTENSION ISSUES: The patient had been on an ACE inhibitor which may have contributed to the prerenal picture. The ACE inhibitor was held during this admission. She was started on a beta blocker; 50 mg by mouth twice per day was the dose she was discharged on. This was also communicated to her primary care physician (Dr. [**Last Name (STitle) 10208**]. 5. ANEMIA ISSUES: The patient had iron studies sent which were borderline for anemia of chronic disease. The patient was continued on by mouth liquid iron. She did have one guaiac-positive stool during this hospital stay. It was felt that this was likely secondary to her duodenal ulcerations. The Gastroenterology Service stated that the patient should not need a small-bowel follow-through to further evaluate her anemia. 6. MENTAL STATUS CHANGES: The patient's mental status significantly improved with improvement of her renal failure. On discharge, the patient was alert and oriented. She felt nearly back to herself; not quite 100% but was ambulating without difficulty and eating a good by mouth diet. CONDITION AT DISCHARGE: Stable, eating a full diet, and ambulating without difficulty. DISCHARGE STATUS: To home with [**Hospital6 407**] services. [**Hospital6 407**] for home safety evaluation, blood pressure checks, fingerstick checks, and blood draw to check her creatinine. DISCHARGE DIAGNOSES: 1. Acute renal failure; prerenal. 2. Status post ileostomy. 3. Type 2 diabetes mellitus. 4. Hypertension. 5. Duodenal ulcerations. MEDICATIONS ON DISCHARGE: 1. Tylenol 325 mg one to two tablets by mouth q.4-6h. 2. Iron sulfate 300-mg liquid 5 mL by mouth twice per day. 3. Pantoprazole 40 mg one tablet by mouth twice per day times eight weeks then decrease to 40 mg by mouth once per day ongoing. 4. Glipizide 10 mg by mouth once per day. 5. Metoprolol 50 mg by mouth twice per day. DISCHARGE INSTRUCTIONS/FOLLOWUP: 1. The patient was to follow up with her primary care physician (Dr. [**Last Name (STitle) 10208**]. 2. She was aware that she needs to call Dr. [**Last Name (STitle) 10208**] for an appointment in the next week. 3. In addition, she will have followup by the [**Hospital6 1587**] for home blood pressure checks, as well as fingerstick checks to follow her glucose level, and a laboratory draw two days after discharge to follow up on her creatinine. 4. The [**Hospital6 407**] were advised that they should call these results to Dr. [**Last Name (STitle) 10208**] (her primary care physician) [**University/College 45471**] Health Center. Dr. [**Last Name (STitle) 10208**] can be contact[**Name (NI) **] at [**Telephone/Fax (1) 35879**]. [**Name6 (MD) 2415**] [**Last Name (NamePattern4) 3474**], M.D. [**MD Number(1) 3475**] Dictated By:[**Name8 (MD) 3482**] MEDQUIST36 D: [**2112-6-8**] 15:23 T: [**2112-6-8**] 18:01 JOB#: [**Job Number 45472**] ICD9 Codes: 5849, 2765, 2859
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Medical Text: Admission Date: [**2147-7-4**] Discharge Date: [**2147-8-23**] Date of Birth: [**2103-7-19**] Sex: F Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**Last Name (NamePattern1) 4377**] Chief Complaint: Left lower leg swelling Major Surgical or Invasive Procedure: hemodialysis left internal jugular hemodialysis catheter placement and removal right upper extremity PICC placement chemotherapy: 1st cycle fludarabine (50% dose due to renal function), 2nd cycle CHOP R Nephrosotomy and L renal stent placement R Nephrostomy and L stent removal History of Present Illness: 43 y.o women with a history of hepatitis C, recent lymph node biopsy on [**2147-6-9**] at [**Hospital3 **] hospital who presents today with left lower extremity redness and pain, who was then found to have severe hyperkalemia and acute renal failure. The patient recently was admitted to [**Hospital3 417**] hospital from [**2147-6-9**] to [**2147-6-13**] for an elective excisional biopsy of diffuse lymphadenopathy, most prominent in her left groin. Based on limited records, her creatinine was 0.9 at that time. She was then discharged from the hospital to a [**Hospital1 1501**] due to inability to ambulate, where she has been residing ever since. Today, at the [**Hospital1 1501**] her labs were checked and she was found to have a K of 7.8 and a creatinine of 9.9. The patient herself reports that she feels that her urine output has been decreasing lately along with some increased generalized edema. In the ED, initial VS were: 98.9 92 146/90 18 95% RA. On labs, her K was 8.6 and her creatinine was 10.6. She was given 10U of regular insulin and 1 amp of D50W for her hyperkalemia. She was also given a dose of vancomycin for a possible cellulitis. A left lower extremity ultrasound was negative for clot. Other notable labs include a uric acid level of 10.1 and a phosphate of 6.7. Nephrology was consulted and recommended that she be admitted to the MICU for medical management of her hyperkalemia. Her K after the above interventions dropped to 6.3, and given an EKG that did not show evidence of cardiac toxicity, dialysis was not initiated. On arrival to the MICU, patient's VS were 97.4 79 118/82 15 98% on RA Past Medical History: Hepatitis C hypertension Anxiety Depression myocardial infarction Bilateral lower extremity edema Irritable bowel syndrome Hemorrhoids Heroin abuse Borderline personality disorder Social History: IVDA, quit years ago according to patient, during a search of her belongings a significant amount of drug paraphenelia was found including a spoon, wrapping papers, and syringes. Current 1ppd smoker. No EtOH. Family History: NC Physical Exam: ADMISSION EXAM: General: somlenent, no acute distress HEENT: Sclera anicteric, dry mucous membranes, PERRL Neck: supple, JVP not elevated, mild left anterior cervical lymphadenoapthy CV: Regular rate and rhythm, normal S1 + S2, mild [**3-20**] mid systolic murmur best heard at RUSB. Lungs: Bibasilar crackles, R>L Abdomen: soft, non-distended, bowel sounds present, no organomegaly, no tenderness to palpation, no rebound or guarding. Dressing at inguinal site c/d/i. Significant bilateral inguinal lymphadenopathy. GU: foley in place Ext: Warm, well perfused, 2+ pulses, significant bilateral LE edema Neuro: GCS 14, oriented x3, moving all 4 extremities, otherwise unable to cooperate with neuro exam. DISCHARGE EXAM: General: alert, no acute distress HEENT: Sclera anicteric, dry mucous membranes, PERRL Neck: supple, JVP not elevated CV: Regular rate and rhythm, normal S1 + S2, no MRG Lungs: CTAB Abdomen: soft, slightly distended, bowel sounds present, no organomegaly, no tenderness to palpation, no rebound or guarding. GU: nephrostomy stent and Ext: Warm, well perfused, 2+ pulses, 1+ bilateral LE edema Neuro: alert and oriented x3, CN II-XII grossly intact, normal gait, normal muscle tone and buk Pertinent Results: ADMISSION LABS: [**2147-7-4**] 09:25PM BLOOD WBC-3.9* RBC-3.50* Hgb-9.4* Hct-30.2* MCV-86 MCH-26.9* MCHC-31.2 RDW-13.0 Plt Ct-266 [**2147-7-4**] 09:25PM BLOOD Neuts-66.6 Lymphs-23.2 Monos-8.5 Eos-1.5 Baso-0.1 [**2147-7-4**] 09:25PM BLOOD PT-10.0 PTT-30.9 INR(PT)-0.9 [**2147-7-5**] 03:02AM BLOOD Ret Aut-1.2 [**2147-7-4**] 09:25PM BLOOD Glucose-80 UreaN-70* Creat-10.6* Na-135 K-8.6* Cl-98 HCO3-22 AnGap-24* [**2147-7-4**] 09:25PM BLOOD CK(CPK)-169 [**2147-7-4**] 09:25PM BLOOD Calcium-9.0 Phos-6.7* Mg-3.2* UricAcd-10.1* [**2147-7-5**] 07:01AM BLOOD calTIBC-247* VitB12-578 Ferritn-200* TRF-190* [**2147-7-5**] 03:02AM BLOOD Osmolal-305 [**2147-7-5**] 03:02AM BLOOD Valproa-47* [**2147-7-4**] 09:25PM BLOOD ASA-NEG Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG [**2147-7-4**] 09:49PM BLOOD Lactate-1.2 URINE: [**2147-7-5**] 12:25AM URINE Color-Straw Appear-Clear Sp [**Last Name (un) **]-1.004 [**2147-7-5**] 12:25AM URINE Blood-NEG Nitrite-NEG Protein-TR Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-NEG pH-7.5 Leuks-MOD [**2147-7-5**] 12:25AM URINE RBC-1 WBC-2 Bacteri-FEW Yeast-NONE Epi-1 TransE-<1 [**2147-7-5**] 12:25AM URINE bnzodzp-NEG barbitr-NEG opiates-POS cocaine-NEG amphetm-NEG mthdone-NEG STUDIES: [**2147-7-4**] Lower extremity ultrasound: No DVT of the left lower extremity. [**2147-7-4**] CXR: 1. Retrocardiac opacity compatible with pneumonia or atelectasis 2. Prominence of the right hilus may be secondary to low lung volumes or hilar opacity. Suggest follow up radiographs, ideally with better inspiration. [**2147-7-5**] CXR: 1. Left IJ catheter in the mid SVC. 2. Mild pulmonary edema. [**2147-7-6**] 3:26 PM # [**Telephone/Fax (1) 103896**] CT CHEST, ABD & PELVIS W/O CON 1. Infiltrative soft tissue mass surrounding the retroperitoneal region, including the aorta, IVC, and presumably the ureters. This is likely secondary to lymphoma and would be expected to be the cause of the patient's bilateral renal obstruction. However, given the cortical thinning on the left, this is likely a chronic process. 2. Ground-glass opacities seen within the right upper lobe and right middle lobe suggestive of atypical infection. The typical consolidations seen with bacterial pneumonia are not evident on this examination. 3. Bilateral pleural effusions are moderate in size, slightly greater on the right and on the left, with associated atelectasis. [**2147-7-12**] 12:20 PM # [**Numeric Identifier 103897**] INTRO CATH RENAL 1. Successful uncomplicated placement of a left-sided 8 French x22 cm nephroureteral stent. 2. Successful uncomplicated placement of an 8 French nephrostomy tube in the right kidney. 3. A future study is recommended in [**3-17**] weeks to try to attempt reconversion of the right-sided nephrostomy tube to a nephroureteral stent and to try to further characterize the filling defect seen in the right renal pelvis, which could be an air bubble. [**2147-7-18**] 11:23 AM # [**Telephone/Fax (1) 103898**] RENAL U.S. IMPRESSION: Complete resolution of left hydronephrosis. Near-complete resolution of right hydronephrosis with only minimal residual hydronephrosis noted. [**2147-7-19**] Cardiovascular ECHO The left atrium and right atrium are normal in cavity size. No atrial septal defect is seen by 2D or color Doppler. 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 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. No masses or vegetations are seen on the aortic valve. Mild (1+) aortic regurgitation is seen. The mitral valve appears structurally normal with trivial mitral regurgitation. There is no mitral valve prolapse. The estimated pulmonary artery systolic pressure is high normal. There is no pericardial effusion. IMPRESSION: Mild aortic regurgitation with normal valve morphology. Normal biventricular cavity sizes with preserved global and regional biventricular systolic function. If clinically indicated, a transesophageal echocardiographic examination is recommended to assess aortic valve morphology. CLINICAL IMPLICATIONS: Based on [**2142**] AHA endocarditis prophylaxis recommendations, the echo findings indicate prophylaxis is NOT recommended. Clinical decisions regarding the need for prophylaxis should be based on clinical and echocardiographic data. [**2147-7-19**] Radiology MRI PELVIS W/O & W/CONT 1. 3.6-cm lymph node in the left external iliac chain has features concerning for a necrotic lymph node with probable secondary infection (suppurative lymph node). An 1.8-cm lymph in the left common iliac chain has similar characteristics, and also is concerning for a suppurative lymph node. 2. Edema and swelling of the left iliacus and obturator internus muscles is suggesting of an ongoing inflammatory or infectious process. 3. Compression of the left external iliac artery and vein due to the enlarged external iliac chain lymph node without evidence of thrombus or occlusion. 4. Extensive pelvic and inguinal lymphadenopathy. [**2147-7-21**] Radiology US UPPER EXTREMITY, SOFT TISSUE NODULE IMPRESSION: Multiple subcutaneous soft tissue nodules in the right and left upper extremity, suggestive of lymphomatous deposits/ lymph nodes in the soft tissues. If desired, these can be FNAed/biopsied under imaging guidance. [**2147-7-24**] Radiology MR THIGH W&W/O CONTRAST 1. Left inguinal lymphadenopathy, slightly progressed since the recent MRI one week ago. No new lesion identified, and no distal lymphadenopathy in the thigh. 2. Diffuse subcutaneous soft tissue swelling and edema is nonspecific but may represent lymphedema or cellulitis. Fluid tracks along the superficial fascia, but this is unlikely to represent fasciitis given the lack of fascial enhancement. Mild inter- and intramuscular edema representing mild myositis. 3. Diffuse patchy bone marrow signal abnormality likely represents red marrow, but osseous lymphomatous involvement is not excluded especially in the intertrochanteric regions bilaterally. [**2147-7-25**] Pathology Tissue: RIGHT ARM NODULE. Hematoma with early organization. No evidence of lymphoma. [**2147-7-27**] Radiology CT CHEST W/O CONTRAST IMPRESSION: No findings to suggest pulmonary infection with unchanged prominent lymph nodes as above. [**2147-8-12**] Abdomen and Pelvis IMPRESSION: 1. Decreased size of left retroperitoneal lymph node conglomerates and bilateral inguinal lymphadenopathy. 2. Right nephrostomy tube and left nephroureteral stent appropriately positioned with interval resolution of bilateral hydronephrosis. [**2147-8-21**] Antegradge nephrogram IMPRESSION: 1. Left antegrade nephrostogram demonstrated brisk passage of contrast through the left ureter into the urinary bladder. Mildly dilated left interpolar to lower pole calices, likely as a result of caliectasis. No left UPJ obstruction. Left NU stent was removed. 2. Right antegrade nephrostogram did not demonstrate hydroureteronephrosis. Brisk passage of contrast through the reter into the bladder. Right nephrostomy catheter was removed. ---------- MICRO: [**2147-7-5**] IMMUNOLOGY HCV VIRAL LOAD-FINAL - 23,720,478 IU/mL. [**2147-7-8**] IMMUNOLOGY HIV-1 Viral Load/Ultrasensitive-FINAL HIV-1 RNA is not detected. [**2147-7-12**] STOOL C. difficile DNA amplification assay-FINAL -NEGATIVE ---- [**2147-7-19**] 9:46 am STOOL CONSISTENCY: SOFT Source: Stool. **FINAL REPORT [**2147-7-21**]** C. difficile DNA amplification assay (Final [**2147-7-19**]): Negative for toxigenic C. difficile by the Illumigene DNA amplification assay. (Reference Range-Negative). FECAL CULTURE (Final [**2147-7-21**]): NO ENTERIC GRAM NEGATIVE RODS FOUND. NO SALMONELLA OR SHIGELLA FOUND. CAMPYLOBACTER CULTURE (Final [**2147-7-21**]): NO CAMPYLOBACTER FOUND. Cryptosporidium/Giardia (DFA) (Final [**2147-7-21**]): NO CRYPTOSPORIDIUM OR GIARDIA SEEN. --- BLOOD CULTURES: 5/22,26,27 all negative. 6/4,5,6,7,8,9,13 all negative ----- ECG - [**2147-7-31**] Sinus rhythm. Precordial T wave inversions of uncertain significance. Since the previous tracing of [**2147-7-28**] ventricular premature beat is not seen, the lateral T waves are improved, early precordial T wave abnormalities persist. Intervals Axes Rate PR QRS QT/QTc P QRS T 82 144 86 [**Telephone/Fax (2) 103899**] 35 ------- Brief Hospital Course: 43 yoF with h/o hepatitis C, HTN, IV drug use, and recent diagnosis of follicular lymphoma who initially presented with acute obstructive renal failure (s/p HD and R nephrostomy and L nephroureteral stent) with course complicated by fevers and left necrotic iliac lymph nodes. # Follicular Lymphoma: Final pathology showed follicular lymphoma, follicular growth pattern, cytological grade 1 of 3. New subcutaneous nodules were concerning for lymphomatous transformation, supported by increasing LDH. Pt had an excisional biopsy of R upper extremity subcutaneous nodule by general surgery on [**2147-7-25**], but these only showed organizing hematoma, perhaps from prior drug use. Choices for treatment were initially limited by Pt's profound obstructive renal failure. Pt was treated with fludarabine D1-5, dose-reduced to 50% normal and completed 2 cycles of R-CHOP when renal function resolved. [**2147-8-12**] CT abdomen showed interval improvement in retroperitoneal masses and improvement of bilateral hydronephrosis. Pt was discharged with acyclovir, fluconazole, and bactrim ss for ppx. She has an appointment with Oncologist Dr [**Last Name (STitle) 21628**] (ph:1-[**Telephone/Fax (1) 71494**] fax: [**Telephone/Fax (1) 83170**] address [**Last Name (NamePattern1) 103900**]. [**Hospital1 1474**], Mass) on [**9-11**]. # Healthcare associated pneumonia: Patient presented with fever and infiltrate on CXR. Pt was treated with vancomycin and pip/tazo 4.5g iv q6h d1 = [**7-10**] for full 8 day course with complete resolution of symptoms and radiographic resolution on repeat CXR. # Acute renal failure/obstructive uropathy: Pt presented in profound obstructive renal failure with Cr 10.6 and potassium 8.6. Pt was initally admitted to ICU, initially medically managed, then dialyzed and transferred to BMT service for further managment. Pt had uneventful placement of R nephrostomy tube and L nephro-ureteral stent placed by IR on [**2147-7-12**]. Pt had little urine output from L nephro-ureteral stent (~250mL over 16 hrs) but plentiful urine output from R nephrostomy (~2.4L over 16 hrs). L nephro-ureteral stent was capped per IR on [**2147-7-13**]. Given rapid improvement in Cr, down to 2.5 on [**2147-7-13**] morning w/out dialysis, further decreasing to 2.0 on [**2147-7-14**], Pt's HD line was discontinued w/out issue. Pt's Cr continues to improve to 1.1 on [**2147-7-24**] and ultimately down to baseline. Repeat renal ultrasound showed complete resolution of L hydronephrosis and almost complete resolution of R hydronephrosis. R nephrostomy was capped on [**2147-7-27**], On [**2147-8-21**], pt had IR evaluate the nephrostomy tubes via nephrostogram which showed no obstruction of R or L ureter, the nephrostomy tube and stents were removed without complication. Patient with good UOP and creatinine of 1.1 at time of discharge # UTI. Patient with positive UA. Ucx + E.Coli. Patient placed on macrobid 100 mg twice per day with instruction to take thru [**2147-9-7**] # Hyperkalemia - Secondary to the acute renal failure, treated with Kayexalate, insulin, and calcium gluconate prior to initiation of HD. No e/o EKG changes. Resolved with HD. K at time of discharge 5.5 # Altered mental status. Noted on admission. Differential diagnosis: uremia, hypoglycemia (although she was quite sleepy prior to getting insulin in the emergency room), accumulation of drugs including klonopin and dilaudid that she had been receiving due to her renal failure. Resolved with HD and mentating at baseline. # Chronic back pain / abdominal pain with possible radiculopathy. Pt is an active cocaine and heroin user.With initial pain consult evaluation, Pt was placed on hydromorphone IV, PO, and methadone, gabapentin, and lidocaine patch. Pt was titrated to methadone 10mg po tid, hydromorphone to 4mg po q4hrs prn. QTc monitored and within normal limits. Pt was strongly opposed any effort to taper her pain medications but after pt was rejected by facilities for having a much too high daily dilaudid requirement, patient was willing to half her Dilaudid dose from 8mg to 4mg every 4 hours. Will need outpatient pain medication taper. # Anxiety / agitation: Very labile behavior with hypothesized underlying personality disorder per psych. Pt was started on divalproex 250 mg PO BID, olanzapine 5mg po tid standing per psychiatry; clonazepam 1 mg PO TID for anxiety and lorazepam 1mg po tid prn. These medications should be tapered as an outpatient. She will follow up with her primary care doctor after discharge. # Normocytic Anemia: Hct initially downtrending, hemolysis labs negative. Nadir of 21.1 on [**2147-7-10**]. Likely related to underproduction in setting of underlying lymphoma/renal failure. Iron studies suggestive of anemia of chronic disease. No evidence of bleeding. HCT 26.8 on discharge. # HCV: HCV viral load 23 million. Pt has not been exposed to HBV. Pt's LFT have been normal. She will need outpatient hepatology follow up for active hepatitis C. # Drug abuse - Patient with current IV drug use. Pt was also using drugs in while hospitalized. Social work was consulted. Will need outpatient support program. Patient will follow up with PCP and pain specialist. # Disposition issues: Pt was homeless prior to admission. Her husband is also at [**Name (NI) 10246**], and they had a significant altercation while at [**Hospital1 18**]. Patient has been barred from several shelters/rehabs due to issues with continued heroin abuse and altercations w/ other residents. Rejected by [**Hospital1 10246**], [**Hospital **] hospital, [**Doctor Last Name **] house. As patient did not meet inpatient criteria after lengthy discussion patient was discharged to live with a friend in [**Name (NI) 5110**], MA per her request. # Follow-up The patient will follow up with her PCP, [**Name10 (NameIs) **] [**Name (NI) 103901**] (ph: [**Telephone/Fax (1) 10216**] fax:[**Telephone/Fax (1) 103902**] address:64 Main [**Location (un) 103903**] Mass)on [**2147-8-28**]. She will also meet with [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 12967**] for pain management. She will meet with Oncologist Dr [**Last Name (STitle) 21628**] in [**Hospital1 1474**] on [**9-11**], [**2147**]. TRANSITIONAL ISSUES: -needs continued chemotherapy for treatment of lymphoma -will need outpatient hepatology follow up for active hepatitis C -will need referral to drug abuse cessation program -taper pain medications -taper sedatives including lorazepam, clonazepam Medications on Admission: Dilaudid 2-4mg PO q3h prn pain. multivitamin 1 tab daily fluconazole 100mg daily depakote 250mg [**Hospital1 **] ativan 0.5mg [**Hospital1 **] prn kayexalate 30mg PO once on [**7-4**] klonopin 1mg tid colace 100mg [**Hospital1 **] hydroxyzine 100mg qhs Discharge Medications: 1. Scalp prosthesis Scalp Prosthesis Dispense: 1 2. docusate sodium 100 mg capsule Sig: One (1) capsule PO BID (2 times a day). 3. senna 8.6 mg tablet Sig: 1-2 Tablets PO BID (2 times a day) as needed for constipation. 4. clonazepam 1 mg tablet Sig: One (1) tablet PO TID (3 times a day): anxiety. Disp:*12 tablet(s)* Refills:*0* 5. divalproex 250 mg tablet,delayed release (DR/EC) Sig: One (1) tablet,delayed release (DR/EC) PO BID (2 times a day). Disp:*30 tablet,delayed release (DR/EC)(s)* Refills:*0* 6. fluconazole 200 mg tablet Sig: One (1) tablet PO Q24H (every 24 hours). Disp:*30 tablet(s)* Refills:*0* 7. hydroxyzine HCl 25 mg tablet Sig: Four (4) tablet PO at bedtime as needed for pruritis. Disp:*30 tablet(s)* Refills:*0* 8. acyclovir 400 mg tablet Sig: One (1) tablet PO Q8H (every 8 hours). Disp:*30 tablet(s)* Refills:*0* 9. sulfamethoxazole-trimethoprim 400-80 mg tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 10. olanzapine 5 mg tablet Sig: One (1) tablet PO TID (3 times a day). Disp:*15 tablet(s)* Refills:*0* 11. lorazepam 0.5 mg tablet Sig: One (1) tablet PO twice a day as needed for anxiety. Disp:*8 tablet(s)* Refills:*0* 12. nitrofurantoin monohyd/m-cryst 100 mg capsule Sig: One (1) capsule PO Q12H (every 12 hours): End date [**2147-9-7**]. Disp:*30 capsule(s)* Refills:*0* 13. hydromorphone 4 mg tablet Sig: One (1) tablet PO every [**5-19**] hours as needed for pain. Disp:*16 tablet(s)* Refills:*0* 14. gabapentin 300 mg capsule Sig: One (1) capsule PO TID (3 times a day). Disp:*30 capsule(s)* Refills:*0* 15. allopurinol 100 mg tablet Sig: Two (2) tablet PO DAILY (Daily). Disp:*30 tablet(s)* Refills:*0* 16. nicotine 14 mg/24 hr Patch 24 hr Sig: One (1) Transdermal once a day: Do not use with tobacco. If you are going to smoke, you must remove this patch due to risk of cardiovascular complications and death. Disp:*4 4* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Primary: pneumonia hyperkalemia, now resolved obstructive renal failure, now resolved follicular lymphoma Secondary: hepatitis C heroin use chronic back pain 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 because you had leg swelling and shortness of breath. You were found to have a large mass in your abdomen, later discovered to be follicular lymphoma, a type of cancer. This mass compressed both of your ureters and caused your kidneys to fail. When you arrived, you had dangerous high levels of potassium in your blood. You were treated with hemodialysis, and your condition stabilized. You then received a urinary stent in your left kidney and a nephrostomy in your right kidney. Your left kidney did not show much improvement in function, likely due to the chronic nature of the urinary obstruction. Your right kidney recovered very well. You were treated with chemotherapy, and you responded well to the initial two cycles. You were also treated for a pneumonia and had a full recovery. Your left leg and abdomen remain swollen, likely due to blockage of lymphatic drainage systems by your cancer. This should improve as your cancer responds to the chemotherapy. The kidney stent and kidney drain (nephrostomy) were removed and your kidney function has improved. Changes to your medications: To treat your pain, the following changes were made: Dilaudid 4 mg every 4-6 hours to treat pain Methadone will be dispensed at methadone clinic Gabapentin 300 mg three times per day **Do not take these medications while driving or drinking alcohol or using recreational drugs as these will cause sedation and possible death if used in combination **Please take stool softeners while taking narcotics because this can cause constipation** For smoking cessation, please take: Nicotine patch 14 mg, replace once daily ** Do not take nicotine patch with cigarettes due to cardiovascular risk and possible death. To prevent infection, the following changes were made: fluconazole 200 mg daily acyclovir 400 mg every 8 hours bactrim single strength tablet daily To treat your urinary tract infection, macrobid 100 mg twice per day, please take through [**2147-9-7**] To treat your mood, continue on olanzapine 5 mg three times per day Please take all your other medications as prescribed. Followup Instructions: 1) [**Hospital **] Clinic: 7 [**Hospital Ward Name 1826**] Outpatient Clinic @[**Hospital1 18**] Time: 12 pm (noon) tomorrow [**8-24**] 2) Dr. [**Last Name (STitle) **] (PCP): Monday [**8-28**] 2:00 pm [**Hospital1 1474**] Neighborhood Health [**Location (un) **] [**Hospital1 1474**], MA 3) [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) 103904**] (pain management): will see at [**Hospital1 1474**] Neighborhood Health 4) Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 21628**] (oncologist): [**9-11**] [**Hospital1 1474**] Neighborhood Health phone [**Telephone/Fax (1) 71494**] ICD9 Codes: 5849, 486, 2767, 412, 5990, 4019
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Medical Text: Admission Date: [**2162-1-31**] Discharge Date: [**2162-2-6**] Date of Birth: [**2103-7-7**] Sex: F Service: CCU HISTORY OF PRESENT ILLNESS: The patient is a 58-year-old female with a past medical history significant for insulin-dependent diabetes, hypertension, hypertriglyceridemia likely causing chronic pancreatitis, and peripheral vascular disease who was transferred from a outside hospital with an inferolateral ST-elevation myocardial infarction. The patient had no known prior coronary artery disease. She had a recent vascular surgery in [**2161-11-2**] for a left femoral to posterior tibialis bypass. Prior to that surgery, the patient had a preoperative stress test done with a Persantine MIBI and noted to have borderline electrocardiogram changes with no perfusion defects with a calculated ejection fraction of 62%. The patient had recovery of 0.5 mm to [**Street Address(2) 100598**] depressions during that stress test. On the morning prior to admission, the patient developed substernal chest pain which the patient describes as her first episode ever of chest pain that radiated to her back and her left arm. She denied any associated symptoms related to that. She called Emergency Medical Service and was sent to an outside hospital. Her electrocardiogram there showed inferior and lateral ST elevations with creatine kinases in the 400s, positive MB, and positive MB index with a troponin I of 15.5. The patient was transferred to [**Hospital1 188**] for emergent catheterization. On cardiac catheterization, the patient was noted to have 3-vessel disease including a 30% left main, 90% left anterior descending artery, 100% left circumflex, 50% right coronary artery, and occluded posterior descending artery and was treated with angioplasty. The patient's posterior descending was treated with percutaneous transluminal coronary angioplasty and noted to have normal flow with moderate-to-severe dissection requiring prolonged inflation. No stent was placed during the procedure, and the patient was sent to the Coronary Care Unit with an intra-aortic balloon pump with a plan for Cardiac Surgery to do a coronary artery bypass graft procedure in the next 48 to 72 hours. PAST MEDICAL HISTORY: (The patient's past medical history is as described in addition to) 1. Anemia of uncertain etiology. 2. Insulin-dependent diabetes. 3. Peripheral vascular disease; status post left femoral to posterior tibialis bypass. 4. Chronic pancreatitis. 5. No known coronary artery disease. 6. Peripheral neuropathy. 7. Hypothyroidism. 8. History of deep venous thrombosis. 9. History of methicillin-resistant Staphylococcus aureus to a left thigh wound in [**2161-12-3**]. 10. She is status post cholecystectomy. 11. Status post thyroidectomy. 12. She has had right shoulder surgery for a vascular and infected necrosis. MEDICATIONS ON ADMISSION: 1. Lopressor 25 three times per day. 2. Zestril 40 once per day. 3. Synthroid 75 mcg once per day. 4. Pepcid 20 twice per day. 5. Lantus 60 at hour of sleep. 6. Humalog sliding-scale. 7. Hydrochlorothiazide 12.5 once per day. Apparently the patient was suppose to be on Tricor, but was not taking that medication. MEDICATIONS ON TRANSFER: The patient was transferred on a nitroglycerin drip, heparin drip, given 25 mg of Demerol, 5 mg of intravenous Lopressor times three, Phenergan, Integrilin, and Plavix 300 times one. ALLERGIES: The patient's allergies include PERCOCET, question to MORPHINE, question of HEPARIN (per patient), and BACTRIM. SOCIAL HISTORY: She is a single female. Denies any current alcohol abuse. Denies any other drug use. She quit smoking 30 years ago. FAMILY HISTORY: Her mother had a myocardial infarction at the age of 26. Her maternal grandmother had a fatal myocardial infarction at uncertain age. The patient's religion is Jehovah Witness and refused blood products. PHYSICAL EXAMINATION ON PRESENTATION: She was febrile at 102.4, her blood pressure was 140/90, her heart rate was 100, her respiratory rate was 20, and she was 219 pounds. In general, she was in no apparent distress. Awake, alert, and oriented. Her pupils were equal, round, and reactive to light. Her extraocular muscles were intact. Moist mucous membranes. Her neck had no evident jugular venous distention. No thyromegaly. Her chest was clear to auscultation bilaterally. Heart examination revealed she had a [**1-8**] holosystolic murmur at the apex. Otherwise, slightly tachycardic. No rubs or gallops appreciated. Her abdomen was soft, nontender, and nondistended with positive bowel sounds. Extremity examination revealed she had no lower extremity edema. She had nonpalpable distal pulses in her lower extremities, but dopplerable distal pulses. On neurologic examination, she had 2+ deep tendon reflexes throughout and 5/5 strength throughout. PERTINENT LABORATORY VALUES ON PRESENTATION: Her creatine phosphokinase on admission was 486, with a MB fraction of 30, and MB index of 6.2. Her second set showed a creatine phosphokinase of 646, with a MB fraction of 42, and a MB index of 6.5. Her troponin I showed an initial value of 15.5 at the outside hospital to 13.8. Her Chemistry-7 showed a sodium of 136, potassium was 3.9, chloride was 102, bicarbonate was 26, blood urea nitrogen was 29, creatinine was 1.2, and blood glucose was 230. Complete blood count showed a white blood cell count of 11.4, hematocrit was 27.3, and platelets were 222. INR was 1.1. Calcium was 8.7, magnesium was 1.7, and phosphate was 3.7. PERTINENT RADIOLOGY/IMAGING: Her electrocardiogram from the outside hospital noted 3-mm ST elevations inferiorly and ST elevations of 1 mm to 2 mm in V2 through V6. Status post catheterization, the patient still had inferior ST elevations of 2 mm to 3 mm and 2-mm to 3-mm ST elevations in V4 through V5. An echocardiogram on [**2161-11-4**] showed an ejection fraction of greater than 65%, left atrium was mildly dilated, trivial mitral regurgitation, trivial pericardial effusion, and normal left ventricular wall motion. On cardiac catheterization, as described above, status post percutaneous transluminal coronary angioplasty of her posterior descending artery with normal flow with dissection with inflation. Her hemodynamics showed a right atrial pressure with a mean of 9, right ventricular of 40 systolic and 10 diastolic, with a PA mean pressure of 33, pulmonary capillary wedge pressure of 18, and a cardiac index of 2. BRIEF SUMMARY OF HOSPITAL COURSE BY ISSUE/SYSTEM: 1. CARDIOVASCULAR ISSUES: (a) Ischemia: For cardiovascular ischemia, the patient had noted 3-vessel disease likely related to her longstanding insulin-dependent diabetes, and a coronary artery bypass graft was recommended given her persistent electrocardiogram changes and 3-vessel disease as well as her diabetes. The patient was maximally treated with medication including Lopressor which was titrated for a goal heart rate of 60. In addition, she was placed on a statin as well as aspirin and ACE inhibitor. The plan was for the patient to go to cardiothoracic surgery for a coronary artery bypass graft. Cardiothoracic Surgery evaluated the patient and recommended the patient have a hematocrit of 45 prior to getting the coronary artery bypass graft procedure given her high risk for blood loss during this procedure. Given the patient's religious beliefs of Jehovah Witness, she refused any blood products. The coronary artery bypass graft surgery was postponed due to that reason. The patient's iron studies were checked, and she was noted to be profoundly iron deficient with a mixed picture of iron deficiency and chronic disease. She was given one dose of intravenous iron and started on Epogen to help increase her hematocrit to a goal preoperative level of 40 to 45. The patient was not put on Plavix secondary to the thought that she was likely going to coronary artery bypass graft in the near future. In addition, the data suggests that it is more efficacious for patients with stent procedures to be placed on Plavix, and this patient did not have a stent procedure, she only had angioplasty done to her posterior descending artery. (b) Pump: The patient had elevated right-sided filling pressures on hemodynamics during catheterization and was diuresed when in the Intensive Care Unit with small amounts of intravenous Lasix, and she responded to 10 mg to 20 mg of intravenous Lasix and diuresed well over the two days status post catheterization. The patient had a repeat echocardiogram done on her second hospital day and was noted to have apical hypokinesis with an ejection fraction decreased to 40%, mild LVH, and mild pulmonary artery hypertension. (c) Rhythm: The patient was in a normal sinus rhythm and was placed on a beta blocker for heart rate control in the 60s, and she maintained most of her heart rates in the 60s to 70s while in the Intensive Care Unit. The patient was discharged from the Coronary Care Unit on [**2-6**] and was chest pain free at that time. She was not requiring any nitrates. 2. HEMATOLOGIC/INFECTIOUS DISEASE ISSUES: Given the patient's religion of Jehovah Witness, she would not accept any blood transfusions for her anemia. Therefore, she was started on intravenous iron therapy as well as by mouth iron therapy and given Epogen 20,000 units once per day. Her iron studies noted a low ferritin and low iron level as well as a low total iron-binding capacity, giving a mixed picture of iron deficiency and chronic disease state. Her hematocrit remained basically stable while in the Coronary Care Unit, ranging from 24 to 28. The patient was febrile on admission; however, she had no evidence of infection. Her urinalysis, chest x-ray, and blood cultures remained negative. She never required antibiotics and was afebrile for the rest of her hospital stay with a stable white count. 3. PULMONARY ISSUES: The patient had an oxygen requirement while in the Coronary Care Unit likely secondary to her high filling pressures and pulmonary edema noted on chest x-ray and on examination. She was diuresed gently with intravenous Lasix 10 mg to 20 mg as needed. Upon leaving the Coronary Care Unit, she was on 4 liters nasal cannula and saturating well. During her first two days on the floor, her oxygen requirements decreased, and she no longer needed Lasix for diuresis. 4. RENAL/FLUIDS/ELECTROLYTES/NUTRITION ISSUES: The patient was noted to have a rising creatinine while in the Coronary Care Unit; likely secondary to dye nephropathy and was initially treated with Mucomyst status post catheterization and intravenous hydration. A renal ultrasound was done to evaluate for obstruction which was negative. Her creatinine resolved slowly; likely secondary to acute tubular necrosis related to contrast dye. 5. GASTROINTESTINAL ISSUES: The patient had recurrent nausea while in the Coronary Care Unit, and it was thought it may have been related to ongoing ischemia. However, her cardiac enzymes remained stable, and her electrocardiogram showed no new changes. She was treated symptomatically with Zofran and Compazine and given Demerol for her epigastric pain. The patient stated that her pain was similar to past episodes of pancreatitis, which are acute flares on her chronic problem. The patient no long has amylase or lipase elevations secondary to a "burned out pancreas." The patient is treated with pain medication, nothing by mouth status, and low-flow intravenous fluids. 6. ENDOCRINE ISSUES: The patient was continued on her outpatient dose of Lantus 60 units and a Humalog sliding-scale, and that was adjusted per her oral intake. Her hemoglobin A1c was checked which was greater than 8, and she was continued on her outpatient Levoxyl dose of 75 mcg for her hypothyroidism. 7. DISPOSITION ISSUES: The patient was transferred to the Medicine Service on [**2-6**] for management of her pancreatitis and her anemia. Please refer to Dr.[**Name (NI) 42300**] Discharge Summary for the remainder of the hospital course and discharge medications and plan. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 15176**], M.D. [**MD Number(1) 15177**] Dictated By:[**Last Name (NamePattern1) 3480**] MEDQUIST36 D: [**2162-2-9**] 15:13 T: [**2162-2-9**] 15:16 JOB#: [**Job Number 100599**] ICD9 Codes: 5845, 4280, 5990
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Medical Text: Admission Date: [**2169-1-27**] Discharge Date: [**2169-1-31**] Date of Birth: [**2095-10-21**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**Last Name (NamePattern4) 290**] Chief Complaint: Rapid Afib, Pulmonary Embolus, Dyspnea Major Surgical or Invasive Procedure: Expired History of Present Illness: This is a 73 yo F with a past medical history significant for NSCLC s/p resection, in remission for 5 years, and marked COPD, who presents to the ED after experiencing progressive dyspnea over the last several weeks, requiring oxygen therapy around the clock rather than just with exertion. In the ED she was found to be in afib (new for this patient) with RVR to 170's. She was sent for CTA and was found to have a small subsegmental PE and was started on a heparin gtt. She was given a dose of levofloxacin for ?infectious process given leukocytosis on CBC to 26 and she was initiated on a dilt gtt after two doses of IV dilt did not affect her HR that much. She also notes swelling in her legs bilaterally and her left arm, as well as a new mass in the left side of her neck which per the patient grew in entirety over the last two weeks. Of note, she also had knowledge of a breast mass, which had not yet been worked up. Last mammogram seems to be in [**2161**]. Per the patient's PCP [**Last Name (NamePattern4) **] [**6-13**], "She has adamantly refused all screening and followup testing at this time. We discussed follow up chest x-rays and CT scans for example and also mammograms, but she refuses that. She refuses colon cancer screening. At this point, she feels that she would not accept or take any further medications or any further therapies for any further diseases." She is admitted to the MICU for further evaluation of her afib with RVR and dyspnea. Currently in the MICU, the patient is hemodynamically stable with a HR in the 140's-150's. She is breathless on supplemental O2. She denies fevers/chills, n/v or nightsweats. She admits to some weight loss, and although does not entertain palpitations, she felt something was wrong and attributed it to her chronic anxiety. She denies calf tenderness, chest or abdominal pain. She is refusing blood draws and foley catheter. Past Medical History: Status post stage III lung cancer s/p left upper lobe lobectomy, with chemo/rads COPD glaucoma Major depressive disorder Anxiety Social History: 2 ppd x 40 years, just quit several months ago. Was real estate [**Doctor Last Name 360**], frequently travels to [**State **] for vaction. Has two daughters, one is in [**Name (NI) 745**] who is HCP. Family History: non-contributory Physical Exam: VS: Temp: 97.6 BP:146/72 HR: 137 RR: 13 O2sat 99% on 4L NC GEN: cachectic, comfortable, NAD but breathless when talking HEENT: PERRL, EOMI, but right strabismus and left eyelid ptosis, anicteric, MM dry, op without lesions. dentures in place. NECK: large left sided nontender, nonmobile hard mass just lateral to the thyroid, no jvd, no carotid bruits. RIJ in place. RESP: No breath sounds at the right base. Scattered crackles and +expiratory wheeze with prolonged E:I ratio. CV: Tachcardic and irregularly irregular. No murmurs. ABD: nd, +b/s, soft, nt, no masses or hepatosplenomegaly EXT: nonpitting 2+ edema in the ext bilaterally, right UE with 1+ nonpitting edema. warm, good pulses SKIN: no rashes/no jaundice NEURO: AAOx3. Cn II-XII intact. 4/5 strength throughout (generally weak). No sensory deficits to light touch appreciated. Essential tremor present. DTR's normoreflexive. Breast exam refused. Pertinent Results: [**2169-1-27**] 11:20AM WBC-25.3*# RBC-4.01* HGB-12.1 HCT-38.9 MCV-97 MCH-30.2 MCHC-31.1 RDW-14.4 NEUTS-96.4* BANDS-0 LYMPHS-1.4* MONOS-1.6* EOS-0.5 BASOS-0 [**2169-1-27**] 11:20AM GLUCOSE-212* UREA N-24* CREAT-0.8 SODIUM-141 POTASSIUM-4.5 CHLORIDE-98 TOTAL CO2-29 ANION GAP-19 [**2169-1-27**] 11:20AM CALCIUM-8.9 PHOSPHATE-3.8 MAGNESIUM-2.0 EKG: Afib with RVR to 170's. CXR: 1. Hazy opacity in the right lung base may represent a layering pleural effusion, although pneumonia cannot be excluded; a lateral view is recommended. 2. Stable emphysematous changes and volume loss on the left related to left upper lobectomy. CTA Chest: 1. Right lower lobe subsegmental pulmonary embolism. No evidence of compression of the SVC. 2. Moderate-to-severe emphysema with interstitial septal thickening consistent with underlying CHF. Small left greater than right pleural effusions, with atelectasis in the right lower lobe. 3. Status post left upper lobectomy with stable left volume loss and post-radiation changes. 4. Interval development of hypodense mass likely arising from the left lobe of the thyroid. Two left upper quadrant soft tissue masses. Multiple mediastinal and hilar lymph nodes as described above. Soft tissue nodule in the left breast and subcentimeter likely lymph node in the presternal soft tissues. Given the patient's history of lung cancer, these findings are suspicious for malignancy. Brief Hospital Course: 73 yo F with a past medical history of NSCLC status-post chemo-radiation and right upper lobectomy admitted with progressive dyspnea in the setting of multiple new masses, new atrial fibrillation with RVR, and subsegmental PE. # Dyspnea: Etiologies for the patient's dyspnea include atrial fibrillation with RVR with decreased forward flow, progression of COPD, interstitial lung disease secondary to radiation therapy, metastasis and infection. Although she had a leukocytosis, and possible effusion at the right base, she was afebrile during her inpatient stay. She does have a very small subsegmental PE, which could have also contributed to dyspnea. Was rate controlled with a esmolol drip. Patient then became suddenly hypoxic with short duration asystole the afternoon of [**2169-1-31**], thought to be secondary to possible mucous plugging. Daughter was [**Name (NI) 653**] concerning the event and her mother's poor prognosis. At that time, she requested she be CMO. All medications were stopped and she was given morphine IV for comfort. She expired at 8:15pm on [**2169-1-31**] due to cardiopulmonary arrest. # Afib with RVR: Unclear if her known small subsegmental PE would actually cause the patient's Afib with RVR. Other possible causes could be dehydration in the setting of poor PO intake/infection. Also rapidly growing mass contiguous with the thyroid could be causing a relative thyroiditis, or be producing thyroid hormone itself. TSH was check and was low normal. Rate was controlled with an esmolol drip until the events immediately preceding her death. # Pulmonary Embolus: Known small subsegmental PE. Thus, she was maintained on a heparin gtt. ED confirmed with Oncology that it was okay to start heparin gtt without head imaging as long as initiated without a bolus. PE thought to be likely [**3-11**] to tumor. Heparin gtt was discontinued once patient was made CMO on [**2169-1-31**]. # Neck Mass: Concerning for malignancy. Patient had a breast mass noted on a mammogram from [**2163**] and has since refused follow up screening. Concerned that this could represent a breast primary with metastases to her thyroid and mediastinal nodes. Unclear what left upper quadrant masses are at this time. Other possibility is recrudescence of NSCLC, but this is unlikely although she continued to smoke until this year. With poor oral intake, fatigue and weight loss, malignancy was high on the differential. Associated hoarseness could be secondary to recurrent laryngeal nerve compression. Heme-onc was consulted and recommended obtaining tissue for a diagnosis. General surgery was consulted but determined she was too unstable during her stay for tissue biopsy. Patient expired without clear diagnosis and family declined autopsy. # Anxiety/Depression: While inpatient was continued on antidepressants and Ativan PRN. # COPD: This ongoing issue likely contributed to her overall respiratory distress while inpatient. She was treated with Atrovent and Albuterol was used only minimally secondary to concern for tachycardia. Patient become increasingly dyspneic during the day of [**2169-1-31**]. At approximately 4pm, physicians were called to the bedside for pulselessness and respiratory arrest thought to be secondary to mucous plugging. Was treated with atropine and epinephrine and subsequently regained a heart rhythm, blood pressure and pulse. Pupils were noted to be unresponsive at that time. Her family was notified of the acute change and poor prognosis and decided to make her CMO status. All medications were discontinued beyond those for comfort. Patient expired on [**2169-1-31**] at 8:15pm secondary to cardiopulmonary arrest. Medications on Admission: Trazadone Buspar Wellbutrin Triazolam Atrovent PPI Veranicicline Reglan TID Discharge Medications: Expired Discharge Disposition: Expired Discharge Diagnosis: Primary: Non-Small Cell Lung Cancer Secondary: COPD, neck mass Discharge Condition: Expired Discharge Instructions: Expired Followup Instructions: Expired [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**Name8 (MD) **] MD [**MD Number(1) 292**] ICD9 Codes: 496, 4275, 4589
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Medical Text: Admission Date: [**2165-2-14**] Discharge Date: [**2165-2-17**] Date of Birth: [**2100-11-15**] Sex: M Service: [**Hospital Unit Name 196**] HISTORY OF PRESENT ILLNESS: Mr. [**Known lastname **] is a 64-year-old male with history of coronary artery disease status post recent non-ST elevation myocardial infarction at the end of [**Month (only) 404**] as well as stenting of the left anterior descending artery with two stents, who presents with left sided chest pain/pressure beginning approximately 10 pm on the night before admission. Onset of the chest pain was at rest, and the pain was somewhat improved with Protonix and one sublingual nitroglycerin, but the sensation persisted, and the patient eventually called EMS. He was given aspirin and sublingual nitroglycerin by EMS with resolution of his symptoms. Patient says that the pain/pressure is the same sensation he had at the time of his non-ST elevation myocardial infarction. Patient denied radiation of the pain, shortness of breath, back, or abdominal pain, cough, nausea, or vomiting, palpitations. Patient was pain free at the time of evaluation in the Emergency Department. Heparin was started in the Emergency Department. PAST MEDICAL HISTORY: 1. Recent non-ST elevation myocardial infarction with a troponin of 29 and a CK peak of 90. Catheterization [**1-16**] showed three-vessel disease and two stents were placed in the left anterior descending artery. He had chest pain after this procedure, and was taken back to the catheterization laboratory, but the catheterization was cut short by a GI bleed. Catheterization on [**1-16**] showed 70% proximal and 95% mid left anterior descending artery stenosis, 70% left circumflex lesion, 80% OM-2 lesion, and 80% right coronary artery lesion. Echocardiogram [**1-18**] showed left atrial enlargement, right atrial enlargement, left ventricular hypertrophy, ejection fraction greater than 55%, and 1+ aortic regurgitation. 2. Hyperlipidemia. 3. End-stage renal disease with dialysis on Monday, Wednesday, Friday. 4. Pancreatitis. 5. Congestive obstructive pulmonary disease. 6. Hypertension. 7. Diverticulosis. 8. Cerebrovascular accident in [**2159**] with residual left sided weakness. 9. Prior history of upper gastrointestinal bleed at [**Hospital6 11241**]. 10. Fistula repair [**2165-1-15**]. MEDICATIONS: 1. Plavix 75 mg po q day. 2. Enalapril 20 mg po q day. 3. Labetalol 200 mg po q day. 4. Isordil 20 mg tid. 5. Clonidine patch q Monday. 6. Renagel. 7. Nephrocaps. 8. Protonix 40 mg [**Hospital1 **]. 9. Sublingual nitroglycerin. ALLERGIES: None. SOCIAL HISTORY: Patient comes from [**Country 2045**], and he lives with his daughter and his wife. [**Name (NI) **] denies any smoking. PHYSICAL EXAMINATION: The patient is a well-developed, thin, elderly appearing man. Temperature is 99.0, blood pressure 88/63, heart rate of 81, respiratory rate of 16, and sating 98% on 3 liters. Oropharynx was clear. Mucous membranes were moist. There was no jugular venous distention. Lungs were clear bilaterally except for a few crackles at the bases. Heart rate was irregularly, irregular. There were no murmurs, rubs, or gallops. Abdomen was soft, nontender, and nondistended. Extremities had no peripheral edema. Rectal was guaiac negative with no masses. At the time of admission, electrocardiogram showed Q waves in lead III, atrial fibrillation at a rate of approximately 70, possibly alternating with flutter with variable block. Chest x-ray showed no infiltrates and no effusions. CK was 46 and troponin was 1.8. HOSPITAL COURSE: 1. Cardiac: The patient's history was suggestive of unstable angina, and the patient was continued on a Heparin drip and underwent cardiac catheterization, which showed significant three vessel disease with 80% instent restenosis in the proximal left anterior descending artery stent and 50% in the distal stent. At this point, the patient was pain free and the case was discussed with Cardiothoracic Surgery. At the time of this dictation, Cardiothoracic Surgery was planning a coronary artery bypass graft after evaluation of the carotid arteries by ultrasound. Patient's blood pressure was treated with labetalol, clonidine, enalapril, and Norvasc. Patient had a second episode of chest pain on [**2165-2-16**] that had a component of radiation to his back. He therefore underwent CT scan of his chest and abdomen to rule out any dissection of his aorta. These examinations were all negative for dissection. Patient presented in atrial fibrillation, with a relatively slow ventricular response. The patient spontaneously converted to a normal sinus rhythm while in the hospital without any further intervention. 2. Renal: Renal service was consulted to assist in the management of this patient with end-stage renal disease. Patient received dialysis after his cardiac catheterization and then returned to his normal schedule of hemodialysis. His Renagel was increased to 1600 mg tid. 3. GI: Patient's stool was guaiacked on admission and after his Heparin had been running for a day. Both of these stools guaiacks were negative, and he was continually followed for evidence of bleeding. The GI service was consulted, and felt that the patient should be catheterized from a cardiac standpoint despite any possible concerns over gastrointestinal bleeding. They suggested treating gastrointestinal bleeding as it grows and not delaying treatment of the patient's coronary artery disease because of considerations of gastrointestinal bleeding. 4. Hematologic: The patient was noted to have a baseline anemia at the time of admission, and this was thought to be due to a combination prior gastrointestinal bleeding as well as end-stage renal disease. At the time of this dictation, iron studies were pending, and there was no evidence of gastrointestinal bleeding. Discharge was still in the planning stage at the point of this dictation. [**First Name8 (NamePattern2) 2064**] [**Last Name (NamePattern1) **], M.D. [**MD Number(2) 2139**] Dictated By:[**Last Name (NamePattern1) 4706**] MEDQUIST36 D: [**2165-2-17**] 21:03 T: [**2165-2-18**] 09:09 JOB#: [**Job Number 32514**] ICD9 Codes: 4111, 4241, 496, 2724
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Medical Text: Admission Date: [**2149-12-17**] Discharge Date: [**2149-12-31**] Date of Birth: [**2075-3-13**] Sex: F Service: MEDICINE Allergies: Altace Attending:[**First Name3 (LF) 689**] Chief Complaint: shortness of breath, increased angina Major Surgical or Invasive Procedure: central line placement History of Present Illness: Ms. [**Known lastname **] is a 74 year-old woman with a history of CAD s/p CABG in 10/84 with redo in 11/84, stent to left subclavian in [**6-17**] and repeat dx cath without intervention in [**10-18**], EF of 35% on echo in [**2145**], atrial fibrillation diagnosed in [**2146**] managed with rate control and anti-coagulation, hypertension, lipids and asthma/possible COPD (no PFT's noted in record/no smoking history) admitted now with SOB/unstable angina. The patient's current symptomatology began last friday [**12-12**] when she developed URI symptoms including nasal congestion and cough. Since then she has noted increased dyspnea, increased episodes of her anginal pain including at rest and cough productive of yellow/celery colored sputum. Dyspnea has increased to point where she has trouble with stairs now where recently she has not. Has dry cough at baseline attributed to Mavik, but her current cough is different. Has also had significantly increased fatigue over this time. Takes combivent or albuterol with some relief of shortness of breath. Her SOB brought her to see her PCP [**Name Initial (PRE) 1262**]. CXR was obtained and revealed no acute process. Other history from that visit is unobtainable. Last night she had palpitations and her shortness of breath subsequently worsened which ultimately brought her to [**Hospital1 18**] today. Reports taking all her medications. Has had some dietary indiscretion recently including salted fish last friday and dining out recnetly. Also reports increased stress and exposure to dogs at family members house. Denies fever or chills. Denies feeling dizzy, syncope. NO weight loss. Appetite has been good. Past Medical History: CAD as above atrial fibrillation htn increased lipids asthma ?COPD(non-smoker) GERD Anemia Social History: No history of smoking. Occasional alcohol and no IVDU. Lives in [**Location 86**] area with excellent support from family. Family History: non-contributory Physical Exam: VS: T: 97.5 BP 124/63 HR: 90's RR 18 95% 3l (on nitro) general: No distress but mildly increased work breathing resting pleasant, HEENT: PERLLA, EOMI, MMM, no pharyngeal exudate, no conj injection, sclarae anicteric, no lymphadneopathy. JVP to about 12cm. No carotid bruits. Neck is supple lung: wheezing throughout the lung fields heart: tachy, irregular, S1 and S2 wnl, no murmurs/rubs or gallops abd; +b/s, soft, non-tender, non-distended, no masses extr: +2 pitting edema bilaterally,swelling is symmetric in lower extremities. non-tender. DP and femoral pulses are 1+. no femoral bruits. neuro; Alert and oriented x 3. no focal deficits appreciated--strength appropriate for age, normal cerebellar and reflexes. CNII-XII intact Pertinent Results: [**12-17**] chest x-ray: PA AND LATERAL VIEWS OF THE CHEST: The patient is S/P CABG. There is a vascular stent projecting above the aorta again demonstrated and unchanged. The cardiac and mediastinal contours are stable. No evidence of failure. The lungs are clear. There is no pleural effusion. IMPRESSION: No evidence of pneumonia. No evidence of CHF. (pulmonary vascular congestion, cardiomegaly) Admit labs: [**2149-12-17**] 12:10PM WBC-8.8 RBC-3.84* HGB-11.7* HCT-34.6* MCV-90 MCH-30.3 MCHC-33.6 RDW-14.4 [**2149-12-17**] 12:10PM NEUTS-83.9* LYMPHS-9.4* MONOS-5.6 EOS-1.1 BASOS-0.1 [**2149-12-17**] 12:10PM PLT COUNT-237 [**2149-12-17**] 12:10PM GLUCOSE-180* UREA N-15 CREAT-1.1 SODIUM-138 POTASSIUM-3.9 CHLORIDE-99 TOTAL CO2-27 ANION GAP-16 [**2149-12-17**] 01:45PM PT-21.3* PTT-31.7 INR(PT)-2.9 Ischemia labs: [**2149-12-17**] 12:10PM CK(CPK)-95 [**2149-12-17**] 12:10PM cTropnT-<0.01 [**2149-12-17**] 06:00PM CK(CPK)-147* [**2149-12-17**] 06:00PM CK-MB-6 cTropnT-0.06* Last cath: PROCEDURE DATE: [**2147-11-15**] INDICATIONS FOR CATHETERIZATION: Chest pain. Prior CABG. S/P subclavian stent. FINAL DIAGNOSIS: 1. Native three vessel coronary artery disease with extensive bridging collaterals of the RCA. 2. Known occluded saphenous vein grafts. 3. Patent LIMA to LAD. 4. Patent left subclavian stent. 5. Mild mitral regurgitation. 6. Mild systolic ventricular dysfunction. 7. Mild right common-femoral vascular disease. COMMENTS: 1. Coronary arteriography in this right dominant system showed native three-vessel coronary artery disease. The LMCA had mild luminal irregularities. The LAD artery was occluded in the mid-vessel. The left circumflex artery was proximally occluded with two distal OMs with a "jump" segment filling via left to left collaterals. The RCA was proximally occluded with many bridging collaterals supplying the distal RCA and posterior LV branches. 2. Saphenous vein grafts were known to be occluded from a prior catheterization dated [**6-17**] and were therefore not visualized. 3. Graft angiography showed a widely patent LIMA to LAD, supplying the distal [**1-18**] of the LAD and large collaterals to the RCA and r-PDA. 4. Left subclavian angiography showed a widely patent left subclavian stent. 5. Resting hemodynamics showed normal left-sided filling pressure. 6. Left ventriculography showed mild global hypokinesis with more pronounced hypokinesis of the inferior wall. There was trace mitral regurgitation. The calculated LVEF was 45%. 7. Limited left ilio-femoral peripheral angiography showed a mild 30% stenosis of the common femoral artery. EKG: afib, left axis deviation, ST depression and TWI in V2-V6. [**12-19**] Echo: Study continues from Tape [**2149**] W487 to tape [**2149**] W 509, starting at 0:15 for an additional seven minutes of recording. LEFT ATRIUM: Mild LA enlargement. RIGHT ATRIUM/INTERATRIAL SEPTUM: Mildly dilated RA. LEFT VENTRICLE: Normal LV cavity size. Suboptimal technical quality, a focal LV wall motion abnormality cannot be fully excluded. Depressed LVEF. Cannot assess LVEF. RIGHT VENTRICLE: RV not well seen. AORTA: Normal aortic root diameter. 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. Mild PA systolic hypertension. PERICARDIUM: No pericardial effusion. GENERAL COMMENTS: Suboptimal image quality - poor echo windows. Conclusions 1. The left atrium is mildly dilated. 2. The left ventricular cavity size is normal. Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. LV systolic function appears depressed. Overall left ventricular systolic function cannot be reliably assessed. 3. The mitral valve leaflets are mildly thickened. Mild (1+) mitral regurgitation is seen. 4. There is mild pulmonary artery systolic hypertension. [**12-26**] cath: PROCEDURE DATE: [**2149-12-26**] INDICATIONS FOR CATHETERIZATION: EKG changes. FINAL DIAGNOSIS: 1. Three vessel coronary artery disease. 2. Patent LIMA-LAD COMMENTS: 1. Selective coronary angiography of this right dominant system revealed three vessel disease. The LMCA was diffusely disease. The LAD was occluded mid-vessel and filled distally via the LIMA. The LCX was occluded proximally, and filled distally from collaterals from the LCX. The RCA was occluded proximally and filled distally via bridging collaterals. 2. Graft angiography revealed a patent LIMA-LAD. The SVGs were not imaged as they were known to be occluded. 3. Left ventriculography was not performed. 4. The left subclavian stent was widely patent. LIVER OR GALLBLADDER ULTRASOUND. INDICATION: 74 year old female with abdominal pain, increased LFTs. Evaluate for gallstones, or liver disease. There are no prior studies for comparison. The patient is status post cholecystectomy. The common bile duct measures 5 mm, and is within normal limits status post cholecystectomy. The liver shows no focal abnormalities. The liver parenchyma is mildly hyperechoic in echotexture, consistent with fatty infiltration. The right kidney measures 8.3 cm. There is a mild hyperechoic focus within the interpolar right kidney, with no evidence of posterior shadowing, possibly representing a small parenchymal calcification Within the lateral aspect of the right kidney, in the interpolar region, there is a 1.2-cm anechoic focus, most likely representing a simple cyst. The left kidney measures 8.1 cm, with no focal abnormalities. IMPRESSION: 1) Patient is status post cholecystectomy. 2) The liver is echogenic, consistent with fatty liver. However, other forms of liver disease, and more advanced liver disease, including significant hepatic fibrosis/cirrhosis cannot be excluded on this study. [**12-24**] chest x-ray: INDICATION: Shortness of breath, s/p extubation. Check status. FINDINGS: A single AP semi-upright image. Comparison study dated [**2149-12-21**]. The heart shows slight left ventricular enlargement. There is evidence of a prior CABG procedure. A vascular stent is noted in the left brachiocephalic vessel. The pulmonary vessels are normal. No pulmonary infiltrates are seen. There is slight blunting of the right costophrenic angle and slight widening of the minor fissure consistent with a small effusion. The hila and mediastinum are otherwise unremarkable. The ETT and the NG line remain well positioned. IMPRESSION: Possible small right pleural effusion. No other acute cardiopulmonary abnormality. Prior CABG surgery noted and prior left brachiocephalic stent in place. Brief Hospital Course: 72 year-old woman with CAD s/p CABG in [**2129**], stent to left subclavian in [**6-17**], re-cath in 02 as above, history of CHF, depressed EF, hypertension, afib astham/COPD who presents now with increasing SOB and anginal episodes after URI last Friday. Cardiovascular: a)ischemia: Concerning past history, very high risk and now with good story for unstable angina [**Female First Name (un) **] admit. Patient was ruled out for MI on admission. After stabilization of her pulmonary issues, given her history and an echo which could not fully assess LVEF and could not rule out RWMA, she went for cardiac catherterization and found to have no new lesions, patent LIMA to LAD. Patient maintained on ACE, beta-blocker, statin, aspirin, imdur. Imdur and beta-blocker titrated up. D/ced calcium channel blocker with likely systolic dysfunction and definite diastolic CHF. Sublingual nitro as needed. Had been on Mavik for unclear reason, tolerating ACE here--would titrate up for heart failure as below. Continues to have seom angina with stress. b)pump: Patient noted to have depressed EF in past-35%? but no recent echo on admission. Echo here showed: 1. The left atrium is mildly dilated. 2. The left ventricular cavity size is normal. Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. LV systolic function appears depressed. Overall left ventricular systolic function cannot be reliably assessed. 3. The mitral valve leaflets are mildly thickened. Mild (1+) mitral regurgitation is seen. 4. There is mild pulmonary artery systolic hypertension. On admission, the patient was felt to be euvolemic to slightly volume overloaded and gently diuresed but her SOB was primarily due to astham/copd exacerbation. AFter transfer to ICU(see below) patient received lots of fluids and needed to be diuresed. Diuresed adequately for discharge--felt to be dry for discharge by exam and labs. Given that she was acutely decompensated from pulmonary perspective and volume overloaded when echo was done, it was not felt to be fully accurate of baseline status. Maintained on beta-blocker, ACE for ischemia and HF. Should titrate ACE/beta to HF goals based on repeat echo (lisinopril 20/toprol 150). c)rhythm; afib: has always been rate controlled, never cardioverted. POor control now and had sensation of palpitations on night PTA. Unclear if ratelead to CHF or CHF lead to increased rate and component of ischemia?--Increaed demand leading to ischemia vs. ischemia leading to tachy-- Patient maintained on metoprolol for rate control with good affect. Had been on dilt but with ? heart failure, systolic-held and went up on beta-blocker for control. Concerning anti-coagulation, we are holding coumadin until patient has outpatient colonoscopy-had guiac positive stools and crit drop (also with neck hematoma after central line placement.) Scheduled for outpatient colonoscopy and then to re-start coumadin then. Shortness of breath/hypoxemia: CHF vs. post URI Reactive airways disease vs. COPD vs. PE vs. pneumonia--ON admission, SOB felt secondary to astham exacerbation-Patient acutely decompensated, wheezy on exam, sent to unit on day 2 of admission for intubation. Treated with predniesone, flovent, azithromycin then levaquin as well as nebs/inhalers. HAd 5 day ICU stay and then was transferred out. By discharge, not wheezy satting well on room air. Felt to be RAD post bronchitis. Was not fluid overloaded on admit--was diuresed after ICU stay with lots of fluids. On discharge satting well on room air. Anemia at baseline/Crit drop/guiaic positive: Patient had crit drop while in ICU. She had a hematoma after central line placement as well as guiac positive stools. Was on heparin during this time for her afib, stopped at this time. She stabilized after transfusion in ICU, and needed no further transfusions. Neck hematoma is resolving. Guiac positive stools-she is scheduled for outpatient colonoscopy. Re-address anti-coagulation for afib after this. Do not want her on iron until after colonoscopy. Elevated LFT's, tbili and PTT: After being off heparin (on it for afib), stopped for crit drop in [**Name (NI) 102488**] PTT remained elevated. WAs on subcu heparin, lft's obtained which showed mild transaminase elevation and t bili elevation. Subcu heparin stopped, RUQ U/S obtained showed fatty liver/h/o cholecystectomy. Lft's, t. bili and PTT trended down on discharge. Patient will need follow -up of these studies as an outpatient. ? MEd affect. Lipitor was increased from 10 to 40 given significant coronary disease--although unlikely to cause acute elevations. Hsitory of DM: Not on meds prior to admission. Needs primary care follow-up. Hypothyroidism: Levoxyl continued, TSH normal GERD: PRotonix continued, no acute issues. General care: VIT D, calcium, multi-vitamins FULL CODE Medications on Admission: cardizem 120 levoxyl 75 warfarin 1/2/2 3 day rotation protonix 40 lipitor 10 HCTZ 25 Imdur 45 metoprolol 12.5 [**Hospital1 **] Mavick O.5 multi-vitmain citrate ferrous gluconate aspirin 81 Discharge Disposition: Extended Care Facility: [**Doctor First Name 391**] Bay - [**Hospital1 392**] Discharge Diagnosis: newly depressed EF- systolic Heart failure acute renal failure hypercoagulability neck hematoma cad diabetes reactive airway disease s/p bronchitis transaminitis Discharge Condition: stable, ambulating with assistance Discharge Instructions: Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight > 3 lbs. Adhere to 2 gm sodium diet Fluid Restriction: 2l Call your doctor if you experience any further chest pain, shortness of breath. All medications as prescribed. You will need to follow up with Dr. [**Last Name (STitle) 14069**] and Dr. [**Last Name (STitle) 120**] this week. Please call to make appointments. They will decide about re-starting coumadin after you [**1-7**] colonscopy. Will also need to have [**Name (NI) 53324**], PT/PTT checked at that time. Please check ast, alt, alk phos and total bilirubin every few days and trend results. If increasing dramatically then [**Name8 (MD) 138**] MD for further work up. Outpatient doctor to re-institute coumadin over next few weeks. Followup Instructions: Dr. [**Last Name (STitle) 14069**] within one week. Provider: [**Name10 (NameIs) **],[**Name11 (NameIs) **] [**Telephone/Fax (1) 37171**] Follow-up appointment should be in 1 week Call Dr. [**Last Name (STitle) 120**] this week to set up appointment. Need to repeat echo in 3 monthsProvider: RADIOLOGY Where: [**Hospital 4054**] RADIOLOGY Phone:[**Telephone/Fax (1) 327**] Date/Time:[**2150-1-2**] 4:00 Date/Time:[**2150-1-7**] 10:30 Provider: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **],MD Where: [**Hospital Ward Name **] BUILDING ([**Hospital Ward Name **] COMPLEX) Phone:[**Telephone/Fax (1) 1983**] Date/Time:[**2150-1-7**] 10:30 You are scheduled for colonscopy on [**1-7**]. Provider: [**Name10 (NameIs) **] WEST,ROOM FIVE GI ROOMS Where: GI ROOMS Date/Time:[**2150-1-7**] 10:30 ICD9 Codes: 5849, 4589, 2449, 2859
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Medical Text: Admission Date: [**2149-5-13**] Discharge Date: Date of Birth: [**2102-12-9**] Sex: F Service: MEDICAL ICU REASON FOR TRANSFER: Management of liver failure. HISTORY OF PRESENT ILLNESS: The patient is a 46 year old woman with past medical history as listed below who was transferred from [**Hospital 8**] Hospital for further management of acute hepatitis. She was in her usual state of health until four days prior to admission there when she developed right upper quadrant/epigastric pain, nausea and vomiting. Family members also reported that they thought that she looked jaundiced. Additionally, she reported chills and temperature to 101 at home. She denied any hematemesis, saying that when she vomited that it was bilious. Her stools were noted to be [**Male First Name (un) 1658**] colored and smaller in caliber than usual. She denied any sick contacts or recent travel. She had started no new medications and denied the use of alcohol or intravenous drug use. Of note, she reported that her ex-husband (divorced three years ago) had a history of hepatitis C. At [**Hospital 8**] Hospital, right upper quadrant ultrasound on the day of admission was initially normal. Her transaminases rose rapidly to the range of [**2146**] to 3000 with INR of 2.1 at the time of transfer. Hepatitis serologies and autoimmune studies were sent, most of which were still pending at the time of transfer. At the time of admission to [**Hospital1 188**], she complained of continuing right upper quadrant pain. She denied further nausea, vomiting, chills or fever. In addition, she reported a thirty pound weight gain over the previous few months as well as increased abdominal girth over the previous week. PAST MEDICAL HISTORY: 1. Open cholecystectomy in [**2124**]. 2. Status post appendectomy. 3. Depression. 4. Multiple benign breast masses. ALLERGIES: Codeine. MEDICATIONS AT THE TIME OF TRANSFER: 1. Protonix. 2. Morphine p.r.n. 3. Klonopin 0.5 mg three times a day. SOCIAL HISTORY: The patient lives with her 21 year old daughter and her father. She reports ongoing smoking with greater than thirty pack year history. She has a history of suicide attempts in the past by overdose with benzodiazepines but denied again any active drug use. MEDICATIONS AT HOME: 1. Effexor. 2. Percocet. 3. Remeron. 4. Vicodin. 5. Trazodone. 6. Neurontin. 7. Compazine. This list was obtained from the patient's local pharmacy. PHYSICAL EXAMINATION: On admission, vital signs revealed the patient was afebrile at 98.2., heart rate 74, blood pressure 113/55, respiratory rate 12, oxygen saturation 97% in room air. Pertinent physical findings included that she was obese and jaundiced. She had scleral icterus. Her heart and lung examinations were without significant findings. Her abdominal examination revealed tenderness over the right upper quadrant, liver palpable approximately 3.0 centimeters below the costal margin. Cholecystectomy scar was noted. She had no stigmata of chronic liver disease or elevated portal pressures. She had no asterixis on examination. Extremities revealed no palmar erythema, cyanosis, clubbing or edema. LABORATORY DATA: On admission, complete blood count was unremarkable. Chem7 revealed sodium of 136, potassium 5.1, blood urea nitrogen and creatinine within normal limits. INR on admission was 2.1. Liver function tests revealed ALT 2481, AST 3416, alkaline phosphatase 203, total bilirubin 16.3, direct bilirubin 9.9, total protein 5.3, albumin 2.9. Numerous serologies looking at possible causes of her liver disease were still pending at the outside hospital at the time of transfer. HOSPITAL COURSE: 1. Acute hepatitis - Upon admission, blood was sent for numerous studies to determine the etiology of her acute hepatitis. Things that were examined included hepatitis A, B and C serologies, hepatitis B and C viral loads, EBV, CMV, HSV serologies, HIV, varicella, RPR, toxoplasma and ceruloplasmin. Ultimately, these results yielded an etiology consistent with acute hepatitis B as her hepatitis B surface antigen returned positive. All other studies were negative. She was treated supportively for her acute hepatitis B with coagulation studies being followed very closely. Her liver enzymes remained stable. On [**2149-5-16**], without any signs of hepatic encephalopathy, the patient was transferred out of the Intensive Care Unit to the medical floor. While still in the Intensive Care Unit and upon transfer to the floor, the patient had been treated with Morphine including a PCA for her severe abdominal pain. On [**2149-5-18**], the patient became acutely more encephalopathic and was transferred to the Surgical Intensive Care Unit, placed on the transplant list for possible liver transplant. While awaiting a liver, the patient admitted to recent intravenous drug use, specifically the use of Heroin. Her admission of illicit drug use precluded her from getting a liver transplant and she was transferred out of the Surgical Intensive Care Unit back to the Medical Intensive Care Unit. In the Medical Intensive Care Unit, she continued to decline neurologically with worsening encephalopathy, increasing asterixis and eventually significant lethargy and obtundation. Her INR continued to elevate and, at the time of readmission to the Medical Intensive Care Unit, her INR was 6.8. On [**2149-5-22**], the patient's INR reached its highest point of 25.0. At that time, hematology was consulted regarding reversal of her INR. It was recommended that she be given daily Vitamin K , fresh frozen plasma, and cryoglobulins for fibrinogen less than 150 and Factor VII-A was suggested for acute bleeding or if any procedure was needed to be performed. On [**2149-5-24**], the patient's mental status deteriorated further and she was ultimately intubated for airway support. Neurosurgery was consulted at that time. After reversal of INR to normal levels, intracerebral pressure monitor (BOLT) was placed for monitoring of her intracranial pressure. Her intracranial pressure was solid and maintained at level of less than 25 with a cerebral perfusion pressure greater than 50. At one point, her intracranial pressure rose to a level of 24 at which time she was treated with 20 grams of intravenous Mannitol. In the interim, the patient had developed acute renal failure and was essentially anuric becoming incredibly volume overloaded with all the blood products she was receiving. Once the BOLT was placed, it was necessary to maintain an INR of less than 1.5. For this, she received very frequent transfusions of fresh frozen plasma, Factor VII-A, cryoglobulins and platelets for levels that were less than 70,000. Renal was consulted and CVVH was instituted in the Intensive Care Unit for volume removal as well as to help with the elevation in intracranial pressure. This treatment continued until [**2149-5-30**], in that the patient received frequent blood products and CVVH for volume removal. The patient's platelets were found to fall precipitously and Heparin dependent antibodies were checked finding that she was HIT positive. For this, Heparin could not be used in the CVVH and the CVVH filter clotted. Citrate was used alternatively as an anticoagulant (see renal below) and ultimately as the patient showed no signs of improvement in her hepatic function, it was decided after a family meeting on [**2149-5-30**], that once the CVVH filter clotted off again that it would not be restarted. That was the case on [**2149-5-30**], after which time, CVVH was not restarted. The patient had her BOLT removed and has since been monitored for progressive neurologic decline. At the time of this dictation, there is evidence of cerebral herniation in that her pupils are fixed and dilated bilaterally. She continues to be sedated on the ventilator so the neurologic examination is difficult beyond that, however, without any improvement in her liver synthetic function, her prognosis is grime. The patient was made "Do Not Resuscitate" after a family meeting. Liver enzymes have trended downward and are actually below normal limits suggesting that hepatic function is not showing any signs of return. 2. Renal - As stated above, the patient developed acute renal failure likely hepatorenal syndrome versus HEN as microscopic examination of the urine reveals casts suggestive thereof. As above, CVVH was instituted to help with volume overload as well as to aid in the treatment of intracranial pressure with the administration of Mannitol. Again, the CVVH filter had clotted off and the patient was not receiving Heparin. Citrate was instituted as anticoagulant. While on Citrate, the patient's free calcium was noted to become very low due to the binding of Citrate and she was repleted with a constant infusion of Calcium Gluconate as well as Calcium Chloride on a p.r.n. basis. Daily laboratories revealed that her body's total calcium was as high as 18.0 as it was measuring the calcium bound to Citrate and though her free calcium was within the normal range of 1.0 to 1.2. When the CVVH filter clotted on [**2149-5-30**], as above, it was decided that it would not be restarted as the patient's prognosis and hope for recovery was minimal. Since CVVH has been discontinued, the patient's creatinine has risen very rapidly from 2.5 on the day of discontinuation to 4.5 on the day of dictation. She continues to be volume overloaded with increasing potassium. 3. Hematology - With worsening liver synthetic function, the patient's coagulopathy was as above with her INR ultimately reaching a level of 25. With the placement of the intracranial pressure monitor, it was necessary to keep the patient's INR less than 1.5, platelets greater than 70,000, fibrinogen greater than 150. Appropriate blood products were transfused on a p.r.n. basis to maintain those goals with Factor VII-A being used frequently for INRs greater than 2.0 to 2.5. Because of its expense, Factor VII-A was reserved only for when fresh frozen plasma was unable to correct the INR on its own which was a frequent occurrence. After the intracranial pressure monitor was removed, reversal of INR was continued for 24 hours to minimize the chance of an intracranial bleed. Since discontinuation of INR control, her INR has already risen to 6.1 eight hours after her last dose of Factor VII-A. No further blood products will be given at this time unless the patient shows signs of active bleeding. On the day of this dictation, the patient's hematocrit was 19.0, status post one unit of packed red blood cells the day prior for the same hematocrit. A source of bleeding is unclear at this time. It is possible the patient is hemolyzing. She will be transfused further packed red blood cells today on [**2149-6-1**]. 4. Hypotension - With the patient's worsening encephalopathy and liver failure as well as likely component of her sedation, the patient was persistently hypotensive requiring pressors to maintain her blood pressure. Specifically, it was important to maintain her cerebral perfusion pressure (MAT minus intracranial pressure) of greater than 50. For this, she was on Levophed, Neo-Synephrine and Vasopressin. The Neo-Synephrine was able to be weaned and the patient has been continued to date on Levophed and Vasopressin. After the family meeting on [**2149-5-30**], it was determined that no further pressors would be used, i.e., Neo-Synephrine would not be restarted but Vasopressin and Levophed would be continued and titrated as needed. 5. Pulmonary - Once intubated, the patient developed worsening oxygenation but chest x-ray was consistent with adult respiratory distress syndrome. She was ventilated with low tidal volumes at high respiratory rates, as high as 34 for a number of days, with continuing poor oxygenation. Over time, her oxygenation did improve and at the time of this dictation, she is still ventilated on assist control with a tidal volume of 600 with a rate of only 22, pCO2 in the mid 30s and pO2 in the 80s to 100s. 6. Acid base - The patient had a triple acidotic disturbance with both a gap and nongap metabolic acidosis as well as respiratory acidosis. In order to compensate for this, she was ventilated as above with respiratory rates as high as 34 to try to decrease her pCO2. 7. FEN - As above, the patient was persistently volume overloaded and her total volume in was minimized by concentrating all fluids that she received. Her calcium was complicated by the Citrate and the CVVH fluid as above. At the time of this dictation, her potassium is rising since CVVH has been off. For nutrition, the patient had been receiving tube feeds but was having problems with high residuals. Therefore, she has been maintained on TPN. 8. Endocrine - The patient was found to be adrenally insufficient by random cortisol and is being treated with Hydrocortisone 100 mg intravenous q8hours. In addition, because of her decrease in hepatic synthetic function, decreased gluconate agenesis, the patient has had q2hour fingerstick and treated with initially a D10 infusion replaced by increased dextrose in her TPN with p.r.n. of D50 as needed for hypoglycemia. The dictation covers the [**Hospital 228**] hospital course from admission through [**2149-6-1**]. The remainder of the [**Hospital 228**] hospital course will be dictated by the intern taking over the Medical Intensive Care Unit service tomorrow. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], M.D. Dictated By:[**Name8 (MD) 3491**] MEDQUIST36 D: [**2149-6-1**] 08:41 T: [**2149-6-1**] 10:39 JOB#: [**Job Number 49613**] ICD9 Codes: 5849, 5185, 2762
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Medical Text: Admission Date: [**2120-8-3**] Discharge Date: [**2120-8-13**] Date of Birth: [**2052-9-12**] Sex: M Service: MEDICINE Allergies: Codeine Attending:[**Last Name (NamePattern4) 290**] Chief Complaint: Self-transferred from [**Hospital 1474**] Hospital for further workup Major Surgical or Invasive Procedure: 1. Bone marrow aspirate History of Present Illness: 67 yo M, PMH of DM, CAD (CABG), DJD (disc surgery), COPD, presents with epistaxis, purpura, lymphadenopathy, back pain, anemia, thrombocytopenia, fevers, fatigue x 2.5 months, 30 lb weight loss over past month. Pt developed persistent epistaxis at 2 pm today, still bleeding 7 hours later. Pt states 30 lb weight loss over past month. His back pain has been so severe that he has not been able to walk properly for the past 2.5 months. The back pain projects down in and along the spinal canal, from the shoulder blades down to his buttocks, worst in disc surgery site in lower thoracic/upper lumbar spine. The pain radiates to his buttocks bilaterally, and radiates down his leg posterolaterally bilaterally. The pt has experienced motor weakness in both legs for the past 2.5 months, no tingling, no sensory loss. No bladder or rectal incontinence. No erectile dysfunction. Pt has felt fatigued and short of breath for the past few months. Pt has never had a bone marrow biopsy. . Pt also has 50 pk yr smoking hx and COPD, and chronic dyspnea on exertion. His PPD test has been negative, he has not traveled out of the country, been in shelters, or been incarcerated over the past several years. Pt has had unprotected sex with his girlfriend for the past 3 years. . Pt has been hospitalized in [**Hospital 1474**] Hospital for the past 4 weeks, for intractable back pain, bilateral hilar and mediastinal adenopathy, anemia, thrombocytopenia, pneumonia, MRSA. Mediastinoscopy and bronchoscopy were performed to sample lymph node tissue, which yielded benign findings. Bronch sample found MRSA in the sputum. Pt was placed on regimen of Vanco and Zosyn for coverage. . Pt had a fine needle aspiration of a right lower lung lesion, but before FNA, pt was noted as having low plts and hct of 19. The patient had hemoptysis with small amounts of bloody sputum. Pt received plts and red cell transfusions. Path for the needle biopsy is still pending. . Pt was in constant pain at [**Hospital1 1474**], and needed his pain regimen adjusted constantly until placed on a PCA pump. He is allergic to codeine. He wished a second opinion for his medical problems. . ROS: +30 lb weight loss, +fatigue, +weakness, +shortness of breath, +constipation, all other negative Past Medical History: PMH: 1. DM 2. HTN 3. DJD 4. CAD 5. Emphysema . PSH: Spinal fusion surgery [**30**] years ago. Social History: 50 pk yr smoking hx (nicotine patch), stopped drinking 35 yrs ago, lives with his children, getting married soon, 4 children. Enjoys hunting, fishing now. Strong social support. Family History: Healthy, uncle may have had cancer, no family member had or have similar symptoms Physical Exam: Vitals: 98.9 / 92 / 28 / 96% sat on 2 L / 132/70 Gen: Ambulatory, breathing loudly HEENT: No JVD, PERRL Lungs: CTAB Chest: No pain on palpation, purpura on chest, barrel-chested Heart: RRR, no m/r/g, clear S1/S2, no S3/S4 Abdomen: Distended, firm, bumpy on palpation, NT, +BS, purpura and petechiae on abdomen, hepatosplenomegaly is difficult to appreciate due to distension of abdomen and bowel Back: Tenderness to palpation along spine from shoulder blades down to buttocks, most tenderness in T8 area of disc surgery, tenderness with palpation of buttocks, less tenderness in cervical spine LYMPH: No anterior/posterior cervical/supraclavicular LN, no axillary or inguinal LN Genital: Vesicle/wart in suprapubic area, discomfort on palpation Extremities: 1+ pitting edema bilaterally Neuro: [**6-13**] motor, sensory equal and intact throughout, good rectal tone and sensation, leg raise to 80 degrees bilaterally without pain, 2+ pulses throughout, PERRL Pertinent Results: [**2120-8-3**] 08:15PM PT-12.7 PTT-20.4* INR(PT)-1.1 [**2120-8-3**] 08:15PM PLT SMR-VERY LOW PLT COUNT-56* [**2120-8-3**] 08:15PM HYPOCHROM-NORMAL ANISOCYT-1+ POIKILOCY-1+ MACROCYT-1+ MICROCYT-1+ POLYCHROM-1+ STIPPLED-1+ HOW-JOL-1+ [**2120-8-3**] 08:15PM NEUTS-52 BANDS-12* LYMPHS-19 MONOS-6 EOS-0 BASOS-1 ATYPS-1* METAS-5* MYELOS-3* PROMYELO-1* NUC RBCS-7* [**2120-8-3**] 08:15PM WBC-5.6 RBC-3.46* HGB-10.4* HCT-29.3* MCV-85 MCH-30.2 MCHC-35.6* RDW-15.9* [**2120-8-3**] 08:15PM calTIBC-235* FERRITIN-GREATER TH TRF-181* [**2120-8-3**] 08:15PM ALBUMIN-3.6 CALCIUM-9.4 PHOSPHATE-2.9 MAGNESIUM-2.0 URIC ACID-4.8 IRON-57 [**2120-8-3**] 08:15PM ALT(SGPT)-38 AST(SGOT)-90* LD(LDH)-4712* ALK PHOS-105 TOT BILI-0.8 [**2120-8-3**] 08:15PM GLUCOSE-114* UREA N-23* CREAT-0.7 SODIUM-133 POTASSIUM-4.3 CHLORIDE-97 TOTAL CO2-25 ANION GAP-15 Brief Hospital Course: A/P: 67 yo M, PMH of DM, CAD (CABG), DJD (disc surgery), COPD, presents with epistaxis, purpura, lymphadenopathy, severe back pain, anemia, thrombocytopenia, fevers, fatigue x months, 30 lb weight loss over past month. . 1. MEDIASTINAL AND ABDOMINAL LAD: Diff Dx: LAD could be due to myeloma, lymphoma, primary lung ca, TB (no apparent exposure), granulomatous diseases, HIV (unprotected sex for 3 years, STD), fungus. Other possibilities are Wegener's (hemoptysis, but no renal failure), sarcoidosis (but unusual patient profile, and Ca is 9.4). . In [**Hospital 1474**] Hospital, the pt had undergone a CT Chest, which showed mediastinal LAD and a RLL lesion. Mediastinoscopy was performed, and the [**Hospital1 1474**] pathologist (Dr. [**First Name (STitle) **] reported "benign findings" (detailed [**Hospital1 1474**] pathology report and phone numbers included in the chart). FNA of a RLL lesion was performed, and Dr.[**Name (NI) 16211**] initial impression was small cell ca of the lung. . At [**Hospital1 18**], a CT Torso was performed, demonstrating diffuse giant LAD throughout the mediastinum and abdomen, as well as a RLL lesion, 2 small liver lesions (one in caudate lobe, one in left lobe), and no splenomegaly. Since the patient had SOB, chest pain, and a R apical pneumothorax after his mediastinoscopy at [**Hospital1 1474**], it was decided that the giant lymph nodes found on CT Torso, the lung lesion, and 2 liver lesions would not be biopsied, in case the results of the bone marrow aspirate were sufficient for diagnosis. HIV and ANCA were negative. . 2. BACK PAIN: Diff Dx: Back pain could be due to myeloma (lytic lesions), colon ca (pathologic fx), mets to bone from lung ca (pathologic fx), slipped disc. . Metastases to the spine were suspected. T- and L-spine XR showed neither a pathologic fracture nor lytic lesions. SPEP/UPEP and PSA were negative. During admission, the pt experienced a fall, in which he was "walking normally, and then all of a sudden my legs went numb, and I went to take a step and my legs buckled like the batteries had been taken out of them". Neurologic findings showed R LE weakness. Pt was started on steroids with communication with Hem-Onc. MRI of the Head, C-, T-, and L-spine ruled out cord compression, but a possibility of an epidural tumor was noted at T10/T11. The next day, neurologic findings progressed to R LE and R UE weakness and decreased pinprick sensation, and decreased R lower face pinprick sensation. MRI Head showed a possible subacute pontine infarct. Pt has a h/o spinal fusion surgery [**30**] years ago, and an LP under fluoro was attempted to rule out carcinomatous meningitis. 2 units plts were transfused before LP. However, while attempting to lie on his abdomen, the pt was in excruciating pain and his O2 sat dropped to 90%, and the LP could not be performed. . 3. EPISTAXIS: Diff Dx: Epistaxis that does not stop after several hours, with a plt count of 56, in a non-uremic pt is unusual, and suggestive of myeloma, lymphoma, bone marrow aplasia, DIC, qualitative plt defects. . The pt presented with plts 56 and profuse epistaxis that did not respond to Afrin, pressure, tilting of his head. Epistaxis ceased only after infusion of 1 unit plts. Hct remained stable throughout admission. Epistaxis was on and off when pt had plts 78. . 4. PURPURA: Diff Dx: Purpura diffusely over the chest, abdomen, and legs, with a plt count of 56, in a non-uremic pt is unusual, and suggestive of myeloma, lymphoma, bone marrow aplasia, DIC, qualitative plt defects. . The pt presented with green-yellow purpura on his chest and abdomen, as well as petechiae on his abdomen with no h/o trauma. Purpura continued to resolve during admission. . 5. ANEMIA: Diff Dx: Anemia of Hct 29.3 suggests colon ca in a 67 yo male (but no black stools, normal bore stools), myeloma, lymphoma, hemolytic anemia, splenomegaly and reticuloendothelial system can be destroying RBC. With fever and thrombocytopenia, TTP is a possibility, but no renal failure or neuro changes (although these are late developments). . Results of uric acid, haptoglobin, retics, total bili, and no schistocytes indicated that a hemolytic anemia or TTP was unlikely. No splenomegaly was found on CT Abd. . CBC with diff twice showed selectively early myeloid precursors in the peripheral blood. Basophilic stippling and [**Location (un) **]-Jolly body was noted on erythrocyte examination. A peripheral smear (showing erythroblasts and no tear drop cells) and bone marrow aspirate was performed by Hem-Onc (Dr. [**First Name4 (NamePattern1) 16212**] [**Last Name (NamePattern1) **] and Dr. [**Last Name (STitle) **]. A bone marrow biopsy could not be performed due to pt's "panic attack" during two attempts. The results of the BM aspirate revealed a diagnosis of small cell carcinoma of the lung with squamous morphology, an undifferentiated tumor. . 6. THROMBOCYTOPENIA: Diff Dx: Plts of 56 with epistaxis and purpura indicates a functional, qualitative thrombocytopenia, suggesting bone marrow suppression, production problem (liver failure and tpo, but bili is WNL), destruction by splenomegaly (should be increase in megakaryocytes). . 7. SOB: Pt's baseline SOB was attributed to COPD (emphysema), as CXR taken for possibility of post-obstructive pneumonia showed no infiltrates. Exacerbated SOB was attributed to R pneumothorax. Pt maintained >95% O2 sat on high flow 5L nasal cannula, and R pneumothorax was resolving. . Echo and daily CXR had not been performed on the day before transfer to OMED, due to more emergent testing. Echo had also been planned as preparation for possible future cancer therapy. . 8. PAIN: Both at [**Hospital 1474**] Hospital and [**Hospital1 18**], pt's pain was difficult to control. Pt's pain is diffuse, "all over", in the chest, and localized especially on the spine from T4 to the sacrum and down the LEs. Pt's pain is episodic, at times [**3-21**] to 10+/10, feels like "sharp, electric shock pain", helped by position of sitting or lying down on his back, and precipitated by muscle use. Pt's pain was successfully controlled on a morphine PCA pump at a maximum of 10 mg/hr. . 9. CAD: Pt's CAD is chronic. He had been maintained on Metoprolol and ASA, but no ACE-I or [**Last Name (un) **]. Pt's ASA was discontinued due to pt's bleeding tendency. . 10. HTN: Pt's HTN is chronic, and well-controlled on Metoprolol. . 11. DM: Pt was maintained on Insulin SS. . 12. COPD (Emphysema): Pt has a 50 pk-yr smoking history and emphysema, and was maintained at >95% O2 sat on 2L O2 nasal cannula alone. High flow 5L O2 nasal cannula was maintained to help resolve pt's pneumothorax. . 13. FEN: Due to pt's 30 lb weight loss over the past month, decreased appetite, and possible cachexia, a house diet and periodic IVFs of D5 0.45NS were provided. . 14. PROPHYLAXIS: Due to pt's bleeding tendency, pneumoboots and no heparin sc were used. PPI was given for GI protection. . . 15. FAMILY CONTACTS: Have permission of the pt to have open communication with: [**Name (NI) **] (son), [**Name (NI) 6480**] (daughter): [**Telephone/Fax (1) 16213**] [**Name (NI) 1328**] (sister). . The patient was kept comfortable until his family could arrive. He was then made CMO and expired on [**2120-8-13**]. Medications on Admission: Morphine Sulfate SR 15 mg PO Q12H Oxycodone 5 mg PO Q4-6H:PRN pain Nicotine Patch 21 mg TD DAILY Pantoprazole 40 mg PO Q24H Insulin SC (per Insulin Flowsheet) Sliding Scale Multivitamins 1 CAP PO DAILY Metoprolol 50 mg PO BID Albuterol 0.083% Neb Soln 1 NEB IH Q6H Ipratropium Bromide Neb 1 NEB IH Q6H Fluticasone Propionate 110mcg 2 PUFF IH [**Hospital1 **] use with spacer Acetaminophen 1000 mg PO Q6H traMADOL 50 mg PO Q4-6H:PRN pain Zolpidem Tartrate 5 mg PO HS:PRN insomnia Oxymetazoline HCl 1 SPRY NU [**Hospital1 **] Duration: 3 Days for epistaxis Discharge Medications: None - patient expired Discharge Disposition: Expired Facility: [**Hospital1 18**] Discharge Diagnosis: Respiratory Failure Discharge Condition: Expired Discharge Instructions: Expired Followup Instructions: Expired [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**Name8 (MD) **] MD [**MD Number(1) 292**] ICD9 Codes: 2875, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8382 }
Medical Text: Admission Date: [**2196-1-7**] Discharge Date: [**2196-1-18**] Date of Birth: [**2139-6-12**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1505**] Chief Complaint: Dyspnea on Exertion Major Surgical or Invasive Procedure: CABGx3(LIMA->LAD< SVG->OM, PDA) [**2196-1-8**] Cardiac Catheterization [**2196-1-7**] History of Present Illness: Mr. [**Known lastname 32283**] is a 56 year old gentleman with no known coronary artery disease. In [**2191-8-5**], he was diagnosed with thyroid cancer and underwent a thyroidectomy and radiation therapy. In [**2194-2-1**] a routine CT scan revealed coronary artery calcification and he was therefore referred for further evaluation. An exercise tolerance test on [**2195-12-18**] was positive with fatigue, dyspnea and ST depressions in the inferolateral leads. Scans showed a moderate reverisble defect in thebasilar and mid-inferior wall. His ejection fraction was predicted to be 66%. Mr. [**Known lastname 32283**] reports intermittant dyspnea on exertion for the past few months but denies ever experiencingany chest pain. He was admitted today [**2195-12-7**] for a cardiac catheterization which revealed an 80% stenosed left main, an 80% stenosed left anterior descending artery and a 90% stenosed right cronary artery. His ejection fraction was normal. Mr. [**Known lastname 32283**] is now being referred for surgical revascularization. Past Medical History: Hypercholesterolemia Thyroid cancer S/P Thyroidectomy Gout Right eye styes Glaucoma Past tonsillectomy Eye surgery to relieve pressure Social History: Live sin [**Location 17448**] with wife. Three children. WOrks full-time as a buisness analyst. Never smoked. Occasional alcohol use. Family History: Father with myocardial infarction and CABG in his 60's. Aunts and [**Name2 (NI) 32284**] with coronary artery disease. Physical Exam: Ht 68" Wt 160 Temp- 98.1 128-147/70's 64 SR 100% room air sats GEN: Overall good health. Appears well in no acute distress. NEURO: Alert and oriented x3. Appropriate. Flat affect. Nonfocal. LUNGS: Bibasilar rales HEART: RRR, normal S1-S2. No murmur ABDOMEN: Soft, round, nontender, nondistended, normoactive bowel sounds EXTREMITIES: Warm, well perfused, no edema, no varicosities. PULSES: 1+ radial, dorsalis pedis and posterior tibial bilaterally. Pertinent Results: [**2196-1-7**] 09:30AM PT-12.9 PTT-28.9 INR(PT)-1.1 [**2196-1-7**] 09:30AM WBC-3.6* RBC-4.39* HGB-13.7* HCT-37.7* MCV-86 MCH-31.3 MCHC-36.4* RDW-12.8 [**2196-1-7**] 09:30AM ALT(SGPT)-32 AST(SGOT)-16 ALK PHOS-38* AMYLASE-35 TOT BILI-0.7 [**2196-1-7**] 09:30AM GLUCOSE-208* UREA N-19 CREAT-1.0 SODIUM-135 POTASSIUM-3.6 CHLORIDE-103 TOTAL CO2-25 ANION GAP-11 [**2196-1-7**] 11:53AM URINE BLOOD-SM NITRITE-NEG PROTEIN-NEG GLUCOSE-TR KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-6.5 LEUK-NEG [**2196-1-7**] CXR No acute cardiopulmonary disease [**2196-1-7**] Cardiac Catheterization 1. Selective coronary angiography of this right dominant system revealed severe three vessel and left main coronary disease. The LMCA contained an 80% ostial lesion. The LAD contained an 80% osital lesion before giving off two large septals and a large diagonal branch. The LCX contained 40% ostial disease. The RCA was a large, domiant vessel and contained a mid vessel 90% lesion and a distal 90% just before the PDA takeoff. 2. Left ventriculography revealed a calculated ejection fraction of 55% with not mitral regurgitation or wall motion abnormalities seen. 3. Limited resting hemodynamics revealed a central aortic pressure of 161/70 with an elevated LVEDP of 23mmHg. There was no gradient across the aortic valve on pull-back. [**2196-1-7**] EKG Sinus rhythm. Right ventricular conduction delay. No previous tracing available for comparison. Rate 57. [**2196-1-14**] EKG Sinus rhythm 74. Short PR interval. Nonspecific inferolateral T wave changes, RSR' in V1. Since last ECG some T wave changes [**2196-1-15**] ECHO 1. The left ventricular cavity size is normal. Overall left ventricular systolic function is moderately depressed. Anterior, septal, and apical hypokinesis to akinesis is present. 2. The aortic valve leaflets (3) are mildly thickened. 3. The mitral valve appears structurally normal with trivial mitral regurgitation. 4. Compared with the findings of the prior report (tape unavailable for review) of [**2195-7-7**], LV function has decreased. Brief Hospital Course: Mr. [**Known lastname 32283**] was admitted to the [**First Name8 (NamePattern2) **] [**First Name4 (NamePattern1) 1675**] [**Last Name (NamePattern1) **] Medical Center on [**2196-1-7**] and underwent a cardiac catheterization. This revealed an 80% stenosed left main coronary artery, an 80% stenosed left anterior descending artery, a 90% stenosed right coronary artery and a normal left ventricular ejection fraction. Heparin was started for anticoagulation. Due to the severity of his disease, the cardiac surgical service was consulted for surgical revascularization. Mr. [**Known lastname 32283**] was worked-up in the usual preoperative manner. On [**2196-1-8**], Mr. [**Known lastname 32283**] was taken to the operating room where he underwent coronary artery bypass grafting to three vessels. Postoperatively, he was taken to the cardiac surgical intensive care unit for monitoring. On postoperative day one, Mr. [**Known lastname 32283**] [**Last Name (Titles) 5058**] neurologically intact and was extubated. Neo-Synephrine continued for hypotension. The endocrinology service was consulted in regards to his difficultly coming off pressors and a thyroid study and cortisol levels were sent. He was gently diuresed towards his preoperative weight. He was transfused with packed red blood cells for postoperative anemia. The physical therapy service was consulted for assistance with his postoperative strength and mobility. His drains and epicardial pacing wires were removed per protocol. An echocardiogram was obtained which ruled out any evidence of tamponade. Ultimately his neo synephrine was weaned off. On postoperative day eight, Mr. [**Known lastname 32283**] was transferred to the step down unit for further recovery. His cortisol level returned mildly elevated at 27.7 micrograms per deciliter and his thyroid studies showed a mildly elevated free T4 and a low thyroid stimulating hormone on Synthroid. Follow-up thyroid studies were recommended in 2 to 4 weeks as an outpatient. Mr. [**Known lastname 32283**] continued to make steady progress and was discharged home on postoperative day ten. He will follow-up with Dr. [**Last Name (STitle) **], his cardiologist and his primary care physician as an outpatient. Medications on Admission: Synthroid 150mcg daily Timoptic one drop to both eyes at bed time Travatan one drop to both eyes at bed time Lipitor 20mg once daily Toprol XL 50mg once daily Doxycycline 50mg once daily Valium 5mg as needed at bed time Ecotrin 81mg 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. 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. Timolol Maleate 0.5 % Drops Sig: One (1) Drop Ophthalmic [**Hospital1 **] (2 times a day). Disp:*1 bottle* Refills:*2* 4. Levothyroxine Sodium 150 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 5. Atorvastatin Calcium 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 6. Ibuprofen 600 mg Tablet Sig: One (1) Tablet PO every six (6) hours as needed. Disp:*120 Tablet(s)* Refills:*0* 7. Atenolol 25 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* 8. Oxycodone-Acetaminophen 5-325 mg/5 mL Solution Sig: 5-10 MLs PO Q4-6H (every 4 to 6 hours) as needed for pain. Disp:*250 ML(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital3 **] Discharge Diagnosis: Coronary artery disease. Discharge Condition: Good. Discharge Instructions: Follow medications on discharge instructions. You may not drive for 4 weeks. You may not lift more than 10 lbs. for 3 months. You should shower, let water flow over wounds, pat dry with a towel. Followup Instructions: Make an appointment with Dr. [**Last Name (STitle) 32285**] for 1-2 weeks. Make an appointment with Dr. [**Last Name (STitle) **] for 2-3 weeks. Make an appointment with Dr. [**Last Name (STitle) **] for 4 weeks. Completed by:[**2196-2-2**] ICD9 Codes: 2724
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8383 }
Medical Text: Admission Date: [**2197-3-15**] Discharge Date: [**2197-3-20**] Date of Birth: [**2137-5-12**] Sex: F Service: CARDIOTHORACIC Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 1406**] Chief Complaint: Dyspnea, palpitations Major Surgical or Invasive Procedure: [**2197-3-15**] Tricuspid Valve repair utilizing a 34mm annuplasty ring with LV lead placement . [**2197-3-17**] Insertion of [**Company 1543**] dual chamber permanent pacemaker, model # ADDRL1 History of Present Illness: This is a 59 year old female with history of polymyositis, who was recently sent in for evaluation of tachy-brady syndrome. Over past month prior to admission, she reported having intermittent chest tightness and palpitations. These episodes lasted approximately 10-40 minutes. She also complained of intermittent dyspnea and decreased exercise tolerance. She also reported episodes in which she feels lightheaded and a sensation of warmth, but denies any dizziness or loss of consciousness. Subsequent cardiac MRI revealed worsening tricuspid regurgitation with RA/RV enlargement and also some mitral regurgitation. Given above findings, cardiac surgery was consulted and further evaluation was performed. After routine preoperative evaluation, she was eventually cleared to proceed with surgical intervention. Past Medical History: - Gallbladder polyps - Polymyositis - biopsy proven. Has refused treatment in the past due to side effects of prednisone - Recent Pneumonia, one month prior to admission - Tricuspid Regurgitation - Sick Sinus Syndrome Social History: Lives with her son [**Name (NI) **]. Nonsmoker. Denies ETOH or drug use. Daily hour long walks per family. Family History: No family history of early MI, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. Physical Exam: PREOP EXAM: BP 103/56 Pulse:54 Resp:18 O2 sat:95/RA Height:66" Weight:59.1 kgs General: WDWN female in no acute distress Skin: Dry [x] intact [x] HEENT: PERRLA [x] EOMI [x] Neck: Supple [x] Full ROM [x] Chest: Lungs clear bilaterally [x] Heart: RRR [x] Irregular [] Murmur [] grade ______ Abdomen: Soft [x] non-distended [x] non-tender [x] bowel sounds + [x] Extremities: Warm [x], well-perfused [x] No edema Varicosities: None [x] Neuro: Grossly intact [x] Pulses: Femoral Right: 2+ Left: 2+ DP Right: 2+ Left: 2+ PT [**Name (NI) 167**]: 2+ Left: 2+ Radial Right: 2+ Left: 2+ Carotid Bruit Right: none Left: none Pertinent Results: Admission labs: [**2197-3-15**] WBC-7.4 RBC-2.71*# Hgb-8.1*# Hct-24.5*# RDW-14.2 Plt Ct-64*# [**2197-3-16**] WBC-11.5* RBC-2.84* Hgb-8.3* Hct-25.2* RDW-15.2 Plt Ct-173 [**2197-3-17**] WBC-15.5* RBC-3.14* Hgb-9.1* Hct-27.7* RDW-15.5 Plt Ct-120* [**2197-3-18**] WBC-8.9 RBC-2.95* Hgb-8.6* Hct-26.7* RDW-15.0 Plt Ct-104* [**2197-3-19**] WBC-9.4 RBC-2.99* Hgb-8.6* Hct-27.1* RDW-15.2 Plt Ct-111* [**2197-3-15**] UreaN-9 Creat-0.4 Na-142 K-3.4 Cl-109* HCO3-28 AnGap-8 [**2197-3-16**] Glucose-100 UreaN-7 Creat-0.3* Na-138 K-4.1 Cl-106 HCO3-30 [**2197-3-17**] Glucose-112* UreaN-8 Creat-0.5 Na-135 K-4.1 Cl-99 HCO3-33* [**2197-3-18**] Glucose-99 UreaN-6 Creat-0.3* Na-138 K-3.8 Cl-101 HCO3-31 AnGap-10 [**2197-3-19**] UreaN-7 Creat-0.3* Na-140 K-3.8 Cl-101 [**2197-3-16**] Mg-2.0, [**2197-3-19**] Mg-2.0 . Discharge labs: [**2197-3-19**] 06:40AM BLOOD WBC-9.4 RBC-2.99* Hgb-8.6* Hct-27.1* MCV-91 MCH-28.9 MCHC-31.9 RDW-15.2 Plt Ct-111* [**2197-3-19**] 06:40AM BLOOD Plt Ct-111* [**2197-3-17**] 03:52AM BLOOD PT-12.7* PTT-26.7 INR(PT)-1.2* [**2197-3-19**] 06:40AM BLOOD UreaN-7 Creat-0.3* Na-140 K-3.8 Cl-101 [**2197-3-19**] 06:40AM BLOOD Mg-2.0 [**2197-3-18**] Chest x-ray: Pulmonary edema has not recurred and pulmonary vascular engorgement has improved. Severe cardiomegaly is stable. Small right and moderate left pleural effusion are stable, left lower lobe collapse is more pronounced. No pneumothorax. Transvenous right ventricular pacer lead may pass into the coronary sinus, but it does not traverse the ring of the tricuspid valve prosthesis [**Hospital1 18**] ECHOCARDIOGRAPHY REPORT Echocardiographic Measurements Results Measurements Normal Range Left Ventricle - Ejection Fraction: 55% >= 55% Findings Multiplanar reconstructions were generated and confirmed on an independent workstation. LEFT ATRIUM: No mass/thrombus in the [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) **] LAA. RIGHT ATRIUM/INTERATRIAL SEPTUM: No ASD by 2D or color Doppler. LEFT VENTRICLE: Normal LV wall thickness. Normal regional LV systolic function. Overall normal LVEF (>55%). RIGHT VENTRICLE: Moderately dilated RV cavity. Mild global RV free wall hypokinesis. AORTA: Normal aortic diameter at the sinus level. Normal ascending aorta diameter. Normal descending aorta diameter. AORTIC VALVE: Normal aortic valve leaflets (3). No AS. Trace AR. MITRAL VALVE: Mildly thickened mitral valve leaflets. Mild to moderate ([**2-6**]+) MR. TRICUSPID VALVE: Moderate to severe [3+] TR. PERICARDIUM: No pericardial effusion. GENERAL COMMENTS: Written informed consent was obtained from the patient. The patient was under general anesthesia throughout the procedure. No TEE related complications. The patient appears to be in sinus rhythm. Results were personally reviewed with the MD caring for the patient. Conclusions Prebypass No mass/thrombus is seen in the left atrium or left atrial appendage. 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%). The right ventricular cavity is moderately dilated with mild global free wall hypokinesis. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis. Trace aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Mild to moderate ([**2-6**]+) mitral regurgitation is seen. Moderate to severe [3+] tricuspid regurgitation is seen. There is no pericardial effusion. Dr. [**Last Name (STitle) **] was notified in person of the results on [**2197-3-15**] at 945am. Post bypass Patient is AV paced and receiving an infusion of phenylephrine. LVEF= 50%. Annuloplasty ring seen in the tricuspid position. It appears well seated . There is trivial tricuspid regurgitation and no stenosis. Aorta is intact post decannulation. The mitral regurgitation is trivial. I certify that I was present for this procedure in compliance with HCFA regulations. Electronically signed by [**Name6 (MD) 1509**] [**Name8 (MD) 1510**], MD, Interpreting physician [**Last Name (NamePattern4) **] [**2197-3-15**] 14:04 Brief Hospital Course: Mrs. [**Known lastname **] was a same day admission to the operating room for tricuspid valve repair along with placement of a left ventricular lead, please see operative report for details. In summary patient had: 1. Tricuspid repair using an [**Doctor Last Name **] MC3 annuloplasty ring, model number 4900. 2. Left ventricular epicardial lead placement x2. 3. Atrial tissue biopsy. 4. Mediastinal reexploration Her bypass time was35 minutes with a crossclamp time of 24 minutes. Following re-operation, she was brought to the CVICU for invasive monitoring. Within 24 hours, she awoke neurologically intact and was extubated without incident. She maintained stable hemodynamics and underwent placement of dual chamber [**Company 1543**] pacemaker on postoperative day two. She tolerated the procedure well without complication. Following pacemaker implantation, she transferred to the cardiac stepdown floor for further care and recovery. She experienced brief episodes of paroxysmal atrial fibrillation but ultimately was apaced. Beta blockade was started and advanced as tolerated. Over several days, she continued to make clinical improvement with diuresis and she was medically cleared for discharge to rehabilitation on postoperative day five. Prior to discharge, pacemaker underwent interrogation and was found to be functioning within normal limits. At discharge, incisional pain was well controlled on Ultram. Follow up appointments were outlined in discharge paperwork. Medications on Admission: metoprolol XL25 mg daily, several Chinese herbal medications 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 [**Hospital1 1926**] 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO once a day. Disp:*90 Tablet, Chewable(s)* Refills:*2* 4. metoprolol tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). Disp:*30 Tablet(s)* Refills:*2* 5. tramadol 50 mg Tablet Sig: One (1) Tablet PO every 6-8 hours as needed for pain management . Disp:*30 Tablet(s)* Refills:*0* 6. furosemide 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily) for 10 days: please take with KCL. Disp:*10 Tablet(s)* Refills:*0* 7. potassium chloride 20 mEq Tablet, ER Particles/Crystals Sig: One (1) Tablet, ER Particles/Crystals PO once a day for 10 days: please take with Lasix. Disp:*10 Tablet, ER Particles/Crystals(s)* Refills:*0* 8. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) neb Inhalation Q6H (every 6 hours) as needed for dyspnea. 9. ipratropium bromide 0.02 % Solution Sig: One (1) neb Inhalation Q6H (every 6 hours) as needed for shortness of breath or wheezing. Discharge Disposition: Extended Care Facility: [**Location (un) 5481**] TCU Discharge Diagnosis: Tricuspid regurgitation- s/p Tricuspid repair Tachy-brady syndrome, s/p Permanent pacemeker implantation Polymyositis Postop Bleeding, s/p re-exploration Discharge Condition: Alert and oriented x3, nonfocal Ambulating with steady gait Incisional pain managed with Tramadol Incisions: Sternal - healing well, no erythema or drainage Edema-trace bilat LE Discharge Instructions: Please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. Look at your incisions daily for redness or drainage Please NO lotions, cream, powder, or ointments to incisions Each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart No driving for one month or while taking narcotics. Driving will be discussed at follow up appointment with surgeon. No lifting more than 10 pounds for 10 weeks Please call 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. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] ([**Telephone/Fax (1) 170**]) on [**4-20**] @1pm phone:[**Telephone/Fax (1) 4044**] EP service/Cardiologist:Dr. [**First Name (STitle) 900**] [**Name8 (MD) 901**], M.D. Phone:[**Telephone/Fax (1) 62**] Date/Time:[**2197-3-30**] 1:40 Provider: [**Name10 (NameIs) **] CARE NURSE Phone:[**Telephone/Fax (1) 170**] Date/Time:[**2197-3-28**] 10:00 Device Clinic- [**Hospital Ward Name 23**] 7: [**2197-3-23**] @ 10AM [**Telephone/Fax (1) 62**] Please call to schedule appointments with: Primary Care: Dr.[**Last Name (STitle) **],[**First Name3 (LF) **] [**Telephone/Fax (1) 10349**] in [**5-11**] weeks **Please call cardiac surgery office with any questions or concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call person during off hours** Completed by:[**2197-3-20**] ICD9 Codes: 4240
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8384 }
Medical Text: Admission Date: [**2146-2-14**] Discharge Date: [**2146-2-18**] Date of Birth: [**2082-7-27**] Sex: M Service: CSU HISTORY OF PRESENT ILLNESS: This 63-year-old gentleman who is relatively asymptomatic from his coronary artery disease had a murmur detected on a physical exam this past [**Month (only) 359**] prior to admission. The workup revealed a dilated ascending aorta of 5.2 cm and 3-vessel disease. Cardiac catheterization performed at [**Hospital6 3872**] on [**2145-12-29**] showed a LAD 80% lesion, a circumflex 80% lesion, a PDA 80% lesion, mild aortic insufficiency, and an ejection fraction of 76%. An echocardiogram performed on [**2145-9-30**] showed an EF of 60%, an aortic root of 4.2 cm, mild AI, and mild MR. PAST MEDICAL HISTORY: 1. Coronary artery disease. 2. Raynaud disease. 3. Hypertension. 4. Hyperlipidemia. 5. Osteoma of the left leg, status post removal in [**2135**]. 6. Status post deviated septal repair in [**2115**]. 7. Wisdom teeth removal in [**2110**]. 8. He also has a history of herniated disc with occasional lower leg paresthesia. MEDICATIONS PRIOR TO ADMISSION: Procardia XL 30 mg p.o. daily, atenolol 25 mg p.o. daily, aspirin 325 mg p.o. daily, and Zocor 20 mg p.o. daily. ALLERGIES: He had no known allergies. CARDIOLOGIST: His cardiologist is Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 32255**]. PRIMARY CARE PHYSICIAN: [**Name10 (NameIs) **] primary care is Dr. [**Last Name (STitle) **] [**Last Name (NamePattern4) 5263**]. FAMILY HISTORY: He has a positive family history. His father had a stroke and a CVA. SOCIAL HISTORY: Mr. [**Known lastname 91245**] is a retired engineer. He lives with his wife who has early dementia, and he is the primary caregiver to his wife. [**Name (NI) **] has no tobacco history whatsoever and rarely uses alcohol. REVIEW OF SYSTEMS: He denied any CVA symptoms, TIA, or syncope, as well as claudication; but he did have a positive history with Raynaud's which improved with the treatment with Procardia. PHYSICAL EXAMINATION: He was 5 feet 11 inches, 152 pounds, his pulse was regular at 60, blood pressure on the right was 120/80, on the left 118/78. He was in no apparent distress and was well appearing. His skin was warm and dry. He had no lesions or rashes. His pupils were equally round and reactive to light and accommodation. His EOMs were intact. His neck was supple with no JVD. His lungs were clear bilaterally. His heart was regular in rate and rhythm with a loud S2 and a grade [**11-25**] to 2/6 systolic ejection murmur. His abdomen was soft, nontender, and nondistended with bowel sounds present. He had no peripheral edema. He had a mild paresthesia on the lateral aspect of his left thigh and lower leg. He had some venous dilation of his left lower extremity, but the left leg vein appeared suitable for a possible conduit with no varicosities present. He was alert and oriented x 3 with 5/5 strength and a steady gait. He had 2+ bilateral femoral, DP, PT, and radial pulses. No carotid bruits were appreciated. PREOPERATIVE LABORATORY DATA: White count of 5.8, hematocrit of 44.2, and platelet count of 245,000. PT of 13.4, PTT of 33.1, and INR of 1.1. Sodium of 140, K of 4.1, chloride of 99, bicarbonate of 33, BUN of 21, creatinine of 1.0, with a blood sugar of 74. His urinalysis was negative. ALT of 25, AST of 25, alkaline phosphatase of 66, amylase of 77, total bilirubin of 0.7, total protein of 7.0, albumin of 4.5, globulin of 2.5, and HBA1C of 5.2%. RADIOLOGIC STUDIES: Preoperative EKG revealed a sinus bradycardia at 51 with an intraventricular conduction delay, and left axis deviation, and a question of an old anteroseptal myocardial infarction. Preoperative chest x-ray revealed evidence of emphysema with no pneumonia or congestive heart failure. HOSPITAL COURSE: The patient was referred to Dr. [**First Name (STitle) **] [**Last Name (Prefixes) **] for coronary artery bypass grafting with possible ascending aortic replacement for his dilated ascending aorta. He was admitted on the [**10-17**] and underwent a coronary artery bypass grafting x 2 with a LIMA to the diagonal, and a vein graft to the OM1, and an ascending aortic replacement with a 28-mm Gelweave 2 graft as well as resuspension of his aortic valve. He was transferred to the cardiothoracic ICU in stable condition on a Levophed drip at 0.05 mcg/kg/min and a propofol drip at 30 mcg/kg/min. In the cardiothoracic ICU that evening he was quickly weaned off his Levophed as his SBPs were rising into the 130s, and nitroglycerin and Nipride were added in and titrated up to keep his systolic blood pressure below 110. He received a blood transfusion with PA diastolic pressures in the teens with a CVP of 13. He also received 4 units of FFP and 2 packs of platelets from anesthesia due to an INR of 2.5, and when he came out of the OR he received an additional 2 units of fresh frozen plasma and 2 units of packed cells for a hematocrit of 23.8. He also received repletion of his low potassium. Over the course of the evening, he was weaned from his propofol slowly in preparation for extubation and was sedated overnight. He did have a postoperative rash and was administered some Benadryl. The following morning he was on a nitroglycerin drip at 4. He was in a sinus rhythm at 72 with a blood pressure of 119/73. Postoperative laboratories showed a BUN of 17, a creatinine of 1.0, a K of 4.6, a hematocrit of 29 (after 2 units of packed red blood cells). His PA line was removed. He began Lopressor beta blockade as well as Lasix diuresis and remained in the cardiothoracic ICU. He was also seen by the case manager. On postoperative day 2, his Lopressor was increased. His heart rate was 77. He was hemodynamically stable. His creatinine rose only slightly to 1.2. His pacing wires were discontinued. His mediastinal tubes were discontinued. His pleural tube remained in place, and he was transferred out to the floor where he was seen and evaluated with physical therapy to begin his ambulation. He immediately made excellent progress with ambulating and progressing his activity level on the floor. On postoperative day 3, he was alert and oriented. His hematocrit remained stable at 28.9. He was restarted on his oral medications including aspirin and continued to finish his perioperatively vancomycin. His sternum was stable. His incision was clean, dry, and intact. His left endoscopic vein harvest incision was clean and dry with no erythema, and his pleural tube was removed. Case management arranged for VNA services for the patient. DISCHARGE STATUS: On postoperative day 4, he did do a level V ambulation. He was doing extremely well postoperatively, and he was ready for home to home with VNA. On the day of discharge his blood pressure was 116/64, in sinus rhythm at 77, saturating 94 percent on room air. His incisions were clean, dry, and intact. DI[**Last Name (STitle) 408**]E FOLLOWUP: He was instructed to follow up in our postoperative wound clinic at 2 weeks post discharge and to see Dr. [**Last Name (Prefixes) **] in the office at 4 weeks post discharge. Also, the patient was instructed to follow up with his primary care physician [**Name Initial (PRE) **] [**Last Name (NamePattern4) **]. [**First Name8 (NamePattern2) 3613**] [**Last Name (NamePattern1) 5263**] - in approximately 3 weeks post discharge. DISCHARGE DISPOSITION: He was discharged to home with VNA services on [**2146-2-18**]. DISCHARGE DIAGNOSES: 1. Status post coronary artery bypass grafting x 2 with resuspension of aortic valve and replacement of ascending aorta. 2. Coronary artery disease. 3. Raynaud disease. 4. Hypertension. 5. Hyperlipidemia. 6. Status post osteoma of left leg. 7. Status post deviated septal repair. 8. Wisdom teeth removal. 9. Herniated disc. MEDICATIONS ON DISCHARGE: 1. Lasix 20 mg p.o. once a day (for 10 days). 2. Potassium chloride 20 mEq p.o. once a day (for 10 days). 3. Colace 100 mg p.o. twice a day. 4. Enteric coated aspirin 81 mg p.o. once a day. 5. Percocet 5/325 1 to 2 tablets p.o. q.4-6h. as needed (for pain). 6. Zocor 20 mg p.o. once a day. 7. Metoprolol 50 mg p.o. twice a day. [**Doctor Last Name **] [**Last Name (Prefixes) **], M.D. [**MD Number(1) 1288**] Dictated By:[**Last Name (NamePattern1) **] MEDQUIST36 D: [**2146-3-22**] 08:51:56 T: [**2146-3-22**] 10:49:03 Job#: [**Job Number 103185**] ICD9 Codes: 4019, 2720
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Medical Text: Admission Date: [**2124-5-10**] Discharge Date: [**2124-5-18**] Date of Birth: [**2043-5-1**] Sex: M Service: MEDICINE Allergies: Penicillins Attending:[**First Name3 (LF) 2074**] Chief Complaint: Shortness of Breath Major Surgical or Invasive Procedure: none History of Present Illness: 81 yo M w/h/o CHF w/EF 22%, CAD, CABG x2, complete AV block with DDD Pacer presented to his Cardiologist's office, Dr. [**Last Name (STitle) **] on [**5-9**] with increasing DOE. His lasix was increased from 40mg daily to 80mg daily without improvement in DOE. Over the past 2 days PTA pt noticed increasing DOE with limitation in ambulating. At baseline pt can walk ~1block and can go up 5-7 stairs without SOB or having to stop secondary to fatigue or SOB. Pt denies any CP/Palpitations or SOB at rest. Pt also denies PND, and orthopnea. . Pt presented to ED with increasing DOE. In [**Name (NI) **], pt was hypoxic with O2Sats 86%RA, BNP [**Numeric Identifier 27074**], CXR c/w mild pulmonary edema. Pt's O2 Sats did not improve on 4LNC-sats remained 86% on 4LNC. Pt was then started on BIPAP, O2 sats improved to 100%. Approximately 1 hour after presenting to ED received 80mg IV Lasix x1, and ASA 600mg PR. Pt's VSS at that time 112/66 88 RR 36 100%Sats on BIPAP, with 400cc UOP. Pt was to be started on Nitro gtt but due to BP 94/50 was held. Pt's SOB improved, BIPAP removed and placed on NRB with 100%sats, comfortable breathing, and transferred to CCU for closer monitoring. . On further ROS: Pt denied any constitutional symptoms, no F/C/Cough. No dysuria, no hematuria, no diarrhea, no BRBPR. No LH/Dizziness-had 1 episode 2 weeks ago of LH and fatigue while gardening. Has not had any recent recurrence of LH/Dizziness. Denies any testicular pain, no penile discharge, itchiness or discomfort (completed course of levofloxacin for testicular infection) Past Medical History: -CAD s/p MI and CABGx2(last CABG-[**2111**])-->Subsequent EF 22% -Complete AV Block s/p DDD Pacer-Atrial sensed, V paced -CHF -HTN -CRI (Baseline Cr 1.7-2.0) -SAH ([**2120**]) -Testicular infection (levofloxacin last week) Social History: -Pt is retired, lives with wife in [**Name (NI) **]. -Denies any h/o TOB use and no ETOH use. No h/o IVDU. Family History: NC Physical Exam: -Afebrile, BP 94/50 HR 74 RR 18 100%NRB -GEN: NAD, pleasant elderly male speaking in full sentences -HEENT: Cataract surgery b/l, EOMI, Anicteric sclera, MMM -RESP: Crackles 2/3 up b/l, no wheezing -CV: Reg Nml S1, S2, 2/6 SEM at LLSB, elevated JVP up to mandible, sternotomy scar, pacer SC-L sided -ABD: Soft ND/NT +BS -EXT: 2+pitting edema b/l up to knees, warm, 1+DP pulses B/L -NEURO: A&OX3, no confusion Pertinent Results: [**2124-5-10**] CXR: IMPRESSION: Cardiomegaly and findings consistent with mild congestive heart failure . [**2124-5-11**] ECHO: Conclusions: The left atrium is moderately dilated. The right atrium is moderately dilated. The inferior vena cava is dilated (>2.5 cm). Left ventricular wall thicknesses are normal. The left ventricular cavity is mildly dilated. There is severe global left ventricular hypokinesis (ejection fraction [**10-6**] percent). No masses or thrombi are seen in the left ventricle. There is no ventricular septal defect. The right ventricular cavity is dilated. Right ventricular systolic function appears depressed. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. Moderate (2+) mitral regurgitation is seen. Moderate to severe [3+] tricuspid regurgitation is seen. There is moderate pulmonary artery systolic hypertension. Significant pulmonic regurgitation is seen. The main pulmonary artery is dilated. The branch pulmonary arteries are dilated. There is no pericardial effusion. Tissue velocity imaging and tissue synchrony imaging demonstrates < 50 msec opposing wall delay to peak velocity in all apical windows (dyssynchrony not present). . Brief Hospital Course: AP: 81 yo M w/CAD, s/p CABG, HTN, CHF p/w CHF exacerbation and respiratory distress . #. CHF exacerbation: Pt's CHF exacerbation most likely in setting of increased fluid intake due to testicular infection. Pt presented with worsening SOB with recently increased Lasix 80 mg PO daily without improvement in symptoms. EF 22% on P-MIBI, no recent ECHO. Received 80 mg IV Lasix in ED with good UOP >800 cc UOP, off BIPAP on NRB w/100% O2 sats. In CCU he received another 80IVLasix x1 with his cardiac meds, including Carvedilol 12.5, lisinopril 5mg and Dig 0.125. His SBP dropped in to the 70s. Pt was asymptomatic, however MAPs dropped to 40s. SBP minimally improved with 100cc IVF bolus. Pt was started on Dopa gtt and subsequently started on lasix gtt for better perfusion and diuresis. Pt diuresed well with -1L per day. He was noted to have severely depressed EF on ECHO 10-20% with 3+TR, 2+MR, Moderate Pulmonary Regurg. He was also noted to have elevated PAD pressures, elevated PCWP 26. With lasix gtt, Wedge decreased to 18, Dopa was weaned off on [**5-13**] as well as lasix gtt. His BB/ACE-I/Dig were held while on Dopa gtt. He was further diuresed on furosemide 80 mg po qd. Eventually his dose was further decreased to 40 mg po qd with ins and outs remaining roughly even. He will be discharged on furosemide 40 mg qd. His respiratory status improved during his hospitalization. He was encouraged to use BiPAP at night to augment his respiratory status. . #. CAD: Pt denies any CP/palpitation. No indication of ischemia on ECG or with CE. CE remained Negative. He was continued on low dose ASA, and statin. Patient needs to have follow-up with cardiology. Would have PCP recommend [**Name Initial (PRE) **] local out-patient cardiologist to follow the patient. He should see cardiology in [**1-21**] weeks. . #. Rhythm: NSR, v-paced. Had an episode of VT on Tele. On ECHO no dy synchrony noted. Pt with DDD Pacer. No further episodes. . #. RESP: Pt with persistent respiratory acidosis with initial ABG 7.27/70S/90S. Noted to have elevated PaCO2. Upon arrival to CCU remained on NRB while diuresing. Pt was started on BIPAP the following morning for the above notable ABG. A respiratory consult was obtained for his respiratory hypercarbia. Per PCP pt noted to have empyema as child with restructured R-sided pulmonary anatomy. R-sided parenchyma with pleural thickening. He was aggressively diuresed with improvement of respiratory status ABG improved 7.40/56/121, the Lasix gtt was turned off and continued on Lasix IV. Patient developed metabolic alkalosis in response to his ongoing respiratory acidosis. Patient was encouraged to wear his BiPAP at night and while napping, however, he often refused as he does not like the machine. Would continue to encourage use of BiPAP. Patient should follow-up with Dr. [**Last Name (STitle) 575**] in the pulmonary clinic. He has an appointment for [**2124-7-17**] but the clinic will call him if an earlier appointment becomes available. A sleep study can be arranged to evaluate for sleep apnea after he has been officially seen in the pulmonary clinic. . #. HTN: Baseline SBP low 100s. Reinitiated BB, ACE-I and titrated as BP tolerated once off the dopamine drip. Patient had SBPs in low 100s during most of his stay. He was discharged on carvedilol 6.25 mg [**Hospital1 **] and lisinopril 7.5 mg QD. Meds, particularly the ace inhibitor, should be titrated up if blood pressure tolerates. . # Testicular infection: Pt had recently completed 1 week course levofloxacin for testicular infection. He remained afebrile, normal WBC, testicular exam normal. Spoke with PCP which confirmed the 1 week course of ABX. Urine culture was negative. No additional antibiotics were administered during his stay. . #. CRI: Cr baseline 1.7-2.0, currently at 1.8. Renally dose meds, avoid nephrotoxins Follow UOP and Cr and electrolytes weekly while taking furosemide. . # Gout: Had been allopurinol as an out-patient, which was not continued during his admission. Developed some R great toe pain on [**5-17**] and was started on colchicine for symptom control ([**Hospital1 **] dosing). Would plan to restart allopurinol in the future after acute symptoms have subsided. Renal function should be followed on colchicine and allopurinol. Allopurinol should be renally dosed. If flare does not improve with colchicine, could use NSAID like sulindac, steroids, or intra-articular steroids. . #. Thrombocytopenia: Plts in low 100s during admission. On review of records, PLTs 100 in [**3-22**], etiology is unclear. HIT (PF4) ab was negative. Would follow in out-patient setting. Consider evaluation by out-patient hematology. . Medications on Admission: MEDS (at home): -Lasix 40mg daily -Lisinopril 5mg daily -Dig 0.125mg daily -Carvedilol 12.5mg [**Hospital1 **] -Lipitor 20mg daily -ASA 81mg Discharge Medications: 1. Atorvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 3. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 4. Albuterol-Ipratropium 103-18 mcg/Actuation Aerosol Sig: [**12-20**] Puffs Inhalation Q6H (every 6 hours). 5. Carvedilol 6.25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 6. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 7. Digoxin 125 mcg Tablet Sig: One (1) Tablet PO EVERY OTHER DAY (Every Other Day). 8. Heparin (Porcine) 5,000 unit/mL Solution Sig: 5000 (5000) units Injection TID (3 times a day). 9. Furosemide 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 10. Lisinopril 5 mg Tablet Sig: 1.5 Tablets PO DAILY (Daily). 11. Colchicine 0.6 mg Tablet Sig: One (1) Tablet PO twice a day for 1 weeks: for acute gouty flare. Discharge Disposition: Extended Care Facility: [**Hospital6 979**] - [**Location (un) 246**] Discharge Diagnosis: CHF exacerbation Pulm HTN CO2 retention Discharge Condition: stable Discharge Instructions: Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight > 3 lbs. Adhere to 2 gm sodium diet Fluid Restriction: 1 Liter * Call your doctor or return to the emergency department if you develop shortness of breath, chest pain, you cannot eat, drink or take your medications or you develop any other symptoms that are concerning to you. Followup Instructions: Please follow-up in pulmonary clinic with Dr. [**Last Name (STitle) 9504**]. * Provider: [**Name10 (NameIs) 2052**],[**First Name3 (LF) **] [**Location (un) 2788**] CARDIOLGY PPS (SB) Date/Time:[**2124-7-4**] 2:00 ICD9 Codes: 4280, 2762, 2749, 4168
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Medical Text: Admission Date: [**2201-3-25**] Discharge Date: [**2201-3-28**] Date of Birth: [**2139-2-27**] Sex: F Service: MEDICINE Allergies: Tylenol-Codeine #3 Attending:[**First Name3 (LF) 4095**] Chief Complaint: nausea, abdominal pain Major Surgical or Invasive Procedure: PICC History of Present Illness: 62 year old female with past history of HTN, pancreatitis, hyperlipidemia, insulin-dependent diabetes who complains of shortness of breath and a bloated feeling. Bloated feeling started 2 weeks prior to presentation to ED, characterized as umbilical dull ache, [**7-12**] severity, no pain like this previously, no exacerbating or relieving factors. Last bowel movement was at least 5 days ago and small. The patient endorses a foul taste in her mouth for the past day. She notes that she has been nauseous for the past two days, with 2 episodes of vomiting up soda that she tried to drink today. Pt denies EtOH use, reports she has taken her usual lantus 20u qd per usual. Denies chest pain or palpitations. Pt was seen at the [**Hospital 2287**] clinic on [**3-25**], with complaints of abdominal discomfort. Blood drawn at that visit detected a very elevated glucose (400s), hyperkalemia and metabolic acidosis. Patient notes that her fingerstick last night was in the 200s. . The patient was diagnosed with diabetes in [**2199**]. She had an episode of a "diabetic coma" in [**2199**] in [**State 19827**]. She was in the ICU for nearly a week, per patient and family. This was the time she was first diagnosed with diabetes and also the first time she was diagnosed with pancreatitis. The patient and family unaware of reason/cause for diabetes. . Pt denies fevers or chills, no diarrhea, subjective abdominal distention, one day of shortness of breath and increased respiratory rate, no chest pain, no headache or change in vision, no neck pain, no dysuria or change in urinary frequency, no lower extremity edema or focal numbness tingling weakness. . In the ED inital vitals were, 96.8 139 101/65 30 99% Non-Rebreather. Per sign-out, PE remarkable for tachycardia, tachypnea, no abd TTP despite complaints of distention and discomfort per pt. The patient received: -3L NS bolus -18 EJ, 22 peripheral -10u SC x1 for hyperK and glucose > 600 -insulin gtt initiated at 7u/hr -Albuterol neb x1 -Kayexalate 60g PO x1 -Repeat EKG in 10 min post above: continues with no peaked T waves EKG: sinus 155, varrying QRS pattern, STD in V3, TWI III, no prior CXray: no acute CP process identified (wet read pending) Bedside US: near complete resp compression of IVC which may represent hypovolemia or distribution shock; no pericard effusion, hypodynamic heart -Empiric Abx given 1d of SOB/cough: levofloxacin -ABG pending Vitals on transfer were: Temp: 97.5, Pulse: 140, RR: 29, BP: 109/67, Rhythm: st, O2Sat: 100, O2Flow: 2.5 liters . On arrival to the ICU, vital signs were: 97.5 148 130/75 24 99% 4L. Patient was alert, oriented, and continued on insulin drip and IVF. . Review of systems: (+) Per HPI (-) Denies fever, chills, night sweats, recent weight loss or gain. Denies headache, sinus tenderness, rhinorrhea or congestion. Denies wheezing. Denies chest pain, chest pressure, palpitations. Denies nausea, vomiting, diarrhea or changes in bowel habits. Denies dysuria, frequency, or urgency. Denies arthralgias or myalgias. Denies rashes or skin changes. Past Medical History: -DM (diabetes mellitus), type 2, uncontrolled -Pancreatitis -OBESITY UNSPEC -HYPERCHOLESTEROLEMIA -RHINITIS - ALLERGIC, UNSPEC CAUSE -LOW BACK PAIN -HTN Social History: - Tobacco: none - Alcohol: none - Illicits: none Family History: glaucoma in mother; DMII in many members of family (mother, son, aunt/uncle) Physical Exam: ADMISSION PHYSICAL EXAM: 97.5 148 130/75 24 99% 4L General: Alert, oriented, no acute distress HEENT: Sclera anicteric, mucous membranes extremely dry Neck: supple, JVP flat, no LAD Lungs: Clear to auscultation bilaterally, no wheezes, rales, rhonchi CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly GU: foley in place Ext: warm, well perfused, dopplerable pedal pulses, no clubbing, cyanosis or edema . Discharge Exam: AVSS Lungs clear Abdomen benign Pertinent Results: Admission Labs; [**2201-3-25**] 10:40AM BLOOD WBC-12.5* RBC-5.03 Hgb-15.0 Hct-47.6 MCV-95 MCH-29.7 MCHC-31.4 RDW-13.7 Plt Ct-422 [**2201-3-25**] 10:40AM BLOOD Neuts-90.0* Lymphs-7.2* Monos-2.4 Eos-0.1 Baso-0.4 [**2201-3-25**] 10:40AM BLOOD Plt Ct-422 [**2201-3-25**] 03:19PM BLOOD Glucose-285* UreaN-19 Creat-0.9 Na-155* K-4.6 Cl-128* HCO3-8* AnGap-24* [**2201-3-25**] 10:40AM BLOOD Glucose-664* UreaN-28* Creat-1.8* Na-146* K-7.7* Cl-107 HCO3-5* AnGap-42* [**2201-3-25**] 10:40AM BLOOD ALT-15 AST-25 AlkPhos-86 TotBili-0.2 [**2201-3-25**] 10:40AM BLOOD Lipase-239* [**2201-3-25**] 10:40AM BLOOD cTropnT-<0.01 [**2201-3-25**] 03:19PM BLOOD CK-MB-3 cTropnT-<0.01 [**2201-3-25**] 10:40AM BLOOD Albumin-4.6 Calcium-9.9 Phos-7.3* Mg-2.3 [**2201-3-25**] 03:19PM BLOOD Calcium-7.2* Phos-1.1*# Mg-1.5* [**2201-3-25**] 10:40AM BLOOD ASA-NEG Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG [**2201-3-25**] 02:32PM BLOOD Type-ART pO2-138* pCO2-12* pH-7.14* calTCO2-4* Base XS--22 [**2201-3-25**] 12:35PM BLOOD Glucose-470* Lactate-3.4* Na-152* K-5.4* Cl-127* PERTINENT INTERVAL LABS: [**2201-3-25**] 03:19PM BLOOD Glucose-285* UreaN-19 Creat-0.9 Na-155* K-4.6 Cl-128* HCO3-8* AnGap-24* [**2201-3-25**] 06:22PM BLOOD Glucose-213* UreaN-14 Creat-0.8 Na-150* K-4.1 Cl-127* HCO3-11* AnGap-16 [**2201-3-25**] 11:14PM BLOOD Glucose-220* UreaN-11 Creat-0.8 Na-147* K-3.8 Cl-126* HCO3-12* AnGap-13 [**2201-3-26**] 03:45AM BLOOD Glucose-88 UreaN-9 Creat-0.7 Na-143 K-4.2 Cl-121* HCO3-14* AnGap-12 [**2201-3-25**] 03:19PM BLOOD Calcium-7.2* Phos-1.1*# Mg-1.5* [**2201-3-25**] 06:22PM BLOOD Calcium-7.5* Phos-0.5* Mg-1.3* [**2201-3-25**] 11:14PM BLOOD Calcium-7.3* Phos-1.0* Mg-3.1* [**2201-3-26**] 03:45AM BLOOD Calcium-7.4* Phos-1.4* Mg-2.7* [**2201-3-25**] 11:31PM BLOOD freeCa-1.17 URINE: [**2201-3-25**] 11:15AM URINE Color-Straw Appear-Clear Sp [**Last Name (un) **]-1.018 [**2201-3-25**] 11:15AM URINE Blood-NEG Nitrite-NEG Protein-30 Glucose-1000 Ketone-150 Bilirub-NEG Urobiln-NEG pH-5.0 Leuks-NEG [**2201-3-25**] 11:15AM URINE RBC-<1 WBC-1 Bacteri-FEW Yeast-NONE Epi-<1 [**2201-3-25**] 11:15AM URINE CastHy-15* MICRO: blood cultures ([**3-25**]): NGTD urine culture ([**3-25**]): NGTD IMAGING: CXR ([**3-25**]): FINDINGS: The lungs are clear without focal consolidation. Previously questioned lucency at the left lung base is not long seen and was likely artifactual. The cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. Degenerative changes about both AC joints are noted. IMPRESSION: No evidence of acute cardiopulmonary process. KUB ([**3-25**]): FINDINGS: Supine and left decubitus views of the abdomen were obtained. There is a non-obstructive bowel gas pattern. Moderate colonic fecal loading is seen throughout. No evidence of free air is seen. Amorphous calcification projecting over the right renal shadow could be artifactual, however, raises concern for possible staghorn calculus. IMPRESSION: No evidence of bowel obstruction or free air. Amorphous calcification projecting over the right renal calculus raises concern for staghorn calculus. WBC RBC Hgb Hct MCV MCH MCHC RDW PLT [**3-27**] 4.9 3.27* 9.3* 27.7* 85 28.6 33.7 14.0 175 [**3-26**] 7.3 3.35* 9.7* 28.4* 85 29.0 34.0 14.1 191 [**3-26**] 8.8 3.66* 10.5* 31.2* 851 28.6 33.6 14.0 202 Glucose UreaN Creat Na K Cl HCO3 AnGap [**3-27**] 106 5* 0.5 144 3.4 116* 20* 11 [**3-26**] 198 9 0.6 141 3.7 116* 18* 11 [**3-26**] [**Telephone/Fax (2) 98122**] 4.0 115* 14*2 13 [**3-26**] 161 6 0.6 137 4.1 115* 15* 11 [**3-26**] 881 9 0.7 143 4.2 121*3 14*3 12 Brief Hospital Course: 62 year old female with past history of pancreatitis, hyperlipidemia, insulin-dependent diabetes who complains of shortness of breath and abdominal pain and was found to be in diabetic ketoacidosis. The patient was admitted to the [**Hospital Ward Name 332**] ICU, initiated on an insulin drip, repleted with IVF and electrolytes, and recovered from DKA. Patient was called out from ICU on [**2201-3-27**]. ACTICE ISSUES: #Diabetic Ketoacidosis: Likely cause of this DKA either URI and/or constipation/poor PO intake. Pt does have hx of pancreatitis and pt has elevated lipase. Lipase, however, is not sensitive for pancreatitis in the setting of DKA, and pt has no clinical signs of pancreatitis (no abd pain to palpation). Although pt has dyspnea, pt CXR looks clear and no production of sputum. No e/o cardiac ischemia as pt has neg trop x1 and EKG w/ non-specific changes. Urine tox sent. On admission, pt has anion gap of 34, ketones in urine and a HCO3 of 5. Pt received 3L NS in ED, 10U SC insulin and initiated on insulin drip at 7u/hr. Received 10+ liters of fluid plus insulin drip. In the ICU, transitioned to subcutaneous insulin and clear diet. Anion gap has closed and patient is no longer acidotic. NGTD on blood and urine cxs. Have continued glargine 20u qhs and HISS, fingersticks q4hrs. Pt tolerating POs. Held metformin while here. [**Last Name (un) **] was consulted and sent an anti-GAD ab to discern type I vs type II. The patient has been advanced to regular diet and will be discharged on Insulin regimen that included an increase in her Lantus from 20 to 24 units daily, and a sliding scale. - Patients Lantus should be titrated up as needed. - The pt was instructed to hold his metformin until seen by her PCP. . # Tachycardia: pt w/ sinus tachycardia to 150 on day of admission, which quickly responded to IVF. On transfer from ICU, pt's HR was 90s. . # Constipation: Pt states hasn't had BM in at least 5 days, per pt. Likely secondary to combination of gastroenteritis and poor fluid intake. colace/senna standing and miralax, bisacodyl PR PRN. No BM by HD #2. . # HTN: pt's BP in 100s in ICU. held losartan for now considering BPs in 90-110s. continued ASA when taking POs. Losartan continued on outpatient. - This should be adjusted as an outpatient. . # hypercholesterolemia: restarted simvastatin . # GERD: continued omeprazole 20mg qd . # Abdominal calcification -- confirmed w/ PCP office was not a new finding. Raises question of staghorn calculus, though urine not suggestive and patient without recurrent UTIs typical of this. PCP to consider further imaging as outpatient. ========================= Transitional Issues ========================= 1. [**Last Name (un) **] recommended checking anti-GAD (sendout) to differentiate between type I and type II DM. Lab ordered. Will need to be followed up. 2. Pt w/ ? staghorn calculus (R renal hilus) on KUB. No e/o infection this admission. Will need outpt urology f/u. 3. pt's PCP [**First Name4 (NamePattern1) 449**] [**Last Name (NamePattern1) **] emailed on [**3-26**] 4. Pt will be sent home with a VNA for insulin teaching. Medications on Admission: -Omeprazole 20 mg Oral Capsule, Delayed Release(E.C.) Take 1 capsule 30 minutes before first meal of day -Insulin Syringe-Needle U-100 (BD INSULIN SYRINGE ULT-FINE II) 0.3 mL 31 x [**6-17**]" Miscellaneous (Misc) Syringe use as directed, up to three times daily -Insulin Needles, Disposable, (BD INSULIN PEN NEEDLE UF SHORT) 31 X [**6-17**] " Misc.(Non-Drug; Combo Route) Needle USE AS DIRECTED with lantus pen -Lipase-Protease-Amylase (CREON) 6,000-19,000 -30,000 unit Oral Capsule, Delayed Release(E.C.) TAKE 1 CAPSULES by mouth 3 times a day with meals -Blood Sugar Diagnostic (FREESTYLE LITE STRIPS) Misc.(Non-Drug; Combo Route) Strip Use as directed 4 times daily pls dispense no substitution -Losartan 50 mg Oral Tablet Take 1 tablet daily -Blood-Glucose Meter (FREESTYLE FREEDOM LITE) Misc.(Non-Drug; Combo Route) Kit Use as directed -Insulin Glargine (LANTUS SOLOSTAR) 100 unit/mL (3 mL) Subcutaneous -Insulin Pen inject 20 units under the skin every night or as directed -Simvastatin 40 mg Oral Tablet Take one-half tablet = 20 mg every evening for cholesterol -Metformin 500 mg Oral Tablet take 1 tab twice daily -Aspirin 81 mg Oral Tablet None Entered Discharge Medications: 1. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 2. simvastatin 10 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 3. lipase-protease-amylase 12,000-38,000 -60,000 unit Capsule, Delayed Release(E.C.) Sig: One (1) Cap PO TID W/MEALS (3 TIMES A DAY WITH MEALS). 4. senna 8.6 mg Tablet Sig: 1-2 Tablets PO BID (2 times a day). 5. insulin glargine 100 unit/mL (3 mL) Insulin Pen Sig: One (1) 24 Subcutaneous at bedtime. 6. insulin lispro 100 unit/mL Cartridge Sig: One (1) As directed Subcutaneous four times a day. 7. losartan 50 mg Tablet Sig: One (1) Tablet PO once a day. 8. simvastatin 20 mg Tablet Sig: One (1) Tablet PO once a day. 9. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 10. Creon 6,000-19,000 -30,000 unit Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO three times a day. Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: Primary Diagnosis -Diabetic Ketoacidosis -Diabetes Mellitus type 2 -Anemia Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: You were admitted with diabetic ketoacidosis after a few weeks of abdominal symptoms. With treatment this normalized. You were found to have anemia, and this should be addressed with Dr. [**Last Name (STitle) **]. Please speak with him about the abdominal radiology findings seen on your abdominal xray -- calcification. It appears they are old as per records at [**First Name9 (NamePattern2) 98123**] [**Location (un) **], and perhaps comparison with older records from [**State 19827**] will confirm this. Please follow the insulin regimen. A visiting nurse will visit to make sure you are doing well. Please hold your Metformin until instructed to restart it. Followup Instructions: Name: [**Last Name (LF) 38584**],[**First Name3 (LF) **] P. Location: [**Hospital1 641**] Address: [**Location (un) **], [**Location (un) **],[**Numeric Identifier 2260**] Phone: [**Telephone/Fax (1) 3530**] Appointment: Thursday [**2201-4-2**] 10:00am . Please make an appointment to follow-up with the [**Last Name (un) **] Diabetes Center as needed. ICD9 Codes: 2859, 5849, 4019, 2720
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8387 }
Medical Text: Admission Date: [**2103-8-13**] Discharge Date: [**2103-8-30**] Date of Birth: [**2021-11-16**] Sex: M Service: NEUROLOGY Allergies: Penicillins Attending:[**Last Name (NamePattern1) 1838**] Chief Complaint: fluent perseverative speech, confusion Major Surgical or Invasive Procedure: Intubation [**2103-8-13**] ([**Hospital6 302**]) History of Present Illness: [**Known firstname **] [**Initial (NamePattern1) **] [**Known lastname 7710**] is an 81-year-old man with history of HTN, HLD, prostate [**Hospital 4699**] transferred from OSH for seizure. History is obtained via chart review as patient is intubated. He was at physical therapy this AM for his left shoulder when he became confused, repetitive, and could not follow commands. This started at 09:40. When asked his name, he would respond, "[**Last Name (un) 46536**], my name," and would move all extremities on his own and speech was clear although he remained "confused." He was taken via EMS to [**Hospital3 **] ED and en route he had a seizure lasting 45-60 seconds and then was thought to be post-ictal afterwards. His FS was 90 and was thought to be in afib with a possible run of vtac per EMS while en route. Upon arrival to [**Hospital3 **] ED, T 96.7 P 80 RR 16 BP 140/67 100% on NRB. He was noted to be non-verbal, un-arousable, and unresponsive, with gaze to the right. After arrival he had another witnessed seizure in the ED, possibly lasting 30 seconds. He received a total of 4 mg ativan, 1 g dilantin, and then was intubated receiving etomidate, succinylcholine and propofol. A CT head prior to transfer was unrevealing. BP was transiently up to 216/99 P 119 prior to transfer. Per his PCP (Dr. [**First Name4 (NamePattern1) 5279**] [**Last Name (NamePattern1) 90800**]) he has no history of seizure, stroke, or CNS infections and is a bright and independent person at baseline. Per EMS note he may have had a similar episode last month and was seen at [**Hospital6 302**] for that. Past Medical History: [] Cardiovascular - HTN, HLD [] Oncologic - Prostate CA (treated > 10 years ago) Social History: Lives with wife. Family History: Not known Physical Exam: At admission: Gen; lying in bed, intubated HEENT; NC/AT, ETT in place CV: RRR, II/VI SEM Pulm; CTA anteriorly Abd; soft, nt, nd Extr; no edema Skin; multiple ecchymoses on arms Neuro; MS; (off propofol x5 minutes) eyes closed but grimaces and briefly opens eyes to noxious. Does not follow any commands or attempt to speak. CN; eyes conjugate in midposition, pupils 3mm and minimally reactive. does not blink to threat. brisk corneals b/l. face obscured by ETT. + gag. Motor; normal bulk, increased tone in legs b/l. spontaneously moves arms and briskly withdraws all extremities to noxious stimuli. Reflexes; 1+ and symmetric at biceps, brachioradialis, and patellars. Toes upgoing b/l. __________________________________________________________ At discharge: Pertinent Results: [**8-13**] EEG - IMPRESSION: This extended routine video EEG telemetry captured no pushbutton activations. Automated and routine sampling captured several brief runs of sharp and slow wave discharges but no clinical correlate. The interictal period showed one every 1-1.5 second periodic epileptiform discharges over the left hemisphere. The background otherwise showed a well-organized posterior predominant rhythm on the right and generalized delta and theta frequency slowing over the left hemispheric leads. [**8-13**] CXR - IMPRESSION: Endotracheal tube ends approximately 5 cm above the carina. Given low lung volumes, bibasilar opacities likely represent atelectasis, although pneumonia cannot be excluded. [**8-14**] EEG - IMPRESSION: This is an abnormal continuous ICU video EEG telemetry due to a few brief electrographic seizures with no clinical correlation all occurring between 9:00 and 10:00 a.m. The interictal period showed one every 1-1.5 second periodic lateralized epileptiform discharges (PLEDs) over the left hemisphere. The background otherwise showed a well- organized posterior predominant rhythm on the right and generalized delta and theta frequency slowing over the left hemispheric leads. These findings are consistent with an epileptogenic focus in the left hemisphere related to an underlying structural lesion. The EEG was improved compared to previous day's recording as the electrographic seizures were shorter and less frequent. [**8-14**] MRI Brain c/s contrast - IMPRESSION: 1. T2 hypointense focus in the posterior aspect of the left thalamus with slowed diffusion and mild contrast enhancement, most likely representing a subacute infarct. With regard to enhancement, a followup study should be scheduled in four to six weeks to definitely rule out underlying mass such as lymphoma. 2. Evidence of global cerebral volume loss as well as sequela of chronic small vessel ischemic disease. [**8-16**] MRI/MRA/MR [**Month/Year (2) **] - BRAIN MRI: There are now new acute infarcts identified in the left posterior temporal and occipital regions since the previous study. The previously seen left thalamic infarct has evolved. There are no definite new infarcts identified in the right cerebral hemisphere. Previously noted changes of small vessel disease and brain atrophy are seen. There is no midline shift. There is no evidence of abnormal parenchymal, vascular, or meningeal enhancement seen. The MR [**First Name (Titles) 15758**] [**Last Name (Titles) 4059**] increase in time to peak in the left occipital lobe, corresponding to the region of infarct. No definite decreased blood volume is appreciated. Subtle increase in the time to peak is identified in the right occipital lobe. IMPRESSION: 1. Acute infarcts are now seen in the left posterior temporal and occipital lobes. No definite new infarcts are seen in the right cerebral hemisphere. 2. No enhancing brain lesions or mass effect is seen. Otherwise, the MRI of the brain is not changed since the previous study. 3. Increased time to peak is identified in the left posterior temporal and occipital lobes corresponding to the infarcts seen and could indicate ischemia. Subtle increased time to peak is identified in the right occipital lobe which could indicate ischemia in the right occipital region. However, no definite new infarct is seen in this region. MRA HEAD: The head MRA [**Last Name (Titles) 4059**] normal flow signal in the arteries of anterior and posterior circulation without stenosis or occlusion. IMPRESSION: Normal MRA of the Head. [**8-16**] EEG IMPRESSION: This is an abnormal continuous ICU video EEG telemetry due to two electrographic seizures in the right hemisphere maximum at T4 and P4 correlating with no clinical correlation on video. Also there were periodic lateralized epileptiform discharges (PLEDs) over the left hemisphere. The background otherwise was markedly suppressed and slow over both hemispheres occasionally reaching low amplitude theta frequency intermixed with delta. These findings are consistent with independent epileptogenic foci in both hemispheres likely related to underlying structural lesions. After 21:00, a burst suppression of background was seen related to midazolam administration. Compared to prior day's EEG, there were fewer and shorter electrographic seizures. [**8-17**] TTE w/bubble study The left atrium is moderately dilated. No atrial septal defect is seen by 2D or color Doppler; single bubble contrast injection negative for right to left shunt at atrial level. No late contrast is seen in the left heart (suggesting absence of intrapulmonary shunting). There is mild symmetric left ventricular hypertrophy. Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. Overall left ventricular systolic function is normal (LVEF 70%). There is no ventricular septal defect. Right ventricular chamber size and free wall motion are normal. There are three aortic valve leaflets. The aortic valve leaflets are moderately thickened. There is mild aortic valve stenosis (valve area 1.2 cm2). The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. Mild (1+) mitral regurgitation is seen. There is moderate pulmonary artery systolic hypertension. There is no pericardial effusion. If clinically indicated, a transesophageal echocardiographic examination is recommended. IMPRESSION: Suboptimal image quality. No obvious intracardiac mass or shunt. However, due to the technically suboptimal nature of this study, a cardiac source of embolus cannot be excluded. If clinically indicated, a transesophageal echocardiogram (with or without bubble study) is recommended to exclude cardiac source of embolus. [**8-17**] Carotid Duplex Series Impression: Right ICA with stenosis 40-59%. Left ICA with stenosis 60-69%. Antegrade bilateral vertebral artery flow. [**8-17**] EEG [**Known lastname **],[**Known firstname **] [**Medical Record Number 90801**] M 81 [**2021-11-16**] Neurophysiology Report EEG Study Date of [**2103-8-17**] OBJECT: ROE, EKG, VIDEO, [**8-17**] TO [**2103-8-18**]. REFERRING DOCTOR: DR. [**First Name (STitle) **] [**Name (STitle) **] FINDINGS: ABNORMALITY #1: The background is markedly abnormal. It shows, for the vast majority of the record, that the two hemispheres appear to be working relatively independently of each other. Over the left hemisphere, there is a fairly persistent pseudoperiodic spike and wave and sharp slow wave discharge broadly present across the left posterior quadrant maximum in the region of the occipital pole. These discharges occur every two to four seconds and interposed between them is a period of marked electrical suppression. The bursts, themselves, in addition to having an epileptiform transient have frontal central irregular theta and suppression of electrical activity except for the spike wave discharge posteriorly. The right hemisphere has similar pseudoperiodic bursting but no clearly identified epileptiform transients. The periods vary from two to six seconds in duration and appear to be occurring relatively independently of the activity on the left. There is also marked suppression of electrical activity in the posterior quadrant on the right when the bursts themselves occur. At about 2:30 in the morning, the amplitude of the background bursts seem to increase slightly and there appeared to be more frequent synchronization between the two hemispheres. SLEEP: No cycling of sleep activity was identified. PUSHBUTTONS: There were no pushbuttons. SEIZURE DETECTIONS: Did not detect any sustained events. AUTOMATED INTERICTAL FILES: Almost all of the occipital sharp discharges from the left were detected. CARDIAC MONITOR: Shows a regular rhythm. IMPRESSION: This EEG gives evidence for an extremely severe diffuse encephalopathy that, curiously, appears independently in the two hemispheres. The right hemisphere appears to be a burst and burst suppressive pattern with no clear epileptic features. The left is a similar pattern seen with a different periodicity to the right and with an occipitally predominant broadly based epileptiform discharge seen with most of the bursts. There were no sustained seizures and most of the effect in the burst and burst suppressive pattern may very well reflect the effects of systemic medication. [**8-18**] UE US - IMPRESSION: Left distal cephalic venous thrombosis. [**8-18**] EEG IMPRESSION: This EEG continues to show a severe diffuse encephalopathy. In comparison to the previous 24 hours, most of this record was synchronous over the two hemispheres and there was little epileptiform activity from the left after 22:00 and, overall, it appears to be a slight improvement to the record. The pattern is still most in keeping with drug effect. [**8-19**] EEG IMPRESSION: This tracing still shows a fairly significant diffuse encephalopathy although the suppressive bursts appear to be somewhat shorter, particularly near the end of the record, on the morning of the 15th. On the morning of the 14th, there was one brief electrographic seizure from the right central temporal region that was not associated with a clinical accompaniment. [**8-20**] EEG IMPRESSION: This EEG did not capture any electrical evidence for sustained seizure discharges. A few isolated left occipital discharges were still seen but they occur very infrequently. The tracing is still compatible with a moderate to moderately severe diffuse encephalopathy with a bursting pattern of electrical activity and suppressive bursts. No clear laterality, except for the occipital discharges, was noted. [**8-21**] EEG IMPRESSION: This EEG gives evidence still for a moderately severe diffuse encephalopathy with suppressive bursts and intervening activity that appears more normal than on previous studies but still shows leftsided slowing, particularly over the more posterior aspects of the left hemisphere admixed with interictal sharp and epileptic spike discharges relatively infrequently in the left occipital pole. It should be noted that there was one brief electrographic seizure discharge from the right temporal central region lasting about 30+ seconds that appeared to be without any electrographic correlate. [**8-22**] EEG IMPRESSION: This EEG gives evidence for both encephalopathic as well as multifocal abnormalities. The encephalopathic features are loss of normal background and suppressive bursts. The epileptiform activity was seen in the left occipital pole and right mid-temporal and there appears to be fairly discrete right lateral temporal slow wave abnormality suggestive of additional structural pathology in that region. [**8-22**] NCHCT - IMPRESSION: 1. No evidence of hemorrhage, mass effect or shift in normally midline structures. 2. Evolution of known left parieto-occipital infarction, compared to previous studies. 3. Poorly-defined hypodensities in the superficial aspect of the right posterior occipital lobe; additional infarction (presumably, embolic) at this site is not excluded. [**8-23**] EEG IMPRESSION: This 24-hour recording shows a fairly persistent posterior left temporal slow wave focus suggestive of a subcortical structural lesion. The left occipital relatively rare epileptiform transients seem to increase significantly throughout the course of the record, both in their frequency of occurrence as well as their distribution. No sustained seizures, however, were identified and the background continues to be a diffusely abnormal encephalopathic pattern. Brief Hospital Course: 81 yo M h/o HTN, HL, prostate CA p/w perseverative and fluent speech disturbance and two convulsive seizures with post-ictal lethargy and confusion and left hemisphere seizure activity, likely secondary to a subacute posterior thalamic ischemic stroke. [] Status Epilepticus - At the OSH, he was given 4 mg of lorazepam, 1000 mg of phenytoin, was intubated at the outside hospital, and was sedated with Propofol. Phenytoin was switched to Fosphenytoin at transfer, and he was given an additional 500 mg IV since his Phenytoin was subtherapeutic. He had evidence of 20 second runs suggesting left hemisphere seizure activity and PLEDS despite the second loading dose. Valproate sodium was added for further seizure suppression. He was initially treated empirically for HSV encephalitis, but his LP cell counts were not suggestive of infection and his HSV PCR was negative. His MRI revealed a subacute left posterior thalamic ischemic stroke which may correlate with an antecedent event three weeks prior to admission when he was noted to be confused with right arm symptoms (described as pain at that time). He was started on aspirin and continued on his home medications for hypertension. A second [**Doctor Last Name 360**], valproate sodium, was added for further suppression as he was continuing to have frequent PLEDs. His Propofol was then weaned for possible extubation but he remained quite lethargic. Overnight on [**8-15**], he had electroencephalographic seizures affecting the right hemisphere as well as report of nonrhythmic arm and leg movements. We opted to switch from Propofol to Midazolam (as the patient was requiring IVF boluses to maintain blood pressure) and uptitrate for burst suppression. Concerned for new lesions, we obtained a repeat MRI with MRA and MR [**Month/Year (2) **] to identify a seizure focus (MR Spectroscopy was not readily available due to requirements to transfer the patient to another campus for which the patient was not stable enough). While the patient's Midazolam was being uptitrated, he had one 60 second right hemisphere electroencephalographic seizure at 20 mg/hr overnight on [**8-16**], but seizures where suppressed at 25 mg/hr. He had additional electroencephalographic evidence of seizures on [**8-17**], so Levetiracetam 500 q12h was started as a third antiseizure [**Doctor Last Name 360**]. He did not have any more EEG evidence of seizures over [**8-18**] and [**8-19**] but did on [**8-20**]; Epilepsy recommended to wean off the Midalazom infusion and Valproate Sodium. He was successfully weaned from the Midazolam infusion with gradually returning background activity, and we started simplifying his antiseizure regimen under close observation in the ICU. He was maintained on Fosphenytoin and Levetiracetam. His EEG gradually showed more return of background activity but continued to show sharp discharges from the left occipital lobe. His clinical exam very slowly recovered, first with brainstem reflexes and subsequently increased motor response to noxious stimuli and then eye opening. However, he never recovered the ability to attend to the examiner or follow commands. [] Acute Subacute Ischemic stroke - His initial MRI revealed a subacute stroke, likely affecting the left posterior choroidal artery. We suspected this event was likely the result of small vessel disease (hypertension), but artery-to-artery and cardioaortoembolic etiologies are also possible. As this event was subacute, he was started on an antiplatelet and kept normotensive. However, in light of the additional seizure activity, we pursued further imaging with a repeat MRI which revealed an acute ischemic infarction of the left occipital and temporal lobes, possibly the event that triggered the initial series of seizures. This was more strongly suggestive of artery-to-artery or [**Last Name (LF) 90802**], [**First Name3 (LF) **] we pursued a carotid/vertebral artery ultrasound and TTE. We increased his aspirin from 81mg to 325mg and kept him normotensive. Given the distribution of strokes suggesting an embolic source and normal vessel imaging with a report of AFib en route to the OSH, he will likely need anticoagulation for stroke prevention; he has a CHADS of 4. He started him on a Heparin GTT. [] Klebsiella pneumonia - On [**8-21**], the patient had two episodes of O2 desaturations in the setting of fever. He was found to have 4+ GNR which were identified as pan-sensitive Klebsiella. He was treated with Cefepime 2gm q12h initially, but his antibiotics were broadened to Cefepime, Vancomycin and Tobramycin due to worsening of his infection with increased leukocytosis. [] Acute Kidney Injury/Acute Tubular Necrosis - The patient's renal function worsening from [**Date range (1) 90803**] (peak of 2) in the setting of relative hypotension in the setting of his pulmonary infection requiring pressors and fluid boluses. His renal US was negative for obstruction or hydronephrosis and his FE Urea was most consistent with ATN, likely from hypoperfusion. His fluid status was monitored closely and his blood pressure stabilized. His antihypertensives were held. His renal function improved back to Cr 1.3 and he required further diuresis but continued to show signs of [**Last Name (un) **] (to Cr 3.1) whenever diuresis was pursued. He had anasarca and significant volume overload including pulmonary congestion which did not permit downtitration of his ventilator settings, yet his kidneys would not tolerate pharmacologic diuresis. [] Liver Dysfunction - The patient has a noted mild coagulopathy and synthetic dysfunction (low albumin), likely contributing to his third-spacing and peripheral edema. His wife agreed that as a young man it is likely that he had consumed excess amounts of alcohol, and he most recently was still drinking [**2-8**] glasses of hard liquor at a time. This baseline liver dysfunction has likely contributed to both his volume overload as well as his prolonged sedation from Midazolam. [] Goals of Care - Several discussions with the wife [**Name (NI) 17301**], [**First Name3 (LF) **] [**Name (NI) **], and other family members were held which revealed hope regarding the patient's prognosis but also understanding of the severity of his illnesses. In discussions with the family on [**8-29**], it was found that he actually had a living will which indicated that he would want to be DNR/DNI. The family came to the hospital on [**8-30**] and decided to make the patient DNR/DNI with goals of care directed toward Comfort Measures Only. He was extubated and placed on a morphine infusion for pain and air hunger. He passed away on [**2103-8-30**] at 3:30 PM of hypoxic respiratory failure. His family was notified and declined autopsy. Medications on Admission: -tricor 145 mg daily -zocor 80 -lisinopril 20 daily -folate 1 mg [**Hospital1 **] -norvasc 5 mg daily Discharge Medications: N/A Discharge Disposition: Expired Discharge Diagnosis: Seizures, Status Epilepticus Subacute ischemic stroke Discharge Condition: Deceased Discharge Instructions: N/A Followup Instructions: N/A ICD9 Codes: 5845, 2760, 5119, 2724, 5859
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Medical Text: Admission Date: [**2170-9-19**] Discharge Date: [**2170-10-12**] Date of Birth: [**2099-5-5**] Sex: F Service: [**Hospital Unit Name 196**] Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 9554**] Chief Complaint: Weight gain, weakness Major Surgical or Invasive Procedure: Colonoscopy-no apparent bleeding lesion. History of Present Illness: 71 y.o Russian speaking female with extensive PMH including CAD, CHF, afib and chronic anemia. She was recently admitted in [**6-3**] for anemia work-up and found to have a bleeding gastric ectasia on EGD which was removed. Colonoscopy revealed a benign polyp. Pt presents today after feeling increased fatigue at home. Denies CP or increasing SOB. On home O2 at 2L and has not required increased amounts. Pt also notes that she has been unable to walk around her apartment as much, but is limited by weakness vs shortness of breath. She does not feel that her breathig has changed. Her symptoms began approx 3 weeks ago. Denies, cough, cold symptoms, fever, chills, nausea, vomting, change in diet or medication. Pt reports that she was told by her PCP that she had gained a lot of weight due to fluid and needed to come into the hospital for diuresis. Past Medical History: CAD h/o CHF AFib on coumadin anemia Restrictive lung disease Social History: married, no alcohol or tobacco Family History: non-contributory Physical Exam: VS: 97.5, 97/50, 57,16, 95 on 2l NC GEn: Morbidly obese, pale, pleasant, speaking in full sentences. HEENT: Ophx clear, MMM, PERRLA, conjinctiva pale, no icterus CV: distant HS, reg [**Last Name (LF) 20687**], [**First Name3 (LF) **], III/VI SEM radiating to carotids. Pulm: Distant BS, good inspiratory effort, bibasilar crackles 1/3 up, no rhonchi or wheezing. Abd: obese, NT, ND, +BS Ext:4+ woody edema to the knee bilat, warm, erythematous, non-tender Neuro: occ resting tremor which is not new. No focal deficits. A&O x3 Pertinent Results: ECHO: Left Atrium - Long Axis Dimension: 3.7 cm (nl <= 4.0 cm) Aortic Valve - Peak Velocity: *4.1 m/sec (nl <= 2.0 m/sec) Aortic Valve - Peak Gradient: 64 mm Hg Aortic Valve - Mean Gradient: 40 mm Hg Mitral Valve - E Wave: 1.1 m/sec Mitral Valve - A Wave: 1.2 m/sec Mitral Valve - E/A Ratio: 0.92 Mitral Valve - E Wave Deceleration Time: 270 msec LEFT ATRIUM: Normal LA size. RIGHT ATRIUM/INTERATRIAL SEPTUM: Normal RA size. LEFT VENTRICLE: Normal LV cavity size. Overall normal LVEF (>55%). RIGHT VENTRICLE: Normal RV chamber size and free wall motion. AORTA: Normal aortic root diameter. AORTIC VALVE: Severely thickened/deformed aortic valve leaflets. Moderate AS. MITRAL VALVE: Mildly thickened mitral valve leaflets. Moderate mitral annular calcification. PERICARDIUM: No pericardial effusion. Conclusions: 1. The left ventricular cavity size is normal. Overall left ventricular systolic function is very difficult to assess but it may be normal (LVEF>55%). 2. The aortic valve leaflets are severely thickened/deformed. There is moderate aortic valve stenosis. 3. The mitral valve leaflets are mildly thickened. 4. Compared with the findings of the prior study (tape reviewed) of [**2167-12-7**], LV function may have improved. COLONOSCOPY: (Rectal polyp, polypectomy): Distorted fragment of benign colonic mucosa with melanosis coli; no adenomatous change seen (multiple levels examined). Brief Hospital Course: 71 yo Russian speaking female with extensive PMH presents with weight gain and increased fatigue over the past 3-4 weeks. 1)Anemia: Pt was recently admitted in [**2170-5-31**] for anemia work-up and found to have a bleeding gastric ectasia on EGD which was removed. Colonoscopy at that time revealed a benign polyp. Pt was found to have Hct of 18 on this admission. Pt was transferred to the CCU for monitoring and received 8 units of PRBC with appropriate increase from 18 to 33. The anemia was thought to be subacute since she was never hemodynamically unstable. GI was consulted. Coumadin was held for suspected GI bleed. Colonoscopy was scheduled but held for persistent high INR which was reversed with vitamin K. Pt was a difficult prep and required almost 4-5 days of prepping with Golytely and other laxative. Pt finally underwent colonoscopy which revealed no source of bleed. Since pt's Hct was stable 25 34-35, no further diagnostic procedure was done. If pt were to develop another acute/subacute anemia, capsule study was recommended. 2) CHF: Pt has a long hx of CHF per old records. Last echo before admission was from [**2168**] which showed EF of 35-40%. She got an echo on [**9-20**] which showed EF>55%. Pt was initially started on niseritide and lasix for diuresis for suspected CHF exacerbation before her initial Hct of 18 came back. Pt received lasix between transfusions. Lisinopril was held for increased creatinine. Pt's wt was stable and CHF status was stable initially. However, after 5 days of prep for the colonoscopy, pt started to gain weight everyday and was net positive daily. Pt was refractory to standing IV Lasix and Diuril. She got PICC line placed under IR and Natrecor gtt was started with still net positive daily. Lasix gtt was added and was titrated up to 10-15mg/hr which gave some reponse initially but again became refractory to it. Dopamine gtt was tried but showed no improvement in UOP. Pt lost PICC access. However one day, she started to respond extremely well with lasix gtt at 10mg/hr and IV Diuril 250 mg [**Hospital1 **] only (without Natrecor). Pt's admission weight was 130 kg (128 kg in a clinic note) and has gotten up as high as 139 kg. However, she was able to diuresis 1-2L/day and her weight came down to 130kg which is her baseline. The diuretics were changed to po form (Lasix po 120 mg [**Hospital1 **] and Diuril po 125 mg [**Hospital1 **]) and pt continued to diuresis with net negative daily. Pt's CHF was thought to be possibly from AS. If that is the case, valve replacement could improve her symtoms. Review of the aortic valve orifice and consideration of valve replacement should be discussed as outpatient. Pt needs to follow up with a [**Hospital 1902**] clinic within 1 week. 3) Afib: Pt with hx of atrial fibrillation but now in sinus rhythm. Rate is bradycardic. Pt noted to have pauses on tele up to 2 seconds. Pt was continued on amiodarone 200 mg po qd. Coumadin was held in a setting of GI bleed and also for high INR prior to colonoscopy. Coumadin was restarted with goal INR of [**1-2**]. Pt needs to be seen by her PCP to check her INR level. 4) COPD/restrictive lung dz: Pt was continued on 2 L of oxygen which is her baseline. Pt was getting nebulizer prn for wheezing and SOB. Pt is on home O2. 5) DM: Pt was initially continued on home meds of avandia and glyburide and was cover with RISS. However, avandia was held while she was NPO. She will be discharged with her home regimen. 9) CODE: DNR/ DNI- this was re-discussed with patient and husband to determine if pt still wants to be DNI/DNR as she has been DNR/DNI on prior admissions. Medications on Admission: avandia 4 [**Hospital1 **] amaryl 2 mg prn FS > 250 protonix 50 qd coumadin 2 qhs- on HOLD amiodorone 200 qd lasix 160 qam, 40 qpm zaroxyln 2.5 qd 30 minute before am lasix lipitor 40 qd iron 325 tid- don't give w/ protonix vit c tid with iron lisinopril 5 qd levoxyl 0.050 mg qd albuterol/atrovent MDI epogen 3000 units 2x per week. Discharge Medications: 1. Amiodarone HCl 200 mg Tablet Sig: One (1) Tablet PO QD (). Disp:*30 Tablet(s)* Refills:*2* 2. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). Disp:*90 Tablet(s)* Refills:*2* 3. Levothyroxine Sodium 50 mcg Tablet Sig: One (1) Tablet PO QD (). Disp:*30 Tablet(s)* Refills:*2* 4. Lisinopril 5 mg Tablet Sig: One (1) Tablet PO QD (). Disp:*30 Tablet(s)* Refills:*2* 5. Epoetin Alfa 4,000 unit/mL Solution Sig: Two (2) Injection QMOWEFR (Monday -Wednesday-Friday). Disp:*qs * Refills:*2* 6. Albuterol Sulfate 0.083 % Solution Sig: [**12-1**] Inhalation Q6H (every 6 hours) as needed. 7. Triamcinolone Acetonide 0.1 % Cream Sig: One (1) Appl Topical HS (at bedtime). Disp:*1 tube* Refills:*2* 8. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 9. Avandia 4 mg Tablet Sig: One (1) Tablet PO twice a day. Disp:*60 Tablet(s)* Refills:*2* 10. Amaryl 2 mg Tablet Sig: One (1) Tablet PO as needed as needed for FS>200. Disp:*30 Tablet(s)* Refills:*0* 11. Atorvastatin Calcium 40 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* 12. Iron 325 (65) mg Capsule, Sustained Release Sig: One (1) Capsule, Sustained Release PO three times a day. Disp:*90 Capsule, Sustained Release(s)* Refills:*2* 13. Metoprolol Succinate 25 mg Tablet Sustained Release 24HR Sig: One (1) Tablet Sustained Release 24HR PO DAILY (Daily). Disp:*30 Tablet Sustained Release 24HR(s)* Refills:*2* 14. Chlorothiazide 250 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 15. Furosemide 80 mg Tablet Sig: 1.5 Tablets PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 16. Pramoxine-Zinc Oxide in MO 1-12.5 % Ointment Sig: One (1) Appl Rectal Q4-6H (every 4 to 6 hours) as needed. Disp:*qs qs* Refills:*0* 17. Coumadin 1 mg Tablet Sig: Three (3) Tablet PO once a day. Disp:*90 Tablet(s)* Refills:*2* Discharge Disposition: Home With Service Facility: [**Hospital 20688**] Home Health Discharge Diagnosis: Acute anemia from GI bleed CHF Discharge Condition: Hemodynamically stable, stable Hct, no chest pain, no symptoms of dizziness. Discharge Instructions: Patient was instructed to take all of the medications as instructed. Pt was instructed to seek medical attention if shed develops fatigue, dizziness, SOB, Chest pain, bloody stool, melena, bloody emesis. Pt should see her PCP [**Last Name (NamePattern4) **] [**12-1**] weeks after the discharge. Followup Instructions: Provider: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] [**Name8 (MD) **], MD Where: [**Hospital6 29**] [**Hospital3 249**] Phone:[**Telephone/Fax (1) 250**] Date/Time:[**2170-10-30**] 1:30 [**First Name8 (NamePattern2) 2064**] [**Last Name (NamePattern1) **] MD [**MD Number(2) 2139**] Completed by:[**2170-10-12**] ICD9 Codes: 4280, 2851, 4241, 5849, 5990, 2449
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Medical Text: Admission Date: [**2117-4-14**] Discharge Date: [**2117-5-9**] Date of Birth: [**2117-4-14**] Sex: M Service: NB HISTORY: Baby [**Name (NI) **] [**Known lastname 61155**] is a 32 [**3-15**] week gestation infant born to a 41-year-old G6 P2 mom. Prenatal screens, 0 positive, antibody negative, hepatitis surface antigen negative, RPR nonreactive and Rubella immune. Prenatal course is significant for placenta previa and probable abruption presented with large vaginal bleeding at approximately 26 weeks. She received 2 doses of betamethasone and was admitted to the hospital on bedrest with a few bleeding episodes. Fetus well. Hepatitis B in the past, resolved. Due to risk for further bleeding and gestational age, over 32 weeks, elected to deliver by C-section. She received second course of betamethasone. The infant delivered by repeat cesarean section with Apgar's of 8 and 9. He emerged active and well-appearing. PHYSICAL EXAMINATION: Infant active, moderate to severe respiratory distress. Anterior fontanelle open and flat. Normal S1 and S2, no murmur. Breath sounds distant bilaterally. Abdomen, soft nontender, nondistended. Extremities well perfused, tone appropriate for gestational age. HISTORY OF HOSPITAL COURSE BY SYSTEMS: Respiratory - [**Known lastname **] was placed on CPAP for mild respiratory distress and remained on CPAP for a total of 3 days at which time he was transitioned to nasal cannula for a brief 4-hour period of time. He has been stable on room air throughout the rest of his hospital course. He did not require any methylxanthines for apnea or bradycardia of prematurity although he did have mild apnea and bradycardia of prematurity. His last documented episode was on [**5-2**]. Cardiovascular - He has been cardiovascularly stable throughout the hospital course. Fluids and electrolytes - Birthweight was 2.435 kg. He was initially started on 80 cc/kg/day of D10 W. Enteral feedings were initiated on day of life #2. Full enteral volumes were achieved by day of life #5. Maximum enteral intake was 150 cc/kg/day of breast milk 24 calorie and he continues to ad lib feed with a minimum of 150/kg of breast milk 24, concentrated with Similac powder. His discharge weight is Gastrointestinal - Peak bilirubin was 12.9/0.3 on day of life #4 and he was treated with phototherapy and was discontinued and this issue has since resolved. Infectious disease - CBC and blood culture obtained on admission, CBC was benign and blood cultures remain negative at 48 hours at which time antibiotics were discontinued. He has not required any further sepsis evaluations during this hospital course. Neurology - He has been appropriate for gestational age. Sensory - Hearing screen has not yet been performed, it should be done prior to discharge. Psychosocial - A social worker has been involved with this family and can be contact[**Name (NI) **] at [**Telephone/Fax (1) 61156**]. CONDITION ON DISCHARGE: Stable. DISCHARGE DISPOSITION: To home. PEDIATRICIAN: CARE/RECOMMENDATIONS: Feeding - Continue ad lib feeding, breast milk 24 calorie, concentrated with Similac powder. Medications - Tri-Vi-[**Male First Name (un) **] and Fer-In-[**Male First Name (un) **]. Car seat position screening - Not yet performed, but should be done prior to discharge. State newborn screens - Sent per protocol and have been within normal limits. Immunizations received - Received hepatitis B vaccine on [**2117-4-28**]. DISCHARGE DIAGNOSIS: Premature infant born at 32 3/7 weeks. Mild respiratory distress syndrome. Mild apnea and bradycardia of prematurity. Hyperbilirubinemia. Mild anemia. Status post rule out sepsis with antibiotics. [**First Name11 (Name Pattern1) 449**] [**Last Name (NamePattern1) **], [**MD Number(1) 54604**] Dictated By:[**Last Name (NamePattern1) **] MEDQUIST36 D: [**2117-5-8**] 00:05:37 T: [**2117-5-8**] 07:00:19 Job#: [**Job Number 61157**] ICD9 Codes: 769, 7742, V290, V053
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Medical Text: Admission Date: [**2199-3-8**] Discharge Date: [**2199-3-14**] Date of Birth: [**2134-1-20**] Sex: F Service: MEDICINE Allergies: Codeine / Bactrim / Sulfa (Sulfonamides) Attending:[**First Name3 (LF) 5301**] Chief Complaint: Shortness of breath Major Surgical or Invasive Procedure: none History of Present Illness: 65 F c COPD, HTN p/w malaise, diaphoresis, SOB for 1 week. Also c nausea, but no vomiting/diarrhea. No cough, chest pain, palpitations, LE edema, orthopnea, PND. In ED, vitals were T 98.5, HR 87, BP 172/101, RR 24, sat 94% on 2L NC. Noted to be in resp. distress, unable to speak in full sentences. Significant wheezing. ABG showed pCO2 60, p02 71; placed on BiPAP. CXR clear by radiology report. Treated with nebulizers, solumedrol, levofloxacin. Also treated for hypertensive urgency (BP to 200/100 in ED after presentation) with lisinopril and amlodipine. . At baseline, pt has home O2 2.5L NC for daily use & BiPAP at night. Pt has never been intubated. Pt reports not using her supplemental 02 during the day, though she says she always uses her BiPAP for sleep. Has not been using Nebs recently. No known sick contacts. . MICU course: Thought to have COPD flare from non-compliance with home 02. Hypertension thought [**2-15**] COPD flare and non-compliance with medications. Treated overnight with BiPAP and nebulizers. BP well controlled and did not require additional meds. Past Medical History: COPD/emphysema OSA HTN hyperlipidemia GERD schizophrenia depression s/p R ankle ORIF obesity s/p T & A Social History: Lives alone, close friend [**Doctor First Name **] is very supportive. Former tobacco 1ppd x 40 years, now "occasional smoking" few cigs/monthly. Has an estranged brother in FL. Family History: mother-deceased brain CA father-deceased suicide sister-deceased PE Physical Exam: 98.6, 193/119, 66, 18, 97% on BiPAP GEN: BiPAP on, appears well, speaking in largely full sentences HEENT: MM dry, Left eye w/purulent discharge & matting, PERRL, no conjunctival irritation. EOMI. No LAD. CV: RRR, distant sounds. No JVD. Good pulses peripherally. PULM: diminished bilaterally w/expiratory wheezes throughout. No focal crackles or consolidations noted. ABD: soft, NT/ND. +BS. Obese. EXT: cool feet bilaterally but palpable DP pp x2. No edema. NEURO: A&Ox3, MAE, CN III-XII intact grossly, strength 5/5 upper and lower extremities bilaterally, sensation intact to light touch. Reflexes not tested. Pertinent Results: [**2199-3-8**] 02:30PM WBC-16.7*# RBC-5.98* HGB-15.4 HCT-48.8* MCV-82 MCH-25.7* MCHC-31.5 RDW-15.4 [**2199-3-8**] 02:30PM CK-MB-NotDone cTropnT-<0.01 [**2199-3-8**] 02:30PM CK(CPK)-56 [**2199-3-8**] 02:30PM GLUCOSE-119* UREA N-22* CREAT-0.6 SODIUM-146* POTASSIUM-4.3 CHLORIDE-103 TOTAL CO2-33* ANION GAP-14 [**2199-3-8**] 02:47PM LACTATE-1.6 K+-4.2 . [**2199-3-8**] CXR: Study is mildly compromised secondary to body habitus. No superimposed consolidations or effusions are noted. There is minimal ectasia of the thoracic aorta with atherosclerotic disease. The cardiac silhouette remains enlarged but stable. No pleural effusion or pneumothorax is evident. IMPRESSION: No acute pulmonary process. Brief Hospital Course: 65 F w/long history of COPD, OSA, and HTN admitted to MICU on [**2199-3-8**] with COPD exacerbation. The following issues were investigated during this hospitalization: . #. COPD exacerbation: Pt's respiratory distress was likely from COPD exacerbation triggered by a viral URI. Additionaly, patient reported non-compliance w/ daytime supplemental 02 which likely contributed to her presentation. She was treated with an initial dose of IV solumedrol on admission, then transitioned to a PO steroids taper. She also received nebs which were transitioned to an MDI. She continued on BiPAP at night and 02 by NC during the day and was improving, however, it was noted that her bicarbonate was slowly trending up. An ABG on room air showed values of 7.37/68/46. This was compared to an ABG in the MICU with a CO2 of 68. Given the hypoxia, a repeat ABG on 3 L NC showed values of 7.34/86/86. The pulmonary consult team was curbsided and advised placing the patient on BiPAP during the day for a few hours each day in order to allow the patient to ventilate her CO2. She remained awake and alert with good mentation despite the readings of the ABG. Additionally, it was confirmed with the respiratory team that knows the patient, that the patient's CO2 baseline is close to that reflected in the initial ABG. She was discharged to pulmonary rehabilitation on 1 L of O2 with a satisfactory O2 saturation of 92%. . #. HTN: Patient was found to have several episodes of hypertensive urgency for which she received one time doses of Amlodipine and Lisinopril. Both of these medications, which the patient had been taking as an outpatient, were increased to maximum values of 10 and 40 mg respectively. A beta blocker was not an ideal 3rd option given the patient's COPD and while HCTZ would have been an ideal choice, a sulfa drug allergy prevented her from safely receiving it. Since increasing Lisinopril, the patient's BP has been better controlled with a sytolic BP range between 150s - 160s. . #. SCHIZOPHRENIA/DEPRESION: Stable during this hospitalization. Pt. is followed at Mass Mental as an outpatient. She was continued on her outpatient regimen of Risperdal, Trazodone and Prozac. . #. GERD: Pt. was maintained on her outpatient PPI. . #. HYPERLIPIDEMIA: Pt. was maintained on her outpatient statin. . #. OSA: Pt. with known pulmonary artery hypertension and large body habitus, on BiPAP ([**10-18**] w/ 3L 02) at home, which was maintained during this hospitalization. . # Conjunctivitis L eye: Noted while in MICU, but resolved with Erythromycin OPH TID. Medications on Admission: Prozac 80 mg' Risperdal 2 mg' Lisinopril 20 mg' Norvasc 5 mg' Trazodone 200 mg po HS Protonix 40 mp po' Lipitor 20 mg' Albuterol Advair Combivent Nebulizers Discharge Medications: 1. Fluoxetine 20 mg Capsule Sig: Four (4) Capsule PO DAILY (Daily). 2. Risperidone 2 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Lisinopril 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 4. Amlodipine 5 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 5. Trazodone 100 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime). 6. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 7. Atorvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. Albuterol 90 mcg/Actuation Aerosol Sig: 1-2 Puffs Inhalation Q6H (every 6 hours). 9. Ipratropium Bromide 17 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation QID (4 times a day). 10. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) injection Injection TID (3 times a day): use for DVT prophylaxis; can discontinue if ambulating. 11. Albuterol 90 mcg/Actuation Aerosol Sig: 1-2 Puffs Inhalation Q4H (every 4 hours) as needed. 12. Prednisone 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily) for 3 doses: Start on [**2199-3-15**]. 13. Prednisone 10 mg Tablet Sig: One (1) Tablet PO once a day for 3 days: Start on [**2199-3-18**]. 14. Prednisone 5 mg Tablet Sig: One (1) Tablet PO once a day for 3 days: Start on [**2199-3-21**]. Discharge Disposition: Extended Care Facility: [**Hospital1 700**] - [**Location (un) 701**] Discharge Diagnosis: Primary: COPD exacerbation . Secondary: OSA HTN Mild aortic valve stenosis on echo hyperlipidemia GERD schizophrenia depression obesity Discharge Condition: Afebrile, Mentating well Discharge Instructions: You were admitted to the hospital with COPD/emphysema attack. This was due to possible viral infection. It is critical that you use your home oxygen and BiPAP as directed. . You are being discharged to [**Hospital **] rehab for further management of your breathing status. They may adjust your BiPAP settings, please follow these recommendations on discharge to home. . It is very important that you stop smoking, please see your primary care doctor if you need assistance with this. . Please take your medications as prescribed. Followup Instructions: Please see your primary care doctor [**Last Name (Titles) **],[**First Name8 (NamePattern2) **] [**Doctor First Name **] [**Telephone/Fax (1) 693**] within 2wks of discharge from the hospital. You should have pulmonary function tests done; please discuss this with Dr. [**Last Name (STitle) **]. ICD9 Codes: 4241, 4019, 2724
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Medical Text: Admission Date: [**2127-7-22**] Discharge Date: [**2127-7-29**] Date of Birth: [**2053-7-1**] Sex: F Service: [**Hospital Unit Name 14178**] REASON FOR ADMISSION: Admission for hypertrophic obstructive cardiomyopathy alcohol septal ablation. HISTORY OF PRESENT ILLNESS: This is a pleasant 74-year-old female with a history of hypertrophic obstructive cardiomyopathy with a left ventricular outflow tract gradient of 60, congestive heart failure, severe mitral regurgitation, paroxysmal atrial fibrillation, and diabetes, who has been admitted multiple times ([**2127-6-17**], [**2127-7-9**], [**2127-7-11**]) with a CHF exacerbation. She now complains of increasing symptoms of congestive heart failure (orthopnea, paroxysmal nocturnal dyspnea at rest and with exertion, peripheral edema) over the past five days. She denies dietary indiscretion. During her last admission, her Zaroxolyn was discontinued. She has had some edema of her lower extremities bilaterally for the past few weeks. Of note, she was started on ciprofloxacin p.o. b.i.d., now on day five of 10 for left upper extremity cellulitis. She has not taken Coumadin since [**2127-7-21**]. REVIEW OF SYSTEMS: Ten systems were reviewed and were negative as above. The patient denies cough, fever, chest discomfort, palpitations, or lightheadedness. PAST MEDICAL HISTORY: 1. Hypertrophic obstructive cardiomyopathy diagnosed in [**2117**] with the most recent ejection fraction of 60%, left ventricular outflow tract of 60, [**11-21**]+ mitral regurgitation during echocardiogram in [**2127-3-20**]. 2. Congestive heart failure as above. 3. Diabetes mellitus type 2. 4. Mitral regurgitation. 5. Paroxysmal atrial fibrillation on Coumadin. 6. Hypertension. 7. Status post DDD pacemaker to induce left ventricular delay compared to the right ventricle in order to decrease the outflow tract obstruction. 8. Left upper extremity cellulitis on day five of 10 on Cipro. ALLERGIES: Penicillin induces hives. MEDICATIONS AT TIME OF ADMISSION: 1. Toprol XL 100 mg q.d. 2. Spironolactone 25 mg q.d. 3. Verapamil 240 mg p.o. b.i.d. 4. Trazodone 50 mg q.h.s. 5. Glipizide 5 mg q.d. 6. Metformin 850 mg one p.o. q.d. 7. Amiodarone 200 mg one p.o. q.d. 8. Lasix 80 mg one p.o. b.i.d. 9. Potassium chloride 40 mEq one p.o. b.i.d. 10. Ciprofloxacin 500 mg p.o. b.i.d. day five of 10. SOCIAL HISTORY: The patient quit smoking 10 years prior to admission. She uses alcohol occasionally less than once per week. She is from [**Country 4754**]. Denies drug use or toxic exposures. FAMILY HISTORY: Mother has diabetes mellitus. Brother had a CABG, the details of which are unknown. PHYSICAL EXAM AT TIME OF ADMISSION: Blood pressure was 134/41, heart rate was 68 and regular, respiratory rate is 14, temperature of 98.1, oxygenation of 93% on room air. General: Pleasant female sitting up in no apparent distress alert and oriented times three. HEENT: Pupils are equal, round, and reactive to light and accommodation. Extraocular movements are intact. Moist mucous membranes. Oropharynx benign. Anicteric sclerae. No jugular venous distention was noted. Lungs: Minimal crackles [**11-23**] of the way up bilaterally. Cardiovascular: Nondisplaced point of maximal impulse, regular, rate, and rhythm with a normal S1 greater than S2, [**1-23**] blowing systolic ejection murmur at the apex and [**1-23**] holosystolic murmur at the base that increased with Valsalva maneuvers. Abdomen is soft, nontender, nondistended with positive bowel sounds, no hepatosplenomegaly or bruits. Extremities: 1+ pitting edema to the ankles bilaterally. Skin: Consistent with mild sunburn over the upper chest, no bruises or rashes. STUDIES: Laboratories: White blood cell count 11.6, 80.2% neutrophils, 14.3% lymphocytes, 4.3% monocytes, 0.8% eosinophils, hematocrit 36.9. INR was 4.8, glucose 66, BUN 55, creatinine 1.4. Sodium 134, potassium 2.9, chloride 90, bicarb 31. CONCISE SUMMARY OF HOSPITAL COURSE: The patient was admitted to the [**Hospital Unit Name 196**] Service, placed on telemetry. Cardiac enzymes were cycled. Patient was placed on standard CHF protocol with a low sodium fluid-restricted diet. Head of the bed elevated at 45 degrees. Lower extremities elevated while patient in bed. 1. Coronaries. In preparation for the HOCM septal ablation, the coronary arteries were imaged with cardiac catheterization and were found to have no significant lesions. The patient's cardiac enzymes were stable prior her septal ablation. CHF: The patient had daily weights and ins and outs monitored. She was continued on Toprol XL, Lasix, spironolactone, Zaroxolyn. Serial chest x-rays at three different points throughout her hospital course demonstrated no evidence of congestive heart failure. The patient's lower extremity edema improved after gentle diuresis. Electrophysiology: The patient remained in an A-V paced rhythm. Her Coumadin continued to be held secondary to supertherapeutic levels. The patient was maintained on amiodarone, Toprol XL, and a calcium-channel blocker. Telemetry was monitored on a daily basis without any abnormalities. Diabetes mellitus: The patient was placed on Glipizide XL 5 mg p.o. q.d. and placed on an insulin-sliding scale. Her glucose control remained adequate throughout her hospital stay. 2. Upper extremity cellulitis: The patient was continued on ciprofloxacin 500 mg p.o. b.i.d. 3. Hypokalemia: The patient was profoundly hypokalemic and was as low as 2.5 mEq/L at various points in her hospital stay despite aggressive p.o. potassium repletion. The patient refused to take intravenous potassium chloride, although on [**2127-7-25**], on the date of her septal ablation, she did allow potassium chloride to be repleted through a concentration of 40 mEq of potassium in a 500 cc 1/2 normal saline bag at 50 cc/hour. 4. Electrolytes: The patient's renal function was monitored throughout her hospital course, and remained stable. 5. Hypertrophic obstructive cardiomyopathy: The patient underwent an alcohol septal ablation on [**2127-7-25**] without complication with minimal right groin bleeding postprocedure that quickly resolved. Summary of alcohol septal ablation: 1. Coronary angiography of the right side dominant system revealed no significant obstructive disease. The left main, left anterior descending artery, left circumflex, right coronary arteries, and mild luminal irregularities without significant obstructive disease. 2. Resting hemodynamic measurements at baseline revealed a left ventricular outflow gradient at 45 mm Hg. Right and left sided filling pressures were severely elevated with a right ventricular end diastolic pressure of 50 mm Hg. Left ventricular end diastolic pressure of 20 mm Hg. Pulmonary artery pressures were moderately elevated to 55/25. Cardiac index was mildly reduced at 2.3 liters/minute/meters squared calculated by the Fick equation using assumed oxygen consumption. On pullback across the aortic valve, the gradient was confirmed to be isolated to the left ventricular outflow tract with no appreciate gradient across the aortic valve. On dobutamine at 5 mcg/kg/min IV drip, hemodynamic measurements revealed worsening of the left ventricular outflow gradient to 100 mm Hg. 3. Septal ablation was successfully performed by injection of ethanol into three septal perforators under fluoroscope and echocardiographic guidance. 4. Post-procedure hemodynamic measurements revealed resolution of the left ventricular outflow gradient. Final hemodynamic measurements reveal a residual outflow gradient of less than 10 mm Hg. An echocardiogram was performed on [**2127-7-28**]. The results are still pending at the time of dictation. By verbal report, the cardiac catheterization findings were confirmed. The patient's prior medications used to control her CHF and cardiomyopathy were gradually weaned beginning with the Lasix, which was weaned on [**2127-7-26**], and the verapamil which was weaned on [**2127-7-28**]. 6. Hematological: The patient's Coumadin was restarted on [**2127-7-26**] with a target INR of 2.0 to 3.0. On the day of discharge, the patient's INR was 1.6 on 5 mg of Coumadin p.o. q.d. CONDITION ON DISCHARGE: At the time of discharge, the patient complained of some anterior and posterior lower extremity pain at the joints, which was relieved with Motrin. The patient denied shortness of breath, chest pressure, palpitations, or lower extremity edema. DISCHARGE STATUS: Good. DISCHARGE DIAGNOSIS: 1. Cardiomyopathy, hypertrophic obstructive. SECONDARY DIAGNOSES: 1. Left sided congestive heart failure with an ejection fraction at 55%. 2. Dyspnea. DISCHARGE MEDICATIONS: 1. Aspirin 325 mg p.o. q.d. 2. Coumadin 5 mg tablet one p.o. q.h.s. The patient will have her INR checked in one week's time by her primary care doctor. 3. Spironolactone 25 mg p.o. q.d. 4. Glipizide 5 mg tablet one p.o. q.d. 5. Brimonidine tartrate eyedrops at 0.2% one drop O.U. q.8h. prn. 6. Metoprolol 25 mg p.o. b.i.d. 7. Docusate sodium 100 mg capsule one p.o. b.i.d. 8. Amiodarone 200 mg tablet one p.o. q.d. FOLLOW-UP PLANS: The patient was evaluated by Physical Therapy and Occupational Therapy, and both of whom felt that she would benefit from evaluation for home safety. The patient was discharged with a home safety evaluation and skilled nursing VNA. The patient was advised to call 911, or go to the nearest Emergency Room, or call her primary care doctor with chest pressure, shortness of breath, palpitations, swelling in the legs, or lightheadedness. She was advised to call her primary medical doctor if she gains more than 5 pounds. She was advised to eat less than 2 grams of sodium per day and limit her fluid intake to 1,000 cc as at the discretion of Dr. [**First Name8 (NamePattern2) 449**] [**Last Name (NamePattern1) 2031**]. She was advised to followup with Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 216**] on [**2127-8-7**] at 9:45 a.m., [**Telephone/Fax (1) 2660**], [**Location (un) 8170**], [**Apartment Address(1) 93647**], [**Location (un) **], [**Numeric Identifier 94054**] and with Dr. [**First Name11 (Name Pattern1) 449**] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 2031**], M.D. at the [**Hospital Ward Name 23**] Center Cardiac Services, [**Telephone/Fax (1) 11216**] on [**2127-8-11**] at 2 p.m. Patient will likely have a follow-up echocardiogram in one month's time, and will gradually wean her beta blocker, amiodarone, and spironolactone in the discretion of Dr. [**First Name (STitle) 2031**]. DR.[**First Name (STitle) **],[**First Name3 (LF) **] 11-691 Dictated By:[**Last Name (NamePattern1) 1811**] MEDQUIST36 D: [**2127-7-29**] 19:56 T: [**2127-7-31**] 07:12 JOB#: [**Job Number 94055**] ICD9 Codes: 4280, 4240, 2768, 4019
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Medical Text: Admission Date: [**2106-6-25**] Discharge Date: [**2106-6-30**] Date of Birth: [**2024-6-28**] Sex: M Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 2610**] Chief Complaint: impacted food bolus Major Surgical or Invasive Procedure: Upper Endoscopy R IJ placement History of Present Illness: History of Present Illness: Mr. [**Known lastname 30226**] is a 81 year old gentleman with dementia and history of aspiration, presenting from nursing home with food bolus impaction, admitted to MICU for urgent upper endoscopy. Patient was supposed to be on liquid diet at nursing home and ate a hamburger. He originally presented to OSH, where he was given glucagon and nitro with minimal effect, but was transfered to [**Hospital1 18**] for further management. . Of note, he was hospitalized recently at OSH [**Date range (3) 90541**] for RLL pneumonia, thought to be secondary to aspiration. . In the ED, initial vs were as follows: 97.4 123 138/76 91% 2L Nasal Cannula. Patient was noted to be drooling and spitting up some pieces of meat. Airway was intact. Patient was awake and responsive. CXR showed COPD with patchy opacities in setting of bronchiectasis which could represent aspiration, and no radiopaque foreign bodies appreciated. Vitals in ED prior to transfer to ICU were as follows: 97 117/74 97% 3L NC. . On arrival to the ICU, patient appeared comfortable. He was noted to have occasional dry cough. Denied fevers, shortness of breath, chest pain, abdominal pain, sore throat. Past Medical History: - Dementia - Dysphagia - BPH - Right inguinal scrotal hernia - History of aspiration pneumonia Social History: Lives in Den [**Hospital **] Nursing Home, dependent on 24hr caregivers. [**Name (NI) **] [**Name (NI) 1022**] [**Name (NI) 90542**] is HCP. DNR/[**Name2 (NI) 835**]. Per last discharge summary from OSH, patient has no recent smoking or alcohol. Family History: Unable to obtain due to patient's dementia. Physical Exam: ON ADDMISSION Vitals: T: 99.4 BP: 112/49 P: 117 R: 29 O2: 95% 2.5L NC General: Alert, oriented to "hospital" and self, no acute distress HEENT: Sclera anicteric, dry mucus membranes, oropharynx clear Neck: supple, JVP not elevated, no LAD Lungs: harsh crackles in LLL CV: Regular rhythm, rate rapid, 2/6 systolic murmur loudest at apex Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly GU: no foley Ext: warm, well perfused, no leg edema ON DISCHARGE: PE: t97.3, bp106/60, h63, r16, s94%RA Gen: AAOx1, NAD, lying comfortably in his hospital bed. Cardiac: RRR, +2/6 systolic murmur loudest at apex Pulm: CTAB anteriorly, good air entry. Abd: S/NT/ND, normoactive BS, no HSM, no rebound or guarding. Ext: all 4 extremeities warmer to touch, no CCE. GU: Has foley placed Neuro: A+O x1, responds to greeting, unchanged, +masked facies. Pertinent Results: [**2106-6-25**] 08:40PM GLUCOSE-154* UREA N-17 CREAT-1.1 SODIUM-140 POTASSIUM-4.5 CHLORIDE-103 TOTAL CO2-25 ANION GAP-17 [**2106-6-25**] 08:40PM WBC-11.2* RBC-4.96 HGB-15.7 HCT-45.0 MCV-91 MCH-31.7 MCHC-35.0 RDW-13.7 [**2106-6-25**] 08:40PM NEUTS-80.6* LYMPHS-15.1* MONOS-3.1 EOS-0.6 BASOS-0.7 [**2106-6-26**] 02:41 40.9* CORTISOL MRSA SCREEN (Final [**2106-6-27**]): POSITIVE FOR METHICILLIN RESISTANT STAPH AUREUS. Upper Endoscopy [**6-25**]: Erythema in the whole Esophagus. No impacted food noted in esophagus. Large hiatal hernia Otherwise normal EGD to Stomach Antrum. CXR [**6-25**]: IMPRESSION: COPD with patchy opacities in both lung bases in the setting of bronchiectasis, which could represent infection, inflammation or aspiration. Probable trace right pleural effusion. Enlargement of the hila may reflect pulmonary arterial hypertension. No radiopaque foreign bodies were identified. [**2106-6-30**] 07:15AM BLOOD WBC-5.2 RBC-3.74* Hgb-12.2* Hct-33.7* MCV-90 MCH-32.6* MCHC-36.1* RDW-13.1 Plt Ct-148* [**2106-6-30**] 07:15AM BLOOD Glucose-87 UreaN-13 Creat-1.2 Na-139 K-3.7 Cl-108 HCO3-27 AnGap-8 [**2106-6-30**] 07:15AM BLOOD Calcium-7.9* Phos-2.3* Mg-2.1 Brief Hospital Course: 81M with hx of dementia presenting with drooling and inability to take POs, presumed to have food bolus impaction in esophagus, admitted to MICU for urgent endoscopy. . # Impacted Food Bolus: Patient was admitted to MICU for urgent endoscopy to remove suspected impacted food bolus. GI preformed upper endoscopy and did not observe any residual food in the esophagus, but did show a large amount of erythema. It was recommended to follow-up with endoscopist within 6 weeks, and to avoid chocolate, peppermint, alcohol, caffeine, onions, aspirin. Elevate the head of the bed 3 inches. He is to go to bed with an empty stomach and take a PPI. . # Likely Aspiration Pneumonia vs Pneumonitis: Patient had a history of dysphagia and aspiration pneumonia presenting with mildly elevated WBC, low grade temperature and hypoxia. Because patient was a nursing home resident with history of aspiration pneumonia and low reserve, it was elected to treat as pneumonia covered broadly with vanc/zosyn for an 7 day course, which completed and his symptoms resolved. He has been afebrile over the last 4 days prior to discharge and has been saturating well. He was evaluated by speech who did not find any evidence of dysphagia, so he was put on a mechanical soft diet with thin liquids. He was also kept on aspiration precautions and the head of his bed was kept at 45 degress. . # Bradycardia/hypotension: Patient was noted to have intermittent heart rates to the 40s with systolics in the 80s. He never exhibited any symptoms during these episodes, continuing to mentate at his baseline. EKGs showed 1st degree AV block. Patient had a random cortisol of 40.9 suggesting he was not adrenally insufficient. On the floor, his SBP averaged 95-110 and his heart rate was around the 60s. He was not symptomatic at all during this time. . # BPH His proscar and flomax were initially held, however once he was cleared by speech and swallow they were restarted. . # Psych: Unclear whether patient has psychiatric history but is on depakote and abilify as an outpatient at nursing home. Pshyc Meds delivered via NG tube while patient was NPO and then transition ed to PO once he was able to tolerate taking pills. ___________________________________________ Pending: -None ___________________________________________ Transition of care: -pt has a follow up appointment with GI on [**2106-7-13**] 01:00p GI,[**Date Range 2606**] [**Doctor Last Name 2607**] RA [**Hospital Unit Name **] ([**Hospital Ward Name **]/[**Hospital Ward Name **] COMPLEX), [**Location (un) **] GI [**Hospital 14974**] CLINIC (SB) Medications on Admission: - Abilify 10mg po daily - Depakote 125mg po TID - Ativan 0.25mg po BID prn anxiety - Trazodone 50mg po at bedtime - Proscar 5mg po daily - Flomax 0.4mg po daily - PRN acetaminophen - PRN milk of mag - PRN fleets enema - PRN dulcolax - PRN immodium Discharge Medications: 1. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 2. aripiprazole 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. trazodone 50 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) as needed for insomnia. Tablet(s) 4. divalproex 125 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO TID (3 times a day). 5. tamsulosin 0.4 mg Capsule, Ext Release 24 hr Sig: One (1) Capsule, Ext Release 24 hr PO HS (at bedtime). 6. finasteride 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for pain, fever. 8. magnesium hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO DAILY PRN () as needed for constipation. 9. Imodium A-D 2 mg Tablet Sig: One (1) Tablet PO once a day as needed for constipation. 10. Ativan 0.5 mg Tablet Sig: 0.5 tablet Tablet PO twice a day as needed for anxiety: PRN anxiety. 11. omeprazole 40 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day: take 30 minutes before breakfast. Disp:*30 Capsule, Delayed Release(E.C.)(s)* Refills:*5* Discharge Disposition: Extended Care Facility: [**Month (only) 53281**] Rehabilitation & Nursing Center - [**Location (un) 28318**] Discharge Diagnosis: Primary diagnosis: Food impaction [**Hospital **] Hospital Acquired Pneumonia Discharge Condition: Awake and Oriented to person. Level of Consciousness: Alert and interactive. Discharge Instructions: It was a pleasure taking care of you during this hospitalization. You were brought to the hospital because it was thought that you had a piece of food stuck in you throat. We looked down your throat with a scope and we did not see any food. You were found to have inflammation of your esophagus. We have you a medication called omeprazole to help with this inflammation. We also thought that you had pneumonia. We gave you antibiotics through your veins for 7 days and your symptoms have improved. You do not need anymore antibiotics. We hope you continue to feel better. Medications Changes: START: Omeprazole 40mg daily- this is a medication for the inflammation in your throat. Followup Instructions: Please make sure to see your primary care doctor in the next 2 days. Department: DIV. OF GASTROENTEROLOGY When: TUESDAY [**2106-7-13**] at 1 PM With: [**Name6 (MD) 2606**] [**Name8 (MD) 2607**], MD [**Telephone/Fax (1) 463**] Building: Ra [**Hospital Unit Name 1825**] ([**Hospital Ward Name 1826**]/[**Hospital Ward Name 1827**] Complex) [**Location (un) **] Campus: EAST Best Parking: Main Garage ICD9 Codes: 0389, 5070
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Medical Text: Admission Date: [**2108-12-13**] Discharge Date: [**2108-12-18**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 6114**] Chief Complaint: Syncope, bradycardia, and hypotension Major Surgical or Invasive Procedure: Right central line placement and removal. Arterial line placement and removal. History of Present Illness: Pt is a 87 yo male with h/o HTN, severe MR, who presents from [**Hospital1 1501**] following syncopal episode w/ bradycardia and hypotension. Per report, patient was was working with PT/OT when he slumped in a chair with decreased MS (unable to follow commands, somnolent, able to open eyes). His SBP was noted to be 74/37 and HR was 46. FS was 114. EMS admistered atropine x 2 which raised pt's HR to 60, and SBP to the 60s. In the ED vital signs were : T 98.8, HR 60s-70s, bp 94/64, resp 24 100% NRB. He received ASA 325 X 1, Atropine 1 mg IV X 1, and levofloxacin 500 mg IV X 1, 2L NS. Dopamine was initiated for hypotension and titrated up to 7.5. EKG showed irregular HR and 0.[**Street Address(2) 1755**] depressions in V4-V6. A Head CT was obtained, which showed showed subacute external capsule infarcts. In the MICU Neurology was consulted who recommended an MRI which showed nothing acute. Cardiology was consulted for bradycardia and hypotension, however A line was placed and BPs were ~20 pts higher than cuff, and thus unlikely pt was hypotensive. Pt was easliy weaned off dopamine. He was then transferred to the regular medicine floor. Past Medical History: 1) HTN 2) Paget's disease 3) Severe MR [**Last Name (Titles) **] 67% 4) PUD 5) HAV 6) ERCP s/p sphincterotomy in [**2099**] for CBD stone -- c/b choledochalduodenal fistula [**2103**] 7) s/p appy 8) Depression 9) H/o EtOH abuse 10) newly diagnosed dementia 11) Chronic LFT abnormalities. Social History: Pt lives at the [**Hospital3 4414**] Rehab Center for one month (previously he lived alone). He has two sons and twelve grandchildren. Retired worker at paper company. Quit smoking at 35. History of EtOH [**3-5**] whiskeys x 4-5 days per week. No history of black outs. No IVDU. Family History: Non-contributory Physical Exam: Upon transfer to the regular medicine floor VS: T: 97.2 m; BP: 120/80 (112-124/60-80); P: 60-64; RR: 20; O2: 96 on 3L I/O 700 cc out 8 hours Gen: Elderly male, nonsensicle in NAD HEENT: [**Name (NI) **] pt does not follow direction to open Neck: right central line in place. No JVD CV: III/VI holosystolic murmur at apex and at LLSB. RRR S1S2. Lungs: right basilar rales. Pt could not take in deep breaths on direction Abd: +BS. soft, nt, nd. Ext: DP 1+. No edema. Pertinent Results: Labs on admission: [**2108-12-12**] 01:50PM URINE COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.018 [**2108-12-12**] 01:50PM URINE BLOOD-NEG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-1 PH-7.0 LEUK-NEG [**2108-12-12**] 01:42PM GLUCOSE-103 LACTATE-2.0 NA+-138 K+-4.2 CL--106 TCO2-28 [**2108-12-12**] 01:40PM UREA N-16 CREAT-0.9 [**2108-12-12**] 01:40PM CK(CPK)-29* AMYLASE-45 [**2108-12-12**] 01:40PM CK-MB-NotDone cTropnT-<0.01 [**2108-12-12**] 01:40PM CALCIUM-8.2* PHOSPHATE-3.7 MAGNESIUM-1.7 [**2108-12-12**] 01:40PM ASA-NEG ETHANOL-NEG ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**2108-12-12**] 01:40PM WBC-4.2 RBC-2.71* HGB-7.9* HCT-24.8* MCV-92 MCH-29.2 MCHC-31.9 RDW-14.4 [**2108-12-12**] 01:40PM PLT COUNT-207 [**2108-12-12**] 01:40PM PT-13.8* PTT-32.9 INR(PT)-1.2 [**2108-12-12**] 01:40PM FIBRINOGE-359 _____________________ Labs on discharge: [**2108-12-18**] 06:22AM BLOOD WBC-5.3 RBC-3.96* Hgb-11.5* Hct-35.7* MCV-90 MCH-29.1 MCHC-32.3 RDW-14.6 Plt Ct-246 [**2108-12-18**] 06:22AM BLOOD Glucose-95 UreaN-14 Creat-0.5 Na-142 K-4.4 Cl-109* HCO3-26 AnGap-11 [**2108-12-18**] 06:22AM BLOOD Calcium-8.5 Phos-2.8 Mg-1.9 ______________________ Other: [**2108-12-17**] 06:48AM BLOOD Triglyc-73 HDL-55 CHOL/HD-2.2 LDLcalc-50 [**2108-12-13**] 03:20AM BLOOD TSH-0.99 [**2108-12-13**] 03:20AM BLOOD Cortsol-32.8* [**2108-12-13**] 10:15AM BLOOD Cortsol-32.4* [**2108-12-13**] 10:47AM BLOOD Cortsol-34.6* _____________________ Cardiac enzymes: [**2108-12-12**] 01:40PM BLOOD CK-MB-NotDone cTropnT-<0.01 [**2108-12-13**] 03:20AM BLOOD cTropnT-0.03* [**2108-12-16**] 01:35AM BLOOD CK-MB-4 cTropnT-0.14* [**2108-12-16**] 01:00PM BLOOD CK-MB-NotDone cTropnT-0.16* [**2108-12-17**] 06:48AM BLOOD CK-MB-NotDone cTropnT-0.15* [**2108-12-16**] 06:30AM BLOOD CK(CPK)-62 [**2108-12-16**] 01:00PM BLOOD CK(CPK)-59 [**2108-12-17**] 06:48AM BLOOD CK(CPK)-29* _____________________ Radiology: CT Head without contrast [**2108-12-12**]-IMPRESSION: 1. No acute intracranial hemorrhage or mass effect. 2. Chronic external capsule infarcts. 3. Mottled appearance of the vertex of the skull, which may be of no clinical significance. A bone scan can be performed to evaluate for conditions such as Paget's disease. _____________________ MRA Brain without contrast [**2108-12-14**]-FINDINGS: The major tributaries of the circle of [**Location (un) 431**] are patent motion. Decreased signal in the proximal basilar may be due to turbulent flow or patient motion. No other areas of abnormality are identified. There is no significant stenosis or aneurysmal dilatation. Within the limits of coverage of this study, no sign of arterial-venous malformation is apparent. IMPRESSION: 1. No evidence of acute infarction. 2. Chronic microvascular infarcts in the periventricular white matter. 3. Areas of susceptibility in the occipital lobes and right parietal and temporal lobes may represent mineralization versus chronic small vessel hemorrhage. 4. Patent circle of [**Location (un) 431**]. Slight irregularity of proximal basilar artery may be secondary to turbulence or patient motion. _____________________ Chest AP [**2108-12-15**]-Since the prior study, there has been removal of the right subclavian line. There is no evidence of pneumothorax. There has been worsening in the degree of diffuse bilateral pulmonary infiltration associated with bilateral pleural effusion. Cardiomegaly is unchanged. IMPRESSION: 1) Interval removal of the right CVP line. 2) Worsening congestive heart failure. Brief Hospital Course: 1. [**Name (NI) **] Pt was maintained on pressors (dopamine) in the MICU for one day. Differential diagnosis on admission included adrenal insufficiency, hypothyroidism, sepsis (although no clear source), myocardial ischemia (minor ST abnormalities noted), and decreased volume status. Pt was likely volume deplete in the setting of decreased PO intake and anemia. Discussed by possible diagnosis: a. Arrythmia/Bradycardia/[**Name (NI) **] Pt received atropine x 2 without large response. Two sets of cardiac enzymes were normal and initial EKG showed lateral ST depressions. Echocardiogram revealed the presence of a preserved EF 70%, moderate AS, 2+ MR, [**12-2**]+ TR. Electrophysiology consulted on pt and there was no indication for a pacemaker. Pt was kept on telemetry without incident in the MICU. CHF was not evident on initial physical exam. Once an a-line was placed, BPs were 20 points higher than on cuff pressure. b. Hypothyroidism-TSH was normal c. Adrenal insufficiency- Cortisol stimulation test was 32-->34. Pt was initially started on dexamethasone in the MICU but this was d/cd when pt came to the floor without incidence. d. [**Name (NI) 15305**] Pt was afebrile throughout and cultures were negative. e. Volume depletion-Pt was hypovolemic in the setting of both decreased PO intake and a chronic anemia. Pt was aggressively fluid resuscitated in the MICU and also received 2 units of pRBCs for volume increase. BPs came up to systolic 110s-130s on the floor. 2. CHF/[**Name (NI) 12329**] Pt was volume resuscitated in the MICU and required lasix as evidence of volume overload. Based on oxygen requirement of 3 L NC(previously not on oxygen) and wheezing, as well as CXR, pt was overloaded. He was slowly diuresed with lasix ~10 mg IV per day. Additionally, ACE inhibitor was added back slowly as pt had been hypotensive on admission. Upon discharge, pt is satting in the mid-90s on room air and is euvolemic. Goal should be to keep pt even at this point. Pt had one acute episode of SOB where he required diureses, and with EKG showing further lateral depressions and increased troponins to .16. CKs were flat and this was in the setting of CHF exacerbation and demand ischemia. EKG returned more to baseline. 3. Anemia- Reported baseline of pt's HCT is 27-29 and was 24.8 on admission. He was guaiac (-) here with no obvious source of bleeding. Pt with history of "slow GI bleed" with negative colonoscopies in the past (per report). He was transfused 2 units pRBC on admission for volume resuscitation and Hct bumped >5 points. Iron studies show iron deficiency anemia with low iron and low ferritin and pt was continued on iron. 4. Endocrine- Cortisol was 32 and post-stimulation was 34. He was started on dexamethasone in the MICU. Upon transfer to the floor, steroids were d/cd. 5. Delirium- Upon transfer to the floor, per family, pt was not at his baseline. He was speaking non-sensibly. Normally pt is conversant and can recognize family which he was not able to do. In the MICU, pt received valium for agitation. On the floor, benzodiazepines were stopped, pt's foley was d/cd, and we tried to orient pt to day/night. He was also started on Seroquel [**Hospital1 **]. On discharge, pt is again oriented to place, time (year and season) and was conversant, making sense. While pt was delirious, he required a 1:1 sitter as he pulled at lines. 6. Subacute infarcts- Head CT showed subacute capsular infarcts. Pt was seen by neuro and had MRI which showed old infarcts and thus nothing further was done. 7. History of EtOH abuse- There were no symptoms of withdrawal. Pt was kept on thiamine and folate here. 8. F/E/[**Name (NI) **] Pt was seen by speech and swallow who recommended thin liquids pureed solids. He was also seen by nutrition who added boost supplements. 9. Prophylaxis- On Lovenox at [**Hospital1 1501**] and subcutaneous heparin here. Continued PPI. Pt received Pneumovax vaccine prior to discharge. 10. [**Name (NI) 59529**] Pt with dementia, continued Aricept. Also with depression continued lexapro here. We also added Seroquel low-dose [**Hospital1 **]. 11. [**Name (NI) 12010**] Pt with Right subclavian line put in MICU which was d/cd on floor. Otherwise had peripheral IVs. 12. Code Status: Pt was DNR/DNI. This was discussed with son [**Name (NI) **] [**Name (NI) **], HCP. Medications on Admission: Lisinopril 10 mg qday ASA 81 mg qday Folate 1 mg qday Thiamine 100 mg qday Lexapro 10 mg qday Lovenox 30 mg qday Aricept 5 mg qday Protonix 20 mg qday Iron 325 mg qday Levoquin ([**Date range (1) 59530**]) Discharge Medications: 1. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Donepezil Hydrochloride 5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 3. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 4. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 5. Lisinopril 2.5 mg Tablet Sig: One (1) Tablet PO once a day. 6. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed. 7. Iron 325 (65) mg Tablet Sig: One (1) Tablet PO once a day. 8. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO once a day. 9. Thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO once a day. 10. Lexapro 10 mg Tablet Sig: One (1) Tablet PO once a day. 11. Quetiapine Fumarate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). 12. Heparin Sodium (Porcine) 5,000 unit/mL Solution Sig: One (1) injection Injection TID (3 times a day). 13. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 14. Furosemide 20 mg Tablet Sig: 0.5 (half) Tablet PO once a day: 10 mg qday. Discharge Disposition: Extended Care Facility: [**Hospital 59531**] REHAB Discharge Diagnosis: Primary Diagnosis: Hypotension Congestive Heart Failure Delirium Secondary Diagnosis: Anemia Depression Dementia Discharge Condition: [**Name (NI) 23148**] Pt is normotensive and is oriented again. He has been stabilized on his medications. Discharge Instructions: -Please call your doctor or go to the emergency room immediately if you have problems breathing, shortness of breath, chest pain, Seizure, feel dizzy or lightheaded, or any other health concern. -You should weigh yourself daily. Call your doctor if your weight increases or decreases by 3 pounds. Followup Instructions: -You should call your doctor (PCP) and set up an appointment within 2 days of discharge. -Pt needs to have his hearing aid reconfigured and hearing retested. -Per the nursing facility ICD9 Codes: 2765, 4019, 2449
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8394 }
Medical Text: Admission Date: [**2120-5-14**] Discharge Date: [**2120-5-24**] Service: MEDICINE Allergies: Tetanus Toxoid / Bee Pollens Attending:[**First Name3 (LF) 5123**] Chief Complaint: Hypoxia Major Surgical or Invasive Procedure: None History of Present Illness: 85M with complete heart block s/p pacer, HTN, diastolic CHF, IDDM, gout, COPD, PVD s/p LLE stents several weeks ago transferred from [**Hospital3 **] ED from NH for hypoxia. . Today at his nursing home, he was found around 1:30pm to be more lethargic, short of breath with BP 70/50 and difficult to assess radial pulses. O2sat 86% on RA. Pt was BIBA to [**Hospital3 **] ED, VS at EMS evaluation was P 50, BP 70/P, RR 20, unable to get a pulse ox, FSBS 114. In the [**Name (NI) 46**] [**Name (NI) **], pt was alert but noted to be cyanotic and pallid with mottled skin. Pt c/o diffuse abdominal pain. VS were not recorded. Labs notable for WBC 21.1 (88.3N, no bands), CPK 48 but trop I 0.6 (ref 0-0.04) - ?0.47 when confirmed; pt remained CP free and EKG showed a paced rhythm at 80 bpm. CXR was read as unremarkable with pacing leads in place. Noncontrast CT chest showed "small patchy interstitial infiltrates with focal bronchiectasis and nodularity in the posterior left lung base" and emphysematous changes. Noncontrast CT abdomen was unremarkable other than for mild diverticulosis. Pt was given vanco/zosyn and 3L IV fluid without improvement in his Started on peripheral levophed for SBP 70/palpable and given hydrocortisone 100mg IV. He was transferred to our ED for further management. . In the ED, initial VS were: T97.8 P80 SBP135 R18 100% on NRB. Transferred on 13 mcg of peripheral levophed but pt was given another 1L NS, and pressures remained stable after levophed weaned off. CXR with increased infiltrate in LLL. WBC 17, Hct 25, guaiac negative. Lactate 2.1. EKG paced at 80. Pt given combivent neb. Only complaint was foot pain. Has 2 PIV in. On transfer, HR80, 100/61, 20, 96% on NRB CXR. . On arrival to the ICU, pt without any complaints other than L toe pain. Earlier abdominal pain had resolved at some point in the [**First Name4 (NamePattern1) 46**] [**Last Name (NamePattern1) **]; not c/w GERD. He does recall feeling more dyspneic on exertion for several days. No CP, shoulder/jaw pain, palpitations, N/V, LH. Per son, pt was recently admitted to [**Hospital3 3583**] on [**5-3**] for dyspnea and L toe pain. Per his son, there was concern for DVT and PE, but LENIs and d-dimer were negative. He was treated with nitro, lasix, ASA, plavix, lovenox, and bronchodilators initially and sx improved while in the ED. Cardiology c/s attributde mildly elevated troponins attributed to demand. Per his son, he underwent a nuclear stress test that was unremarkable and was discharged. He was started on prednisone for presumed gout with no improvement in his sx since. . 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: (1) Syncope/presyncope (2) complete AV block, status post [**Company 1543**] pacemaker [**2112-11-11**] (3) Hypertension (4) Diastolic CHF and possible restrictive cardiomyopathy (5) AEA/VEA/CAD (6) IDDM with albuminuria (7) Gout on prednisone (8) COPD Social History: - Tobacco: Quit 45 years ago - Alcohol: Denies - Illicits: Denies Family History: Non-contributary Physical Exam: Vitals: T 95.6, P 80, BP 123/78, RR 17, O2sat 97 on 4L General: Alert, oriented, no acute distress HEENT: Sclera anicteric, MMM, oropharynx clear Neck: Supple, JVP not elevated, no LAD Lungs: Clear to auscultation bilaterally with only minimal wheezes at bases, 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: Extremities slightly mottled b/l, 2+ pulses, L toe tender on plantar surface but not erythematous, warm, or swollen. Neuro: AAOx3, nonfocal exam. Pertinent Results: [**2120-5-14**] 11:24PM GLUCOSE-136* UREA N-57* CREAT-1.9* SODIUM-138 POTASSIUM-5.7* CHLORIDE-108 TOTAL CO2-19* ANION GAP-17 [**2120-5-14**] 11:24PM ALT(SGPT)-3211* AST(SGOT)-3169* LD(LDH)-6280* CK(CPK)-98 ALK PHOS-72 TOT BILI-0.7 [**2120-5-14**] 11:24PM CK-MB-NotDone cTropnT-0.15* [**2120-5-14**] 11:24PM CALCIUM-8.1* PHOSPHATE-4.4 MAGNESIUM-2.1 IRON-172* [**2120-5-14**] 11:24PM calTIBC-221 VIT B12-GREATER TH FOLATE-GREATER TH HAPTOGLOB-209* FERRITIN-GREATER TH TRF-170* [**2120-5-14**] 11:24PM WBC-21.9* RBC-3.55*# HGB-10.6*# HCT-34.3*# MCV-97 MCH-30.0 MCHC-31.0 RDW-14.0 [**2120-5-14**] 11:24PM NEUTS-93.8* LYMPHS-3.0* MONOS-2.6 EOS-0.3 BASOS-0.2 [**2120-5-14**] 11:24PM PLT COUNT-304 [**2120-5-14**] 11:24PM PT-14.8* PTT-28.7 INR(PT)-1.3* [**2120-5-14**] 11:24PM FIBRINOGE-339 [**2120-5-14**] 11:24PM RET AUT-1.1* [**2120-5-14**] 07:00PM URINE COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.017 [**2120-5-14**] 07:00PM URINE BLOOD-NEG NITRITE-NEG PROTEIN-30 GLUCOSE-100 KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-NEG [**2120-5-14**] 07:00PM URINE RBC-0-2 WBC-0-2 BACTERIA-FEW YEAST-NONE EPI-0-2 [**2120-5-14**] 07:00PM URINE AMORPH-FEW [**2120-5-14**] 06:18PM COMMENTS-GREEN TOP [**2120-5-14**] 06:18PM LACTATE-2.1* [**2120-5-14**] 06:05PM GLUCOSE-92 UREA N-38* CREAT-1.1 SODIUM-144 POTASSIUM-3.4 CHLORIDE-123* TOTAL CO2-12* ANION GAP-12 [**2120-5-14**] 06:05PM estGFR-Using this [**2120-5-14**] 06:05PM CK(CPK)-48 [**2120-5-14**] 06:05PM CK-MB-NotDone cTropnT-0.10* [**2120-5-14**] 06:05PM CALCIUM-4.3* PHOSPHATE-3.1 MAGNESIUM-1.2* [**2120-5-14**] 06:05PM WBC-17.3*# RBC-2.57*# HGB-7.6*# HCT-25.5*# MCV-99* MCH-29.4 MCHC-29.7* RDW-13.9 [**2120-5-14**] 06:05PM NEUTS-95.4* LYMPHS-2.7* MONOS-1.6* EOS-0.2 BASOS-0.1 [**2120-5-14**] 06:05PM PLT COUNT-238 CXR (Portable) [**2120-5-14**]: HISTORY: This is an 85-year-old male with elevated white blood cell count, hypotension and wheeze. Evaluate for acute process. COMPARISON: Chest radiograph [**2114-7-3**]. SINGLE PORTABLE UPRIGHT VIEW OF THE CHEST: There is no change in the cardiomediastinal contour, with mild cardiomegaly, but no evidence for CHF. A left chest pacing device is in unchanged position in comparison to [**2114**]. There is left lung base atelectasis, but developing infection cannot be completely excluded. The bony thorax appears unremarkable. IMPRESSION: Left lung base atelectasis, but developing pneumonia cannot be excluded. PA and lateral may be helpful for further evaluation if clinically feasible. Brief Hospital Course: # Shock: Patient with hypotension requiring pressors at OSH ED with a lactate 2.1. At [**Hospital1 18**] patient was responsive to IVF and weaned off levophed. Most likely septic given mild hypothermia, WBC 17.3 and neutrophilia, hypoxia, and CT chest finding c/w pneumonia. While it is possible that the leukocytosis may be secondary to prednisone, the prednisone may also be masking a fever. Treated empirically with vanc, zosyn with rapid improvment. There may have also been a component of hypovolemia in setting of decreased oral intake at [**Hospital1 1501**] given response to IVF. Pt has only been on short taper of prednisone so less likely adrenal insufficiency although did receive hydrocortisone at OSH. Pt with elevated troponin but less likely cardiogenic shock - may more likely represent end organ damage from hypoperfusion; no evidence of CHF and BP unlikely to reverse so quickly. He was never again hypotensive on the floor and his white count resolved with IV Abx. We were never 100% convinced that this was from pneumonia and a foot CT was checked prior to discharge to r/o osteomyelitis which showed no evidence of osteomyelitis. All cultures were negative. . Plan going forward: -Complete 14day course of broad spectrum abx (last day [**5-28**]) -Patient must have CXR in 1 month to f/u for complete resolution of his PNA/r/o underlying malignancy. . # Hypoxia: Patient quickly weaned from NRB to NC to room air. This was likely related to pneumonia, though volume overload from resuscitation can not be excluded, or any contribution from his underlying lung disease. . # CAD: Nl CK but elevated trop likely represents demand in setting of ARF and hypoperfusion rather than an occlusive lesion. The patient peaked and ruled out on labs in house. EKG was paced and c/w prior. Per son, recent stress test unremarkable. . # DM: Patient had issues with o/n low blood sugars, [**Last Name (un) **] was consulted, we dialed back his PM humalog and lantus and his blood sugar control optimized. . # Anemia: Hct here 25.5, was 32.3 at OSH. Pt is on ASA and plavix but guaiac negative, no evidence of active bleeding. Concern for DIC in setting of sepsis although pt currently appears well. [**Month (only) 116**] have been hemoconcentrated at OSH and now diluted in setting of 4L IVF. Patient drifted back up to 33 without intervention . # Toe pain: Recently s/p LLE stenting; embolic event possible, but this was thought to be most likely Gout in house. Prior noted mottling more likely d/t shock than embolus however as b/l and appears to be improving w/ fluid resuscitation. No acute inflammation concerning for gout although has been on prednisone. Pain unchanged per pt. He underwent CT foot to r/o osteomyelitis or osteonecrosis as a source, this instead showed evidence of pseudogout and osteoarthritis. . Plan going forward: Patient has follow-up scheduled with rheumatology . #DVT/?PE: Patient found to have RUE DVT on exam, later found to have LLL consolidation with resolution of RUE swelling. Most likley PE. Patient to continue lovenox. . Plan going forward: Patient to continue [**Hospital1 **] lovenox for [**4-13**] mo, pending PCP f/u . Urinary Retention: Patient developed new urinary retention while in house. This was felt to be secondary to oxycodone which was stopped. A foley was placed on the day prior to d/c and the patient was started on flomax. . Plan going forward: Foley to be d/c'd in 3 days, patient must void spontaneously 8-10 hours following the removal. If he does not void the floor physician must be consulted. Medications on Admission: Medications: Per NH notes Prednisone 40mg x 2 days, 30mg x 3 days (completed), then prednisone 20mg x 3 days, 10mg x 3days Vicodin 5/500 [**2-10**] tab q6h prn pain Lantus 50 units SQ qhs (previously on 28 units) Diovan 20mg daily Verapamil 120mg daily Pulmicort 200 mcg 2 puffs inh [**Hospital1 **] (4 puffs [**Hospital1 **] per pt) [**Name (NI) 44405**] 50 mcg 2 puffs [**Hospital1 **] Spiriva 18 mcg q puff inhaler daily ASA 81mg daily Plavix 75mg daily Metoprolol 50mg [**Hospital1 **] Erythromycin 500mg q8h x 7 days (unclear why) Discharge Medications: 1. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for Constipation. 2. Combivent 18-103 mcg/Actuation Aerosol Sig: Two (2) Puffs Inhalation every 4-6 hours as needed for shortness of breath or wheezing. 3. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Aspirin 325 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. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 7. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). 8. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO Q6H (every 6 hours) as needed for constipation. 9. Ciprofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours) for 4 days: last dose 4/20. 10. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 11. Piperacillin-Tazobactam-Dextrs 4.5 gram/100 mL Piggyback Sig: 4.5 Grams Intravenous Q8H (every 8 hours) for 4 days: last dose 4/20. 12. Vancomycin 500 mg Recon Soln Sig: 1000 (1000) mg Intravenous Q 24H (Every 24 Hours) for 4 days: should finish [**5-28**]. . 13. Insulin Glargine 100 unit/mL Cartridge Sig: Twenty Four (24) units Subcutaneous at bedtime. 14. Pulmicort Flexhaler 180 mcg/Inhalation Aerosol Powdr Breath Activated Sig: Two (2) puffs Inhalation twice a day. 15. Salmeterol 50 mcg/Dose Disk with Device Sig: Two (2) puffs Inhalation twice a day. 16. Spiriva with HandiHaler 18 mcg Capsule, w/Inhalation Device Sig: One (1) puff Inhalation once a day. 17. Insulin Aspart 100 unit/mL Cartridge Sig: One (1) as directed Subcutaneous qACHS: as per attached sliding scale. 18. Valsartan 40 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 19. Simvastatin 10 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 20. Tamsulosin 0.4 mg Capsule, Sust. Release 24 hr Sig: One (1) Capsule, Sust. Release 24 hr PO at bedtime. 21. Enoxaparin 100 mg/mL Syringe Sig: Ninety (90) units Subcutaneous Q12H (every 12 hours). 22. Acetaminophen 500 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for pain. 23. Chest XRAY Patient must have f/u CXR 1 mo. following discharge from hospital. Discharge Disposition: Extended Care Facility: [**Location (un) 582**] at Silver [**Doctor Last Name **] Commons Discharge Diagnosis: Septic Shock Pneumonia Gout Flare Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: You were admitted to [**Hospital1 **] after you were found to be severly ill at your rehabilitation center. You were briefly in the ICU where you were found to be hypotensive and have a condition known as septic shock. This was thought to be caused by pneumonia. You improved quickly with IV antibiotics. You also developed a blood clot in the hospital for which you are being treated with a blood thinner called lovenox. You were monitored on the floor and aside from toe pain you had not other major issues. . The following changes were made to your medication regimen: Your antibiotics will be completed on [**2120-5-28**] You completed your prednisone course We believe that oxycodone was causing you to retain urine, we stopped the oxycodone and started you on tylenol. Your Bedtime lantus was reduced to 24mg. Your metoprolol was reduced to 12.5mg twice per day You were started on lovenox 90mg twice per day Followup Instructions: Department: RHEUMATOLOGY When: WEDNESDAY [**2120-5-29**] at 1 PM With: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], MD [**Telephone/Fax (1) 2226**] Building: LM [**Hospital Unit Name **] [**Location (un) 861**] Campus: WEST Best Parking: [**Doctor First Name **]. GARAGE . Department: [**Last Name (un) **] Diabetes Center When: [**2120-6-3**] 10:00am With: NP [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 7280**] Location: [**Last Name (un) 3911**], [**Location (un) 86**] MA Phone: [**Telephone/Fax (1) 2384**] Completed by:[**2120-5-24**] ICD9 Codes: 0389, 486, 5849, 4019, 4280, 496, 4439, 2859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 8395 }
Medical Text: Admission Date: [**2146-5-30**] Discharge Date: [**2146-6-4**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 7591**] Chief Complaint: shortness of breath Major Surgical or Invasive Procedure: EGD [**5-31**] History of Present Illness: [**Known firstname **] [**Known lastname 29298**] is an 85 yo with MDS and maltoma, and recent GI Bleed who presented to [**Hospital1 **] [**Location (un) 620**] with shortness of breath and found to have melanotic stools with drop in hematocrit. Of note he had a recent admission from [**Date range (1) 10375**] for BRBPR requiring 7 units of PRBCs. During that admission, he underwent EGD which showed an ulcerated, malignant-appearing mass in the antrum of the stomach, with stigmata of recent bleeding. Biosies were taken but the vessel was unable to be clipped due to difficult location and access. Biopsies since returned showing B cell, non-Hodgkin lymphoma, marginal zone type which is consistent with his previous MALT lymphoma. During the last admission, he underwent XRT to stomach for Maltoma; he was supposed to get 8th/10 dose of XRT today but tx held for evaluation. Patient reports that he had some vague abdominal pain yesterday and felt gassy. This morning he felt extremely fatigued and short of breath. He had a loose bowel movement this morning. He reports brown stool, but his wife thought it looked bloody. . In the ED, initial vs were: 92 111/49 22 100%. Patient was given 1 bag of platelets and one unit of blood and 500cc of NS. He was given lasix for shorntess of breath. He received benadryl and tylenol prior to platelet transfusion. In the ED, patient has been hemodynamically stable with SBP 90-100s. GI was consulted, and they plan to see patient in the ICU. VS prior to transfer were 98 113/56 20 99% ra. . In the ICU, the patient feels weel. His fatigue and shortness of breath resolved with the unit of PRBCs. He denies abdominal pain, nausea or vomiting. NG lavage performed and was negative. Past Medical History: Oncologic History: 1. MDS on dacogen - presented in [**2143-9-28**] with pancytopenia, complained of dyspnea on exertion - cytopenias progressed and he had a repeat bone marrow done in [**1-4**] which showed a markedly hypercellular bone marrow with significant dysplasia in the erythroid and megakaryocytic lineages. There were >15% ringed sideroblasts. Flow cytometry demonstrated CD-34-positive cells comprised 4-5% of total blast gated events. Cytogenetics revealed [**11-16**] cells have abnormal chromosome 12 and an abnormal chromosome 17 in a possible three way translocation. - refractory to Procrit, at escalating doses and then became red blood cell transfusion dependent - Decitabine therapy was initiated [**2145-9-13**] but had to be discontinued due to a hematoma which developed at the site of a wound. He resumed C1D1 Dacogen for MDS on [**2146-2-21**]. So far he has tolerated therapy well but remains severely pancytopenic and requires frequent blood product support. . 2. MALT lymphoma of the stomach: no evidence of disease since [**2142**] - initially presented in [**2139**] with abdominal upset/indigestion. CT scan demonstrated perigastric adenopathy and EGD had a multilobulated mass with ulceration. Biopsy demonstrated extranodal marginal zone lymphoma of mucosa associated lymphoid tissue (MALT). - Bone marrow biopsy demonstrated mildly hypercellular marrow for age with megakaryocytic dysplasia and occasional ringed sideroblasts (10%) without evidence of lymphoma. Evolving myelodysplastic syndrome could not be excluded. - treated for Stage IIB MALT lymphoma of the stomach with 6 cycles of CVP, completed in [**11-30**] - recurred in [**2142**] and was treated with four weeks of Rituxan therapy ([**Date range (1) 51244**]) - no evidence of disease since this time. . Other Past Medical History: Open AAA repair-[**2130**] Cataract surgery HTN Social History: The patient is married with two children, three grandchildren and four great grandchildren. He smoked a pack a day for 40 years and quit in [**2123**]. He previously drank heavily, currently only 2 drinks/day. He is a retired electrician. Family History: Mother-died in her 70s of acute leukemia Father-died of AAA Sister-Hemochromatosis [**Name (NI) 51245**] Physical Exam: General: well-nourished, well-appearing, no acute distress HEENT: Sclera anicteric, MMM, oropharynx clear, no white plaques, Neck: supple, JVP flat, no LAD Lungs: Clear to auscultation bilaterally, no wheezes, rales, rhonchi CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops Abdomen: obese, soft, tender to deep palpation in epigastric area, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly GU: no foley Ext: warm, well perfused, 2+ radial, DP & PT pulses, no clubbing, cyanosis or edema. Neuro: A&Ox3, CN grossly intact, strength 5/5 in UE and LE bilat, sensation grossly intact. Pertinent Results: [**2146-5-30**] 07:29PM HCT-19.1* [**2146-5-30**] 07:29PM PLT COUNT-32*# [**2146-5-30**] 11:40AM WBC-0.2*# RBC-2.19*# HGB-6.6*# HCT-19.2*# MCV-88 MCH-30.0 MCHC-34.2 RDW-15.4 [**2146-5-30**] 11:40AM NEUTS-84* BANDS-0 LYMPHS-8* MONOS-8 EOS-0 BASOS-0 ATYPS-0 METAS-0 MYELOS-0 NUC RBCS-2* [**2146-5-30**] 11:40AM PLT SMR-RARE PLT COUNT-10*# . [**5-31**] EGD: Schatzki's ring Erosions in the gastroesophageal junction compatible with esophagitis Mass in the lesser curvature (endoclip) Erythema and petechiae in the duodenal bulb compatible with duodenitis There is no fresh red blood or coffee-ground liquid in his stomach and duodenum. Erythema in the antrum compatible with gastritis Otherwise normal EGD to third part of the duodenum CXR [**2146-6-2**]: In comparison with the study of [**5-31**], the left hemidiaphragm is more sharply seen, consistent with some improvement in the atelectatic change in the region. No evidence of acute focal pneumonia. Tortuosity of the aorta is again seen. Port-A-Cath remains in place. Brief Hospital Course: 85 yo with MDS and maltoma, and recent GI Bleed who presented to [**Hospital1 **] [**Location (un) 620**] with shortness of breath, found to have GI bleed. . #. Acute blood loss anemia: Likely secondary to an upper GI bleed given his history of ulcerated maltoma in his GI tract, melena on exam, and a visible vessel which was clipped on EGD. The patient remained hemodynamically stable with BPs in the 90s-100s systolic which he says is at his baseline. He was transfused a total of 7 units of pRBCs with a goal Hct of 30 and 3 units of platelets with a goal of maintaing platelets above 30. He is on a PPI [**Hospital1 **] and his diet was advanced slowly. He continued to have episodes of diarrhea, but no further BRBPR. C. diff was negative x2. His Hct remained stable throughout the rest of the hospital course. He will be discharged on PPI [**Hospital1 **]. . #. Dyspnea: Likely related to anemia. Improved with pRBC transfusion. CXR at OSH was normal. . # Acute Kidney Injury: Creatinine was up to 1.2 from baseline of 0.8 on admission. Likely pre-renal, given blood loss and improvement with transfusions. Improved back to baseline Cr 0.8 prior to discharge. . # Maltoma: The patient completed XRT 2500 cGy to stomach on [**2146-6-2**]. . # Pancytopenia: Anemia most likely secondary to bleeding. Patient is neutropenic, anemic, and thrombocytopenic. Neupogen injections were administered while inpatient in an attempt to improve neutropenia. The patient will follow-up with Dr. [**Last Name (STitle) 410**] for further management upon discharge. . #. Myelodysplastic Syndrome on decitabine: He received C3 of decitabine from [**4-25**] - [**4-29**]. Continued on treatment guided per his primary oncologist. . # Fevers: The patient with a febrile episode. CXR revealed improving atelectasis, but no evidence of PNA. Cultures failed to yield any organisms. The patient was started empirically on Levaquin 750mg daily. Fevers have resolved prior to discharge. Medications on Admission: 1. Furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day. 2. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day. 3. Gabapentin 400 mg Capsule Sig: Two (2) Capsule PO three times a day. 4. Compazine 10 mg Tablet Sig: One (1) Tablet PO q 6H PRN as needed for nausea. 5. Magnesium 250 mg Tablet Sig: One (1) Tablet PO at bedtime. 6. Vitamin E Oral 7. Multivitamin Tablet Sig: One (1) Tablet PO once a day. Discharge Medications: 1. Multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Gabapentin 400 mg Capsule Sig: Two (2) Capsule PO Q8H (every 8 hours). 3. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 4. Levofloxacin 750 mg Tablet Sig: One (1) Tablet PO DAILY (Daily) for 14 days: Please take until instructed to stop by Dr. [**Last Name (STitle) 410**]. Disp:*14 Tablet(s)* Refills:*0* Discharge Disposition: Home Discharge Diagnosis: Primary: Myelodysplastic syndrome, mucosa-associated lymphoid tissue lymphoma, acute upper gastrointestinal bleed Secondary: 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 because you noticed blood in your stool. We found your red blood cell count to be very low and gave you red blood cells and platelets. We performed an endoscopy (also called esophagogastroduodenoscopy). It showed that you had a recent bleed from an ulcer in your stomach caused by your lymphoma in the stomach. A blood vessel in your stomach was clipped to prevent further bleeding. Afterward, you had an episode of fever and we started you on a course of antibiotics. You had no further bleeding and your red blood cell counts remain stable. You are now ready to go home. We made the following changes to your medications: We STARTED you on Pantoprazole 40mg twice a day We STARTED you on Levaquin 750mg daily. Please continue to take it until told by Dr. [**Last Name (STitle) 410**] to stop. Please continue to take all your other medications as prescribed. Please follow up with Dr. [**Last Name (STitle) 410**] as shown below. Please call [**Telephone/Fax (1) 8717**] and ask for [**Telephone/Fax (1) 3242**] fellow on call or come to the hospital right away if your develop any of the following symptoms: chest pain, shortness of breath, fevers, dizziness, lightheadedness, bleeding from below, dark or tarry stools, vomiting, nausea, worsening diarrhea, or any other concerning symptoms. Followup Instructions: You need to follow up with your primary oncologist Dr. [**First Name4 (NamePattern1) 449**] [**Last Name (NamePattern1) 410**] as follows: [**Last Name (LF) 766**], [**2146-6-6**]. Please call the clinic first thing on [**Year (4 digits) 766**] to schedule a same day appointment. You can schedule by calling: [**Telephone/Fax (1) 3760**]. Thursday, [**2146-6-9**] at 09:30 am Completed by:[**2146-7-19**] ICD9 Codes: 5849, 2851, 4019
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Medical Text: Admission Date: [**2147-11-24**] Discharge Date: [**2148-1-20**] Date of Birth: [**2071-9-23**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 330**] Chief Complaint: Bilateral parotid gland swelling; dehydration. Major Surgical or Invasive Procedure: Endotracheal intubation Placement of plasmapheresis catheter Tracheostomy History of Present Illness: 76 yo male with below med hx presents with bilateral parotitis suspectedly due to dehydration who are consulting for help with management of fluid balance and question of when to restart [**First Name3 (LF) 17339**]. Pt reports increasing parotid pain and swelling for 4 days associated with worsening dry mouth. He denies fever, chills, cough or sick contacts but does produced very thick oral secretions that he has to spit out and are white in color. Pain on left face radiates up to his ear but no changes in hearing. He reports not being able to tolerate PO's since his radiation but has be taking 2 cans of G-tube feeds tid along with 2x 16oz boluses of water [**Hospital1 **] consistently. He denies current diziness but does report diziness with standing in the past around his time of chemotherapy which is why he was taken off his lasix and lopressor. His blood pressure had been in the low 100's systolic and so they have not been reinitiated. He is very sedentary and does report intermittent LE swelling worse on the left leg where his SVG CABG graft was harvested from. He denies any CP, CT, SOB, PND or orthopnea. He stopped his [**Hospital1 17339**] 2 months ago since he had to start Diflucan to treat XRT associated thrush and has not initiated it since. He lost >20 lb's over the past 3 months and felt that his cholesterol can't be bad at this point. Past Medical History: 1. Laryngeal SCC T4 dx [**5-15**] s/p chemo unknown type(still has port in place followed by Dr. [**Last Name (STitle) 17315**] at [**Hospital1 4601**] ) and XRT for 7 weeks 5 days/week ending [**2147-8-17**] Esophageal stricture s/p dilation for stricture [**2147-11-16**] s/p G tube placement CHF preserved EF(records at [**Hospital1 756**]) CAD s/p 3v CABG [**10-14**] HTN-off meds for unclear reason hypercholesterolemia BCC on nose and back Social History: Quit smoking 20 yrs ago after 1ppd x 30yrs Pt admits to 3 shots of vodka a day Family History: Mother died at the age 65 from an MI/CAD Physical Exam: PE-T 98.7 HR 84 BP 100/50 RR 18 O2sats 96% [**Female First Name (un) **] Gen-NAD HEENT-PERRL, mild left mouth droop, severe parotid swelling bilat, no ant or post cerv LAD, erythema and warmth over parotids bilat, neck supple, JVD to 7cm Hrt-RRR nS1S2 [**2-13**] SM at RUSB Lungs-poor air movement, no crackles or wheeze Abd-soft, NT, mod distended, PEG in place with min surrounding erythema and no drainage Extrem-2+ pitting edema to mid shin on left and to ankle on rt Neuro-CNII-XII intact except mouth droop as above, [**4-13**] UE and LE strenth, distal sensation intact Skin-multiple telangiectasias around neck and erythema Pertinent Results: Admission Labs: 134 97 19 ------------<135 4.6 29 0.8 estGFR: >75 (click for details) Ca: 8.7 Mg: 2.2 P: 3.0 D Alb: 3.7 Cholesterol:145 . Iron: 20 calTIBC: 222 Ferritn: 483 TRF: 171 Triglyc: 57 HDL: 52 CHOL/HD: 2.8 LDLcalc: 82 . 10.5 2.7>---<120 29.0 N:87.0 L:8.2 M:3.3 E:1.4 Bas:0.1 Macrocy: 3+ . . OTHER: . . [**2147-12-3**] GBM AB: <3 U/ML [**2147-12-3**] C-ANCA positive Summary of results of proteinase 3 [**Doctor First Name **]: Date Direct [**Doctor First Name **] [**Location (un) **] [**Doctor First Name **] (anti-proteinase 3 titer in units) ---- ------------ -------------- [**2147-12-3**] 301 >65,536 [**2147-12-14**] 147 3,225 [**2147-12-15**] 83 2.304 . [**2147-12-16**] HEPARIN DEPENDENT ANTIBODIES: NEGATIVE . MICROBIOLOGY: [**2147-11-28**] BRONCHOALVEOLAR LAVAGE: GRAM STAIN (Final [**2147-11-28**]): 1+ (<1 per 1000X FIELD): POLYMORPHONUCLEAR LEUKOCYTES. NO MICROORGANISMS SEEN. RESPIRATORY CULTURE (Final [**2147-11-30**]): NO GROWTH, <1000 CFU/ml. LEGIONELLA CULTURE (Preliminary): NO LEGIONELLA ISOLATED. IMMUNOFLUORESCENT TEST FOR PNEUMOCYSTIS CARINII (Final [**2147-11-29**]): PNEUMOCYSTIS CARINII NOT SEEN. FUNGAL CULTURE (Preliminary): NO FUNGUS ISOLATED. ACID FAST SMEAR (Final [**2147-11-29**]): NO ACID FAST BACILLI SEEN ON CONCENTRATED SMEAR. ACID FAST CULTURE (Pending) [**2147-11-28**] Rapid Respiratory Viral Screen & Culture: No Virus isolated so far. STOOL [**2147-11-25**]: negative for c.diff. [**2147-11-28**]: negative for c.diff, shigella, campylobacter [**2147-11-29**]: negative for c.diff . . IMAGING AND PATHOLOGY: . . EKG: sinus rhythm, no change from prior Bronchoscopy report [**11-27**]: Hemoptysis with likely source the anterior segment of the left upper lobe blood cultures: [**2147-11-26**] NGTDx2, [**2147-11-27**] NGTDx2, [**2147-11-29**] NGTDx2 urine cx [**2147-11-25**] <10,000 organisms, [**2147-11-26**] NG, [**2147-11-30**] pending . [**11-26**] CXR: Patchy opacities throughout the left lung are concerning for pneumonia. Small bilateral pleural effusions. . [**11-27**] CXR: Compared with [**2147-11-27**], the moderately extensive left lung infiltrate shows marked interval consolidation, consistent with progressive pneumonia and/or intra-alveolar blood or infarction. Right lung remains grossly clear. No CHF. . [**11-27**] Echo The left atrium is mildly dilated. Left ventricular wall thickness, cavity size, and systolic function are normal (LVEF>55%). Regional left ventricular wall motion is normal. Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. The mitral valve appears structurally normal with trivial mitral regurgitation. There is no mitral valve prolapse. There is moderate pulmonary artery systolic hypertension. There is no pericardial effusion. IMPRESSION: Normal global and regional biventricular systolic function. Moderate pulmonary hypertension. . CTA CHEST W&W/O C &RECONS [**2147-12-3**] 3:51 PM 1. Interval marked worsening of alveolar consolidations including the entire lungs The findings appear consistent with infection ehich might overlay aspiration, especially in the setting of gradual worsening. 2. No evidence of pulmonary emboli. 3. Small associated bilateral pleural effusions. 4. Mild-to-moderate emphysema, unchanged. 5. Heterogeneous spleen enhancement with rounded hypodense lesions might represent splenic infection. . [**12-2**] Bronchial lavage: NEGATIVE FOR MALIGNANT CELLS. Scant cellularity with bronchial epithelial cells, pulmonary macrophages and blood. . CT NECK W/CONTRAST (EG:PAROTIDS) [**2147-12-4**] 10:17 AM Limited study, without definite fluid collection. Fluid in nasopharynx and upper trachea, with fluid density posterior to left nasopharynx, probably a continuation of nasopharyngeal cavity. No definite abscess. Mild diffuse increase of the subcutaneous fat, especially at the level of the tongue base, which can be due to edema, however, inflammation in this area cannot be totally excluded given the clinical setting. Please correlate with physical examination. . [**2147-12-18**] CT ABDOMEN W/O CONTRAST; CT PELVIS W/O CONTRAST Limited study due to bony artifact from patient's arms in the scanner. Bilateral pleural effusions, intra-abdominal fluid, and anasarca are suggestive of fluid overload. No evidence of retroperitoneal bleed or fluid collections within the abdomen. . Tracheal Wall Bx: Fibrous connective tissue, cartilage and focal ossification. No malignancy identified. . Skin Bx [**2147-12-12**] Skin, left cheek, biopsy (A): Leukocytoclastic vasculitis with adjacent granulomas, some containing fragmented elastic fibers (see note). . . BILAT LOWER EXT VEINS PORT [**2147-12-28**] 4:57 PM No evidence of deep vein thrombosis in the bilateral lower extremities. . CHEST (PORTABLE AP) [**2147-12-28**] 11:31 AM 1. Interval improvement in right mid lung and left upper lung air space opacities, consistent with either resolving pneumonia or resolving pulmonary hemorrhage given history of Wegener's granulomatosis. 2. Increase in right perihilar opacity likely represents worsening mild asymmetric pulmonary edema. Brief Hospital Course: Mr. [**Known lastname 27273**] is a 76 yo gentleman with newly diagnosed laryngeal ca ([**5-15**]) c/b esophageal stricture s/p dilation, who presented with bilateral parotiditis, transferred to the medical ICU with hypoxia and diffuse alveolar hemorrhage. Found to have Wegeners by C-ANCA and skin biopsy. His hospital course is summarized below and by problem subsequently. . Patient was admitted to the ENT service and started on clinda and ceftriaxone. He was later transferred to the medicine service for fevers x 2 d ([**11-25**]). On medicine team, patient was complaining of worsening shortness of breath, and cough with hemoptysis. CXR revealed patchy opacities and CTA revealed multifocal PNA L>R. Patient was treated vanco (started [**11-27**])/levo (started [**11-26**])/clinda (started [**11-23**]). . Patient also had loose stools x 2 d (c diff neg x 2). In addition his Hct dropped from 28--> 24. Aspirin was held. Patient was then transferred to the ICU after bronch and IR procedure for concern of hemoptysis and hypoxia. He continued to have hemoptysis, dried dark blood, small amounts. He continued to be dyspneic but was improving with 40% humidified face mask. He has been noted to be tachycardic in the ICU (sinus) and was given 500cc IVF [**11-29**] with no improvement. He was also restarted on metoprolol at 12.5 tid [**2147-11-28**] which was increased to 25mg tid [**2147-11-29**]. Patient was transferred to the floor [**11-29**] as his respiratory status improved and this RUL bleeding seemed to be stable. . On the floor, patient remained on 40% fm until a.m. of [**11-30**] when he was found to be tachypneic to the 20's. His hematocrit was found to be 22 so he was given 1u prbc. During the transfusion he became increasingly tachypneic, tachychardic and had a fever of 101. He was given 40 IV lasix. ABG was done 7.5/32/67 on 60%. He was then changed to 100% FM and tranferred back to the MICU. . MICU COURSE BY PROBLEM: . # WEGENER'S: Diagnosed [**12-7**] by positive C-ANCA, Anti-GBM negative. Derm biopsy of neck rash demonstrated vasculitis. Patient was transferred to the MICU and reintubated due to increasing hemoptysis and bloody output from ETT. No focal bleeding sites were found on Bronchoscopy [**12-2**]. Patient was started on treatment with Cytoxan 150 mg [**Hospital1 **] for 10 days however this was held on [**2147-12-22**] in the setting of dropping WBC and pancytopenia. He was also treated with Dexamethasone. He also received plasmapheresis starting [**12-7**] for four sessions. He was treated with Vit K and FFP to maintain an INR <1.5. He remained difficult to wean from the ventilator despite no further bleeding. A tracheostopy was placed on [**2146-12-22**] by ENT. Rheumatology was consulted and recommended Prednisone 60 mg daily. Patient was placed on Neutropenic precautions when his WBC reached a nadir of 1.1, although the ANC remained >1000. He was started on Ceftriaxone for a fever on [**12-24**]. He was also treated with GCSF. Cytoxan was restarted once his WBC recovered on [**12-28**], GCSF discontinued. Mr. [**Known lastname 27273**] was eventually able to use the trach collar duing the day with minimal rusty sputum production. Patient spiked a low grade fever to 100.7 on [**12-29**] and was started on Ceftrixone. Repeat sputum cultures have been negative. Prednisone and Cytoxan were continued with close monitoring of his counts. Eventually Rituxan was also added at the request of the rheumatology service. Eventually, the family decided to make the patient CMO due to failing clinical status. At this time, his immunosuppressants (prednisone, cytoxan, and rituxan) were all discontinued. . # RESPIROTORY FAILURE: Patient was intubated in the MICU for diffuse alveolar hemorrhage subsequently diagnosed with Wegener's. The patient was difficult to wean from the vent and ultimately required trach placement by ENT on [**2147-12-22**]. Eventually, he required less support and was maintained on the trach collar during the day with pressure support overnight. He continued to have minimal rusty sputum production with cultures showing sparse oropharyngeal flora. He was very weak secondary to a prolonged hospitalization and possibly steroid myopathy. At one point during his hospitalization, he successfully used a Passy Muir valve; however, his speech was not fully recovered. ENT changed his trach to a 7.0 on [**2147-12-30**]. Laryngoscopy at that time showed laryngeal edema. In addition, Mr. [**Known lastname 27273**] had been fluid overloaded due to IVF he received throughout his admission. He was transiently on a lasix drip and subsequently diruesed with prn lasix IV boluses. Eventually, he began to have increase in bloody secretions. After discussion with the family, he was made CMO and eventually expired secondary to respiratory failure due to diffuse alveolar hemorrhage related to his underlying Wegener's. He was made comfortable at the time of his death with morphine, ativan, and scopolamine to minimize secretions. . # PANCYTOPENIA: Thought to be multifactorial in etiology with largest contributant from cytoxan therapy and possibly Bactrim. Plts nadir at 41 on [**2147-12-19**], Hct nadir 20.7 [**2147-12-18**], WBC nadir 1.1 ANC 1010 on [**2147-12-24**]. Anemia exacerbated by ongoing slow ongoing bleeding, phlebotomy, thrombocytopenia exacerbated by recent plasmapheresis. As described above, patient was transiently on Neutropenic precautions, never frankly neutropenic. He was started on GCSF transiently. Cefepime was used transiently for fever and neutropenia. Patient's lines (left port) and PIV's were monitored closely for infection, blood cx remained negative, sputum with sparse oropharyngeal flora. Patient had loose stool however was negative for C.diff. . #) LARYNGEAL CANCER: Status post chemo and radiation. Recently had esophageal stricture dilated [**11-15**]. Patient was maintained NPO during his admission and given tube feeds. . #) ABDOMINAL PAIN: The patient complained of intermittent abdominal pain, with decreased bs/increased residuals, likely secondary to ileus. This resolved with reglan. . #) PAROTIDIS: This was thought to be secondary to radiation scarring vs. infection. Resolved throughout his admission. . #) CAD s/p CABG: No evidence of active ischemia. He was continued on high dose metoprolol; however, [**Month/Day (4) **] was held due to alveolar hemorrhage. He was also continued on [**Month/Day (4) 17339**] and captopril. . #) NSVT: Patient had recurrent NSVT. Bilateral LENIs ruled out clot. EKG was unchanged. The patient's beta blocker was uptitrated with good effect. . #) HTN: Continued metoprolol, captopril. . #) CODE STATUS: Patient was initially DNR, not DNI; patient was later made CMO by family after clinical status continued to decline and patient had further bloody secretions. . #) DISPO: Patient expired on [**2148-1-20**] secondary to respiratory failure due to diffuse alveolar hemorrhage related to his underlying Wegener's. He was made comfortable at the time of his death with morphine, ativan, and scopolamine. Family was present at the time of expiration and declined autopsy. . Medications on Admission: Roxicet [**12-12**] tsp q4h prn Lopressor 50mg [**Hospital1 **] Lasix 40mg qd [**Hospital1 **] 10mg qd Discharge Disposition: Expired Discharge Diagnosis: 1) Wegener's 2) Diffuse Alveolar Hemorrhage 3) Respiratory Failure 4) Pancytopenia 5) Laryngeal Cancer 6) Acute Renal Failure Discharge Condition: Expired Discharge Instructions: N/A Followup Instructions: N/A ICD9 Codes: 486, 2851, 5845, 4280
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Medical Text: Admission Date: [**2150-1-26**] Discharge Date: [**2150-2-1**] Date of Birth: [**2088-9-19**] Sex: M Service: CSU HISTORY OF PRESENT ILLNESS: This 61-year-old male had no prior history of coronary artery disease, but reported a 10- year history of angina with progressive angina in the past year. Electrocardiogram showed ST depressions in leads I, II and V4 through V6 as well as ST elevations in V1. He was admitted to the hospital on [**2150-1-26**], and cardiac catheterization was performed which showed a 90 percent distal left vein lesion, a 90 percent left anterior descending lesion, 70 percent circumflex lesion and a totally occluded RCA in the mid portion. His ejection fraction was 40-45 percent. Intra-aortic balloon pump was placed in the Cardiac Cath Laboratory at the time of catheterization. It also showed anterolateral and distal inferior hypokinesis. PAST MEDICAL HISTORY: Angina. Bell's palsy. Hypertension. Hypercholesterolemia. PAST SURGICAL HISTORY: Repair of his left shoulder. Tonsillectomy. ALLERGIES: No known drug allergies. MEDICATIONS: He was on no medications daily. SOCIAL HISTORY: The patient was a cab driver who said that he never smoked and had no history of alcohol use. FAMILY HISTORY: Unknown as the patient was adopted. PHYSICAL EXAMINATION: He is 5 feet, 8 inches tall and 195 pounds. He is in sinus rhythm at 65. Blood pressure 175/95. Respiratory rate 21. Sating 100 percent on three liters nasal cannula. He was in bed in the Coronary Care Unit. He was in no apparent distress. He was alert, oriented and appropriate. He had a slight left facial droop due to his Bell's palsy and no carotid bruits. His lungs were clear to auscultation anteriorly bilaterally. His heart was regular rate and rhythm with S1 and S2 tones. His balloon pump was on 1:1. His abdomen was soft, round, obese, nontender and nondistended with positive bowel sounds. His extremities were warm and well perfused with no edema or varicosities noted. He had 2+ bilateral radial dorsalis pedis and posterior tibial pulses. PREOPERATIVE LABORATORY DATA: White count 7.6. Hematocrit 41.6. Platelet count 234,000. Sodium 136. Potassium 3.9. Chloride 103. Bicarb 27. BUN 11. Creatinine 0.8 with a blood sugar of 99. PT 12.7. PTT 33.8. INR 1.0. ALT 19. AST 22. Alkaline phosphatase 49. Amylase 22. Total bilirubin 0.5. Albumin 3.8. Chest x-ray showed no acute cardiopulmonary disease. His urinalysis was negative. The patient was referred immediately in the Cath Laboratory to Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **]. Additional history showed that the patient in the morning of admission had walked to the [**Hospital Ward Name 8559**] and thinks he passed out or almost passed out. He was brought in to the emergency room directly at that time. Dr. [**Last Name (STitle) **] saw the patient emergently in the Cath Laboratory and in consultation asked by Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], the cathing cardiologist, and the patient consented to have surgery the following morning. That day in the evening in the Coronary Care Unit the patient was started on captopril and metoprolol as well as a nitroglycerin drip with good effect. He did not have any complaints at that time. He was also given aspirin and Lipitor and remained stable overnight. On the morning of the 28th, he was taken to the operating room where he had a coronary artery bypass grafting times three by Dr. [**Last Name (STitle) **] with a left internal mammary artery to the left anterior descending, a vein graft to the obtuse margin and a vein graft to the distal RCA with a balloon pump in place. He was transferred to the Cardiac Cath Intensive Care Unit in stable condition on the Neo-Synephrine drip at 0.4 mcg/kg/minute and a propofol drip at 20 mcg/kg/minute. He was extubated on the evening of the 28th without incident sating 95 percent. The balloon remained in place with good augmentation and systolic and diastolic unloading. He did have some episodes of sinus tachycardia to the 120s-130s. He awakened in pain, and he was monitored without any intervention. His heart rate was in the 90s at rest. His Neo-Synephrine was weaned off. His nitroglycerin was started after extubation and weaned off through the night. He was taking sips of water and also remained on an insulin drip with plans to remove his balloon. He was also seen by Case Management. In the CSRU, his balloon was removed later that day, and he was transferred out to the floor. The patient was also seen by Social Work as the patient had few supports and there was concern about his ability to care for himself and have rehabilitation. The patient was living in a rooming house at [**Location (un) **] at the time with three roommates. On postoperative day two, the patient was in sinus rhythm at 100, a blood pressure of 112/67. Postoperative labs were as follows, white count 14.6, hematocrit 32.7, platelet count 167,000, potassium 5.0, BUN 20, creatinine 1.0 and INR 1.1. He began his beta blockade with Lopressor 25 b.i.d. He continued with Lasix intravenous diuresis. Aspirin also had been restarted. His chest tubes remained in place. His intravenous line was removed. Pacing wires remained in place. Later that day, his chest tubes were discontinued. The patient was encouraged to get up with physical therapist and the nurse. He was evaluated by the staff of physical therapy to work on his ambulation. He was switched over to Percocet p.r.n. for pain control. His pacing wires were discontinued on postoperative day three. His blood pressure remained stable. He was alert with a nonfocal examination. His heart was regular in rate and rhythm. His lungs were clear bilaterally. He had one episode of mild heart palpitations while on the stairs which subsided immediately with rest. He was steady on his feet though and quite independent, and discharge planning continued. He had some trace ankle edema bilaterally. The patient had a complaint of constipation on [**1-31**]. He did have flatus. Milk of Magnesia was also given as well as prune juice. Percocets were providing good pain relief. He was also given a Dulcolax suppository. Incisions were clean, dry and intact. The patient continued on telemetry monitoring with encouragement to increase his pulmonary toilet and continue to ambulate. The patient did verbalize some fears and despondent thoughts secondary to his home situation. Nursing staff continued to work with Social Work and Case Manager to help plan postoperative services with the [**Hospital6 407**] for counseling, etc. On postoperative day four, the patient's examination was unremarkable. He continued on diuresis, and his medications. He continued with physical therapy and working with the Social Work staff to plan for his discharge. Case Management also agreed to help the patient fill out his health insurance paperwork as he was slightly anxious about it. The patient was discharged to his rooming house with [**Hospital6 1587**] services on [**2150-2-1**] with the following discharge diagnoses: Status post emergency coronary artery bypass grafting times three. Bell's palsy. Hypertension. DISCHARGE INSTRUCTIONS: The patient was instructed to follow up with his primary care physician in approximately two weeks and to follow up with Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] his cardiac surgeon in the office first postoperative surgical visit in approximately one month. DISCHARGE MEDICATIONS: Potassium chloride 20 mEq p.o. twice a day for seven days. Lasix 20 mg p.o. twice a day for seven days. Zantac 150 mg p.o. twice a day. Enteric coated aspirin 81 mg p.o. once a day. Percocet 5/325 one tablet p.o. p.r.n. every four hours for pain. Lipitor 20 mg p.o. daily. Metoprolol 50 mg p.o. twice a day. The patient was discharged with care group home care services on [**2150-2-1**] in stable condition. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 1714**], [**MD Number(1) 1715**] Dictated By:[**Last Name (NamePattern1) **] MEDQUIST36 D: [**2150-2-18**] 12:35:32 T: [**2150-2-18**] 14:17:45 Job#: [**Job Number 111184**] ICD9 Codes: 4111, 4019
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Medical Text: Admission Date: [**2194-2-10**] Discharge Date: [**2194-2-21**] Date of Birth: [**2155-3-7**] Sex: M Service: HISTORY OF PRESENT ILLNESS: The patient is a 39 year old male with the history of alcoholism whose last drink was on [**2194-2-9**]. He presented to an outside emergency room after having a tonic clonic seizure at alcohol detoxification. In the emergency room at the outside hospital patient was found to have a blood pressure of 70/40 which decreased to 60/40 on standing. Patient was aggressively fluid resuscitated with normal saline, however, had a near syncopal episode while using the commode. Patient was transferred to [**Hospital1 18**] for further treatment of his hypotension. In the E.D. patient had a temperature of 97.2, blood pressure 80/53, pulse 88, respiratory rate 22, sating 99% on 2 liters. Patient had an arterial blood gas that was notable for pH of 7.7, PCO2 19, PO2 79. Given the concern for hypotension, cardiology was consulted for a bedside echo in the E.D. which revealed a huge RV with decreased function, high pulmonary pressures, but no evidence of tamponade physiology. Given patient's RV dysfunction, patient received a CTA which showed no definite evidence of pulmonary embolism. Patient was started on a dopamine drip. Patient was also noted to be in acute renal failure with creatinine of 1.6 and had a Foley placed with minimal urine output. PAST MEDICAL HISTORY: Notable for alcoholism as above with a seizure. MEDICATIONS ON ADMISSION: Librium, promazine 10 mg p.o. q.day. Promazine is an alpha agonist. ALLERGIES: No known drug allergies. SOCIAL HISTORY: Remarkable for tobacco use as well as alcoholism. Patient is currently homeless. PHYSICAL EXAMINATION: On admission temperature was 97.5, blood pressure as noted above 80/53, pulse 82, respirations 12, sating 99% on 2 liters. Generally, patient was lethargic, oriented to time and person, but not place, had coherent speech. HEENT was notable for mildly icteric sclerae, poor dentition, pupils were reactive. Patient was noted to have diffuse expiratory wheeze. Heart had regular rate, 3/6 systolic murmur at left lower sternal border. Abdomen mild tenderness in the upper quadrants bilaterally with normoactive bowel sounds, nondistended, no hepatosplenomegaly. No lower extremity edema. Neurologic exam was grossly nonfocal. LABORATORY DATA: On admission white count was 14.2, hematocrit 34.8, platelets 95. INR was elevated at 1.4, PTT 37.0, PT 14.8. Sodium was 135, potassium 5.7, chloride 106, bicarb 19, BUN 14, creatinine 1.6, glucose 98. ALT was 23, AST 53, alka phos 86, total bili 2.6, total protein 6.3, albumin 3.0. Tox screen was negative. CK was 256, MB 2, troponin 0.22. Chest x-ray showed mild cardiomegaly, no evidence of congestive heart failure. EKG was normal sinus rhythm at 85 with rightward axis, deep T inversions in leads V1 through V6, left atrial enlargement, no ST segment depressions, right bundle pattern. Right seated EKG showed no evidence of infarct. HOSPITAL COURSE: In short, this is a 39 year old male with alcoholism who presented with hypotension, status post seizure. He was noted to have a dilated right ventricle with negative CTA and no evidence of acute ischemia as well as acute renal failure and elevated total bilirubin. Patient's MICU course was as follows. Patient was hydrated with normal saline and was briefly on dopamine. With hydration patient's acute renal failure resolved and creatinine was 0.8. Patient had a right heart catheterization showing markedly elevated PA pressure of 97/42 and increased pulmonary vascular resistance of 832. Patient had no response to Adenosine challenge. Patient was also found to have a small nodular liver on right upper quadrant ultrasound with small ascites. This was evaluated by the hepatology service for further workup. Patient was also started on Levaquin for bilateral basilar infiltrates that were seen on chest CT. 1. Pulmonary hypertension. The patient had no evidence of pulmonary embolus on CTA and on CTA lung parenchyma appeared grossly normal. As noted above patient's elevated pulmonary artery pressure would suggest that this is not an acute process. Indeed, on further questioning patient revealed that he had symptoms of lightheadedness and dizziness with exertion for months prior to admission. Additionally, patient had been evaluated by an outside physician and started on an alpha agonist due to questionable orthostatic hypotension. As noted above, patient underwent formal right heart catheterization in the cardiac cath lab as well as Adenosine challenge. Since patient had no response to Adenosine challenge, it was felt that calcium channel blockers would be of little use in this patient. Patient's inability to abstain from alcohol additionally made him a poor candidate for this. In the absence of other causes that could be located for patient's pulmonary hypertension, it was thought likely that he had portal pulmonary hypertension due to cirrhosis which will be discussed below. 2. As noted in HPI patient was found to have elevated bilirubin upon admission. He underwent right upper quadrant ultrasound which showed a small nodular liver consistent with cirrhosis as well as small ascites. Patient was elevated by the liver service. Patient's hepatitis serologies were checked and were negative. Patient underwent EGD while hospitalized to evaluate for evidence of varices. Patient was noted to have grade 2 varices in the middle third of the esophagus. There was no stigmata of bleeding. Patient was vaccinated against hepatitis B. Because of varices, patient was started on a low dose of nadolol. 3. Infectious disease. The patient was treated for 10 days with levofloxacin for bilateral lower lobe pneumonia present on chest CT. 4. Substance abuse. The patient was started on Librium while in-house to prevent withdrawal. Patient had no further seizures or evidence of withdrawal while hospitalized. He was continued on a Librium taper. At the time of this intern going off service on [**2194-2-16**], the patient was still in-house on Librium taper, clinically stable, awaiting placement. Given patient's substance abuse issues and severe disability due to his pulmonary hypertension, ongoing attempts to find appropriate placement for him were underway. This discharge summary will require an addendum. Further dictation will be performed by [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **]. [**First Name11 (Name Pattern1) 734**] [**Last Name (NamePattern1) 735**], M.D. [**MD Number(1) 736**] Dictated By:[**Name8 (MD) 8330**] MEDQUIST36 D: [**2194-6-5**] 15:56 T: [**2194-6-11**] 10:17 JOB#: [**Job Number 47162**] ICD9 Codes: 5849, 2765
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Medical Text: Admission Date: [**2162-8-25**] Discharge Date: [**2162-9-1**] Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 16115**] Chief Complaint: Abdominal Pain Major Surgical or Invasive Procedure: ERCP History of Present Illness: [**Age over 90 **]M w/ho gallstones presenting to the emergency department from an [**Hospital1 1562**] for likely cholangitis. Patient reports having right upper quadrant and epigastric abdominal pain for the last 24-36 hours. At the outside hospital his initial VS were 96.8, 116/65, 65 16, 100RA, and he spiked a temp to 102.2 and he had an episode of NBNB emesis. His labs were notable for evated T. bili to 1.6 as well as elevated alkaline phosphatase. He was given 3g IV Unasyn, morphine, zofran and MD [**First Name (Titles) **] [**Last Name (Titles) 90357**] for likely cholangitis transferred. The patient has had ERCP with sphincterotomy approximately a year ago. Right upper quadrant ultrasound did demonstrate sludging and stones but no evidence of CBD dilatation or cholecystitis. Also received tylenol at the OSH for his fever. Was initially stable here initial VS were: 99.5 65 130/53 18 98% ra. Had increased O2 requirement and became hypotensive sbp 70s, got 1L at OSH, 1.5L here. Had RIJ put in 92/33, Vpaced. RR 20 99%2L. Started on norepi in ED, also vanc here. ERCP fellow contact[**Name (NI) **]. [**Name2 (NI) **] do it in the morning. FFP will need to be given. On arrival to the MICU, patient's VS were BP 77/53 (not on pressors), HR 65 Vpaced, 20 97% 2L. He was mentating well with complaints of a slightly upset stomach and feeling like his speech was slurred from the pain medicaitons. He denied any abdominal pain currently, chest pain, shortness of breath, dizziness or lightheadedness. He reports recently trying a low fat diet. Pt reports the pain comes on when he eats. Review of systems: (+) Per HPI (-) denies fevers, chills, dysuria, nausea, vomiting currently. Past Medical History: atrial fibrillation on coumadin HTN CAD Hypercholastrolemia OSA on CPAP AAA repair Pacemaker spinal surgery Social History: no ETOH or drug abuse. Family History: not relevant to the current hospitalization Physical Exam: Admission: Vitals: 98.2 83/41 65 17 96% 2L NC General: Alert, oriented, no acute distress, very comfortable-appearing HEENT: MMM, oropharynx clear, EOMI, PERRL Neck: supple, no JVD CV: Normal rate, reg ryhthm, +systolic murmur Lungs: Crackles at bases bilaterally Abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly, no rebound or guarding GU: no foley Ext: Warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Neuro: AAOx3, moves all extremities, gait deferred. Discharge exam: T 99.2 HR 60 BP 130/64 RR 18 98% RA General: Alert, oriented, no acute distress, very comfortable-appearing HEENT: MMM, oropharynx clear, EOMI, PERRL Neck: supple, no JVD CV: Normal rate, reg ryhthm, +systolic murmur Lungs: Crackles at bases bilaterally Abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly, no rebound or guarding GU: no foley Ext: Warm, well perfused, 2+ pitting edema LE bilaterally, with scrotal edema (improving) Neuro: AAOx3, moves all extremities, gait deferred. Pertinent Results: Admission: [**2162-8-25**] 09:45PM WBC-12.7* RBC-3.69* HGB-12.5* HCT-37.0* MCV-100* MCH-34.0* MCHC-33.9 RDW-13.4 [**2162-8-25**] 09:45PM NEUTS-91.6* LYMPHS-4.6* MONOS-3.5 EOS-0.1 BASOS-0.2 [**2162-8-25**] 09:45PM ALT(SGPT)-207* AST(SGOT)-556* ALK PHOS-399* TOT BILI-3.1* [**2162-8-25**] 09:45PM LIPASE-18 [**2162-8-25**] 09:45PM GLUCOSE-119* UREA N-21* CREAT-1.1 SODIUM-140 POTASSIUM-3.8 CHLORIDE-103 TOTAL CO2-25 ANION GAP-16 [**2162-8-25**] 09:53PM PT-28.3* PTT-37.5* INR(PT)-2.7* ERCP [**2162-8-26**] -Impression: Evidence of a previous sphincterotomy was noted in the major papilla. Cannulation of the biliary duct was successful and deep with a balloon catheter using a free-hand technique. Contrast medium was injected resulting in partial opacification. Thick sludge was seen exuding out of the ampulla after cannulation. A mild diffuse dilation was seen at the main duct with the CBD measuring 10 mm. Multiple stones ranging in size from 6 mm to 10 mm that were causing partial obstruction were seen at the main duct. Given cholangitis, only limited contrast injection was made. Given cholangitis and elevated INR, a 5cm by 10FR double pig tail biliary stent was placed successfully in the main duct. Otherwise normal ercp to third part of the duodenum -Recommendations: Return to [**Hospital Unit Name 153**]. NPO overnight with aggressive IV hydration as tolerated with LR at 100-150 cc/hr. Follow for response and complications. If any abdominal pain, fever, jaundice, gastrointestinal bleeding please call ERCP fellow on call ([**Pager number 8437**]). Continue IV antibiotics. Will need antibiotics for total of 2 weeks. Can be transitioned to oral antibiotics prior to discharge. Repeat ERCP in 5 weeks for stent removal and extraction of stones. Hold coumadinn for 5 days prior to ERCP. [**2162-8-28**] URINE CULTURE-FINAL no growth [**2162-8-26**] URINE CULTURE-FINAL no growth Brief Hospital Course: [**Age over 90 **] yo male with CAD, Afib, HTN p/w hypotension requiring pressors in setting of likely cholangitis. Active Issues: #Sepsis: Pt was initially hypotensive despite fluid resuscitation and required BP support with norepinephrine. Though his U/S is unchanged from prior study, in the setting of his fever, hypotension, and rising enzymes and bili, most likely cause is cholangitis. ERCP on [**8-26**] showed stones and some sludge. Pt had stent placed but did not have sphincterotomy given elevated INR. Pt had 1 of 4 bottles at OSH growing pan sensitive E coli. Pt was initially treated with IV vancomycin and unasyn. Weaned off norepinephrine [**2162-8-28**] once his paced rate was increased from 65 to 85 bpm. WBC and LFTs continued to down trend and normalized by the time of discharge. UA [**2162-8-27**] concerning for UTI so Pt was started ciprofloxacin po. Vancomycin and unasyn were discontinued on [**8-29**] given results of blood cultures and switched to PO cipro at 750mg [**Hospital1 **] per ERCP and pharmacy recs. He tolerated a regular diet and had complete resolution of his abdominal pain. Pt needs repeat ERCP in 5 weeks, and will need to hold warfarin 5 days prior to procedure. He will need a total of 14 days of oral antibiotics to treat the cholangitis. #Hypotension: Presumed [**1-14**] sepsis in the setting of cholangitis. Low cardiac output could also be contributing to the hypotension since his BP responded to increasing his paced rate to 85 from baseline 65. Pt needed norepinephrine to support BP despite receiving fluids but was weaned off once his HR was increased. TTE showed 45% LVEF, markedly dilated RA, moderately dilated LA. Overall LV systolic function is mildly depressed (LVEF = 45 %) secondary to pacemaker-induced dyssynchrony and to ventricular interaction, with a pressure/volume overloaded right ventricle. Pt also had moderate to severe [3+] tricuspid regurgitation, moderate pulmonary artery systolic hypertension. These results indicate that he is preload dependent and requires to be hydrated optimally. On transfer to the floor, however, and on day of discharge to the [**Hospital1 1501**], he was significantly volume overloaded with extensive LE edema and scrotal edema. He was given lasix 40 mg IV over last 3 days to assist in getting rid of the extra fluid, and discharged on Lasix 40 mg PO daily. Please continue to monitor his renal function and electrolytes with diuresis. # ? UTI. UA with pyuria. Pt asymptomatic but was started on ciprofloxacin (see above). Urine cultures negative to date. #Afib: Paced rhythm (See above). On warfarin with therapeutic INR, Pt was given FFP x 2 to correct coagulopathy but INR was 2.1 at time of ERCP, so no sphincterotomy was performed. Pt's rate was increased to 85 given hypotension by EP service and was reverted back to 60 by EP on discharge. He tolerated this reversion back to his baseline HR without any problems. The coumadin was restarted initially at 2.5 mg QHS and then 2 mg QHS on [**8-31**] once his INR became therapeutic. #CAD: Continue statin. ASA was initially held given plan for ERCP but restarted aftewards given absence of sphincterotomy. Carvedilol, enalipril, furosemide were all held due to hypotension. These medications can be resumed if his BP continues to be elevated. Of note, the patient has not taken his furosemide in approximately 2 years because he feels he does not have swelling but his cardiologist is not aware. # Urinary retention: due to significant scrotal and penile edema, a foley was placed in the ICU. The foley needed to be performed by the urology - reportedly due to phimosis (likely from the extra swelling). Mr. [**Known lastname 7568**] also has a history of urinary retention most consistent with BPH. He was placed on flomax and should be continued.. Once the extra fluid and edema is properly eliminated, the foley should be discontinued. #OSA: Continue CPAP. #HLD: Continue statin. # Communication: Patient , wife [**Name (NI) 2048**] [**Name (NI) 7568**] [**Telephone/Fax (1) 90358**] # Code: DNR/DNI Medications on Admission: Preadmission medications listed are correct and complete. Information was obtained from Patient. 1. Calcium Carbonate 1000 mg PO DAILY 2. NexIUM *NF* (esomeprazole magnesium) 40 mg Oral daily 3. Enalapril Maleate 5 mg PO DAILY hold for sbp<100 or hr<60 4. Warfarin Dose is Unknown PO DAILY16 5. Coreg CR *NF* (carvedilol phosphate) 30 mg Oral daily 6. Furosemide 40 mg PO DAILY 7. Vitamin D 1000 UNIT PO DAILY 8. Aspirin 81 mg PO DAILY 9. Clonazepam 0.25 mg PO QHS:PRN insomnia Discharge Medications: 1. Aspirin 81 mg PO DAILY 2. Warfarin 2 mg PO DAILY16 3. Acetaminophen 650 mg PO Q4H:PRN pain 4. Albuterol 0.083% Neb Soln 1 NEB IH Q6H:PRN wheezing/sob 5. Ciprofloxacin HCl 500 mg PO Q12H 6. Docusate Sodium 100 mg PO BID:PRN constipation 7. Tamsulosin 0.4 mg PO HS 8. Enalapril Maleate 5 mg PO DAILY hold for sbp<100 or hr<60 9. Clonazepam 0.25 mg PO QHS:PRN insomnia 10. Calcium Carbonate 1000 mg PO DAILY 11. Furosemide 40 mg PO DAILY 12. NexIUM *NF* (esomeprazole magnesium) 40 mg ORAL DAILY 13. Vitamin D 1000 UNIT PO DAILY Discharge Disposition: Extended Care Facility: [**Male First Name (un) 4542**] Nursing Center - [**Hospital1 1562**] Discharge Diagnosis: - Cholangitis - Hypotension (chronotropic insufficiency) - Peripheral edema - Urinary tract infection Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: You were admitted with an infected common bile duct (cholangitis) and low blood pressure. The infected common bile duct was attributed to stones obstructing the duct pathway. An ERCP was performed to remove the stones and place a stent to facilitate emptying of the bile. You were treated with antibiotics and should continue on oral antibiotics for another 7 days. You will need to return on [**9-30**] to have the stent removed. You had low blood pressure - which warranted a stay in the intensive care unit. You were given iv fluids and your pacemaker was temporarily increased in rate. Your blood pressure is now stable and thus the pacemaker was reverted to its previous settings. You have substantial extra fluid and will benefit from continued lasix (diuretic). Followup Instructions: Department: ENDO SUITES When: THURSDAY [**2162-9-30**] at 1 PM Department: DIGESTIVE DISEASE CENTER When: THURSDAY [**2162-9-30**] at 1 PM With: [**Name6 (MD) 1948**] [**Last Name (NamePattern4) 1949**], MD [**Telephone/Fax (1) 463**] Building: [**First Name8 (NamePattern2) **] [**Hospital Ward Name 1950**] Building ([**Hospital Ward Name 1826**]/[**Hospital Ward Name 1827**] Complex) [**Location (un) 1951**] Campus: EAST Best Parking: Main Garage ICD9 Codes: 0389, 5849, 2875, 5990, 4280, 2768, 4168, 2724, 4019