CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 52-year-old
female with a history of severe ulcerative colitis,
insulin-dependent diabetes mellitus, hypertension, and
chronic renal insufficiency (on dialysis).

MEDICAL HISTORY: 1.  Ulcerative colitis; the patient has been treated
successfully with Asacol in the past.
 2.  Insulin-dependent diabetes mellitus times 30 years; the
patient's illness is complicated by neuropathy, nephropathy,
and retinopathy.
 3.  Chronic renal insufficiency (on dialysis); dialysis was
started in the middle of [**Month (only) 404**] due to "fluid overload."
 4.  Hypertension.
 5.  Gout.
 6.  Status post cerebrovascular accident in [**2192**]; the
patient now on Coumadin.  Following her stroke, the patient
sustained a hypoxic brain injury.
 7.  Asthma.
 8.  Hypothyroidism.
 9.  Nephrolithiasis.
10.  Coronary artery disease; the patient noted to have
anterior wall ischemia on a stress test done in [**2195-1-2**].  Her ejection fraction was 66%.
11.  Status post hysterectomy.
12.  Status post appendectomy.
13.  Status post operations on kidneys for "stone disease."

MEDICATION ON ADMISSION: 

ALLERGIES: DEMEROL, DILAUDID, TALWIN, GENTAMICIN, and SHELL
FISH.

PHYSICAL EXAM: 

FAMILY HISTORY: Family history not elicited on admission due
to the patient's poor mental status.

SOCIAL HISTORY: The patient lives in [**Location (un) 3844**].  History
negative for tobacco, alcohol, and drugs.  The patient is a
former nurse.  She has three daughters.
Infection and inflammatory reaction due to other vascular device, implant, and graft,Disseminated candidiasis,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Acute respiratory failure,Hyposmolality and/or hyponatremia,Acute kidney failure, unspecified,Ulcerative colitis, unspecified,Diabetes with neurological manifestations, type II or unspecified type, not stated as uncontrolled
React-oth vasc dev/graft,Disseminated candidiasis,Hyp kid NOS w cr kid V,Acute respiratry failure,Hyposmolality,Acute kidney failure NOS,Ulceratve colitis unspcf,DMII neuro nt st uncntrl
Admission Date:  [**2196-1-9**]       Discharge Date:  [**2196-1-20**]

Date of Birth:   [**2143-9-27**]       Sex:  F

Service:  Medical Intensive Care Unit

NOTE:  This dictation will cover the [**Hospital 228**] Hospital
Course from [**2196-1-9**] until [**2196-1-20**].  The
remainder of the dictation will be completed by the medical
team which is accepts the patient upon her discharge from the
Medical Intensive Care Unit.

REASON FOR ADMISSION:  The patient was transferred from
[**Hospital6 7472**] in [**Location (un) 31384**], [**State 350**] for
treatment of probable fungemia and concern for ischemic
colitis versus ulcerative colitis flare.

HISTORY OF PRESENT ILLNESS:  The patient is a 52-year-old
female with a history of severe ulcerative colitis,
insulin-dependent diabetes mellitus, hypertension, and
chronic renal insufficiency (on dialysis).

The patient was transferred to [**Hospital1 188**] from [**Hospital 46039**] [**Hospital **] Hospital in [**Location (un) 31384**],
[**State 350**].  The patient was admitted to that hospital on
[**12-28**] following an episode of hypotension during
hemodialysis.  Later that day, the patient developed bloody
diarrhea and was admitted to the [**Hospital6 7472**].

At that hospital, the patient underwent a colonoscopy which
disclosed edema, redness, and necrotic mucosa in the sigmoid
colon.  It was concluded that the patient was suffering from
a flare of her ulcerative colitis or possibly from ischemic
bowel.  The patient was started on Unasyn and Flagyl.
Steroids were withheld due to the concern of masking a
perforation.  The patient seemed to improve slowly.  A
noncontrast computed tomography showed nonspecific colonic
thickening.  The patient was maintained on hyperalimentation
through her Perm-A-Cath.  Her white blood cell count began to
normalize, but within two days she complained of increased
abdominal pain and spiked a temperature on [**1-8**].

A Surgery consultation was placed.  The patient did not have
a surgical abdomen, yet it was decided that the patient would
be transferred to [**Hospital1 69**] for
further management and possible colon resection.  Of note,
[**6-8**] blood cultures were growing a yeast.  The patient was
given a dose of Diflucan.  The fungal infection was thought
to be due to her indwelling right Perm-A-Cath and left
hemodialysis tunnelled catheter.

The patient was transferred to [**Hospital1 188**].

PAST MEDICAL HISTORY:
 1.  Ulcerative colitis; the patient has been treated
successfully with Asacol in the past.
 2.  Insulin-dependent diabetes mellitus times 30 years; the
patient's illness is complicated by neuropathy, nephropathy,
and retinopathy.
 3.  Chronic renal insufficiency (on dialysis); dialysis was
started in the middle of [**Month (only) 404**] due to "fluid overload."
 4.  Hypertension.
 5.  Gout.
 6.  Status post cerebrovascular accident in [**2192**]; the
patient now on Coumadin.  Following her stroke, the patient
sustained a hypoxic brain injury.
 7.  Asthma.
 8.  Hypothyroidism.
 9.  Nephrolithiasis.
10.  Coronary artery disease; the patient noted to have
anterior wall ischemia on a stress test done in [**2195-1-2**].  Her ejection fraction was 66%.
11.  Status post hysterectomy.
12.  Status post appendectomy.
13.  Status post operations on kidneys for "stone disease."

MEDICATIONS ON TRANSFER:
 1.  Reglan 5 mg p.o. q.d.
 2.  Colace 100 mg p.o. q.d.
 3.  MS Contin 15 mg p.o. q.a.m. and 30 mg p.o. q.p.m.
 4.  Coumadin 5 mg p.o. q.d.
 5.  Tegretol-SR 200 mg p.o. b.i.d.
 6.  Humulin 70/30 40 units subcutaneously q.a.m. and 10
units subcutaneously q.p.m.
 7.  Toprol-XL 150 mg p.o. b.i.d.
 8.  Norvasc 10 mg p.o. q.d.
 9.  Pravachol 40 mg p.o. q.d.
10.  Levoxyl 0.175 p.o. q.d.
11.  Nexium 40 mg p.o. q.d.
12.  Nortriptyline 50 mg p.o. b.i.d.
13.  Allopurinol 100 mg p.o. q.d.
14.  Benadryl 25 mg p.o. q.4h. as needed.
15.  Ativan 1 p.o. b.i.d. as needed.
16.  Tylenol as needed.

ALLERGIES:  DEMEROL, DILAUDID, TALWIN, GENTAMICIN, and SHELL
FISH.

FAMILY HISTORY:  Family history not elicited on admission due
to the patient's poor mental status.

SOCIAL HISTORY:  The patient lives in [**Location (un) 3844**].  History
negative for tobacco, alcohol, and drugs.  The patient is a
former nurse.  She has three daughters.

PHYSICAL EXAMINATION ON PRESENTATION:  In general, the
patient was anxious, crying out, and disoriented.  Vital
signs revealed temperature was 104, heart rate was 140, blood
pressure was 211/76, respiratory rate was 40, SaO2 was 96% on
room air.  Head, eyes, ears, nose, and throat examination
revealed pupils were equally round and reactive to light.
Extraocular movements were intact.  Mucous membranes were
dry.  The neck was obese.  Left tunnelled catheter.  No
lymphadenopathy.  No thyromegaly.  Heart was tachycardic.
Normal first heart sounds and second heart sounds.  No
murmurs, rubs, or gallops.  Unable to assess jugular venous
pulsation.  Lungs were clear to auscultation bilaterally.
The abdomen revealed positive bowel sounds.  Obese, soft, and
nontender.  Rectal examination revealed stool
guaiac-positive.  Extremities revealed tenderness in the
bilateral lower extremities, mild edema to shins.  Neurologic
examination was difficult to assess secondary to agitation.
Strength was intact.  Cranial nerves II through XII were
intact.

PERTINENT LABORATORY VALUES ON PRESENTATION:  Laboratory data
revealed white blood cell count was 23.8, hematocrit was
28.6, and platelets were 286.  Sodium was 134, potassium was
3.9, chloride was 102, bicarbonate was 20, blood urea
nitrogen was 55, creatinine was 2.9, and blood glucose was
327.  Calcium was 7.9, magnesium was 1.3, phosphate was 2.6.
Prothrombin time was 20.7, partial thromboplastin time was
35.1, and INR was 2.8.  Fibrinogen was 657.  ALT was 15, AST
was 15, total bilirubin was 0.3, albumin was 2.6, alkaline
phosphatase was 93, and amylase was 40.  Microbiology data
revealed 7/9 bottles from the outside hospital growing fungi.

RADIOLOGY/IMAGING:  Electrocardiogram revealed sinus
tachycardia at 140 beats per minute.  Normal intervals.
Normal P-R interval and normal QRS.  Prolonged QTc.  Left
atrial abnormality.  No signs of ischemia.

A chest x-ray revealed cardiomegaly, a right Port-A-Cath in
the subclavian vein, left tunnel dialysis catheter in
internal jugular.

IMPRESSION:  This is a 52-year-old female with multiple
medical problems including ulcerative colitis, diabetes
mellitus, hypertension, and chronic renal failure who was
transferred to [**Hospital1 69**] for
treatment of fungemia due to indwelling venous catheters.

HOSPITAL COURSE BY ISSUE/SYSTEM:

 1.  PULMONARY SYSTEM:  On admission, the patient was
tachypneic with a respiratory rate of 36.  The patient was
also disoriented and agitated, so she was intubated.  She was
sedated with Fentanyl and Versed.

Intubation was without complications.  The patient was
maintained on the ventilator until [**1-19**].  She was
diuresed aggressively while on the ventilator.  Extubation
was attempted on [**1-15**], yet deflation of the
endotracheal tube cuff did not produce an air leak.  The
patient was started on Decadron 10 mg q.8h.

A bronchoscopy on [**1-18**] disclosed mild vocal cord
edema.  There was a space between the endotracheal tube and
the vocal cord.  An air leak was present with the cuff down.
The patient was successfully extubated on [**1-19**].
Anesthesia was present during the extubation.

 2.  INFECTIOUS DISEASE ISSUES:  As noted above, [**6-8**] cultures
from the outside hospital grew yeast. Blood cultures from
[**1-9**] and [**1-10**] done at this hospital grew [**Female First Name (un) 564**]
albicans.

The patient was initially treated with AmBisome.  When the
organism was identified as [**Female First Name (un) 564**] albicans, the patient was
switched to fluconazole.  She will continue on fluconazole
until [**1-25**].

On [**1-10**], the patient's dialysis catheter and
Perm-A-Cath were removed by Surgery.  One of the catheter
tips grew [**Female First Name (un) 564**] albicans.  Due to persistent fevers, and an
abdominal computed tomography was done on [**1-14**].  There
was no evidence of an abscess.  A transesophageal
echocardiogram was done, and there was no evidence of
vegetations.

On [**1-13**], another catheter tip grew coagulase-negative
staph.  The patient's blood cultures never grew an organism.
The patient was treated with vancomycin.  Over the course of
her hospital stay, the patient defervesced and her white
blood cell count decreased.

 3.  CARDIOVASCULAR SYSTEM:  On admission, the patient's
cardiac enzymes were cycled.  She was noted to have an
evaluated troponin of 5.9.  Her creatine kinase was 207 and
MB was 6.  Her troponin trended down over the next few hours.
The elevation was attributed to a troponin leak due to demand
ischemia, since the patient was tachycardic.

As noted above, a transthoracic echocardiogram done on
admission did not disclose evidence of vegetations.  The
transesophageal echocardiogram done on [**1-15**] also
showed no evidence of valvular vegetations.

A PA catheter was placed on [**1-10**].  Cardiac output was 7
and systemic vascular resistance was 640; consistent with a
septic picture.  The patient's blood pressure remained high
during her hospital stay.  Her blood pressure has been
treated with increasing doses of Lopressor and hydralazine as
well as amlodipine.  The patient will require further
medication adjustments for treatment of her elevated blood
pressure.

 4.  GASTROINTESTINAL ISSUES:  At the outside hospital there
was concern for ischemic colitis versus ulcerative colitis.
The patient was seen by the Gastroenterology Service.

A computed tomography of the abdomen done on [**1-9**]
disclosed thickening of the colonic wall.  A sigmoidoscopy on
the following day showed diffuse disease from the rectum to
the mid transverse colon.  There were both ulcerations and
erythema; consistent with an ulcerative colitis flare.

The patient was started on a course of intravenous
antibiotics; levofloxacin and Flagyl, and bowel rest.  The
patient was also treated with mezilamine enemas.  She was
started back on Asacol on [**1-20**].  The patient was also
maintained on a proton pump inhibitor during her hospital
stay.  Three stool samples were sent to the laboratory during
her hospitalization, and all were negative for Clostridium
difficile.

 5.  HEMATOLOGIC ISSUES:  The patient has a history of
chronic anemia.  During her hospital stay, she required a
total of 6 units of packed red blood cells.  In addition, she
required a transfusion of fresh frozen plasma to reverse her
coagulopathy on admission.  Her Coumadin was held during her
hospital stay.

The patient has been started on Epogen three times per week;
per the Renal Service.  She has also be maintained on
subcutaneous heparin for deep venous thrombosis prophylaxis.

 6.  RENAL SYSTEM:  The patient was followed by the Renal
Service during her hospital stay.  A 24-hour urine collection
was done which disclosed a creatinine clearance of 18.

The patient's renal dysfunction was attributed to diabetic
nephropathy and/or hypertensive nephrosclerosis.  The patient
has been treated with Phos-Lo and Amphojel.  The Renal
Service has noted that at the present time there was no
indication for hemodialysis.  The patient has maintained good
urine output and responded well to Lasix.  Her creatinine has
been stable.

 7.  ENDOCRINE SYSTEM:  The patient was maintained on an
insulin drip for maintenance of blood sugars of less than
120.  She was also administered levothyroxine for her
hypothyroidism.

 8.  NUTRITION ISSUES:  The patient was maintained on tube
feeds.  She is currently taking Nepro.

 9.  OPHTHALMOLOGIC ISSUES:  An ophthalmologic evaluation was
done to rule out endophthalmitis.  There was no evidence of
endophthalmitis.  There was evidence of moderate diabetic
retinopathy in both eyes.

10.  RHEUMATOLOGIC ISSUES:  The patient's allopurinol was
held during her hospital stay.

11.  NEUROLOGIC ISSUES:  As noted above, the patient was very
agitated on admission with change in mental status; requiring
intubation.  The patient takes Coumadin.  She has been
Coumadin since her stroke in [**2192**].  Coumadin was held during
her hospitalization in the Medical Intensive Care Unit.
Nortriptyline and Tegretol were also held.  The patient has
been administered Klonopin and as needed Haldol for her
agitation.

12.  ELECTROLYTES ISSUES:  The patient was noted to be
hyponatremic on [**1-19**] and [**1-20**].  Hyponatremia
was attributed to loss of free water with diuresis.  The
patient undergoing repletion with intravenous fluids.

As noted above, the remainder of this dictation will be
completed by the medical team that accepts the patient from
the Medical Intensive Care Unit




                DR [**First Name11 (Name Pattern1) **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **]



Dictated By:[**Last Name (NamePattern1) 5092**]
MEDQUIST36

D:  [**2196-1-20**]  16:08
T:  [**2196-1-20**]  16:18
JOB#:  [**Job Number 46040**]


Admission Date:  [**2196-1-9**]       Discharge Date: [**2196-1-26**]

Date of Birth:   [**2143-9-27**]       Sex:  F

Service:

                        ADDENDUM

HOSPITAL COURSE:  The patient was transferred from the MICU
to the Medicine Floor Service.  The patient's mental status
gradually cleared over the rest of her hospital stay as
sedatives that had been used during her MICU course were
weaned.  The patient became alert, oriented and responsive
and eventually was able to get out of bed to a chair and work
with physical therapy.

The patient took p.o. clear diet and otherwise gradually
improved but had not yet reached her baseline at the time of
discharge to rehabilitation.

Significant events during the rest of her hospital course:

The patient was diuresed for worsening pulmonary edema on
arrival on the floor.  The patient responded very well to
this diuresis, and since then, her breathing has continued to
improve, and she no longer requires oxygen supplementation.

Additionally, the patient's hypertension has gradually been
controlled with the addition of Clonidine, as well as
Captopril, and her Hydralazine has been stopped.  The
patient's chronic renal failure has stabilized.  The patient
had excellent urine output through the rest of her history of
admission.  She has been followed by the Renal Service, and
it has been determined that she no longer requires
hemodialysis at this time.

The patient was evaluated by the Psychiatry Service for
comments about wanting to die and wishing to die.  She was
evaluated and not felt to be acutely suicidal, and
recommendations were made to wean her sedative medications
which as been done.

The patient continues to get Haldol p.r.n. for agitation.
Her Klonopin dose is being weaned, and Compazine for nausea
has been discontinued at this time in favor of Haldol which
also works as an antiemetic.

The patient's electrolytes have been repleted periodically
during the rest of the patient's admission.  The patient had
hypernatremia when arriving from the MICU which was corrected
gradually over a period of three days with D5 boluses.

The patient finished a course of Fluconazole covering her
fungemia secondary to line infection as noted previously.
The patient also completed a course of Metronidazole and
Levaquin treating her ulcerative colitis flare.  The patient
continued to have chronic lower abdominal pain with mild
tenderness, which she reports has not changed from her
long-standing abdominal pain which she has had since long
before this admission.

The patient remained afebrile.  Her stool has been guaiac
negative.  There has been no other indications of recurrence
of her ulcerative colitis flare at this time.  The patient
did have several loose bowel movements, and stool samples for
C-diff are pending at this time.

DISCHARGE STATUS:  The patient is awaiting placement at a
rehabilitation facility, preferably in [**State **],
closer to where she is from.

DISCHARGE MEDICATIONS:  Pravastatin 40 mg p.o. q.d.,
Levothyroxine 175 mcg p.o. q.d., Albuterol/Ipratropium 1-2
puffs inhaled q.6 hours p.r.n., Nystatin all suspension 5 mg
p.o. q.i.d. p.r.n. swish and spit, Acetaminophen 325-650 mg
p.o. or p.r. q.4-6 hours p.r.n., Fluconazole powder 2% one
application t.i.d. p.r.n., Epoetin 4000 U subcue 3 times per
week, Monday, Wednesday and Friday, Lopressor 150 mg p.o.
t.i.d., Mesalamine DR 800 mg p.o. t.i.d., Amlodipine 10 mg
p.o. q.d., Clonidine HCL 0.1 mg p.o. t.i.d., Protonix 40 mg
p.o. q.d., Heparin 5000 U subcue t.i.d., Insulin sliding
scale, Insulin fixed dose of 70/30 20 U q.a.m., 5 U q.p.m.,
Clonazepam taper as follows on [**1-26**] she will take 1 mg
p.o. t.i.d., on [**1-27**] morning dose of 0.5 mg p.o.,
afternoon, evening doses of 1 mg p.o., on [**1-28**] she
will take morning and afternoon doses of 0.5 mg p.o. and an
evening dose of 1 mg p.o., [**1-29**] she will take 0.5 mg
p.o. t.i.d., [**1-30**] she will take 0.5 mg p.o. b.i.d., [**1-31**] she will take 0.5 mg p.o. q.d., and will then discontinue
Clonazepam, Haloperidol 0.5 mg IV q.4 hours p.r.n. agitation
and nausea.

DISCHARGE DIAGNOSIS:
1.  [**Female First Name (un) 564**] albicans fungemia secondary to line infection.
2.  Ulcerative colitis flare.
3.  Insulin-dependent diabetes mellitus.
4.  Hypertension.
5.  Chronic renal insufficiency.
6.  Hypothyroidism.
7.  Gout.
8.  Asthma.
9.  Coronary artery disease.
10. Status post cerebrovascular accident.
11. Status post hypoxic brain injury.






                            [**First Name8 (NamePattern2) 2946**] [**Last Name (NamePattern1) **], M.D.

Dictated By:[**Name8 (MD) 29946**]
MEDQUIST36

D:  [**2196-1-26**]  14:30
T:  [**2196-1-26**]  14:44
JOB#:  [**Job Number 46041**]


Name:  [**Known lastname **], [**Known firstname 4193**]                    Unit No:  [**Numeric Identifier 8468**]

Admission Date:  [**2196-1-9**]     Discharge Date:  [**2196-1-29**]

Date of Birth:   [**2143-9-27**]     Sex:  F

Service:  MEDICINE

ADDENDUM:  The following is an addendum covering the period
of [**2196-1-26**] to [**2196-1-29**].

HOSPITAL COURSE:  The patient's mental status continued to
clear as Clonazepam was tapered.  The patient has been much
more active and responding to physical therapy.  The patient
did have a fall out of bed attempting to stand on her own.  A
head CT was performed which was negative for intracranial
hemorrhage, fracture, or other injury.  The head CT did have
an incidental finding of suprasellar mass which could not be
further identified.

MRI/MRA of the head was attempted but the patient was unable
to cooperate and sedation was withheld due to the fact that
the patient was being weaned from sedatives and it was not
deemed necessary to give the patient further setbacks in
terms of her mental status by giving sedatives.  It was
recommended that MRI/MRA should be pursued within one week as
an outpatient when the patient is more cooperative and had
been further weaned off Clonazepam.  The patient may be
sedated for MRI/MRA if necessary.

The MRI/MRA would be to further identify the suprasellar mass
which was listed as possibly a meningioma but also possibly
an aneurysm.

During the hospital course, the patient's hypernatremia was
corrected with D5 water boluses.  Her free water deficit was
repleted.

ADDITIONAL DISCHARGE DIAGNOSIS:  Suprasellar mass, not
otherwise specified.

ADDITIONAL MEDICATIONS ON DISCHARGE:
1.  Captopril 37.5 mg p.o. t.i.d.
2.  Clonazepam taper; on [**2196-1-29**] was to receive 0.5 mg
Clonazepam t.i.d.; on [**2196-1-30**] was to receive 0.5 mg
Clonazepam b.i.d.; on [**2196-1-31**] to receive 0.5 mg Clonazepam
q.d., and to discharge Clonazepam entirely on [**2196-2-1**].
3.  Magnesium oxide 400 mg p.o. b.i.d. times one week.

DISCHARGE STATUS:  To nursing home/rehabilitation facility on
[**2196-1-29**].






Dictated By:[**Name8 (MD) 5633**]

MEDQUIST36

D:  [**2196-3-11**]  03:44
T:  [**2196-3-11**]  22:33
JOB#:  [**Job Number 8469**]
{'Infection and inflammatory reaction due to other vascular device, implant, and graft,Disseminated candidiasis,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Acute respiratory failure,Hyposmolality and/or hyponatremia,Acute kidney failure, unspecified,Ulcerative colitis, unspecified,Diabetes with neurological manifestations, type II or unspecified type, not stated as uncontrolled'}


You are an AI assistant analyzing clinical admission notes from the MIMIC III dataset. Your task is to map symptoms mentioned in the notes to a list of provided ICD-9 LONG_TEXT.



### Clinical text :
CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 52-year-old
female with a history of severe ulcerative colitis,
insulin-dependent diabetes mellitus, hypertension, and
chronic renal insufficiency (on dialysis).

MEDICAL HISTORY: 1.  Ulcerative colitis; the patient has been treated
successfully with Asacol in the past.
 2.  Insulin-dependent diabetes mellitus times 30 years; the
patient's illness is complicated by neuropathy, nephropathy,
and retinopathy.
 3.  Chronic renal insufficiency (on dialysis); dialysis was
started in the middle of [**Month (only) 404**] due to "fluid overload."
 4.  Hypertension.
 5.  Gout.
 6.  Status post cerebrovascular accident in [**2192**]; the
patient now on Coumadin.  Following her stroke, the patient
sustained a hypoxic brain injury.
 7.  Asthma.
 8.  Hypothyroidism.
 9.  Nephrolithiasis.
10.  Coronary artery disease; the patient noted to have
anterior wall ischemia on a stress test done in [**2195-1-2**].  Her ejection fraction was 66%.
11.  Status post hysterectomy.
12.  Status post appendectomy.
13.  Status post operations on kidneys for "stone disease."

MEDICATION ON ADMISSION: 

ALLERGIES: DEMEROL, DILAUDID, TALWIN, GENTAMICIN, and SHELL
FISH.

PHYSICAL EXAM: 

FAMILY HISTORY: Family history not elicited on admission due
to the patient's poor mental status.

SOCIAL HISTORY: The patient lives in [**Location (un) 3844**].  History
negative for tobacco, alcohol, and drugs.  The patient is a
former nurse.  She has three daughters. 

### Response:
{'Infection and inflammatory reaction due to other vascular device, implant, and graft,Disseminated candidiasis,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Acute respiratory failure,Hyposmolality and/or hyponatremia,Acute kidney failure, unspecified,Ulcerative colitis, unspecified,Diabetes with neurological manifestations, type II or unspecified type, not stated as uncontrolled'}
