CHIEF COMPLAINT: nausea, chills

PRESENT ILLNESS: [**Age over 90 **]F Russian speaking (poor historian) who went to bed at 10pm
yesterday with nausea and chills. No diarrhea/vomitting. She
awoke with cough, fever, and nausea was found soaked in urine
and feces. Son in [**Name2 (NI) 7349**] who is HCP but the pt lives alone here but
has vna 3 hrs/day. She was presumably sent to ED by her home
aids where she was found to have BP in 180s-190s, VS  158/72,
65, 24, 99%3L, CXR with retrocardiac density concerning for PNA.
She received [**Last Name (LF) 14990**], [**First Name3 (LF) **], BB and 750cc IVF. She had a new R
bundle and TW inversions on her EKG, cards was consulted and not
concerned, her 1st set CEs were negative. She was admitted to
medicine for further workup.
.
On the floor for 3 days, the pt was treated with antibiotics but
then developed AF with [**First Name3 (LF) 5509**] x2 (the first time converting back to
sinus rhythm after lopressor and dilt boluses). During the
second major [**First Name3 (LF) 5509**] episode the pt received dilt 10 IV x2, HR was
in fib in 90-100s, BPs went from 130 to 100-110 and pt required
face mask oxygenation (up from 4L NC). MICU was called given the
pt's full code status and her worsening oxygen requirement. CXR
at the time was at baseline, ABG showed pO2 64, CO2 35, pH 7.43.
She was transferred to the ICU where she was placed on metop 50
TID and converted spontaneously to sinus. She was diuresed with
20 and 10 IV lasix and put out net -1.2L. Now pt is doing well
on the floor on 2L NC and ready for transfer back to the floor.
Pt is reported to not have BM for last 5 days.
.
ROS:
(-) Denies night sweats, recent weight loss or gain. Denies
headache, sinus tenderness, rhinorrhea or congestion. Denied
chest pain or tightness, palpitations. Denied  vomiting,
diarrhea, constipation or abdominal pain. No recent change in
bowel or bladder habits. No dysuria. Denied arthralgias or
myalgias.

MEDICAL HISTORY: Gout
Hypercholesterolemia
hypertension
Colon CA
Mild LV systolic and diastolic dysfunction.
LVEF 40-45 (echo [**2136**]).
COPD
Depression
Psoriasis
Eosinophilia
Hyperlipid
Hypertension
Afib

MEDICATION ON ADMISSION: Metoprolol tartrate 12.5 b.i.d.
ECASA 325
Citalopram 20
colchicine 0.6
Voltaren gel p.r.n.
fluticasone spray
lactulose
lidocaine patch
SLTNG 0.4 p.r.n.
polyethylene glycol
acetaminophen
vitamin C
docusate 100
MVI one daily,
senna 8.6
vitamin A and D ointment.

ALLERGIES: Ampicillin / Cephalexin

PHYSICAL EXAM: Vitals: T:96.1 P:158/84 BP:68 R:24 SaO2:96 2L NC
General: Awake, alert, belabored breathing
HEENT: NC/AT, EOMI without nystagmus, no scleral icterus noted
Neck: supple, no JVD or carotid bruits appreciated
Pulmonary: b/l crackles and exp wheeze
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 and PT pulses
b/l.
Neurologic:
-mental status: follows commands, poor historian.
-motor/sensory: grossly intact

FAMILY HISTORY: No family history of early MI, otherwise non-contributory.

SOCIAL HISTORY: Lives at home. Has VNA services through [**Hospital6 1952**]
(nurse visits 2x per week, with personal care and cleaning
services daily). Son in [**Name2 (NI) **].  No tobacco or EtOH.
Pneumonia, organism unspecified,Acute on chronic combined systolic and diastolic heart failure,Atrial fibrillation,Gout, unspecified,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Coronary atherosclerosis of native coronary artery,Other and unspecified hyperlipidemia,Chronic airway obstruction, not elsewhere classified,Other psoriasis,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Urinary incontinence, unspecified,Depressive disorder, not elsewhere classified,Personal history of malignant neoplasm of large intestine,Chronic kidney disease, Stage III (moderate),Hypoxemia
Pneumonia, organism NOS,Ac/chr syst/dia hrt fail,Atrial fibrillation,Gout NOS,Hy kid NOS w cr kid I-IV,Crnry athrscl natve vssl,Hyperlipidemia NEC/NOS,Chr airway obstruct NEC,Other psoriasis,DMII wo cmp nt st uncntr,Urinary incontinence NOS,Depressive disorder NEC,Hx of colonic malignancy,Chr kidney dis stage III,Hypoxemia
Admission Date:  [**2139-3-8**]              Discharge Date:   [**2139-3-16**]


Service: MEDICINE

Allergies:
Ampicillin / Cephalexin

Attending:[**First Name3 (LF) 1070**]
Chief Complaint:
nausea, chills

Major Surgical or Invasive Procedure:
none


History of Present Illness:
[**Age over 90 **]F Russian speaking (poor historian) who went to bed at 10pm
yesterday with nausea and chills. No diarrhea/vomitting. She
awoke with cough, fever, and nausea was found soaked in urine
and feces. Son in [**Name2 (NI) 7349**] who is HCP but the pt lives alone here but
has vna 3 hrs/day. She was presumably sent to ED by her home
aids where she was found to have BP in 180s-190s, VS  158/72,
65, 24, 99%3L, CXR with retrocardiac density concerning for PNA.
She received [**Last Name (LF) 14990**], [**First Name3 (LF) **], BB and 750cc IVF. She had a new R
bundle and TW inversions on her EKG, cards was consulted and not
concerned, her 1st set CEs were negative. She was admitted to
medicine for further workup.
.
On the floor for 3 days, the pt was treated with antibiotics but
then developed AF with [**First Name3 (LF) 5509**] x2 (the first time converting back to
sinus rhythm after lopressor and dilt boluses). During the
second major [**First Name3 (LF) 5509**] episode the pt received dilt 10 IV x2, HR was
in fib in 90-100s, BPs went from 130 to 100-110 and pt required
face mask oxygenation (up from 4L NC). MICU was called given the
pt's full code status and her worsening oxygen requirement. CXR
at the time was at baseline, ABG showed pO2 64, CO2 35, pH 7.43.
She was transferred to the ICU where she was placed on metop 50
TID and converted spontaneously to sinus. She was diuresed with
20 and 10 IV lasix and put out net -1.2L. Now pt is doing well
on the floor on 2L NC and ready for transfer back to the floor.
Pt is reported to not have BM for last 5 days.
.
ROS:
(-) Denies night sweats, recent weight loss or gain. Denies
headache, sinus tenderness, rhinorrhea or congestion. Denied
chest pain or tightness, palpitations. Denied  vomiting,
diarrhea, constipation or abdominal pain. No recent change in
bowel or bladder habits. No dysuria. Denied arthralgias or
myalgias.

Past Medical History:
Gout
Hypercholesterolemia
hypertension
Colon CA
Mild LV systolic and diastolic dysfunction.
LVEF 40-45 (echo [**2136**]).
COPD
Depression
Psoriasis
Eosinophilia
Hyperlipid
Hypertension
Afib

Social History:
Lives at home. Has VNA services through [**Hospital6 1952**]
(nurse visits 2x per week, with personal care and cleaning
services daily). Son in [**Name2 (NI) **].  No tobacco or EtOH.


Family History:
No family history of early MI, otherwise non-contributory.


Physical Exam:
Vitals: T:96.1 P:158/84 BP:68 R:24 SaO2:96 2L NC
General: Awake, alert, belabored breathing
HEENT: NC/AT, EOMI without nystagmus, no scleral icterus noted
Neck: supple, no JVD or carotid bruits appreciated
Pulmonary: b/l crackles and exp wheeze
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 and PT pulses
b/l.
Neurologic:
-mental status: follows commands, poor historian.
-motor/sensory: grossly intact

Pertinent Results:
[**2139-3-13**] 06:30AM BLOOD WBC-7.1 RBC-4.11* Hgb-11.7* Hct-36.2
MCV-88 MCH-28.4 MCHC-32.3 RDW-14.7 Plt Ct-161
[**2139-3-10**] 07:13AM BLOOD WBC-8.1 RBC-4.02* Hgb-11.5* Hct-35.0*
MCV-87 MCH-28.6 MCHC-32.8 RDW-15.0 Plt Ct-132*
[**2139-3-8**] 03:38PM BLOOD WBC-10.5 RBC-4.74 Hgb-13.8# Hct-41.4
MCV-87 MCH-29.1 MCHC-33.3 RDW-15.1 Plt Ct-132*
[**2139-3-12**] 03:57AM BLOOD Neuts-72.8* Lymphs-13.0* Monos-4.7
Eos-9.1* Baso-0.4
[**2139-3-12**] 03:57AM BLOOD PT-12.1 PTT-29.4 INR(PT)-1.0
[**2139-3-8**] 05:25PM BLOOD PT-13.0 PTT-24.6 INR(PT)-1.1
[**2139-3-13**] 06:30AM BLOOD Glucose-100 UreaN-54* Creat-1.7* Na-140
K-4.9 Cl-106 HCO3-24 AnGap-15
[**2139-3-12**] 03:57AM BLOOD Glucose-103* UreaN-56* Creat-1.9* Na-137
K-4.6 Cl-104 HCO3-24 AnGap-14
[**2139-3-9**] 06:10AM BLOOD Glucose-108* UreaN-31* Creat-1.7* Na-138
K-4.5 Cl-106 HCO3-18* AnGap-19
[**2139-3-10**] 07:13AM BLOOD CK(CPK)-230*
[**2139-3-9**] 06:10AM BLOOD ALT-9 CK(CPK)-85
[**2139-3-8**] 05:25PM BLOOD CK(CPK)-29
[**2139-3-9**] 06:10AM BLOOD CK-MB-NotDone cTropnT-0.02*
[**2139-3-8**] 05:25PM BLOOD cTropnT-0.03*
[**2139-3-13**] 06:30AM BLOOD Calcium-9.0 Phos-3.2 Mg-2.3
[**2139-3-9**] 06:10AM BLOOD Calcium-9.2 Phos-3.0 Mg-1.7
[**2139-3-8**] 03:53PM BLOOD Glucose-138* Lactate-2.8* Na-146 K-4.9
Cl-107 calHCO3-20*
[**2139-3-11**] 09:58AM BLOOD Type-ART pO2-64* pCO2-35 pH-7.43
calTCO2-24 Base XS-0 Intubat-NOT INTUBA
[**2139-3-8**] 04:00PM URINE Color-Straw Appear-Clear Sp [**Last Name (un) **]-1.016
[**2139-3-8**] 04:00PM URINE Blood-NEG Nitrite-NEG Protein-25
Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-NEG pH-5.0 Leuks-NEG
[**2139-3-8**] 04:00PM URINE RBC-0-2 WBC-0-2 Bacteri-FEW Yeast-NONE
Epi-0-2
[**2139-3-8**] 04:00PM URINE CastGr-0-2 CastHy-0-2
.
.
[**2139-3-8**] URINE URINE CULTURE-FINAL INPATIENT
[**2139-3-8**] BLOOD CULTURE Blood Culture, Routine-PENDING
EMERGENCY [**Hospital1 **] - negative
.
[**2139-3-8**] CXR: Interval worsening of right perihilar opacification
since [**2138-10-31**] that is worrisome for pneumonia. CT can help in
further delineating this region though given stated demographic,
alternatively, repeat radiograph status post appropriate
treatment can be obtained to evaluate for resolution and help
exclude an underlying mass.
.
[**2139-3-10**] CXR: Slight improvement in right perihilar opacity.
Recommend CT to rule out underlying mass/obstruction.
.
[**2139-3-15**] CXR: IMPRESSION: Persistent right lower lobe
consolidation suggestive of pneumonia with accompanying pleural
effusion. New left lower lobe opacity favoring atelectasis.


Brief Hospital Course:
[**Age over 90 **]F Russian speaking (poor historian) who p/w nausea and chills
and resp distress with infiltrate concern for PNA.
.
# PNA: on admission had new O2 req of 3L, retrocardiac opacity
on CXR, concerning for community acquired PNA. WBC slightly
elevated with 90% PMNs. UCx neg. sputum cannot be produced. The
pt was treated with [**Age over 90 14990**] renally dosed and
tylenol/guaifenesin/tessylon as needed for cough. She was also
given nebs prn shortness of breath. Her breathing slowly
improved but her lung sounds continued to be rhonchorous. She
likely also has some component of upper airway obstruction and
perhaps OSA. She was discharged on [**Age over 90 14990**] to be completed for
a total of 10 days. Of note, the original CXR for the pt
suggested that rpt imaging after resolution might be useful to
r/o possible malignancy but this was not seen in rpt CXR. In the
past, she has refused w/u of breast mass and other outpt
findings. If pt fails to improve in future, rpt imaging or
consultation with PCP [**Last Name (NamePattern4) **]. [**Last Name (STitle) **] to talk about rpt imaging
could be considered.
.
# Afib: Per report the pt has a h/o PAfib but on admission she
was in NSR on 12.5 [**Hospital1 **] of metoprolol. During her stay she
triggered three times for AF with [**Hospital1 5509**] up to 140s which responded
to boluses of IV dilt 10mg. She was also increased to 50 TID
metoprolol and spontaneously converted back to sinus with HR in
60s. Due to one of her episodes of [**Hospital1 5509**] she went into flash
pulmonary edema and required transfer to the ICU for diuresis
and potential cardioversion (although pt converted spontaneously
to sinus). She was called out of the ICU after one day when she
was breathing on 2L. She is discharged to a facility for tele
monitoring. She was kept on her home aspirin 325. If the pt has
an episode of [**Last Name (LF) 5509**], [**First Name3 (LF) **] her cardiologist it was recommended to
not start amiodarone or dronedarone due to its high risks. She
may start PO dilt on top of her metoprolol if needed but it
would be most ideal to simply titrate up her metoprolol (at
37.5mg TID on dicharge).
.
# CAD/CHF: Pt not on lasix at home. EF 40-45. Pt did not have
any CP and there was low concern for ACS although new RBBB and
TWIs. She ruled out for MI with cardiac enzymes x3. As noted
above, if the pt goes into [**First Name3 (LF) 5509**] she is prone to flash pulmonary
edema given her poor EF at baseline. She responds to IV lasix
10-20 mg boluses as she is relatively lasix naive.
.
# Gout: stable without flare this admission. We held her home
colchicine 0.6 in acute setting. We treated with tylenol prn.
.
# CKD: pt is discharged within her baseline of 1.7-2.0
.
# Social: Found in feces/urine at home. Concern for elder abuse
or poor social situation. Son is in NY and is HCP. [**Name (NI) **] is not
involved in care as his wife and the pt do not get along. SW
visited pt and did not find any concerns for elder abuse at this
time.
.
# Depression: stable. we continued home celexa.
.
# Contact: son [**Name (NI) **] (HCP) [**Numeric Identifier 108536**]
#) Code Status: Full (confirmed with pt and son this admission)

.


Medications on Admission:
Metoprolol tartrate 12.5 b.i.d.
ECASA 325
Citalopram 20
colchicine 0.6
Voltaren gel p.r.n.
fluticasone spray
lactulose
lidocaine patch
SLTNG 0.4 p.r.n.
polyethylene glycol
acetaminophen
vitamin C
docusate 100
MVI one daily,
senna 8.6
vitamin A and D ointment.

Discharge Medications:
1. Levofloxacin 500 mg Tablet Sig: 1.5 Tablets PO Q48H (every 48
hours): Stop date [**2139-3-22**].
2. Aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO DAILY (Daily).
3. Citalopram 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

4. Multivitamin     Tablet Sig: One (1) Tablet PO DAILY (Daily).

5. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO BID (2
times a day).
6. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day) as needed for constipation.
7. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
8. Guaifenesin 100 mg/5 mL Syrup Sig: Ten (10) ML PO Q6H (every
6 hours) as needed for cough.
9. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every
6 hours) as needed for pain, fever.
10. Ipratropium Bromide 0.02 % Solution Sig: One (1)  Inhalation
Q6H (every 6 hours) as needed for sob, wheeze.
11. Benzonatate 100 mg Capsule Sig: One (1) Capsule PO TID (3
times a day).
12. Miconazole Nitrate 2 % Powder Sig: One (1) Appl Topical PRN
(as needed) as needed for rash.
13. Metoprolol Tartrate 25 mg Tablet Sig: 1.5 Tablets PO TID (3
times a day).


Discharge Disposition:
Extended Care

Facility:
[**Hospital3 105**] - [**Location (un) 86**]

Discharge Diagnosis:
Primary:
Community acquired pneumonia
Paroxysmal atrial fibrillation with rapid ventricular response
.
Secondary:
HTN
Chronic CHF
COPD


Discharge Condition:
Mental Status: Clear and coherent
Level of Consciousness: Alert and interactive
Activity Status: Out of Bed with assistance to chair or
wheelchair


Discharge Instructions:
You were admitted due to a pneumonia. You were initially treated
with antibiotics. You suffered from some episodes of a fast
heart rate called atrial fibrillation which we were able to
control with medications. You were in the ICU for one day due to
this leading to fluid build up in your lungs which was removed
with diuretics. When you returned to the medical floor your
breathing was improved and you were working with physical
therapy. Your heart rate has been in control as well. Please
take levofloxacin as prescribed for your pneumonia. Please take
metoprolol 37.5mg three times a day for control of your heart
rate. Please take guaifenesin and benzonatate as needed for
cough and nebulizers as needed for shortness of breath. There
were no other changes to your medications.
.
Please take all medications as prescribed.
Please follow up with all appointments
Please do not hesitate to return to the hospital if you have any
concerning symptoms at all.
Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight goes up more
than 3 lbs.

Followup Instructions:
Please follow up with your primary care provider upon discharge.


Please follow up with the following providers:
Cardiology: [**Name6 (MD) **] [**Last Name (NamePattern4) 1401**], M.D. Phone:[**Telephone/Fax (1) 62**]
Date/Time:[**2139-4-16**] 1:20
Optometry: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 14290**], OD Phone:[**Telephone/Fax (1) 253**] Date/Time:[**2139-4-24**]
1:00
Primary Care: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 2967**], [**Last Name (NamePattern1) 280**] Phone:[**Telephone/Fax (1) 250**]
Date/Time:[**2139-5-14**] 1:50



Completed by:[**2139-3-16**]
{'Pneumonia, organism unspecified,Acute on chronic combined systolic and diastolic heart failure,Atrial fibrillation,Gout, unspecified,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Coronary atherosclerosis of native coronary artery,Other and unspecified hyperlipidemia,Chronic airway obstruction, not elsewhere classified,Other psoriasis,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Urinary incontinence, unspecified,Depressive disorder, not elsewhere classified,Personal history of malignant neoplasm of large intestine,Chronic kidney disease, Stage III (moderate),Hypoxemia'}


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: nausea, chills

PRESENT ILLNESS: [**Age over 90 **]F Russian speaking (poor historian) who went to bed at 10pm
yesterday with nausea and chills. No diarrhea/vomitting. She
awoke with cough, fever, and nausea was found soaked in urine
and feces. Son in [**Name2 (NI) 7349**] who is HCP but the pt lives alone here but
has vna 3 hrs/day. She was presumably sent to ED by her home
aids where she was found to have BP in 180s-190s, VS  158/72,
65, 24, 99%3L, CXR with retrocardiac density concerning for PNA.
She received [**Last Name (LF) 14990**], [**First Name3 (LF) **], BB and 750cc IVF. She had a new R
bundle and TW inversions on her EKG, cards was consulted and not
concerned, her 1st set CEs were negative. She was admitted to
medicine for further workup.
.
On the floor for 3 days, the pt was treated with antibiotics but
then developed AF with [**First Name3 (LF) 5509**] x2 (the first time converting back to
sinus rhythm after lopressor and dilt boluses). During the
second major [**First Name3 (LF) 5509**] episode the pt received dilt 10 IV x2, HR was
in fib in 90-100s, BPs went from 130 to 100-110 and pt required
face mask oxygenation (up from 4L NC). MICU was called given the
pt's full code status and her worsening oxygen requirement. CXR
at the time was at baseline, ABG showed pO2 64, CO2 35, pH 7.43.
She was transferred to the ICU where she was placed on metop 50
TID and converted spontaneously to sinus. She was diuresed with
20 and 10 IV lasix and put out net -1.2L. Now pt is doing well
on the floor on 2L NC and ready for transfer back to the floor.
Pt is reported to not have BM for last 5 days.
.
ROS:
(-) Denies night sweats, recent weight loss or gain. Denies
headache, sinus tenderness, rhinorrhea or congestion. Denied
chest pain or tightness, palpitations. Denied  vomiting,
diarrhea, constipation or abdominal pain. No recent change in
bowel or bladder habits. No dysuria. Denied arthralgias or
myalgias.

MEDICAL HISTORY: Gout
Hypercholesterolemia
hypertension
Colon CA
Mild LV systolic and diastolic dysfunction.
LVEF 40-45 (echo [**2136**]).
COPD
Depression
Psoriasis
Eosinophilia
Hyperlipid
Hypertension
Afib

MEDICATION ON ADMISSION: Metoprolol tartrate 12.5 b.i.d.
ECASA 325
Citalopram 20
colchicine 0.6
Voltaren gel p.r.n.
fluticasone spray
lactulose
lidocaine patch
SLTNG 0.4 p.r.n.
polyethylene glycol
acetaminophen
vitamin C
docusate 100
MVI one daily,
senna 8.6
vitamin A and D ointment.

ALLERGIES: Ampicillin / Cephalexin

PHYSICAL EXAM: Vitals: T:96.1 P:158/84 BP:68 R:24 SaO2:96 2L NC
General: Awake, alert, belabored breathing
HEENT: NC/AT, EOMI without nystagmus, no scleral icterus noted
Neck: supple, no JVD or carotid bruits appreciated
Pulmonary: b/l crackles and exp wheeze
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 and PT pulses
b/l.
Neurologic:
-mental status: follows commands, poor historian.
-motor/sensory: grossly intact

FAMILY HISTORY: No family history of early MI, otherwise non-contributory.

SOCIAL HISTORY: Lives at home. Has VNA services through [**Hospital6 1952**]
(nurse visits 2x per week, with personal care and cleaning
services daily). Son in [**Name2 (NI) **].  No tobacco or EtOH. 

### Response:
{'Pneumonia, organism unspecified,Acute on chronic combined systolic and diastolic heart failure,Atrial fibrillation,Gout, unspecified,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Coronary atherosclerosis of native coronary artery,Other and unspecified hyperlipidemia,Chronic airway obstruction, not elsewhere classified,Other psoriasis,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Urinary incontinence, unspecified,Depressive disorder, not elsewhere classified,Personal history of malignant neoplasm of large intestine,Chronic kidney disease, Stage III (moderate),Hypoxemia'}
