CHIEF COMPLAINT: PCP: [**First Name4 (NamePattern1) 1060**] [**Last Name (NamePattern1) 21883**], MD
.
CHIEF COMPLAINT: s/p mechanical fall
REASON FOR MICU ADMISSION: GI bleed

PRESENT ILLNESS: Ms. [**Known lastname **] is an 84 y.o. F with h/o falls, atrial
fibrillation on coumadin, chronic kidney disease stage IV, HTN,
and T2 DM, who presents s/p mechanical fall day prior to
admission. Pt fell down 1 step and slid down to her knees as she
was holding on to the door. Denied neck and back pain. Denies
loss of consciousness. She was ambulatory after the fall and
drove herself home, but the pain increased this AM in her left
knee. She complained of bilateral knee pain, L > R, and thus,
presented to the ED. She has noted darker colored stools for the
last 1-2 months, but denies BRBPR, hemorrhoids. Has 1 BM per
day. Denies lightheadedness, dizziness. Last colonoscopy > 10
years ago and reportedly negative.
.
In the ED, initial VS: T 97.5 HR 109 BP 162/62 RR 16 O2 100%RA.
VS in ED: 134-162/44-60, HR 88-109. Labs drawn, significant for
Hct 22 and INR 4.3. Knee X-rays and EKG performed. Rectal
performed by GI showed reddish tinged, dark brown, guiaic
positive. NG lavage negative. GI consulted. Pt given
oxycodone-acetaminophen 5/325 po x 1, pantoprazole 40 mg IV x 1,
Vitamin K 10 mg IV x 1, 2 L NS. Active T&S. Ordered for 2pRBC,
not hung. 2 large bore PIVs placed. Physical Therapy consulted
in ED and recommended home with PT.
.
Currently, she has L > R knee pain, [**6-22**], aching.
.
ROS: Denies fever, chills, cough, shortness of breath, chest
pain, abdominal pain, nausea, vomiting, diarrhea, constipation,
BRBPR, melena, hematochezia, dysuria, hematuria. + dark stools

MEDICAL HISTORY: - Type 2 Diabetes Mellitus
- Atrial Fibrillation on Coumadin
- Hypertension
- Hyperlipidemia
- Pulmonary arterial hypertension
- Chronic kidney disease
- Anemia
- Hyperparathyroidism s/p parathyroidectomy [**6-21**]
- Pelvic fracture lateral compression type I and a left proximal

MEDICATION ON ADMISSION: Atorvastatin 20 mg po daily
Digoxin 125 mcg po daily
Folic acid 1 mg po daily
Lasix 60 mg po daily
Hydralazine 67.5 mg po BID
Hydralazine 50 mg po qhs
Humalog 75-25 - 25 units q AM, 40 units q PM
Nifedipine ER 60 mg po daily
Propanolol SR 80 mg po daily
Valsartan 320 mg po daily
Coumadin 2.5 mg po daily or directed by [**Hospital **] Clinic
Calcium carbonate 1000 mg po QID
Tylenol OTC

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Vitals - T: 96.6 BP: 151/41 HR: 102 RR: [**9-28**] 02 sat: 96% RA
GENERAL: pleaseant, elderly female in NAD
HEENT: EOMI, anicteric, conjunctivae pink, MMM, no cervical LAD

FAMILY HISTORY: Her mother had hypertension, died at 89. Her father had lung
cancer, died at 74. Denies colon cancer, colon polyps in family.

SOCIAL HISTORY: She never smoked. Last drink [**2-14**] glass of wine 1 week ago. Lives
with sister, walks on her own.
Hemorrhage of gastrointestinal tract, unspecified,Acute kidney failure, unspecified,Chronic kidney disease, Stage IV (severe),Acute posthemorrhagic anemia,Secondary hyperparathyroidism (of renal origin),Accidental fall on or from other stairs or steps,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Atrial fibrillation,Long-term (current) use of anticoagulants,Other chronic pulmonary heart diseases,Other and unspecified hyperlipidemia,Benign neoplasm of colon,Abnormal coagulation profile,Anticoagulants causing adverse effects in therapeutic use,Diverticulosis of colon (without mention of hemorrhage),Osteoarthrosis, localized, not specified whether primary or secondary, lower leg,Diabetes with other specified manifestations, type II or unspecified type, uncontrolled,Contusion of knee
Gastrointest hemorr NOS,Acute kidney failure NOS,Chr kidney dis stage IV,Ac posthemorrhag anemia,Sec hyperparathyrd-renal,Fall on stair/step NEC,Hy kid NOS w cr kid I-IV,Atrial fibrillation,Long-term use anticoagul,Chr pulmon heart dis NEC,Hyperlipidemia NEC/NOS,Benign neoplasm lg bowel,Abnrml coagultion prfile,Adv eff anticoagulants,Dvrtclo colon w/o hmrhg,Loc osteoarth NOS-l/leg,DMII oth uncntrld,Contusion of knee
Admission Date:  [**2138-11-14**]              Discharge Date:   [**2138-11-20**]

Date of Birth:  [**2054-4-12**]             Sex:   F

Service: MEDICINE

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 9454**]
Chief Complaint:
PCP: [**First Name4 (NamePattern1) 1060**] [**Last Name (NamePattern1) 21883**], MD
.
CHIEF COMPLAINT: s/p mechanical fall
REASON FOR MICU ADMISSION: GI bleed


Major Surgical or Invasive Procedure:
EGD and colonoscopy on [**2138-11-17**]


History of Present Illness:
Ms. [**Known lastname **] is an 84 y.o. F with h/o falls, atrial
fibrillation on coumadin, chronic kidney disease stage IV, HTN,
and T2 DM, who presents s/p mechanical fall day prior to
admission. Pt fell down 1 step and slid down to her knees as she
was holding on to the door. Denied neck and back pain. Denies
loss of consciousness. She was ambulatory after the fall and
drove herself home, but the pain increased this AM in her left
knee. She complained of bilateral knee pain, L > R, and thus,
presented to the ED. She has noted darker colored stools for the
last 1-2 months, but denies BRBPR, hemorrhoids. Has 1 BM per
day. Denies lightheadedness, dizziness. Last colonoscopy > 10
years ago and reportedly negative.
.
In the ED, initial VS: T 97.5 HR 109 BP 162/62 RR 16 O2 100%RA.
VS in ED: 134-162/44-60, HR 88-109. Labs drawn, significant for
Hct 22 and INR 4.3. Knee X-rays and EKG performed. Rectal
performed by GI showed reddish tinged, dark brown, guiaic
positive. NG lavage negative. GI consulted. Pt given
oxycodone-acetaminophen 5/325 po x 1, pantoprazole 40 mg IV x 1,
Vitamin K 10 mg IV x 1, 2 L NS. Active T&S. Ordered for 2pRBC,
not hung. 2 large bore PIVs placed. Physical Therapy consulted
in ED and recommended home with PT.
.
Currently, she has L > R knee pain, [**6-22**], aching.
.
ROS: Denies fever, chills, cough, shortness of breath, chest
pain, abdominal pain, nausea, vomiting, diarrhea, constipation,
BRBPR, melena, hematochezia, dysuria, hematuria. + dark stools


Past Medical History:
- Type 2 Diabetes Mellitus
- Atrial Fibrillation on Coumadin
- Hypertension
- Hyperlipidemia
- Pulmonary arterial hypertension
- Chronic kidney disease
- Anemia
- Hyperparathyroidism s/p parathyroidectomy [**6-21**]
- Pelvic fracture lateral compression type I and a left proximal

humerus fracture [**10-21**]
- s/p Hysterectomy


Social History:
She never smoked. Last drink [**2-14**] glass of wine 1 week ago. Lives
with sister, walks on her own.

Family History:
Her mother had hypertension, died at 89. Her father had lung
cancer, died at 74. Denies colon cancer, colon polyps in family.


Physical Exam:
Vitals - T: 96.6 BP: 151/41 HR: 102 RR: [**9-28**] 02 sat: 96% RA
GENERAL: pleaseant, elderly female in NAD
HEENT: EOMI, anicteric, conjunctivae pink, MMM, no cervical LAD

CARDIAC: irreg irreg, no m/r/g
LUNG: CTAB, no w/r/r
ABDOMEN: NDNT, soft, 2 ecchymoses 3x3 cm on R mid abdomen and L
mid abdomen, NABS
EXT: no c/c/e, 2+ DP, L knee with inner ecchymoses and
ballotable swelling, R knees with ballotable swelling
NEURO: A&O x 3
DERM: no rashes


Pertinent Results:
Labs on admission:
LABS:
WBC 9.6
h/h 8.6/25 --> s/p 2U PRBC's
plts 228
INR currently 1.5 <-- 4.3 on presentation
Chems significant for glucose 53, BUN/Cr 106/3.6
.
B12 normal
.
Iron 58 (30-160)
TIBC 242 (260-470)
Ferritin 430 (13-150)
Transferrin 186 (200-360)
.
UA with negative blood, negative nitrites Lg LE, 168 WBC's, mod
bacteria, however was asymptomatic
.
By discharge
Hct had stabilized in the high 24's.
WBC 5.8
Plts 179

INR had decreased to 1.2
BUN/Cr was within baseline 63/2.8
Digoxin level normal 0.8

MICROBIOLOGY: None.

BILATERAL KNEE XRAYS (WET READ): No acute fracture or
dislocation. Unchanged calcinosis in bilateral compartment.
Subchondral cyst in superior pole of patella. Vascular
calcifications again noted. No large joint effusions.
.
[**2138-11-17**] GI Bx's
Colonic polypectomies:

A.  Hepatic flexure:

Adenoma.

B.  Transverse, polyp:

Sessile serrated adenoma.


Brief Hospital Course:
84 y.o. F with h/o falls, atrial fibrillation on coumadin,
chronic kidney disease, HTN, and T2 DM, who presents s/p
mechanical fall day prior to admission, incidentally found to
have worsening anemia with guiaic + stools in setting of
supratherapeutic INR.

1. GIB: Given negative NG lavage, guiaic positive reddish brown
stools on rectal, likely lower GI bleed; however, may also be
oozing from upper GI tract given supratherapeutic INR of 4.3.
Hemodynamically stable in ED. Pt received vitamin K IV 10 mg x 1
in ED. Patient received a total of 3U PRBC's. Hct remained
stable for >48 hours in the high 24's by the time of discharge.
No gross bleeding was seen after admission, no worrisome changes
in vitals signs. On [**2138-11-17**] the pt went for EGD/colonoscopy
which showed diverticuloses in colon and two polyps which were
removed with pathology as above. The prep was considered limited
and GI recommended a repeat colonoscopy for further evaluation
as well as a capsule endoscopy to evaluate the small bowel in
the near future. These procedures were deferred to the outpt
setting, and will need to be followed up on by the pt's PCP.

2. S/p mechanical fall--Pt had plain films showing no fracture.
She did have large effusions on the medial aspect of her
chronically arthritic knees. Pain was only an occasional
complaint during admission and was relieved with small amts of
narcotics, lidocaine patches, and Tylenol. Physical therapy came
to work with her both while she was in the unit, at which time
they cleared her for home with PT services, and also while she
on the floor, at which time they recommended the same. The pt
was seen to be ambulating the halls with a walker and able to
climb stairs without difficulty.

3. HTN--All HTN meds were held on admission. Subsequently
Propanolol and Valsartan were added back. However, other bp meds
Lasix, Hydralazine, and Nifedipine continued to be held and this
will need to be addressed by PCP. [**Name10 (NameIs) **] was ranging between
120-150 on the day of discharge.

4. Type 2 DM: Pt was seen to have 2 episodes of symptomatic
hypoglycemia which resolved with juice and crackers. Her insulin
regimen was made less aggressive on admission to the floor with
an regimen of NPH [**12-2**] in the am/pm and sliding scale insulin
as well. She felt that she was not eating as much as she does at
home. After this change she did not have any more episodes of
hypoglycemia. On discharge, we lowered her home regimen of
Humalog 75/25 from its original dose of 25/40 in the am/pm to a
lower dose of 15/30 in the am/pm. She stated she checks her
finger sticks often and would continue to do so until follow up.
This is another aspect of her care that will need to be followed
in the outpt setting.

5. [**Name (NI) 100757**] pt was maintained on Digoxin. A level was measured
at 0.8. Rate was also controlled with Propanolol which was added
back when her Hct was stable and it was clear she was not
bleeding. The patient had excellent heart rate control and no
episodes of RVR while admitted.

The pt's Coumadin was also held in the setting of active
bleeding, and was not restarted while admitted. Her INR was 4.3
on admission and 1.2 by discharge. This is another issue that
will need to be addressed by pt's PCP. [**Name10 (NameIs) **] has a high risk for
stroke according to CHADS2 and will likely need to be restarted,
however as was discussed, she also has a h/o falls. Therefore
risks/benefits will need to be weighed when restarting
anticoagulation. Currently the risks of a recurrent GIB and fall
appear to outweight the risk of stroke. This was discussed with
the patient and the patient agreed with the management.

6. [**Name (NI) 94062**] pt was seen to be chronically anemic, with a
picture consistent with anemia of chronic disease and was given
a dose of erythropoietin on the advice of her nephrologist. She
was NOT given a prescription for this on discharge and this will
need to be followed up, likely by her nephrologist or PCP.

7. Acute on Chronic Renal [**Name (NI) 94059**] pt's Cr on transfer from
the ICU was within limits of her baseline and by discharge was
also within limits of baseline. This was not an acute issue
while on the floor.

8. Hyperlipidemia--Continued home atorvastatin.

9. Hyperparathyroidism--Followed by Dr. [**Last Name (STitle) 13059**] at [**Hospital1 18**].
Continued Calcium and Vitamin D supplementation

# CODE: DNR/DNI  (confirmed with patient)

IN CONCLUSION: For the outpt provider, [**Name10 (NameIs) **] are several
considerations after discharge.
1. We stopped her Coumadin in the setting of bleed, she has high
CHADS2 and will likely need to be restarted soon, but with the
understanding that she has now had at least 2 falls.
2. She had a GI bleed and her Hct was stable on d/c, please
check a Hct and make sure it is steady.
3. We have her back on 3 of her 5 home HTN meds (Valsartan and
Propanolol) but Lasix, Nifedipine, and Hydralazine were not
added back, please check her bp.
4. We changed her original insulin regimen as above to a less
aggressive regimen. Please follow up her finger sticks and
adjust accordingly.
5. She received Epogen while in house, may want to consider
continuing


Medications on Admission:
Atorvastatin 20 mg po daily
Digoxin 125 mcg po daily
Folic acid 1 mg po daily
Lasix 60 mg po daily
Hydralazine 67.5 mg po BID
Hydralazine 50 mg po qhs
Humalog 75-25 - 25 units q AM, 40 units q PM
Nifedipine ER 60 mg po daily
Propanolol SR 80 mg po daily
Valsartan 320 mg po daily
Coumadin 2.5 mg po daily or directed by [**Hospital **] Clinic
Calcium carbonate 1000 mg po QID
Tylenol OTC


Discharge Medications:
1. Atorvastatin 20 mg Tablet Sig: One (1) Tablet PO HS (at
bedtime).
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. Insulin Lispro Protam & Lispro 100 unit/mL (75-25) Suspension
Sig: One (1) injection Subcutaneous twice a day: Take 15U every
morning and 30U every evening.
5. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1)
Tablet, Chewable PO TID (3 times a day).
6. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One
(1) Tablet, Delayed Release (E.C.) PO twice a day.
Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*5*
7. Propranolol 80 mg Capsule, Sust. Release 24 hr Sig: One (1)
Capsule, Sust. Release 24 hr PO once a day.
8. Valsartan 160 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily).

9. Epoetin Alfa 4,000 unit/mL Solution Sig: One (1) dose
Injection QMOWEFR (Monday -Wednesday-Friday).
10. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: Two (2)
Tablet PO BID (2 times a day).
Disp:*60 Tablet(s)* Refills:*2*


Discharge Disposition:
Home With Service

Facility:
CareGroup

Discharge Diagnosis:
Anemia due to acute blood loss, likely from GI tract
Trauma to knees due to mechanical fall without loss of
consciousness
AFib
Hypertension
Chronic Renal Insufficiency
Diabetes type 2
Hyperlipidemia


Discharge Condition:
By the time of discharge, the pt's Hct was stable, was not
losing blood from any source, vital signs were stable, pt was
taking good PO food and liquids, was ambulating with a walker,
and was medically clear for discharge.


Discharge Instructions:
You were admitted to [**Hospital1 18**] after a fall in which you injured
your knees. During your evaluation you were noted to have a drop
in your blood level and were also noted to have blood coming
from your GI tract. You were admitted to the intensive care unit
and given some blood products. After you stabilized, you
underwent a procedure to visualize your GI tract. The bowel prep
was poor and your GI tract was not properly visualized, however
your colon was seen to have diverticuli and also several polyps
were removed. The GI doctors [**Name5 (PTitle) 2985**] a repeat colonoscopy with a
better prep was warranted in the future.

CHANGES TO YOUR MEDICATIONS:
1. While you were admitted, your anticoagulation medicine
Coumadin was held because it can aggravate bleeding problems.
2. [**Name2 (NI) **] of your blood pressure meds were also held due to
concern of low blood pressures. You were kept on Digoxin,
Propanolol, and Valsartan, but Lasix, Hydralazine, and
Nifedipine were all held. You will need to follow up with your
primary care physician (PCP) to asssess your blood pressure and
whether you need to restart these meds.
3. Your insulin regimen was also made less aggressive as it was
seen that your blood sugars were occasionally too low. After
discharge, you should temporarily lower your insulin regimen to
Humalog Mix 75/25 --> 15 units in the morning and 30 units in
the evening. You should continue to monitor your blood sugars
and follow up with your PCP to evaluate your sugars--they may
need to be increased or decreased accordingly.
4. You were started on Erythropoietin shots, which will help
your bone marrow make more blood.
5. You were started on Vitamin D which contributes to bone
health
6. You were started on oral Pantoprazole which makes your
stomach less acidic

Please return to the hospital if you experience any fevers,
chills, night sweats, continued blood loss from your GI system,
or any blood loss anywhere, abdominal pain that does not
resolve, shortness of breath, chest pain, dizziness, new pain in
your knees or pain that is not resolved with medications, or any
other concerns.

Followup Instructions:
Please follow up with:

1. [**Company 191**] discharge clinic, [**Hospital Ward Name 23**] Building, [**Location (un) **] in [**Hospital Ward Name 5074**], [**Hospital1 18**]
Tuesday [**11-25**], 2:50pm
Have your hematocrit checked --> This is VERY IMPORTANT. Make
sure your healthcare provider knows what your hematocrit level
is. During this appointment please have them schedule you an
appointment with your PCP [**First Name4 (NamePattern1) 1060**] [**Last Name (NamePattern1) 21883**] who is also at [**Hospital **].

2. Dr. [**First Name8 (NamePattern2) 437**] [**Last Name (NamePattern1) 20540**]
GI fellow who performed your colonoscopy
Wednesday [**11-26**], at 3pm.
[**Location (un) 453**] [**Hospital Unit Name **] on [**Initials (NamePattern4) 1388**] [**Last Name (NamePattern4) **]

4. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 1968**] [**Name8 (MD) 20868**], NP in Nephrology
[**12-5**], at 10am
[**Last Name (un) **] Diabetes Center



Completed by:[**2138-11-20**]
{'Hemorrhage of gastrointestinal tract, unspecified,Acute kidney failure, unspecified,Chronic kidney disease, Stage IV (severe),Acute posthemorrhagic anemia,Secondary hyperparathyroidism (of renal origin),Accidental fall on or from other stairs or steps,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Atrial fibrillation,Long-term (current) use of anticoagulants,Other chronic pulmonary heart diseases,Other and unspecified hyperlipidemia,Benign neoplasm of colon,Abnormal coagulation profile,Anticoagulants causing adverse effects in therapeutic use,Diverticulosis of colon (without mention of hemorrhage),Osteoarthrosis, localized, not specified whether primary or secondary, lower leg,Diabetes with other specified manifestations, type II or unspecified type, uncontrolled,Contusion of knee'}


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: PCP: [**First Name4 (NamePattern1) 1060**] [**Last Name (NamePattern1) 21883**], MD
.
CHIEF COMPLAINT: s/p mechanical fall
REASON FOR MICU ADMISSION: GI bleed

PRESENT ILLNESS: Ms. [**Known lastname **] is an 84 y.o. F with h/o falls, atrial
fibrillation on coumadin, chronic kidney disease stage IV, HTN,
and T2 DM, who presents s/p mechanical fall day prior to
admission. Pt fell down 1 step and slid down to her knees as she
was holding on to the door. Denied neck and back pain. Denies
loss of consciousness. She was ambulatory after the fall and
drove herself home, but the pain increased this AM in her left
knee. She complained of bilateral knee pain, L > R, and thus,
presented to the ED. She has noted darker colored stools for the
last 1-2 months, but denies BRBPR, hemorrhoids. Has 1 BM per
day. Denies lightheadedness, dizziness. Last colonoscopy > 10
years ago and reportedly negative.
.
In the ED, initial VS: T 97.5 HR 109 BP 162/62 RR 16 O2 100%RA.
VS in ED: 134-162/44-60, HR 88-109. Labs drawn, significant for
Hct 22 and INR 4.3. Knee X-rays and EKG performed. Rectal
performed by GI showed reddish tinged, dark brown, guiaic
positive. NG lavage negative. GI consulted. Pt given
oxycodone-acetaminophen 5/325 po x 1, pantoprazole 40 mg IV x 1,
Vitamin K 10 mg IV x 1, 2 L NS. Active T&S. Ordered for 2pRBC,
not hung. 2 large bore PIVs placed. Physical Therapy consulted
in ED and recommended home with PT.
.
Currently, she has L > R knee pain, [**6-22**], aching.
.
ROS: Denies fever, chills, cough, shortness of breath, chest
pain, abdominal pain, nausea, vomiting, diarrhea, constipation,
BRBPR, melena, hematochezia, dysuria, hematuria. + dark stools

MEDICAL HISTORY: - Type 2 Diabetes Mellitus
- Atrial Fibrillation on Coumadin
- Hypertension
- Hyperlipidemia
- Pulmonary arterial hypertension
- Chronic kidney disease
- Anemia
- Hyperparathyroidism s/p parathyroidectomy [**6-21**]
- Pelvic fracture lateral compression type I and a left proximal

MEDICATION ON ADMISSION: Atorvastatin 20 mg po daily
Digoxin 125 mcg po daily
Folic acid 1 mg po daily
Lasix 60 mg po daily
Hydralazine 67.5 mg po BID
Hydralazine 50 mg po qhs
Humalog 75-25 - 25 units q AM, 40 units q PM
Nifedipine ER 60 mg po daily
Propanolol SR 80 mg po daily
Valsartan 320 mg po daily
Coumadin 2.5 mg po daily or directed by [**Hospital **] Clinic
Calcium carbonate 1000 mg po QID
Tylenol OTC

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Vitals - T: 96.6 BP: 151/41 HR: 102 RR: [**9-28**] 02 sat: 96% RA
GENERAL: pleaseant, elderly female in NAD
HEENT: EOMI, anicteric, conjunctivae pink, MMM, no cervical LAD

FAMILY HISTORY: Her mother had hypertension, died at 89. Her father had lung
cancer, died at 74. Denies colon cancer, colon polyps in family.

SOCIAL HISTORY: She never smoked. Last drink [**2-14**] glass of wine 1 week ago. Lives
with sister, walks on her own. 

### Response:
{'Hemorrhage of gastrointestinal tract, unspecified,Acute kidney failure, unspecified,Chronic kidney disease, Stage IV (severe),Acute posthemorrhagic anemia,Secondary hyperparathyroidism (of renal origin),Accidental fall on or from other stairs or steps,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Atrial fibrillation,Long-term (current) use of anticoagulants,Other chronic pulmonary heart diseases,Other and unspecified hyperlipidemia,Benign neoplasm of colon,Abnormal coagulation profile,Anticoagulants causing adverse effects in therapeutic use,Diverticulosis of colon (without mention of hemorrhage),Osteoarthrosis, localized, not specified whether primary or secondary, lower leg,Diabetes with other specified manifestations, type II or unspecified type, uncontrolled,Contusion of knee'}
