CHIEF COMPLAINT: Right thigh hematoma, pain limiting ability
to walk.

PRESENT ILLNESS: The patient is a 75-year-old
man with a history of CVAs with poor gait at baseline.  He
suffered a fall on [**2178-1-23**] for which he came into the [**Hospital1 18**]
Emergency Room.  He was found to have a right thigh hematoma
at that time.  Hematocrit was 33.7.  He had a plain film done
of the femur which did not show any fracture.  He is on
Coumadin at baseline for stroke prophylaxis.

MEDICAL HISTORY: 1.  Right parietal cortical stroke.
2.  Right-sided weakness secondary to stroke.  The patient
walks with a walker at baseline.
3.  Chronic lower back pain.
4.  Hypertension.
5.  Depression.
6.  Migraine headaches.
7.  Seizure disorder.
8.  Hypercholesterolemia.
9.  History of falls.

MEDICATION ON ADMISSION: 1.  Valproic acid 500 mg q.d.
2.  Neurontin 300 mg t.i.d.
3.  Coumadin 5 mg on Monday, Wednesday, and Friday, 2.5 mg
q.d. on the other days.
4.  Zoloft 50 mg q.d.
5.  Aspirin 325 mg q.d.
6.  Lipitor 10 mg q.d.

ALLERGIES: The patient has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: He use to smoke cigars, occasionally drinks
alcohol.  He is married.  He lives with his wife and his
daughter.
Acute posthemorrhagic anemia,Acute respiratory failure,Mitral valve disorders,Contusion of thigh,Other convulsions,Closed fracture of sacrum and coccyx without mention of spinal cord injury
Ac posthemorrhag anemia,Acute respiratry failure,Mitral valve disorder,Contusion of thigh,Convulsions NEC,Fx sacrum/coccyx-closed
Admission Date:  [**2178-1-28**]       Discharge Date:  [**2178-2-2**]

Date of Birth:   [**2102-11-4**]       Sex:  M

Service:  MEDICINE

CHIEF COMPLAINT:  Right thigh hematoma, pain limiting ability
to walk.

HISTORY OF THE PRESENT ILLNESS:  The patient is a 75-year-old
man with a history of CVAs with poor gait at baseline.  He
suffered a fall on [**2178-1-23**] for which he came into the [**Hospital1 18**]
Emergency Room.  He was found to have a right thigh hematoma
at that time.  Hematocrit was 33.7.  He had a plain film done
of the femur which did not show any fracture.  He is on
Coumadin at baseline for stroke prophylaxis.

He returned to the Emergency Department on [**2178-1-28**] with
complaints of right thigh pain limiting his ability to walk.
He was observed to have a right thigh hematoma at that time.
His hematocrit was 25.7 on [**2178-1-28**].  This was felt secondary
to continued bleeding into his right thigh.  Consequently, he
was given 3 units of fresh frozen plasma transfusion.  During
infusion of the 3 units of fresh frozen plasma, he became
hypertensive, tachypneic, and tachycardiac.  He required
elective intubation and was transferred to the Medical
Intensive Care Unit.

His clinical picture was consistent with
transfusion-associated acute lung injury.  Benadryl and
Solu-Medrol were started.  He extubated without difficulty on
[**2178-1-29**] and was transferred to the Medical Service
at that point.  Further details available in the hospital
course stated later in this discharge summary.

PAST MEDICAL HISTORY:
1.  Right parietal cortical stroke.
2.  Right-sided weakness secondary to stroke.  The patient
walks with a walker at baseline.
3.  Chronic lower back pain.
4.  Hypertension.
5.  Depression.
6.  Migraine headaches.
7.  Seizure disorder.
8.  Hypercholesterolemia.
9.  History of falls.

MEDICATIONS ON ADMISSION:
1.  Valproic acid 500 mg q.d.
2.  Neurontin 300 mg t.i.d.
3.  Coumadin 5 mg on Monday, Wednesday, and Friday, 2.5 mg
q.d. on the other days.
4.  Zoloft 50 mg q.d.
5.  Aspirin 325 mg q.d.
6.  Lipitor 10 mg q.d.

ALLERGIES:  The patient has no known drug allergies.

SOCIAL HISTORY:  He use to smoke cigars, occasionally drinks
alcohol.  He is married.  He lives with his wife and his
daughter.

PRIMARY CARE MEDICAL DOCTOR: Dr. [**Last Name (STitle) 74869**] located at [**Hospital3 **]
in [**Location (un) 1439**], [**State 350**].

PHYSICAL EXAMINATION ON ADMISSION:  Vital signs on admission
to the Intensive Care Unit:  Temperature 103, blood pressure
112/72, heart rate 105, respiratory rate 21, 02 saturation
100% on assist control ventilation.  General:  He was
intubated and sedated.  Chest:  Bilateral rales.  Cardiac:
Regular rate and rhythm with holosystolic murmur at the apex
at the right upper sternal border.  Abdomen:  Soft,
nontender, nondistended.  Extremities:  Right thigh hematoma.

On arrival to the Medicine floor on [**2178-1-29**], temperature
98.6, pulse 76, blood pressure 106/62, 02 saturation 96% on 2
liters.  Chest:  Minimal crackles at the bases, otherwise
clear to auscultation bilaterally.  Cardiovascular:  Regular
rate and rhythm, normal S1, S2, with a systolic murmur.
Abdomen:  Soft, nontender, nondistended.  Extremities:  Right
upper thigh had an ecchymosis that was tender to palpation.
Of note, on [**2178-2-2**], the borders of the ecchymosis had
regressed and the patient was also reporting less pain in the
area.  The area was also noted to be less tense on [**2178-2-2**].

LABORATORY VALUES:  Hematocrit 33.7 on [**2178-1-23**], 25.7 on
[**2178-1-28**], 22.1 on [**2178-1-29**], 21.2 on [**2178-1-30**], 32.2 (stable)
status post transfusion with 3 units of packed red blood
cells, RBCs transfused on [**2178-1-30**], hematocrit 32.2 on
[**2178-2-2**].  INR 3.6 on [**2178-1-23**], 2.1 on [**2178-1-24**], 2.3 on
[**2178-1-28**], 1.2 on [**2178-2-1**].

On [**2178-2-2**], WBC 11.7 (peak 18.7 on [**2178-1-30**]), hematocrit
32.2, platelets 322,000.

Reticulocyte percentage 5.2% on [**2178-1-28**].

The urinalysis was negative for infection on [**2178-1-28**].

Chem-7 on [**2178-1-28**] revealed a sodium of 141, K 3.5, CL 98,
C02 23, BUN 22, creatinine 0.8, glucose 122.  On [**2178-2-2**],
sodium 141, K 3.7, CL 106, C02 26, BUN 20, creatinine 0.6,
glucose 126.

On [**2178-1-28**] CK 226, LDH 264, total bilirubin 1.5.

Troponin 0.7 on [**2178-1-29**], peak was 1.3 on [**2178-1-29**].

On [**2178-1-29**], haptoglobin 226, HDL 45, LDL 63, triglycerides
161.

IgA level 195 (normal).

EKG on [**2178-1-28**]:  Sinus rhythm at 100 beats per minute, axis
normal.  There is evidence of left ventricular hypertrophy.
There are ST depressions in leads V4, V5, and V6.  Of note,
these ST depressions normalized on [**2178-1-29**].

IMAGING DATA:
1.  Plain film of right femur and hip on [**2178-1-23**]:  There is
no evidence of fracture.  There is a small suprapatellar
effusion.
2.  CT of the head on [**2178-1-28**]:  There is an old infarction
in the right parietal lobe.  There was bilateral low
attenuation of the periventricular white matter.  There was
no evidence of acute hemorrhage or mass affect.
3.  Cervical spine plain film [**2178-1-28**]:  Carotid
calcifications are present.  No cervical spine fracture is
seen.
4.  Hip x-ray on [**2178-1-28**]:  Possible left sacral strut
fractures.  No abnormalities seen on the ankle film.
5.  Ultrasound of right thigh hematoma on [**2178-1-28**]:  There is
a small right thigh fluid collection consistent with a small
hematoma.
6.  Chest x-ray on [**2178-1-28**]:  Status post intubation,
interstitial pulmonary edema which is new compared with
[**2177-5-22**].
7.  Cardiac echocardiogram on [**2178-1-30**]:  Ejection fraction is
70-80%, TR gradient 47 mmHg.  There was moderate symmetric
left ventricular hypertrophy.  The LV systolic function is
hyperdynamic.  These findings are consistent with
hypertrophic obstructive cardiomyopathy.  There was 2+ mitral
regurgitation.  There was moderate left ventricular outflow
tract obstruction at rest.

IMPRESSION/PLAN:  The patient is a 74-year-old gentleman with
a history of mechanical falls who comes in with right thigh
pain status post mechanical fall and was found to have a
hematoma.  He received fresh frozen plasma on [**2178-1-28**] and
subsequently developed respiratory distress during the third
unit of FFP transfusion.

1.  RESPIRATORY DISTRESS:  This was felt secondary to
transfusion-related acute lung injury.  He was intubated on
[**2178-1-28**] and extubated easily on [**2178-1-29**].  He was given two
days of steroids, Solu-Medrol 100 mg q.i.d.  He was evaluated
by the Transfusion Medicine attending who felt that his
clinical picture and findings were consistent with
transfusion-related acute lung injury.  He made notes that
this event does not place patients at increased risk in the
future of recurrence of this event.

The patient did well from a respiratory standpoint status
post extubation.

2.  ANEMIA:  The patient's baseline hematocrit appears to be
30-32.  The drop in his hematocrit to a nadir of 21-22 on
[**2178-1-29**] to [**2178-1-30**] was felt secondary to his bleed into his
thigh hematoma.  He was transfused with 3 units of packed red
blood cells on [**2178-1-30**].  He tolerated this transfusion well
without any difficulty.

3.  ELEVATED TROPONINS:  The patient does not have a known
history of coronary artery disease.  He had a cardiac
echocardiogram done on [**2178-1-30**] which showed evidence of
hypertrophic obstructive cardiomyopathy as stated in the
echocardiogram reports in this discharge summary.

EKG of [**2178-1-28**] showed depressions in V4 through V6.  He had
a peak troponin of 1.3 when cardiac enzymes were cycled.
This picture was consistent with demand ischemia, likely felt
secondary to his anemia.  This was another indication for his
transfusion of 3 units of packed red blood cells on [**2178-1-30**].

4.  RIGHT THIGH PAIN/INABILITY TO WALK:  The patient's
inability to walk was felt secondary to musculoskeletal and
soft tissue discomfort status post his fall.  He was given
Percocet p.r.n. as needed with relief of symptoms.  He also
was found to have a left sacral strut fracture on his plain
film.

He was evaluated by the Orthopedic Surgery Service and they
felt that no operative intervention was indicated.

5.  HISTORY OF STROKES:  The patient was maintained on
Coumadin for stroke prophylaxis as well as aspirin.  Given
his history of mechanical falls as well as his drop in
hematocrit with this admission, we held the Coumadin while he
was in-house.  We plan on holding the Coumadin indefinitely
until he is seen by his outpatient neurologist, Dr. [**Last Name (STitle) **],
who can decide at that time whether the benefits of Coumadin
anticoagulation for stroke prophylaxis may outweigh the
risks.

In general, the patient did well status post his extubation
and after his blood transfusion he is ready to go to
rehabilitation on [**2178-2-2**].

DISCHARGE DIAGNOSIS:
1.  Transfusion-related acute lung injury.
2.  Right thigh hematoma.
3.  Sacral fracture.
4.  Hypertrophic obstructive cardiomyopathy.
5.  Anemia requiring transfusion complicated by evidence of
cardiac ischemia on EKG prior to transfusion.

DISPOSITION: The patient is discharged to rehabilitation.

DISCHARGE MEDICATIONS:
1.  Valproic acid 500 mg q.d.
2.  Neurontin 300 mg t.i.d.
3.  Zoloft 50 mg q.d.
4.  Aspirin 325 mg q.d.
5.  Heparin 5,000 units subcutaneously b.i.d. (discontinue
when the patient is mobile).
6.  Percocet (5/325) one to two tablets p.o. q. 4-6 hours
p.r.n. pain.
7.  Ambien 10 mg q.h.s. p.r.n. insomnia.



                            [**Name6 (MD) 251**] [**Name8 (MD) **], M.D.  [**MD Number(1) 1197**]

Dictated By:[**Name8 (MD) 4123**]
MEDQUIST36

D:  [**2178-2-2**]  11:20
T:  [**2178-2-2**]  11:37
JOB#:  [**Job Number 100409**]


Admission Date:  [**2178-1-28**]       Discharge Date:  [**2178-2-2**]

Date of Birth:   [**2102-11-4**]       Sex:  M

Service:  MEDICINE

CHIEF COMPLAINT:  Right thigh hematoma, pain limiting ability
to walk.

HISTORY OF THE PRESENT ILLNESS:  The patient is a 75-year-old
man with a history of CVAs with poor gait at baseline.  He
suffered a fall on [**2178-1-23**] for which he came into the [**Hospital1 18**]
Emergency Room.  He was found to have a right thigh hematoma
at that time.  Hematocrit was 33.7.  He had a plain film done
of the femur which did not show any fracture.  He is on
Coumadin at baseline for stroke prophylaxis.

He returned to the Emergency Department on [**2178-1-28**] with
complaints of right thigh pain limiting his ability to walk.
He was observed to have a right thigh hematoma at that time.
His hematocrit was 25.7 on [**2178-1-28**].  This was felt secondary
to continued bleeding into his right thigh.  Consequently, he
was given 3 units of fresh frozen plasma transfusion.  During
infusion of the 3 units of fresh frozen plasma, he became
hypertensive, tachypneic, and tachycardiac.  He required
elective intubation and was transferred to the Medical
Intensive Care Unit.

His clinical picture was consistent with
transfusion-associated acute lung injury.  Benadryl and
Solu-Medrol were started.  He extubated without difficulty on
[**2178-1-29**] and was transferred to the Medical Service
at that point.  Further details available in the hospital
course stated later in this discharge summary.

PAST MEDICAL HISTORY:
1.  Right parietal cortical stroke.
2.  Right-sided weakness secondary to stroke.  The patient
walks with a walker at baseline.
3.  Chronic lower back pain.
4.  Hypertension.
5.  Depression.
6.  Migraine headaches.
7.  Seizure disorder.
8.  Hypercholesterolemia.
9.  History of falls.

MEDICATIONS ON ADMISSION:
1.  Valproic acid 500 mg q.d.
2.  Neurontin 300 mg t.i.d.
3.  Coumadin 5 mg on Monday, Wednesday, and Friday, 2.5 mg
q.d. on the other days.
4.  Zoloft 50 mg q.d.
5.  Aspirin 325 mg q.d.
6.  Lipitor 10 mg q.d.

ALLERGIES:  The patient has no known drug allergies.

SOCIAL HISTORY:  He use to smoke cigars, occasionally drinks
alcohol.  He is married.  He lives with his wife and his
daughter.

PRIMARY CARE MEDICAL DOCTOR: Dr. [**Last Name (STitle) 74869**] located at [**Hospital3 **]
in [**Location (un) 1439**], [**State 350**].

PHYSICAL EXAMINATION ON ADMISSION:  Vital signs on admission
to the Intensive Care Unit:  Temperature 103, blood pressure
112/72, heart rate 105, respiratory rate 21, 02 saturation
100% on assist control ventilation.  General:  He was
intubated and sedated.  Chest:  Bilateral rales.  Cardiac:
Regular rate and rhythm with holosystolic murmur at the apex
at the right upper sternal border.  Abdomen:  Soft,
nontender, nondistended.  Extremities:  Right thigh hematoma.

On arrival to the Medicine floor on [**2178-1-29**], temperature
98.6, pulse 76, blood pressure 106/62, 02 saturation 96% on 2
liters.  Chest:  Minimal crackles at the bases, otherwise
clear to auscultation bilaterally.  Cardiovascular:  Regular
rate and rhythm, normal S1, S2, with a systolic murmur.
Abdomen:  Soft, nontender, nondistended.  Extremities:  Right
upper thigh had an ecchymosis that was tender to palpation.
Of note, on [**2178-2-2**], the borders of the ecchymosis had
regressed and the patient was also reporting less pain in the
area.  The area was also noted to be less tense on [**2178-2-2**].

LABORATORY VALUES:  Hematocrit 33.7 on [**2178-1-23**], 25.7 on
[**2178-1-28**], 22.1 on [**2178-1-29**], 21.2 on [**2178-1-30**], 32.2 (stable)
status post transfusion with 3 units of packed red blood
cells, RBCs transfused on [**2178-1-30**], hematocrit 32.2 on
[**2178-2-2**].  INR 3.6 on [**2178-1-23**], 2.1 on [**2178-1-24**], 2.3 on
[**2178-1-28**], 1.2 on [**2178-2-1**].

On [**2178-2-2**], WBC 11.7 (peak 18.7 on [**2178-1-30**]), hematocrit
32.2, platelets 322,000.

Reticulocyte percentage 5.2% on [**2178-1-28**].

The urinalysis was negative for infection on [**2178-1-28**].

Chem-7 on [**2178-1-28**] revealed a sodium of 141, K 3.5, CL 98,
C02 23, BUN 22, creatinine 0.8, glucose 122.  On [**2178-2-2**],
sodium 141, K 3.7, CL 106, C02 26, BUN 20, creatinine 0.6,
glucose 126.

On [**2178-1-28**] CK 226, LDH 264, total bilirubin 1.5.

Troponin 0.7 on [**2178-1-29**], peak was 1.3 on [**2178-1-29**].

On [**2178-1-29**], haptoglobin 226, HDL 45, LDL 63, triglycerides
161.

IgA level 195 (normal).

EKG on [**2178-1-28**]:  Sinus rhythm at 100 beats per minute, axis
normal.  There is evidence of left ventricular hypertrophy.
There are ST depressions in leads V4, V5, and V6.  Of note,
these ST depressions normalized on [**2178-1-29**].

IMAGING DATA:
1.  Plain film of right femur and hip on [**2178-1-23**]:  There is
no evidence of fracture.  There is a small suprapatellar
effusion.
2.  CT of the head on [**2178-1-28**]:  There is an old infarction
in the right parietal lobe.  There was bilateral low
attenuation of the periventricular white matter.  There was
no evidence of acute hemorrhage or mass affect.
3.  Cervical spine plain film [**2178-1-28**]:  Carotid
calcifications are present.  No cervical spine fracture is
seen.
4.  Hip x-ray on [**2178-1-28**]:  Possible left sacral strut
fractures.  No abnormalities seen on the ankle film.
5.  Ultrasound of right thigh hematoma on [**2178-1-28**]:  There is
a small right thigh fluid collection consistent with a small
hematoma.
6.  Chest x-ray on [**2178-1-28**]:  Status post intubation,
interstitial pulmonary edema which is new compared with
[**2177-5-22**].
7.  Cardiac echocardiogram on [**2178-1-30**]:  Ejection fraction is
70-80%, TR gradient 47 mmHg.  There was moderate symmetric
left ventricular hypertrophy.  The LV systolic function is
hyperdynamic.  These findings are consistent with
hypertrophic obstructive cardiomyopathy.  There was 2+ mitral
regurgitation.  There was moderate left ventricular outflow
tract obstruction at rest.

IMPRESSION/PLAN:  The patient is a 74-year-old gentleman with
a history of mechanical falls who comes in with right thigh
pain status post mechanical fall and was found to have a
hematoma.  He received fresh frozen plasma on [**2178-1-28**] and
subsequently developed respiratory distress during the third
unit of FFP transfusion.

1.  RESPIRATORY DISTRESS:  This was felt secondary to
transfusion-related acute lung injury.  He was intubated on
[**2178-1-28**] and extubated easily on [**2178-1-29**].  He was given two
days of steroids, Solu-Medrol 100 mg q.i.d.  He was evaluated
by the Transfusion Medicine attending who felt that his
clinical picture and findings were consistent with
transfusion-related acute lung injury.  He made notes that
this event does not place patients at increased risk in the
future of recurrence of this event.

The patient did well from a respiratory standpoint status
post extubation.

2.  ANEMIA:  The patient's baseline hematocrit appears to be
30-32.  The drop in his hematocrit to a nadir of 21-22 on
[**2178-1-29**] to [**2178-1-30**] was felt secondary to his bleed into his
thigh hematoma.  He was transfused with 3 units of packed red
blood cells on [**2178-1-30**].  He tolerated this transfusion well
without any difficulty.

3.  ELEVATED TROPONINS:  The patient does not have a known
history of coronary artery disease.  He had a cardiac
echocardiogram done on [**2178-1-30**] which showed evidence of
hypertrophic obstructive cardiomyopathy as stated in the
echocardiogram reports in this discharge summary.

EKG of [**2178-1-28**] showed depressions in V4 through V6.  He had
a peak troponin of 1.3 when cardiac enzymes were cycled.
This picture was consistent with demand ischemia, likely felt
secondary to his anemia.  This was another indication for his
transfusion of 3 units of packed red blood cells on [**2178-1-30**].

4.  RIGHT THIGH PAIN/INABILITY TO WALK:  The patient's
inability to walk was felt secondary to musculoskeletal and
soft tissue discomfort status post his fall.  He was given
Percocet p.r.n. as needed with relief of symptoms.  He also
was found to have a left sacral strut fracture on his plain
film.

He was evaluated by the Orthopedic Surgery Service and they
felt that no operative intervention was indicated.

5.  HISTORY OF STROKES:  The patient was maintained on
Coumadin for stroke prophylaxis as well as aspirin.  Given
his history of mechanical falls as well as his drop in
hematocrit with this admission, we held the Coumadin while he
was in-house.  We plan on holding the Coumadin indefinitely
until he is seen by his outpatient neurologist, Dr. [**Last Name (STitle) **],
who can decide at that time whether the benefits of Coumadin
anticoagulation for stroke prophylaxis may outweigh the
risks.

In general, the patient did well status post his extubation
and after his blood transfusion he is ready to go to
rehabilitation on [**2178-2-2**].

DISCHARGE DIAGNOSIS:
1.  Transfusion-related acute lung injury.
2.  Right thigh hematoma.
3.  Sacral fracture.
4.  Hypertrophic obstructive cardiomyopathy.
5.  Anemia requiring transfusion complicated by evidence of
cardiac ischemia on EKG prior to transfusion.

DISPOSITION: The patient is discharged to rehabilitation.

DISCHARGE MEDICATIONS:
1.  Valproic acid 500 mg q.d.
2.  Neurontin 300 mg t.i.d.
3.  Zoloft 50 mg q.d.
4.  Aspirin 325 mg q.d.
5.  Heparin 5,000 units subcutaneously b.i.d. (discontinue
when the patient is mobile).
6.  Percocet (5/325) one to two tablets p.o. q. 4-6 hours
p.r.n. pain.
7.  Ambien 10 mg q.h.s. p.r.n. insomnia.



                            [**Name6 (MD) 251**] [**Name8 (MD) **], M.D.  [**MD Number(1) 1197**]

Dictated By:[**Name8 (MD) 4123**]
MEDQUIST36

D:  [**2178-2-2**]  11:20
T:  [**2178-2-2**]  11:37
RP: [**2178-2-2**]  kbh
JOB#:  [**Job Number 100409**]
{'Acute posthemorrhagic anemia,Acute respiratory failure,Mitral valve disorders,Contusion of thigh,Other convulsions,Closed fracture of sacrum and coccyx without mention of spinal cord injury'}


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: Right thigh hematoma, pain limiting ability
to walk.

PRESENT ILLNESS: The patient is a 75-year-old
man with a history of CVAs with poor gait at baseline.  He
suffered a fall on [**2178-1-23**] for which he came into the [**Hospital1 18**]
Emergency Room.  He was found to have a right thigh hematoma
at that time.  Hematocrit was 33.7.  He had a plain film done
of the femur which did not show any fracture.  He is on
Coumadin at baseline for stroke prophylaxis.

MEDICAL HISTORY: 1.  Right parietal cortical stroke.
2.  Right-sided weakness secondary to stroke.  The patient
walks with a walker at baseline.
3.  Chronic lower back pain.
4.  Hypertension.
5.  Depression.
6.  Migraine headaches.
7.  Seizure disorder.
8.  Hypercholesterolemia.
9.  History of falls.

MEDICATION ON ADMISSION: 1.  Valproic acid 500 mg q.d.
2.  Neurontin 300 mg t.i.d.
3.  Coumadin 5 mg on Monday, Wednesday, and Friday, 2.5 mg
q.d. on the other days.
4.  Zoloft 50 mg q.d.
5.  Aspirin 325 mg q.d.
6.  Lipitor 10 mg q.d.

ALLERGIES: The patient has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: He use to smoke cigars, occasionally drinks
alcohol.  He is married.  He lives with his wife and his
daughter. 

### Response:
{'Acute posthemorrhagic anemia,Acute respiratory failure,Mitral valve disorders,Contusion of thigh,Other convulsions,Closed fracture of sacrum and coccyx without mention of spinal cord injury'}
