CHIEF COMPLAINT: s/p PEA cardiac arrest

PRESENT ILLNESS: 70 y/o with DM2, HTN, HLD, asthma, who presented from her [**Hospital1 1501**]
with cardiac arrest.  She was reported to be in respiratory
distress, and when receiving a nebulizer, went into PEA arrest.
EMS was called, CPR was initiated and epinephrine was given x2.
The pt was intubated in the field and an I/O line was placed.
She arrived to [**Hospital1 18**] with CPR in progress, however shortly upon
arrival had confirmed return of spontaneous circulation with SBP
was low ~60s.  She was started on norepinephrine and
phenylephrine and dopamine were added sequentially.  Initial
labratory tests showed a lactate of 10 and a venous pH of 6.95.
She received one ampule of sodium bicarb and 3L NS.  Bedside
cardiac ultrasound showed global hypokinesis, but no pericardial
effusion or right heart strain.  ECG showed sinus rhythm.  ET
tube placement was confirmed by laryngoscopy (was pulled back
out of right main stem bronchus).  She had a sterile right
subclavian line placed and an unsterile femoral arterial line
placed.  She was started on the artic sun cooling protocol.
.
She then became increasingly more difficult to ventilate, with
high peak pressures.  Manual bagging was attempted, but was also
difficult.  Needle decompression was then preformed on the right
with positive release of air.  Right chest tube then placed,
however, bagging was persistently difficult.  Needle
decompression on left was negative, but chest tube was placed on
the left anyway, with improvement in bagging.
.
Family is here and attending spoke with family.  Requested
aggressive care including pressor support, but no CPR/DNR.
.
Most recent set of vitals prior to transfer: afebrile, 110,
87/56 18 100% on AC 300/24/8/100% with peak pressures 31.  Plan
was to get CT-A on way up to MICU to r/o PE.

MEDICAL HISTORY: - Type 2 diabetes mellitus
- Hypertension
- Dyslipidemia
- Obesity
- s/p GI bleed
- Peptic ulcer disease/GERD/hiatus hernia
- Diverticulosis
- Osteoarthritis
- OSA on CPAP at home, Epworth Sleepiness score is a [**8-8**]
- Sinusitis
- recurrent (4 severe episodes) of Group B strep
cellulitis/bacteremia
- TIA in [**12-24**] presented with facial droop and weakness for 2
hours; had her aspirin increased to 325mg.
- Panic disorder/Depression (3 prior suicide attempts by drug
overdose)
- Personality disorder, NOS
- Borderline personality
.
PSxH:
- Total abdominal hysterectomy-for Ovarian CA in [**2158**]
- She mentioned that she had a recent lung biopsy which was
suggestive of sarcoidosis according to the patient, in her CTA
chest carried out in [**2182-3-18**], there is a mention of possible
BAL
lung ca.
- Bilateral Breast reduction complicated by Left breast
cellulitis/abscess
- s/p R knee replacement [**2176**]
- cholecystectomy

MEDICATION ON ADMISSION: ALBUTEROL SULFATE - 90 mcg HFA - 2 puffs inhaled q4-6h
ALENDRONATE [FOSAMAX] -  70 mg Tablet - 1 Tab QD
AZELASTINE - 137 mcg (0.1 %) Aerosol,  - 2 spray [**Hospital1 **], post nasal
drip
CITALOPRAM - 20 mg Tablet - 3 Tabs QD
***CLINDAMYCIN HCL - 300 mg Cap - 2 Capsule(s) by mouth today
and tonight as needed
FLUTICASONE - 50 mcg Spray, Suspension - 2 squirts(s) nasally QD
FUROSEMIDE - 20 mg Tab, every other day
GLIPIZIDE - 10 mg Tablet - 1 Tab QD
HYDROCODONE-ACETAMINOPHEN [VICODIN] - Dosage uncertain
LAMOTRIGINE [LAMICTAL] - 200 mg Tab - 1 Tab QD
LIPITOR - 40MG Tablet - 40MG QD
LISINOPRIL - 10MG Tablet - 10MG QD
METFORMIN -  500 mg Tablet Extended Release 24 hr - one tablet
QD
METOCLOPRAMIDE - 5 mg Tablet - 1 Tablet [**Hospital1 **]
METOPROLOL TARTRATE - 25 mg Tab - t1/2 tablet [**Hospital1 **]
MIRTAZAPINE - 15 mg Tablet - 3 Tab QHS
MUPIROCIN - 2 % Ointment - apply to ulcers QD under xeroform
gauze
MUPIROCIN - 2 % Ointment - [**Hospital1 **] to ulcerated areas around
umbilicus
PROPOXYPHENE - Dosage uncertain
QUETIAPINE [SEROQUEL] - 400 mg Tab, 1 Tab QHS
SIMVASTATIN [ZOCOR] -  80 mg Tab - 1 Tab QD
TEMAZEPAM - 15 mg Capsule - 1 QHS
VALSARTAN [DIOVAN] - 40 mg QD

ALLERGIES: Penicillins / Erythromycin Base / Compazine / Benadryl / Sulfa
(Sulfonamide Antibiotics) / Zinc / Phenothiazines / Oxycodone /
aspirin

PHYSICAL EXAM: ADMISSION EXAM:
Intubated, sedated, not responsive to voice, pupils fixed and
dilated.  Right subclavian CVL and femoral line in place.  RRR.
Bilateral chest tubes in place.  Coarse breath sounds
bilaterally.  Abdomen soft but increasingly distended with
minimal bowel sounds. Extremities cool with palpable pulses.

FAMILY HISTORY: Mother died of renal failure. Father died of an MI at age 58.
She has a brother with skin cancer. She has another sister w
HTN.

SOCIAL HISTORY: Currently lives at [**Hospital3 **]. She is able to ambulate with
assistance of a walker but is basically wheelchair dependant.
She does not smoke, or drink alcohol. Tried marijuana for a year
in the [**2142**].
Cardiac arrest,Acidosis,Cardiogenic shock,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Asthma, unspecified type, unspecified,Obstructive sleep apnea (adult)(pediatric),Osteoarthrosis, unspecified whether generalized or localized, site unspecified,Esophageal reflux,Borderline personality disorder,Panic disorder without agoraphobia,Depressive disorder, not elsewhere classified,Do not resuscitate status
Cardiac arrest,Acidosis,Cardiogenic shock,DMII wo cmp nt st uncntr,Hypertension NOS,Hyperlipidemia NEC/NOS,Asthma NOS,Obstructive sleep apnea,Osteoarthros NOS-unspec,Esophageal reflux,Borderline personality,Panic dis w/o agorphobia,Depressive disorder NEC,Do not resusctate status
Admission Date:  [**2183-11-14**]              Discharge Date:   [**2183-11-14**]

Date of Birth:  [**2111-12-2**]             Sex:   F

Service: MEDICINE

Allergies:
Penicillins / Erythromycin Base / Compazine / Benadryl / Sulfa
(Sulfonamide Antibiotics) / Zinc / Phenothiazines / Oxycodone /
aspirin

Attending:[**Last Name (NamePattern4) 290**]
Chief Complaint:
s/p PEA cardiac arrest

Major Surgical or Invasive Procedure:
Endotracheal intubation
Right subclavian line placement
Femoral line placement
Therapeutic hypothermia protocol
Needle decompression for pneumothorax
Bilateral chest tube placement

History of Present Illness:
70 y/o with DM2, HTN, HLD, asthma, who presented from her [**Hospital1 1501**]
with cardiac arrest.  She was reported to be in respiratory
distress, and when receiving a nebulizer, went into PEA arrest.
EMS was called, CPR was initiated and epinephrine was given x2.
The pt was intubated in the field and an I/O line was placed.
She arrived to [**Hospital1 18**] with CPR in progress, however shortly upon
arrival had confirmed return of spontaneous circulation with SBP
was low ~60s.  She was started on norepinephrine and
phenylephrine and dopamine were added sequentially.  Initial
labratory tests showed a lactate of 10 and a venous pH of 6.95.
She received one ampule of sodium bicarb and 3L NS.  Bedside
cardiac ultrasound showed global hypokinesis, but no pericardial
effusion or right heart strain.  ECG showed sinus rhythm.  ET
tube placement was confirmed by laryngoscopy (was pulled back
out of right main stem bronchus).  She had a sterile right
subclavian line placed and an unsterile femoral arterial line
placed.  She was started on the artic sun cooling protocol.
.
She then became increasingly more difficult to ventilate, with
high peak pressures.  Manual bagging was attempted, but was also
difficult.  Needle decompression was then preformed on the right
with positive release of air.  Right chest tube then placed,
however, bagging was persistently difficult.  Needle
decompression on left was negative, but chest tube was placed on
the left anyway, with improvement in bagging.
.
Family is here and attending spoke with family.  Requested
aggressive care including pressor support, but no CPR/DNR.
.
Most recent set of vitals prior to transfer: afebrile, 110,
87/56 18 100% on AC 300/24/8/100% with peak pressures 31.  Plan
was to get CT-A on way up to MICU to r/o PE.

Past Medical History:
- Type 2 diabetes mellitus
- Hypertension
- Dyslipidemia
- Obesity
- s/p GI bleed
- Peptic ulcer disease/GERD/hiatus hernia
- Diverticulosis
- Osteoarthritis
- OSA on CPAP at home, Epworth Sleepiness score is a [**8-8**]
- Sinusitis
- recurrent (4 severe episodes) of Group B strep
cellulitis/bacteremia
- TIA in [**12-24**] presented with facial droop and weakness for 2
hours; had her aspirin increased to 325mg.
- Panic disorder/Depression (3 prior suicide attempts by drug
overdose)
- Personality disorder, NOS
- Borderline personality
.
PSxH:
- Total abdominal hysterectomy-for Ovarian CA in [**2158**]
- She mentioned that she had a recent lung biopsy which was
suggestive of sarcoidosis according to the patient, in her CTA
chest carried out in [**2182-3-18**], there is a mention of possible
BAL
lung ca.
- Bilateral Breast reduction complicated by Left breast
cellulitis/abscess
- s/p R knee replacement [**2176**]
- cholecystectomy

Social History:
Currently lives at [**Hospital3 **]. She is able to ambulate with
assistance of a walker but is basically wheelchair dependant.
She does not smoke, or drink alcohol. Tried marijuana for a year
in the [**2142**].

Family History:
Mother died of renal failure. Father died of an MI at age 58.
She has a brother with skin cancer. She has another sister w
HTN.

Physical Exam:
ADMISSION EXAM:
Intubated, sedated, not responsive to voice, pupils fixed and
dilated.  Right subclavian CVL and femoral line in place.  RRR.
Bilateral chest tubes in place.  Coarse breath sounds
bilaterally.  Abdomen soft but increasingly distended with
minimal bowel sounds. Extremities cool with palpable pulses.

DISCHARGE EXAM:
No pulse detected.  Patient not responsive to voice or sternal
rub.  Pupils fixed and dilated. No spontaneous respirations.  No
cardiac sounds auscultated. No respirations auscultated.

Pertinent Results:
[**2183-11-14**] 02:50AM BLOOD WBC-9.6 RBC-3.55* Hgb-10.2* Hct-34.4*
MCV-97 MCH-28.8 MCHC-29.7* RDW-14.8 Plt Ct-194
[**2183-11-14**] 02:50AM BLOOD PT-12.9 PTT-35.1* INR(PT)-1.1
[**2183-11-14**] 02:50AM BLOOD PT-12.9 PTT-35.1* INR(PT)-1.1
[**2183-11-14**] 02:50AM BLOOD Fibrino-311
[**2183-11-14**] 02:50AM BLOOD UreaN-18 Creat-1.1
[**2183-11-14**] 02:50AM BLOOD Lipase-18
[**2183-11-14**] 02:50AM BLOOD Cortsol-8.5
[**2183-11-14**] 02:50AM BLOOD ASA-NEG Ethanol-NEG Acetmnp-10
Bnzodzp-NEG Barbitr-NEG Tricycl-NEG
[**2183-11-14**] 02:54AM BLOOD pH-6.95* Comment-GREEN TOP
[**2183-11-14**] 02:54AM BLOOD Glucose-340* Lactate-10.3* Na-139 K-4.8
Cl-99 calHCO3-24
[**2183-11-14**] 02:54AM BLOOD freeCa-1.17

[**2183-11-14**] 07:17AM BLOOD WBC-21.7*# RBC-3.73* Hgb-10.9* Hct-33.3*
MCV-89# MCH-29.1 MCHC-32.6 RDW-14.8 Plt Ct-242
[**2183-11-14**] 07:17AM BLOOD Neuts-91.2* Lymphs-6.3* Monos-0.8*
Eos-1.5 Baso-0.3
[**2183-11-14**] 07:17AM BLOOD Glucose-326* UreaN-23* Creat-1.3* Na-150*
K-4.5 Cl-101 HCO3-37* AnGap-17
[**2183-11-14**] 03:15PM BLOOD Glucose-425* UreaN-28* Creat-1.6* Na-136
K-3.6 Cl-93* HCO3-23 AnGap-24*
[**2183-11-14**] 07:17AM BLOOD ALT-63* AST-138* LD(LDH)-477*
AlkPhos-124* TotBili-0.2
[**2183-11-14**] 11:44AM BLOOD CK(CPK)-596*
[**2183-11-14**] 07:17AM BLOOD CK-MB-10 cTropnT-<0.01
[**2183-11-14**] 11:44AM BLOOD cTropnT-0.03*
[**2183-11-14**] 07:17AM BLOOD Calcium-7.3* Phos-7.9*# Mg-1.9
[**2183-11-14**] 03:15PM BLOOD Calcium-8.3* Phos-5.3* Mg-1.9
[**2183-11-14**] 04:03PM BLOOD Type-ART pO2-123* pCO2-71* pH-7.14*
calTCO2-26 Base XS--6
[**2183-11-14**] 04:03PM BLOOD Lactate-4.6*
[**2183-11-14**] 04:03PM BLOOD freeCa-1.09*

Blood culture [**11-14**]: Pending
Urine culture [**11-14**]: ENTEROCOCCUS SP..    10,000-100,000
ORGANISMS/ML..

TTE: The left atrium is moderately dilated. There is mild
symmetric left ventricular hypertrophy with normal cavity size
and regional/global systolic function (LVEF>55%). Right
ventricular chamber size and free wall motion are normal. Mild
(1+) aortic regurgitation is seen. The mitral valve leaflets are
structurally normal. Mild (1+) mitral regurgitation is seen. The
estimated pulmonary artery systolic pressure is normal. There is
no pericardial effusion.
IMPRESSION: Symmetric LVH with normal global and regional
biventricular systolic function.

CTA Chest:
1. No pulmonary embolism or acute aortic pathology.
2. Bilateral chest tubes terminating in the medial lung bases.
No large pneumothorax.
3. Nonspecific patchy opacity in the right upper lobe, could
represent pulmonary contusion from chest compression and/or
insertion of chest tube, pneumonia or aspiration.

CT Head: Limited study. No acute intracranial pathologic
process. No intracranial hemorrhage.

Brief Hospital Course:
70F with DM2, HTN, HLD, and asthma, who presented from her [**Hospital1 1501**]
s/p PEA arrest.  Suspected that acute hypoxia, possibly
secondary to asthma exacerbation, had led to cardiac arrest.
The patient was intubated in the field, arrived to the [**Hospital1 18**] ED
with CPR in progress, and shortly upon arrival was found to have
return of spontaneous circulation with SBP in the 60s.
Admission labs notable for lactate 10 and venous pH of 6.95.
She had a sterile right subclavian line placed and an unsterile
femoral arterial line placed.   She was bolused 3L NS, treated
with sodium bicarb, and started on norepinephrine,
phenylephrine, and dopamine for blood pressure support.  She was
started on the therapeutic hypothermic cooling protocol.  In
setting of patient becoming difficult to ventilate with high
peak pressures, she had right-sided needle compression with
positive release of air; right chest tube then placed.  Needle
decompression on left was negative for release of air; left
chest tube also placed.   Bedside cardiac ultrasound showed
global hypokinesis, but no pericardial effusion or right heart
strain.  ECG showed sinus rhythm.  CTA chest did not show e/o PE
or acute aortic pathology.  CT head was negative for acute
intracranial pathologic process and intracranial hemorrhage.
Per discussion between attending and patient's family, decision
was made to pursue aggressive care including pressor support,
but no CPR/DNR.  Patient was admitted to the MICU for further
management.  In the ICU, she continued to require maximum doses
of three pressors to maintain adequate blood pressure in the
setting of post-arrest distributive and cardiogenic shock.   She
was continued on the cooling protocol, and bedside EEG was
set-up.  Over the course of the day, she was noted to have an
increasing amount of ectopy on telemetry.  Another family
meeting was held between the ICU attending and the patient's
sister/HCP.  [**Name (NI) 227**] poor prognosis, decision was made to withdraw
aggressive care and focus on patient's comfort.  The patient
expired at 21:20 on [**2183-11-14**] with her family at the bedside.  The
family declined an autopsy.

Medications on Admission:
ALBUTEROL SULFATE - 90 mcg HFA - 2 puffs inhaled q4-6h
ALENDRONATE [FOSAMAX] -  70 mg Tablet - 1 Tab QD
AZELASTINE - 137 mcg (0.1 %) Aerosol,  - 2 spray [**Hospital1 **], post nasal
drip
CITALOPRAM - 20 mg Tablet - 3 Tabs QD
***CLINDAMYCIN HCL - 300 mg Cap - 2 Capsule(s) by mouth today
and tonight as needed
FLUTICASONE - 50 mcg Spray, Suspension - 2 squirts(s) nasally QD
FUROSEMIDE - 20 mg Tab, every other day
GLIPIZIDE - 10 mg Tablet - 1 Tab QD
HYDROCODONE-ACETAMINOPHEN [VICODIN] - Dosage uncertain
LAMOTRIGINE [LAMICTAL] - 200 mg Tab - 1 Tab QD
LIPITOR - 40MG Tablet - 40MG QD
LISINOPRIL - 10MG Tablet - 10MG QD
METFORMIN -  500 mg Tablet Extended Release 24 hr - one tablet
QD
METOCLOPRAMIDE - 5 mg Tablet - 1 Tablet [**Hospital1 **]
METOPROLOL TARTRATE - 25 mg Tab - t1/2 tablet [**Hospital1 **]
MIRTAZAPINE - 15 mg Tablet - 3 Tab QHS
MUPIROCIN - 2 % Ointment - apply to ulcers QD under xeroform
gauze
MUPIROCIN - 2 % Ointment - [**Hospital1 **] to ulcerated areas around
umbilicus
PROPOXYPHENE - Dosage uncertain
QUETIAPINE [SEROQUEL] - 400 mg Tab, 1 Tab QHS
SIMVASTATIN [ZOCOR] -  80 mg Tab - 1 Tab QD
TEMAZEPAM - 15 mg Capsule - 1 QHS
VALSARTAN [DIOVAN] - 40 mg QD

Medications - OTC
CALCIUM CARBONATE -  500 mg (1,250 mg) 1 Tab TID
CHOLECALCIFEROL (VITAMIN D3) [VITAMIN D-3] -  400 u Tab QD
OMEPRAZOLE MAGNESIUM - 20 mg Tablet, Delayed Release (E.C.) - QD
SENNOSIDES [SENNA] -  Dosage uncertain
ZEASORB-AF - 2% Powder - [**Hospital1 **] for fungal infection

Discharge Medications:
None

Discharge Disposition:
Expired

Discharge Diagnosis:
s/p PEA arrest
Distributive and cardiogenic shock s/p cardiac arrest
Hypoxic respiratory failure
Metabolic acidosis
Pneumothorax with chest tube placement

Discharge Condition:
Patient expired.

Discharge Instructions:
Not applicable.

Followup Instructions:
Not applicable.

                             [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**Name8 (MD) **] MD [**MD Number(1) 292**]
{'Cardiac arrest,Acidosis,Cardiogenic shock,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Asthma, unspecified type, unspecified,Obstructive sleep apnea (adult)(pediatric),Osteoarthrosis, unspecified whether generalized or localized, site unspecified,Esophageal reflux,Borderline personality disorder,Panic disorder without agoraphobia,Depressive disorder, not elsewhere classified,Do not resuscitate status'}


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: s/p PEA cardiac arrest

PRESENT ILLNESS: 70 y/o with DM2, HTN, HLD, asthma, who presented from her [**Hospital1 1501**]
with cardiac arrest.  She was reported to be in respiratory
distress, and when receiving a nebulizer, went into PEA arrest.
EMS was called, CPR was initiated and epinephrine was given x2.
The pt was intubated in the field and an I/O line was placed.
She arrived to [**Hospital1 18**] with CPR in progress, however shortly upon
arrival had confirmed return of spontaneous circulation with SBP
was low ~60s.  She was started on norepinephrine and
phenylephrine and dopamine were added sequentially.  Initial
labratory tests showed a lactate of 10 and a venous pH of 6.95.
She received one ampule of sodium bicarb and 3L NS.  Bedside
cardiac ultrasound showed global hypokinesis, but no pericardial
effusion or right heart strain.  ECG showed sinus rhythm.  ET
tube placement was confirmed by laryngoscopy (was pulled back
out of right main stem bronchus).  She had a sterile right
subclavian line placed and an unsterile femoral arterial line
placed.  She was started on the artic sun cooling protocol.
.
She then became increasingly more difficult to ventilate, with
high peak pressures.  Manual bagging was attempted, but was also
difficult.  Needle decompression was then preformed on the right
with positive release of air.  Right chest tube then placed,
however, bagging was persistently difficult.  Needle
decompression on left was negative, but chest tube was placed on
the left anyway, with improvement in bagging.
.
Family is here and attending spoke with family.  Requested
aggressive care including pressor support, but no CPR/DNR.
.
Most recent set of vitals prior to transfer: afebrile, 110,
87/56 18 100% on AC 300/24/8/100% with peak pressures 31.  Plan
was to get CT-A on way up to MICU to r/o PE.

MEDICAL HISTORY: - Type 2 diabetes mellitus
- Hypertension
- Dyslipidemia
- Obesity
- s/p GI bleed
- Peptic ulcer disease/GERD/hiatus hernia
- Diverticulosis
- Osteoarthritis
- OSA on CPAP at home, Epworth Sleepiness score is a [**8-8**]
- Sinusitis
- recurrent (4 severe episodes) of Group B strep
cellulitis/bacteremia
- TIA in [**12-24**] presented with facial droop and weakness for 2
hours; had her aspirin increased to 325mg.
- Panic disorder/Depression (3 prior suicide attempts by drug
overdose)
- Personality disorder, NOS
- Borderline personality
.
PSxH:
- Total abdominal hysterectomy-for Ovarian CA in [**2158**]
- She mentioned that she had a recent lung biopsy which was
suggestive of sarcoidosis according to the patient, in her CTA
chest carried out in [**2182-3-18**], there is a mention of possible
BAL
lung ca.
- Bilateral Breast reduction complicated by Left breast
cellulitis/abscess
- s/p R knee replacement [**2176**]
- cholecystectomy

MEDICATION ON ADMISSION: ALBUTEROL SULFATE - 90 mcg HFA - 2 puffs inhaled q4-6h
ALENDRONATE [FOSAMAX] -  70 mg Tablet - 1 Tab QD
AZELASTINE - 137 mcg (0.1 %) Aerosol,  - 2 spray [**Hospital1 **], post nasal
drip
CITALOPRAM - 20 mg Tablet - 3 Tabs QD
***CLINDAMYCIN HCL - 300 mg Cap - 2 Capsule(s) by mouth today
and tonight as needed
FLUTICASONE - 50 mcg Spray, Suspension - 2 squirts(s) nasally QD
FUROSEMIDE - 20 mg Tab, every other day
GLIPIZIDE - 10 mg Tablet - 1 Tab QD
HYDROCODONE-ACETAMINOPHEN [VICODIN] - Dosage uncertain
LAMOTRIGINE [LAMICTAL] - 200 mg Tab - 1 Tab QD
LIPITOR - 40MG Tablet - 40MG QD
LISINOPRIL - 10MG Tablet - 10MG QD
METFORMIN -  500 mg Tablet Extended Release 24 hr - one tablet
QD
METOCLOPRAMIDE - 5 mg Tablet - 1 Tablet [**Hospital1 **]
METOPROLOL TARTRATE - 25 mg Tab - t1/2 tablet [**Hospital1 **]
MIRTAZAPINE - 15 mg Tablet - 3 Tab QHS
MUPIROCIN - 2 % Ointment - apply to ulcers QD under xeroform
gauze
MUPIROCIN - 2 % Ointment - [**Hospital1 **] to ulcerated areas around
umbilicus
PROPOXYPHENE - Dosage uncertain
QUETIAPINE [SEROQUEL] - 400 mg Tab, 1 Tab QHS
SIMVASTATIN [ZOCOR] -  80 mg Tab - 1 Tab QD
TEMAZEPAM - 15 mg Capsule - 1 QHS
VALSARTAN [DIOVAN] - 40 mg QD

ALLERGIES: Penicillins / Erythromycin Base / Compazine / Benadryl / Sulfa
(Sulfonamide Antibiotics) / Zinc / Phenothiazines / Oxycodone /
aspirin

PHYSICAL EXAM: ADMISSION EXAM:
Intubated, sedated, not responsive to voice, pupils fixed and
dilated.  Right subclavian CVL and femoral line in place.  RRR.
Bilateral chest tubes in place.  Coarse breath sounds
bilaterally.  Abdomen soft but increasingly distended with
minimal bowel sounds. Extremities cool with palpable pulses.

FAMILY HISTORY: Mother died of renal failure. Father died of an MI at age 58.
She has a brother with skin cancer. She has another sister w
HTN.

SOCIAL HISTORY: Currently lives at [**Hospital3 **]. She is able to ambulate with
assistance of a walker but is basically wheelchair dependant.
She does not smoke, or drink alcohol. Tried marijuana for a year
in the [**2142**]. 

### Response:
{'Cardiac arrest,Acidosis,Cardiogenic shock,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Asthma, unspecified type, unspecified,Obstructive sleep apnea (adult)(pediatric),Osteoarthrosis, unspecified whether generalized or localized, site unspecified,Esophageal reflux,Borderline personality disorder,Panic disorder without agoraphobia,Depressive disorder, not elsewhere classified,Do not resuscitate status'}
