CHIEF COMPLAINT: Altered mental status and fever

PRESENT ILLNESS: 73 year old Male with a PMH significant for Alzheimer's
dementia, Type 1 Diabetes, and CAD s/p CABG admitted for
bilateral pyelonephritis with septicemia due to urinary
obstruction. The patient developed altered mental status, fever
to 103, and blood glucose of 500 at his nursing home on the day
of admission, for which he was brought into the [**Hospital1 18**] ED.

MEDICAL HISTORY: 1.  Alzheimer's disease:  Diagnosed approximately a year ago by
Dr. [**Last Name (STitle) **] after extensive neuropsychiatry testing.  He has not
ever received any therapy for symptoms and is not followed by
Neurology despite referral in past.  There is a head CAT scan on
record.
2.  Diabetes type 1:  Diagnosis 47 years ago, currently
maintained on an insulin pump.  No known complications, per
patient's wife.  [**Name (NI) **] history of DKA.
3.  Coronary artery disease:  Status post 2 prior heart attacks
and a bypass surgery.
4.  Hyperlipidemia.
5.  Hypothyroidism.
6.  Hyperkalemia.
7.  Basal cell cancer followed by Dermatology last seen in
[**10-18**].
8.  History of colon adenomatous polyps, last colonoscopy in
[**2131-3-13**].  Follow-up in five years recommended.
9.  Hyperhomocystinemia on folic acid.

MEDICATION ON ADMISSION: Atorvastatin 20 mg daily
Lantus 22 units QAM
Lispro ISS
Isosorbide mononitrate 30 mg daily
Levothyroxine 112 mcg daily
Lorazepam 0.5 mg po tid
Memantine 10 mg po bid
Toprol XL 12.5 mg daily
ASA 325 mg daily
Folate 0.4 mg po bid
Vitamin B6
.

ALLERGIES: Lisinopril

PHYSICAL EXAM: VS: 98.8 84 157/66 22 97% RA
Gen: Age appropriate male in NAD
HEENT: Perrl, eomi, sclerae anicteric. MMM, OP clear without
lesions, exudate, or erythema.
CV: Nl S1+S2, no m/r//g
Pulm: CTAB
Abd: Non-tender/non-distended, +bs. -CVAT
Ext: No c/c/e. +bs
Neuro: Oriented to person. CN II-XII grossly intact.

FAMILY HISTORY: Mother died at age [**Age over 90 **]. Father is also deceased.
He had two sisters both deceased. One died at 50 with a heart
attack and one had alcoholism. He had one brother who died of
complications of coronary artery disease at 74. He is the only
surviving sibling. He has four children, a son aged 49, a son
aged 47, a daughter aged 46 and a son aged 44. [**Name2 (NI) **] are healthy
with no known medical problems.

SOCIAL HISTORY: He has been married to [**Doctor First Name 4489**] for the last 50
years. They have four children together, 3 boys and 1
girl, [**Doctor First Name 4489**] is his healthcare proxy. [**Name (NI) **] worked for [**Location (un) 86**]
[**Male First Name (un) 17703**] for many years before retiring. He graduated from
[**University/College 5130**] and lives in [**Location 86**]. He is not a smoker.
Unspecified septicemia,Acute kidney failure, unspecified,Acute pyelonephritis without lesion of renal medullary necrosis,Hydronephrosis,Acidosis,Sepsis,Alzheimer's disease,Dementia in conditions classified elsewhere without behavioral disturbance,Diabetes mellitus without mention of complication, type I [juvenile type], not stated as uncontrolled,Coronary atherosclerosis of unspecified type of vessel, native or graft,Benign essential hypertension,Unspecified acquired hypothyroidism,Other and unspecified hyperlipidemia,Long-term (current) use of insulin,Aortocoronary bypass status
Septicemia NOS,Acute kidney failure NOS,Ac pyelonephritis NOS,Hydronephrosis,Acidosis,Sepsis,Alzheimer's disease,Dementia w/o behav dist,DMI wo cmp nt st uncntrl,Cor ath unsp vsl ntv/gft,Benign hypertension,Hypothyroidism NOS,Hyperlipidemia NEC/NOS,Long-term use of insulin,Aortocoronary bypass
Admission Date:  [**2135-7-31**]              Discharge Date:   [**2135-8-5**]

Date of Birth:  [**2062-7-9**]             Sex:   M

Service: MEDICINE

Allergies:
Lisinopril

Attending:[**First Name3 (LF) 1973**]
Chief Complaint:
Altered mental status and fever

Major Surgical or Invasive Procedure:
none

History of Present Illness:
73 year old Male with a PMH significant for Alzheimer's
dementia, Type 1 Diabetes, and CAD s/p CABG admitted for
bilateral pyelonephritis with septicemia due to urinary
obstruction. The patient developed altered mental status, fever
to 103, and blood glucose of 500 at his nursing home on the day
of admission, for which he was brought into the [**Hospital1 18**] ED.

In the [**Hospital1 18**] ED, VS 98.3 157/72 86 18 98%RA. He received
levofloxacin and flagyl as he as noted to have a distended
abdomen. A foley catheter was placed and was noted to drain 2
liters of urine. Given his altered mental status and fever, the
patient also received CNS dosing ceftriaxone for possible
meningitis, although LP was deferred after CTAP demonstrated
bilateral perinephric stranding and hydronephrosis concerning
for bilateral pyelonephritis. The patient received 2L IVF and
was transferred to the [**Hospital Unit Name 153**] for further management.

The patient proceeded to improve steadily, and was transferred
out to the floor. It was also noted that the patient had not had
a bowel movement in many days, and the patient was given
mirilax, along with an agressive bowel regimen, and the patient
proceeded to have multiple massive BM's with additional
improvement in mental status.

Past Medical History:
1.  Alzheimer's disease:  Diagnosed approximately a year ago by
Dr. [**Last Name (STitle) **] after extensive neuropsychiatry testing.  He has not
ever received any therapy for symptoms and is not followed by
Neurology despite referral in past.  There is a head CAT scan on
record.
2.  Diabetes type 1:  Diagnosis 47 years ago, currently
maintained on an insulin pump.  No known complications, per
patient's wife.  [**Name (NI) **] history of DKA.
3.  Coronary artery disease:  Status post 2 prior heart attacks
and a bypass surgery.
4.  Hyperlipidemia.
5.  Hypothyroidism.
6.  Hyperkalemia.
7.  Basal cell cancer followed by Dermatology last seen in
[**10-18**].
8.  History of colon adenomatous polyps, last colonoscopy in
[**2131-3-13**].  Follow-up in five years recommended.
9.  Hyperhomocystinemia on folic acid.

Social History:
He has been married to [**Doctor First Name 4489**] for the last 50
years. They have four children together, 3 boys and 1
girl, [**Doctor First Name 4489**] is his healthcare proxy. [**Name (NI) **] worked for [**Location (un) 86**]
[**Male First Name (un) 17703**] for many years before retiring. He graduated from
[**University/College 5130**] and lives in [**Location 86**]. He is not a smoker.


Family History:
Mother died at age [**Age over 90 **]. Father is also deceased.
He had two sisters both deceased. One died at 50 with a heart
attack and one had alcoholism. He had one brother who died of
complications of coronary artery disease at 74. He is the only
surviving sibling. He has four children, a son aged 49, a son
aged 47, a daughter aged 46 and a son aged 44. [**Name2 (NI) **] are healthy
with no known medical problems.

Physical Exam:
VS: 98.8 84 157/66 22 97% RA
Gen: Age appropriate male in NAD
HEENT: Perrl, eomi, sclerae anicteric. MMM, OP clear without
lesions, exudate, or erythema.
CV: Nl S1+S2, no m/r//g
Pulm: CTAB
Abd: Non-tender/non-distended, +bs. -CVAT
Ext: No c/c/e. +bs
Neuro: Oriented to person. CN II-XII grossly intact.


Pertinent Results:
[**2135-8-4**] 06:05AM BLOOD WBC-10.8 RBC-3.53* Hgb-10.6* Hct-31.0*
MCV-88 MCH-30.1 MCHC-34.3 RDW-16.4* Plt Ct-281
[**2135-8-2**] 04:16AM BLOOD WBC-20.4* RBC-3.96* Hgb-12.2* Hct-35.5*
MCV-90 MCH-30.7 MCHC-34.3 RDW-16.4* Plt Ct-192
[**2135-8-1**] 07:25PM BLOOD WBC-20.2* RBC-3.98* Hgb-12.1* Hct-35.9*
MCV-90 MCH-30.4 MCHC-33.7 RDW-16.5* Plt Ct-200
[**2135-8-1**] 02:24AM BLOOD WBC-26.8* RBC-4.26* Hgb-13.0* Hct-37.2*
MCV-87 MCH-30.5 MCHC-34.9 RDW-16.5* Plt Ct-192
[**2135-7-31**] 02:45PM BLOOD WBC-31.4*# RBC-3.83* Hgb-11.7* Hct-33.5*
MCV-88 MCH-30.6 MCHC-35.0 RDW-16.0* Plt Ct-219
[**2135-7-31**] 02:45PM BLOOD Neuts-93.7* Bands-0 Lymphs-2.8* Monos-2.9
Eos-0.2 Baso-0.4
[**2135-8-1**] 07:25PM BLOOD Hypochr-OCCASIONAL Anisocy-NORMAL
Poiklo-3+ Macrocy-NORMAL Microcy-NORMAL Polychr-OCCASIONAL
Ovalocy-OCCASIONAL Schisto-1+ Burr-2+ Ellipto-OCCASIONAL
[**2135-8-2**] 04:16AM BLOOD PT-16.9* PTT-37.5* INR(PT)-1.5*
[**2135-8-1**] 12:43PM BLOOD PT-18.2* PTT-34.4 INR(PT)-1.6*
[**2135-8-1**] 02:24AM BLOOD PT-17.7* PTT-32.5 INR(PT)-1.6*
[**2135-7-31**] 02:45PM BLOOD PT-14.0* PTT-29.3 INR(PT)-1.2*
[**2135-8-5**] 06:05AM BLOOD Glucose-134* UreaN-10 Creat-0.8 Na-133
K-3.9 Cl-100 HCO3-25 AnGap-12
[**2135-8-1**] 06:52PM BLOOD UreaN-22* Creat-1.0 Na-128* K-3.8 Cl-95*
HCO3-23 AnGap-14
[**2135-8-1**] 12:43PM BLOOD UreaN-27* Creat-1.3* Na-127* K-4.0 Cl-95*
HCO3-24 AnGap-12
[**2135-8-1**] 02:24AM BLOOD Glucose-215* UreaN-40* Creat-2.2* Na-125*
K-4.4 Cl-97 HCO3-16* AnGap-16
[**2135-7-31**] 09:25PM BLOOD Glucose-244* UreaN-47* Creat-3.2*#
Na-125* K-4.4 Cl-93* HCO3-21* AnGap-15
[**2135-7-31**] 02:45PM BLOOD Glucose-188* UreaN-64* Creat-5.8*#
Na-120* K-5.0 Cl-88* HCO3-15* AnGap-22*
[**2135-7-31**] 02:45PM BLOOD ALT-35 AST-34 CK(CPK)-480* AlkPhos-102
Amylase-36 TotBili-0.9
[**2135-7-31**] 02:45PM BLOOD cTropnT-0.01
[**2135-7-31**] 02:45PM BLOOD CK-MB-13* MB Indx-2.7
[**2135-8-5**] 06:05AM BLOOD Calcium-7.5* Phos-2.7 Mg-2.0
[**2135-8-1**] 02:24AM BLOOD PSA-1.2
[**2135-8-1**] 02:36AM BLOOD Type-[**Last Name (un) **] Temp-36.8 Comment-GREEN TOP
[**2135-8-1**] 02:36AM BLOOD Lactate-1.4
[**2135-7-31**] 02:57PM BLOOD Glucose-184* Lactate-2.6*
[**2135-8-1**] 07:26PM URINE Color-Yellow Appear-Clear Sp [**Last Name (un) **]-1.016
[**2135-8-1**] 04:12AM URINE Color-Straw Appear-Clear Sp [**Last Name (un) **]-1.012
[**2135-7-31**] 09:00PM URINE Color-Straw Appear-Clear Sp [**Last Name (un) **]-1.017
[**2135-7-31**] 03:00PM URINE Color-Yellow Appear-Clear Sp [**Last Name (un) **]-1.022
[**2135-8-1**] 07:26PM URINE Blood-LG Nitrite-NEG Protein-30
Glucose-300 Ketone-NEG Bilirub-NEG Urobiln-NEG pH-5.5 Leuks-SM
[**2135-8-1**] 04:12AM URINE Blood-LG Nitrite-NEG Protein-TR
Glucose->1000 Ketone-10 Bilirub-NEG Urobiln-NEG pH-5.0 Leuks-TR
[**2135-7-31**] 09:00PM URINE Blood-LG Nitrite-NEG Protein-NEG
Glucose-1000 Ketone-NEG Bilirub-NEG Urobiln-NEG pH-5.0 Leuks-NEG
[**2135-7-31**] 03:00PM URINE Blood-SM Nitrite-NEG Protein-NEG
Glucose-1000 Ketone-NEG Bilirub-NEG Urobiln-NEG pH-6.5 Leuks-NEG
[**2135-8-1**] 07:26PM URINE RBC-432* WBC-9* Bacteri-NONE Yeast-NONE
Epi-0
[**2135-8-1**] 04:12AM URINE RBC-13* WBC-13* Bacteri-NONE Yeast-NONE
Epi-<1
[**2135-7-31**] 09:00PM URINE RBC-[**6-22**]* WBC-0-2 Bacteri-OCC Yeast-NONE
Epi-0
[**2135-7-31**] 03:00PM URINE RBC-[**6-22**]* WBC-0-2 Bacteri-RARE Yeast-NONE
Epi-0

[**2135-7-31**] 3:00 pm URINE     Site: CLEAN CATCH
                            **FINAL REPORT [**2135-8-1**]**
   URINE CULTURE (Final [**2135-8-1**]):    NO GROWTH.

[**2135-8-1**] 2:30 am MRSA SCREEN      NASAL SWAB.
                            **FINAL REPORT [**2135-8-3**]**
   MRSA SCREEN (Final [**2135-8-3**]):    No MRSA isolated.

ECG Study Date of [**2135-7-31**]  11:57:52 PM
Sinus rhythm. Occasional premature atrial contractions. Compared
to the
previous tracing of [**2133-5-12**] ventricular premature beats have
resolved.
Intervals Axes
Rate PR QRS QT/QTc P QRS T
82 138 90 356/394 47 -1 58


CHEST (PA & LAT) Study Date of [**2135-7-31**] 3:44 PM
IMPRESSION: Mild interstitial pulmonary edema.


CT HEAD W/O CONTRAST Study Date of [**2135-7-31**] 5:57 PM
IMPRESSION: No intracranial hemorrhage or edema.


RENAL U.S. Study Date of [**2135-8-1**] 1:18 PM
IMPRESSION: Little overall change to bilateral mild to moderate
hydronephrosis. No perinephric abscess identified.


PORTABLE ABDOMEN Study Date of [**2135-8-2**] 4:46 AM
IMPRESSION: Stool mixed with contrast is noted throughout the
colon.

Brief Hospital Course:
Mr. [**Known lastname 11060**] is a 73 year old gentleman with a PMH significant
for Alzheimer's dementia, DM 1, and CAD s/p CABG admitted for
bilateral pyelonephritis.

1. Septicemia due to pyelonephritis:
- Patient with CTAP demonstrating bilateral perinephric fat
stranding and hydronephrosis. That said, patient has had two
UA's in the ED that were negative for pyuria, which is atypical
for pyelonephritis, suggesting that a non-infectious
post-obstructive uropathy leading to hydronephrosis may be
causing his symptoms, although given fever and leukocytosis and
prior dose of antibiotics this may be a culture with no growth
due to antibiotics.  Discussed with Urology, who recommended to
start flomax, check PSA, f/u with urology as outpt (Dr. [**Last Name (STitle) **] as
below, discharge with catheter in place, the patient was
discharged on ciprofloxacin.

2. Constipation:
KUB showed large amts of stool in bowel. Pt had one BM
overnight. Also noted previous days to have some scrotal edema,
which is now improved. No need for scrotal u/s at this time. We
continued bowel regimen and enema to relieve constipation, and
finally mirilax with good effect.

3. Acute renal failure:
Likely secondary to post-obstructive uropathy. Appears to be
resolved, Cr now 0.8, after IVF.

4. Hyponatremia:
Most likely etiology is intravascular volume depletion. Has
resolved at time of discharge.

5. Anion gap acidosis:
Likely secondary to lactic acidosis given lactate of 2.6.
Patient without ketones on UA, although was noted to have a
blood glucose of 500 at his NH.  Anion gap closed at 10. We
continued her insulin sliding scale.

6. CAD Bypass Vessle, Benign Hypertension:
We increased his home metoprolol to 25 [**Hospital1 **], and started his home
isosorbide. Continued home atorvastatin and ASA 81 mg daily.

7. Type 1 Diabetes:
Continued home basal lantus and HISS.

8. Dementia and Acute Delerium:
Held home namenda until delerium resolved, and then it was
restarted.

9. Hyperlipidemia:
Continued home atorvastatin

10. Hypothyroid:
Continue home levothyroxine.

Code: DNR/DNI (form in chart)

Medications on Admission:
Atorvastatin 20 mg daily
Lantus 22 units QAM
Lispro ISS
Isosorbide mononitrate 30 mg daily
Levothyroxine 112 mcg daily
Lorazepam 0.5 mg po tid
Memantine 10 mg po bid
Toprol XL 12.5 mg daily
ASA 325 mg daily
Folate 0.4 mg po bid
Vitamin B6
.


Discharge Medications:
1. Heparin (Porcine) 5,000 unit/mL Solution Sig: 5000 (5000)
units Injection TID (3 times a day). units
2. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable
PO DAILY (Daily).
3. Atorvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
4. Levothyroxine 112 mcg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
5. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

6. Polyethylene Glycol 3350 100 % Powder Sig: One (1) packet PO
DAILY (Daily): Hold for loose stools.
7. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2
times a day).
8. Tamsulosin 0.4 mg Capsule, Sust. Release 24 hr Sig: One (1)
Capsule, Sust. Release 24 hr PO HS (at bedtime).
9. Acetaminophen 160 mg/5 mL Solution Sig: Six [**Age over 90 1230**]y
(650) mg PO Q6H (every 6 hours) as needed for Fever.
10. Isosorbide Mononitrate 30 mg Tablet Sustained Release 24 hr
Sig: One (1) Tablet Sustained Release 24 hr PO DAILY (Daily).
11. Insulin Glargine 100 unit/mL Solution Sig: Twenty Six (26)
units Subcutaneous once a day.
12. Insulin Sliding Scale
Insulin SC Sliding Scale
  Breakfast Lunch Dinner Bedtime
Humalog Humalog Humalog Humalog
Glucose Insulin Dose Insulin Dose Insulin Dose Insulin Dose
0-75   mg/dL [**1-14**] amp D50 [**1-14**] amp D50 [**1-14**] amp D50 [**1-14**] amp D50
76-150   mg/dL 0   Units 0   Units 0   Units 0   Units
151-200   mg/dL 2   Units 2   Units 2   Units 2   Units
201-250   mg/dL 4   Units 4   Units 4   Units 4   Units
251-300   mg/dL 6   Units 6   Units 6   Units 6   Units
301-350   mg/dL 8   Units 8   Units 8   Units 8   Units
351-400   mg/dL 10   Units 10   Units 10   Units 10   Units
  Instructons for NPO Patients: 1/2 dose if NPO

13. Ciprofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q12H
(every 12 hours) for 7 days.
14. Memantine 5 mg Tablet Sig: Two (2) Tablet PO Daily ().


Discharge Disposition:
Extended Care

Facility:
[**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 731**] - [**Location (un) 2498**]

Discharge Diagnosis:
Septicemia
Pyelonephritis
Urinary Obstruction
Hyponatremia
Acute Delerium
Alzheimer's Dementia
Benign Hypertension
CAD Native Vessle
Hypothyroidism

Discharge Condition:
Good

Discharge Instructions:
Return to the hospital with fever, chills, nausea, vomitting,
diahrea.

The patient is being discharged with an indwelling foley
catheter, which must stay in until he is seen by urology on [**8-15**].
It can be changed (normal foley) but he will obstruct if he does
not have a foley.

Please give daily mirilax as directed and only hold for loose
stools, as he becomes very constipated.

Followup Instructions:
Provider: [**First Name8 (NamePattern2) 161**] [**Name11 (NameIs) 162**] [**Name8 (MD) 163**], MD Phone:[**Telephone/Fax (1) 921**]
Date/Time:[**2135-8-15**] 1:30 [**Hospital Ward Name 23**] Bldg [**Location (un) **]
{"Unspecified septicemia,Acute kidney failure, unspecified,Acute pyelonephritis without lesion of renal medullary necrosis,Hydronephrosis,Acidosis,Sepsis,Alzheimer's disease,Dementia in conditions classified elsewhere without behavioral disturbance,Diabetes mellitus without mention of complication, type I [juvenile type], not stated as uncontrolled,Coronary atherosclerosis of unspecified type of vessel, native or graft,Benign essential hypertension,Unspecified acquired hypothyroidism,Other and unspecified hyperlipidemia,Long-term (current) use of insulin,Aortocoronary bypass 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: Altered mental status and fever

PRESENT ILLNESS: 73 year old Male with a PMH significant for Alzheimer's
dementia, Type 1 Diabetes, and CAD s/p CABG admitted for
bilateral pyelonephritis with septicemia due to urinary
obstruction. The patient developed altered mental status, fever
to 103, and blood glucose of 500 at his nursing home on the day
of admission, for which he was brought into the [**Hospital1 18**] ED.

MEDICAL HISTORY: 1.  Alzheimer's disease:  Diagnosed approximately a year ago by
Dr. [**Last Name (STitle) **] after extensive neuropsychiatry testing.  He has not
ever received any therapy for symptoms and is not followed by
Neurology despite referral in past.  There is a head CAT scan on
record.
2.  Diabetes type 1:  Diagnosis 47 years ago, currently
maintained on an insulin pump.  No known complications, per
patient's wife.  [**Name (NI) **] history of DKA.
3.  Coronary artery disease:  Status post 2 prior heart attacks
and a bypass surgery.
4.  Hyperlipidemia.
5.  Hypothyroidism.
6.  Hyperkalemia.
7.  Basal cell cancer followed by Dermatology last seen in
[**10-18**].
8.  History of colon adenomatous polyps, last colonoscopy in
[**2131-3-13**].  Follow-up in five years recommended.
9.  Hyperhomocystinemia on folic acid.

MEDICATION ON ADMISSION: Atorvastatin 20 mg daily
Lantus 22 units QAM
Lispro ISS
Isosorbide mononitrate 30 mg daily
Levothyroxine 112 mcg daily
Lorazepam 0.5 mg po tid
Memantine 10 mg po bid
Toprol XL 12.5 mg daily
ASA 325 mg daily
Folate 0.4 mg po bid
Vitamin B6
.

ALLERGIES: Lisinopril

PHYSICAL EXAM: VS: 98.8 84 157/66 22 97% RA
Gen: Age appropriate male in NAD
HEENT: Perrl, eomi, sclerae anicteric. MMM, OP clear without
lesions, exudate, or erythema.
CV: Nl S1+S2, no m/r//g
Pulm: CTAB
Abd: Non-tender/non-distended, +bs. -CVAT
Ext: No c/c/e. +bs
Neuro: Oriented to person. CN II-XII grossly intact.

FAMILY HISTORY: Mother died at age [**Age over 90 **]. Father is also deceased.
He had two sisters both deceased. One died at 50 with a heart
attack and one had alcoholism. He had one brother who died of
complications of coronary artery disease at 74. He is the only
surviving sibling. He has four children, a son aged 49, a son
aged 47, a daughter aged 46 and a son aged 44. [**Name2 (NI) **] are healthy
with no known medical problems.

SOCIAL HISTORY: He has been married to [**Doctor First Name 4489**] for the last 50
years. They have four children together, 3 boys and 1
girl, [**Doctor First Name 4489**] is his healthcare proxy. [**Name (NI) **] worked for [**Location (un) 86**]
[**Male First Name (un) 17703**] for many years before retiring. He graduated from
[**University/College 5130**] and lives in [**Location 86**]. He is not a smoker. 

### Response:
{"Unspecified septicemia,Acute kidney failure, unspecified,Acute pyelonephritis without lesion of renal medullary necrosis,Hydronephrosis,Acidosis,Sepsis,Alzheimer's disease,Dementia in conditions classified elsewhere without behavioral disturbance,Diabetes mellitus without mention of complication, type I [juvenile type], not stated as uncontrolled,Coronary atherosclerosis of unspecified type of vessel, native or graft,Benign essential hypertension,Unspecified acquired hypothyroidism,Other and unspecified hyperlipidemia,Long-term (current) use of insulin,Aortocoronary bypass status"}
