CHIEF COMPLAINT: Dyspnea

PRESENT ILLNESS: The patient is a 66 year old male with multiple medical problems
including diabetes, COPD on oxygen at baseline, hypertension and
hyperlipidemia who presented to the [**Last Name (un) **] diabetes clinic this
afternoon complaining of increased fatigue, shortness of breath
and cough for the past three weeks.  He also has been
experiencing lightheadedness and blurry vision intermittently.
The patient also experienced an episode of hypoglycemia this
morning (finger stick of 25) which he treated with [**Location (un) 2452**] juice
and glucose with rapid resolution.  Given his symptoms this AM
in diabetes clinic, he was advised to present to the ED.
.
He denies chest pain and worsening cough.  He does report
increased shortness of breath but has not needed to increase his
home oxygen use.  He denies fevers, chills.  He has a cough at
baseline which is non-productive and non-purulent and may be
slightly more productive over the past few weeks. He has lost 15
lbs over three months when his lasix dose was increased.  He
denies any recent medication changes, or dietary changes.  He
denies hemoptysis.  He denies any recent periods of immobility,
long distance travel.  No recent sick contacts.
.
In the ED the patient was found to be afebrile, hypoxic with an
O2 sat of 84% on 100% O2, and hypotensive with a BP of 83/60 and
HR 92.  His hypotension resolved with IV fluids.  An EKG was
performed which revealed a right bundle branch block and there
was concern for anterioseptal ST-depression.  Cardiology was
consulted who did not feel that he was experience an acute
coronary event.  He did recieve aspirin 325, and was started on
a heparin and nitroglycerine gtt.  First set of troponins came
back negative.  Initial chem7 revelaed a serum potassium of 6.4
on an non-hemolyzed specimen and he received insulin, sodium
bicarbonate, calcium gluconate, dextrose and kaexylate.

MEDICAL HISTORY: 1. DM2 (complicated by nephropathy, neuropathy)
2. CKD (proteinuria)
3. HTN
4. Hyperlipid
5. COPD, home O2 3-4L NC
6. depression
7. anxiety
8. morbid obesity
9. Obstructive sleep apnea

MEDICATION ON ADMISSION: Gabapentin 300 mg TID
NPH 30 units in AM, 10 units in PM
Toprol 50 mg [**Hospital1 **]
Diovan 160 mg daily
Niaspan 500 mg QHS
Potassium Chloride 10 mg QID
Lipitor 80 mg daily
Glyburide 5 mg (2 in AM, 2 in PM)
Coumadin 8 mg daily
Lisinopril 20 mg daily
Lasix 40 mg daily
Norvasc 5 mg daily
Zoloft 50 mg [**Hospital1 **]
Centrum Silver MVI daily
Xanax 0.5 mg [**3-24**] x daily PRN
Spironolactone 25 mg daily
Spiriva daily
Advair 500/50 1 PUFF [**Hospital1 **]
Albuterol 2 PUFFs QID
Oxygen 4-5 L at baseline

ALLERGIES: No Drug Allergy Information on File

PHYSICAL EXAM: Vitals: T: 98.2 HR: 87  BP: 119/62 RR: 22  02: 98% on
non-rebreather mask
Gen: Alert and oriented, mild-respiratory distress
HEENT: PERRL, EOMI, pharynx clear and without exudates
Neck: JVP ~ 12 cm
CV: Distant heart sounds, RRR, no murmurs or gallops appreciated
Resp: Decreased breath sounds throughout, no wheezes or ronchi
appreciated
GI: Obese, soft, non-tender, non-distended, + BS
GU: Foley in place draining clear yellow urine
Ext: WWP, 1+ pulses bilaterally, 1+ pitting edemas to shins, no
clubbing or cyanosis
Neuro: Grossly intact
Rectal: Guaiac negative per ED

FAMILY HISTORY: Sons had [**Name2 (NI) **] in 30s and 40s, mother and father had [**Name2 (NI) **] in older
age.  History of cancer but unknown type.

SOCIAL HISTORY: Single, lives in [**Location 3786**].  Currently not working.  Used to smoke
5 packs per day, currently smokes [**3-24**] cigarettes daily.  No
alcohol use, no ilicits
Pneumonitis due to inhalation of food or vomitus,Obstructive chronic bronchitis with (acute) exacerbation,Hypoxemia,Atrial fibrillation,Alkalosis,Acute kidney failure, unspecified,Chronic kidney disease, unspecified,Diabetes with renal manifestations, type II or unspecified type, not stated as uncontrolled,Nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere,Polyneuropathy in diabetes,Dysthymic disorder,Morbid obesity,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Right bundle branch block,Benign neoplasm of adrenal gland,Chronic pulmonary heart disease, unspecified,Hypotension, unspecified
Food/vomit pneumonitis,Obs chr bronc w(ac) exac,Hypoxemia,Atrial fibrillation,Alkalosis,Acute kidney failure NOS,Chronic kidney dis NOS,DMII renl nt st uncntrld,Nephritis NOS in oth dis,Neuropathy in diabetes,Dysthymic disorder,Morbid obesity,Hypertension NOS,Hyperlipidemia NEC/NOS,Rt bundle branch block,Benign neoplasm adrenal,Chr pulmon heart dis NOS,Hypotension NOS
Admission Date:  [**2114-11-13**]              Discharge Date:   [**2114-11-18**]

Date of Birth:  [**2048-4-14**]             Sex:   M

Service: MEDICINE

Allergies:
No Drug Allergy Information on File

Attending:[**First Name3 (LF) 3556**]
Chief Complaint:
Dyspnea

Major Surgical or Invasive Procedure:
None


History of Present Illness:
The patient is a 66 year old male with multiple medical problems
including diabetes, COPD on oxygen at baseline, hypertension and
hyperlipidemia who presented to the [**Last Name (un) **] diabetes clinic this
afternoon complaining of increased fatigue, shortness of breath
and cough for the past three weeks.  He also has been
experiencing lightheadedness and blurry vision intermittently.
The patient also experienced an episode of hypoglycemia this
morning (finger stick of 25) which he treated with [**Location (un) 2452**] juice
and glucose with rapid resolution.  Given his symptoms this AM
in diabetes clinic, he was advised to present to the ED.
.
He denies chest pain and worsening cough.  He does report
increased shortness of breath but has not needed to increase his
home oxygen use.  He denies fevers, chills.  He has a cough at
baseline which is non-productive and non-purulent and may be
slightly more productive over the past few weeks. He has lost 15
lbs over three months when his lasix dose was increased.  He
denies any recent medication changes, or dietary changes.  He
denies hemoptysis.  He denies any recent periods of immobility,
long distance travel.  No recent sick contacts.
.
In the ED the patient was found to be afebrile, hypoxic with an
O2 sat of 84% on 100% O2, and hypotensive with a BP of 83/60 and
HR 92.  His hypotension resolved with IV fluids.  An EKG was
performed which revealed a right bundle branch block and there
was concern for anterioseptal ST-depression.  Cardiology was
consulted who did not feel that he was experience an acute
coronary event.  He did recieve aspirin 325, and was started on
a heparin and nitroglycerine gtt.  First set of troponins came
back negative.  Initial chem7 revelaed a serum potassium of 6.4
on an non-hemolyzed specimen and he received insulin, sodium
bicarbonate, calcium gluconate, dextrose and kaexylate.

Past Medical History:
1. DM2 (complicated by nephropathy, neuropathy)
2. CKD (proteinuria)
3. HTN
4. Hyperlipid
5. COPD, home O2 3-4L NC
6. depression
7. anxiety
8. morbid obesity
9. Obstructive sleep apnea

Social History:
Single, lives in [**Location 3786**].  Currently not working.  Used to smoke
5 packs per day, currently smokes [**3-24**] cigarettes daily.  No
alcohol use, no ilicits

Family History:
Sons had [**Name2 (NI) **] in 30s and 40s, mother and father had [**Name2 (NI) **] in older
age.  History of cancer but unknown type.

Physical Exam:
Vitals: T: 98.2 HR: 87  BP: 119/62 RR: 22  02: 98% on
non-rebreather mask
Gen: Alert and oriented, mild-respiratory distress
HEENT: PERRL, EOMI, pharynx clear and without exudates
Neck: JVP ~ 12 cm
CV: Distant heart sounds, RRR, no murmurs or gallops appreciated
Resp: Decreased breath sounds throughout, no wheezes or ronchi
appreciated
GI: Obese, soft, non-tender, non-distended, + BS
GU: Foley in place draining clear yellow urine
Ext: WWP, 1+ pulses bilaterally, 1+ pitting edemas to shins, no
clubbing or cyanosis
Neuro: Grossly intact
Rectal: Guaiac negative per ED

Pertinent Results:
Admit Labs
[**2114-11-13**] 04:38PM BLOOD WBC-10.5 RBC-4.99 Hgb-13.8* Hct-44.2
MCV-89 MCH-27.7 MCHC-31.2 RDW-17.4* Plt Ct-148*
[**2114-11-13**] 04:38PM BLOOD Neuts-75.4* Lymphs-17.2* Monos-5.8
Eos-0.9 Baso-0.7
[**2114-11-13**] 04:38PM BLOOD Hypochr-3+ Anisocy-1+ Microcy-1+
[**2114-11-13**] 04:38PM BLOOD PT-39.8* PTT-37.7* INR(PT)-4.5*
[**2114-11-13**] 05:30PM BLOOD Glucose-190* UreaN-29* Creat-1.3* Na-134
K-6.4* Cl-95* HCO3-36* AnGap-9
[**2114-11-13**] 05:30PM BLOOD CK(CPK)-153
[**2114-11-13**] 05:30PM BLOOD CK-MB-6 cTropnT-<0.01 proBNP-5032*
[**2114-11-14**] 04:30AM BLOOD CK-MB-6 cTropnT-<0.01
[**2114-11-13**] 04:38PM BLOOD Lactate-5.8* K-8.7*
[**2114-11-13**] 05:14PM BLOOD Lactate-4.2* K-6.4*
[**2114-11-14**] 12:32PM BLOOD O2 Sat-87
.
Discharge Labs
[**2114-11-18**] 04:16AM BLOOD WBC-8.9 RBC-4.89 Hgb-13.5* Hct-41.0
MCV-84 MCH-27.7 MCHC-33.1 RDW-16.9* Plt Ct-132*
[**2114-11-18**] 04:16AM BLOOD PT-14.7* PTT-23.5 INR(PT)-1.3*
[**2114-11-18**] 04:16AM BLOOD Glucose-80 UreaN-22* Creat-0.8 Na-141
K-4.0 Cl-99 HCO3-39* AnGap-7*
[**2114-11-18**] 04:16AM BLOOD Calcium-9.4 Phos-3.2 Mg-2.2
.
Imaging
.
[**11-13**] CXR: Suspected bilateral hilar enlargement and bilateral
consolidations, suggesting infectious process as a more likely
diagnosis.
.
[**11-13**] CT-PA:
1.  Bibasilar posterior patchy consolidations representing
multifocal
pneumonia versus aspiration versus aspiration pneumonia.  Mild
atelectasis. Associated prominence of lymph nodes is probably
reactive, however, follow-up scan after appropriate clinical
interval recommended to ensure resolution.
2.  Evidence of mild fluid overload.  No pleural effusions.
3.  No pulmonary embolism or aortic dissection.
4.  Radiopaque gallstone with calcification in gallbladder wall
which may
reflect porcelain gallbladder.  Please correlate.
5.  Left kidney scarring with calcification.
6.  Left adrenal adenoma.
.
[**11-14**] TTE
1.The left atrium is mildly dilated.
2.There is moderate symmetric left ventricular hypertrophy. The
left
ventricular cavity size is normal. Regional left ventricular
wall motion is  normal. Overall left ventricular systolic
function is normal (LVEF>55%).
3.The right ventricular cavity is markedly dilated. Right
ventricular systolic  function appears depressed. There is
abnormal diastolic septal motion/position  consistent with right
ventricular volume overload.
4.The aortic valve is not well seen. No aortic regurgitation is
seen.
5.The mitral valve is not well seen. No mitral regurgitation
seen.
6.The estimated pulmonary artery systolic pressure is normal.
7.There is no pericardial effusion.
8. Bubble study for shunt was performed Bubble study with cough
was recorded  but not at rest or with valsalva. Reported to be
negative by Fellow and echo technician present.


Brief Hospital Course:
The patient is a 66 year old male with multiple medical problems
including diabetes, COPD on oxygen at baseline, hypertension and
hyperlipidemia who presented to the [**Last Name (un) **] diabetes clinic
complaining of increased fatigue, shortness of breath and cough
for the past three weeks.  Pt was admitted to the MICU for
management of respiratory distress with hypercarbic hypoxia.
The following issues were addressed during this admission:
.
# Hypoxemia: We originally considered cardiac versus primary
respiratory etiologies for his hypoxia.  There was no evidence
of ischemia per routine cycling of cardiac markers.
Additionally, clinical exam, TTE, and CXR failed to reveal
significant evidence of CHF, and CT-PA was negative for PE.
Physical exam and CXR findings appeared most consistent with an
exacerbation of COPD, possibly compounded by underlying cardiac
disease.  Accordingly, pt began a one week course of
azithromycin, started high dose IV steroids, combivent nebs,
home-dose flovent/advair/spiriva, and was placed on BiPAP for
improved ventilation/oxygenation.  Pt showed rapid improvement
in his respiratory status.  As pt continued to improve, his
steroids were transitioned from IV to po with subsequent taper,
and mask ventilation was transitioned to nasal cannula w/o
issue.  At discharge, pt had returned to his clinical baseline,
with mildly increased O2 requirement vs. baseline (currently
SpO2 >88% on 6 L NC).  Pt was discharged on prednisone taper,
azithromycin, home resp meds, with recommendation for close
PCP/pulmonology f/u.  Pt noted that he understood and agreed
with this plan.
.
# Diabetes: [**Last Name (un) **] continued to follow during admission,
adjusting insulin dosing as needed in the face of inflammation
and steroid use.  Pt will continue to f/u with [**Last Name (un) **] as an
outpatient as he tapers off of the prednisone.
.
# Hypertension: BP was well-controlled on home meds (Toprol XL
50 mg, Norvasc 5 mg, Lisinopril 20 mg); lasix, diovan, and
spironolactone were held during this admission due to thickened
resp secretions suggesting the need for hydration.  Pt will f/u
with his PCP for further management.
.
# Hyperkalemia - Resolved with withdrawal of agents with a
tendency to induce hyperkalemia (spironolactone).
.
# A-Fib - chronic coumadin for anticoagulation, toprol for rate
control; INR 1.3 at discharge, so returned to home-dose coumadin
schedule (initially altered due to INR 4.5 on admission).  Pt
instructed to f/u with PCP for INR check this week.
.
# Chronic Kidney Disease: Stable at baseline, admission Cr 1.3
improved rapidly with fluid resuscitation.
.
# Hyperlipidemia - continued lipitor 80 mg daily and niaspan 500
mg daily.
.
# Depression, Anxiety - continued home Xanax PRN, zoloft 50 mg
[**Hospital1 **].
.
# FEN: Renal, diabetic, heart healthy diet.  Continued to
replete electrolytes as needed.
.
# Prophylaxis:  DVT (on coumadin, daily ambulation), GI (PPI).

Medications on Admission:
Gabapentin 300 mg TID
NPH 30 units in AM, 10 units in PM
Toprol 50 mg [**Hospital1 **]
Diovan 160 mg daily
Niaspan 500 mg QHS
Potassium Chloride 10 mg QID
Lipitor 80 mg daily
Glyburide 5 mg (2 in AM, 2 in PM)
Coumadin 8 mg daily
Lisinopril 20 mg daily
Lasix 40 mg daily
Norvasc 5 mg daily
Zoloft 50 mg [**Hospital1 **]
Centrum Silver MVI daily
Xanax 0.5 mg [**3-24**] x daily PRN
Spironolactone 25 mg daily
Spiriva daily
Advair 500/50 1 PUFF [**Hospital1 **]
Albuterol 2 PUFFs QID
Oxygen 4-5 L at baseline

Discharge Medications:
1. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4-6H
(every 4 to 6 hours) as needed.
2. Gabapentin 300 mg Capsule Sig: One (1) Capsule PO TID (3
times a day).
3. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
4. Sertraline 50 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day).
5. Hexavitamin     Tablet Sig: One (1) Cap PO DAILY (Daily).
6. Alprazolam 0.25 mg Tablet Sig: Two (2) Tablet PO TID (3 times
a day) as needed.
7. Tiotropium Bromide 18 mcg Capsule, w/Inhalation Device Sig:
One (1) Cap Inhalation DAILY (Daily).
8. Fluticasone-Salmeterol 250-50 mcg/Dose Disk with Device Sig:
One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day).
9. Albuterol Sulfate 0.083 % Solution Sig: One (1)  Inhalation
Q2H (every 2 hours) as needed.
10. Niacin 500 mg Capsule, Sustained Release Sig: One (1)
Capsule, Sustained Release PO DAILY (Daily).
11. Azithromycin 250 mg Capsule Sig: Two (2) Capsule PO Q24H
(every 24 hours) for 1 days: Last dose 10/30.
12. Metoprolol Succinate 50 mg Tablet Sustained Release 24HR
Sig: One (1) Tablet Sustained Release 24HR PO DAILY (Daily).
13. Amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

14. Lisinopril 20 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
15. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable
PO DAILY (Daily).
16. Prednisone 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily)
for 4 days: Last dose 11/1.
17. Warfarin 4 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily).
18. Prednisone 20 mg Tablet Sig: One (1) Tablet PO once a day
for 2 days: start [**11-22**].
Disp:*2 Tablet(s)* Refills:*0*
19. Prednisone 20 mg Tablet Sig: .5 Tablet PO once a day for 2
days: start [**11-24**].
Disp:*1 Tablet(s)* Refills:*0*


Discharge Disposition:
Home

Discharge Diagnosis:
Primary
1. COPD Exacerbation
2. Pneumonia
3. A-Fib

Secondary
1. DM2 (complicated by nephropathy, neuropathy)
2. Chronic Proteinuria
3. HTN
4. Hyperlipidemia
5. Obstructive sleep apnea


Discharge Condition:
Improved


Discharge Instructions:
You were diagnosed with a COPD exacerbation, likely due to
infection.  Please complete your antibiotic regimen as
instructed, finish  your prednisone taper as prescribed, take
all medications as instructed, and follow up with your primary
physician(s) within the next week to reevaluate your condition
and adjust medications as needed.  Of note, your coumadin level
(INR) was lower than therapeutic and will need to be addressed
by your primary care provider (the physician that manages your
coumadin dosing).  Also, please continue to follow up with
[**Last Name (un) **] for management of your diabetes.  Finally, we highly
recommend that you quit smoking ASAP given your lung disease,
hypertension and diabetes.

Followup Instructions:
Please call to schedule an appointment with your primary care
doctor within the next week for a reevaluation and manaagement
of your coumadin level.

Please call to schedule an appointment with your primary
pulmonologist for reevaluation of your COPD.


                             [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 3559**] MD, [**MD Number(3) 3560**]

Completed by:[**2114-11-18**]
{'Pneumonitis due to inhalation of food or vomitus,Obstructive chronic bronchitis with (acute) exacerbation,Hypoxemia,Atrial fibrillation,Alkalosis,Acute kidney failure, unspecified,Chronic kidney disease, unspecified,Diabetes with renal manifestations, type II or unspecified type, not stated as uncontrolled,Nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere,Polyneuropathy in diabetes,Dysthymic disorder,Morbid obesity,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Right bundle branch block,Benign neoplasm of adrenal gland,Chronic pulmonary heart disease, unspecified,Hypotension, unspecified'}


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: Dyspnea

PRESENT ILLNESS: The patient is a 66 year old male with multiple medical problems
including diabetes, COPD on oxygen at baseline, hypertension and
hyperlipidemia who presented to the [**Last Name (un) **] diabetes clinic this
afternoon complaining of increased fatigue, shortness of breath
and cough for the past three weeks.  He also has been
experiencing lightheadedness and blurry vision intermittently.
The patient also experienced an episode of hypoglycemia this
morning (finger stick of 25) which he treated with [**Location (un) 2452**] juice
and glucose with rapid resolution.  Given his symptoms this AM
in diabetes clinic, he was advised to present to the ED.
.
He denies chest pain and worsening cough.  He does report
increased shortness of breath but has not needed to increase his
home oxygen use.  He denies fevers, chills.  He has a cough at
baseline which is non-productive and non-purulent and may be
slightly more productive over the past few weeks. He has lost 15
lbs over three months when his lasix dose was increased.  He
denies any recent medication changes, or dietary changes.  He
denies hemoptysis.  He denies any recent periods of immobility,
long distance travel.  No recent sick contacts.
.
In the ED the patient was found to be afebrile, hypoxic with an
O2 sat of 84% on 100% O2, and hypotensive with a BP of 83/60 and
HR 92.  His hypotension resolved with IV fluids.  An EKG was
performed which revealed a right bundle branch block and there
was concern for anterioseptal ST-depression.  Cardiology was
consulted who did not feel that he was experience an acute
coronary event.  He did recieve aspirin 325, and was started on
a heparin and nitroglycerine gtt.  First set of troponins came
back negative.  Initial chem7 revelaed a serum potassium of 6.4
on an non-hemolyzed specimen and he received insulin, sodium
bicarbonate, calcium gluconate, dextrose and kaexylate.

MEDICAL HISTORY: 1. DM2 (complicated by nephropathy, neuropathy)
2. CKD (proteinuria)
3. HTN
4. Hyperlipid
5. COPD, home O2 3-4L NC
6. depression
7. anxiety
8. morbid obesity
9. Obstructive sleep apnea

MEDICATION ON ADMISSION: Gabapentin 300 mg TID
NPH 30 units in AM, 10 units in PM
Toprol 50 mg [**Hospital1 **]
Diovan 160 mg daily
Niaspan 500 mg QHS
Potassium Chloride 10 mg QID
Lipitor 80 mg daily
Glyburide 5 mg (2 in AM, 2 in PM)
Coumadin 8 mg daily
Lisinopril 20 mg daily
Lasix 40 mg daily
Norvasc 5 mg daily
Zoloft 50 mg [**Hospital1 **]
Centrum Silver MVI daily
Xanax 0.5 mg [**3-24**] x daily PRN
Spironolactone 25 mg daily
Spiriva daily
Advair 500/50 1 PUFF [**Hospital1 **]
Albuterol 2 PUFFs QID
Oxygen 4-5 L at baseline

ALLERGIES: No Drug Allergy Information on File

PHYSICAL EXAM: Vitals: T: 98.2 HR: 87  BP: 119/62 RR: 22  02: 98% on
non-rebreather mask
Gen: Alert and oriented, mild-respiratory distress
HEENT: PERRL, EOMI, pharynx clear and without exudates
Neck: JVP ~ 12 cm
CV: Distant heart sounds, RRR, no murmurs or gallops appreciated
Resp: Decreased breath sounds throughout, no wheezes or ronchi
appreciated
GI: Obese, soft, non-tender, non-distended, + BS
GU: Foley in place draining clear yellow urine
Ext: WWP, 1+ pulses bilaterally, 1+ pitting edemas to shins, no
clubbing or cyanosis
Neuro: Grossly intact
Rectal: Guaiac negative per ED

FAMILY HISTORY: Sons had [**Name2 (NI) **] in 30s and 40s, mother and father had [**Name2 (NI) **] in older
age.  History of cancer but unknown type.

SOCIAL HISTORY: Single, lives in [**Location 3786**].  Currently not working.  Used to smoke
5 packs per day, currently smokes [**3-24**] cigarettes daily.  No
alcohol use, no ilicits 

### Response:
{'Pneumonitis due to inhalation of food or vomitus,Obstructive chronic bronchitis with (acute) exacerbation,Hypoxemia,Atrial fibrillation,Alkalosis,Acute kidney failure, unspecified,Chronic kidney disease, unspecified,Diabetes with renal manifestations, type II or unspecified type, not stated as uncontrolled,Nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere,Polyneuropathy in diabetes,Dysthymic disorder,Morbid obesity,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Right bundle branch block,Benign neoplasm of adrenal gland,Chronic pulmonary heart disease, unspecified,Hypotension, unspecified'}
