CHIEF COMPLAINT: Slurred speech, nausea, vomiting

PRESENT ILLNESS: Patient is a 53 year old right handed Italian American man
with past medical history of left parietal stroke 1 year ago
with
slurred speech, right sided incoordination (followed at [**Hospital1 2025**]),
obesity, atrial fibrillation on coumadin, diabetes,
hypertension,
hypercholesterolemia, CAD status post angioplasty, who presented
to ED today for evaluation of several day history of slurred
speech and 1 day of vertigo, nausea, vomiting.

MEDICAL HISTORY: 1. Stroke 1 year ago with slurred speech, right sided
incoordination
2. Atrial fibrillation, on coumadin
3. Obesity
4. Diabetes mellitus
5. Asthma
6. Obstructive sleep apnea
7. Hypertension
8. Hyperlipidemia
9. CAD status post angioplasty
10. History of melanoma resection over abdomen, remotely
11. COPD

MEDICATION ON ADMISSION: 1. Effexor
2. Lasix
3. Verapamil
4. Ativan
5. Cialis
6. Metformin
7. Nasacort
8. Percocet
9. Zantac
10. Digoxin
11. Potassium chloride
12. Coumadin
13. Magnesium oxide
14. Topamax (for mood)
15. Singulair

ALLERGIES: Sulfa (Sulfonamides) / Penicillins

PHYSICAL EXAM: PHYSICAL EXAM:
Tc: 96.6
BP: 164/83
HR: 68, irregular
RR: 16
O2Sat.: 100%/2 liters
Gen: WD/WN obese male, diffusely diaphoretic, uncomfortable, in
moderate distress. Stops at several points during exam to vomit.
HEENT: NC/AT. Anicteric. MMM.
Neck: Supple. No masses or LAD. No JVD. No thyromegaly. No
carotid bruits.
Lungs: CTA bilaterally. No R/R/W.
Cardiac:  Irregularly irregular. S1/S2. No M/R/G.
Abd: Soft, obese,  NT, ND, +NABS. No rebound or guarding. No
HSM.
Extrem: Warm and well-perfused. No C/C/E.
.
Neuro:
Mental status: Awake and alert, but extremely inattentive.
Defers
to girlfriend to answer questions. Cannot relate coherent
history. Unable to recite [**Doctor Last Name 1841**] forwards and backwards. Did not
register despite multiple attempts. Speech fluent with fair
comprehension and repetition. Impaired naming for low frequency
naming. Moderate dysarthria. No apraxia, no neglect.
.
Cranial Nerves:
I: Not tested
II: Pupils equally round and reactive to light, 3 to 2 mm
bilaterally. Unable to cooperate with formal resistance testing.
Blinks to threat bilaterally.
III, IV, VI: Extraocular movements intact bilaterally without
nystagmus but complains of diplopia in all fields of gaze. Gets
frustrated and looks to girlfriend when I ask him to explain
further.
V, VII: Right nasolabial lobe flattening. Facial sensation
intact
and symmetric.
VIII: Hearing grossly intact to finger rub bilaterally.
IX, X: Palatal elevation symmetrical.
[**Doctor First Name 81**]: Shoulder shrug strong bilaterally.
XII: Tongue midline without fasciculations. No tongue weakness.
.
Motor: Normal bulk and tone bilaterally. No abnormal movements,
tremors. Strength full power [**4-30**] throughout. No pronator drift.
.
Sensation: Intact to light touch. Inattentive during rest of
sensory exam.
.
Reflexes: Trace but symmetric. Left toe is downgoing. Right toe
is upgoing.
.
Coordination: Right finger-nose-finger with mild dysmetria.
Dysrhythmia on rapid alternating movements, fine finger
movements.  Normal on finger-nose-finger, rapid alternating
movements on left.
.
Gait: Did not assess. Out of concern for possible posterior
circulation problem, kept patient in bed with [**Name (NI) **] <30 degrees.

FAMILY HISTORY: Girlfriend not aware if any history of neurologic
disease.

SOCIAL HISTORY: Divorced. 3 kids. Lives with girlfriend of 14 years.
Smoker, quite several years ago. No tobacco, alcohol, drug use
currently. Moved here from [**Country 2559**] 30 years ago.
Cerebral artery occlusion, unspecified with cerebral infarction,Atrial fibrillation,Chronic obstructive asthma, unspecified,Acute kidney failure, unspecified,Dehydration,Chronic kidney disease, unspecified,Obesity, unspecified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Other and unspecified hyperlipidemia,Unspecified essential hypertension,Coronary atherosclerosis of native coronary artery,Obstructive sleep apnea (adult)(pediatric),Personal history of other diseases of circulatory system,Percutaneous transluminal coronary angioplasty status,Personal history of malignant melanoma of skin
Crbl art ocl NOS w infrc,Atrial fibrillation,Chronic obst asthma NOS,Acute kidney failure NOS,Dehydration,Chronic kidney dis NOS,Obesity NOS,DMII wo cmp nt st uncntr,Hyperlipidemia NEC/NOS,Hypertension NOS,Crnry athrscl natve vssl,Obstructive sleep apnea,Hx-circulatory dis NEC,Status-post ptca,Hx-malig skin melanoma
Admission Date:  [**2190-1-8**]              Discharge Date:   [**2190-1-15**]

Date of Birth:  [**2136-1-21**]             Sex:   M

Service: NEUROLOGY

Allergies:
Sulfa (Sulfonamides) / Penicillins

Attending:[**First Name3 (LF) 8747**]
Chief Complaint:
Slurred speech, nausea, vomiting

Major Surgical or Invasive Procedure:
none


History of Present Illness:
Patient is a 53 year old right handed Italian American man
with past medical history of left parietal stroke 1 year ago
with
slurred speech, right sided incoordination (followed at [**Hospital1 2025**]),
obesity, atrial fibrillation on coumadin, diabetes,
hypertension,
hypercholesterolemia, CAD status post angioplasty, who presented
to ED today for evaluation of several day history of slurred
speech and 1 day of vertigo, nausea, vomiting.

Patient is unable to give a history so history taken from his
girlfriend. She states that she has noticed intermittent
slurring
of his speech for past 3 days. Yesterday, he seemed off balance
and unsteady when walking. Then this morning, he had a right
sided headache radiating from his right posterolateral neck up
to
over the vertex. Then around 10am, he started to have
nausea and vomiting of non-bloody, non-bilious material. He
became diaphoretic. He felt dizzy, like sensation room was
spinning and felt unsteady when walking. EMS was called and he
was transported to ED. Finger stick en route 175.

Patient able to tell me that he has had double vision and
problems with his hearing for months. No dysphagia. He feels
like
he is off balance and that he has to hold onto things to walk.
His right side is clumsier than usual. He states this is exactly
how he felt during his stroke, with exception of the nausea and
vomiting.

No recent illnesses, fevers, chills, chest pain, shortness of
breath, palpitations, cough, sputum, abdominal pain, increased
urinary frequency, dysuria. No new visual changes (states
diplopia has been going on for months), comprehension
difficulty,
focal numbness, weakness, paresthesias. No bowel or bladder
incontinence.

Past Medical History:
1. Stroke 1 year ago with slurred speech, right sided
incoordination
2. Atrial fibrillation, on coumadin
3. Obesity
4. Diabetes mellitus
5. Asthma
6. Obstructive sleep apnea
7. Hypertension
8. Hyperlipidemia
9. CAD status post angioplasty
10. History of melanoma resection over abdomen, remotely
11. COPD

Social History:
Divorced. 3 kids. Lives with girlfriend of 14 years.
Smoker, quite several years ago. No tobacco, alcohol, drug use
currently. Moved here from [**Country 2559**] 30 years ago.


Family History:
Girlfriend not aware if any history of neurologic
disease.


Physical Exam:
PHYSICAL EXAM:
Tc: 96.6
BP: 164/83
HR: 68, irregular
RR: 16
O2Sat.: 100%/2 liters
Gen: WD/WN obese male, diffusely diaphoretic, uncomfortable, in
moderate distress. Stops at several points during exam to vomit.
HEENT: NC/AT. Anicteric. MMM.
Neck: Supple. No masses or LAD. No JVD. No thyromegaly. No
carotid bruits.
Lungs: CTA bilaterally. No R/R/W.
Cardiac:  Irregularly irregular. S1/S2. No M/R/G.
Abd: Soft, obese,  NT, ND, +NABS. No rebound or guarding. No
HSM.
Extrem: Warm and well-perfused. No C/C/E.
.
Neuro:
Mental status: Awake and alert, but extremely inattentive.
Defers
to girlfriend to answer questions. Cannot relate coherent
history. Unable to recite [**Doctor Last Name 1841**] forwards and backwards. Did not
register despite multiple attempts. Speech fluent with fair
comprehension and repetition. Impaired naming for low frequency
naming. Moderate dysarthria. No apraxia, no neglect.
.
Cranial Nerves:
I: Not tested
II: Pupils equally round and reactive to light, 3 to 2 mm
bilaterally. Unable to cooperate with formal resistance testing.
Blinks to threat bilaterally.
III, IV, VI: Extraocular movements intact bilaterally without
nystagmus but complains of diplopia in all fields of gaze. Gets
frustrated and looks to girlfriend when I ask him to explain
further.
V, VII: Right nasolabial lobe flattening. Facial sensation
intact
and symmetric.
VIII: Hearing grossly intact to finger rub bilaterally.
IX, X: Palatal elevation symmetrical.
[**Doctor First Name 81**]: Shoulder shrug strong bilaterally.
XII: Tongue midline without fasciculations. No tongue weakness.
.
Motor: Normal bulk and tone bilaterally. No abnormal movements,
tremors. Strength full power [**4-30**] throughout. No pronator drift.
.
Sensation: Intact to light touch. Inattentive during rest of
sensory exam.
.
Reflexes: Trace but symmetric. Left toe is downgoing. Right toe
is upgoing.
.
Coordination: Right finger-nose-finger with mild dysmetria.
Dysrhythmia on rapid alternating movements, fine finger
movements.  Normal on finger-nose-finger, rapid alternating
movements on left.
.
Gait: Did not assess. Out of concern for possible posterior
circulation problem, kept patient in bed with [**Name (NI) **] <30 degrees.

Pertinent Results:
[**2190-1-8**] 01:17PM   PT-15.9* PTT-22.4 INR(PT)-1.7
[**2190-1-8**] 01:17PM   PLT COUNT-350
[**2190-1-8**] 01:17PM   NEUTS-65.7 LYMPHS-24.0 MONOS-6.9 EOS-2.4
BASOS-1.0
[**2190-1-8**] 01:17PM   WBC-17.1* RBC-5.67 HGB-16.0 HCT-45.2 MCV-80*
MCH-28.3 MCHC-35.5* RDW-14.5
[**2190-1-8**] 01:17PM   CALCIUM-10.1 PHOSPHATE-4.9* MAGNESIUM-1.8
[**2190-1-8**] 01:17PM   CK-MB-13* MB INDX-4.8 cTropnT-0.03*
[**2190-1-8**] 01:17PM   LIPASE-54
[**2190-1-8**] 01:17PM   ALT(SGPT)-77* AST(SGOT)-39 LD(LDH)-261*
CK(CPK)-269* AMYLASE-187* TOT BILI-0.5
[**2190-1-8**] 10:00PM   CK-MB-31* MB INDX-6.7* cTropnT-0.03*
.
CT head [**1-8**]:
FINDINGS: There is no evidence for intracranial hemorrhage.
There is no mass effect or shift of the normally midline
structures. The ventricles, sulci, and cisterns demonstrate no
effacement. The patient is status post left parietal lobe
infarct with hypodense sequelae at this site. There is no
hydrocephalus. The paranasal sinuses are clear. The [**Doctor Last Name 352**]-white
matter junction is indistinct.
IMPRESSION: No evidence for intracranial hemorrhage.
.
CT head [**1-9**]:
No intracranial hemorrhage is identified. Within the right
cerebellar hemisphere, there is a large area of low attenuation,
which was not seen previously, with associated slight mass
effect. The remainder of the [**Doctor Last Name 352**]-white matter differentiation
is preserved. There is an area of decreased attenuation within
the left parietal lobe, which is increased, and corresponds to
chronic changes from prior infarct. The ventricles are
symmetric, and there is no shift of normally midline structures.
Soft tissue and osseous structures are within normal limits.
IMPRESSION: There is a new area of low attenuation within the
right cerebellar hemisphere, which is concerning for a acute
right cerebellar infarct. No intracranial hemorrhage is
identified.
.
CTA head: prelim.
1. No evidence of vertebral artery or carotid dissection.
2. Area of decreased attentuation within the right cerebellar
hemisphere is again seen, likely representing subacute infarct.
Recons pending.
.
RUQ US:
1. Diffuse increased echogenicity of the liver parenchyma,
consistent with fatty infiltration. Other forms of liver
disease, including more severe forms such as hepatic
fibrosis/cirrhosis cannot be excluded on this study.
2. No radiographic evidence for acute cholecystitis or
cholelithiasis. No gallbladder wall edema, pericholecystic
fluid, or intrahepatic biliary dilatation.
.
CT head [**1-12**]:
No acute intracranial hemorrhage is seen. The previously
identified areas of low attenuation in the left parietal lobe,
as well as the right cerebellar hemisphere are unchanged.
There is no hydrocephalus or shift of normal midline structures.
Overall, the exam is not significantly changed from [**2190-1-9**].
.
Right LENIs [**1-13**]:
No evidence of DVT.
.
ECG:
Atrial fibrillation
Diffuse nonspecific ST-T wave abnormalities

Brief Hospital Course:
The patient is 53 year old man with a past medical history of
stroke one year ago (slurred speech and right sided
incoordination), obesity, type II DM, COPD, atrial fibrillation,
and a history of melanoma who presented to the ED [**1-8**] with a
three day history of slurred speech, imbalance, and vertigo.
During the initial exam, the patient was diffusely diaphoretic
and he had to stop during the exam to vomit several times. He
was also inattentive and confused, with his speech mildly
dysarthric, and complaints of diplopia in all directions of
gaze, mild right nasolabial flattening, and clumsiness on right
FNF, FFM,
RAMS. An initial CT head was negative for bleed and showed an
old left parietal infarct. A repeat CT on [**1-9**] showed a new R
cerebellar hypodensity that explains all his symtpoms. A CTA did
not show evidence for dissection.
Initially the patient was admitted to medicine for suspicion of
MI. He was transferred to the ICU for close monitoring after the
cerebellar ischemic stroke was noted. He was then transferred to
the floor [**1-11**].
.
Neuro:
After transfer to the floor, the patient continued to be
somnolent (combination of OSA and pain medications), but always
arousable. He had residual R-sided dysmetria (arms and legs) and
dysarthria His pain medications were kept to a minimum. The
neurological exam was significant for R-sided ataxia, rebound of
the R-arm and dysarthria. Lipid panel: chol 212 TG288 HDL50  4.2
 LDL104. HbA1C 7.6.
The patient was started on ASA 325mg and lipitor 80mg. The
importance of life style modifications were discussed (weight
loss, healthy diet, exercise).
.
CV:
Initially the patient's blood pressure was allowed to
autoregulate.
Lopressor was started to rate control Afib. A dose of 25mg [**Hospital1 **]
appeared sufficient, whereas higher doses would drop the SBP to
90. Lisinopril was added to the regimen. Digoxin (0.125mg daily
at home) and verapamil (180mg daily at home) were held.
Coumadin was restarted [**1-11**] (5mg). INR [**1-11**] 1.3. On [**1-12**], 5mg
coumadin was given with an INR [**1-13**] of 1.1. [**1-13**] and [**1-14**] the
patient received 7.5mg, with an INR of 1.2 on [**1-15**] The patient
should continue to take Coumadin to titrate a goal INR of
2.0-3.0. As long as the INR is not therapeutic he will need to
receive lovenox (80mg sc BID).
.
Pain/psych:
Initially, oxycodone SR 20mg TID was prescribed, but this needed
to be held for sedation. Percocet was given PRN for
breakthrough. Please note that the patient easily becomes
somnolent on these medications.
In addition, clonazepam 1mg TID, topamax 50mg [**Hospital1 **], ativan 0.5mg
qHS and venlafaxine were continued.
.
CRI:
Creatinine was stable at 1.1-1.5. Creatinine at d/c was 1.1.
.
DM:
The patient was put on an ISS. Metformin 1000mg [**Hospital1 **] was resumed
once he was able to eat a regular diet.
.
COPD:
Stable; albuterol PRN as needed.
At night, BiPAP was indicated ([**4-3**]) given OSA in combination
with COPD. The patient was non-compliant. Please avoid
supplementary oxygen as this may add to CO2 retention and
lethargy.
.
Right Leg Pain:
The day of discharge the patient complained of right leg pain;
no swelling or tenderness to touch was present. Given that the
patient had been sedentary, right LENIs was obtained: there was
no evidence of DVT.
.
Prophylaxis:
-GI: ranitidine
-PE: VD boots, sc lovenox
.
Diet: Regular, cardiac-diabetic; the patient was non-compliant.
.
The patient was discharged to rehab.

Medications on Admission:
1. Effexor
2. Lasix
3. Verapamil
4. Ativan
5. Cialis
6. Metformin
7. Nasacort
8. Percocet
9. Zantac
10. Digoxin
11. Potassium chloride
12. Coumadin
13. Magnesium oxide
14. Topamax (for mood)
15. Singulair

Discharge Medications:
1. Montelukast 10 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
2. Venlafaxine 75 mg Capsule, Sust. Release 24HR Sig: Two (2)
Capsule, Sust. Release 24HR PO HS (at bedtime).
3. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO HS (at
bedtime) as needed for insomnia.
4. Topiramate 25 mg Tablet Sig: Two (2) Tablet PO BID (2 times a
day).
5. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2
times a day).
6. Clonazepam 1 mg Tablet Sig: One (1) Tablet PO TID (3 times a
day).
7. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
8. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO once a day.
9. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
10. Metformin 500 mg Tablet Sig: Two (2) Tablet PO BID (2 times
a day).
11. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
12. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q6H (every 6 hours) as needed.
13. Insulin Regular Human 100 unit/mL Solution Sig: Two (2)
units Injection ASDIR (AS DIRECTED): per sliding scale.
14. Warfarin 2.5 mg Tablet Sig: Three (3) Tablet PO ONCE (once)
for 1 doses: Please dose based INR.
Disp:*90 Tablet(s)* Refills:*0*
15. Lisinopril 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Disp:*30 Tablet(s)* Refills:*2*


Discharge Disposition:
Extended Care

Facility:
[**Hospital6 **] - TCU

Discharge Diagnosis:
1. cerebellar ischemid stroke, right
2. diabetes
3. hypertension
4. opioid dependence
5. chronic pain


Discharge Condition:
good


Discharge Instructions:
Please take your medications as instructed. Do not over-use
narcotics as these will depress your breathing.
.
Please have your INR checked and have the coumadin dosed
accordingly to a goal of [**1-29**]. Continue the lovenox until INR is
therapeutic.
.
Please follow up as indicated below.

Followup Instructions:
Please follow up at the [**Hospital 878**] Clinic:
- Dr. [**Last Name (STitle) **]. [**3-9**], 5:30 PM. [**Hospital1 18**] [**Hospital Ward Name 516**], [**Hospital Ward Name 23**]
Building [**Location (un) 858**]
Please call [**Telephone/Fax (1) 2574**] to register before your appointment.
.
Please follow-up with your PCP.



Completed by:[**2190-1-15**]
{'Cerebral artery occlusion, unspecified with cerebral infarction,Atrial fibrillation,Chronic obstructive asthma, unspecified,Acute kidney failure, unspecified,Dehydration,Chronic kidney disease, unspecified,Obesity, unspecified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Other and unspecified hyperlipidemia,Unspecified essential hypertension,Coronary atherosclerosis of native coronary artery,Obstructive sleep apnea (adult)(pediatric),Personal history of other diseases of circulatory system,Percutaneous transluminal coronary angioplasty status,Personal history of malignant melanoma of skin'}


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: Slurred speech, nausea, vomiting

PRESENT ILLNESS: Patient is a 53 year old right handed Italian American man
with past medical history of left parietal stroke 1 year ago
with
slurred speech, right sided incoordination (followed at [**Hospital1 2025**]),
obesity, atrial fibrillation on coumadin, diabetes,
hypertension,
hypercholesterolemia, CAD status post angioplasty, who presented
to ED today for evaluation of several day history of slurred
speech and 1 day of vertigo, nausea, vomiting.

MEDICAL HISTORY: 1. Stroke 1 year ago with slurred speech, right sided
incoordination
2. Atrial fibrillation, on coumadin
3. Obesity
4. Diabetes mellitus
5. Asthma
6. Obstructive sleep apnea
7. Hypertension
8. Hyperlipidemia
9. CAD status post angioplasty
10. History of melanoma resection over abdomen, remotely
11. COPD

MEDICATION ON ADMISSION: 1. Effexor
2. Lasix
3. Verapamil
4. Ativan
5. Cialis
6. Metformin
7. Nasacort
8. Percocet
9. Zantac
10. Digoxin
11. Potassium chloride
12. Coumadin
13. Magnesium oxide
14. Topamax (for mood)
15. Singulair

ALLERGIES: Sulfa (Sulfonamides) / Penicillins

PHYSICAL EXAM: PHYSICAL EXAM:
Tc: 96.6
BP: 164/83
HR: 68, irregular
RR: 16
O2Sat.: 100%/2 liters
Gen: WD/WN obese male, diffusely diaphoretic, uncomfortable, in
moderate distress. Stops at several points during exam to vomit.
HEENT: NC/AT. Anicteric. MMM.
Neck: Supple. No masses or LAD. No JVD. No thyromegaly. No
carotid bruits.
Lungs: CTA bilaterally. No R/R/W.
Cardiac:  Irregularly irregular. S1/S2. No M/R/G.
Abd: Soft, obese,  NT, ND, +NABS. No rebound or guarding. No
HSM.
Extrem: Warm and well-perfused. No C/C/E.
.
Neuro:
Mental status: Awake and alert, but extremely inattentive.
Defers
to girlfriend to answer questions. Cannot relate coherent
history. Unable to recite [**Doctor Last Name 1841**] forwards and backwards. Did not
register despite multiple attempts. Speech fluent with fair
comprehension and repetition. Impaired naming for low frequency
naming. Moderate dysarthria. No apraxia, no neglect.
.
Cranial Nerves:
I: Not tested
II: Pupils equally round and reactive to light, 3 to 2 mm
bilaterally. Unable to cooperate with formal resistance testing.
Blinks to threat bilaterally.
III, IV, VI: Extraocular movements intact bilaterally without
nystagmus but complains of diplopia in all fields of gaze. Gets
frustrated and looks to girlfriend when I ask him to explain
further.
V, VII: Right nasolabial lobe flattening. Facial sensation
intact
and symmetric.
VIII: Hearing grossly intact to finger rub bilaterally.
IX, X: Palatal elevation symmetrical.
[**Doctor First Name 81**]: Shoulder shrug strong bilaterally.
XII: Tongue midline without fasciculations. No tongue weakness.
.
Motor: Normal bulk and tone bilaterally. No abnormal movements,
tremors. Strength full power [**4-30**] throughout. No pronator drift.
.
Sensation: Intact to light touch. Inattentive during rest of
sensory exam.
.
Reflexes: Trace but symmetric. Left toe is downgoing. Right toe
is upgoing.
.
Coordination: Right finger-nose-finger with mild dysmetria.
Dysrhythmia on rapid alternating movements, fine finger
movements.  Normal on finger-nose-finger, rapid alternating
movements on left.
.
Gait: Did not assess. Out of concern for possible posterior
circulation problem, kept patient in bed with [**Name (NI) **] <30 degrees.

FAMILY HISTORY: Girlfriend not aware if any history of neurologic
disease.

SOCIAL HISTORY: Divorced. 3 kids. Lives with girlfriend of 14 years.
Smoker, quite several years ago. No tobacco, alcohol, drug use
currently. Moved here from [**Country 2559**] 30 years ago. 

### Response:
{'Cerebral artery occlusion, unspecified with cerebral infarction,Atrial fibrillation,Chronic obstructive asthma, unspecified,Acute kidney failure, unspecified,Dehydration,Chronic kidney disease, unspecified,Obesity, unspecified,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Other and unspecified hyperlipidemia,Unspecified essential hypertension,Coronary atherosclerosis of native coronary artery,Obstructive sleep apnea (adult)(pediatric),Personal history of other diseases of circulatory system,Percutaneous transluminal coronary angioplasty status,Personal history of malignant melanoma of skin'}
