CHIEF COMPLAINT: angina

PRESENT ILLNESS: 64yo diabetic female who was recently hospitalized for foot
ulcers.  She is also being treated for pneumonia.  She was
worked up for her anginal pain at this time and told she needed
AVR/CABG.  She presents to [**Hospital1 18**] for a second opinion.  Cath
reveals 2vessel CAD and critical aortidc stenosis.  She is
referred for surgical evaluation

MEDICAL HISTORY: # Coronary artery disease status post myocardial infarction x 4
per patient with multiple PCIs in [**2131**], performed at [**Hospital3 15054**],
anatomy unknown)
# s/p Removal of external fixator left foot ([**2149-12-30**])
# s/p Bilateral Charcot reconstruction [**2149-10-14**]
# H/o MRSA ([**2149-10-14**]) from skin wounds
# H/o Pseudomonas ([**2149-7-31**]) from skin wounds
# Diabetes mellitus, type 2, since [**2133**]
# Hypercholesterolemia
# Hypertension
# Neuropathy
# B/l charcot s/p RLE recon ([**1-28**])
# H/o sepsis, in MICU [**4-/2147**]
# Rheumatic fever at age 7 or 8

MEDICATION ON ADMISSION: ACETAMINOPHEN [ACETAMINOPHEN EXTRA STRENGTH]- 500 mg Tablet - 2
Tablet(s) twice a day
ASCORBIC ACID 500 mg Tablet - Tablet(s) by mouth
ASPIRIN 81 mg once a day
BACITRACIN
CALCIUM CARBONATE [TUMS ULTRA]
CALCIUM CARBONATE-VITAMIN D3 500 mg (1,250 mg)-400 unit Tablet -
1 Tablet(s) by mouth twice a day
CHOLECALCIFEROL (VITAMIN D3) [VITAMIN D-3]- 400 unit Capsule - 1
Capsule(s) by mouth daily
DOCUSATE SODIUM [COLACE] 100 mg Capsule - 1 Capsule(s) by mouth
twice a day
FERROUS SULFATE- 325 mg (65 mg iron) Tablet - 1 Tablet(s) by
mouth every several days
IBUPROFEN [MOTRIN]- 800
mg Tablet - 1 Tablet(s) by mouth twice a day
INSULIN NPH & REGULAR HUMAN [NOVOLIN 70/30] - 100 unit/mL
(70-30)
Suspension - twice a day per sliding scale
KETOTIFEN FUMARATE [ALAWAY]- 0.025 % Drops - 1 drop as needed
MAGNESIUM- 250 mg Tablet - 1 Tablet(s) by mouth twice a day
METHYL SALICYLATE-MENTHOL [ANALGESIC BALM]
MULTIVITAMIN -
NEOMYCIN-POLYMYXIN-GRAMICIDIN [TRIPLE ANTIBIOTIC] - Dosage
uncertain
NIACIN - 500 mg Capsule, Sustained Release - 1 Capsule(s) by
mouth daily
SENNA - 8.6 mg Tablet - 2 Tablet(s) by mouth twice a day
VITAMIN E- 400 unit
Capsule - 1 Capsule(s) by mouth daily
ZINC ACETATE (ORAL) [GALZIN] - 50 mg (zinc) Capsule - 1
Capsule(s) by mouth twice a day

ALLERGIES: Gemfibrozil / Ranitidine / Aloe / Lipitor / Avandia

PHYSICAL EXAM: Admission Physical Exam

FAMILY HISTORY: Family h/o CAD; no Family h/o DM or Charcot joints

SOCIAL HISTORY: Lives in [**Hospital1 1559**] with her significant other, [**Name (NI) **]. She works
occasionally as a bookkeeper. She has three children. Denies
tobacco, EtOH, and illicits.
Aortic valve disorders,Pneumonia, organism unspecified,Chronic systolic heart failure,Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris,Old myocardial infarction,Diabetes with other specified manifestations, type II or unspecified type, not stated as uncontrolled,Ulcer of other part of foot,Percutaneous transluminal coronary angioplasty status,Other chronic pulmonary heart diseases,Pure hypercholesterolemia,Unspecified essential hypertension,Thrombocytopenia, unspecified,Anemia, unspecified,Mononeuritis of unspecified site,Venous (peripheral) insufficiency, unspecified,Calculus of kidney
Aortic valve disorder,Pneumonia, organism NOS,Chr systolic hrt failure,Crnry athrscl natve vssl,Angina pectoris NEC/NOS,Old myocardial infarct,DMII oth nt st uncntrld,Ulcer other part of foot,Status-post ptca,Chr pulmon heart dis NEC,Pure hypercholesterolem,Hypertension NOS,Thrombocytopenia NOS,Anemia NOS,Mononeuritis NOS,Venous insufficiency NOS,Calculus of kidney
Admission Date:  [**2151-10-27**]              Discharge Date:   [**2151-11-9**]

Date of Birth:  [**2087-5-24**]             Sex:   F

Service: CARDIOTHORACIC

Allergies:
Gemfibrozil / Ranitidine / Aloe / Lipitor / Avandia

Attending:[**First Name3 (LF) 1406**]
Chief Complaint:
angina

Major Surgical or Invasive Procedure:
1.Coronary artery bypass grafting x3 with left internal
    mammary artery to left anterior descending artery and
    reverse saphenous vein graft to the diagonal artery and
    the posterior left ventricular branch artery.
2. Aortic valve replacement with an [**Doctor Last Name **] Magna Ease
    pericardial tissue valve size 21 mm, model number
    3300TFX


History of Present Illness:
64yo diabetic female who was recently hospitalized for foot
ulcers.  She is also being treated for pneumonia.  She was
worked up for her anginal pain at this time and told she needed
AVR/CABG.  She presents to [**Hospital1 18**] for a second opinion.  Cath
reveals 2vessel CAD and critical aortidc stenosis.  She is
referred for surgical evaluation

Past Medical History:
# Coronary artery disease status post myocardial infarction x 4
per patient with multiple PCIs in [**2131**], performed at [**Hospital3 15054**],
anatomy unknown)
# s/p Removal of external fixator left foot ([**2149-12-30**])
# s/p Bilateral Charcot reconstruction [**2149-10-14**]
# H/o MRSA ([**2149-10-14**]) from skin wounds
# H/o Pseudomonas ([**2149-7-31**]) from skin wounds
# Diabetes mellitus, type 2, since [**2133**]
# Hypercholesterolemia
# Hypertension
# Neuropathy
# B/l charcot s/p RLE recon ([**1-28**])
# H/o sepsis, in MICU [**4-/2147**]
# Rheumatic fever at age 7 or 8


Social History:
Lives in [**Hospital1 1559**] with her significant other, [**Name (NI) **]. She works
occasionally as a bookkeeper. She has three children. Denies
tobacco, EtOH, and illicits.


Family History:
Family h/o CAD; no Family h/o DM or Charcot joints

Physical Exam:
Admission Physical Exam

Pulse: 89  Resp: 20  O2 sat: 91%RA
B/P  Right: 122/69   Left:
Height: 5'9"    Weight: 98.4kg

General: NAD, WG, obese female, appears stated age
Skin: Warm[x] Dry [x] intact [x]
HEENT: NCAT[x] PERRLA [x] EOMI [x]
Neck:  Supple [x] Full ROM [x]
Chest: Lungs clear bilaterally [x]
Heart: RRR [x]  Irregular []  Murmur 2/6 SEM
Abdomen: Soft [x] non-distended [x] non-tender [x]  bowel sounds
+ [x] obese
Extremities: Warm [x], well-perfused [x]  Edema  1+ bilaterally
numerous scars s/p multiple orthopedic procedures of bilateral
lower extremities
ulceration of plantar surface of right foot- (dressed by
podiatry)
Varicosities: None [x]
Neuro: Grossly intact x

Pulses:
Femoral      Right: cath site  Left: 2+
DP           Right: NP  Left: 1+
PT           [**Name (NI) 167**]: 1+  Left: NP
Radial       Right: 2+  Left: 2+

Carotid Bruit        Right:    Left:
radiation of cardiac murmur


Pertinent Results:
[**2151-11-9**] 05:48AM BLOOD WBC-7.1 RBC-3.35*# Hgb-10.3*# Hct-29.5*#
MCV-88 MCH-30.6 MCHC-34.8 RDW-15.0 Plt Ct-212
[**2151-10-26**] 12:11PM BLOOD WBC-6.3 RBC-3.79* Hgb-11.7* Hct-35.8*
MCV-95 MCH-30.9 MCHC-32.7 RDW-15.1 Plt Ct-284
[**2151-11-7**] 12:01AM BLOOD PT-13.6* PTT-29.8 INR(PT)-1.2*
[**2151-10-27**] 11:45AM BLOOD PT-13.0 PTT-28.2 INR(PT)-1.1
[**2151-11-9**] 05:48AM BLOOD UreaN-20 Creat-0.7 Na-138 K-4.2 Cl-101
[**2151-10-26**] 12:11PM BLOOD UreaN-23* Creat-1.0 Na-140 K-4.4 Cl-102
HCO3-23 AnGap-19


[**Hospital1 18**] ECHOCARDIOGRAPHY REPORT

[**Known lastname **], [**Known firstname **]       [**Hospital1 18**] [**Numeric Identifier 62970**] (Complete)
Done [**2151-11-4**] at 2:42:07 PM      FINAL
Referring Physician     [**Name9 (PRE) **] Information
[**Name9 (PRE) **], [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **]
[**Last Name (NamePattern4) 18**] - Department of Cardiac S
[**Last Name (NamePattern1) 439**], 2A
[**Location (un) 86**], [**Numeric Identifier 718**]  Status: Inpatient DOB: [**2087-5-24**]
Age (years): 64 F  Hgt (in):
BP (mm Hg): /  Wgt (lb):
HR (bpm):  BSA (m2):
Indication: Intraoperative TEE for CABG/AVR
ICD-9 Codes: 424.1, 424.0
Test Information
Date/Time: [**2151-11-4**] at 14:42    Interpret MD: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 4901**], MD
Test Type: TEE (Complete) Son[**Name (NI) 930**]: [**Name Initial (MD) **] [**Name8 (MD) 4901**], MD
Doppler: Full Doppler and color Doppler Test Location:
Anesthesia West OR cardiac
Contrast: None Tech Quality: Suboptimal
Tape #: 2010AW1-: Machine: AW1
Echocardiographic Measurements
Results  Measurements  Normal Range
Left Atrium - Four Chamber Length:  *6.0 cm  <= 5.2 cm
Left Ventricle - Inferolateral Thickness:  1.0 cm  0.6 - 1.1 cm

Left Ventricle - Ejection Fraction:  50% to 55%  >= 55%
Aorta - Ascending:  3.1 cm  <= 3.4 cm
Aorta - Arch:  2.1 cm  <= 3.0 cm
Aorta - Descending Thoracic:  1.9 cm  <= 2.5 cm
Aortic Valve - Peak Gradient:  *70 mm Hg  < 20 mm Hg
Aortic Valve - Mean Gradient:  55 mm Hg
Aortic Valve - LVOT diam:  2.2 cm
Aortic Valve - Valve Area:  *0.6 cm2  >= 3.0 cm2
Mitral Valve - MVA (P [**1-23**] T):  2.6 cm2

Findings
LEFT ATRIUM: Elongated LA. Dilated LA. Mild spontaneous echo
contrast in the body of the LA. Good (>20 cm/s) LAA ejection
velocity.

RIGHT ATRIUM/INTERATRIAL SEPTUM: A catheter or pacing wire is
seen in the RA and extending into the RV. No ASD by 2D or color
Doppler.

LEFT VENTRICLE: Wall thickness and cavity dimensions were
obtained from 2D images. Normal LV wall thickness. Mild regional
LV systolic dysfunction.

RIGHT VENTRICLE: Normal RV chamber size and free wall motion.

AORTA: Focal calcifications in aortic root. Normal ascending
aorta diameter. Simple atheroma in ascending aorta. Focal
calcifications in ascending aorta. Normal aortic arch diameter.
Simple atheroma in aortic arch. Normal descending aorta
diameter. Complex (>4mm) atheroma in the descending thoracic
aorta. Focal calcifications in descending aorta.

AORTIC VALVE: Three aortic valve leaflets. Severely
thickened/deformed aortic valve leaflets. Severe AS (area
0.8-1.0cm2). Mild to moderate ([**1-23**]+) AR.

MITRAL VALVE: Moderately thickened mitral valve leaflets.
Moderate mitral annular calcification. No MS. [**Name13 (STitle) 15110**] to co-existing
AR, the pressure half-time estimate of mitral valve area may be
an OVERestimation of true area. Moderate (2+) MR.

TRICUSPID VALVE: Tricuspid valve not well visualized.
Physiologic TR.

PULMONIC VALVE/PULMONARY ARTERY: Pulmonic valve not well seen.
No PR.

GENERAL COMMENTS: A TEE was performed in the location listed
above. I certify I was present in compliance with HCFA
regulations. The patient was under general anesthesia throughout
the procedure. No TEE related complications. Suboptimal image
quality. The patient appears to be in sinus rhythm. Results were
Conclusions
PRE BYPASS The left atrium is elongated. The left atrium is
dilated. Mild spontaneous echo contrast is seen in the body of
the left atrium. No atrial septal defect is seen by 2D or color
Doppler. Left ventricular wall thicknesses are normal. There is
mild regional left ventricular systolic dysfunction with
moderate apical and distal anteroseptal hypokinesis. Right
ventricular chamber size and free wall motion are normal. There
are simple atheroma in the ascending aorta. There are simple
atheroma in the aortic arch. There are complex (>4mm) atheroma
in the descending thoracic aorta. There are three aortic valve
leaflets. The aortic valve leaflets are severely
thickened/deformed. There is severe aortic valve stenosis (valve
area 0.6 cm2). Mild to moderate ([**1-23**]+) aortic regurgitation is
seen. The mitral valve leaflets are moderately thickened. Due to
co-existing aortic regurgitation, the pressure half-time
estimate of mitral valve area may be an OVERestimation of true
mitral valve area. Moderate (2+) mitral regurgitation is seen.
Dr. [**Last Name (STitle) **] was notified in person of the results in the operating
room at the time of the study.

POST BYPASS The patient is in sinus rhythm. The right ventricle
displays normal systolic function. The left ventricle displays
slightly improved systolic function compared to pre-bypass
study. There is still apical and anteroseptal hypokinesis. EF is
about 55%. There is a bioprosthesis in the aortic position. It
appears well seated. The leaflets can be seen moving normally.
The peak gradient across the aortic valve was 18 mm Hg with a
mean gradient of 11 mmHg at a cardiac output of about 5 l/m.
There is trace aortic regurgitation seen but the source can not
be established due to suboptimal image quality. The mitral
regurgitation is improved - now mild to moderate. The thoracic
aorta appears intact after decannulation.
  I certify that I was present for this procedure in compliance
with HCFA regulations.

Electronically signed by [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 4901**], MD, Interpreting physician
[**Last Name (NamePattern4) **] [**2151-11-4**] 17:51


?????? [**2144**] CareGroup IS. All rights reserved.


Brief Hospital Course:
[**2151-11-4**] Ms.[**Known lastname 62966**] was taken to the operating room and
underwent Coronary artery bypass grafting x3 (left internal
mammary artery to left anterior descending artery and reverse
saphenous vein graft to the diagonal artery and the posterior
left ventricular branch artery)/ Aortic valve replacement
([**Doctor Last Name **] Magna Ease
pericardial tissue valve size 21 mm, model number 3300TFX) with
Dr.[**Last Name (STitle) **]. Please refer to operative report for further details.
She tolerated the procedure well and was transferred to the
CVICU intubated, sedated, in critical but stable condition. She
awoke neurologically intact and was extubated without
difficulty. All lines and drains were discontinued in a timely
fashion. She was weaned off all drips and
Beta-blocker/Statin/ASA and diuresis were initiated. She
remained in the CVICU until POD#3 due to hyperglycemia. She was
transferred to the step down unit for further monitoring.
Physical therapy was consulted for evaluation of strength and
mobility. She continued to progress. Postoperatively Podiatry
reevaluated her foot ulcers. On POD# 4 she was cleared by Dr.[**Last Name (STitle) **]
for discharge to home with VNA. All follow up appointments were
advised.


Medications on Admission:
ACETAMINOPHEN [ACETAMINOPHEN EXTRA STRENGTH]- 500 mg Tablet - 2
Tablet(s) twice a day
ASCORBIC ACID 500 mg Tablet - Tablet(s) by mouth
ASPIRIN 81 mg once a day
BACITRACIN
CALCIUM CARBONATE [TUMS ULTRA]
CALCIUM CARBONATE-VITAMIN D3 500 mg (1,250 mg)-400 unit Tablet -
1 Tablet(s) by mouth twice a day
CHOLECALCIFEROL (VITAMIN D3) [VITAMIN D-3]- 400 unit Capsule - 1
Capsule(s) by mouth daily
DOCUSATE SODIUM [COLACE] 100 mg Capsule - 1 Capsule(s) by mouth
twice a day
FERROUS SULFATE- 325 mg (65 mg iron) Tablet - 1 Tablet(s) by
mouth every several days
IBUPROFEN [MOTRIN]- 800
mg Tablet - 1 Tablet(s) by mouth twice a day
INSULIN NPH & REGULAR HUMAN [NOVOLIN 70/30] - 100 unit/mL
(70-30)
Suspension - twice a day per sliding scale
KETOTIFEN FUMARATE [ALAWAY]- 0.025 % Drops - 1 drop as needed
MAGNESIUM- 250 mg Tablet - 1 Tablet(s) by mouth twice a day
METHYL SALICYLATE-MENTHOL [ANALGESIC BALM]
MULTIVITAMIN -
NEOMYCIN-POLYMYXIN-GRAMICIDIN [TRIPLE ANTIBIOTIC] - Dosage
uncertain
NIACIN - 500 mg Capsule, Sustained Release - 1 Capsule(s) by
mouth daily
SENNA - 8.6 mg Tablet - 2 Tablet(s) by mouth twice a day
VITAMIN E- 400 unit
Capsule - 1 Capsule(s) by mouth daily
ZINC ACETATE (ORAL) [GALZIN] - 50 mg (zinc) Capsule - 1
Capsule(s) by mouth twice a day

Plavix - last dose: [**2151-10-27**]


Discharge Medications:
1. albuterol sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig:
Four (4) Puff Inhalation Q4H (every 4 hours) as needed for
wheezing.
Disp:*qs * Refills:*0*
2. allopurinol 300 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*60 Tablet(s)* Refills:*2*
3. pravastatin 20 mg Tablet Sig: Four (4) Tablet PO DAILY
(Daily).
Disp:*120 Tablet(s)* Refills:*2*
4. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1)
Capsule, Delayed Release(E.C.) PO DAILY (Daily).
Disp:*60 Capsule, Delayed Release(E.C.)(s)* Refills:*2*
5. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*2*
6. zinc sulfate 220 mg Capsule Sig: One (1) Capsule PO DAILY
(Daily).
7. vitamin E 400 unit Capsule Sig: One (1) Capsule PO DAILY
(Daily).
8. multivitamin,tx-minerals     Tablet Sig: One (1) Tablet PO
DAILY (Daily).
9. cholecalciferol (vitamin D3) 400 unit Tablet Sig: One (1)
Tablet PO DAILY (Daily).
10. ascorbic acid 500 mg Tablet Sig: One (1) Tablet PO BID (2
times a day).
11. aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO DAILY (Daily).
Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*2*
12. metoprolol tartrate 25 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
Disp:*60 Tablet(s)* Refills:*2*
13. metformin 500 mg Tablet Sig: Two (2) Tablet PO BID (2 times
a day).
14. potassium chloride 20 mEq Tab Sust.Rel. Particle/Crystal
Sig: One (1) Tab Sust.Rel. Particle/Crystal PO BID (2 times a
day) for 14 days.
Disp:*28 Tab Sust.Rel. Particle/Crystal(s)* Refills:*0*
15. Lasix 40 mg Tablet Sig: One (1) Tablet PO twice a day for 14
days.
Disp:*28 Tablet(s)* Refills:*0*
16. hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO Q3H (every 3
hours) as needed for pain.
Disp:*50 Tablet(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
[**Hospital1 **] VNA, [**Hospital1 1559**]

Discharge Diagnosis:
PRIMARY
Coronary Artery Disease
Aortic Stenosis

SECONDARY
Hypercholesterolemia
Hypertension
Chronic foot ulcers


Discharge Condition:
Alert and oriented x3 nonfocal
Ambulating with steady gait
Incisional pain managed with oral analgesia
Incisions:
Sternal - healing well, no erythema or drainage
Leg Right/Left - healing well, no erythema or drainage. Edema


Discharge Instructions:
Please shower daily including washing incisions gently with mild
soap, no baths or swimming until cleared by surgeon. Look at
your incisions daily for redness or drainage
Please NO lotions, cream, powder, or ointments to incisions
Each morning you should weigh yourself and then in the evening
take your temperature, these should be written down on the chart

No driving for approximately one month and while taking
narcotics, will be discussed at follow up appointment with
surgeon when you will be able to drive
No lifting more than 10 pounds for 10 weeks
Please call with any questions or concerns [**Telephone/Fax (1) 170**]
Females: Please wear bra to reduce pulling on incision, avoid
rubbing on lower edge
**Please call cardiac surgery office with any questions or
concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call
person during off hours**


Followup Instructions:
You are scheduled for the following appointments
Surgeon: Dr.[**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], [**First Name3 (LF) **] appointment was arranged for [**12-1**],[**2151**] at 1:15pm
Cardiologist:Dr.[**Last Name (STitle) **] on [**2151-12-14**] at 2:40pm

Please call to schedule appointments with your
Primary Care Dr.[**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 62967**] in [**1-23**] weeks

**Please call cardiac surgery office with any questions or
concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call
person during off hours**




Completed by:[**2151-11-9**]
{'Aortic valve disorders,Pneumonia, organism unspecified,Chronic systolic heart failure,Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris,Old myocardial infarction,Diabetes with other specified manifestations, type II or unspecified type, not stated as uncontrolled,Ulcer of other part of foot,Percutaneous transluminal coronary angioplasty status,Other chronic pulmonary heart diseases,Pure hypercholesterolemia,Unspecified essential hypertension,Thrombocytopenia, unspecified,Anemia, unspecified,Mononeuritis of unspecified site,Venous (peripheral) insufficiency, unspecified,Calculus of kidney'}


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: angina

PRESENT ILLNESS: 64yo diabetic female who was recently hospitalized for foot
ulcers.  She is also being treated for pneumonia.  She was
worked up for her anginal pain at this time and told she needed
AVR/CABG.  She presents to [**Hospital1 18**] for a second opinion.  Cath
reveals 2vessel CAD and critical aortidc stenosis.  She is
referred for surgical evaluation

MEDICAL HISTORY: # Coronary artery disease status post myocardial infarction x 4
per patient with multiple PCIs in [**2131**], performed at [**Hospital3 15054**],
anatomy unknown)
# s/p Removal of external fixator left foot ([**2149-12-30**])
# s/p Bilateral Charcot reconstruction [**2149-10-14**]
# H/o MRSA ([**2149-10-14**]) from skin wounds
# H/o Pseudomonas ([**2149-7-31**]) from skin wounds
# Diabetes mellitus, type 2, since [**2133**]
# Hypercholesterolemia
# Hypertension
# Neuropathy
# B/l charcot s/p RLE recon ([**1-28**])
# H/o sepsis, in MICU [**4-/2147**]
# Rheumatic fever at age 7 or 8

MEDICATION ON ADMISSION: ACETAMINOPHEN [ACETAMINOPHEN EXTRA STRENGTH]- 500 mg Tablet - 2
Tablet(s) twice a day
ASCORBIC ACID 500 mg Tablet - Tablet(s) by mouth
ASPIRIN 81 mg once a day
BACITRACIN
CALCIUM CARBONATE [TUMS ULTRA]
CALCIUM CARBONATE-VITAMIN D3 500 mg (1,250 mg)-400 unit Tablet -
1 Tablet(s) by mouth twice a day
CHOLECALCIFEROL (VITAMIN D3) [VITAMIN D-3]- 400 unit Capsule - 1
Capsule(s) by mouth daily
DOCUSATE SODIUM [COLACE] 100 mg Capsule - 1 Capsule(s) by mouth
twice a day
FERROUS SULFATE- 325 mg (65 mg iron) Tablet - 1 Tablet(s) by
mouth every several days
IBUPROFEN [MOTRIN]- 800
mg Tablet - 1 Tablet(s) by mouth twice a day
INSULIN NPH & REGULAR HUMAN [NOVOLIN 70/30] - 100 unit/mL
(70-30)
Suspension - twice a day per sliding scale
KETOTIFEN FUMARATE [ALAWAY]- 0.025 % Drops - 1 drop as needed
MAGNESIUM- 250 mg Tablet - 1 Tablet(s) by mouth twice a day
METHYL SALICYLATE-MENTHOL [ANALGESIC BALM]
MULTIVITAMIN -
NEOMYCIN-POLYMYXIN-GRAMICIDIN [TRIPLE ANTIBIOTIC] - Dosage
uncertain
NIACIN - 500 mg Capsule, Sustained Release - 1 Capsule(s) by
mouth daily
SENNA - 8.6 mg Tablet - 2 Tablet(s) by mouth twice a day
VITAMIN E- 400 unit
Capsule - 1 Capsule(s) by mouth daily
ZINC ACETATE (ORAL) [GALZIN] - 50 mg (zinc) Capsule - 1
Capsule(s) by mouth twice a day

ALLERGIES: Gemfibrozil / Ranitidine / Aloe / Lipitor / Avandia

PHYSICAL EXAM: Admission Physical Exam

FAMILY HISTORY: Family h/o CAD; no Family h/o DM or Charcot joints

SOCIAL HISTORY: Lives in [**Hospital1 1559**] with her significant other, [**Name (NI) **]. She works
occasionally as a bookkeeper. She has three children. Denies
tobacco, EtOH, and illicits. 

### Response:
{'Aortic valve disorders,Pneumonia, organism unspecified,Chronic systolic heart failure,Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris,Old myocardial infarction,Diabetes with other specified manifestations, type II or unspecified type, not stated as uncontrolled,Ulcer of other part of foot,Percutaneous transluminal coronary angioplasty status,Other chronic pulmonary heart diseases,Pure hypercholesterolemia,Unspecified essential hypertension,Thrombocytopenia, unspecified,Anemia, unspecified,Mononeuritis of unspecified site,Venous (peripheral) insufficiency, unspecified,Calculus of kidney'}
