CHIEF COMPLAINT: Malaise, abdominal pain

PRESENT ILLNESS: Mr. [**Known lastname 112301**] is a 65 year old man with a history of pancreatic
cancer s/p CBD stent placement in [**2-/2183**] with subsequent
revisions in [**4-/2183**] and [**7-/2183**] who presents from OSH with
malaise and mild abdominal pain. He was diagnosed with
pancreatic cancer in early [**2183**] and underwent an attempted
Whipple in [**3-/2183**] that was aborted when metastatic disease to
the liver was discovered at laparotomy. He started chemotherapy
shortly thereafter, and reports feeling malaise shortly after
his chemotherapy sessions, the most recent of which was on
Friday [**8-15**]. He has also been feeling increasingly weak since
[**Month (only) 958**], sometimes tiring after 10 minutes of walking. He denies
accompanying chest pain, dizziness, lightheadedness, orthopea,
or PND.

MEDICAL HISTORY: - Type II diabetes mellitus
- Atrial fibrillation: per patient report, developed 12 years
ago, resolved 8 years ago after switching jobs

MEDICATION ON ADMISSION: insulin glargine 25U qHS
actos 15mg PO daily
glipizide 5mg PO daily
omeprazole 20mg PO daily
aspirin 81mg PO daily
zenpep 10,000 TID
prescribed diltiazem, metoprolol, and lisinopril, but not taking

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: Vitals: 99.4 134 109/85 22 96%/RA
General: Alert, oriented, no acute distress
HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, PERRL
Neck: supple, no LAD
CV: Irregular, tachycardic, normal S1 + S2, no murmurs, rubs,
gallops. JVP 7-8cm.
Lungs: Decreased breath sounds at bases and bibasilar rales, L >
R. Otherwise clear to auscultation bilaterally, no wheezes,
ronchi
Abdomen: soft, non-distended, TTP in RUQ w/o rebound or
guarding, hypoactive bowel sounds, Liver edge palpable 4cm below
costal margin
GU: no foley
Ext: Warm, well perfused, 2+ pulses, trace pitting edema to
shins bilaterally, no clubbing, cyanosis
Neuro: CNII-XII intact, 5/5 strength upper/lower extremities,
grossly normal sensation, gait deferred.

FAMILY HISTORY: No cancer. Otherwise, nonncontributory.

SOCIAL HISTORY: [**Country 3992**] war veteran, worked as chemical and mechanical engineer.
Now retired. Denies tobacco, etOH, drugs.
Acute cholecystitis,Acidosis,Malignant neoplasm of head of pancreas,Atrial fibrillation,Malignant neoplasm of liver, secondary,Constipation, unspecified,Secondary malignant neoplasm of bone and bone marrow,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Nonspecific elevation of levels of transaminase or lactic acid dehydrogenase [LDH],Insomnia, unspecified,Unspecified essential hypertension,Personal history of antineoplastic chemotherapy,Other postprocedural status
Acute cholecystitis,Acidosis,Mal neo pancreas head,Atrial fibrillation,Second malig neo liver,Constipation NOS,Secondary malig neo bone,DMII wo cmp nt st uncntr,Elev transaminase/ldh,Insomnia NOS,Hypertension NOS,Hx antineoplastic chemo,Post-proc states NEC
Admission Date:  [**2183-8-18**]              Discharge Date:   [**2183-8-21**]

Date of Birth:  [**2118-2-17**]             Sex:   M

Service: MEDICINE

Allergies:
No Known Allergies / Adverse Drug Reactions

Attending:[**First Name3 (LF) 3565**]
Chief Complaint:
Malaise, abdominal pain

Major Surgical or Invasive Procedure:
Ultrasound-guided drainage of gall bladder abscess

History of Present Illness:
Mr. [**Known lastname 112301**] is a 65 year old man with a history of pancreatic
cancer s/p CBD stent placement in [**2-/2183**] with subsequent
revisions in [**4-/2183**] and [**7-/2183**] who presents from OSH with
malaise and mild abdominal pain. He was diagnosed with
pancreatic cancer in early [**2183**] and underwent an attempted
Whipple in [**3-/2183**] that was aborted when metastatic disease to
the liver was discovered at laparotomy. He started chemotherapy
shortly thereafter, and reports feeling malaise shortly after
his chemotherapy sessions, the most recent of which was on
Friday [**8-15**]. He has also been feeling increasingly weak since
[**Month (only) 958**], sometimes tiring after 10 minutes of walking. He denies
accompanying chest pain, dizziness, lightheadedness, orthopea,
or PND.

The weekend prior to admission, the patient had poor appetite
and did not eat or drink very much. He syncopized twice, and
each episode was preceded by presyncope. He reports brief LOC
but no head strike or abnormal movements. He also reports
measuring a low blood pressure at home to 85/61 (baseline in the
110s systolic) though was asymptomatic. His wife grew worried
given apparently increasing weakness and took him to [**Hospital1 **] ED. At [**Hospital3 **], he received 5L NS, 2U
PRBCs, and vanc/cefepime. He was in Afib with RVR and was
started on a ditliazem drip at 10mg/hr. He was given vancomycin
and cefepime and transferred to [**Hospital1 18**].

In the ED, initial VS were: T:100.2 HR:150 BP:113/73 RR:18
O2:97%. A CTA was negative for PE and showed numerous lung and
liver lesion and an air-filled strucutre at the anterior border
of the liver that could represent gallbladder with pneumobilia,
bowel, or a necrotic lesion. A RUQ u/s showed a CBD dilated to
8-11mm and the same incompletely characterized air-filled
structure at the anterior border of the liver. His Afib with RVR
broke with the diltiazem gtt and he was given tylenol 1g for
pain.

On arrival to the MICU, patient's VS were 99.4 134 109/85 22
96%/RA. He denied dizziness, lightheadedness, cheset pain, or
SOB.

Past Medical History:
- Type II diabetes mellitus
- Atrial fibrillation: per patient report, developed 12 years
ago, resolved 8 years ago after switching jobs

Social History:
[**Country 3992**] war veteran, worked as chemical and mechanical engineer.
Now retired. Denies tobacco, etOH, drugs.

Family History:
No cancer. Otherwise, nonncontributory.

Physical Exam:
Vitals: 99.4 134 109/85 22 96%/RA
General: Alert, oriented, no acute distress
HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, PERRL
Neck: supple, no LAD
CV: Irregular, tachycardic, normal S1 + S2, no murmurs, rubs,
gallops. JVP 7-8cm.
Lungs: Decreased breath sounds at bases and bibasilar rales, L >
R. Otherwise clear to auscultation bilaterally, no wheezes,
ronchi
Abdomen: soft, non-distended, TTP in RUQ w/o rebound or
guarding, hypoactive bowel sounds, Liver edge palpable 4cm below
costal margin
GU: no foley
Ext: Warm, well perfused, 2+ pulses, trace pitting edema to
shins bilaterally, no clubbing, cyanosis
Neuro: CNII-XII intact, 5/5 strength upper/lower extremities,
grossly normal sensation, gait deferred.


Pertinent Results:
Admission Labs:

[**2183-8-18**] 07:30PM   PT-11.8 PTT-23.6* INR(PT)-1.1
[**2183-8-18**] 07:30PM   PLT COUNT-354
[**2183-8-18**] 07:30PM   NEUTS-94.0* LYMPHS-3.1* MONOS-0.9* EOS-1.8
BASOS-0.1
[**2183-8-18**] 07:30PM   WBC-9.2 RBC-4.26* HGB-11.2* HCT-35.0* MCV-82
MCH-26.3* MCHC-32.0 RDW-15.9*
[**2183-8-18**] 07:30PM   ALBUMIN-2.7*
[**2183-8-18**] 07:30PM   LIPASE-175*
[**2183-8-18**] 07:30PM   ALT(SGPT)-49* AST(SGOT)-40 ALK PHOS-374* TOT
BILI-2.1*
[**2183-8-18**] 07:30PM   estGFR-Using this
[**2183-8-18**] 07:30PM   GLUCOSE-326* UREA N-29* CREAT-0.9 SODIUM-133
POTASSIUM-4.6 CHLORIDE-100 TOTAL CO2-21* ANION GAP-17
[**2183-8-18**] 07:51PM   LACTATE-2.1*
[**2183-8-18**] 08:30PM URINE  MUCOUS-RARE
[**2183-8-18**] 08:30PM URINE  RBC-3* WBC-3 BACTERIA-FEW YEAST-NONE
EPI-<1 TRANS EPI-<1
[**2183-8-18**] 08:30PM URINE  BLOOD-NEG NITRITE-NEG PROTEIN-30
GLUCOSE-1000 KETONE-40 BILIRUBIN-NEG UROBILNGN-2* PH-6.0
LEUK-NEG
[**2183-8-18**] 08:30PM URINE  COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.030
[**2183-8-18**] 08:30PM URINE  GR HOLD-HOLD
[**2183-8-18**] 08:30PM URINE  HOURS-RANDOM

Discharge Labs [**8-21**]:
WBC 10.4   (N:89.1 L:5.5 M:4.2 E:0.9 Bas:0.4)
HGB 9.5
HCT 29.6
PLT 253

Na 133
Cl 102
Bicarb 22
K 3.8
BUN 22
Cr 0.7
Glucose 135
Ca: 7.8 Mg: 1.7
ALT: 32 AP: 312 Tbili: 0.7
AST: 25 LDH: 184

Imaging:

[**8-20**] CT ABDOMEN/PELVIS WITH CONTRAST
ABDOMEN:
Few small pulmonary nodules are seen in the imaged portion of
the left lower lobe, the largest measuring 7 mm (2a:4).  There
is a small right pleural effusion with compressive atelectasis
of the right lower lobe.

Multiple hypoenhancing  lesions are seen throughout the liver,
with the
largest in segment V measuring 4.2 x 4.1 cm (2ae:28).  The
portal vein is
patent.  Small amount of pneumobilia, relates to the presence of
a CBD stent.

Inflammatory changes are seen around the gallbladder, consistent
with acute cholecystitis.  There is disruption of the
gallbladder wall at the level of the fundus, with a 9.6 x 2.7 cm
hepatic subcapsular fluid collection which communicates freely
with the gallbladder.  This collection contains a small amount
of air which may be due to superinfection or due to the presence
of a biliary stent.

An adjacent rim enhancing fluid collection is seen in the right
lateral abdominal wall musculature measuring 4.0 x 2.0 cm
(300b:16).

The adrenal glands are normal.  Both kidneys enhance and excrete
contrast symmetrically, without evidence of hydronephrosis.  The
spleen is mildly enlarged measuring 13.8 cm.

There is an ill-defined hypodense mass centered in the region of
the pancreatic head/uncinate process, measuring approximately
3.1 x 2.7 cm. There is encasement of the common hepatic artery
by the mass.  An additional hypoechoic lesion measuring 3.7 x
2.5 cm (2a:32) in the portocaval region may represent a lymph
node or posterior extension of the known pancreatic tumor.
Reactive inflammation seen in the distal portion of the stomach.
 A duodenal stent is in place.  The administered oral contrast
passes freely through the stent into the proximal small bowel.
There is no evidence of bowel obstruction. The abdominal aorta
has mild atherosclerotic calcification without aneurysmal
dilation.

Small retroperitoneal lymph nodes are seen, with the largest in
the aortocaval region measuring 10 mm (2a:46).  There is mild
stranding of the mesenteric fat along the right paracolic
gutter.  A mesenteric nodule in the right lower quadrant of the
abdomen measuring 15 x 12 mm (2a:54), concerning for metastatic
disease.  There is a small amount of simple pelvic ascites.

PELVIS:
The urinary bladder and prostate are unremarkable.  There is a
small amount of pelvic free fluid.  The rectum and sigmoid colon
are unremarkable.  No significant pelvic lymphadenopathy or free
fluid is seen.  Incidental note of a small fat-containing right
inguinal hernia is made.

BONES AND SOFT TISSUES:  Few small lucent lesions are seen in
the lumbar spine, the largest in L2 vertebral body measuring 7
mm (2a:44).  and a lucent lesion in the right iliac bone
(300b:43), are concerning metastatic disease.

IMPRESSION:
1.  Presumed gangrenous cholecystitis with perforation.
Subcapsular hepatic fluid collection communicating with the
gallbladder.  These findings have not significantly changed
since the earlier study of [**2183-8-18**] but are better
characterized on this study given the abdominal coverage today.
A rim enhancing fluid collection in the right lateral abdominal
wall musculature, concerning for abscess, likely communicating
with the larger collection.

2.  Multiple hypoenhancing liver lesions, in the setting of
known pancreatic cancer may represent metastatic disease or
multiple abscesses. Comparison to prior imaging might provide
assistance in evaluating temporal change for assistance in
differentiating the two.

3.  Poorly defined hypoenhancing mass in the pancreatic
head/uncinate process, represents known pancreatic cancer.
Additional hypoechoic lesion in the portacaval region may
represent posterior tumor extension versus a lymph node.

4.  Patent duodenal stent.
5.  Peritoneal metastasis and possible osseous metastasis.

[**8-21**]
SINGLE FRONTAL VIEW OF THE CHEST
REASON FOR EXAM:  Assess line.
Comparison is made with prior study, [**8-20**].
Right PICC tip is difficult to visualize can be followed to the
mid to lower SVC.  There are low lung volumes with persistent
elevation of the right hemidiaphragm.  Right lower lobe
atelectasis has increased. Cardiomegaly and widened mediastinum
are stable.  Small right pleural effusion is unchanged.
Multiple lung nodules described in prior CT are not clearly
visualized in this examination and are below the resolution of
this exam.  rib fractures are again noted.

[**8-18**] CTA CHEST W&W/O C&RECONS, NON-CORONARY
IMPRESSION:
1.  No evidence of pulmonary embolism although with suboptimal
opacification of distal vessels.

2.  Multiple lung parenchymal nodules which, given history, are
concerning for metastatic disease though the appearance is not
typical and infectious or inflammatory etiologies may also be
considered.

3.  Small right-sided pleural effusion and associated opacity,
in the setting of right hemidiaphragm elevation, likely due to
atelectasis although it is difficult to completely exclude an
infectious process.

4.  Partially imaged upper abdomen demonstrating hypodense
lesions within the liver concerning for metastatic disease.  Low
density areas with air along the anterior margin of the liver
are incompletely imaged and could represent gallbladder with
pneumobilia, bowel or possibly even necrotic lesions.  If
further evaluation is needed, a CT of the abdomen may be
obtained if clinically indicated, noting that the anatomy of the
area is not well delineated by this study, or an accompanying
ultrasound performed around the same time.  Correlation to prior
outside imaging, if any prior abdominal CT is available, may
also be helpful.

[**8-18**] RUQ ULTRASOUND
1.  Predominantly hypoechoic structure with internal echoes and
containing air.  This cannot be connected to bowel and may
represent distended gallbladder with sludge and pneumobilia;
however noting limited assessment, stomach or bowel, or
potentially a necrosis lesion are difficult to exclude.  If more
definitive characterization is needed clinically, CT abdomen may
be obtained, preferably with intravenous contrast is possible.

2.  The CBD measures up to 11 mm shortly above the stent, but
there is no intrahepatic biliary dilatation.

3.  Heterogeneous liver with several hypoechoic foci concerning
for metastatic disease.

Brief Hospital Course:
# Fever/Malaise: The patient presented with RUQ tenderness,
elevated transaminases, and elevated TBili. He was started on
cipro 400mg IV q12h and flagyl 500mg IV q8h for empIric coverage
for potential intra-abdominal infection. His transaminases, alk
phos, and TBili were downtrending during his admission. GI/ERCP
evaluated the patient and felt that his symptoms were unlikley
to be due to cholangitis or biliary obstruction and felt that an
ERCP was unnecessary. Early imaging in the [**Hospital1 18**] ED suggested
the presence of a possible liver abscess. A CT abdomen/pelvis
showed perforated cholecystitis with an adjacent fluid
collection that was concerning for abscess. A gram stain of the
fluid showed polymicrobial infection and cultures were pending.
He was discharged on cipro 400mg IV q12h and flagyl 500mg IV q8h
with a planned 4 week course ([**Date range (1) 112302**]). Day 1 of antibiotics
was [**8-19**]. Pending culture results, the proposed antibiotic plan
was to obtain repeat imaging upon discharge from [**Hospital1 2436**] to
ensure that the fluid collection was being drained adequately,
to continue IV antibiotics for 2 weeks (last day of IV abx
[**9-2**]), to reimage the abdomen, and then to potentially
transition to PO antibiotics for the last two weeks of his 4
week course (ending [**9-16**]).

# Afib with RVR: The patient presented from [**Hospital3 **]
in Afib with RVR to the 150s on a diltiazem gtt at 10mg/hr. He
returned to sinus rhythm in the [**Hospital1 18**] ED and his diltiazem gtt
was stopped. He returned to Afib with RVR on the floor that
reverted to NSR with diltiazem gtt at 15mg/hr. He was
transitioned to diltiazem PO 90mg q6h with good rate control,
though remained in and out of AFib.

# Hyperglycemia: The patient presented with a glucose level of
326, glucosuria, and ketonuria. He was given his home lantus 25
units QHS and placed on an insulin sliding scale. His blood
sugars were better controlled with this regimen.

Medications on Admission:
insulin glargine 25U qHS
actos 15mg PO daily
glipizide 5mg PO daily
omeprazole 20mg PO daily
aspirin 81mg PO daily
zenpep 10,000 TID
prescribed diltiazem, metoprolol, and lisinopril, but not taking

Discharge Medications:
1. Ciprofloxacin 400 mg IV Q12H Day 1 = [**8-19**]
2. Aspirin 81 mg PO DAILY
3. Diltiazem 90 mg PO Q6H please hold for HR<60, SBP<100
4. Glargine 25 Units Bedtime
5. MetRONIDAZOLE (FLagyl) 500 mg IV Q8H D1 [**8-19**]
6. Mirtazapine 7.5 mg PO HS
7. Omeprazole 20 mg PO DAILY

Discharge Disposition:
Extended Care

Discharge Diagnosis:
Perforated cholecystitis with abscess
Atrial fibrillation with rapid ventricular response

Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.

Discharge Instructions:
It was a pleasure taking care of you at [**Hospital1 18**]. You were admitted
because you were feeling unwell. We initially felt your symptoms
might have been due to a bile duct obstruction or a bile duct
infection (cholangitis), but your labs normalized and we did not
feel an ERCP was necessary. We did a CT scan that showed you had
a perforated gall bladder that was infected. We took a sample of
the infected fluid and the culture results are pending in the
[**Hospital1 18**] microbiology lab.

You were given ciprofloxacin and Flagyl (metronidazole) for
antibiotics, which were started on [**8-19**]. Your antibiotics may
change depending on the final culture results. You will need IV
antibiotics for at least two weeks (last day of IV antibiotics:
[**9-2**]). You were given a PICC line for getting IV antibiotics at
home. You should have another imaging study to see if the fluid
collection is improving. If it looks better, you should switch
to oral antibiotics for two more weeks (last dose on [**9-16**], for a
total 4 week course).

You were also in rapid atrial fibrillation while in the
hospital. You were given diltiazem 90mg by mouth every 6 hours
to control your heart rate. You should continue to take this
medication at home.

Your blood sugars were elevated during your hospitalization. In
addition to your usual evening long-acting insulin dose, you
were placed on a short-acting insulin sliding scale. You should
check with your doctors [**First Name (Titles) **] [**Hospital3 **] about continuing
this at home.

Change the dressing around the biliary drain daily. Wash the
skin with 1/2 strength hydrogen peroxide, rinse with a
saline-moistened QTip, and apply a new sterile dressing.

The percutaneous drain should be flushed daily according to the
following instructions:
Flush with 10cc sterile saline and aspirate back.
Repeat this until aspirate is clear. Do not continue to flush if
the volume out is significantly less than the volume in.
If there is pain with flushing this may mean that the abscess
cavity has collapsed.
In this case, please call [**Hospital1 18**] operator ([**Telephone/Fax (1) 2756**]) and ask
for [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] with the radiology nurse practitioner's
office for further instructions.

Troubleshooting: If catheter stops draining suddenly:
1) Check that the stopcock is open.
2) Remove dressing carefully and inspect to make sure that there
is no kink in the catheter.
3) Inspect to be sure that there is no debris blocking the
catheter. If there is, then firmly flush 5 cc of sterile saline
into the catheter.

Followup Instructions:
PCP: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], MD
Oncologist: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], MD

You should follow up with your PCP and oncologist in the next
1-2 days.

You should have your gall bladder reimaged in [**2-7**] days, and
again in 2 weeks.


Completed by:[**2183-8-21**]
{'Acute cholecystitis,Acidosis,Malignant neoplasm of head of pancreas,Atrial fibrillation,Malignant neoplasm of liver, secondary,Constipation, unspecified,Secondary malignant neoplasm of bone and bone marrow,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Nonspecific elevation of levels of transaminase or lactic acid dehydrogenase [LDH],Insomnia, unspecified,Unspecified essential hypertension,Personal history of antineoplastic chemotherapy,Other postprocedural 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: Malaise, abdominal pain

PRESENT ILLNESS: Mr. [**Known lastname 112301**] is a 65 year old man with a history of pancreatic
cancer s/p CBD stent placement in [**2-/2183**] with subsequent
revisions in [**4-/2183**] and [**7-/2183**] who presents from OSH with
malaise and mild abdominal pain. He was diagnosed with
pancreatic cancer in early [**2183**] and underwent an attempted
Whipple in [**3-/2183**] that was aborted when metastatic disease to
the liver was discovered at laparotomy. He started chemotherapy
shortly thereafter, and reports feeling malaise shortly after
his chemotherapy sessions, the most recent of which was on
Friday [**8-15**]. He has also been feeling increasingly weak since
[**Month (only) 958**], sometimes tiring after 10 minutes of walking. He denies
accompanying chest pain, dizziness, lightheadedness, orthopea,
or PND.

MEDICAL HISTORY: - Type II diabetes mellitus
- Atrial fibrillation: per patient report, developed 12 years
ago, resolved 8 years ago after switching jobs

MEDICATION ON ADMISSION: insulin glargine 25U qHS
actos 15mg PO daily
glipizide 5mg PO daily
omeprazole 20mg PO daily
aspirin 81mg PO daily
zenpep 10,000 TID
prescribed diltiazem, metoprolol, and lisinopril, but not taking

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: Vitals: 99.4 134 109/85 22 96%/RA
General: Alert, oriented, no acute distress
HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, PERRL
Neck: supple, no LAD
CV: Irregular, tachycardic, normal S1 + S2, no murmurs, rubs,
gallops. JVP 7-8cm.
Lungs: Decreased breath sounds at bases and bibasilar rales, L >
R. Otherwise clear to auscultation bilaterally, no wheezes,
ronchi
Abdomen: soft, non-distended, TTP in RUQ w/o rebound or
guarding, hypoactive bowel sounds, Liver edge palpable 4cm below
costal margin
GU: no foley
Ext: Warm, well perfused, 2+ pulses, trace pitting edema to
shins bilaterally, no clubbing, cyanosis
Neuro: CNII-XII intact, 5/5 strength upper/lower extremities,
grossly normal sensation, gait deferred.

FAMILY HISTORY: No cancer. Otherwise, nonncontributory.

SOCIAL HISTORY: [**Country 3992**] war veteran, worked as chemical and mechanical engineer.
Now retired. Denies tobacco, etOH, drugs. 

### Response:
{'Acute cholecystitis,Acidosis,Malignant neoplasm of head of pancreas,Atrial fibrillation,Malignant neoplasm of liver, secondary,Constipation, unspecified,Secondary malignant neoplasm of bone and bone marrow,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Nonspecific elevation of levels of transaminase or lactic acid dehydrogenase [LDH],Insomnia, unspecified,Unspecified essential hypertension,Personal history of antineoplastic chemotherapy,Other postprocedural status'}
