CHIEF COMPLAINT: Lab abnormalities/direct transfer from clinic

PRESENT ILLNESS: Mr. [**Known lastname 49552**] is a 52 year-old man with a history of HIV ([**4-18**] VL
undetectable, CD4 266, toxo seronegative in [**Month (only) 958**]) and HCV
cirrhosis (no varices, MELD 13 in [**6-17**]) who presented from
clinic in setting of further work-up of recent diagnosis of
brain masses.
.
The patient had visited several specialists. He had two LPs with
negative PCR in the recent month for diagnosis of his white
matter lesions in the CNS. This work-up was being done in the
setting of a liver transplant evaluation. Therfore, the brain
mass evaluation was of secondary importance relating to his
potential exclusion from liver transplant. Given these negative
lesions, brain biopsy was being considered as the next
diagnostic option.
.
At baseline, he stated his abdomen had been protuberant for
quite some time with some increasing peripheral edema. He had
not had issues since his last hospitalization in [**Month (only) 116**] with AMS
and is compliant with medications. He does endorse decreased
strength.
.
On the floor, patient was stable, AAOx3, and eating dinner.
.
Review of sytems:
(+) Per HPI
(-) Denies fever, chills, night sweats, recent weight loss or
gain. Denies headache, sinus tenderness, rhinorrhea or
congestion. Denied cough, shortness of breath. Denied chest pain
or tightness, palpitations. Denied nausea, vomiting, diarrhea,
constipation or abdominal pain. No recent change in bowel or
bladder habits. No dysuria. Denied arthralgias or myalgias.

MEDICAL HISTORY: HCV Cirrhosis - decompensated with ascites
--EGD [**2136-5-29**] - gastritis, no varices, +portal gastropathy
--No h/o SBP, has not had paracentesis prior
--on lactulose and rifaximin
HIV - on HAART ([**2136-4-25**] VL undetectable; CD4 266)
Nonreducible Abdominal Hernia
Anal neoplasia

MEDICATION ON ADMISSION: - Cholestyramine-Sucrose 4grams [**Hospital1 **]
- Clotrimazole 10mg Troche
- Efavirenz-Emtricitabin-Tenofov 600-200-300mg Daily
- Lasix 40mg [**Hospital1 **]
- Lactulose 30ml TID
- Rifaximin 400mg TID
- Spironolactone 100mg [**Hospital1 **]
- Bactrim 800/160mg daily
- Warfarin 0.5mg daily
- Vitamin D 50,000 unit weekly

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: ON ADMISSION
Vitals: T 99.2 BP: 132/68 P: 87 R: 18 O2: 100 RA
General: Alert, oriented, no acute distress
HEENT: Sclera icteric, MMM, oropharynx with some evidence of
thrush
Neck: supple, JVP not elevated, no LAD
Lungs: Clear to auscultation bilaterally, no wheezes, rales,
ronchi
CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs,
gallops
Abdomen: protuberant with umbilical herniation, bowel sounds not
appreciated, no rebound tenderness or guarding; appears to be
massive ascites
GU: no foley
Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or
edema
Skin: Scattered red, raised lesions not well-circumscribed

FAMILY HISTORY: noncontributory

SOCIAL HISTORY: The patient lives alone, is not currently working, and is MSM.
He used to work full time as a flight attendant for American
Airlines. He denies current ETOH or drug use. He occasionally
smokes a pipe but denies cigarette use. The patient reported a
history of significant alcohol consumption up to two bottles or
more of red wine per night, but reports no EtOH since [**4-16**]. The
patient reported that he has used other substances including
IVDU in the past, but nothing after [**2111**].
Unspecified intracranial hemorrhage,Unspecified viral hepatitis C with hepatic coma,Human immunodeficiency virus [HIV] disease,Pneumonia, organism unspecified,Severe sepsis,Acute kidney failure, unspecified,Portal vein thrombosis,Acute respiratory failure,Hepatorenal syndrome,Methicillin susceptible Staphylococcus aureus septicemia,Acute myeloid leukemia, without mention of having achieved remission,Other ascites,Hemiplegia, unspecified, affecting dominant side,Urinary tract infection, site not specified,Jaundice, unspecified, not of newborn,Hyposmolality and/or hyponatremia,Delirium due to conditions classified elsewhere,Other and unspecified coagulation defects,Candidiasis of mouth,Cirrhosis of liver without mention of alcohol,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Chronic kidney disease, unspecified,Other convulsions,Dysplasia of anus,Anemia, unspecified,Nonspecific abnormal findings in stool contents,Long-term (current) use of anticoagulants,Encounter for palliative care
Intracranial hemorr NOS,Hpt C w hepatic coma NOS,Human immuno virus dis,Pneumonia, organism NOS,Severe sepsis,Acute kidney failure NOS,Portal vein thrombosis,Acute respiratry failure,Hepatorenal syndrome,Meth susc Staph aur sept,Ac myl leuk wo achv rmsn,Ascites NEC,Unsp hemiplga domnt side,Urin tract infection NOS,Jaundice NOS,Hyposmolality,Delirium d/t other cond,Coagulat defect NEC/NOS,Thrush,Cirrhosis of liver NOS,Hy kid NOS w cr kid I-IV,Chronic kidney dis NOS,Convulsions NEC,Dysplasia of anus,Anemia NOS,Abn find-stool contents,Long-term use anticoagul,Encountr palliative care
Admission Date:  [**2136-8-16**]              Discharge Date:   [**2136-9-21**]

Date of Birth:  [**2083-6-30**]             Sex:   M

Service: MEDICINE

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 4393**]
Chief Complaint:
Lab abnormalities/direct transfer from clinic


Major Surgical or Invasive Procedure:
Intubation

History of Present Illness:
Mr. [**Known lastname 49552**] is a 52 year-old man with a history of HIV ([**4-18**] VL
undetectable, CD4 266, toxo seronegative in [**Month (only) 958**]) and HCV
cirrhosis (no varices, MELD 13 in [**6-17**]) who presented from
clinic in setting of further work-up of recent diagnosis of
brain masses.
.
The patient had visited several specialists. He had two LPs with
negative PCR in the recent month for diagnosis of his white
matter lesions in the CNS. This work-up was being done in the
setting of a liver transplant evaluation. Therfore, the brain
mass evaluation was of secondary importance relating to his
potential exclusion from liver transplant. Given these negative
lesions, brain biopsy was being considered as the next
diagnostic option.
.
At baseline, he stated his abdomen had been protuberant for
quite some time with some increasing peripheral edema. He had
not had issues since his last hospitalization in [**Month (only) 116**] with AMS
and is compliant with medications. He does endorse decreased
strength.
.
On the floor, patient was stable, AAOx3, and eating dinner.
.
Review of sytems:
(+) Per HPI
(-) Denies fever, chills, night sweats, recent weight loss or
gain. Denies headache, sinus tenderness, rhinorrhea or
congestion. Denied cough, shortness of breath. Denied chest pain
or tightness, palpitations. Denied nausea, vomiting, diarrhea,
constipation or abdominal pain. No recent change in bowel or
bladder habits. No dysuria. Denied arthralgias or myalgias.

Past Medical History:
HCV Cirrhosis - decompensated with ascites
--EGD [**2136-5-29**] - gastritis, no varices, +portal gastropathy
--No h/o SBP, has not had paracentesis prior
--on lactulose and rifaximin
HIV - on HAART ([**2136-4-25**] VL undetectable; CD4 266)
Nonreducible Abdominal Hernia
Anal neoplasia

Social History:
The patient lives alone, is not currently working, and is MSM.
He used to work full time as a flight attendant for American
Airlines. He denies current ETOH or drug use. He occasionally
smokes a pipe but denies cigarette use. The patient reported a
history of significant alcohol consumption up to two bottles or
more of red wine per night, but reports no EtOH since [**4-16**]. The
patient reported that he has used other substances including
IVDU in the past, but nothing after [**2111**].

Family History:
noncontributory

Physical Exam:
ON ADMISSION
Vitals: T 99.2 BP: 132/68 P: 87 R: 18 O2: 100 RA
General: Alert, oriented, no acute distress
HEENT: Sclera icteric, MMM, oropharynx with some evidence of
thrush
Neck: supple, JVP not elevated, no LAD
Lungs: Clear to auscultation bilaterally, no wheezes, rales,
ronchi
CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs,
gallops
Abdomen: protuberant with umbilical herniation, bowel sounds not
appreciated, no rebound tenderness or guarding; appears to be
massive ascites
GU: no foley
Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or
edema
Skin: Scattered red, raised lesions not well-circumscribed


Pertinent Results:
[**5-8**] Toxo Ab neg
[**8-1**] Spinal Fluid - Crypto neg, Cx neg, Fungal Cx neg, Viral cx
neg

[**2136-8-15**] 04:05PM BLOOD WBC-6.6 RBC-2.50* Hgb-7.6* Hct-23.9*
MCV-96 MCH-30.4 MCHC-31.8 RDW-25.0* Plt Ct-173
[**2136-8-15**] 04:05PM BLOOD PT-26.6* INR(PT)-2.6*
[**2136-8-15**] 04:05PM BLOOD  WBC-6.6 Lymph-22 Abs [**Last Name (un) **]-1452 CD3%-86
Abs CD3-1242 CD4%-16 Abs CD4-226* CD8%-70 Abs CD8-1012*
CD4/CD8-0.2*
[**2136-8-15**] 04:05PM BLOOD ALT-65* AST-184* AlkPhos-158*
TotBili-5.4*

[**8-18**]: CT head w/o contrast: Acute right temporoparietal
intraparenchymal hemorrhage, possibly at site of subcortical
white matter irregularity. Mass effect upon the right lateral
ventricle but no herniation or midline shift. No
intraventricular extension to this hemorrhage.

[**8-22**]: CT Head w/o contrast: Stable right temperoparietal
intraparenchymal hematoma with slightly increased blood layering
in lateral ventricles. Leftward shift of midline structures is
stable.

[**2136-8-22**] 11:02 am URINE      Source: Catheter.

                            **FINAL REPORT [**2136-8-24**]**

   URINE CULTURE (Final [**2136-8-24**]):
      ENTEROBACTER CLOACAE.    >100,000 ORGANISMS/ML..
         This organism may develop resistance to third
generation
         cephalosporins during prolonged therapy. Therefore,
isolates that
         are initially susceptible may become resistant within
three to
         four days after initiation of therapy.  For serious
infections,
         repeat culture and sensitivity testing may therefore be
warranted
         if third generation cephalosporins were used.

                              SENSITIVITIES: MIC expressed in
MCG/ML

_________________________________________________________
                             ENTEROBACTER CLOACAE
                             |
CEFEPIME--------------   <=1 S
CEFTAZIDIME-----------   <=1 S
CEFTRIAXONE-----------   <=1 S
CIPROFLOXACIN---------<=0.25 S
GENTAMICIN------------   <=1 S
MEROPENEM-------------<=0.25 S
NITROFURANTOIN--------    64 I
PIPERACILLIN/TAZO-----   <=4 S
TOBRAMYCIN------------   <=1 S
TRIMETHOPRIM/SULFA----  =>16 R

[**2136-9-7**] 5:30 pm BLOOD CULTURE

                            **FINAL REPORT [**2136-9-11**]**

   Blood Culture, Routine (Final [**2136-9-11**]):
      STAPH AUREUS COAG +.
         Consultations with ID are recommended for all blood
cultures
         positive for Staphylococcus aureus and [**Female First Name (un) 564**] species.

         FINAL SENSITIVITIES.
         Trimethoprim/Sulfa sensitivity testing confirmed by
[**First Name8 (NamePattern2) 3077**] [**Last Name (NamePattern1) 3060**].

                              SENSITIVITIES: MIC expressed in
MCG/ML

_________________________________________________________
                             STAPH AUREUS COAG +
                             |
CLINDAMYCIN-----------<=0.25 S
ERYTHROMYCIN----------<=0.25 S
GENTAMICIN------------ <=0.5 S
LEVOFLOXACIN----------     4 R
OXACILLIN-------------   0.5 S
TRIMETHOPRIM/SULFA---- =>320 R

   Aerobic Bottle Gram Stain (Final [**2136-9-8**]):
      GRAM POSITIVE COCCI IN CLUSTERS.
      REPORTED BY PHONE TO [**First Name8 (NamePattern2) 5478**] [**Doctor Last Name 5479**] #[**Numeric Identifier 11644**] [**2136-9-8**] AT
1410.

   Anaerobic Bottle Gram Stain (Final [**2136-9-8**]):
      GRAM POSITIVE COCCI IN PAIRS AND CLUSTERS.

Brief Hospital Course:
A/P: 53-year-old male w/ HIV ([**8-/2136**] VL undectable, CD4 226,
toxo seronegative in [**Month (only) 958**]), HCV cirrhosis c/b ascites and
recent diagnosis of brain masses that was a direct admission
from clinic for evaluation of masses.

# Post MICU course: On [**2136-9-14**], he was transferred back to the
[**Doctor Last Name 3271**]-[**Doctor Last Name 679**] service.  On arrival to [**Hospital Ward Name 26179**], he had persistent
left sided paralysis from his ICH.  He was responsive to voice
and touch, but waxed and waned.  He had become incoherent in
speech.  His liver disease worsened and the combination of his
ESLD, HIV complicated by PML, and ICH left his prognosis as very
poor.  Ethics, Palliative Care, and Social Work were all
involved and worked closely with the family on goals of care.
Through the weekend he was tenuous but stable.  On Tuesday [**9-18**]
he was made CMO.  On [**9-20**] his foley was taken out in an effort
to make him comfortable. Urine in the bag was clear and yellow.
Upon removing the foley, he began to bleed.  The bleeding was
stabilized by replacing the foley.  His blood pressure and HR
remained stable throughout the episode of bleeding.  On [**9-21**], at
3:58pm, he expired peacefully with his brother at his bedside.


# Brain masses/Intracranial Hemorrhage
The patient was admitted for further work-up of his brain masses
with the differential being PML vs. lymphoma given two negative
LPs excluding other causes. An MRI was scheduled to track lesion
progression.  He was neurologically intact on the floor without
any issues until early [**8-18**] AM when he had sudden onset L sided
weakness, L facial droop sparing the forehead and dysphagia. On
his way to CT scan he seized and was transferred to the SICU for
intubation.  Pt was started on keppra.  A CT identified a right
temporoparietal intraparenchymal hemorrhage.  At the time it was
believed that the patient had bled into one of the lesions
previously noted.  The patient received mannitol and was
hyperventilated to decrease intracranial pressure.  During this
time, it was noted that the patient was able to follow commands
with his right side, and withdraw to pain on the left.  He was
extubated on [**8-22**].  At this time it was noted that although he
could maintain his airway, he had no gag reflex and a weak
cough.  Serial CTs were stable, and given his improving clinical
picture, he was transferred to the [**Doctor Last Name 3271**]-[**First Name4 (NamePattern1) 679**] [**Last Name (NamePattern1) 4869**].  On
transfer his neurologic exam was evaluated and remained stable,
with 4/5 strength of his right extremities, 1/5 strength of his
left extremities.  The patient was continued on his keppra until
[**8-30**], when he was changed to phenytoin for rising LFTs as
discussed below.

# Altered Mental Status:
On admission, the patient's mental status was at his baseline.
His lactulose and rifaximin were continued.  Post-intracranial
hemorrhage, the patient was noted to have altered mental status.
 Given his intracranial hemorrhage it was difficult to assess
what portion of his altered mental status was a result of
encephalopathy and what was his new baseline s/p intracranial
hemorrhage.  His lactulose was titrated up and the patient's
mental status improved: he was alert and oriented to person and
place, oftentimes also to the date. He was able to hold a
conversation but was often tangiential.  However, around [**8-25**],
the patient's mental status began to decline, despite a stable
head CT, aggressive titration of his lactulose, and treatment of
a concurrent UTI (see below).  He became drowsy and difficult to
arouse.  This downturn persisted through the remainder of his
stay on the [**Doctor Last Name 3271**] [**First Name4 (NamePattern1) 679**] [**Last Name (NamePattern1) 4869**].  By [**9-7**] he was quite
somnolent and minimally responsive to verbal commands.

#Hyperbilirubinemia: Beginning [**8-29**], the patient's bilirubin
began to rise (his baseline for this hospitalization was between
5 and 7).  No hepatobilliary obstructive process was observed on
abdominal ultrasound.  His HCV level was 2,550,000 IU/mL, down
from 5,220,000 IU/mL in [**4-/2136**], making HCV infection less
likely.  His most recent medication change had been the addition
of keppra.  The keppra was changed to phenytoin, however his
bilirubin continued to rise.  His bactrim and HAART therapy were
discontinued on [**9-6**], after which his bilirubin stabilized
around 20.  Over the rest of his hospital course, his bilirubin
continued to increase and was at 30.5 the last day that labs
were checked.

#PNA and Sepsis: Beginning [**9-7**], the patient began to spike
fevers to 101 with a WCC of 11.7.  Urine, blood, and ascites
cultures were sent.  A CXR demonstrated only minimally increased
bibasilar opacities thought to be atelectasis.  His blood
culture came back growing MSSA.  In the setting of the patient's
altered mental status, the source was believed to be his lungs
[**3-13**] to aspiration pneumonia.  Pending sensitivities he was
started on vanco + zosyn (to cover oral anaerobes/gram negs).
On [**9-8**], he was noted to be tachypnic to the high 20s with a
metabolic acidosis.  On [**9-9**], his tachypnea had worsened, and he
was showing signs of fatigue.  Given his worsening respiratory
distress, he was triggered and sent to the MICU. He was found to
have MSSA bacteremia and developed

# Urinary Tract Infection: On [**8-25**], the patient developed fevers
to 101.  A previous urine culture was noted to be growing
Enterobacter, sensitive to ciprofloxacin.  He was treated with a
7 day course of Ciprofloxacin 400mg q12h with good effect.

# Acute Renal Failure
His renal function was impaired on admission with a rise in Cr
from 1.2 to 1.9 with a subsequent decrease likely secondary to a
pre-renal process given FeUREA. His spirolactone and lasix were
held and his Cr returned to its baseline.  During this time, his
acites remained stable.

# HIV
The patient's recent viral load was undetectable with CD4 count
of 226. He was continued on Atripla and his bactrim prophylaxis.
 These were both discontinued in the setting of locating the
cause for the patient's rising bilirubin.

# Thrush
For the treatment of thrush, the patient was switched from
clotrimazole to oral swabs with nystatin.

# Portal vein thrombosis
The patient was admitted on anticoagulation for his portal vein
thrombosis.  However, given the patient's intracranial
hemorrhage during this hospital stay, his anticoagulation was
discontinued and his INR was reversed with vitamin K.

#Hypertension
The patient was started on metoprolol for improved blood
pressure control in the setting of an intracranial bleed.  This
was discontinued in the setting of locating the cause for the
patient's rising bilirubin.

Medications on Admission:
- Cholestyramine-Sucrose 4grams [**Hospital1 **]
- Clotrimazole 10mg Troche
- Efavirenz-Emtricitabin-Tenofov 600-200-300mg Daily
- Lasix 40mg [**Hospital1 **]
- Lactulose 30ml TID
- Rifaximin 400mg TID
- Spironolactone 100mg [**Hospital1 **]
- Bactrim 800/160mg daily
- Warfarin 0.5mg daily
- Vitamin D 50,000 unit weekly


Discharge Disposition:
Expired

Discharge Diagnosis:
PRIMARY:
Intracranial hemorrhage
End Stage Liver Disease secondary to Hepatitis C
Methicillin sensitive Staph aureus bacteremia
SECONDARY:
HIV

Discharge Condition:
The patient Expired on [**9-21**]


Discharge Instructions:
Patient Expired

Followup Instructions:
Patient Expired

                             [**First Name8 (NamePattern2) **] [**Name8 (MD) **] MD [**MD Number(2) 4407**]

Completed by:[**2136-9-23**]
{'Unspecified intracranial hemorrhage,Unspecified viral hepatitis C with hepatic coma,Human immunodeficiency virus [HIV] disease,Pneumonia, organism unspecified,Severe sepsis,Acute kidney failure, unspecified,Portal vein thrombosis,Acute respiratory failure,Hepatorenal syndrome,Methicillin susceptible Staphylococcus aureus septicemia,Acute myeloid leukemia, without mention of having achieved remission,Other ascites,Hemiplegia, unspecified, affecting dominant side,Urinary tract infection, site not specified,Jaundice, unspecified, not of newborn,Hyposmolality and/or hyponatremia,Delirium due to conditions classified elsewhere,Other and unspecified coagulation defects,Candidiasis of mouth,Cirrhosis of liver without mention of alcohol,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Chronic kidney disease, unspecified,Other convulsions,Dysplasia of anus,Anemia, unspecified,Nonspecific abnormal findings in stool contents,Long-term (current) use of anticoagulants,Encounter for palliative care'}


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: Lab abnormalities/direct transfer from clinic

PRESENT ILLNESS: Mr. [**Known lastname 49552**] is a 52 year-old man with a history of HIV ([**4-18**] VL
undetectable, CD4 266, toxo seronegative in [**Month (only) 958**]) and HCV
cirrhosis (no varices, MELD 13 in [**6-17**]) who presented from
clinic in setting of further work-up of recent diagnosis of
brain masses.
.
The patient had visited several specialists. He had two LPs with
negative PCR in the recent month for diagnosis of his white
matter lesions in the CNS. This work-up was being done in the
setting of a liver transplant evaluation. Therfore, the brain
mass evaluation was of secondary importance relating to his
potential exclusion from liver transplant. Given these negative
lesions, brain biopsy was being considered as the next
diagnostic option.
.
At baseline, he stated his abdomen had been protuberant for
quite some time with some increasing peripheral edema. He had
not had issues since his last hospitalization in [**Month (only) 116**] with AMS
and is compliant with medications. He does endorse decreased
strength.
.
On the floor, patient was stable, AAOx3, and eating dinner.
.
Review of sytems:
(+) Per HPI
(-) Denies fever, chills, night sweats, recent weight loss or
gain. Denies headache, sinus tenderness, rhinorrhea or
congestion. Denied cough, shortness of breath. Denied chest pain
or tightness, palpitations. Denied nausea, vomiting, diarrhea,
constipation or abdominal pain. No recent change in bowel or
bladder habits. No dysuria. Denied arthralgias or myalgias.

MEDICAL HISTORY: HCV Cirrhosis - decompensated with ascites
--EGD [**2136-5-29**] - gastritis, no varices, +portal gastropathy
--No h/o SBP, has not had paracentesis prior
--on lactulose and rifaximin
HIV - on HAART ([**2136-4-25**] VL undetectable; CD4 266)
Nonreducible Abdominal Hernia
Anal neoplasia

MEDICATION ON ADMISSION: - Cholestyramine-Sucrose 4grams [**Hospital1 **]
- Clotrimazole 10mg Troche
- Efavirenz-Emtricitabin-Tenofov 600-200-300mg Daily
- Lasix 40mg [**Hospital1 **]
- Lactulose 30ml TID
- Rifaximin 400mg TID
- Spironolactone 100mg [**Hospital1 **]
- Bactrim 800/160mg daily
- Warfarin 0.5mg daily
- Vitamin D 50,000 unit weekly

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: ON ADMISSION
Vitals: T 99.2 BP: 132/68 P: 87 R: 18 O2: 100 RA
General: Alert, oriented, no acute distress
HEENT: Sclera icteric, MMM, oropharynx with some evidence of
thrush
Neck: supple, JVP not elevated, no LAD
Lungs: Clear to auscultation bilaterally, no wheezes, rales,
ronchi
CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs,
gallops
Abdomen: protuberant with umbilical herniation, bowel sounds not
appreciated, no rebound tenderness or guarding; appears to be
massive ascites
GU: no foley
Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or
edema
Skin: Scattered red, raised lesions not well-circumscribed

FAMILY HISTORY: noncontributory

SOCIAL HISTORY: The patient lives alone, is not currently working, and is MSM.
He used to work full time as a flight attendant for American
Airlines. He denies current ETOH or drug use. He occasionally
smokes a pipe but denies cigarette use. The patient reported a
history of significant alcohol consumption up to two bottles or
more of red wine per night, but reports no EtOH since [**4-16**]. The
patient reported that he has used other substances including
IVDU in the past, but nothing after [**2111**]. 

### Response:
{'Unspecified intracranial hemorrhage,Unspecified viral hepatitis C with hepatic coma,Human immunodeficiency virus [HIV] disease,Pneumonia, organism unspecified,Severe sepsis,Acute kidney failure, unspecified,Portal vein thrombosis,Acute respiratory failure,Hepatorenal syndrome,Methicillin susceptible Staphylococcus aureus septicemia,Acute myeloid leukemia, without mention of having achieved remission,Other ascites,Hemiplegia, unspecified, affecting dominant side,Urinary tract infection, site not specified,Jaundice, unspecified, not of newborn,Hyposmolality and/or hyponatremia,Delirium due to conditions classified elsewhere,Other and unspecified coagulation defects,Candidiasis of mouth,Cirrhosis of liver without mention of alcohol,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Chronic kidney disease, unspecified,Other convulsions,Dysplasia of anus,Anemia, unspecified,Nonspecific abnormal findings in stool contents,Long-term (current) use of anticoagulants,Encounter for palliative care'}
