CHIEF COMPLAINT: hypotension

PRESENT ILLNESS: 51 yo male with AIDs (dx [**2158**], on HAART, VL undetectable, CD4 90
[**1-3**], h/o thrush and esophagitis) admitted with back pain/flank
pain and fevers. He was in hus USOH until [**2174-1-27**] when he went
to his PCP's with R sided pleurtic chest pain. He also had a
resurangence of fevers to 102 - 105 and night sweats which he
had had for 13 years, then stopped 2 years prior when he started
HAART. CXR on [**2174-1-27**] showed infiltrate within the left upper
lobe and an opacityl at the right heart border. He was started
on Levaquin at that time. Then on [**2174-2-3**], he went to [**Hospital1 **]
[**Location (un) 620**] with L calf pain. He was admitted with a DVT and
multiple PEs. Chest CT at that time also showed multiple
bilateral segments and subsegmental pulmonary emboli,
consolidation vs. infarct in the posterior left upper lobe and
anterior right lower lobe, multiple bilateral pulmonary nodules,
and mediastinal lymphadenopathy. MDs there were also concerned
that he could have TB as he had weight loss, fevers, and pulm
nodules. He underwent bronch on [**2174-2-7**] which was "normal".
Cytology showedd atypical flora. Cultures/labs from there showed
negative crypto ag, oral flora from the bronch, AFB smear
negative, culture pending. He was started on coumadin and
heparin and a second of levofloxacin. During this stay, he had
no pulmonary symptoms.
.
On discharge from [**Location (un) 620**], he noticed his Right leg now was
tender, where it had not been before. He then was switched to a
course of Doxy on [**2-11**] my his PCP. [**Name10 (NameIs) **] was not doing well at home
since he was having extreem pain in both his legs. The swelling
in the LLE diminished, but the right increased. He had no
pulmonary symptoms until the afternoon on [**2-18**] when he began to
become SOB. He came to the ED.
.
In ED, initial vitals were 103.6, HR 145, BP 78/62, RR 18, 98%
-> 100% on 2L .He was complaiing of worsening SOB and pleurtic
right chest pain. Code sepsis called, RIJ placed. Initial CVP
was 7. he was boluesd 8 L NS in the ED. Of note, his O2 sat on
arrival was 98% RA, then 100% 2l in the ED,94% on 4L NC on
arrival to MICU. he was started on Dopamine and levophed. He was
given 1 gram of vancomycin, 1 gram of CTX, and a DS bactrim.
Blood cultures and urine cultures were sent. A ct chest revealed
a left upper lobe opacity, subsegmental PE's, multiple B pulm
nodules.
.
Currently, he is SOB and c/o pleurtic right sided and posterior
chest pain and bilateral calf pain. He has been having fevers to
102 - 105 daily with night sweats. Denies large weight gain (he
has had touble with weight loss since his MAC). No HA. No neck
pain. No nausea. No vomiting. Has one loose BM daily [**3-3**] HAART.
Denies missing any of his medicine. Quit smoking 2 eeks agi. No
recent PPD. No TB contacts. [**Name (NI) **] Rashes. No recent travel.

MEDICAL HISTORY: AIDS on HAART c/b thrush
H/O MAC infection of unknown site
DVT left leg- [**2174-2-3**]
COPD- bullous changes
intermittent diplopia
asymptomatic UTI
Moderate cervical spondylosis with moderate spinal canal
stenosis
and multilevel bilateral neural foraminal narrowing seen on MR
cervical spine- [**2170**]
Epidermal inclusion cyst- right thigh

MEDICATION ON ADMISSION: Truvada
Reyataz 150'
Norvir 100'
Bactrim DS'
Azithromycin twice weekly
Ambien prn
Doxycycline 100 mg [**Hospital1 **] since [**2-11**]
Vicodin 5/725 prn for leg pain

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: wt: 62kg, 97.9 po, p123, 108/75 (dopamine 9, levophed .2), r28,
96% on 4l nc (ED 8liter in and 1500cc out)
General: mild resp distress, talkitave. Able to relate history
well.
HEENT: NC/AT, PERRLA. dentures in, no thrush seen. no scleral
icterus noted, MMM.
Neck: Supple, JVP normal
Pulmonary: Anterior reveals a three componet pulmonary rub.
Cardiac: RRR, nl. S1S2, no M/R/G noted
Abdomen: diffusly tender with voluntary guarding. normoactive
bowel sounds, no masses or organomegaly noted. extreme right
CVAT
Extremities: 1+ pitting edema bilaterally on calf. VERY tender
gastroc. 2+ radial, DP and PT pulses b/l.
Neurologic: A and O x3; srength grossly normal.

FAMILY HISTORY: Mother- breast cancer, stomach cancer Father: CVA, heart disease

SOCIAL HISTORY: +tobacco ([**1-31**] pack a day) x35 years and quit 2 weeks ago, no
ETOH. no illict drugs, lives alone. Works part-time with
caterers.
Unspecified septicemia,Human immunodeficiency virus [HIV] disease,Chronic airway obstruction, not elsewhere classified,Septic shock,Other pulmonary embolism and infarction,Pneumonia, organism unspecified,Malignant neoplasm of other parts of bronchus or lung,Cerebral thrombosis with cerebral infarction,Acute venous embolism and thrombosis of unspecified deep vessels of lower extremity,Hematemesis,Other pulmonary insufficiency, not elsewhere classified,Secondary and unspecified malignant neoplasm of lymph nodes of multiple sites,Other complications due to other vascular device, implant, and graft,Embolism and thrombosis of other specified artery,Hepatic infarction,Pressure ulcer, other site,Severe sepsis,Abnormal coagulation profile,Other chronic pulmonary heart diseases,Other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure,Accidents occurring in residential institution,Disseminated due to other mycobacteria,Polyuria,Antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use,Nausea with vomiting,Vascular disorders of kidney
Septicemia NOS,Human immuno virus dis,Chr airway obstruct NEC,Septic shock,Pulm embol/infarct NEC,Pneumonia, organism NOS,Mal neo bronch/lung NEC,Crbl thrmbs w infrct,Ac DVT/embl low ext NOS,Hematemesis,Other pulmonary insuff,Mal neo lymph node-mult,Comp-oth vasc dev/graft,Arterial embolism NEC,Hepatic infarction,Pressure ulcer, site NEC,Severe sepsis,Abnrml coagultion prfile,Chr pulmon heart dis NEC,Abn react-procedure NEC,Accid in resident instit,DMAC bacteremia,Polyuria,Adv eff antineoplastic,Nausea with vomiting,Renal vascular disorder
Admission Date:  [**2174-2-19**]              Discharge Date:   [**2174-3-16**]

Date of Birth:  [**2122-12-12**]             Sex:   M

Service: MEDICINE

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 562**]
Chief Complaint:
hypotension

Major Surgical or Invasive Procedure:
R internal jugular central line

History of Present Illness:
51 yo male with AIDs (dx [**2158**], on HAART, VL undetectable, CD4 90
[**1-3**], h/o thrush and esophagitis) admitted with back pain/flank
pain and fevers. He was in hus USOH until [**2174-1-27**] when he went
to his PCP's with R sided pleurtic chest pain. He also had a
resurangence of fevers to 102 - 105 and night sweats which he
had had for 13 years, then stopped 2 years prior when he started
HAART. CXR on [**2174-1-27**] showed infiltrate within the left upper
lobe and an opacityl at the right heart border. He was started
on Levaquin at that time. Then on [**2174-2-3**], he went to [**Hospital1 **]
[**Location (un) 620**] with L calf pain. He was admitted with a DVT and
multiple PEs. Chest CT at that time also showed multiple
bilateral segments and subsegmental pulmonary emboli,
consolidation vs. infarct in the posterior left upper lobe and
anterior right lower lobe, multiple bilateral pulmonary nodules,
and mediastinal lymphadenopathy. MDs there were also concerned
that he could have TB as he had weight loss, fevers, and pulm
nodules. He underwent bronch on [**2174-2-7**] which was "normal".
Cytology showedd atypical flora. Cultures/labs from there showed
negative crypto ag, oral flora from the bronch, AFB smear
negative, culture pending. He was started on coumadin and
heparin and a second of levofloxacin. During this stay, he had
no pulmonary symptoms.
.
On discharge from [**Location (un) 620**], he noticed his Right leg now was
tender, where it had not been before. He then was switched to a
course of Doxy on [**2-11**] my his PCP. [**Name10 (NameIs) **] was not doing well at home
since he was having extreem pain in both his legs. The swelling
in the LLE diminished, but the right increased. He had no
pulmonary symptoms until the afternoon on [**2-18**] when he began to
become SOB. He came to the ED.
.
In ED, initial vitals were 103.6, HR 145, BP 78/62, RR 18, 98%
-> 100% on 2L .He was complaiing of worsening SOB and pleurtic
right chest pain. Code sepsis called, RIJ placed. Initial CVP
was 7. he was boluesd 8 L NS in the ED. Of note, his O2 sat on
arrival was 98% RA, then 100% 2l in the ED,94% on 4L NC on
arrival to MICU. he was started on Dopamine and levophed. He was
given 1 gram of vancomycin, 1 gram of CTX, and a DS bactrim.
Blood cultures and urine cultures were sent. A ct chest revealed
a left upper lobe opacity, subsegmental PE's, multiple B pulm
nodules.
.
Currently, he is SOB and c/o pleurtic right sided and posterior
chest pain and bilateral calf pain. He has been having fevers to
102 - 105 daily with night sweats. Denies large weight gain (he
has had touble with weight loss since his MAC). No HA. No neck
pain. No nausea. No vomiting. Has one loose BM daily [**3-3**] HAART.
Denies missing any of his medicine. Quit smoking 2 eeks agi. No
recent PPD. No TB contacts. [**Name (NI) **] Rashes. No recent travel.


Past Medical History:
AIDS on HAART c/b thrush
H/O MAC infection of unknown site
DVT left leg- [**2174-2-3**]
COPD- bullous changes
intermittent diplopia
asymptomatic UTI
Moderate cervical spondylosis with moderate spinal canal
stenosis
and multilevel bilateral neural foraminal narrowing seen on MR
cervical spine- [**2170**]
Epidermal inclusion cyst- right thigh


Social History:
+tobacco ([**1-31**] pack a day) x35 years and quit 2 weeks ago, no
ETOH. no illict drugs, lives alone. Works part-time with
caterers.

Family History:
Mother- breast cancer, stomach cancer Father: CVA, heart disease

Physical Exam:
wt: 62kg, 97.9 po, p123, 108/75 (dopamine 9, levophed .2), r28,
96% on 4l nc (ED 8liter in and 1500cc out)
General: mild resp distress, talkitave. Able to relate history
well.
HEENT: NC/AT, PERRLA. dentures in, no thrush seen. no scleral
icterus noted, MMM.
Neck: Supple, JVP normal
Pulmonary: Anterior reveals a three componet pulmonary rub.
Cardiac: RRR, nl. S1S2, no M/R/G noted
Abdomen: diffusly tender with voluntary guarding. normoactive
bowel sounds, no masses or organomegaly noted. extreme right
CVAT
Extremities: 1+ pitting edema bilaterally on calf. VERY tender
gastroc. 2+ radial, DP and PT pulses b/l.
Neurologic: A and O x3; srength grossly normal.


Brief Hospital Course:
Assessment: 51 yo m with AIDS, recent diagnosis of PE, pulmonary
nodules, fevers, and shock. His shock is most likely due to
sepsis given his increasing WBC and low CVP making right heart
strain from PE unlikley.
.
Plan:
# Septic shock: He seems to be in distributive shock. Most
likely this is sepsis, given that he is immunocompromised with
fevers and respiratory distress. However,  Adrenal insufficiency
unlikely given normal [**Last Name (un) 104**] stim test. Given his
immunocomprimised state, he has many potential sources for
sepsis including bactreial, fungal, and viral. Infectious
disease was consulted who recommended continue treatment with
caspofungin, azithromycin, imipenem-cilastin. Continue
antiretrovirals and bactrim ppx.  Unclear source at this point.
So far all cultures NGTD, cryptococcus, CMV, and histo
serologies negative, AFB x3, PCP stain, [**Name9 (PRE) 20613**] ag, negative.  Pt
was placed on Sepsis protocol. With frequent NS fluid bolus for
CVP >12 and pressors.  He had episode of NSVT on arrival while
on dopamine and was changed over to levophed, which he required
for several days of his addmision to keep MAP>65. Given
persistent hypotension concern for neurogenic shock secondary to
autonomic dysfunction, Neuro consult was obtained who did not
think that patient has autonomic dysfunction on initial
assessement.
.
#  Respiratory distress - as above, most likely secondary to
pulmonary infection complicated by pulmonary emboli. Required
significant oxygen supplementation initially but this was
reduced by 6 days of hospitalization from NRB to 40% by
facemask.
.
# PE/DVT: Hx of DVT and PE on recent hospitalization.  RL LENI
shows DVT this admission.  Given likely coumadin failure IVC
filter was placed.  Pt was started on heparin initially and then
changed over to lovenox 1mcg/kg [**Hospital1 **].  [**2-27**] AM with RUE swelling
as well, with DVT.  Heme onc consulted, started on heparin as
developing DVTs through lovenox.
- Given recurrent dvt and ?pulmonary nodules and enlarged
lymphnode concern for malignancy in setting of hypercoguble
state high.
- Currently morphine prn.
.
#. hemoptysis - likely secondary to underlying pulmonary
processes. Consider bronchoscopy only if this worsens (currently
stable).
.
#Polyuria - Unclear etiology. Continues to urinate to the point
of hypotension despite IVF being stopped. [**Month (only) 116**] have neprogenic DI
[**3-3**] ambisome. [**Month (only) 116**] also not be able to concentrate urine to
excrete all the salt he has gotten on the sepsis portocol
causing an solute diuresis. Gave dose of ddAVP to see if can
concentrate urine. Ambisome switched to caspofungin.
- Renal was consulted given concern for DI.  They did not think
that the pt has diabetes insipidus given that the patient has
had normal Uosm and Una. More likely, this is consistent with a
solute diuresis from the large amounts of fluid the patient has
received during this hospitalization. It is unclear whether he
is intravascularly depleted or overloaded, and his weight is up
approx 6kg. If he is making appropriate urine to previous IVF
administration, would expect his urine now to more accurately
match his input.  With restriction on NS IVF, pt's urine output
has improved.
.
# Infection - unclear etiology most likely source of infectionis
pulmonary, but differential in this immunocompromised patient is
very broad. ID following. So far all cultures NGTD,
cryptococcus, CMV, and histo serologies negative
- on retrovirals, azithro/bactrim
- imipenem dc'd- continuing with vanco
.
## Neuro - pt with c/o diplopia this morning which is new.  Also
with nystagmus on exam concerning for brainstem process.
- per discussion with neuro attg, given pt's likely
hypercoaguble state need to rule out stroke.
- MRI/MRA -small L cerebellar stroke, w/ sluggish basilar artery
flow, CTA also showed no thrombus but decreased basilar artery
flow.  Per Neuro ordered TTE w/ bubble, no ASD or PFO
- Daily CT showed no change (needs daily CTx7 day to assess no
hemorrhagic development
.
#Hemoptysis - likel secodary to PE and PNA. Stable in amount and
frequency. Is small amounts at this time. If decompensates of
hemoptysis progresses beyond tsp amounts will need bronchoscopy
and possible surgical consult.
.
## Neuro - pt with c/o diplopia this morning which is new.  Also
with nystagmus on exam concerning for brainstem process.
- per discussion with neuro attg, given pt's likely
hypercoaguble state need to rule out stroke.
- MRI/MRA to eval for stroke.
.
# AIDS: Initially held  HAART therapy. Restarted on [**2173-2-24**].

#. pulm nodules - concern for malignancy given fevers, LAD. o/w
infection as above. with LUL mass, discuss timing of biopsy as
differential includes lymphoma vs lung neoplasm, will need to
discuss holding anticoagulation.
.
PPx: PPI, no pneumoboots, lovenox, increase bowel regimen given
constipation, no bowel movement since admission per pt
FEN: po diet as resp status stable
Access: RIJ, R art line, PIV
Communication: sister [**Name (NI) **]
Dispo: ICU until HD stable
# Code Status: Full, discussed extensively with paitent and HCP,
[**Name (NI) **], his sister. [**Name (NI) **] is very nervous about intubation, but
agrees that he may benefit from it in the short term.
# Dispo: ICU for now given hypotension.
# Contact: [**Name (NI) **], sister  ...

The patient had a prolonged intensive care unit stay.  He
developed further progressive thromboses.  An IVC filter was
placed to prevent further pulmonary emboli.  He developed
ischemic bowel with thrombosis of celiac and mesenteric
arteries.  After extensive discussion with patient and his
sister [**Name (NI) **], the patient was made care and comfort measures
only.  He was treated with IV morphine and expired peacefully on
[**2174-3-16**].


Medications on Admission:
Truvada
Reyataz 150'
Norvir 100'
Bactrim DS'
Azithromycin twice weekly
Ambien prn
Doxycycline 100 mg [**Hospital1 **] since [**2-11**]
Vicodin 5/725 prn for leg pain


Discharge Medications:
None

Discharge Disposition:
Expired

Discharge Diagnosis:
Acquired immune deficiency syndrome
adenocarcinoma of lung
pulmonary emboli
mesenteric ischemia


Discharge Condition:
Deceased

Discharge Instructions:
Remains released to funeral home

Followup Instructions:
None
{'Unspecified septicemia,Human immunodeficiency virus [HIV] disease,Chronic airway obstruction, not elsewhere classified,Septic shock,Other pulmonary embolism and infarction,Pneumonia, organism unspecified,Malignant neoplasm of other parts of bronchus or lung,Cerebral thrombosis with cerebral infarction,Acute venous embolism and thrombosis of unspecified deep vessels of lower extremity,Hematemesis,Other pulmonary insufficiency, not elsewhere classified,Secondary and unspecified malignant neoplasm of lymph nodes of multiple sites,Other complications due to other vascular device, implant, and graft,Embolism and thrombosis of other specified artery,Hepatic infarction,Pressure ulcer, other site,Severe sepsis,Abnormal coagulation profile,Other chronic pulmonary heart diseases,Other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure,Accidents occurring in residential institution,Disseminated due to other mycobacteria,Polyuria,Antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use,Nausea with vomiting,Vascular disorders 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: hypotension

PRESENT ILLNESS: 51 yo male with AIDs (dx [**2158**], on HAART, VL undetectable, CD4 90
[**1-3**], h/o thrush and esophagitis) admitted with back pain/flank
pain and fevers. He was in hus USOH until [**2174-1-27**] when he went
to his PCP's with R sided pleurtic chest pain. He also had a
resurangence of fevers to 102 - 105 and night sweats which he
had had for 13 years, then stopped 2 years prior when he started
HAART. CXR on [**2174-1-27**] showed infiltrate within the left upper
lobe and an opacityl at the right heart border. He was started
on Levaquin at that time. Then on [**2174-2-3**], he went to [**Hospital1 **]
[**Location (un) 620**] with L calf pain. He was admitted with a DVT and
multiple PEs. Chest CT at that time also showed multiple
bilateral segments and subsegmental pulmonary emboli,
consolidation vs. infarct in the posterior left upper lobe and
anterior right lower lobe, multiple bilateral pulmonary nodules,
and mediastinal lymphadenopathy. MDs there were also concerned
that he could have TB as he had weight loss, fevers, and pulm
nodules. He underwent bronch on [**2174-2-7**] which was "normal".
Cytology showedd atypical flora. Cultures/labs from there showed
negative crypto ag, oral flora from the bronch, AFB smear
negative, culture pending. He was started on coumadin and
heparin and a second of levofloxacin. During this stay, he had
no pulmonary symptoms.
.
On discharge from [**Location (un) 620**], he noticed his Right leg now was
tender, where it had not been before. He then was switched to a
course of Doxy on [**2-11**] my his PCP. [**Name10 (NameIs) **] was not doing well at home
since he was having extreem pain in both his legs. The swelling
in the LLE diminished, but the right increased. He had no
pulmonary symptoms until the afternoon on [**2-18**] when he began to
become SOB. He came to the ED.
.
In ED, initial vitals were 103.6, HR 145, BP 78/62, RR 18, 98%
-> 100% on 2L .He was complaiing of worsening SOB and pleurtic
right chest pain. Code sepsis called, RIJ placed. Initial CVP
was 7. he was boluesd 8 L NS in the ED. Of note, his O2 sat on
arrival was 98% RA, then 100% 2l in the ED,94% on 4L NC on
arrival to MICU. he was started on Dopamine and levophed. He was
given 1 gram of vancomycin, 1 gram of CTX, and a DS bactrim.
Blood cultures and urine cultures were sent. A ct chest revealed
a left upper lobe opacity, subsegmental PE's, multiple B pulm
nodules.
.
Currently, he is SOB and c/o pleurtic right sided and posterior
chest pain and bilateral calf pain. He has been having fevers to
102 - 105 daily with night sweats. Denies large weight gain (he
has had touble with weight loss since his MAC). No HA. No neck
pain. No nausea. No vomiting. Has one loose BM daily [**3-3**] HAART.
Denies missing any of his medicine. Quit smoking 2 eeks agi. No
recent PPD. No TB contacts. [**Name (NI) **] Rashes. No recent travel.

MEDICAL HISTORY: AIDS on HAART c/b thrush
H/O MAC infection of unknown site
DVT left leg- [**2174-2-3**]
COPD- bullous changes
intermittent diplopia
asymptomatic UTI
Moderate cervical spondylosis with moderate spinal canal
stenosis
and multilevel bilateral neural foraminal narrowing seen on MR
cervical spine- [**2170**]
Epidermal inclusion cyst- right thigh

MEDICATION ON ADMISSION: Truvada
Reyataz 150'
Norvir 100'
Bactrim DS'
Azithromycin twice weekly
Ambien prn
Doxycycline 100 mg [**Hospital1 **] since [**2-11**]
Vicodin 5/725 prn for leg pain

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: wt: 62kg, 97.9 po, p123, 108/75 (dopamine 9, levophed .2), r28,
96% on 4l nc (ED 8liter in and 1500cc out)
General: mild resp distress, talkitave. Able to relate history
well.
HEENT: NC/AT, PERRLA. dentures in, no thrush seen. no scleral
icterus noted, MMM.
Neck: Supple, JVP normal
Pulmonary: Anterior reveals a three componet pulmonary rub.
Cardiac: RRR, nl. S1S2, no M/R/G noted
Abdomen: diffusly tender with voluntary guarding. normoactive
bowel sounds, no masses or organomegaly noted. extreme right
CVAT
Extremities: 1+ pitting edema bilaterally on calf. VERY tender
gastroc. 2+ radial, DP and PT pulses b/l.
Neurologic: A and O x3; srength grossly normal.

FAMILY HISTORY: Mother- breast cancer, stomach cancer Father: CVA, heart disease

SOCIAL HISTORY: +tobacco ([**1-31**] pack a day) x35 years and quit 2 weeks ago, no
ETOH. no illict drugs, lives alone. Works part-time with
caterers. 

### Response:
{'Unspecified septicemia,Human immunodeficiency virus [HIV] disease,Chronic airway obstruction, not elsewhere classified,Septic shock,Other pulmonary embolism and infarction,Pneumonia, organism unspecified,Malignant neoplasm of other parts of bronchus or lung,Cerebral thrombosis with cerebral infarction,Acute venous embolism and thrombosis of unspecified deep vessels of lower extremity,Hematemesis,Other pulmonary insufficiency, not elsewhere classified,Secondary and unspecified malignant neoplasm of lymph nodes of multiple sites,Other complications due to other vascular device, implant, and graft,Embolism and thrombosis of other specified artery,Hepatic infarction,Pressure ulcer, other site,Severe sepsis,Abnormal coagulation profile,Other chronic pulmonary heart diseases,Other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure,Accidents occurring in residential institution,Disseminated due to other mycobacteria,Polyuria,Antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use,Nausea with vomiting,Vascular disorders of kidney'}
