CHIEF COMPLAINT: "DOE with dry cough and n/v."

PRESENT ILLNESS: 23 year old homeless female presents to the ED with temp 100.3,
dyspnea on exertion and dry cough.
.
Patient has had intermittent dry cough since [**2194-7-24**].  At
the end of [**Month (only) **] she was treated with azithromycin x 5 days
for an atypical pneumonia.  Patient was subsequently
hospitalized at [**Hospital1 18**] from [**2194-10-25**] - [**2194-10-28**] with persistent
cough, nightsweats and chills.  Her CXR showed a RUL infiltrate
which was thought to be an old pneumonia, not treated with any
antibiotics.  Initial concern for active TB, she had two
negative AFB sputums however samples were noted to be
concentrated with upper respiratory secretions.  PPD was
negative.  Follow-up chest film on [**2194-12-4**] showed progression of
lung lesion, now identified as two discrete lung lesions, in
right upper vs lower lobe and lingula.  Differential includes
fungus, mycobacterial and nocardia infection.  Patient was
referred to pulmonary, per phone note from [**2194-12-8**], and
scheduled for a CT chest without contrast tomorrow ([**2194-12-12**]).
Patient complained of worsening chest tightness, sob and
nightsweats.  She was advised to go to the ED if symptoms
persisted.
.
Patient reports Temp to 100.3 several days ago.  She reports
that she had been feeling better until Sunday when she had a
episode of nausea and NB NB vomitting.  She also reports
worsening NS, chills and decreased activity tolerance.  She
reports that she is usually able to go for 15 minute walks
without difficulty.  Now she gets sob with about 5 minutes of
walking.  She says that she had infections fairly frequently in
the past, but unsure of exact duration or location.  She has a
h/o pna at age 12 yo but no other pulmonary issues.  Her ROS is
also positive for vaginal discharge that she feels is from an
untreated BV infection.  She denies CP per say but says she has
occasional parathesias in her chest.  ROS is otherwise negative.

MEDICAL HISTORY: -Fibromyalgia and chronic pain
-Iron deficiency
-Depression, anxiety, PTSD
-Gonorrhea/chlamydia [**2188**] and Gonorrhea [**6-/2194**]
-Abnormal Pap in [**2187**]
-Bed bug bites
-h/o PNA

MEDICATION ON ADMISSION: MEDROXYPROGESTERONE
PNV WITH CA,NO.71-IRON-FA [NATALCARE PLUS] - 27 mg-1 mg Tablet
daily
ACETAMINOPHEN - 325 mg Tablet - 2 Tablet(s) by mouth q6h prn
pain
NICOTINE - 14 mg/24 hour Patch 24 hr - apply 1 patch daily

ALLERGIES: Egg [**Location (un) 76704**] Dust

PHYSICAL EXAM: Exam on admission:
VS: 98.2  117/69  94  18 100 RA
General: AAOX3 in NAD
HEENT: CN 2-12 grossly intact, MMM, oropharynx clear
Endo/Lymph: no obvious thyroid nodules, no LAd
CV: RRR, no RMG
Lungs: mild bibasilar crackles, left greater then right, equal
lung expansion
Abdomen: flat, not TTP, no HSM, active BS
Extremities:
UE: WWP, pulses equal, sensation intact, strength wnl
LE: WWP, pulses euqal, sensation intact, strenght wnl
Derm: no obvious rashes, no stigmata of IE
Psych: mood and affect wnl

FAMILY HISTORY: No family h/o lung pathology.  Son with asthma.

SOCIAL HISTORY: -Living in a shelter with her 3 year old son.
-Recently spent some time at grandparents house because she had
bed bug bites from the shelter.
-5 py hx of smoking, quit 1 month PTA.
-No known TB exposure.
-denies IVDU
-denies ETOH
-on depo for birth control, has unprotected sex with father of
child
Pneumonia, organism unspecified,Hemorrhage complicating a procedure,Unspecified pleural effusion,Myalgia and myositis, unspecified,Lack of housing,Vaginitis and vulvovaginitis, unspecified,Bacterial infection, unspecified, in conditions classified elsewhere and of unspecified site,Asthma, unspecified type, unspecified,Anxiety state, unspecified
Pneumonia, organism NOS,Hemorrhage complic proc,Pleural effusion NOS,Myalgia and myositis NOS,Lack of housing,Vaginitis NOS,Bacterial infection NOS,Asthma NOS,Anxiety state NOS
Admission Date:  [**2194-12-11**]              Discharge Date:   [**2194-12-17**]

Date of Birth:  [**2171-6-8**]             Sex:   F

Service: MEDICINE

Allergies:
Egg [**Location (un) 76704**] Dust

Attending:[**First Name3 (LF) 4095**]
Chief Complaint:
"DOE with dry cough and n/v."

Major Surgical or Invasive Procedure:
1. CT-guided lung biopsy of the 1.9cm lesion in the RUL.

History of Present Illness:
23 year old homeless female presents to the ED with temp 100.3,
dyspnea on exertion and dry cough.
.
Patient has had intermittent dry cough since [**2194-7-24**].  At
the end of [**Month (only) **] she was treated with azithromycin x 5 days
for an atypical pneumonia.  Patient was subsequently
hospitalized at [**Hospital1 18**] from [**2194-10-25**] - [**2194-10-28**] with persistent
cough, nightsweats and chills.  Her CXR showed a RUL infiltrate
which was thought to be an old pneumonia, not treated with any
antibiotics.  Initial concern for active TB, she had two
negative AFB sputums however samples were noted to be
concentrated with upper respiratory secretions.  PPD was
negative.  Follow-up chest film on [**2194-12-4**] showed progression of
lung lesion, now identified as two discrete lung lesions, in
right upper vs lower lobe and lingula.  Differential includes
fungus, mycobacterial and nocardia infection.  Patient was
referred to pulmonary, per phone note from [**2194-12-8**], and
scheduled for a CT chest without contrast tomorrow ([**2194-12-12**]).
Patient complained of worsening chest tightness, sob and
nightsweats.  She was advised to go to the ED if symptoms
persisted.
.
Patient reports Temp to 100.3 several days ago.  She reports
that she had been feeling better until Sunday when she had a
episode of nausea and NB NB vomitting.  She also reports
worsening NS, chills and decreased activity tolerance.  She
reports that she is usually able to go for 15 minute walks
without difficulty.  Now she gets sob with about 5 minutes of
walking.  She says that she had infections fairly frequently in
the past, but unsure of exact duration or location.  She has a
h/o pna at age 12 yo but no other pulmonary issues.  Her ROS is
also positive for vaginal discharge that she feels is from an
untreated BV infection.  She denies CP per say but says she has
occasional parathesias in her chest.  ROS is otherwise negative.

.
Had a negative HIV test in [**Month (only) 359**].  Attempting to relocate to a
new shelter, reports high levels of mold.
.
ED: 98.6 108 120/60 16 100% RA; CTA Chest: neg for pe,
multifocal nodules in both lungs, cavitation in 2 nodules, ddx
includes multifocal infection, fungal vs septic emboli; patient
given unasyn, nafcillin, gent and ambisome - to cover
endocarditis and fungal etiologies
.
ROS:negative.

Past Medical History:
-Fibromyalgia and chronic pain
-Iron deficiency
-Depression, anxiety, PTSD
-Gonorrhea/chlamydia [**2188**] and Gonorrhea [**6-/2194**]
-Abnormal Pap in [**2187**]
-Bed bug bites
-h/o PNA

Social History:
-Living in a shelter with her 3 year old son.
-Recently spent some time at grandparents house because she had
bed bug bites from the shelter.
-5 py hx of smoking, quit 1 month PTA.
-No known TB exposure.
-denies IVDU
-denies ETOH
-on depo for birth control, has unprotected sex with father of
child

Family History:
No family h/o lung pathology.  Son with asthma.

Physical Exam:
Exam on admission:
VS: 98.2  117/69  94  18 100 RA
General: AAOX3 in NAD
HEENT: CN 2-12 grossly intact, MMM, oropharynx clear
Endo/Lymph: no obvious thyroid nodules, no LAd
CV: RRR, no RMG
Lungs: mild bibasilar crackles, left greater then right, equal
lung expansion
Abdomen: flat, not TTP, no HSM, active BS
Extremities:
UE: WWP, pulses equal, sensation intact, strength wnl
LE: WWP, pulses euqal, sensation intact, strenght wnl
Derm: no obvious rashes, no stigmata of IE
Psych: mood and affect wnl

Exam at discharge:

T 97.6 BP 112/60 P 70s-80s RR 16 99% RA
General: Alert, oriented, no acute distress
HEENT: Sclera anicteric, MMM, oropharynx clear
Neck: supple, JVP not elevated, no LAD
Lungs: Clear to auscultation bilaterally, no wheezes, rales,
ronchi
CV: Regular rate and rhythm, normal S1 + S2, [**11-28**] blowing
systolic murmur best heard at LUSB
Abdomen: soft, non-tender, non-distended, bowel sounds present,
no rebound tenderness or guarding, no organomegaly
GU: no foley
Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or
edema
Neuro: CNs2-12 intact, motor function grossly normal


Pertinent Results:
Labs upon admission:
[**2194-12-11**] 02:58AM   LACTATE-1.3
[**2194-12-11**] 02:43AM   GLUCOSE-116* UREA N-14 CREAT-0.6 SODIUM-140
POTASSIUM-4.2 CHLORIDE-106 TOTAL CO2-26 ANION GAP-12
[**2194-12-11**] 02:43AM   WBC-6.7 RBC-4.05* HGB-13.3 HCT-38.2 MCV-95
MCH-32.8* MCHC-34.7 RDW-12.6
[**2194-12-11**] 02:43AM   NEUTS-41.9* LYMPHS-45.7* MONOS-7.2 EOS-4.1*
BASOS-1.2
[**2194-12-11**] 02:43AM   PLT COUNT-208
[**2194-12-11**] 02:20AM URINE  HOURS-RANDOM
[**2194-12-11**] 02:20AM URINE  UCG-NEGATIVE
[**2194-12-11**] 02:20AM URINE  COLOR-Straw APPEAR-Clear SP [**Last Name (un) 155**]-1.018
[**2194-12-11**] 02:20AM URINE  BLOOD-NEG NITRITE-NEG PROTEIN-NEG
GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-6.0
LEUK-LG
[**2194-12-11**] 02:20AM URINE  RBC-1 WBC-3 BACTERIA-NONE YEAST-NONE
EPI-1
[**2194-12-11**] 02:20AM URINE  MUCOUS-RARE
Pregnancy test negative

Labs prior to discharge:
[**2194-12-12**] 06:35AM BLOOD ESR-7
[**2194-12-12**] 06:00PM BLOOD PT-15.7* PTT-32.8 INR(PT)-1.5*
[**2194-12-13**] 03:05AM BLOOD PT-14.5* PTT-29.0 INR(PT)-1.4*
[**2194-12-12**] 06:00PM BLOOD Albumin-4.3 Calcium-9.2 Phos-3.5 Mg-2.1
[**2194-12-11**] 02:43AM BLOOD RheuFac-5
[**2194-12-11**] 02:43AM BLOOD [**Doctor First Name **]-NEGATIVE
[**2194-12-12**] 06:35AM BLOOD CRP-2.0
[**2194-12-11**] 02:43AM BLOOD ANCA-NEGATIVE B
Aspergillus Galactomannin: Negative
Beta Glucan: Negative
ACE, serum: Negative

Micro:
Blood culture x4 negative, included fungal and AFB culture
.
Cryptococcal antigen: negative
.
TISSUE      RUL NODULE.
GRAM STAIN (Final [**2194-12-12**]):
      NO POLYMORPHONUCLEAR LEUKOCYTES SEEN.
      NO MICROORGANISMS SEEN.
TISSUE (Final [**2194-12-15**]):    NO GROWTH.
ANAEROBIC CULTURE (Final [**2194-12-18**]):    NO GROWTH.
FUNGAL CULTURE (Preliminary):    NO FUNGUS ISOLATED.
POTASSIUM HYDROXIDE PREPARATION (Final [**2194-12-15**]):
   NO FUNGAL ELEMENTS SEEN.
ACID FAST SMEAR (Final [**2194-12-13**]):
   NO ACID FAST BACILLI SEEN ON DIRECT SMEAR.
ACID FAST CULTURE (Preliminary):
Immunoflourescent test for Pneumocystis jirovecii (carinii)
(Final
      [**2194-12-14**]):    NEGATIVE for Pneumocystis jirovecii
(carinii)..
.
AFB smear x3 negative
.
Reports:
[**2194-12-11**] CTA Chest: 1. No evidence of acute pulmonary embolism or
thoracic aortic pathology. 2. Multiple nodules in both lungs,
with suggestion of cavitation in a single nodule. The
differential considerations include multifocal infections, with
etiologies including fungal and Nocardia infection and
malignancy such as lymphoma. Septic emboli is considered
unlikely given the time course of progression. Recommended
biopsy for further evaluation.

[**2194-12-11**] CXR: Three nodules in the right upper lobe and left mid
lung, are
concerning for an infectious process including fungal and
nocardia infection.  Malignancy is also in the differential.
Please refer to the CT chest performed on the same day for
further evaluation.

Biopsy results from Right lung lesion:
Lung nodule, needle core biopsy:
Pulmonary parenchyma with non-necrotizing granulomatous
inflammation, see note.
Note: AFB and GMS (fungal) stains are negative for organisms.
No polarizable material seen. The differential diagnosis
includes an infectious process and other causes of granulomatous
lung disease (sarcoidosis, etc...).
.
Cytology of right lung lesion:
NEGATIVE FOR MALIGNANT CELLS.
Bronchial cells, abundant macrophages, and structures
suggestive of granulomas.
.
[**12-12**] TTE:
The left atrium is normal in size. No atrial septal defect is
seen by 2D or color Doppler. Left ventricular wall thickness,
cavity size and regional/global systolic function are normal
(LVEF >55%). There is no ventricular septal defect. Right
ventricular chamber size and free wall motion are normal. The
diameters of aorta at the sinus, ascending and arch levels are
normal. The aortic valve leaflets (3) appear structurally normal
with good leaflet excursion and no aortic stenosis or aortic
regurgitation. The mitral valve appears structurally normal with
trivial mitral regurgitation. There is no mitral valve prolapse.
The pulmonary artery systolic pressure could not be determined.
There is no pericardial effusion.


Brief Hospital Course:
23 year old woman with history of pneumonia and bronchitis as a
child, recent history of presumed right upper lobe pneumonia
treated with subsequent improvement but persistence of symptoms
(dry cough, fatigue, night sweats, chills, shortness of breath
on exertion), found to have progressive pulmonary nodules
(increasing in size and number), now s/p CT guided biopsy with
significant hemoptysis transferred to ICU for monitoring.
.
# Hemoptysis: [**1-25**] cups of hemoptysis acutely during CT guided
biopsy of the right lung. Patient remained hemodynamically
stable, transferred to the [**Hospital Unit Name 153**] with continued intermittent
scant hemoptysis. 2 large PIVs were maintained and patient was
T&S'd. Hct stable at 39, satting 100% on RA. Patient was kept on
her right side (the side of the biopsy) and kept NPO. IP and IR
were consulted and requested her transfer to the [**Hospital Ward Name **] for
monitoring, should she need intervention. Repeat CXR showed new
right pleural effusion, right upper nodule now hazier,
consistent with post-biopsy state, no pneumothorax identified.
Patient was trasnferred west for further monitoring.  She was
hemodynamically stable throughout the rest of her hospital
course with resolution of hemoptysis.
.
# Non-necrotizing granulomatous lung nodules: No fever or
leukocytosis. Biopsy and cytology results revealed
non-necrotizing granulomatous disease.  Tissue culture was
negative, Staining for fungi and AFB were negative, serum fungal
markers negative, AFBx3 negative, Normal ESR, CRP, and
Rheumatoid factor, and [**Doctor First Name **] and ANCA negative.  Based on these
findings in conjunction with imaging studies, infectious
etiologies, connective tissue disease/vasculidities, and
lymphoma were considered highly unlikely.  The exact disease is
unclear at this time, but consideration was given to nodular
sarcoid, which although typically presents with hilar
lymphadenopathy and interstitial infiltrates can also present as
nodular lesions with minimal hilar lymphadenopathy.
.
# Pain: Patient is having post procedural pain which was
controlled initially with IV fentanyl, however was transtioned
to IV morphine and then oxycodone with good control.
.
# Anxiety: Managed with ativan prn.
.
# Fibromyalgia and chronic pain: Patient does not appear to be
managed with an SSRI at home.
.
# Iron deficiency anemia: not on iron supplements at home, no
evidence of iron deficiency on OMR. MCV is 95-98.
.
# Depression, anxiety, PTSD: not on outpatient meds.
.
.
Code: Full
TRANSITIONAL: Follow up on lesions.  Given worsening of symptoms
at homeless shelter likely some component of allergies and
reactive airway disease.  Recommend consideration of allergy
testing.

Medications on Admission:
MEDROXYPROGESTERONE
PNV WITH CA,NO.71-IRON-FA [NATALCARE PLUS] - 27 mg-1 mg Tablet
daily
ACETAMINOPHEN - 325 mg Tablet - 2 Tablet(s) by mouth q6h prn
pain
NICOTINE - 14 mg/24 hour Patch 24 hr - apply 1 patch daily


Discharge Medications:
1. albuterol sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig:
Two (2) puffs Inhalation every 4-6 hours as needed for shortness
of breath or wheezing.
2. multivitamin     Tablet Sig: One (1) Tablet PO DAILY (Daily).
Tablet(s)
3. Depo-Provera  Intramuscular
4. cyanocobalamin (vitamin B-12) 50 mcg Tablet Sig: One (1)
Tablet PO once a day.
5. nicotine 7 mg/24 hr Patch 24 hr Sig: One (1) Patch 24 hr
Transdermal DAILY (Daily).
Disp:*14 Patch 24 hr(s)* Refills:*0*
6. cholecalciferol (vitamin D3) 400 unit Tablet Sig: One (1)
Tablet PO twice a day.
7. calcium carbonate 200 mg calcium (500 mg) Tablet, Chewable
Sig: One (1) Tablet, Chewable PO BID (2 times a day).
8. fluticasone 250 mcg/Actuation Disk with Device Sig: One (1)
Inhalation twice a day.
Disp:*1 disk* Refills:*1*
9. oxycodone 5 mg Tablet Sig: One (1) Tablet PO Q4H (every 4
hours) as needed for pain.
Disp:*5 Tablet(s)* Refills:*0*


Discharge Disposition:
Home

Discharge Diagnosis:
Primary: Non-necrotizing granulmatous pneumonitis

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

Discharge Instructions:
Dear Ms [**Known lastname 51795**],

It was a pleasure taking care of you at [**Hospital1 18**].

You were admitted for worsening of your dry cough, shortness of
breath, fever, and nightsweats.  You had imaging of your lungs
done which demonstrated progression of your lung nodules
including cavitation in one of them.  Because it was unclear
what was causing these lesions to progress, a biopsy was
performed of a right upper lobe nodule.  This caused you to
cough up significant amounts of blood due to injury of a lung
vessel.  As a result, you went to the intensive care unit.  Your
coughing up blood resolved.

Your sputums revealed no evidence of active tuberculosis and
results of the biopsy showed no evidence of cancer,
tuberculosis, or fungal infection.  You did have a significant
amount of inflammation on your biopsy in which certain cells
have "walled off" a harmful substance that your immune system
cannot clear; however, at this time, it is unclear what is
causing this.

The following changes were made to your medication:
Increase dose of fluticasone
Started oxycodone for chest pain just for the next few days

Followup Instructions:
Department: PULMONARY FUNCTION LAB
When: THURSDAY [**2194-12-18**] at 2:10 PM
With: PULMONARY FUNCTION LAB [**Telephone/Fax (1) 609**]
Building: [**Hospital6 29**] [**Location (un) **]
Campus: EAST     Best Parking: [**Hospital Ward Name 23**] Garage

Department: PFT
When: THURSDAY [**2194-12-18**] at 2:30 PM

Department: MEDICAL SPECIALTIES
When: THURSDAY [**2194-12-18**] at 2:30 PM
With: DR. [**Last Name (STitle) **]/DR. [**Last Name (STitle) **] [**Telephone/Fax (1) 612**]
Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **]
Campus: EAST     Best Parking: [**Hospital Ward Name 23**] Garage



Completed by:[**2194-12-18**]
{'Pneumonia, organism unspecified,Hemorrhage complicating a procedure,Unspecified pleural effusion,Myalgia and myositis, unspecified,Lack of housing,Vaginitis and vulvovaginitis, unspecified,Bacterial infection, unspecified, in conditions classified elsewhere and of unspecified site,Asthma, unspecified type, unspecified,Anxiety state, unspecified'}


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: "DOE with dry cough and n/v."

PRESENT ILLNESS: 23 year old homeless female presents to the ED with temp 100.3,
dyspnea on exertion and dry cough.
.
Patient has had intermittent dry cough since [**2194-7-24**].  At
the end of [**Month (only) **] she was treated with azithromycin x 5 days
for an atypical pneumonia.  Patient was subsequently
hospitalized at [**Hospital1 18**] from [**2194-10-25**] - [**2194-10-28**] with persistent
cough, nightsweats and chills.  Her CXR showed a RUL infiltrate
which was thought to be an old pneumonia, not treated with any
antibiotics.  Initial concern for active TB, she had two
negative AFB sputums however samples were noted to be
concentrated with upper respiratory secretions.  PPD was
negative.  Follow-up chest film on [**2194-12-4**] showed progression of
lung lesion, now identified as two discrete lung lesions, in
right upper vs lower lobe and lingula.  Differential includes
fungus, mycobacterial and nocardia infection.  Patient was
referred to pulmonary, per phone note from [**2194-12-8**], and
scheduled for a CT chest without contrast tomorrow ([**2194-12-12**]).
Patient complained of worsening chest tightness, sob and
nightsweats.  She was advised to go to the ED if symptoms
persisted.
.
Patient reports Temp to 100.3 several days ago.  She reports
that she had been feeling better until Sunday when she had a
episode of nausea and NB NB vomitting.  She also reports
worsening NS, chills and decreased activity tolerance.  She
reports that she is usually able to go for 15 minute walks
without difficulty.  Now she gets sob with about 5 minutes of
walking.  She says that she had infections fairly frequently in
the past, but unsure of exact duration or location.  She has a
h/o pna at age 12 yo but no other pulmonary issues.  Her ROS is
also positive for vaginal discharge that she feels is from an
untreated BV infection.  She denies CP per say but says she has
occasional parathesias in her chest.  ROS is otherwise negative.

MEDICAL HISTORY: -Fibromyalgia and chronic pain
-Iron deficiency
-Depression, anxiety, PTSD
-Gonorrhea/chlamydia [**2188**] and Gonorrhea [**6-/2194**]
-Abnormal Pap in [**2187**]
-Bed bug bites
-h/o PNA

MEDICATION ON ADMISSION: MEDROXYPROGESTERONE
PNV WITH CA,NO.71-IRON-FA [NATALCARE PLUS] - 27 mg-1 mg Tablet
daily
ACETAMINOPHEN - 325 mg Tablet - 2 Tablet(s) by mouth q6h prn
pain
NICOTINE - 14 mg/24 hour Patch 24 hr - apply 1 patch daily

ALLERGIES: Egg [**Location (un) 76704**] Dust

PHYSICAL EXAM: Exam on admission:
VS: 98.2  117/69  94  18 100 RA
General: AAOX3 in NAD
HEENT: CN 2-12 grossly intact, MMM, oropharynx clear
Endo/Lymph: no obvious thyroid nodules, no LAd
CV: RRR, no RMG
Lungs: mild bibasilar crackles, left greater then right, equal
lung expansion
Abdomen: flat, not TTP, no HSM, active BS
Extremities:
UE: WWP, pulses equal, sensation intact, strength wnl
LE: WWP, pulses euqal, sensation intact, strenght wnl
Derm: no obvious rashes, no stigmata of IE
Psych: mood and affect wnl

FAMILY HISTORY: No family h/o lung pathology.  Son with asthma.

SOCIAL HISTORY: -Living in a shelter with her 3 year old son.
-Recently spent some time at grandparents house because she had
bed bug bites from the shelter.
-5 py hx of smoking, quit 1 month PTA.
-No known TB exposure.
-denies IVDU
-denies ETOH
-on depo for birth control, has unprotected sex with father of
child 

### Response:
{'Pneumonia, organism unspecified,Hemorrhage complicating a procedure,Unspecified pleural effusion,Myalgia and myositis, unspecified,Lack of housing,Vaginitis and vulvovaginitis, unspecified,Bacterial infection, unspecified, in conditions classified elsewhere and of unspecified site,Asthma, unspecified type, unspecified,Anxiety state, unspecified'}
