CHIEF COMPLAINT: AMS, hypoglycemia

PRESENT ILLNESS: 59 yo man with IDDM, EtOH cirrhosis transferred from
[**Hospital1 **] ED here for management of AMS. Per EMS notes,
family reported pt became agitated and went into room. They went
to check on him and found him unresponsive with cyanotic head,
neck, and face. When EMS arrived, FSG was 29. Pt was placed on
15L O2. Pulse was not appreciated and pt thought to have agonal
breathing, so CPR was done for "PEA arrest" while IV fluids
started. After a minute of CPR, pulse was found. Pt given 1 amp
D50 with repeat FSG 145 and improved MS. EKG was NSR @ 70 bpm.
He was brought to the [**Hospital1 **] ED where FSG was 158. He
was reportedly conversant on arrival and following commands but
thought to have "agonal breathing" so was intubated. EKG read as
junctional rhythm. CT head negative for acute intracranial
changes. The pt was transferred here for further management.
.
In the ED, initial VS were: Afebrile, P 75, 143/69 RR 20, O2sat
100% on PS, FSG 105. Intubated but awake & following commands.
2->1 pupils. BS ok. 1+ b/l pitting edema. EKG without ischemic
changes, prolonged PR. CXR showed ETT in good position. Ammonia
pending. VS on transfer: T 98.3, P 92, BP 119/71, RR 20, O2sat
100% on PS 10/5, FiO2 40%.
.
On the floor, pt has been extubated. Complains only of sore
throat [**2-5**] intubation. He cannot recall the evening's events but
recalls being in his USOH prior. He has had widely fluctuant FSG
recently with AM FSG as low as 40s; this AM was in 70s and
asymptomatic. He reports normal meals; no N/V/D; no
F/C/CP/cough/SOB/dysuria. He was admitted to [**Location (un) 1459**] [**Hospital1 107**]
1 month ago for similar episode of AMS in the setting of
hypoglycemia and presumed hepatic encephalopathy.
.
Review of systems:
As above, otherwise negative.

MEDICAL HISTORY: Hypertension
Hyperlipidemia
Type 2 DM c/b nephropathy and diabetic neuropathy
EtOH cirrhosis without varices on [**11-10**] EGD
Anemia thought due to EtOH BM suppression per pt
OSA
Obesity
B/l knee osteoarthritis
S/p left knee meniscus repair in [**2152**]
S/p bilateral cataract surgery

MEDICATION ON ADMISSION: Albuterol prn
Nadolol 20mg daily (per pt, no longer on atenolol)
Bupropion SR 150mg daily
Ergocalciferol [**Numeric Identifier 1871**] units qmonth
Ezetimibe 10mg daily
Fluticasone-Salmeterol
Folic acid 1mg daily
Furosemide 20mg daily
Levemir 30 units qAM, 35 units qhs
Apidra sliding scale
Lisinopril 10mg daily
Morphine SR 15mg q12h ?
Oxycodone 5-10mg q4h prn pain ?
MVI
Pramlintide (Symlin) 120 mcg 3 times daily before each meal
(dose?)
Topiramate 150mg [**Hospital1 **]
Tramadol 50mg qid prn pain
Iron 325mg daily
Pyridoxine SR 400mg daily
Lactulose 2 tsp tid w/ meals

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 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,
rhonchi
CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs,
gallops
Abdomen: Soft, non-tender, non-distended, bowel sounds present,
no rebound tenderness or guarding, no organomegaly
GU: +Foley
Ext: Warm, well perfused, 2+ pulses, no clubbing, cyanosis, 1+
edema at ankles b/l
Neuro: AAO x 3, CN II-XII intact, strength 5/5, sensation to LT
intact, cerebellar fxn nl, no pronator drift, +mild tremor,
reflexes symmetric, toes downgoing on Babinski, gait not
assessed.

FAMILY HISTORY: Father with alcoholic cirrhosis, died of "thoracic aneurysm."
Uncle with diabetes.

SOCIAL HISTORY: Does computer sales from home.  Lives with wife and mother. [**Name (NI) **]
1 son and 1 daughter.
- Tobacco: Denies
- Alcohol: H/o [**1-7**] scotch on weekends x 25 years, then [**1-7**]
scotch daily x 1 year until [**4-11**], abstinent since.
- Illicits: Denies.
Diabetes with other specified manifestations, type II or unspecified type, uncontrolled,Hepatic encephalopathy,Other pulmonary insufficiency, not elsewhere classified,Nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere,Polyneuropathy in diabetes,Alcoholic cirrhosis of liver,Other and unspecified alcohol dependence, continuous,Acute kidney failure, unspecified,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Chronic kidney disease, unspecified,Anemia in chronic kidney disease,Thrombocytopenia, unspecified,Other and unspecified hyperlipidemia,Obstructive sleep apnea (adult)(pediatric),Obesity, unspecified,Osteoarthrosis, unspecified whether generalized or localized, lower leg,Personal history of sudden cardiac arrest,Long-term (current) use of insulin
DMII oth uncntrld,Hepatic encephalopathy,Other pulmonary insuff,Nephritis NOS in oth dis,Neuropathy in diabetes,Alcohol cirrhosis liver,Alcoh dep NEC/NOS-contin,Acute kidney failure NOS,Hy kid NOS w cr kid I-IV,Chronic kidney dis NOS,Anemia in chr kidney dis,Thrombocytopenia NOS,Hyperlipidemia NEC/NOS,Obstructive sleep apnea,Obesity NOS,Osteoarthros NOS-l/leg,Hx sudden cardiac arrest,Long-term use of insulin
Admission Date:  [**2160-4-17**]              Discharge Date:   [**2160-4-19**]

Date of Birth:  [**2100-6-9**]             Sex:   M

Service: MEDICINE

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 2145**]
Chief Complaint:
AMS, hypoglycemia

Major Surgical or Invasive Procedure:
extubated here (intubated at OSH)


History of Present Illness:
59 yo man with IDDM, EtOH cirrhosis transferred from
[**Hospital1 **] ED here for management of AMS. Per EMS notes,
family reported pt became agitated and went into room. They went
to check on him and found him unresponsive with cyanotic head,
neck, and face. When EMS arrived, FSG was 29. Pt was placed on
15L O2. Pulse was not appreciated and pt thought to have agonal
breathing, so CPR was done for "PEA arrest" while IV fluids
started. After a minute of CPR, pulse was found. Pt given 1 amp
D50 with repeat FSG 145 and improved MS. EKG was NSR @ 70 bpm.
He was brought to the [**Hospital1 **] ED where FSG was 158. He
was reportedly conversant on arrival and following commands but
thought to have "agonal breathing" so was intubated. EKG read as
junctional rhythm. CT head negative for acute intracranial
changes. The pt was transferred here for further management.
.
In the ED, initial VS were: Afebrile, P 75, 143/69 RR 20, O2sat
100% on PS, FSG 105. Intubated but awake & following commands.
2->1 pupils. BS ok. 1+ b/l pitting edema. EKG without ischemic
changes, prolonged PR. CXR showed ETT in good position. Ammonia
pending. VS on transfer: T 98.3, P 92, BP 119/71, RR 20, O2sat
100% on PS 10/5, FiO2 40%.
.
On the floor, pt has been extubated. Complains only of sore
throat [**2-5**] intubation. He cannot recall the evening's events but
recalls being in his USOH prior. He has had widely fluctuant FSG
recently with AM FSG as low as 40s; this AM was in 70s and
asymptomatic. He reports normal meals; no N/V/D; no
F/C/CP/cough/SOB/dysuria. He was admitted to [**Location (un) 1459**] [**Hospital1 107**]
1 month ago for similar episode of AMS in the setting of
hypoglycemia and presumed hepatic encephalopathy.
.
Review of systems:
As above, otherwise negative.


Past Medical History:
Hypertension
Hyperlipidemia
Type 2 DM c/b nephropathy and diabetic neuropathy
EtOH cirrhosis without varices on [**11-10**] EGD
Anemia thought due to EtOH BM suppression per pt
OSA
Obesity
B/l knee osteoarthritis
S/p left knee meniscus repair in [**2152**]
S/p bilateral cataract surgery

Social History:
Does computer sales from home.  Lives with wife and mother. [**Name (NI) **]
1 son and 1 daughter.
- Tobacco: Denies
- Alcohol: H/o [**1-7**] scotch on weekends x 25 years, then [**1-7**]
scotch daily x 1 year until [**4-11**], abstinent since.
- Illicits: Denies.

Family History:
Father with alcoholic cirrhosis, died of "thoracic aneurysm."
Uncle with diabetes.

Physical Exam:
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,
rhonchi
CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs,
gallops
Abdomen: Soft, non-tender, non-distended, bowel sounds present,
no rebound tenderness or guarding, no organomegaly
GU: +Foley
Ext: Warm, well perfused, 2+ pulses, no clubbing, cyanosis, 1+
edema at ankles b/l
Neuro: AAO x 3, CN II-XII intact, strength 5/5, sensation to LT
intact, cerebellar fxn nl, no pronator drift, +mild tremor,
reflexes symmetric, toes downgoing on Babinski, gait not
assessed.


Pertinent Results:
[**2160-4-18**] 03:49AM BLOOD WBC-8.3# RBC-4.50* Hgb-12.9* Hct-38.3*
MCV-85 MCH-28.8 MCHC-33.8 RDW-17.6* Plt Ct-97*
[**2160-4-18**] 03:49AM BLOOD Neuts-80.4* Lymphs-10.6* Monos-7.9
Eos-0.6 Baso-0.5
[**2160-4-18**] 03:49AM BLOOD Plt Ct-97*
[**2160-4-18**] 03:49AM BLOOD PT-14.8* PTT-32.3 INR(PT)-1.3*
[**2160-4-18**] 12:45AM BLOOD Glucose-93 UreaN-29* Creat-1.9*# Na-144
K-4.2 Cl-110* HCO3-22 AnGap-16
[**2160-4-18**] 12:45AM BLOOD ALT-35 AST-82* AlkPhos-83 TotBili-1.4
[**2160-4-18**] 03:49AM BLOOD CK(CPK)-432*
[**2160-4-18**] 03:47PM BLOOD CK(CPK)-301
[**2160-4-18**] 03:49AM BLOOD CK-MB-10 MB Indx-2.3 cTropnT-0.07*
[**2160-4-18**] 03:47PM BLOOD CK-MB-6 cTropnT-0.05*
[**2160-4-19**] 07:35AM BLOOD Calcium-8.6 Phos-3.1 Mg-2.0
[**2160-4-18**] 12:15AM BLOOD Ammonia-65*
[**2160-4-18**] 12:45AM BLOOD ASA-NEG Ethanol-NEG Acetmnp-NEG
Bnzodzp-NEG Barbitr-NEG Tricycl-NEG

cxr [**4-17**]: IMPRESSION:
1. Adequate endotracheal tube position.
2. Cardiomegaly, with central vascular congestion suggesting
volume
overload/decompensation.

Brief Hospital Course:
59 yo man with h/o IDDM, alcoholic cirrhosis p/w AMS, found to
be hypoglycemic with report of PEA arrest and intubation for
airway protection admitted to the medical ICU for further
management.
.
# Hypoglycemia: He has a history of labile blood sugars and was
found to be symptomatically hypoglycemic requiring EMS. During
his hospitalization his sugars were closely monitored.  [**Last Name (un) **]
diabetes service was consulted regarding insulin management.  He
was restarted on a reduced dose of levemir and a modified
insulin sliding scale as well as symlin.
-Pt asked to make f/u with his endocrinologist asap
.
# Altered mental status: He was found to be confused in the
setting of hypoglycemia that rapidly corrected with return to
normoglycemia. CT head at the outside hospital was negative for
intracranial bleed. At [**Hospital1 18**], the patient was at baseline mental
status with a non-focal neurological exam.
.
# Questionable PEA arrest:  Pt returned to hemodynamic stability
with less than one minute of chest compressions in the field.
Given his low blood sugar in the field and the rapidity with
which he recovered, it is not clear that he had a true cardiac
arrest.  He had EKGs from OSH which showed a junctional rhythm
with occasional PACs. At [**Hospital1 18**], pt was in NSR. He was monitored
on telemetry without event. Pt was also intubated in the field,
extubated on admission to [**Hospital1 18**].

# Chronic renal failure: He was found to have an elevated
creatinine of 1.9, with recent baseline of 1.7.  Medications
were renally dosed. Nephrotoxic medications were held. Pt
already had f/u arranged with his nephrologist for 3days
post-discharge.
.
# Anemia: Pt reports seeing hematologist for chronic anemia,
presumed BM suppression [**2-5**] EtOH (hct ~35). Continued iron,
folic acid, MVI.
.
# Thrombocytopenia: This was thought likely to be due to alcohol
or cirrhosis. No e/o active bleeding and similar to prior
measurements.
.
# Cirrhosis: Does not appear acutely decompensated at this time.
Continued nadolol and lactulose.
.
# Hypertension: Blood pressures ranged from 100s to 140s
systolic while he was continued on home dose of lisinopril,
lasix, and nadolol.
.
# Hyperlipidemia: He was continued on home dose of Zetia.
.
# COPD: He was continued on his home regimen of advair and
albuterol/ipratropium nebs as needed.

Medications on Admission:
Albuterol prn
Nadolol 20mg daily (per pt, no longer on atenolol)
Bupropion SR 150mg daily
Ergocalciferol [**Numeric Identifier 1871**] units qmonth
Ezetimibe 10mg daily
Fluticasone-Salmeterol
Folic acid 1mg daily
Furosemide 20mg daily
Levemir 30 units qAM, 35 units qhs
Apidra sliding scale
Lisinopril 10mg daily
Morphine SR 15mg q12h ?
Oxycodone 5-10mg q4h prn pain ?
MVI
Pramlintide (Symlin) 120 mcg 3 times daily before each meal
(dose?)
Topiramate 150mg [**Hospital1 **]
Tramadol 50mg qid prn pain
Iron 325mg daily
Pyridoxine SR 400mg daily
Lactulose 2 tsp tid w/ meals

Discharge Medications:
1. Albuterol Sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig:
1-2 Puffs Inhalation Q2H (every 2 hours) as needed for
sob/wheezing.
2. Nadolol 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
3. Wellbutrin SR 150 mg Tablet Sustained Release Sig: One (1)
Tablet Sustained Release PO once a day.
4. Ergocalciferol (Vitamin D2) 50,000 unit Capsule Sig: One (1)
Capsule PO once a month.
5. Ezetimibe 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

6. Fluticasone-Salmeterol 250-50 mcg/Dose Disk with Device Sig:
One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day).
7. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

8. Lasix 20 mg Tablet Sig: One (1) Tablet PO once a day.
9. Levemir 100 unit/mL Solution Sig: Twenty (20) UNITS
Subcutaneous at bedtime.
10. Apidra 100 unit/mL Cartridge Sig: per sliding scale
Subcutaneous four times a day.
11. Lisinopril 10 mg Tablet Sig: One (1) Tablet PO once a day.
12. Symlin 600 mcg/mL Solution Subcutaneous
13. Topiramate 100 mg Tablet Sig: 1.5 Tablets PO BID (2 times a
day).
14. Ferrous Sulfate 300  mg (60 mg Iron) Tablet Sig: One (1)
Tablet PO DAILY (Daily).
15. Pyridoxine 50 mg Tablet Sig: Eight (8) Tablet PO DAILY
(Daily).
16. Lactulose 10 gram/15 mL Syrup Sig: Thirty (30) ML PO TID (3
times a day) as needed for titrate to 3 BM daily.
17. Acetaminophen 325 mg Tablet Sig: One (1) Tablet PO Q6H
(every 6 hours) as needed for pain.
18. Tramadol 50 mg Tablet Sig: One (1) Tablet PO four times a
day as needed for pain.


Discharge Disposition:
Home

Discharge Diagnosis:
primary: hypoglycemia, cardiac arrest
secondary: diabetes mellitus type 2


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


Discharge Instructions:
You were admitted for low blood sugar and a cardiac arrest
believed to be because of the low blood sugar. You were feeling
better by the time you got here. We lowered your diabetes
medicines while you were here to prevent low blood sugar in the
future.

When you go home please take your medicines with the following
changes:
1. please DECREASE your apidra sliding scale to the one that we
give you here
2. please DECREASE your levemir to 20 units at night (and none
in the morning)
3. please restart your symlin

Followup Instructions:
Please go to the following appointments:
Name: [**Last Name (LF) 3050**],[**First Name3 (LF) **] S.
Location: [**Hospital6 17557**]
Address: [**Apartment Address(1) 17558**], [**Location (un) **],[**Numeric Identifier 17559**]
Phone: [**Telephone/Fax (1) 15916**]
Appointment: [**2160-4-28**] 11:15am

Department: ADULT SPECIALTIES
When: MONDAY [**2160-6-16**] at 9:30 AM
With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 17785**], MD [**Telephone/Fax (1) 8645**]
Building: [**Location (un) 2790**] ([**Location (un) **], MA) [**Location (un) 551**]
Campus: OFF CAMPUS     Best Parking: Free Parking on Site

Department: ADULT SPECIALTIES
When: FRIDAY [**2160-6-20**] at 10:00 AM
With: [**Name6 (MD) 8741**] [**Last Name (NamePattern4) 95699**], MD [**Telephone/Fax (1) 8645**]
Building: [**Location (un) 2790**] ([**Location (un) **], MA) [**Location (un) 551**]
Campus: OFF CAMPUS     Best Parking: Free Parking on Site

Department: LIVER CENTER
When: THURSDAY [**2160-8-28**] at 10:20 AM
With: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] [**Telephone/Fax (1) 2422**]
Building: LM [**Hospital Unit Name **] [**Location (un) 858**]
Campus: WEST     Best Parking: [**Hospital Ward Name **] Garage

Please go to the [**Last Name (un) **] appointment that you already had
scheduled on Tuesday and please also arrange to see your
endocrinologist as soon as possible!!


                             [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 2158**]

Completed by:[**2160-4-21**]
{'Diabetes with other specified manifestations, type II or unspecified type, uncontrolled,Hepatic encephalopathy,Other pulmonary insufficiency, not elsewhere classified,Nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere,Polyneuropathy in diabetes,Alcoholic cirrhosis of liver,Other and unspecified alcohol dependence, continuous,Acute kidney failure, unspecified,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Chronic kidney disease, unspecified,Anemia in chronic kidney disease,Thrombocytopenia, unspecified,Other and unspecified hyperlipidemia,Obstructive sleep apnea (adult)(pediatric),Obesity, unspecified,Osteoarthrosis, unspecified whether generalized or localized, lower leg,Personal history of sudden cardiac arrest,Long-term (current) use of insulin'}


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: AMS, hypoglycemia

PRESENT ILLNESS: 59 yo man with IDDM, EtOH cirrhosis transferred from
[**Hospital1 **] ED here for management of AMS. Per EMS notes,
family reported pt became agitated and went into room. They went
to check on him and found him unresponsive with cyanotic head,
neck, and face. When EMS arrived, FSG was 29. Pt was placed on
15L O2. Pulse was not appreciated and pt thought to have agonal
breathing, so CPR was done for "PEA arrest" while IV fluids
started. After a minute of CPR, pulse was found. Pt given 1 amp
D50 with repeat FSG 145 and improved MS. EKG was NSR @ 70 bpm.
He was brought to the [**Hospital1 **] ED where FSG was 158. He
was reportedly conversant on arrival and following commands but
thought to have "agonal breathing" so was intubated. EKG read as
junctional rhythm. CT head negative for acute intracranial
changes. The pt was transferred here for further management.
.
In the ED, initial VS were: Afebrile, P 75, 143/69 RR 20, O2sat
100% on PS, FSG 105. Intubated but awake & following commands.
2->1 pupils. BS ok. 1+ b/l pitting edema. EKG without ischemic
changes, prolonged PR. CXR showed ETT in good position. Ammonia
pending. VS on transfer: T 98.3, P 92, BP 119/71, RR 20, O2sat
100% on PS 10/5, FiO2 40%.
.
On the floor, pt has been extubated. Complains only of sore
throat [**2-5**] intubation. He cannot recall the evening's events but
recalls being in his USOH prior. He has had widely fluctuant FSG
recently with AM FSG as low as 40s; this AM was in 70s and
asymptomatic. He reports normal meals; no N/V/D; no
F/C/CP/cough/SOB/dysuria. He was admitted to [**Location (un) 1459**] [**Hospital1 107**]
1 month ago for similar episode of AMS in the setting of
hypoglycemia and presumed hepatic encephalopathy.
.
Review of systems:
As above, otherwise negative.

MEDICAL HISTORY: Hypertension
Hyperlipidemia
Type 2 DM c/b nephropathy and diabetic neuropathy
EtOH cirrhosis without varices on [**11-10**] EGD
Anemia thought due to EtOH BM suppression per pt
OSA
Obesity
B/l knee osteoarthritis
S/p left knee meniscus repair in [**2152**]
S/p bilateral cataract surgery

MEDICATION ON ADMISSION: Albuterol prn
Nadolol 20mg daily (per pt, no longer on atenolol)
Bupropion SR 150mg daily
Ergocalciferol [**Numeric Identifier 1871**] units qmonth
Ezetimibe 10mg daily
Fluticasone-Salmeterol
Folic acid 1mg daily
Furosemide 20mg daily
Levemir 30 units qAM, 35 units qhs
Apidra sliding scale
Lisinopril 10mg daily
Morphine SR 15mg q12h ?
Oxycodone 5-10mg q4h prn pain ?
MVI
Pramlintide (Symlin) 120 mcg 3 times daily before each meal
(dose?)
Topiramate 150mg [**Hospital1 **]
Tramadol 50mg qid prn pain
Iron 325mg daily
Pyridoxine SR 400mg daily
Lactulose 2 tsp tid w/ meals

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 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,
rhonchi
CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs,
gallops
Abdomen: Soft, non-tender, non-distended, bowel sounds present,
no rebound tenderness or guarding, no organomegaly
GU: +Foley
Ext: Warm, well perfused, 2+ pulses, no clubbing, cyanosis, 1+
edema at ankles b/l
Neuro: AAO x 3, CN II-XII intact, strength 5/5, sensation to LT
intact, cerebellar fxn nl, no pronator drift, +mild tremor,
reflexes symmetric, toes downgoing on Babinski, gait not
assessed.

FAMILY HISTORY: Father with alcoholic cirrhosis, died of "thoracic aneurysm."
Uncle with diabetes.

SOCIAL HISTORY: Does computer sales from home.  Lives with wife and mother. [**Name (NI) **]
1 son and 1 daughter.
- Tobacco: Denies
- Alcohol: H/o [**1-7**] scotch on weekends x 25 years, then [**1-7**]
scotch daily x 1 year until [**4-11**], abstinent since.
- Illicits: Denies. 

### Response:
{'Diabetes with other specified manifestations, type II or unspecified type, uncontrolled,Hepatic encephalopathy,Other pulmonary insufficiency, not elsewhere classified,Nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere,Polyneuropathy in diabetes,Alcoholic cirrhosis of liver,Other and unspecified alcohol dependence, continuous,Acute kidney failure, unspecified,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage I through stage IV, or unspecified,Chronic kidney disease, unspecified,Anemia in chronic kidney disease,Thrombocytopenia, unspecified,Other and unspecified hyperlipidemia,Obstructive sleep apnea (adult)(pediatric),Obesity, unspecified,Osteoarthrosis, unspecified whether generalized or localized, lower leg,Personal history of sudden cardiac arrest,Long-term (current) use of insulin'}
