CHIEF COMPLAINT: nausea, vomiting, diarrhea

PRESENT ILLNESS: 68-year-old female with a history of basal cell CA, breast CA,
ETOH cirrhosis, multiple ETOH related falls, ? history of GIB
(5-6 years ago)who presented to the ED this morning with nausea,
vomiting and diarrhea that started acutely (no sick contacts, no
new foods) 4 days prior. Pt states her diarrhea has been "very
dark" 4-5 times a day. Vomiting without blood or coffee grounds,
denies any abdominal pain. Last night, felt week and fell
backwards into chair but denies hitting her head or any loss of
consciousness.  Has been sober for 2 months but for the last two
weeks was drinking, reports last drink last Friday (5 days ago).
On aspirin 81 mg daily no other anticoagulation, no other NSAID
use. Last EGD [**2132-9-20**], no varices, mild gastritis, no
ulcers.  However, patient reports that 5-6 years ago she thinks
she had an ulcer and was on a PPI for a couple of years but has
not been using it recently.  Of note, patient took her atenolol
75mg po this morning.
.
In the ED, initial vs were: 97.8 77 94/47 16 96%on RA. Exam
notable for pale conjunctiva, non-tender abdomen, dark brown
guaiac positive stool.  NG lavage was negative.  Patient was
given 40IV pantoprazole and 2 LIVF, SBPs increased to SBP >105s.
 Her labs were notable for HCT 20.1, sodium 131, serum tox
negative, LFTs within normal limits.
.
On transfer to the unit her VS were 113/36 74 12 98% on RA , she
has 2 18 guage peripheral IVs in place.  Typed and crossed for 2
units which the ED resident reported would be started in the ED
prior to transport.  Liver seeing her right now and plan for EGD
on arrival to ICU.
.
On the floor, the patient reports no nausea, abdominal pain,
dizziness, chest pain, palpitations, and reports her last BM in
the ED.
.
Review of systems:
(+) Per HPI and + weight loss
(-) Denies fever, chills, night sweats, recent weight gain.
Denies headache, sinus tenderness, rhinorrhea or congestion.
Denies cough, shortness of breath, or wheezing. Denies chest
pain, chest pressure, palpitations.  Denies dysuria, frequency,
or urgency. Denies rashes or skin changes.

MEDICAL HISTORY: --EtOH cirrhosis
- EtOH abuse
--[**2-/2129**]: upper GI bleed. Endoscopy at the time revealed
multiple erosions in the stomach. There was a Shatzki's ring in
the esophagus.
- Breast cancer, stage IC: underwent lumpectomy on [**2130-6-27**]
and lymph node biopsy which was negative.  Her tumor consisted
of 1.4-cm, grade 2, ER+, PR-, HER-2-negative infiltrating ductal
carcinoma. Following surgery she received XRT and started
adjuvant Arimidex on [**2130-9-11**].
- Cardiomyopathy in past? presumed due to EtOH.  Most recent EF
50%
- Single known episode of Afib in [**2130**], seen on holter monitor.

MEDICATION ON ADMISSION: Arimidex 1 mg Tab One Tablet(s) by mouth daily
Lipitor 10 mg Tab 1 Tablet(s) by mouth daily
Seroquel 50 mg Tab 4 Tablet(s) by mouth at bedtime
Lexapro 20 mg Tab 1 Tablet(s) by mouth daily
Aspirin 325 mg Tab 1 Tablet(s) by mouth daily
Atenolol 50 mg Tab 2.5 Tablet(s) by mouth daily taken in divided
doses (75mg am, 50mg pm)
Folic Acid 400 mcg Tab
Wellbutrin SR 150 mg Tab 1 Tablet(s) by mouth twice a day

ALLERGIES: Acyclovir

PHYSICAL EXAM: Tmax: 35.9 ??????C (96.7 ??????F)
Tcurrent: 35.9 ??????C (96.7 ??????F)
HR: 79 (79 - 79) bpm
BP: 91/41(54) {91/41(54) - 91/41(54)} mmHg
RR: 15 (15 - 15) insp/min
SpO2: 87%

FAMILY HISTORY: Uterine CA

SOCIAL HISTORY: Patient lives alone.  She is retired from working at
Bloomindale's.  She is divorced but is still in touch with her
ex-husband.  ETOH longstanding was sober for 2 months after new
year's but began drinking again 2 weeks prior. Denies any other
drug use or smoking.  Patient's daughter is her health-care
proxy.
Other esophagitis,Chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction,Other specified gastritis, without mention of hemorrhage,Alcoholic cirrhosis of liver,Alcohol abuse, continuous,Other and unspecified hyperlipidemia,Unspecified essential hypertension,Osteoarthrosis, unspecified whether generalized or localized, site unspecified,Obesity, unspecified,Depressive disorder, not elsewhere classified,Insomnia, unspecified,Hypopotassemia,Anemia, unspecified,Personal history of malignant neoplasm of breast
Other esophagitis,Chr duoden ulcer w hem,Oth spf gstrt w/o hmrhg,Alcohol cirrhosis liver,Alcohol abuse-continuous,Hyperlipidemia NEC/NOS,Hypertension NOS,Osteoarthros NOS-unspec,Obesity NOS,Depressive disorder NEC,Insomnia NOS,Hypopotassemia,Anemia NOS,Hx of breast malignancy
Admission Date:  [**2135-3-16**]              Discharge Date:   [**2135-3-22**]

Date of Birth:  [**2066-7-7**]             Sex:   F

Service: MEDICINE

Allergies:
Acyclovir

Attending:[**First Name3 (LF) 689**]
Chief Complaint:
nausea, vomiting, diarrhea

Major Surgical or Invasive Procedure:
N/A

History of Present Illness:
68-year-old female with a history of basal cell CA, breast CA,
ETOH cirrhosis, multiple ETOH related falls, ? history of GIB
(5-6 years ago)who presented to the ED this morning with nausea,
vomiting and diarrhea that started acutely (no sick contacts, no
new foods) 4 days prior. Pt states her diarrhea has been "very
dark" 4-5 times a day. Vomiting without blood or coffee grounds,
denies any abdominal pain. Last night, felt week and fell
backwards into chair but denies hitting her head or any loss of
consciousness.  Has been sober for 2 months but for the last two
weeks was drinking, reports last drink last Friday (5 days ago).
On aspirin 81 mg daily no other anticoagulation, no other NSAID
use. Last EGD [**2132-9-20**], no varices, mild gastritis, no
ulcers.  However, patient reports that 5-6 years ago she thinks
she had an ulcer and was on a PPI for a couple of years but has
not been using it recently.  Of note, patient took her atenolol
75mg po this morning.
.
In the ED, initial vs were: 97.8 77 94/47 16 96%on RA. Exam
notable for pale conjunctiva, non-tender abdomen, dark brown
guaiac positive stool.  NG lavage was negative.  Patient was
given 40IV pantoprazole and 2 LIVF, SBPs increased to SBP >105s.
 Her labs were notable for HCT 20.1, sodium 131, serum tox
negative, LFTs within normal limits.
.
On transfer to the unit her VS were 113/36 74 12 98% on RA , she
has 2 18 guage peripheral IVs in place.  Typed and crossed for 2
units which the ED resident reported would be started in the ED
prior to transport.  Liver seeing her right now and plan for EGD
on arrival to ICU.
.
On the floor, the patient reports no nausea, abdominal pain,
dizziness, chest pain, palpitations, and reports her last BM in
the ED.
.
Review of systems:
(+) Per HPI and + weight loss
(-) Denies fever, chills, night sweats, recent weight gain.
Denies headache, sinus tenderness, rhinorrhea or congestion.
Denies cough, shortness of breath, or wheezing. Denies chest
pain, chest pressure, palpitations.  Denies dysuria, frequency,
or urgency. Denies rashes or skin changes.


Past Medical History:
--EtOH cirrhosis
- EtOH abuse
--[**2-/2129**]: upper GI bleed. Endoscopy at the time revealed
multiple erosions in the stomach. There was a Shatzki's ring in
the esophagus.
- Breast cancer, stage IC: underwent lumpectomy on [**2130-6-27**]
and lymph node biopsy which was negative.  Her tumor consisted
of 1.4-cm, grade 2, ER+, PR-, HER-2-negative infiltrating ductal
carcinoma. Following surgery she received XRT and started
adjuvant Arimidex on [**2130-9-11**].
- Cardiomyopathy in past? presumed due to EtOH.  Most recent EF
50%
- Single known episode of Afib in [**2130**], seen on holter monitor.

Briefly on coumadin, but difficulty with controlling INR.
- HTN
- Osteoarthritis
- Basal Cell Carcinoma in remission

Social History:
Patient lives alone.  She is retired from working at
Bloomindale's.  She is divorced but is still in touch with her
ex-husband.  ETOH longstanding was sober for 2 months after new
year's but began drinking again 2 weeks prior. Denies any other
drug use or smoking.  Patient's daughter is her health-care
proxy.


Family History:
Uterine CA

Physical Exam:
Tmax: 35.9 ??????C (96.7 ??????F)
Tcurrent: 35.9 ??????C (96.7 ??????F)
HR: 79 (79 - 79) bpm
BP: 91/41(54) {91/41(54) - 91/41(54)} mmHg
RR: 15 (15 - 15) insp/min
SpO2: 87%

General Appearance: Overweight / Obese
Eyes / Conjunctiva: Conjunctiva pale
Head, Ears, Nose, Throat: Normocephalic
Cardiovascular: (S1: Normal), (S2: Normal)
Peripheral Vascular: (Right radial pulse: Present), (Left radial
pulse: Present), (Right DP pulse: Not assessed), (Left DP pulse:
Not assessed
Respiratory / Chest: (Expansion: Symmetric), (Breath Sounds:
Clear : )
Abdominal: Soft, Non-tender, Obese
Skin:  Warm, pale
Neurologic: Attentive, Follows simple commands, Responds to:
Verbal stimuli, Oriented (to): x3, Movement: Not assessed, Tone:
Not assessed

Pertinent Results:
Admission labs:
[**2135-3-22**] 06:05AM BLOOD WBC-4.3 RBC-2.90* Hgb-9.1* Hct-28.4*
MCV-98 MCH-31.4 MCHC-32.1 RDW-19.1* Plt Ct-210
[**2135-3-22**] 06:05AM BLOOD Glucose-99 UreaN-8 Creat-0.6 Na-142 K-3.9
Cl-109* HCO3-26 AnGap-11
[**2135-3-21**] 12:15PM BLOOD WBC-4.4 RBC-2.91* Hgb-9.5* Hct-28.3*
MCV-97 MCH-32.8* MCHC-33.7 RDW-19.8* Plt Ct-208
[**2135-3-20**] 02:26PM BLOOD Hct-29.6*
[**2135-3-20**] 05:38AM BLOOD WBC-4.7 RBC-2.63* Hgb-8.5* Hct-25.9*
MCV-98 MCH-32.1* MCHC-32.7 RDW-21.4* Plt Ct-166
[**2135-3-20**] 12:20AM BLOOD Hct-25.8*
[**2135-3-19**] 03:04PM BLOOD Hct-27.8*
[**2135-3-19**] 06:22AM BLOOD Hct-26.6*
[**2135-3-17**] 05:00PM BLOOD Hct-32.2*
[**2135-3-17**] 12:20AM BLOOD Hct-27.3*
[**2135-3-16**] 01:00PM BLOOD WBC-8.3 RBC-1.87*# Hgb-6.6*# Hct-20.1*#
MCV-108* MCH-35.5* MCHC-33.0 RDW-20.5* Plt Ct-211
[**2135-3-16**] 01:00PM BLOOD Neuts-67.6 Lymphs-25.1 Monos-5.2 Eos-2.0
Baso-0.2
[**2135-3-16**] 01:00PM BLOOD PT-13.0 PTT-27.8 INR(PT)-1.1
[**2135-3-16**] 01:00PM BLOOD Glucose-96 UreaN-37* Creat-1.0 Na-131*
K-3.3 Cl-91* HCO3-27 AnGap-16
[**2135-3-16**] 01:00PM BLOOD ALT-29 AST-33 CK(CPK)-52 AlkPhos-75
TotBili-0.9
[**2135-3-16**] 01:00PM BLOOD Lipase-45
[**2135-3-16**] 01:00PM BLOOD CK-MB-NotDone cTropnT-<0.01
[**2135-3-16**] 01:00PM BLOOD ASA-NEG Ethanol-NEG Acetmnp-NEG
Bnzodzp-NEG Barbitr-NEG Tricycl-NEG

MICRO:
[**3-16**] H Pylori serology: negative

STUDIES:
[**3-16**] CXR: No acute intrathoracic process. Stable cardiomegaly.

EGD: Erythema and friability and ulcers in the lower third of
the esophagus compatible with esophagitis
Erythema and petechiae in the antrum compatible with gastritis
Ulcer in the duodenal bulb
Otherwise normal EGD to third part of the duodenum
.
.
[**2135-3-22**]
RUQ ultrasound
Final Report
LIVER OR GALLBLADDER ULTRASOUND, [**2135-3-22**]

INDICATION: ETOH cirrhosis, upper GI bleed.

COMPARISON: Ultrasound from [**2133-12-11**] and MRI from [**2134-5-3**].

FINDINGS: The liver again shows no discrete abnormalities,
though evaluation
is slightly limited due to unchanged left lobe atrophy. There
are no focal
liver lesions. There is no biliary ductal dilatation, or
ascites.
Gallbladder is surgically absent. Pancreas is obscured by bowel
gas. The
spleen is nonenlarged. Main portal vein is patent with
appropriate antegrade
flow.

IMPRESSION: Unchanged appearance of the liver. No focal liver
lesions.

The study and the report were reviewed by the staff radiologist.

DR. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 5718**]
DR. [**First Name11 (Name Pattern1) 177**] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **]
Approved: TUE [**2135-3-22**] 7:10 PM
.
.


Brief Hospital Course:
Ms. [**Known lastname **] is a 68 year old female with ETOH cirrhosis, hx
of GI bleed, HTN, basal cell and breast carcinomas s/p tx, now
presenting with dark stools, hypotensive, Hct to 20 from
baseline of 39. The following issues were addressed at this
admission:
.
# GI bleed/low hematocrit: HCT was 39 in [**2135-1-21**] and on
presentation to the ED was 20. NG lavage was negative in the ED,
though stool was guaiac positive and drak.  EGD upon arrival to
the MICU was notable for a large duodenal ulcer without signs of
bleeding as well as esophagitis and gastritis.  HCT bumped to 31
after 5 units of blood. She was started on sucralfate and
protonix [**Hospital1 **] and transferred to the medicine floor. Her serum H.
pylori was negative. HCT then contrinued to trend down to 26
after call out to the floor, and she received another unit of
blood. She was transferred back to the ICU briefly for
transfusion. She then stabilized and was d/c'd with HCT 28. No
repeat EGD was performed in house since the pt was stable and
did not have subsequent GI bleeding or HCT drops. She is to have
f/u EGD in 8 weeks and to follow up as an outpatient with Dr.
[**Last Name (STitle) 497**]. She is to have her HCT checked at the end of the week and
followed up by her PCP, [**Last Name (NamePattern4) **]. [**Last Name (STitle) **].
.
# ETOH Abuse: Patient reports her last drink was the Friday
prior to admission. She has had no signs of recent withdrawl.
ETOH likely worsening her gastritis and esophagitis and may have
contributed to bleeding.  She was placed on CIWA scale without
requirement for benzodiazepines. She was also placed on folate
and thiamine and a multivitamin during this admission. The
patient expresses understanding of the risks associated with
contibued drinking and states a commitment to quit. She was seen
by social work, who determined adequate support; the patient
declined additional referrals.
.
# ETOH Cirrhosis: Stable during this admission. As pt has h/o
poor followup she had an inhouse RUQ ultrasound. She will f/u
with these results and for her cirrhosis with Dr. [**Last Name (STitle) 497**].
.
#. Depression:
-continue Lexapro and Welbutrin
.
#. Insomnia:
-continue Seroquel
.
#. Breast Ca s/p lumpectomy and XRT:
-Arimidex not on inpt formulary
.
#. HLD:
-continue lipitor
.
# HTN:
-continue atenolol
.

Medications on Admission:
Arimidex 1 mg Tab One Tablet(s) by mouth daily
Lipitor 10 mg Tab 1 Tablet(s) by mouth daily
Seroquel 50 mg Tab 4 Tablet(s) by mouth at bedtime
Lexapro 20 mg Tab 1 Tablet(s) by mouth daily
Aspirin 325 mg Tab 1 Tablet(s) by mouth daily
Atenolol 50 mg Tab 2.5 Tablet(s) by mouth daily taken in divided
doses (75mg am, 50mg pm)
Folic Acid 400 mcg Tab
Wellbutrin SR 150 mg Tab 1 Tablet(s) by mouth twice a day

Discharge Medications:
1. arimidex 1mg PO daily
2. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
3. Quetiapine 100 mg Tablet Sig: Two (2) Tablet PO QHS (once a
day (at bedtime)).
4. Escitalopram 10 mg Tablet Sig: Two (2) Tablet PO DAILY
(Daily).
5. Folic Acid 400 mcg Tablet Sig: One (1) Tablet PO once a day.

6. Atenolol 25 mg Tablet Sig: Three (3) Tablet PO once a day.
7. Atenolol 25 mg Tablet Sig: Two (2) Tablet PO each evening.
8. Bupropion HCl 150 mg Tablet Sustained Release Sig: One (1)
Tablet Sustained Release PO BID (2 times a day).
9. Sucralfate 1 gram Tablet Sig: One (1) Tablet PO QID (4 times
a day).
Disp:*120 Tablet(s)* Refills:*2*
10. glucosamine PO daily
11. Caltrate
12. Vitamin D
13. Vitamin B6
14. Vitamin B12
15. Thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Disp:*30 Tablet(s)* Refills:*2*
16. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One
(1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours).
Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*2*
17. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1)
Tablet, Chewable PO QID (4 times a day) as needed for heartburn.
Disp:*30 Tablet, Chewable(s)* Refills:*1*
18. Outpatient Lab Work
please check CBC (hematocrit, hemoglobin) on [**2135-3-24**]. please
fax results to Dr. [**Last Name (STitle) **] at [**Telephone/Fax (1) 11059**].


Discharge Disposition:
Home With Service

Facility:
[**Hospital1 1474**] VNA

Discharge Diagnosis:
esophagitis
gastritis
duodenal ulcer


Discharge Condition:
Mental Status: Clear and coherent
Level of Consciousness: Alert and interactive
Ambulatory


Discharge Instructions:
You were admitted to the hospital with gastrointestinal
bleeding.  Your hematocrit was low and you required blood
transfusions.  You underwent an esophagogastroduodenoscopy which
revealed esophagitis, gastritis, and a duodenal ulcer.  You were
started on medicine to treat this inflammation and ulcer. Please
have your hematocrit checked on Thursday and have it sent to Dr.
[**Last Name (STitle) **] for followup.
.
It is important that you DO NOT take any aspirin or NSAIDS as
these may further irritate and cause bleeding from ulcers.
Please start taking sucralfate 1g four times a day.
Please stop taking omeprazole.
Please start taking pantoprazole 40mg twice a day.
.
You will need to have a follow-up esophagogastroduodenoscopy in
8 weeks.  You will need to arrange this with the
gastroenterologist, [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **].
.
Please take all medications as prescribed.
Please followup with all appointments.
Please do not hesitate to return to the hospital if you have any
concerning symptoms at all.

Followup Instructions:
1. PRIMARY CARE - Dr. [**First Name8 (NamePattern2) 553**] [**Last Name (NamePattern1) **]
Phone: [**Telephone/Fax (1) 3329**]
- [**3-30**], 230pm
- Please have your bloodwork done on Thurs, [**2135-3-24**], faxed to Dr.
[**Last Name (STitle) **].
.
2. GI: Please call [**Telephone/Fax (1) 2422**] in the next 2-3 days for
followup appointment. Dr. [**Last Name (STitle) 497**] is aware. You will also need to
schedule an esophagogastroduodenoscopy to be performed within 8
weeks.
- Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 8507**], MD Phone:[**Telephone/Fax (1) 2422**]
Date/Time:[**2135-6-17**] 11:40
.
{'Other esophagitis,Chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction,Other specified gastritis, without mention of hemorrhage,Alcoholic cirrhosis of liver,Alcohol abuse, continuous,Other and unspecified hyperlipidemia,Unspecified essential hypertension,Osteoarthrosis, unspecified whether generalized or localized, site unspecified,Obesity, unspecified,Depressive disorder, not elsewhere classified,Insomnia, unspecified,Hypopotassemia,Anemia, unspecified,Personal history of malignant neoplasm of breast'}


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: nausea, vomiting, diarrhea

PRESENT ILLNESS: 68-year-old female with a history of basal cell CA, breast CA,
ETOH cirrhosis, multiple ETOH related falls, ? history of GIB
(5-6 years ago)who presented to the ED this morning with nausea,
vomiting and diarrhea that started acutely (no sick contacts, no
new foods) 4 days prior. Pt states her diarrhea has been "very
dark" 4-5 times a day. Vomiting without blood or coffee grounds,
denies any abdominal pain. Last night, felt week and fell
backwards into chair but denies hitting her head or any loss of
consciousness.  Has been sober for 2 months but for the last two
weeks was drinking, reports last drink last Friday (5 days ago).
On aspirin 81 mg daily no other anticoagulation, no other NSAID
use. Last EGD [**2132-9-20**], no varices, mild gastritis, no
ulcers.  However, patient reports that 5-6 years ago she thinks
she had an ulcer and was on a PPI for a couple of years but has
not been using it recently.  Of note, patient took her atenolol
75mg po this morning.
.
In the ED, initial vs were: 97.8 77 94/47 16 96%on RA. Exam
notable for pale conjunctiva, non-tender abdomen, dark brown
guaiac positive stool.  NG lavage was negative.  Patient was
given 40IV pantoprazole and 2 LIVF, SBPs increased to SBP >105s.
 Her labs were notable for HCT 20.1, sodium 131, serum tox
negative, LFTs within normal limits.
.
On transfer to the unit her VS were 113/36 74 12 98% on RA , she
has 2 18 guage peripheral IVs in place.  Typed and crossed for 2
units which the ED resident reported would be started in the ED
prior to transport.  Liver seeing her right now and plan for EGD
on arrival to ICU.
.
On the floor, the patient reports no nausea, abdominal pain,
dizziness, chest pain, palpitations, and reports her last BM in
the ED.
.
Review of systems:
(+) Per HPI and + weight loss
(-) Denies fever, chills, night sweats, recent weight gain.
Denies headache, sinus tenderness, rhinorrhea or congestion.
Denies cough, shortness of breath, or wheezing. Denies chest
pain, chest pressure, palpitations.  Denies dysuria, frequency,
or urgency. Denies rashes or skin changes.

MEDICAL HISTORY: --EtOH cirrhosis
- EtOH abuse
--[**2-/2129**]: upper GI bleed. Endoscopy at the time revealed
multiple erosions in the stomach. There was a Shatzki's ring in
the esophagus.
- Breast cancer, stage IC: underwent lumpectomy on [**2130-6-27**]
and lymph node biopsy which was negative.  Her tumor consisted
of 1.4-cm, grade 2, ER+, PR-, HER-2-negative infiltrating ductal
carcinoma. Following surgery she received XRT and started
adjuvant Arimidex on [**2130-9-11**].
- Cardiomyopathy in past? presumed due to EtOH.  Most recent EF
50%
- Single known episode of Afib in [**2130**], seen on holter monitor.

MEDICATION ON ADMISSION: Arimidex 1 mg Tab One Tablet(s) by mouth daily
Lipitor 10 mg Tab 1 Tablet(s) by mouth daily
Seroquel 50 mg Tab 4 Tablet(s) by mouth at bedtime
Lexapro 20 mg Tab 1 Tablet(s) by mouth daily
Aspirin 325 mg Tab 1 Tablet(s) by mouth daily
Atenolol 50 mg Tab 2.5 Tablet(s) by mouth daily taken in divided
doses (75mg am, 50mg pm)
Folic Acid 400 mcg Tab
Wellbutrin SR 150 mg Tab 1 Tablet(s) by mouth twice a day

ALLERGIES: Acyclovir

PHYSICAL EXAM: Tmax: 35.9 ??????C (96.7 ??????F)
Tcurrent: 35.9 ??????C (96.7 ??????F)
HR: 79 (79 - 79) bpm
BP: 91/41(54) {91/41(54) - 91/41(54)} mmHg
RR: 15 (15 - 15) insp/min
SpO2: 87%

FAMILY HISTORY: Uterine CA

SOCIAL HISTORY: Patient lives alone.  She is retired from working at
Bloomindale's.  She is divorced but is still in touch with her
ex-husband.  ETOH longstanding was sober for 2 months after new
year's but began drinking again 2 weeks prior. Denies any other
drug use or smoking.  Patient's daughter is her health-care
proxy. 

### Response:
{'Other esophagitis,Chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction,Other specified gastritis, without mention of hemorrhage,Alcoholic cirrhosis of liver,Alcohol abuse, continuous,Other and unspecified hyperlipidemia,Unspecified essential hypertension,Osteoarthrosis, unspecified whether generalized or localized, site unspecified,Obesity, unspecified,Depressive disorder, not elsewhere classified,Insomnia, unspecified,Hypopotassemia,Anemia, unspecified,Personal history of malignant neoplasm of breast'}
